With the sole exception of progressive cardiovascular disease leading to the occlusion of blood vessels due to plaque deposition, your number of arteries and veins remain stable throughout your lifetime. When you finally depart this good earth, you end up leaving with the same number of these large vessels that you entered with as a child.
It is the microvasculature that does not withstand our movement through time. Theoretically, when you wake up tomorrow, your network of microscopic capillaries will be less than you took to bed with you the night before. What this means is that your ability to deliver nutrients to your cells and to take waste products away from them progressively worsens over time. This phenomenon is the explanation for all diseases of advancing age.
If we just focus on the eye alone, it becomes abundantly clear why such diseases as glaucoma and macular degeneration, with rare exception, are not found in the twenty- and thirty-year-old populations. In those unfortunate, much younger individuals that do suffer from retinal disease, it is actually their genetic predisposition which leads to accelerated disease processes in the eye.
With the exception of this small group of individuals, the eye diseases that have been mentioned are found only in individuals of advancing age, and the final escort that brings them to full expression is the loss of the microvasculature in the retina and other regions of the eye.
If this disease process is to be reversed, it will only be possible as a result of restoring the microvasculature to optimal function once again. Take all of the supplements that you want. Pursue detoxification as aggressively as humanly possible to no avail. The fact of the matter is that you will not be successful, because your transit system for delivering those nutrients and removing toxic waste is not available to carry out the task.
Once again, let the message be clear that the ravages of age and diminished blood flow can be reversed. It is possible to return your capillary network to function once again. The first measure that we will discuss that will accomplish this is a medical modality known as ECP.
ECP (external counter pulsation) was created in the 1980s and is an FDA-approved and potentially insurance-covered procedure. As potent a force as ECP is, it is very difficult to find. There are clinicians throughout the country that do offer it. Although you more than likely will not be fortunate to find it available in your backyard, you will most certainly find it in your region. We will address the availability of ECP a little further on in this section. For the moment, let’s discuss what ECP does and how it does it.
ECP is the only modality I am familiar with that can actually develop a brand-spanking-new set of blood vessels that you do not even own right now. Just think about that for a moment. Even though the devastation of time has “dried up” your microvasculature in your retina, you can get it back. You will not have to take a drug or any pharmaceutical preparation. Even though vigorous exercise is beneficial, you will not need to join a health club or obtain the services of an athletic trainer.
The oldest patient I have ever treated with ECP was ninety-four years old. He did need some assistance to get onto the device, but once in position, he did not need to twitch a single muscle to receive the full benefit of the treatment. This fact has been extremely helpful in treating an elderly population where other diseases have advanced to such an extent that ambulation is severely compromised.
What Does an ECP Treatment Consist Of?
Let me draw your attention to a photograph of an ECP device with a patient in position to initiate a treatment. As you can see, the patient is lying in a comfortable position. She has large inflatable cuffs around her extremities, one set around each of the calves, another set around each of the thighs, and an additional cuff placed around the buttocks and pelvis.
The cuffs have a similar construction to a blood-pressure cuff in that there is an inflatable bladder in each of them. When the bladder is inflated with air, the cuffs immediately constrict the legs and pelvis in a similar fashion as would occur with taking a blood pressure.
The difference is that the size of the tubing that propels the air into the cuff is not like the small rubber hose of a blood-pressure device. Instead, it is a large-caliber corrugated hose. The other big difference is that, instead of a squeezable rubber bulb to blow up the cuffs incrementally, they are filled by a very large compressor found under the bed. When the compressor fires, there is an immediate and forceful squeeze around the extremities and the pelvis.
The second component of an ECP bed is that the control panel acts as an EKG (electrocardiogram) device. Three small leads are placed on the chest, which allows the device to accurately display your own heart rhythm. At that point, the device knows where you are with each heartbeat. It knows if the heart is contracting or relaxing or anything in between.
Once the two main components of the ECP device are in place (the cuffs and the EKG), it is time to turn the switch on to have the ECP device cycle rhythmically and in synchronicity with the contraction of the heart.
