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Two Of Our Oldest Sciences
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by Robert B. Gordon,
ScD and Bruce R. Gordon, MA, MD
November 11, 2004
Dr. Robert B. Gordon has been unable to write for the past six weeks. His infirmity is due to arteriosclerosis, hardening of the arteries, affecting the vessels going to his brain. Over the past several years, he has had a series of minor events, that, in retrospect, were warning signs of impending trouble: brief blackout spells, at times a funny feeling of "fogginess" in the head, and occasional imbalance or sense of dizziness. His internist ordered anticoagulants to thin the blood, and several diagnostic tests to determine if this were a problem of seizures, irregular heart beats, or strokes. None of the tests were positive, until an MRI / MRA scan was done, and that detected reduced blood circulation to the back of the brain.
Until very recently, that would have been the end of the story. Frail elderly patients with blockages in the arteries leading to the brain have been considered too high a risk to undergo surgery to remove the blocks, when these were accessible to surgery. In many others, surgery was not possible because of the inaccessible location of the blockages. However, over the past few years, a small, dedicated group of medical experts have persisted in experiments to repair blocked arteries wherever they are in the body. They have now succeeded, and this new technology is beginning to be available to everyone. On Nov. 10th, Dr. Edward Diethrich, one of the pioneers in this type of endovascular repair, is going to attempt to fix Robert Gordon‘s vertebral arteries.
The first contributing old science is Cardiology, the science of the study of the heart and blood vessels. Beginning in 1958, with the first angiographic visualization of the coronary arteries by injecting X-Ray dye, there has been rapid progress. In 1967, surgical bypass of blocked heart arteries became possible. And, in 1977, the first balloon treatment of heart artery blockage was achieved. Balloon angioplasty was a revolution, since it could be done as an outpatient, with much less risk than open heart surgery. Now, over one million angioplasties are done in the U.S. each year.
Unfortunately, many of these early balloon angioplasties gradually re-blocked and needed to be re-done. This led to the need for a second old science: Metallurgy, the science of the properties of metals. During the 1960s, the Naval Ordinance Laboratory was researching metal alloys that could "remember" a previous shape, despite being compressed. They found that combinations of Nickel and Titanium had this property, and subsequent work by several medical equipment companies resulted in the production of wire mesh tubes, called stents, that can be used to repair a narrow area in an artery, after it is opened by a balloon. Stents were introduced in 1987, and have been very successful at preventing re-narrowing.
At first, this technology was only applied to the heart. But then, skilled vascular intervention specialists began to treat other narrowed arteries, in the kidneys, in the legs, and elsewhere. The only organ that remained off limits was the brain. This is because attempts to open the brain arteries, the carotid and vertebral arteries, sometimes led to disastrous complications such as strokes. The very act of opening the arteries may cause the squeezing of fatty material from the narrowing plaques into the blood stream, which can then block arteries further into the head. The solution, which was just found a few years ago, is to protect the brain by inserting a screen into the artery before using the balloon. Using this new method, seven centers in the U.S. have been investigating angioplasty opening of the brain arteries, and have just published results that show this new method is at least as good as open carotid endarterectomy surgery, and can be used successfully in even very frail patients. Furthermore, almost any area of blockage can now be treated, no matter where it is.
So, the take-home lesson is that everyone now needs to be aware of the health of their own arteries. There is no longer a reason to die or become disabled by surprise heart attacks or strokes. But, every person needs to also take responsibility for their health and see their doctors for regular checkups. Also, regular exercise, good diet, kicking smoking, and keeping blood pressure, sugar, and cholesterol under control are essential. Regular ultrasound examinations of the carotid arteries, heart stress tests, and targeted CAT scans or MRI / MRA scans give doctors the ability to identify possible problem blockages before they cause trouble. Balloon angioplasty and stenting allow repairs to be done. The only missing link is you. Will you take responsibility for your health?
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PERSONAL NOTE FROM DR. ROBERT B. GORDON
There will never be a convenient time in your life for you to consider how the very serious problems that have affected my life in recent months could affect you. Fortunately, scientific progress will be producing new solutions for developing new problems. But, each of us needs to avail ourselves of the solutions.
I hope to be back to my usual mental functioning after my upcoming procedure, but there are no certainties in life. I do want to thank all of my readers, as well as my publishers, for their helpful feedback and many kind remarks over the years. I have striven to give sound advice and to teach each investor to think for themselves. Remember to constantly re-evaluate your investments, not be afraid to sell, and always look for the optimum mix of safety and possible profit. If it seems too good to be true, it probably is!
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© 2004 Robert B. Gordon, Sc.
D.
Dr,
Gordon's Editorial Archive
Robert
B. Gordon, Sc. D. & Bruce R. Gordon, MA, MD
Sun City West, Arizona
November 11, 2004
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