[Note: The first half of this message, inlcuding our comments, was originally
posted on another group, which I asked Jessie to repost here. --Paul]

Wes had been having severe pain around his hiatus hernia for the last few days.
On 11 August, after dialysis, his systolic blood pressure refused to go above
80. The level of BP was not as low as a similar occurrence late last year, but
the dialysis nurse in charge sent Wes by ambulance to Emergency at Geelong
Hospital. After about four hours, his blood pressure returned to normal and the
Emergency staff said he could go home. They rang Wes's renal specialist, who
said 'No." He wanted Wes admitted to have an angiogram, because blood tests
showed the heart muscle had been damaged. Also a gastroscopy to investigate
whether a gastric ulcer of many years ago had recurred. He stated that Wes had
angina, although an anginine tablet placed under Wes's tongue did not do
anything for the pain. To me this suggests the pain was not an angina pain.

Wes was agreeable to the gastroscopy, but not the angiogram. This damned renal
specialist had me telephone him so that he could tell me to persuade Wes to have
the angiogram, which I was not going to do. In the meantime, however. Wes had
decided maybe he ought to have the angiogram. The pain completely disappeared
yesterdayl

The renal specialist sent a cardiologist to Wes's hospital bed to tell him about
the angiogram. I had been reading about a CT angiogram which sounds safer, but
apparently this is not possible for renal patients and is not available in
Geelong anyway. The cardiologist stated that he had been doing this procedure
for 15 years and in that time had had only two mishaps, a stroke and a heart
attack. He did not say whether the patients survived. He wanted to have Wes
dialyze after the procedure to get rid of the dye, which is apparently toxic.
In the morning it was decided the two procedures one after the other would
impose too much strain on the heart, so Wes did dialysis today wearing a heart
monitor.

The gastric specialist would not do a gastroscopy, simply ordering Wes to take
Omeprazole, which he had had when he had an ulcer.

I worried that the dye may cause damage if left in the body until being dialyzed
the next day. I gather from what doctors have said that Wes may have some
narrowing of the arteries. It is his decision of course, but I wondered whether
increasing his dose of ALT-711 and other things for the arteries, such as Peak
ATP & GlycoCarn and/or Pomegranate, may be the safer way to go. I am certainly
not expecting you to make a medical decision, just an opinion that might help us
put things in perspective.tinuing the story.

[Jessie, I don't know what to say. There are many things that are beneficial for
arteries, most of which are listed in the LEF protocols and I expect that you
are aware of them.
(http://www.lef.org/protocols/heart_circulatory/coronary_artery_disease_atherosc\
lerosis_01.htm is the primary one.) I do not think that increasing any of the
supplements that you mention above would accutely help this situation, nor
likely also help in the longer run, particularly if Wes is already taking a
reasonable dosage of them. As I have said a number of times (years ago), the
most important thing for Wes to do would be to eat a much healthier diet and to
exercise regularly. --Paul]

[Jes, I know that you have not had an easy time caring for Wes, especially
regarding his diet. We have had group discussions on the subject of his
nutritional intake for almost 4 years (and a bit longer privately). But Wes has
to take responsibility for the consequences of not making the changes that we
have recommended - and likely many of those by dieticians that have talked with
him over the years.

You also cannot *make* Wes exercise - even if his sight and hearing are limited
- if he does not want to do it. We had this discussion almost 4 years ago also
here at [the group where this originated], when you mentioned how his 91 year
old mother was extremely physically active and that despite her diet that
included numerous fatty favorites she did not have diabetes, which had been or
was present in other family members besides Wes.

All you can do, Jes, is provide Wes with information, transportation, caring and
encouragement. You can also provide examples by preparing and eating the kind of
diet and doing exercise (combined with activities of daily living, not
necessarily a health club) that will benefit *your* health. If Wes refuses to
eat what you prepare, what are his options other than complaining? In fact, if
he thereby needed to actually work to prepare his own food that would be good
too, since he would then be exercising! And if you choose not to purchase
certain food items, what can he do besides complain?

If Wes refuses to walk in the house or yard (working up to more ambitious
locations) with your assistance and possibly that of a walker, there is nothing
that you can do. If he refuses to strengthen his upper body with purposeful
muscle using activity there is nothing that you can do. (Remember the old saying
about the horse and water?)

This is not a pleasant situation for you I understand, but do not blame yourself
for decsions that Wes has made despite your advice and urging that he do
something that all evidence shows will be more healthy. His decisions were/are
based on what he viewed/views would/will give him more happiness - he may very
well not have looked very long range, but that is always part of the
decision-making process, whether or not consciously acknowledged. **Kitty]


[There is another view on what Jessie ought to do. Perhaps she thinks that it is
her responsibility as Wes' life partner to purchase and prepare the foods that
he likes rather than refusing to do so and, in effect, treating him like a child
rather than an adult fully responsible for his own decisions. I certainly cannot
fault this point of view, however, it once again emphasizes that Jessie should
not in any way feel responsible for what happens to Wes. From this point of view
the only alternative would be, as Kitty suggests, for Jessie to at least keep
herself healthy thereby providing an example to Wes of excellent diet and
exercise.

We keep thinking that we are through with this, but here's an "on the other
hand". If Wes were a smoker, then it would be entirely reasonable for you to
refuse to purchase tabacco products for him, since you would be refusing to be
an accomplice to his harm to himself. Therefore, by analogy you could also still
refuse to purchase and prepare the negative dietary foods that he demands, in
order to not be an accomplice in his folly. Just as with tabacco if he were a
smoker, it would then be up to him to find ways to continue to eat the diet that
he wants. Bearing the full cost (in both money and inconvenience) of this might
be sufficient to persuade him to alter to the foods which you purchase and
prepare. --Paul]


[The following message, including our comments, was a follow-up to the the one
above. --Paul]

Continuing the story. I arrived at the hospital Wedyesday morning in time to
see Wes recovering from his angiogram. A different contrast medium specially
for dialysis patients was given. Nevertheless I have started giving him NAC to
clean up any nasties.

[It would be best to give him NAC every day, since it is very beneficial. But
perhaps you meant that you now gave him extra. --Paul]


The arteries were 'fine', as was the heart. Three cheers for ALT-711. The
only thing wroing was leakage from the small blood vessels, which we knew about
anyway.

[There are a number of supplements such as quercetin, rutin and bioflavonoids
which should help prevent capilary leakage. --Paul]


The doctors believe the problem is in Wes's stomach, which has caused him
problems for many years off and on. Stronger mediction for this has been
prescribed and no gastroscopy for now at least, thank goodness.

[Perhaps a daily dose of a good probiotic, use of live culture yogurt and kefir
and use of fructooligosaccharides would help the digestive system. In addition,
zinc carnosine is now available from LEF (Carnosoothe) and many studies suggest
that it is beneficial for stomach ulcers. --Paul]


Incidentally, the cardiac doctors removed digoxin from Wes's list of
prescriptions.