During the contraction phase of the heart (systole), the cuffs are deflated. The compressor fires at the precise point in the heart cycle that the heart begins its relaxation phase (diastole). The first cuffs to fill are those that are around the calves. Fifty milliseconds later, the cuffs around the thighs are filled and constrict. Fifty milliseconds after that, the same thing occurs with the cuffs around the pelvis. When you add up all of your 50 millisecond intervals, you then determine that all of the cuffs have been filled in just over one-tenth of a second. At that point, the heart enters another contraction phase of the heart cycle, and the cuffs are deflated once again. This means that if you have a heart rate of seventy-two beats per minute, the ECP device cycles seventy-two times in synchronicity to it.
The entire treatment lasts one hour. I know that your first reaction may be that you are not sure you can tolerate an ECP treatment for an hour. Let me share with you that I understand that initial apprehension. Let me also share with you that when I peek into the ECP room in my office, what I observe in the vast majority of patients is that they are sleeping quite comfortably through the ECP treatment. My own first ECP treatment had me feeling equally concerned. All I can tell you is that within five minutes of the start of your first treatment, you will realize, as do others, that an ECP treatment is actually quite pleasurable. I swear, quite pleasurable.
What Does an ECP Treatment Do?
Now that I have fully described what you may have incorrectly perceived as the agony of an ECP treatment, let me take this time to explain what undoubtedly is the ecstasy of it. My initial statement about ECP bears remembrance. ECP is the only modality that will allow you to both create a new and, at the same time, restore a previously functioning microvasculature that has been diminished with age. It is for this reason that I encourage all of my patients to consider incorporating ECP into their treatment program no matter what their particular health challenge may be. It then only stands to reason that it should be included as part of your efforts to regain your sight.
So that I can clear up how ECP can accomplish the restoration of your microvasculature, let’s discuss the physiology of what is happening in the body during an ECP treatment.
If you recall, your legs and pelvis are being squeezed in sync with your natural heart cycle. Keep in mind that when the cuffs are inflated, that inflation occurs first in the calves, then the thighs, and then the hips. That type of squeezing order results in all your blood volume below the waist being forced above your waist at each ECP cycle. When the cuffs deflate, all the blood returns back to the lower portion of the body only to be forced above the waist at the next ECP cycle.
Greater than 50 percent of your total blood volume is found below the waist. That 50 percent is being forced above that line with every cycle of the ECP device. This volume of blood has never been seen by the arterial system in the upper part of the body before and can only be made to do so with mechanical intervention. Nevertheless, every ECP cycle is delivering that enormous volume of blood to all of the arteries and, consequently, all of the body parts above the waist, including the eye.
The first thing to mention is even though the volume of blood delivered to all these tissues is considerable, it is not harmful in any way. What needs to be appreciated is that the arteries receiving that quantity of blood have a hormonal mechanism to try to accommodate it. Even though they never will really accomplish the accommodation, they still have a mechanism available to try.
You see, blood vessels secrete a very special hormone when exposed to these large volumes of blood. The hormone is called “VEGF.” VEGF stands for vascular endothelial growth factor. That hormone is rarely, if ever, secreted by the arteries because there is never such a significant volume of blood that requires urgent accommodation. The ECP device provides that urgency. The arteries secrete the hormone VEGF, which under its influence causes new blood vessels to grow instantaneously. That is correct. You grow a brand-new set of blood vessels around every party of the body that secretes it, including the eye.
Let’s be clear. Under the influence of VEGF, you do not grow any new arteries. That number remains constant. What you do grow, and plenty of them, are those microscopic blood vessels that were referred to as the microvasculature. It is through ECP that we can begin to supply the body tissue with the nutrients that just could not get there before. You have just taken a step to undo what the passage of time has created. You can now have the three-step equation working for you to achieve what the aging process has taken away—a functioning microvasculature network.
To make the discussion of ECP more complete, we should take the time to present some additional related issues regarding ECP. The medical doctors who run ECP facilities in your area will be aware of these items, but in an attempt to make you an enlightened consumer, let me try to tackle a few of them for you.
AAA. If you qualify to do ECP, you should know that this procedure is completely safe and cannot harm you in any way. There are some contraindications to ECP. The first of these is absolute, meaning that ECP is never permitted to be done in a group of patients who have evidence of an abdominal aortic aneurism, or so-called triple A. Some individuals have a defect in their aorta, which is the largest artery in the body by which all of the arteries branch from. This aneurism is an outpouching or dilatation of the aorta with a diseased or weakened wall, which allows it to grow in size to such a degree that it actually can rupture. If that should happen, the mortality associated with such an event is greater than 95 percent, even with the immediate availability of surgical intervention.
