also see: Doctors Are the Third Leading Cause of Death
Do you actively strive to achieve and maintain health?
Or do you wait for something to go wrong and then go to the doctor?
Do you know that being under a doctor’s “care” is the third leading cause of death?
DEATH IN AMERICA
By Jon Rappoport
June 28, 2010NewsWithViews.com
An Exclusive Interview With Barbara StarfieldThe American health system, like clockwork, causes a mind-boggling number of deaths every year.
The figures have been known for a decade. The story was covered briefly when a landmark study surfaced, and then it sank like a stone.
The truth was inconvenient for many interests. That has not changed. “Medical coverage for all” is a banner that conceals ugly facts.
On July 26, 2000, the US medical community received a titanic shock to the system, when one of its most respected public-health experts, Dr. Barbara Starfield, revealed her findings on healthcare in America. Starfield was, and still is, associated with the Johns Hopkins School of Public Health.
The Starfield study, “Is US health really the best in the world?”, published in the Journal of the American Medical Association, came to the following conclusions:
Every year in the US there are:
12,000 deaths from unnecessary surgeries;
7,000 deaths from medication errors in hospitals;
20,000 deaths from other errors in hospitals;
80,000 deaths from infections acquired in hospitals;
106,000 deaths from FDA-approved correctly prescribed medicines.
The total of medically-caused deaths in the US every year is 225,000.
This makes the medical system the third leading cause of death in the US, behind heart disease and cancer.
The Starfield study is the most disturbing revelation about modern healthcare in America ever published. The credentials of its author and the journal in which it appeared are, within the highest medical circles, impeccable.
On the heels of Starfield’s astonishing findings, media reporting was extensive, but it soon dwindled. No major newspaper or television network mounted an ongoing “Medicalgate” investigation. Neither the US Department of Justice nor federal health agencies undertook prolonged remedial action.
All in all, those parties who could have taken effective steps to correct this situation preferred to ignore it.
I interviewed Dr. Starfield by email. This is an edited version of the interview.
In the medical research community, have your medically-caused mortality statistics been debated, or have these figures been accepted, albeit with some degree of shame?
The findings have been accepted by those who study them. There has been only one detractor, a former medical school dean, who has received a lot of attention for claiming that the US health system is the best there is and we need more of it. He has a vested interest in medical schools and teaching hospitals (they are his constituency).
Have health agencies of the federal government consulted with you on ways to mitigate the effects of the US medical system?
NO.
Are you aware of any systematic efforts, since your 2000 JAMA study was published, to remedy the main categories of medically caused deaths in the US?
No systematic efforts; however, there have been a lot of studies. Most of them indicate higher rates [of death] than I calculated.
Can you offer an opinion about how the FDA can be so mortally wrong about so many drugs?Yes, it cannot divest itself from vested interests. [There is] a large literature about this, mostly unrecognized by the people because the industry-supported media give it no attention.
Did your 2000 JAMA study sail through peer review, or was there some opposition to publishing it?
It was rejected by the first journal that I sent it to, on the grounds that ‘it would not be interesting to readers’!
Would it be correct to say that, when your JAMA study was published in 2000, it caused a momentary stir and was thereafter ignored by the medical community and by pharmaceutical companies?
Are you sure it was a momentary stir? I still get at least one email a day asking for a reprint---ten years later! The problem is that its message is obscured by those that do not want any change in the US health care system.
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Since the FDA approves every medical drug given to the American people, and certifies it as safe and effective, how can that agency remain calm about the fact that these medicines are causing 106,000 deaths per year?
Even though there will always be adverse events that cannot be anticipated, the fact is that more and more unsafe drugs are being approved for use. Many people attribute that to the fact that the pharmaceutical industry is (for the past ten years or so) required to pay the FDA for reviews---which puts the FDA into an untenable position of working for the industry it is regulating. There is a large literature on this. Aren't your 2000 findings a severe indictment of the FDA and its standard practices?
They are an indictment of the US health care industry: insurance companies, specialty and disease-oriented medical academia, the pharmaceutical and device manufacturing industries, all of which contribute heavily to re-election campaigns of members of Congress. The problem is that we do not have a government that is free of influence of vested interests. Alas, [it] is a general problem of our society—which clearly unbalances democracy.
What was your personal reaction when you reached the conclusion that the US medical system was the third leading cause of death in the US?
I had previously done studies on international comparisons and knew that there were serious deficits in the US health care system, most notably in lack of universal coverage and a very poor primary care infrastructure. So I wasn’t surprised.
Do the 106,000 deaths from medical drugs only involve drugs prescribed to patients in hospitals, or does this statistic also cover people prescribed drugs who are not in-patients in hospitals?
I tried to include everything in my estimates. Since the commentary was written, many more dangerous drugs have been added to the marketplace.
INTERVIEWER COMMENTS:
This interview with Dr. Starfield reveals that, even when an author has unassailable credentials within the medical-research establishment, the findings can result in no changes made to the system.
Yes, many persons and organizations within the medical system contribute to the annual death totals of patients, and media silence and public ignorance are certainly major factors, but the FDA is the assigned gatekeeper, when it comes to the safety of medical drugs. The buck stops there. If those drugs the FDA is certifying as safe are killing, like clockwork, 106,000 people a year, the Agency must be held accountable. The American people must understand that.
As for the other 119,000 people killed every year as a result of hospital treatment, this horror has to be laid at the doors of those institutions. Further, to the degree that hospitals are regulated and financed by state and federal governments, the relevant health agencies assume culpability.
It is astounding, as well, that the US Department of Justice has failed to weigh in on Starfield’s findings. If 225,000 medically caused deaths per year is not a crime by the Dept. of Justice’s standards, then what is?
To my knowledge, not one person in America has been fired from a job or even censured as result of these medically caused deaths.
The pharmaceutical giants stand back and carve up the populace into “promising markets.” They seek new disease labels and new profits from more and more toxic drugs. They do whatever they can—legally or illegally—to influence doctors in their prescribing habits. Some drug studies which cast new medicines in a negative light are buried. FDA panels are filled with doctors who have drug-company ties. Legislators are incessantly lobbied and supported with pharma campaign monies.
Nutrition, the cornerstone of good health, is ignored or devalued by most physicians. The FDA continues to attack nutritional supplements, even though the overall safety record of these nutrients is good, whereas, once again, the medical drugs the FDA certifies as safe are killing 106,000 Americans per year.
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Physicians are trained to pay exclusive homage to peer-reviewed published drug studies. These doctors unfailingly ignore the fact that, if medical drugs are killing a million Americans per decade, the studies on which those drugs are based must be fraudulent or, at the very least, massively incompetent. In other words, the whole literature is suspect, unreliable, and impenetrable.
Monday, June 28, 2010
Sunday, June 27, 2010
Vitamin D Deficiency Linked to Diabetes, Metabolic Syndrome in Studies
Vitamin D Deficiency Linked to Diabetes, Metabolic Syndrome in Studies
Sun Jun 20, 11:48 pm ET
-- A pair of new studies has uncovered evidence that low levels of vitamin D could lead to poor blood sugar control among diabetics and increase the risk of developing metabolic syndrome among seniors.
Both findings are slated to be presented Saturday at the Endocrine Society's annual meeting in San Diego.
In one study, researchers at the Johns Hopkins University School of Medicine in Baltimore reviewed the medical charts of 124 type 2 diabetes patients who sought specialty care at an endocrine outpatient facility between 2003 and 2008.
More than 90 percent of the patients, who ranged in age from 36 to 89, had either vitamin D deficiency or insufficiency, the authors found, despite the fact that they all had had routine primary care visits before their specialty visit.
Just about 6 percent of the patients were taking a vitamin D supplement at the time of their visit, the research team noted, and those who had lower vitamin D levels were also more likely to have higher average blood sugar levels.
"This finding supports an active role of vitamin D in the development of type 2 diabetes," study co-author Dr. Esther Krug, an assistant professor of medicine, said in a news release from the Endocrine Society.
"Since primary care providers diagnose and treat most patients with type 2 diabetes, screening and vitamin D supplementation as part of routine primary care may improve health outcomes of this highly prevalent condition," Krug added.
A second study involving nearly 1,300 white Dutch men and women over the age of 65 found almost half were vitamin D-deficient, while 37 percent had metabolic syndrome.
Metabolic syndrome is a grouping of health risk factors, including high blood pressure, abdominal obesity, abnormal cholesterol levels and high blood sugar.
"Because the metabolic syndrome increases the risk of diabetes and cardiovascular disease, an adequate vitamin D level in the body might be important in the prevention of these diseases," study co-author Dr. Marelise Eekhoff, of VU University Medical Center in Amsterdam, said in the same news release.
Regardless of gender, those with insufficient amounts of vitamin D in their blood were more likely to have the syndrome than those with sufficient amounts of vitamin D, Eekhoff and her colleagues found.
"It is important," added Eekhoff, "to investigate the exact role of vitamin D in diabetes to find new and maybe easy ways to prevent it and cardiovascular disease."
More information
For more on vitamin D, visit the U.S. National Library of Medicine.
Sun Jun 20, 11:48 pm ET
-- A pair of new studies has uncovered evidence that low levels of vitamin D could lead to poor blood sugar control among diabetics and increase the risk of developing metabolic syndrome among seniors.
Both findings are slated to be presented Saturday at the Endocrine Society's annual meeting in San Diego.
In one study, researchers at the Johns Hopkins University School of Medicine in Baltimore reviewed the medical charts of 124 type 2 diabetes patients who sought specialty care at an endocrine outpatient facility between 2003 and 2008.
More than 90 percent of the patients, who ranged in age from 36 to 89, had either vitamin D deficiency or insufficiency, the authors found, despite the fact that they all had had routine primary care visits before their specialty visit.
Just about 6 percent of the patients were taking a vitamin D supplement at the time of their visit, the research team noted, and those who had lower vitamin D levels were also more likely to have higher average blood sugar levels.
"This finding supports an active role of vitamin D in the development of type 2 diabetes," study co-author Dr. Esther Krug, an assistant professor of medicine, said in a news release from the Endocrine Society.
"Since primary care providers diagnose and treat most patients with type 2 diabetes, screening and vitamin D supplementation as part of routine primary care may improve health outcomes of this highly prevalent condition," Krug added.
A second study involving nearly 1,300 white Dutch men and women over the age of 65 found almost half were vitamin D-deficient, while 37 percent had metabolic syndrome.
Metabolic syndrome is a grouping of health risk factors, including high blood pressure, abdominal obesity, abnormal cholesterol levels and high blood sugar.
"Because the metabolic syndrome increases the risk of diabetes and cardiovascular disease, an adequate vitamin D level in the body might be important in the prevention of these diseases," study co-author Dr. Marelise Eekhoff, of VU University Medical Center in Amsterdam, said in the same news release.
Regardless of gender, those with insufficient amounts of vitamin D in their blood were more likely to have the syndrome than those with sufficient amounts of vitamin D, Eekhoff and her colleagues found.
"It is important," added Eekhoff, "to investigate the exact role of vitamin D in diabetes to find new and maybe easy ways to prevent it and cardiovascular disease."
More information
For more on vitamin D, visit the U.S. National Library of Medicine.
Thursday, June 24, 2010
Coming Soon to a Food Supply Near You
Coming Soon to a Food Supply Near You
by Nancy Matthis at American Daughter
The toxic chemical dispersant Corexit 9500 was pumped into the Gulf to counter the oil spill. Now it appears to have gassified, entered the atmosphere, and rained down on inland farmers, damaging crops and killing songbirds:
One month ago, on May 24, The European Union Times wrote about a report prepared by Russia's Ministry of Natural Resources for President Medvedev -- Toxic Oil Spill Rains Warned Could Destroy North America:
A dire report prepared for President Medvedev by Russia's Ministry of Natural Resources is warning ... that the British Petroleum (BP) oil and gas leak in the Gulf of Mexico is about to become the worst environmental catastrophe in all of human history threatening the entire eastern half of the North American continent with "total destruction".
