Word: bypassers
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Even after complications develop, the prognosis is not unrelentingly grim. Laser surgery is saving eyesight. Bypass surgery is salvaging hearts and feet. Dialysis machines and organ transplants are pinch-hitting for nonfunctioning kidneys. Most important, insulin pumps and home-monitoring kits are enabling diabetics to control their blood-sugar levels more precisely than ever before. With good control, diabetic women, once cautioned not to have children, are now delivering healthy babies. Says Dr. Gordon Weir, medical director of the Joslin Diabetes Center: "Patients are finally tuning in to the fact that high blood sugar is serious business...
...reduce both levels, such as the one promoted by the American Heart Association, may actually harm women, Crouse argues. The dearth of data on women and heart disease may also have contributed to an alarming problem: women are significantly more likely than men to die after they undergo heart-bypass surgery. One reason, suggested a study last spring, is that doctors are slower to spot serious heart trouble in their female patients and slower to recommend surgery...
...alone, surgeons annually perform 330,000 coronary bypass operations. An additional 190,000 cardiac patients every year undergo angioplasty, which usually involves the use of a balloon-tipped catheter to widen their arterial passages. Both operations provide immediate, dramatic relief for the cardiac patient. But there are some risks: in rare cases, either technique can trigger a heart attack. Then, too, relief is only temporary. Five years or so after bypass surgery, on average, plaque has built up in the grafted veins. And arteries opened by angioplasty sometimes become partly blocked again within three to six months. Finally, the price...
...many cases, bypass surgery or angioplasty will remain the strategy of choice. There are those with advanced heart disease, says Blankenhorn, "who clearly can't wait. If they try therapy alone when they really need surgery, they can have a disastrous outcome -- a catastrophic heart attack." But others, with less serious cases, may be able to avoid surgery -- if they are willing to make radical changes in their diet and life-style...
While trials beginning in the 1950s had shown that drugs and diet could reverse atherosclerosis in laboratory animals, Blankenhorn's groundbreaking work, begun in 1980, was the first controlled study demonstrating that the same results could be produced in humans. His subjects were 188 nonsmoking males who had undergone bypass surgery. (Most heart-disease research has been done on men rather than women.) Blankenhorn placed half of them on a diet containing 22% fat and gave them colestipol and large doses of niacin, both standard cholesterol-reducing drugs. The other recruits, the control group, merely limited the fat content...