It is a mystery to me as to why it is never routinely checked for, but in fact it is not. Any facility that offers ECP will check for it by ordering an abdominal sonogram. If a triple A is detected, ECP is contraindicated because of the potential for an abrupt rise in blood volume within it, which will cause it to grow even larger or possibly rupture. If a sonogram does not detect the presence of a triple A, you should be assured that no such event is possible. In my fifteen years of doing ECP, I have encountered four patients with a triple A. The number of patients I have assessed is now well into the thousands.
Those four patients were not permitted to do ECP. Three of the four went on to have it surgically repaired. One had his triple A monitored and never did have surgery. Remember, if you do not have a triple A, you are not going to develop one, yet each candidate who wishes to do ECP will be checked. The protocol doctors follow is clear. If there is a triple A, there can be no ECP.
Relative contraindications for ECP. The presence of a triple A is an absolute contraindication. There are a couple of relative contraindications that should also be mentioned that are much more common. Relative contraindications mean that maybe you can do ECP or maybe not.
The first of these is a condition known as aortic regurgitation, which is a leaky valve on the left side of the heart. In this anomaly, blood passing through a valve at the origination of the aorta flows backward because the valve does not fully close.
This can be visualized on an echocardiogram of the heart. It has four classifications. Grade 1 and 2 usually can do ECP and receive the full benefit from it. Grade 3 occasionally can also do ECP. Grade 4 is severe enough that ECP is contraindicated, and the patient more than likely is a candidate for valve replacement surgery.
Pleasurable experience. As I have said, ECP is a pleasurable experience. The majority of patients having an ECP treatment fall asleep. Some patients, however, have rapid heart rates due to some heart anomaly. In these situations, ECP is not pleasurable but is downright uncomfortable. Rather than listing the disorders, let’s just say that your doctor will treat you for each to have your heart rate in a safe and controlled range that will make ECP the enjoyable experience that it should be.
Referral. You need a referral to do ECP. That referral can only come from a cardiologist. They control ECP in that the insurance company will only reimburse for the procedure with the accompanying referral. It always has amazed me that so few cardiologists actually do ECP in their offices. They are far more interested in the “sexy” procedures like catheterizations and stent placement. When you do find a facility that does ECP, it will either be operated by a cardiologist or at least work closely with one. They make the final decision as to whether or not you qualify for a referral to do ECP.
Length of ECP treatment. ECP is usually done one hour a day, five days a week, for seven weeks. It has been determined through research that at around thirty-five treatments, optimization of the benefits of ECP should be achieved.
For those patients who travel a considerable distance, the ECP protocol, which is honored by insurance companies, does allow for two ECP treatments a day. The only qualification concerning the two-treatment protocol is that there must be at least one hour that separates Treatment 1 from Treatment 2. In this way, patients will be required to be at the facility for at least three hours a day in order to compress the time from seven weeks to three and a half weeks. This is greatly appreciated by someone who may travel two hours to the facility or who has come from out of town to participate in our ECP program.
Insurance coverage. ECP is not a “one-and-done” experience. The insurer will reimburse for this treatment annually as long as it is accompanied by the corresponding referral from a cardiologist. I can only deduce that the insurer feels that the benefits to a patient are so plentiful that they must feel they are receiving a good return on their investment. In that same way, they are not really happy with the big stuff.
Invasive procedures such as catheterizations, stent placement, and coronary artery bypass grafting (CABG) are not good returns on investment. The cost of them is astronomical when compared to ECP. The results are not long lasting. Stents are sometimes re-occluded in a week and need to be repeated. Bypass grafting of the coronary arteries, when done with veins harvested from the legs, have an average life expectancy of seven years.
ECP done annually can usually allow patients to avoid either of the two medical interventions. By the time one year has elapsed since your last ECP round was concluded, you would always benefit from another round of this microscopic revascularization procedure. At about the ten-month mark, if our patients have not already contacted us for their annual cardiovascular workup, we call them. In that way, they never really are able to creep back into poor levels of perfusion to any body part, including the eye.