Russian scientists are basing their apocalyptic destruction assessment due to BP's use of millions of gallons of the chemical dispersal agent known as Corexit 9500 which is being pumped directly into the leak of this wellhead over a mile under the Gulf of Mexico waters and designed, this report says, to keep hidden from the American public the full, and tragic, extent of this leak that is now estimated to be over 2.9 million gallons a day.
The dispersal agent Corexit 9500 is a solvent originally developed by Exxon and now manufactured by the Nalco Holding Company of Naperville, Illinois that is four times more toxic than oil....
A greater danger involving Corexit 9500, and as outlined by Russian scientists in this report, is that with its 2.61ppm toxicity level, and when combined with the heating Gulf of Mexico waters, its molecules will be able to "phase transition" from their present liquid to a gaseous state allowing them to be absorbed into clouds and allowing their release as "toxic rain" upon all of Eastern North America.
Even worse, should a Katrina like tropical hurricane form in the Gulf of Mexico while tens of millions of gallons of Corexit 9500 are sitting on, or near, its surface the resulting "toxic rain" falling upon the North American continent could "theoretically" destroy all microbial life to any depth it reaches resulting in an "unimaginable environmental catastrophe" destroying all life forms from the "bottom of the evolutionary chart to the top"....
By June 10 the San Fransico Chronicle reported crop damage -- BP oil spill Corexit dispersants suspected in widespread crop damage:
....It seems like damage brought by the oil gusher has spread way beyond the ocean, coastal areas and beaches. Collateral damage now appears to include agricultural damage way inland Mississippi.
A mysterious "disease" has caused widespread damage to plants from weeds to farmed organic and conventionally grown crops. There is very strong suspicion that ocean winds have blown Corexit aerosol plumes or droplets and that dispersants have caused the unexplained widespread damage or "disease"....
The warning on the Corexit 9500 label is clear enough:
"Keep container tightly closed. Do not get in eyes, on skin, on clothing. Do not take internally. Avoid breathing vapor. Use with adequate ventilation. In case of contact with eyes, rinse immediately with plenty of water and seek medical advice. After contact with skin, wash immediately with plenty of soap and water. Wear suitable protective clothing."
Now the stuff is raining down on us!
It has been well-known in the oil industry since the 1980s that oil-eating microbes can clean up the oil with no lasting environmental impact. They were developed at the behest of the Texas Land Office and the Texas Water Commission, and used successfully in 1990 to clean up a large oil spill in Galveston (see Business Insider -- An Oil-Eating Microbe That's Been Around Since 1989 Could Single-Handedly Clean Up BP's Entire Oil Spill).
So why is Corexit 9500 being used in the Gulf of Mexico? Back on May 30 blogger Jo Anne Mor published a Bombshell Exposé based on meticulous and lengthy research that she had performed showing that Democrat party bigwigs including Warren Buffett, Maurice Strong, Al Gore, and George Soros reaped huge profits from the sale of Corexit. Not only that, but her findings show that some increased their holdings preceding the disaster:
There is big money and even bigger players in this scam. While they are letting the oil blow wide open into the Gulf, the stakes and profit rise.
The Dolphins, Whales, Manatees, Sea Turtles and fish suffocate and die. The coastal regions, salt marshes, tourist attractions and the shore front properties are being destroyed, possibly permanently. The air quality is diminished. The Gulf of Mexico fishing industry is decimated.
All to create a need for their expensive and extremely profitable poison.
By now an outraged public has become aware of the microbes, which were warehoused in large quantities and available for use in the Gulf. But it is too late to use them now that Corexit has depleted the oxygen in the water. The microbes need oxygen to live long enough to eat the oil.
The European Union Times report sums it up best:
...the greatest lesson to be learned by these Americans is that their government-oil industry cabal has been just as destructive to them as their government-banking one, both of which have done more to destroy the United States these past couple of years than any foreign enemy could dare dream was possible.
But to their greatest enemy the Americans need look no further than their nearest mirror as they are the ones who allowed these monsters to rule over them in the first place.
Tail wag: Serg N of Common Sense Patriots
Related reading:
JoAnneMor -- Bombshell exposé. The real reason the oil still flows into the Gulf of Mexico.
[Note: Jo Anne Mor represents the best of the Blogosphere, an ordinary blogger whose dedicated work uncovers hidden evils that endanger us and makes them public knowledge.]
The Next Right -- BP's strange Democrat bedfellows
One of the top media consultants for British Petroleum gave free rent to a politician who became White House Chief of Staff. And, no, this was not Karl Rove giving a freebie to Andy Card. No, the recipient of the favor was Rahm Emanuel and the benefactor was Stanley Greenberg....
© Nancy Matthis, all rights reserved, published with permission.
Sunday, June 20, 2010
The advantages of autism
Most of you know that Sam Sewell is the Gifted Child Coordinator for his local Mensa chapter. Many of you may not know that autism is sometimes a high IQ related diorder.
Mensa Gifted Child Coordinators are frequently contacted by the parents of intellectually gifted children who are classified as "2-e" or "Twice Exceptional". The second way in which the children are exceptional may come in the form of a physical handicap, a processing issue, a mental illness, or many other things, including a diagnosis that places them on the Autistic spectrum.
They come to us for information, and often just for a safe place to vent their frustrations and fears.
Anyone who works with these families needs reminders that "different" does not necessarily mean "worse".
~~~~~~~~~~~~
The advantages of autism
04 May 2010 by David Wolman
MICHELLE Dawson can't handle crowded bus journeys, and she struggles to order a cup of coffee in a restaurant because contact with strangers makes her feel panicky. Yet over the past few years, Dawson has been making a name for herself as a researcher at the Rivière-des-Prairies hospital, part of the University of Montreal in Canada.
Dawson's field of research is the cognitive abilities of people with autism - people such as herself. She is one of a cadre of scientists who say that current definitions of this condition rely on findings that are outdated, if not downright misleading, and that the nature of autism has been fundamentally misunderstood for the past 70 years.
Medical textbooks tell us that autism is a developmental disability diagnosed by a classic "triad of impairments": in communication, imagination and social interaction. While the condition varies in severity, about three-quarters of people with autism are classed, in the official language of psychiatrists, as mentally retarded.
Over the past decade or so, a growing autistic pride movement has been pushing the idea that people with autism aren't disabled, they just think differently to "neurotypicals". Now, research by Dawson and others has carried this concept a step further. They say that auties, as some people with autism call themselves, don't merely think differently: in certain ways they think better. Call it the autie advantage.
How can a group of people who are generally seen as disabled actually have cognitive advantages? For a start, research is challenging the original studies that apparently demonstrated the low IQ of people with autism. Other studies are revealing the breadth of their cognitive strengths, ranging from attention to detail and sensitivity to musical pitch to better memory.
More recently, brain imaging is elucidating what neurological differences might lie behind these strengths. Entrepreneurs have even started trying to harness autistic people's talents (see "Nice work if you can get it"). "Scientists working in autism always reported abilities as anecdotes, but they were rarely the focus of research," says Isabelle Soulières, a neuropsychologist at Harvard Medical School in Boston, who works with Dawson. "Now they're beginning to develop interest in those strengths to help us understand autism."
The fact that some people with autism have certain talents is hardly a revelation. Leo Kanner, the psychiatrist who first described autism in the early 1940s, noted that some of his patients had what he termed "islets of ability", in areas such as memory, drawing and puzzles. But Kanner's emphasis, like that of most people since, was on autism's drawbacks.
Today it is recognised that autism varies widely in terms of which traits are present and how prominently they manifest themselves. The cause remains mysterious, although evidence is pointing towards many genes playing a role, possibly in concert with factors affecting development in the womb.
A single, elegant explanation capturing all that is different about the autistic mind has so far proved elusive, but several ideas have been put forward that attempt to explain the most notable traits. Perhaps one of the best known is the idea that autistic people lack theory of mind - the understanding that other people can have different beliefs to yourself, or to reality. This account would explain why many autistic people do not tell lies and cannot comprehend those told by others, although the supporting evidence behind this theory has come under fire lately.
Verbal cues
People with autism are also said to have weak central coherence - the ability to synthesise an array of information, such as verbal and gestural cues in conversation. In other words, sometimes they can't see the wood for the trees.
The idea of the autistic savant, with prodigious, sometimes jaw-dropping, talents has taken hold in popular culture. Yet savants are the exception, not the rule. The usual figure cited is that about 1 in 10 people with autism have some kind of savant-like ability. That includes many individuals with esoteric skills that are of little use in everyday life - like being able to instantly reckon the day of the week for any past or future date.
The reality is that children with autism generally take longer to hit milestones such as talking and becoming toilet-trained, and as adults commonly struggle to fit into society. Only 15 per cent of autistic adults have a paying job in the UK, according to government figures. The mainstream medical view of autism is that it represents a form of developmental brain damage. But what if that view is missing something?
The first way in which Dawson challenged the mainstream view was to address the association between autism and low IQ. In 2007, Dawson and Laurent Mottron, head of the autism research programme at the University of Montreal, published a study showing that an autistic person's IQ score depends on which kind of test is used. With the most common test, the Weschsler Intelligence Scale, three-quarters of people with autism score 70 or lower, which classifies them as mentally retarded, as defined by the World Health Organization's International Classification of Diseases. But when the team administered a different, yet equally valid, IQ test known as the Raven's Progressive Matrices, which places less weight on social knowledge, most people with autism scored at a level that lifted them out of this range (Psychological Science, vol 18, p 657).
Dawson believes her personal connection to this field of inquiry gives her unique insights. Recently, she began wondering if autistic strengths might already have surfaced in research settings, only to be buried in a literature dominated by the view of autistic people as damaged goods. "No one had ever thought to ask: What cognitive strengths have been reported in the literature?" she says.
After reviewing thousands of papers and re-examining the data, Dawson says she has found dozens that include empirical evidence of autistic strengths that are cloaked by a preoccupation with deficits.
Take, for example, a 2004 study where autistic and non-autistic people did sentence comprehension tests while lying in a brain scanner (Brain, vol 127, p 1811). The autistic volunteers showed less synchronicity between the different language areas of the brain as they performed the task. The authors speculate that this could explain some of the language problems seen in autism. Yet according to the results section, the autistic group did better at this particular comprehension task than the control group. "The researchers use the higher performance in one area to speculate about deficit elsewhere," says Dawson.
Attention to detail
Evidence for autistic advantages is also coming in from new studies. One strength derives from an aspect of autism that has long been seen as one of its chief deficits: weak central coherence. The flip side of an inability to see the wood for the trees is being very, very good at seeing trees.
Psychologists investigate the ability to aggregate or tease apart information by showing volunteers drawings of objects such as a house, and asking them to identify the shapes embedded within it, like triangles and rectangles. Numerous studies have shown that people with autism can do these tasks faster and more accurately. And that's not just with pictures; autistic people also do it with music, in tasks such as identifying individual notes within chords.
Maretha de Jonge, a child psychiatrist at the University Medical Centre in Utrecht, the Netherlands, who has done such studies, explains that "weak" in the context of central coherence doesn't have to mean inferior in daily life. "Weakness in integration is sometimes an asset," she says. It can be useful to filter out external stimuli if you are writing an email in a noisy coffee shop, for example, or are searching for a camouflaged insect in a rainforest. Recasting weak central coherence as attention to detail and resistance to distraction suggests a mode of thought that could have advantages.
