Rare and Unique Cholesterol Treatment Gives Patients Hope

March 3, 2011 - PRLog -- (Naples, Florida) "Heartburn. It has to be heartburn."  Margaret Donachy of Naples repeated this mantra for more than four hours before the nausea became too intense, and she went to the emergency room. It was a heart attack.

Margaret had known for years that she had high cholesterol that had caused a buildup of plaque in her arteries, resulting in coronary artery disease. Her body had not reacted well to cholesterol medication, so she stopped taking it. She tried the medication route again after her heart attack, but no luck.

That is when Margaret’s cardiologist referred her to John Diaz, M.D., Director of Millennium Physician Group’s Cardiovascular Risk Reduction Center in Naples.

After analyzing her family and medication histories, Dr. Diaz determined the 77-year-old woman had a hereditary cholesterol disorder that made her cholesterol particularly difficult to manage. Dr. Diaz proposed a new treatment for Margaret: cholesterol apheresis.

Cholesterol apheresis is a relatively new procedure that filters the blood to remove low density lipoprotein, also called LDL or “bad” cholesterol. The Cardiovascular Risk Reduction Center is one of only 60 centers throughout the nation and the only location in Southwest Florida that offers cholesterol apheresis. The next closest facilities are in Fort Lauderdale and Tampa, Dr. Diaz says.

Less than .02 percent of patients with high cholesterol are candidates for apheresis, Dr. Diaz says. “Diet and exercise is the cornerstone of what we do here, but sometimes a person needs more than that and medication,” he says.

When managing cholesterol through diet and exercise and/or medication has failed, apheresis may be an option, he says. The treatment is considered for those patients who have LDL levels consistently higher than 200 milligrams per deciliter and have heart disease, or patients who have LDL levels higher than 300 milligrams per deciliter but do not have heart disease. A good LDL level is 100 milligrams per deciliter or less.

Cholesterol apheresis involves inserting a catheter into each of the patient’s arms, and then hooking the catheters up to a machine that functions similar to a dialysis machine. The machine withdraws the blood from the body through one catheter, and then separates the red and white blood cells from the plasma, says Joni Newman, RN, Dr. Diaz’s nurse who administers the apheresis treatment.

The plasma is filtered to remove LDL cholesterol; very low density lipoprotein, or VLDL; and lipoprotein A, or Lp(a). The blood is then returned to the body through the other catheter. “When the blood re-enters the body, it has about 80 percent less ‘bad’ cholesterol,” Dr. Diaz says.

The Cardiovascular Risk Reduction Center has a 100 percent success rate in helping their apheresis patients to meet their cholesterol goals.

Each treatment can take from three to four hours, depending on the patient, and most patients require apheresis once every two weeks, Joni says. However, some patients may require weekly treatments.

Margaret had never heard of apheresis when Dr. Diaz broached the subject. She contacted her son in Ireland to ask his opinion. He called some friends in the medical profession. Only a few of them were familiar with the treatment. “I was at the bottom of the line because no medication could help me. Taking those medications was like a battering ram on my body,” she says.

In May, Margaret decided to give apheresis a shot. “I think I’m better off for it. If I had been doing the treatments a few years ago, I probably could have avoided that heart attack,” she says.

Apheresis can lower a person’s risk of heart attack by 40 to 50 percent, Dr. Diaz says.
During treatment, Margaret often reads, watches TV or even has a snack. “I don’t feel hot or cold. It’s a pretty comfortable procedure,” she says.

“I’ve definitely noticed patients having more energy after treatment, although some do want to nap the afternoon of the procedure,” Joni also says.

One drawback to apheresis, in some patients’ eyes, is that they will have to receive the treatments for the rest of their lives to maintain lower cholesterol, Dr. Diaz says. “I have a patient who is 45 years old. He has had two heart attacks and cardiac bypass surgery. He does not want to do apheresis. It’s not for everybody,” he says.

Margaret doesn’t love the idea of treatment forever, but she says she has no regrets. Her high cholesterol led to many other health issues in addition to heart disease, such as diabetes and aches and pains throughout her legs and back. After five months of apheresis treatments, she says she can definitely notice a difference.

“I don’t ache like I used to. I had to miss a treatment a few weeks ago, and my legs and back really started to ache again,” she says. “Now that I have had my treatment, I’m starting to feel pretty good. I might go dancing, who knows?” she says, laughing.
Cholesterol apheresis is covered by most insurance plans and Medicare.

John Diaz, M.D.
Millennium Physician Group
Cardiovascular Risk Reduction Center
671 Goodlette Road N, Ste. 200
Naples, FL 34102
239-263-8222

# # #

Millennium Physician Group is one of the largest and comprehensive primary care practices in SW Florida. With offices from Englewood to Naples, our more than 50 health care providers are ready and available to care for the residents in our communities.