Other autistic strengths are harder to paint as disabilities in any way. For example, Pamela Heaton of Goldsmiths, University of London, has shown that people with autism have better musical pitch recognition.
On the visual side, a few autistic savants who are immensely talented artists are well known, but recent studies suggest superior visuospatial skills may be more common in autism than previously supposed. Autistic people are better at three-dimensional drawing, for example, and tasks such as assembling designs out of blocks printed with different patterns (Journal of Autism and Developmental Disorders, vol 39, p 1039).
Brain scans indicate that this may be because people with autism recruit more firepower from the brain's visual areas when doing such tasks. They may even use their visual areas for other thought processes. Mottron's team found that people with autism were completing the reasoning tasks in the Raven's IQ test by using what is usually regarded as the visual part of the brain, along with more typical intelligence networks (Human Brain Mapping, vol 30, p 4082).
Many researchers note that people with autism seem hypersensitive to sights and sounds. In 2007, based partly on this finding, Kamila Markram and Henry Markram and Tania Rinaldi of the Swiss Federal Institute of Technology in Lausanne set out a theory of autism dubbed the "intense world syndrome" (Frontiers in Neuroscience, vol 1, p 77). According to this, autism is caused by a hyperactive brain that makes everyday sensory experiences overwhelming.
One of their planks of evidence is autopsy findings of structural differences in the brain's cortex, or outer layer. People with autism have smaller minicolumns - clusters of around 100 neurons that some researchers think act as the brain's basic processing units - but they also have more of them. While some have linked this trait to superior functioning, the Lausanne team still framed their theory as explaining autism's disabilities and deficits.
Mottron's team has published an alternative theory of autism that they believe more fully and accurately incorporates autistic strengths. Their "enhanced perceptual function model" suggests autistic brains are wired differently, but not necessarily because they are damaged (Journal of Autism and Developmental Disorders, vol 36, p 27). "These findings open a new educational perspective on autism that can be compared to sign language for deaf people," says Mottron.
While Henry Markram maintains that autism involves a "core neuropathology", he told New Scientist that the intense world idea and Mottron's theory are "aligned in most aspects". "Of course the brain is different, but to say whether the brain is damaged or not depends on what you mean by damaged."
What other cognitive abilities make up the autistic advantage? More rational decision-making seems to be one - people with autism are less susceptible to subjective or emotional factors such as how a question is worded (New Scientist, 18 October 2008, p 16). Still, until the idea of the autie advantage gains ground, the full range of autistic strengths will remain unknown.
Yet the idea seems to be taking root. When speaking at the TED conference in Long Beach, California, in February, professor of animal science Temple Grandin, who has autism, was cheered after quipping that Silicon Valley wouldn't exist without the condition. She also claimed the tech-heavy crowd was probably stacked with "autism genetics".
Galling message
Perhaps it will prove impossible to draw all-encompassing conclusions about the advantages and disadvantages of a condition described as a spectrum. Autism includes brilliant engineers, music prodigies who can't unload a dishwasher, maths savants who can't speak, and other combinations of talent and disability.
It is important to note, however, that the concept of the autie advantage has not been universally welcomed. A number of researchers, as well as parents of autistic people, are leery of too much emphasis on autistic strengths. They fear it could lead society to underestimate some people's impairments and the difficulties they face.
That outcome could threaten funding for badly needed social services and therapy programmes. As one researcher who did not want to be identified put it: "Michelle Dawson's first-hand experience is valuable. But her experience doesn't necessarily map onto other people's."
For a parent struggling with a child who cannot feed or use the toilet themselves it must be galling to hear that the condition may be advantageous. Yet other parents may be equally fed up of hearing uniformly negative messages about their children's potential. Perhaps only by considering the advantages of autism as well as its disadvantages can those affected reap better opportunities in life.
As far as Dawson is concerned, what matters most is evidence. Last year, at an autism conference, she presented a poster on her work. "When people looked at my results, they said, 'It's so good to see something positive!' I said that I don't see it as positive or negative. I see it as accurate."
Nice work if you can get it
Thorkil Sonne, founder of the IT firm Specialisterne in Copenhagen, Denmark, has led private-sector efforts to capitalise on autistic strengths, such as memory and attention to detail. His company employs 48 people, 38 of whom have autism.
After receiving training, employees work as IT consultants to other firms. Sonne, a former IT consultant himself, founded the company in 2004, soon after his son was diagnosed with autism. "I am just a father who reacted in despair by establishing a company tailored to meet the working conditions of people with autism," he says.
Specialisterne is no charity, though. The company turns a healthy profit - £120,000 in 2008 - and branches will soon open in the UK, Iceland and Germany. In Chicago, a non-profit start-up called Aspiritech is based on Sonne's model.
Michelle Dawson, an autistic cognition researcher at the University of Montreal, Canada, who has the condition herself, is hopeful that such enterprises will improve public attitudes and career opportunities for people with autism. Yet she cautions against pigeonholing people: "Asking what kind of job is good for an autistic is like asking what kind of job is good for a woman," she says.
Sonne says it is not his intention to stereotype autistic people as data-entry drones. The IT connection is because that's where his experience lay, but he's already ramping up the operation to cater to individual preferences and talents. He recently established an education programme for adolescents with autism, and hired a music and art teacher. Sonne says: "Our ambition is to work out a model in which people who struggle with traditional expectations of social skills can excel."
David Wolman is a science writer in Portland, Oregon. His book Righting the Mother Tongue is available from HarperCollins/Smithsonian Books
http://www.newscientist.com/article/mg20627581.500-the-advantages-of-autism.html?full=true
Mensa Gifted Child Coordinators are frequently contacted by the parents of intellectually gifted children who are classified as "2-e" or "Twice Exceptional". The second way in which the children are exceptional may come in the form of a physical handicap, a processing issue, a mental illness, or many other things, including a diagnosis that places them on the Autistic spectrum.
They come to us for information, and often just for a safe place to vent their frustrations and fears.
Anyone who works with these families needs reminders that "different" does not necessarily mean "worse".
~~~~~~~~~~~~
The advantages of autism
04 May 2010 by David Wolman
MICHELLE Dawson can't handle crowded bus journeys, and she struggles to order a cup of coffee in a restaurant because contact with strangers makes her feel panicky. Yet over the past few years, Dawson has been making a name for herself as a researcher at the Rivière-des-Prairies hospital, part of the University of Montreal in Canada.
Dawson's field of research is the cognitive abilities of people with autism - people such as herself. She is one of a cadre of scientists who say that current definitions of this condition rely on findings that are outdated, if not downright misleading, and that the nature of autism has been fundamentally misunderstood for the past 70 years.
Medical textbooks tell us that autism is a developmental disability diagnosed by a classic "triad of impairments": in communication, imagination and social interaction. While the condition varies in severity, about three-quarters of people with autism are classed, in the official language of psychiatrists, as mentally retarded.
Over the past decade or so, a growing autistic pride movement has been pushing the idea that people with autism aren't disabled, they just think differently to "neurotypicals". Now, research by Dawson and others has carried this concept a step further. They say that auties, as some people with autism call themselves, don't merely think differently: in certain ways they think better. Call it the autie advantage.
How can a group of people who are generally seen as disabled actually have cognitive advantages? For a start, research is challenging the original studies that apparently demonstrated the low IQ of people with autism. Other studies are revealing the breadth of their cognitive strengths, ranging from attention to detail and sensitivity to musical pitch to better memory.
More recently, brain imaging is elucidating what neurological differences might lie behind these strengths. Entrepreneurs have even started trying to harness autistic people's talents (see "Nice work if you can get it"). "Scientists working in autism always reported abilities as anecdotes, but they were rarely the focus of research," says Isabelle Soulières, a neuropsychologist at Harvard Medical School in Boston, who works with Dawson. "Now they're beginning to develop interest in those strengths to help us understand autism."
The fact that some people with autism have certain talents is hardly a revelation. Leo Kanner, the psychiatrist who first described autism in the early 1940s, noted that some of his patients had what he termed "islets of ability", in areas such as memory, drawing and puzzles. But Kanner's emphasis, like that of most people since, was on autism's drawbacks.
Today it is recognised that autism varies widely in terms of which traits are present and how prominently they manifest themselves. The cause remains mysterious, although evidence is pointing towards many genes playing a role, possibly in concert with factors affecting development in the womb.
A single, elegant explanation capturing all that is different about the autistic mind has so far proved elusive, but several ideas have been put forward that attempt to explain the most notable traits. Perhaps one of the best known is the idea that autistic people lack theory of mind - the understanding that other people can have different beliefs to yourself, or to reality. This account would explain why many autistic people do not tell lies and cannot comprehend those told by others, although the supporting evidence behind this theory has come under fire lately.
Verbal cues
People with autism are also said to have weak central coherence - the ability to synthesise an array of information, such as verbal and gestural cues in conversation. In other words, sometimes they can't see the wood for the trees.
The idea of the autistic savant, with prodigious, sometimes jaw-dropping, talents has taken hold in popular culture. Yet savants are the exception, not the rule. The usual figure cited is that about 1 in 10 people with autism have some kind of savant-like ability. That includes many individuals with esoteric skills that are of little use in everyday life - like being able to instantly reckon the day of the week for any past or future date.
The reality is that children with autism generally take longer to hit milestones such as talking and becoming toilet-trained, and as adults commonly struggle to fit into society. Only 15 per cent of autistic adults have a paying job in the UK, according to government figures. The mainstream medical view of autism is that it represents a form of developmental brain damage. But what if that view is missing something?
The first way in which Dawson challenged the mainstream view was to address the association between autism and low IQ. In 2007, Dawson and Laurent Mottron, head of the autism research programme at the University of Montreal, published a study showing that an autistic person's IQ score depends on which kind of test is used. With the most common test, the Weschsler Intelligence Scale, three-quarters of people with autism score 70 or lower, which classifies them as mentally retarded, as defined by the World Health Organization's International Classification of Diseases. But when the team administered a different, yet equally valid, IQ test known as the Raven's Progressive Matrices, which places less weight on social knowledge, most people with autism scored at a level that lifted them out of this range (Psychological Science, vol 18, p 657).
Dawson believes her personal connection to this field of inquiry gives her unique insights. Recently, she began wondering if autistic strengths might already have surfaced in research settings, only to be buried in a literature dominated by the view of autistic people as damaged goods. "No one had ever thought to ask: What cognitive strengths have been reported in the literature?" she says.
After reviewing thousands of papers and re-examining the data, Dawson says she has found dozens that include empirical evidence of autistic strengths that are cloaked by a preoccupation with deficits.
Take, for example, a 2004 study where autistic and non-autistic people did sentence comprehension tests while lying in a brain scanner (Brain, vol 127, p 1811). The autistic volunteers showed less synchronicity between the different language areas of the brain as they performed the task. The authors speculate that this could explain some of the language problems seen in autism. Yet according to the results section, the autistic group did better at this particular comprehension task than the control group. "The researchers use the higher performance in one area to speculate about deficit elsewhere," says Dawson.
Attention to detail
Evidence for autistic advantages is also coming in from new studies. One strength derives from an aspect of autism that has long been seen as one of its chief deficits: weak central coherence. The flip side of an inability to see the wood for the trees is being very, very good at seeing trees.
Psychologists investigate the ability to aggregate or tease apart information by showing volunteers drawings of objects such as a house, and asking them to identify the shapes embedded within it, like triangles and rectangles. Numerous studies have shown that people with autism can do these tasks faster and more accurately. And that's not just with pictures; autistic people also do it with music, in tasks such as identifying individual notes within chords.
Maretha de Jonge, a child psychiatrist at the University Medical Centre in Utrecht, the Netherlands, who has done such studies, explains that "weak" in the context of central coherence doesn't have to mean inferior in daily life. "Weakness in integration is sometimes an asset," she says. It can be useful to filter out external stimuli if you are writing an email in a noisy coffee shop, for example, or are searching for a camouflaged insect in a rainforest. Recasting weak central coherence as attention to detail and resistance to distraction suggests a mode of thought that could have advantages.
Other autistic strengths are harder to paint as disabilities in any way. For example, Pamela Heaton of Goldsmiths, University of London, has shown that people with autism have better musical pitch recognition.
On the visual side, a few autistic savants who are immensely talented artists are well known, but recent studies suggest superior visuospatial skills may be more common in autism than previously supposed. Autistic people are better at three-dimensional drawing, for example, and tasks such as assembling designs out of blocks printed with different patterns (Journal of Autism and Developmental Disorders, vol 39, p 1039).
Brain scans indicate that this may be because people with autism recruit more firepower from the brain's visual areas when doing such tasks. They may even use their visual areas for other thought processes. Mottron's team found that people with autism were completing the reasoning tasks in the Raven's IQ test by using what is usually regarded as the visual part of the brain, along with more typical intelligence networks (Human Brain Mapping, vol 30, p 4082).
Many researchers note that people with autism seem hypersensitive to sights and sounds. In 2007, based partly on this finding, Kamila Markram and Henry Markram and Tania Rinaldi of the Swiss Federal Institute of Technology in Lausanne set out a theory of autism dubbed the "intense world syndrome" (Frontiers in Neuroscience, vol 1, p 77). According to this, autism is caused by a hyperactive brain that makes everyday sensory experiences overwhelming.
One of their planks of evidence is autopsy findings of structural differences in the brain's cortex, or outer layer. People with autism have smaller minicolumns - clusters of around 100 neurons that some researchers think act as the brain's basic processing units - but they also have more of them. While some have linked this trait to superior functioning, the Lausanne team still framed their theory as explaining autism's disabilities and deficits.
Mottron's team has published an alternative theory of autism that they believe more fully and accurately incorporates autistic strengths. Their "enhanced perceptual function model" suggests autistic brains are wired differently, but not necessarily because they are damaged (Journal of Autism and Developmental Disorders, vol 36, p 27). "These findings open a new educational perspective on autism that can be compared to sign language for deaf people," says Mottron.
While Henry Markram maintains that autism involves a "core neuropathology", he told New Scientist that the intense world idea and Mottron's theory are "aligned in most aspects". "Of course the brain is different, but to say whether the brain is damaged or not depends on what you mean by damaged."
What other cognitive abilities make up the autistic advantage? More rational decision-making seems to be one - people with autism are less susceptible to subjective or emotional factors such as how a question is worded (New Scientist, 18 October 2008, p 16). Still, until the idea of the autie advantage gains ground, the full range of autistic strengths will remain unknown.
Yet the idea seems to be taking root. When speaking at the TED conference in Long Beach, California, in February, professor of animal science Temple Grandin, who has autism, was cheered after quipping that Silicon Valley wouldn't exist without the condition. She also claimed the tech-heavy crowd was probably stacked with "autism genetics".
Galling message
Perhaps it will prove impossible to draw all-encompassing conclusions about the advantages and disadvantages of a condition described as a spectrum. Autism includes brilliant engineers, music prodigies who can't unload a dishwasher, maths savants who can't speak, and other combinations of talent and disability.
It is important to note, however, that the concept of the autie advantage has not been universally welcomed. A number of researchers, as well as parents of autistic people, are leery of too much emphasis on autistic strengths. They fear it could lead society to underestimate some people's impairments and the difficulties they face.
That outcome could threaten funding for badly needed social services and therapy programmes. As one researcher who did not want to be identified put it: "Michelle Dawson's first-hand experience is valuable. But her experience doesn't necessarily map onto other people's."
For a parent struggling with a child who cannot feed or use the toilet themselves it must be galling to hear that the condition may be advantageous. Yet other parents may be equally fed up of hearing uniformly negative messages about their children's potential. Perhaps only by considering the advantages of autism as well as its disadvantages can those affected reap better opportunities in life.
As far as Dawson is concerned, what matters most is evidence. Last year, at an autism conference, she presented a poster on her work. "When people looked at my results, they said, 'It's so good to see something positive!' I said that I don't see it as positive or negative. I see it as accurate."
Nice work if you can get it
Thorkil Sonne, founder of the IT firm Specialisterne in Copenhagen, Denmark, has led private-sector efforts to capitalise on autistic strengths, such as memory and attention to detail. His company employs 48 people, 38 of whom have autism.
After receiving training, employees work as IT consultants to other firms. Sonne, a former IT consultant himself, founded the company in 2004, soon after his son was diagnosed with autism. "I am just a father who reacted in despair by establishing a company tailored to meet the working conditions of people with autism," he says.
Specialisterne is no charity, though. The company turns a healthy profit - £120,000 in 2008 - and branches will soon open in the UK, Iceland and Germany. In Chicago, a non-profit start-up called Aspiritech is based on Sonne's model.
Michelle Dawson, an autistic cognition researcher at the University of Montreal, Canada, who has the condition herself, is hopeful that such enterprises will improve public attitudes and career opportunities for people with autism. Yet she cautions against pigeonholing people: "Asking what kind of job is good for an autistic is like asking what kind of job is good for a woman," she says.
Sonne says it is not his intention to stereotype autistic people as data-entry drones. The IT connection is because that's where his experience lay, but he's already ramping up the operation to cater to individual preferences and talents. He recently established an education programme for adolescents with autism, and hired a music and art teacher. Sonne says: "Our ambition is to work out a model in which people who struggle with traditional expectations of social skills can excel."
David Wolman is a science writer in Portland, Oregon. His book Righting the Mother Tongue is available from HarperCollins/Smithsonian Books
http://www.newscientist.com/article/mg20627581.500-the-advantages-of-autism.html?full=true
Wednesday, June 16, 2010
Poisonous elements in popular protein drinks
Poisonous elements in popular protein drinks
ANI, Jun 15, 2010, 04.38pm IST
Protein drinks contain poisonous elements, according to a new report.
A monthly review of consumer products and services, the Consumer Reports, has found that three such drinks available in the market had harmful content.
EAS Myoplex Original Dark Chocolate Shake and two versions of Muscle Milk chocolate drinks, the report claims, had high levels of arsenic, cadmium and lead.
The finding challenges senior vice president of scientific and regulatory affairs at the Council for Responsible Nutrition, Andrew Shao’s, claim that protein powders and drinks are a safe option for adolescents and pregnant women.
The Consumers Reports drew attention to the fact that federal regulations don't require compulsory testing of protein drinks and other dietary supplements, before they are sold, for contaminants.
"Most consumers and even many doctors don't realize that in this country we're left to simply trust the manufacturer to decide what level of quality and safety they'll provide," Discover News quoted Pieter Cohen, an internist at Cambridge Health Alliance, as saying.
Cadmium causes kidney and lung damage. Arsenic and lead cause cancer and brain damage.
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ANI, Jun 15, 2010, 04.38pm IST
Protein drinks contain poisonous elements, according to a new report.
A monthly review of consumer products and services, the Consumer Reports, has found that three such drinks available in the market had harmful content.
EAS Myoplex Original Dark Chocolate Shake and two versions of Muscle Milk chocolate drinks, the report claims, had high levels of arsenic, cadmium and lead.
The finding challenges senior vice president of scientific and regulatory affairs at the Council for Responsible Nutrition, Andrew Shao’s, claim that protein powders and drinks are a safe option for adolescents and pregnant women.
The Consumers Reports drew attention to the fact that federal regulations don't require compulsory testing of protein drinks and other dietary supplements, before they are sold, for contaminants.
"Most consumers and even many doctors don't realize that in this country we're left to simply trust the manufacturer to decide what level of quality and safety they'll provide," Discover News quoted Pieter Cohen, an internist at Cambridge Health Alliance, as saying.
Cadmium causes kidney and lung damage. Arsenic and lead cause cancer and brain damage.
~~~~~~~~~~~~~~~~
Shaklee: Always Safe - Always Works - Always Green
100% Guaranteed
Cinch® Shake Mix,
Skip to the good part
With tons of protein so you feel full. Leucine so you don't lose muscle. And a creamy flavor so you don't lose your will. You get all the benefits of a meal. Except it tastes like dessert.
Delicious, healthy, and satisfying meal at home or on-the-go
Powered by Leucine™ to help preserve muscle while you lose weight
With 24 grams of protein* to help control hunger and help you feel full
http://bestself.myshaklee.com/us/en/welcome.html#
Sunday, June 13, 2010
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www.bestself.myshaklee.com 239/591-4565
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Vitalizer is one quick easy way to boost your resiliency, energy & vitality, enhance your immune function, and manage stresses of everyday life. Backed by over 90 years of clinical research, Vitalizer is guaranteed to improve eye, lung, heart & muscle health, while protecting the nervous system, genetic material & prostrate health. The patented delivery system is proven to get the right nutrients to the right places at the right time, guaranteeing healthier:
Nutritional Levels
Homocysteine Levels
HDO Cholesterol
Triglycerides
Overall Health
Better Digestion
More energy
Better Sleep
Eat right, exercise, reduce your risk of high blood pressure, heart attacks diabetes, strokes, heart failure. 100% guaranteed or your money back! Join us Monday to learn more!
Shaklee Vitalizer VideoWatch this Shaklee Vitalizer video and learn why Vitalizer was fifty years in the making, based on 12 Shaklee clinical studies, with 80 bio-optimized clinically proven nutrients. Vitalizer provides the best spectrum of vitamins, minerals, antioxidants, anti-aging phytonutrients, omega-3 fatty acids, and probiotics.* Now with NEW higher levels of Vitamin D3, clinically supported for bone, heart and immune health. (4 minutes)
2009 Cinch video featuring people who have lost weight with Cinch (4 minutes.)
2009 Cinch Video - English
2009 Cinch Video - Spanish
NutriFeron Video
This video highlights the benefits of NutriFeron--a Shaklee exclusive. NutriFeron is a patented, clinically proven blend of immune-strengthening plant extracts. Taken daily, NutriFeron strengthens immune response by boosting the body’ natural interferon.* (3 ½ minutes.)
Vivix Video
Vivix 2009 Video, Spanish
The Vivix video describes why Vivix Cellular Anti-Aging* Tonic is a revolutionary breakthrough and how it impacts the four key mechanisms in the fight against cellular aging. (2 minutes.)
Join us Monday 7PM to learn how you can benefit! RSVP
10202 Vanderbilt Dr
(NE corner @ Vanderbilt Dr)
Naples Fl 34108
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
www.bestself.myshaklee.com 239/591-4565
Products in harmony with nature! Sam & Bunny Sewell
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Saturday, June 12, 2010
Just in time for Father’s day - FREE SHIPPING
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“Your wisdom, wit, intelligence, research and commitment to reality regarding victory over heart disease and death should be required reading for every doctor, patient, hospital staff, care giver, and pharmacist.”
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Saturday, June 5, 2010
de-register methyliodide for agricultural use
Dear Friend,
You may have heard that California, the nation's largest agriculturalproducer, is on the verge of approving a potent carcinogenic gas for useon strawberry fields and other food crops. The chemical -- methyl iodide-- is so toxic that scientists in labs use only small amounts with specialprotective equipment, yet agricultural applications mean it could bereleased directly into the air and water.Whatever California decides, the only surefire way to keep this poisonaway from our food and farm workers is for the U.S. EnvironmentalProtection agency to re-evaluate and ban methyl iodide at the federallevel.I just signed a petition to the EPA asking them to de-register methyliodide for agricultural use. Will you too?
http://act.credoaction.com/campaign/methyl_iodide_epa/?r_by=&rc=mailto2
Sincerely,
Roberta Vallery Marten
Shaklee Independent DistributorNaples, FL 239-775-4160Shaklee Mission:
We provide a healthier life for everyone and a better life for anyone.
You may have heard that California, the nation's largest agriculturalproducer, is on the verge of approving a potent carcinogenic gas for useon strawberry fields and other food crops. The chemical -- methyl iodide-- is so toxic that scientists in labs use only small amounts with specialprotective equipment, yet agricultural applications mean it could bereleased directly into the air and water.Whatever California decides, the only surefire way to keep this poisonaway from our food and farm workers is for the U.S. EnvironmentalProtection agency to re-evaluate and ban methyl iodide at the federallevel.I just signed a petition to the EPA asking them to de-register methyliodide for agricultural use. Will you too?
http://act.credoaction.com/campaign/methyl_iodide_epa/?r_by=&rc=mailto2
Sincerely,
Roberta Vallery Marten
Shaklee Independent DistributorNaples, FL 239-775-4160Shaklee Mission:
We provide a healthier life for everyone and a better life for anyone.
Thursday, June 3, 2010
Vitally Important! -Why your Cardiologist Doesn’t Want You to Know About Fighter Pilots “G-Suits.
Why your Cardiologist Doesn’t Want You to Know About Fighter Pilots “G-Suits.
http://heartdisease.about.com/cs/coronarydisease/a/EECP_3.htm
The only facility for EECP in Collier County is:
Walther R Evenhuis
(239) 262-5770
1351 Pine St
Naples, FL
Specialty
Cardiology, Internal Medicine, Cardiovascular Disease
A G-suit is a special garment and generally takes the form of tightly-fitting trousers, which fit either under or over (depending on the design) the flying suit worn by the aviator or astronaut. The trousers are fitted with inflatable bladders which, when pressurized through a G-sensitive valve in the aircraft or spacecraft, press firmly on the abdomen and legs, thus restricting the draining of blood away from the brain during periods of high acceleration.
Now imagine a “G-Suit for your heart. If you were hooked up to a EKG machine that applied external counter pressure whenever your heart beat it would have the potential to give you a natural by-pass to clogged arteries plus other benefits.
Such treatment is available and is often kept secret from heart patients.
EECP therapy is a safe, non-invasive, outpatient treatment option for patients suffering from ischemic heart diseases such as angina and heart failure. EECP therapy has helped thousands of patients. In fact, clinical studies show, over 75% of patients benefit from EECP therapy and sustain improvement up to three years post- treatment.
Recent data documenting the effectiveness of Enhanced External Counterpulsation (EECP) for the treatment of angina has failed to bring this apparently effective procedure into the mainstream of cardiology practice. In this article, DrRich discusses what EECP is, how it works, and why cardiologists are avoiding this safe, noninvasive treatment like the plague.
What is EECP?
EECP is a mechanical procedure in which long inflatable cuffs (like blood pressure cuffs) are wrapped around both of the patient’s legs. While the patient lies on a bed, the leg cuffs are inflated and deflated with each heartbeat. This is accomplished by means of a computer, which triggers off the patient’s ECG so that the cuffs deflate just as each heartbeat begins, and inflate just as each heartbeat ends. When the cuffs inflate they do so in a sequential fashion, so that the blood in the legs is “milked” upwards, toward the heart.
EECP has two potentially beneficial actions on the heart. First, the milking action of the leg cuffs increases the blood flow to the coronary arteries. (The coronary arteries, unlike other arteries in the body, receive their blood flow after each heartbeat instead of during each heartbeat. EECP, effectively, “pumps” blood into the coronary arteries.) Second, by its deflating action just as the heart begins to beat, EECP creates something like a sudden vacuum in the arteries, which reduces the work of the heart muscle in pumping blood into the arteries. Both of these actions have long been known to reduce cardiac ischemia (the lack of oxygen to the heart muscle) in patients with coronary artery disease. Indeed, an invasive procedure that does the same thing, intra-aortic counterpulsation (IACP, in which a balloon-tipped catheter is positioned in the aorta, which then inflates and deflates in time with the heartbeat), has been in widespread use in intensive care units for decades, and its effectiveness in stabilizing extremely unstable patients is well known.
While a primitive form of external counterpulsation has also been around for a long time, it has not been very effective until recently. Thanks to new computer technology that allows the perfect timing of the inflation and deflation of the cuffs, and produces the milking action, modern EECP has been greatly enhanced.
EECP is administered as a series of outpatient treatments. Patients receive 5 one-hour sessions per week, for 7 weeks (for a total of 35 sessions). The 35 one-hour sessions are aimed at provoking long lasting beneficial changes in the circulatory system.
How effective is it?
EECP now appears to be quite effective in treating chronic stable angina. A randomized trial with EECP, published in the Journal of the American College of Cardiologyin 1999, showed that EECP significantly improved both the symptoms of angina (a subjective measurement) and exercise tolerance (a more objective measurement) in patients with coronary artery disease. EECP also significantly improved “quality of life” measures, as compared to placebo therapy.
More recent data show that this improvement in symptoms following a course of EECP seems to persist for up to five years.
Furthermore, there is also preliminary data suggesting that EECP may be useful for treating unstable angina, as adjunctive therapy after revascularization (i.e., with angioplasty, stent, and/or bypass surgery), and even as first-line (instead of last resort) therapy for more routine forms of angina. (Read about EECP as early therapy for angina here.)
Finally, clinical trials have suggested that EECP may be useful in improving symptoms in patients with heart failure. Read about EECP for heart failure here.
Who is likely to benefit from EECP?
Based on what is already known, EECP should be considered in anybody who still has angina despite maximal medical therapy and prior revascularization. No cardiologist could argue logically against this. And, frankly, if a patient insisted on trying EECP prior to agreeing to purely elective revascularization for chronic stable angina, the cardiologist might not like it, but would be hard pressed to give anything beyond a purely emotional reason as to why this should not be tried.
Why does EECP work?
The mechanism for the sustained benefits seen with EECP still amount to speculation. Everyone can agree that there are good reasons for EECP (just as for IACP) to benefit the heart while the therapy is actually taking place. But as to why the benefit of EECP persists even after the therapy is finished, no one can say for sure.
There are preliminary data suggesting that EECP can help induce the formation of collateral vessels in the coronary artery tree, by stimulating the release of nitric oxide and other growth factors in within the coronary arteries. There is also evidence that EECP may act as a form of “passive” exercise, leading to the same sorts of persistent beneficial changes in the autonomic nervous system that are seen with real exercise.
Can EECP be harmful?
EECP can be somewhat uncomfortable (it is said to be more difficult to watch – what with the patient being noticeably jostled due to the milking action of the inflatable leg cuffs – than it is to actually have it done), but is not painful. In fact, it is apparently very well tolerated by the large majority of patients.
But not everyone can have it. People probably should not have EECP if they have certain types of valvular heart disease (especially aortic insufficiency), or if they have had a recent cardiac catheterization, an irregular heart rhythm, severe hypertension, significant blockages in the leg arteries, or a history of deep venous thrombosis (blood clots in the legs). For anyone else, however, the procedure appears to be quite safe.
Despite its increasingly apparent potential usefulness, EECP is hardly taking the cardiology world by storm. In fact, it seems that for most cardiologists EECP is not even on the list of potential treatments for coronary artery disease. Why is that?
There are several possible reasons. Let us dispense with the most obvious first, namely, that EECP doesn’t pay well. A series of 35 treatments costs $5000 to $6000 dollars. That’s not chicken feed, but keep in mind that we’re talking about 35 hours of therapy over 7 weeks, which involves not only the doctor’s time but also the time of office staff, nursing personnel, etc., etc. Still not a terrible return, but when you consider that a cardiologist can often bill that much by spending a morning in the cath lab, well - - -.
Then there’s the fact that EECP remains somewhat intellectually unsatisfying. To your average cardiologist, there’s no reason at all that anyone should have thought it would work in the first place – that temporarily providing counterpulsation would have lasting effects. And the fact that it apparently does work is merely blind luck, and leaves investigators scrambling ridiculously to explain why it does. This is a less than satisfying way to advance science.
In addition, to most cardiologists, EECP is logistically difficult. To accommodate patients for EECP, they would not only have to purchase expensive equipment, but also would have to radically change the organization of their offices, their office staff, and their space.
Finally, and most importantly, EECP has nothing in common with what cardiologists do. Cardiologists study and treat the heart, for goodness sake. They stress it, image it, measure it, pace it, shock it, stent it, ablate it, revascularize it, and bathe it in drugs. What they do takes years of specialized training and expertise, millions of dollars of high-tech equipment, and tremendous manual dexterity, and it brings them significant prestige, even within the medical community.
Now they’re supposed to drop all that? In order to attach fancy balloons to peoples’ legs, throw a switch, watch them bounce around for an hour, then say, “See you tomorrow?” That’s not cardiology. That’s glorified physical therapy.
This, in DrRich’s estimation, is the real reason the average cardiologist is completely ignoring EECP, as if it doesn’t even exist. They simply can’t believe anyone really expects them to do this.
In any case, you may need to raise your cardiologist’s consciousness. If you have coronary artery disease that has proved difficult to treat, then you need to bring EECP up yourself.
Once enough patients show themselves to be aware of this new therapy and to be expecting it, suddenly EECP will no longer be beneath cardiologists, and they’ll eagerly find a way to incorporate it into their practices.
How can you receive EECP?
If you are a candidate for EECP and wish to pursue it, start with your doctor. If your doctor discourages you from pursuing EECP, make sure he/she gives you a good reason for discouraging it. Good reasons would include: you don’t have the sort of coronary artery disease or angina that would benefit from EECP; your coronary artery disease is of the type that requires revascularization; or you have one of the contraindications (listed above) for having EECP. (Good reasons would not include: it’s unproven; it doesn’t work; it’s voodoo; or I’ve never heard of it.)
There are fewer than 200 places today performing EECP, though the number is growing rapidly. If your doctor can’t think of a place to refer you for EECP, go online. The best place to start online would be EECP.com. This is a website run by Vasomedical, Inc., the company that makes the equipment for EECP, so it is not unbiased. But it does offer an excellent means of finding a place where you can get EECP in your area.
Your insurance carrier should cover EECP, though these fine humanitarians might well deny coverage initially. Medicare has approved EECP for reimbursement, and once Medicare approves a new treatment, insurance companies normally fall in line quite quickly. In the case of EECP, however, many insurance companies are still balking at paying, perhaps because their cardiology consultants are telling them it’s not really a serious therapy. Don’t let this discourage you. If you are turned down for reimbursement, appeal the decision. Most insurance companies count on patients failing to appeal (which is why they so frequently deny therapy that is obviously needed), and with Medicare supporting your contention that EECP ought to be covered, odds are that if you appeal you’ll win.
More than 100 articles and studies on EECP have been published in leading cardiology journals, all supporting the treatment's safety and effectiveness. We hope you find this sampling helpful, and we will continue to update this section as often as possible.
• Predictors of benefit in angina patients one year after completing enhanced external counterpulsation: initial responders to treatment versus nonresponders.
Lawson WE, Hui JC, Kennard ED, Barsness G, Kelsey SF; IEPR investigators.
Cardiology. 2005;103(4):201-6. Epub 2005 Apr 13.
• An update on enhanced external counterpulsation.
Shea ML, Conti CR, Arora RR.
Clinical Cardiology. 2005 Mar;28(3):115-8. Review.
• Enhanced external counterpulsation: a new technique to augment renal function in liver cirrhosis.
Werner D, Tragner P, Wawer A, Porst H, Daniel WG, Gross P.
Nephrology, Dialysis, Transplantation. 2005 May;20(5):920-6. Epub 2005 Mar 23.
• Enhanced External Counterpulsation.
Brosche TA, Middleton SK, Boogaard RG.
Dimensions of Critical Care Nursing. 2005 September/October;23(5):208-214.
• Enhanced external counter pulsation (EECP) as a novel treatment for restless legs syndrome (RLS): a preliminary test of the vascular neurologic hypothesis for RLS.
Rajaram SS, Shanahan J, Ash C, Walters AS, Weisfogel G.
Sleep Medicine. 2005 Mar;6(2):101-6. Epub 2005 Jan 24.
• Angina patients with diastolic versus systolic heart failure demonstrate comparable immediate and one-year benefit from enhanced external counterpulsation.
Lawson WE, Silver MA, Hui JC, Kennard ED, Kelsey SF.
Journal of Cardiac Failure. 2005 Feb;11(1):61-6.
• Frequency and efficacy of repeat enhanced external counterpulsation for stable angina pectoris (from the International EECP Patient Registry).
Michaels AD, Barsness GW, Soran O, Kelsey SF, Kennard ED, Hui JC, Lawson WE; International EECP Patient Registry Investigators.
American Journal of Cardiology. 2005 Feb 1;95(3):394-7.
• Effects of enhanced external counterpulsation on hemodynamics and its mechanism.
Taguchi I, Ogawa K, Kanaya T, Matsuda R, Kuga H, Nakatsugawa M.
Circulation Journal. 2004 Nov;68(11):1030-4.
• Effectiveness of enhanced external counterpulsation in patients with left main disease and angina.
Lawson WE, Hui JC, Barsness GW, Kennard ED, Kelsey SF; IEPR Investigators.
Clinical Cardiology. 2004 Aug;27(8):459-63.
• Accelerated reperfusion of poorly perfused retinal areas in central retinal artery occlusion and branch retinal artery occlusion after a short treatment with enhanced external counterpulsation.
Werner D, Michalk F, Harazny J, Hugo C, Daniel WG, Michelson G.
Retina. 2004 Aug;24(4):541-7.
• Enhanced external counterpulsation improves skin oxygenation and perfusion.
Hilz MJ, Werner D, Marthol H, Flachskampf FA, Daniel WG.
European Journal of Clinical Investigations. 2004 Jun;34(6):385-91.
• Successful treatment of symptomatic coronary endothelial dysfunction with enhanced external counterpulsation.
Bonetti PO, Gadasalli SN, Lerman A, Barsness GW.
Mayo Clinic Proceedings. 2004 May;79(5):690-2.
• Two-year outcomes after enhanced external counterpulsation for stable angina pectoris (from the International EECP Patient Registry [IEPR]).
Michaels AD, Linnemeier G, Soran O, Kelsey SF, Kennard ED.
American Journal of Cardiology. 2004 Feb 15;93(4):461-4.
• A New Treatment Modality in Heart Failure Enhanced External Counterpulsation (EECP)
Soran O.
Cardiology in Review. 2004 Jan-Feb;12(1):15-20.
• Enhanced External Counterpulsation as Initial Revascularization Treatment for Angina Refractory to Medical Therapy
Fitzgerald CP, Lawson WE, Hui JC, Kennard ED; IEPR Investigators.
Cardiology. 2003;100(3):129-35.
• Enhanced External Counterpulsation and Functional Improvement in Octogenarians with Symptomatic Ischemic Heart Disease
Braverman D, Wechsler B.
Archives of Physical Medicine and Rehabilitation. 2003 Sept;84(9):A10.
• Enhanced External Counterpulsation in the Management of Angina in the Elderly
Linnemeier G, Michaels AD, Soran O, Kennard ED; International EECP Registry (IEPR) Investigators.
American Journal of Geriatric Cardiology. 2003 Mar-Apr;12(2):90-6.
• Ongoing and Planned Studies of Enhanced External Counterpulsation
Conti CR.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II26-28.
• Treatment Options for Angina Pectoris and the Future Role of Enhanced External Counterpulsation
Holmes DR Jr.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II22-25.
• Current Use of Enhanced External Counterpulsation and Patient Selection
Lawson WE.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II16-21.
• Enhanced External Counterpulsation: Mechanism of Action
Feldman AM.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II11-15.
• A Review of Enhanced External Counterpulsation Clinical Trials
Beller GA.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II6-10.
• A Historical Overview of Enhanced External Counterpulsation
DeMaria AN.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II3-5.
• Enhanced External Counterpulsation as Treatment for Chronic Angina in Patients with Left Ventricular Dysfunction: A Report from the International EECP Patient Registry (IEPR)
Soran O, Kennard ED, Kelsey SF, Holubkov R, Strobeck J, Feldman AM.
Congestive Heart Failure. 2002 Nov-Dec;8(6):297-302.
• Left Ventricular Systolic Unloading and Augmentation of Intracoronary Pressure and Doppler Flow During Enhanced External Counterpulsation
Michaels AD, Accad M, Ports TA, Grossman W.
Circulation. 2002 Sep 3;106(10):1237-1242.
• Enhanced External Counterpulsation in Patients with Heart Failure: A Multicenter Feasibility Study
Soran O, Fleishman B, Demarco T, Grossman W, Schneider VM, Manzo K, de Lame PA, Feldman AM.
Congestive Heart Failure. 2002 Jul-Aug;8(4)204-8, 227.
• Relation of the Pattern of Diastolic Augmentation During a Course of Enhanced External Counterpulsation (EECP) to Clinical Benefit [from the International EECP Patient Registry (IEPR)]
Lakshmi MV, Kennard ED, Kelsey SF, Holubkov R, Michaels AD.
American Journal of Cardiology. 2002 Jun 1;89(11):1303-1305.
• Comparison of Patients Undergoing Enhanced External Counterpulsation and Percutaneous Coronary Intervention for Stable Angina Pectoris
Holubkov R, Kennard ED, Foris JM, Kelsey SF, Soran O, Williams DO, Holmes Jr. DR.
The American Journal of Cardiology. 2002 May 15;89:1182-1186.
• Effects of Enhanced External Counterpulsation on Stress Radionuclide Coronary Perfusion and Exercise Capacity in Chronic Stable Angina Pectoris
Stys TP, Lawson WE, Hui JCK, Fleishman B, Manzo K, Strobeck JE, Tartaglia J, Ramasamy S, Suwita R, Zheng ZS, Liang H, Werner D.
The American Journal of Cardiology. 2002 Apr 1;89(7):822-824.
• Effects of Enhanced External Counterpulsation on Health-Related Quality of Life Continue 12 Months After Treatment: A Substudy of the Multicenter Study of Enhanced External Counterpulsation
Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto R, Ferrans CE, Keller S.
Journal of Investigative Medicine. 2002 Jan;50(1):25-32.
• Acute and Chronic Hemodynamic Effects of Enhanced External Counterpulsation in Patients with Angina Pectoris
Arora RR, Carlucci ML, Malone AM, Baron NV.
Journal of Investigative Medicine. 2001 Nov;49(6):500-504.
• Acute Hemodynamic Effects and Angina Improvement with Enhanced External Counterpulsation
Stys T, Lawson WE, Hui JCK, Lang G, Liuzzo J, Cohn PF.
Angiology. 2001 Oct;52(10):653-658.
• A Report from the International Enhanced External Counterpulsation Registry (IEPR)
Holubkov R, Kennard E, Kelsey S, Soran O.
Advances in Coronary Artery Diseases-4th International Congress on Coronary Artery Disease. 2001 Oct 21-24;(Prague, Czech Republic):387-391.
• Benefit and Safety of Enhanced External Counterpulsation in Treating Coronary Artery Disease Patients with a History of Congestive Heart Failure
Lawson WE, Kennard ED, Holubkov R, Kelsey SF, Strobeck JE, Soran O, Feldman AM.
Cardiology. 2001;96(2):78-84.
• Enhanced External Counterpulsation Improved Myocardial Perfusion and Coronary Flow Reserve in Patients with Chronic Stable Angina; Evaluation by 13N-Ammonia Positron Emission Tomography
Masuda D, Nohara R, Hirai T, Kataoka K, Chen LG, Hosokawa R, Inubushi M, Tadamura E, Fujita M, Sasayama S.
European Heart Journal. 2001 Aug;22(16):1451-1458.
• Safety and Effectiveness of Enhanced External Counterpulsation in Improving Angioplasty Restenosis
Stys TP, Lawson WE, Hui JCK, Tartaglia JJ, Subramanian R, Du ZM, Zhang MQ.
Proceedings of the 2nd International Congress on Heart Disease – New Trends in Research, Diagnosis and Treatment (International Academy of Cardiology).. 2001 Jul 21-24;(Washington DC, USA):369-372.
• Psychosocial Effects of Enhanced External Counterpulsation in the Angina Patient: A Second Study
Springer S, Fife A, Lawson W, Hui JCK, Jandorf L, Cohn PF, Fricchione G.
Psychosomatics. 2001 Mar-Apr;42(2):124-132.
• Enhanced External Counterpulsation Improves Exercise Tolerance, Reduces Exercise-Induced Myocardial Ischemia and Improves Left Ventricular Diastolic Filling in Patients with Coronary Artery Disease
Urano H, Ikeda H, Ueno T, Matsumoto T, Murohara T, Imaizumi T.
Journal of the American College of Cardiology. 2001 Jan;37(1):93-99.
• Comparison of Hemodynamic Effects of Enhanced External Counterpulsation and Intra-Aortic Balloon Pumping in Patients with Acute Myocardial Infarction
Taguchi I, Ogawa K, Oida A, Abe S, Kaneko N, Sakio H.
The American Journal of Cardiology. 2000 Nov 15;86(10):1139-1141.
• Treatment Benefit in the Enhanced External Counterpulsation Consortium
Lawson WE, Hui JCK, Lang G.
Cardiology. 2000;94(1):31-35.
• Noninvasive Revascularization by Enhanced External Counterpulsation: A Case Study and Literature Review
Singh M, Holmes Jr. DR, Tajik AJ, Barsness GW.
Mayo Clinic Proceedings. 2000 Sep;75(9):961-965.
• Long-Term Prognosis of Patients with Angina Treated with Enhanced External Counterpulsation: Five-Year Follow-Up Study
Lawson WE, Hui JCK, Cohn PF.
Clinical Cardiology. 2000 Apr;23(4):254-258.
• Pneumatic External Counterpulsation: A New Noninvasive Method to Improve Organ Perfusion
Werner D, Schneider M, Weise M, Nonnast-Daniel B, Daniel WG.
The American Journal of Cardiology. 1999 Oct 15;84(8):950-952.
• The Multicenter Study of Enhanced External Counterpulsation (MUST-EECP): Effect of EECP on Exercise-Induced Myocardial Ischemia and Anginal Episodes
Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto R.
The Journal of the American College of Cardiology. 1999 Jun;33(7):1833-1840.
• Improvement of Regional Myocardial and Coronary Blood Flow Reserve in a Patient Treated with Enhanced External Counterpulsation: Evaluation by Nitrogen-13 Ammonia PET
Masuda D, Nohara R, Inada H, Hirai T, Li-Guang C, Kanda H, Inubushi M, Tadamura E, Fujita M, Sasayama S.
Japanese Circulation Journal. 1999 May;63(5):407-411.
• Enhanced External Counterpulsation as a New Treatment Modality for Patients with Erectile Dysfunction
Froschermaier SE, Werner D, Leike S, Schneider M, Waltenberger J, Daniel WG, Wirth MP.
Urologia Internationalis. 1998;61(3):168-171.
• Prior Revascularization Increases the Effectiveness of Enhanced External Counterpulsation
Lawson WE, Hui JCK, Guo T, Burger L, Cohn PF.
Clinical Cardiology. 1998 Nov;21(11):841-844.
• Three-Year Sustained Benefit from Enhanced External Counterpulsation in Chronic Angina Pectoris
Lawson WE, Hui JCK, Zheng ZS, Oster Z, Katz JP, Diggs P, Burger L, Cohn CD, Soroff HS, Cohn PF.
The American Journal of Cardiology. 1995 Apr 15;75:840-841.
http://heartdisease.about.com/cs/coronarydisease/a/EECP_3.htm
The only facility for EECP in Collier County is:
Walther R Evenhuis
(239) 262-5770
1351 Pine St
Naples, FL
Specialty
Cardiology, Internal Medicine, Cardiovascular Disease
A G-suit is a special garment and generally takes the form of tightly-fitting trousers, which fit either under or over (depending on the design) the flying suit worn by the aviator or astronaut. The trousers are fitted with inflatable bladders which, when pressurized through a G-sensitive valve in the aircraft or spacecraft, press firmly on the abdomen and legs, thus restricting the draining of blood away from the brain during periods of high acceleration.
Now imagine a “G-Suit for your heart. If you were hooked up to a EKG machine that applied external counter pressure whenever your heart beat it would have the potential to give you a natural by-pass to clogged arteries plus other benefits.
Such treatment is available and is often kept secret from heart patients.
EECP therapy is a safe, non-invasive, outpatient treatment option for patients suffering from ischemic heart diseases such as angina and heart failure. EECP therapy has helped thousands of patients. In fact, clinical studies show, over 75% of patients benefit from EECP therapy and sustain improvement up to three years post- treatment.
Recent data documenting the effectiveness of Enhanced External Counterpulsation (EECP) for the treatment of angina has failed to bring this apparently effective procedure into the mainstream of cardiology practice. In this article, DrRich discusses what EECP is, how it works, and why cardiologists are avoiding this safe, noninvasive treatment like the plague.
What is EECP?
EECP is a mechanical procedure in which long inflatable cuffs (like blood pressure cuffs) are wrapped around both of the patient’s legs. While the patient lies on a bed, the leg cuffs are inflated and deflated with each heartbeat. This is accomplished by means of a computer, which triggers off the patient’s ECG so that the cuffs deflate just as each heartbeat begins, and inflate just as each heartbeat ends. When the cuffs inflate they do so in a sequential fashion, so that the blood in the legs is “milked” upwards, toward the heart.
EECP has two potentially beneficial actions on the heart. First, the milking action of the leg cuffs increases the blood flow to the coronary arteries. (The coronary arteries, unlike other arteries in the body, receive their blood flow after each heartbeat instead of during each heartbeat. EECP, effectively, “pumps” blood into the coronary arteries.) Second, by its deflating action just as the heart begins to beat, EECP creates something like a sudden vacuum in the arteries, which reduces the work of the heart muscle in pumping blood into the arteries. Both of these actions have long been known to reduce cardiac ischemia (the lack of oxygen to the heart muscle) in patients with coronary artery disease. Indeed, an invasive procedure that does the same thing, intra-aortic counterpulsation (IACP, in which a balloon-tipped catheter is positioned in the aorta, which then inflates and deflates in time with the heartbeat), has been in widespread use in intensive care units for decades, and its effectiveness in stabilizing extremely unstable patients is well known.
While a primitive form of external counterpulsation has also been around for a long time, it has not been very effective until recently. Thanks to new computer technology that allows the perfect timing of the inflation and deflation of the cuffs, and produces the milking action, modern EECP has been greatly enhanced.
EECP is administered as a series of outpatient treatments. Patients receive 5 one-hour sessions per week, for 7 weeks (for a total of 35 sessions). The 35 one-hour sessions are aimed at provoking long lasting beneficial changes in the circulatory system.
How effective is it?
EECP now appears to be quite effective in treating chronic stable angina. A randomized trial with EECP, published in the Journal of the American College of Cardiologyin 1999, showed that EECP significantly improved both the symptoms of angina (a subjective measurement) and exercise tolerance (a more objective measurement) in patients with coronary artery disease. EECP also significantly improved “quality of life” measures, as compared to placebo therapy.
More recent data show that this improvement in symptoms following a course of EECP seems to persist for up to five years.
Furthermore, there is also preliminary data suggesting that EECP may be useful for treating unstable angina, as adjunctive therapy after revascularization (i.e., with angioplasty, stent, and/or bypass surgery), and even as first-line (instead of last resort) therapy for more routine forms of angina. (Read about EECP as early therapy for angina here.)
Finally, clinical trials have suggested that EECP may be useful in improving symptoms in patients with heart failure. Read about EECP for heart failure here.
Who is likely to benefit from EECP?
Based on what is already known, EECP should be considered in anybody who still has angina despite maximal medical therapy and prior revascularization. No cardiologist could argue logically against this. And, frankly, if a patient insisted on trying EECP prior to agreeing to purely elective revascularization for chronic stable angina, the cardiologist might not like it, but would be hard pressed to give anything beyond a purely emotional reason as to why this should not be tried.
Why does EECP work?
The mechanism for the sustained benefits seen with EECP still amount to speculation. Everyone can agree that there are good reasons for EECP (just as for IACP) to benefit the heart while the therapy is actually taking place. But as to why the benefit of EECP persists even after the therapy is finished, no one can say for sure.
There are preliminary data suggesting that EECP can help induce the formation of collateral vessels in the coronary artery tree, by stimulating the release of nitric oxide and other growth factors in within the coronary arteries. There is also evidence that EECP may act as a form of “passive” exercise, leading to the same sorts of persistent beneficial changes in the autonomic nervous system that are seen with real exercise.
Can EECP be harmful?
EECP can be somewhat uncomfortable (it is said to be more difficult to watch – what with the patient being noticeably jostled due to the milking action of the inflatable leg cuffs – than it is to actually have it done), but is not painful. In fact, it is apparently very well tolerated by the large majority of patients.
But not everyone can have it. People probably should not have EECP if they have certain types of valvular heart disease (especially aortic insufficiency), or if they have had a recent cardiac catheterization, an irregular heart rhythm, severe hypertension, significant blockages in the leg arteries, or a history of deep venous thrombosis (blood clots in the legs). For anyone else, however, the procedure appears to be quite safe.
Despite its increasingly apparent potential usefulness, EECP is hardly taking the cardiology world by storm. In fact, it seems that for most cardiologists EECP is not even on the list of potential treatments for coronary artery disease. Why is that?
There are several possible reasons. Let us dispense with the most obvious first, namely, that EECP doesn’t pay well. A series of 35 treatments costs $5000 to $6000 dollars. That’s not chicken feed, but keep in mind that we’re talking about 35 hours of therapy over 7 weeks, which involves not only the doctor’s time but also the time of office staff, nursing personnel, etc., etc. Still not a terrible return, but when you consider that a cardiologist can often bill that much by spending a morning in the cath lab, well - - -.
Then there’s the fact that EECP remains somewhat intellectually unsatisfying. To your average cardiologist, there’s no reason at all that anyone should have thought it would work in the first place – that temporarily providing counterpulsation would have lasting effects. And the fact that it apparently does work is merely blind luck, and leaves investigators scrambling ridiculously to explain why it does. This is a less than satisfying way to advance science.
In addition, to most cardiologists, EECP is logistically difficult. To accommodate patients for EECP, they would not only have to purchase expensive equipment, but also would have to radically change the organization of their offices, their office staff, and their space.
Finally, and most importantly, EECP has nothing in common with what cardiologists do. Cardiologists study and treat the heart, for goodness sake. They stress it, image it, measure it, pace it, shock it, stent it, ablate it, revascularize it, and bathe it in drugs. What they do takes years of specialized training and expertise, millions of dollars of high-tech equipment, and tremendous manual dexterity, and it brings them significant prestige, even within the medical community.
Now they’re supposed to drop all that? In order to attach fancy balloons to peoples’ legs, throw a switch, watch them bounce around for an hour, then say, “See you tomorrow?” That’s not cardiology. That’s glorified physical therapy.
This, in DrRich’s estimation, is the real reason the average cardiologist is completely ignoring EECP, as if it doesn’t even exist. They simply can’t believe anyone really expects them to do this.
In any case, you may need to raise your cardiologist’s consciousness. If you have coronary artery disease that has proved difficult to treat, then you need to bring EECP up yourself.
Once enough patients show themselves to be aware of this new therapy and to be expecting it, suddenly EECP will no longer be beneath cardiologists, and they’ll eagerly find a way to incorporate it into their practices.
How can you receive EECP?
If you are a candidate for EECP and wish to pursue it, start with your doctor. If your doctor discourages you from pursuing EECP, make sure he/she gives you a good reason for discouraging it. Good reasons would include: you don’t have the sort of coronary artery disease or angina that would benefit from EECP; your coronary artery disease is of the type that requires revascularization; or you have one of the contraindications (listed above) for having EECP. (Good reasons would not include: it’s unproven; it doesn’t work; it’s voodoo; or I’ve never heard of it.)
There are fewer than 200 places today performing EECP, though the number is growing rapidly. If your doctor can’t think of a place to refer you for EECP, go online. The best place to start online would be EECP.com. This is a website run by Vasomedical, Inc., the company that makes the equipment for EECP, so it is not unbiased. But it does offer an excellent means of finding a place where you can get EECP in your area.
Your insurance carrier should cover EECP, though these fine humanitarians might well deny coverage initially. Medicare has approved EECP for reimbursement, and once Medicare approves a new treatment, insurance companies normally fall in line quite quickly. In the case of EECP, however, many insurance companies are still balking at paying, perhaps because their cardiology consultants are telling them it’s not really a serious therapy. Don’t let this discourage you. If you are turned down for reimbursement, appeal the decision. Most insurance companies count on patients failing to appeal (which is why they so frequently deny therapy that is obviously needed), and with Medicare supporting your contention that EECP ought to be covered, odds are that if you appeal you’ll win.
More than 100 articles and studies on EECP have been published in leading cardiology journals, all supporting the treatment's safety and effectiveness. We hope you find this sampling helpful, and we will continue to update this section as often as possible.
• Predictors of benefit in angina patients one year after completing enhanced external counterpulsation: initial responders to treatment versus nonresponders.
Lawson WE, Hui JC, Kennard ED, Barsness G, Kelsey SF; IEPR investigators.
Cardiology. 2005;103(4):201-6. Epub 2005 Apr 13.
• An update on enhanced external counterpulsation.
Shea ML, Conti CR, Arora RR.
Clinical Cardiology. 2005 Mar;28(3):115-8. Review.
• Enhanced external counterpulsation: a new technique to augment renal function in liver cirrhosis.
Werner D, Tragner P, Wawer A, Porst H, Daniel WG, Gross P.
Nephrology, Dialysis, Transplantation. 2005 May;20(5):920-6. Epub 2005 Mar 23.
• Enhanced External Counterpulsation.
Brosche TA, Middleton SK, Boogaard RG.
Dimensions of Critical Care Nursing. 2005 September/October;23(5):208-214.
• Enhanced external counter pulsation (EECP) as a novel treatment for restless legs syndrome (RLS): a preliminary test of the vascular neurologic hypothesis for RLS.
Rajaram SS, Shanahan J, Ash C, Walters AS, Weisfogel G.
Sleep Medicine. 2005 Mar;6(2):101-6. Epub 2005 Jan 24.
• Angina patients with diastolic versus systolic heart failure demonstrate comparable immediate and one-year benefit from enhanced external counterpulsation.
Lawson WE, Silver MA, Hui JC, Kennard ED, Kelsey SF.
Journal of Cardiac Failure. 2005 Feb;11(1):61-6.
• Frequency and efficacy of repeat enhanced external counterpulsation for stable angina pectoris (from the International EECP Patient Registry).
Michaels AD, Barsness GW, Soran O, Kelsey SF, Kennard ED, Hui JC, Lawson WE; International EECP Patient Registry Investigators.
American Journal of Cardiology. 2005 Feb 1;95(3):394-7.
• Effects of enhanced external counterpulsation on hemodynamics and its mechanism.
Taguchi I, Ogawa K, Kanaya T, Matsuda R, Kuga H, Nakatsugawa M.
Circulation Journal. 2004 Nov;68(11):1030-4.
• Effectiveness of enhanced external counterpulsation in patients with left main disease and angina.
Lawson WE, Hui JC, Barsness GW, Kennard ED, Kelsey SF; IEPR Investigators.
Clinical Cardiology. 2004 Aug;27(8):459-63.
• Accelerated reperfusion of poorly perfused retinal areas in central retinal artery occlusion and branch retinal artery occlusion after a short treatment with enhanced external counterpulsation.
Werner D, Michalk F, Harazny J, Hugo C, Daniel WG, Michelson G.
Retina. 2004 Aug;24(4):541-7.
• Enhanced external counterpulsation improves skin oxygenation and perfusion.
Hilz MJ, Werner D, Marthol H, Flachskampf FA, Daniel WG.
European Journal of Clinical Investigations. 2004 Jun;34(6):385-91.
• Successful treatment of symptomatic coronary endothelial dysfunction with enhanced external counterpulsation.
Bonetti PO, Gadasalli SN, Lerman A, Barsness GW.
Mayo Clinic Proceedings. 2004 May;79(5):690-2.
• Two-year outcomes after enhanced external counterpulsation for stable angina pectoris (from the International EECP Patient Registry [IEPR]).
Michaels AD, Linnemeier G, Soran O, Kelsey SF, Kennard ED.
American Journal of Cardiology. 2004 Feb 15;93(4):461-4.
• A New Treatment Modality in Heart Failure Enhanced External Counterpulsation (EECP)
Soran O.
Cardiology in Review. 2004 Jan-Feb;12(1):15-20.
• Enhanced External Counterpulsation as Initial Revascularization Treatment for Angina Refractory to Medical Therapy
Fitzgerald CP, Lawson WE, Hui JC, Kennard ED; IEPR Investigators.
Cardiology. 2003;100(3):129-35.
• Enhanced External Counterpulsation and Functional Improvement in Octogenarians with Symptomatic Ischemic Heart Disease
Braverman D, Wechsler B.
Archives of Physical Medicine and Rehabilitation. 2003 Sept;84(9):A10.
• Enhanced External Counterpulsation in the Management of Angina in the Elderly
Linnemeier G, Michaels AD, Soran O, Kennard ED; International EECP Registry (IEPR) Investigators.
American Journal of Geriatric Cardiology. 2003 Mar-Apr;12(2):90-6.
• Ongoing and Planned Studies of Enhanced External Counterpulsation
Conti CR.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II26-28.
• Treatment Options for Angina Pectoris and the Future Role of Enhanced External Counterpulsation
Holmes DR Jr.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II22-25.
• Current Use of Enhanced External Counterpulsation and Patient Selection
Lawson WE.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II16-21.
• Enhanced External Counterpulsation: Mechanism of Action
Feldman AM.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II11-15.
• A Review of Enhanced External Counterpulsation Clinical Trials
Beller GA.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II6-10.
• A Historical Overview of Enhanced External Counterpulsation
DeMaria AN.
Clinical Cardiology. 2002 Dec;25(12 Suppl 2):II3-5.
• Enhanced External Counterpulsation as Treatment for Chronic Angina in Patients with Left Ventricular Dysfunction: A Report from the International EECP Patient Registry (IEPR)
Soran O, Kennard ED, Kelsey SF, Holubkov R, Strobeck J, Feldman AM.
Congestive Heart Failure. 2002 Nov-Dec;8(6):297-302.
• Left Ventricular Systolic Unloading and Augmentation of Intracoronary Pressure and Doppler Flow During Enhanced External Counterpulsation
Michaels AD, Accad M, Ports TA, Grossman W.
Circulation. 2002 Sep 3;106(10):1237-1242.
• Enhanced External Counterpulsation in Patients with Heart Failure: A Multicenter Feasibility Study
Soran O, Fleishman B, Demarco T, Grossman W, Schneider VM, Manzo K, de Lame PA, Feldman AM.
Congestive Heart Failure. 2002 Jul-Aug;8(4)204-8, 227.
• Relation of the Pattern of Diastolic Augmentation During a Course of Enhanced External Counterpulsation (EECP) to Clinical Benefit [from the International EECP Patient Registry (IEPR)]
Lakshmi MV, Kennard ED, Kelsey SF, Holubkov R, Michaels AD.
American Journal of Cardiology. 2002 Jun 1;89(11):1303-1305.
• Comparison of Patients Undergoing Enhanced External Counterpulsation and Percutaneous Coronary Intervention for Stable Angina Pectoris
Holubkov R, Kennard ED, Foris JM, Kelsey SF, Soran O, Williams DO, Holmes Jr. DR.
The American Journal of Cardiology. 2002 May 15;89:1182-1186.
• Effects of Enhanced External Counterpulsation on Stress Radionuclide Coronary Perfusion and Exercise Capacity in Chronic Stable Angina Pectoris
Stys TP, Lawson WE, Hui JCK, Fleishman B, Manzo K, Strobeck JE, Tartaglia J, Ramasamy S, Suwita R, Zheng ZS, Liang H, Werner D.
The American Journal of Cardiology. 2002 Apr 1;89(7):822-824.
• Effects of Enhanced External Counterpulsation on Health-Related Quality of Life Continue 12 Months After Treatment: A Substudy of the Multicenter Study of Enhanced External Counterpulsation
Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto R, Ferrans CE, Keller S.
Journal of Investigative Medicine. 2002 Jan;50(1):25-32.
• Acute and Chronic Hemodynamic Effects of Enhanced External Counterpulsation in Patients with Angina Pectoris
Arora RR, Carlucci ML, Malone AM, Baron NV.
Journal of Investigative Medicine. 2001 Nov;49(6):500-504.
• Acute Hemodynamic Effects and Angina Improvement with Enhanced External Counterpulsation
Stys T, Lawson WE, Hui JCK, Lang G, Liuzzo J, Cohn PF.
Angiology. 2001 Oct;52(10):653-658.
• A Report from the International Enhanced External Counterpulsation Registry (IEPR)
Holubkov R, Kennard E, Kelsey S, Soran O.
Advances in Coronary Artery Diseases-4th International Congress on Coronary Artery Disease. 2001 Oct 21-24;(Prague, Czech Republic):387-391.
• Benefit and Safety of Enhanced External Counterpulsation in Treating Coronary Artery Disease Patients with a History of Congestive Heart Failure
Lawson WE, Kennard ED, Holubkov R, Kelsey SF, Strobeck JE, Soran O, Feldman AM.
Cardiology. 2001;96(2):78-84.
• Enhanced External Counterpulsation Improved Myocardial Perfusion and Coronary Flow Reserve in Patients with Chronic Stable Angina; Evaluation by 13N-Ammonia Positron Emission Tomography
Masuda D, Nohara R, Hirai T, Kataoka K, Chen LG, Hosokawa R, Inubushi M, Tadamura E, Fujita M, Sasayama S.
European Heart Journal. 2001 Aug;22(16):1451-1458.
• Safety and Effectiveness of Enhanced External Counterpulsation in Improving Angioplasty Restenosis
Stys TP, Lawson WE, Hui JCK, Tartaglia JJ, Subramanian R, Du ZM, Zhang MQ.
Proceedings of the 2nd International Congress on Heart Disease – New Trends in Research, Diagnosis and Treatment (International Academy of Cardiology).. 2001 Jul 21-24;(Washington DC, USA):369-372.
• Psychosocial Effects of Enhanced External Counterpulsation in the Angina Patient: A Second Study
Springer S, Fife A, Lawson W, Hui JCK, Jandorf L, Cohn PF, Fricchione G.
Psychosomatics. 2001 Mar-Apr;42(2):124-132.
• Enhanced External Counterpulsation Improves Exercise Tolerance, Reduces Exercise-Induced Myocardial Ischemia and Improves Left Ventricular Diastolic Filling in Patients with Coronary Artery Disease
Urano H, Ikeda H, Ueno T, Matsumoto T, Murohara T, Imaizumi T.
Journal of the American College of Cardiology. 2001 Jan;37(1):93-99.
• Comparison of Hemodynamic Effects of Enhanced External Counterpulsation and Intra-Aortic Balloon Pumping in Patients with Acute Myocardial Infarction
Taguchi I, Ogawa K, Oida A, Abe S, Kaneko N, Sakio H.
The American Journal of Cardiology. 2000 Nov 15;86(10):1139-1141.
• Treatment Benefit in the Enhanced External Counterpulsation Consortium
Lawson WE, Hui JCK, Lang G.
Cardiology. 2000;94(1):31-35.
• Noninvasive Revascularization by Enhanced External Counterpulsation: A Case Study and Literature Review
Singh M, Holmes Jr. DR, Tajik AJ, Barsness GW.
Mayo Clinic Proceedings. 2000 Sep;75(9):961-965.
• Long-Term Prognosis of Patients with Angina Treated with Enhanced External Counterpulsation: Five-Year Follow-Up Study
Lawson WE, Hui JCK, Cohn PF.
Clinical Cardiology. 2000 Apr;23(4):254-258.
• Pneumatic External Counterpulsation: A New Noninvasive Method to Improve Organ Perfusion
Werner D, Schneider M, Weise M, Nonnast-Daniel B, Daniel WG.
The American Journal of Cardiology. 1999 Oct 15;84(8):950-952.
• The Multicenter Study of Enhanced External Counterpulsation (MUST-EECP): Effect of EECP on Exercise-Induced Myocardial Ischemia and Anginal Episodes
Arora RR, Chou TM, Jain D, Fleishman B, Crawford L, McKiernan T, Nesto R.
The Journal of the American College of Cardiology. 1999 Jun;33(7):1833-1840.
• Improvement of Regional Myocardial and Coronary Blood Flow Reserve in a Patient Treated with Enhanced External Counterpulsation: Evaluation by Nitrogen-13 Ammonia PET
Masuda D, Nohara R, Inada H, Hirai T, Li-Guang C, Kanda H, Inubushi M, Tadamura E, Fujita M, Sasayama S.
Japanese Circulation Journal. 1999 May;63(5):407-411.
• Enhanced External Counterpulsation as a New Treatment Modality for Patients with Erectile Dysfunction
Froschermaier SE, Werner D, Leike S, Schneider M, Waltenberger J, Daniel WG, Wirth MP.
Urologia Internationalis. 1998;61(3):168-171.
• Prior Revascularization Increases the Effectiveness of Enhanced External Counterpulsation
Lawson WE, Hui JCK, Guo T, Burger L, Cohn PF.
Clinical Cardiology. 1998 Nov;21(11):841-844.
• Three-Year Sustained Benefit from Enhanced External Counterpulsation in Chronic Angina Pectoris
Lawson WE, Hui JCK, Zheng ZS, Oster Z, Katz JP, Diggs P, Burger L, Cohn CD, Soroff HS, Cohn PF.
The American Journal of Cardiology. 1995 Apr 15;75:840-841.