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A Controversial Way to Bypass Coronary Surgery : Chelation has been the subject of heated argument among doctors since the 1950s. Results of clinical trials are due in 1992.


Richard Trillwood had no idea he was a "walking time bomb" that hot August day last year when he took his dog, Cleo, a rambunctious Dalmatian, out for a walk.

That's when the chest pains started. They weren't sharp or sudden, "more like how you'd feel if you'd been breathing some toxic, unpleasant fumes," recalls the 54-year-old Santa Ana resident. And in fact, he first thought that the heavy smog that day might be causing his problem. But when the pain only got worse after he went inside to rest, Trillwood's wife, Pat, hurried him to the doctor.

Before he knew it, Trillwood was in a hospital, where a cardiologist and cardiac surgeon diagnosed the pain as angina pectoris. After an angiogram, in which the doctors injected dye into his coronary arteries and monitored the flow with X-ray equipment, they told him he needed immediate coronary bypass surgery because of a severe blockage in one of the arteries that supply oxygen to the heart muscle.

But Trillwood balked.

Against both doctors' advice, he asked that his heart monitor and IV be disconnected, and he checked out of the hospital to seek a second opinion. The pain was so bad, he remembers, that he had to stop and rest several times between the parking lot and the office. But today, after undergoing a controversial non-surgical treatment called chelation, he can do all the walking he wants, whether it's keeping up with the dog or undergoing a treadmill test, without any further symptoms.

In chelation, the chemical compound ethylene diamine tetra acetate, commonly known as EDTA, is introduced into the patient's bloodstream intravenously over several hours. The word chelate means to clamp onto, and in cases of lead, mercury or other heavy metal poisoning, the compound binds with the toxic metal and both are then excreted through the urine.

Chelation therapy has been the subject of heated argument among doctors since the 1950s, when it was first used to remove toxic levels of lead from the bloodstreams of people who had inhaled toxic fumes while painting battleships during World War II. Some of those patients also had angina and leg pains caused by atherosclerosis and resulting poor circulation, and doctors were surprised to find that in many cases, those symptoms were alleviated by chelation treatment.

Although they weren't sure how it worked, the doctors speculated that the EDTA attached itself to calcium and other components of the fatty atherosclerotic plaque responsible for clogging arteries.

Ever since, doctors have been debating over whether the treatment should be used for heart disease patients in general. After more than three decades of discussion, the U.S. Food and Drug Adminstration decided two years ago to allow double-blind controlled clinical trials at Walter Reed and Letterman Army hospitals in Washington, D.C., and San Francisco. Results of those trials are due in 1992, according to a report by the Pennsylvania-based People's Medical Society.

But some physicians, such as Dr. Julian Whitaker of the Whitaker Wellness Center in Newport Beach, are already convinced of the value of chelation based on a plethora of earlier studies.

Trillwood had never heard of Whitaker before his chest pains started, but while he was waiting for a diagnosis, his wife went out to the local bookstore and returned to the hospital with an armload of books, including Whitaker's "Reversing Heart Disease," published by Warner Books.

By the time his doctors recommended surgery, Trillwood had already decided to seek Whitaker's opinion.

"I wondered where in the United States I'd have to travel for a consultation," Trillwood says, "and then I looked on the back of the book and saw that he was right here in Orange County."

Whitaker, a longtime proponent of non-surgical alternatives to bypass surgery and other invasive forms of treating heart disease, was himself reluctant to use chelation therapy until about two years ago.

"I knew about EDTA. I knew there were doctors promoting it," Whitaker says. "But I was afraid to find out that it worked, because if I did I might be wanting to use it, and I'd have to face the consequences."

Although any licensed physician may treat patients with EDTA chelation therapy, many of those who do so are subjected to investigations and other problems.

"By using EDTA, I'm risking all kinds of censure and criticism by my colleagues," Whitaker says. "But the studies that were published in the 1980s convinced me that it was not only effective but very effective, and I decided it was worth the risk."

The therapy may be risky for doctors, but hardly so for patients. In the 1950s, two patients died after being treated with high levels of EDTA. But since then, the dosage has been reduced and no further deaths have been reported. By comparison, coronary bypass surgery has about a 7% death rate in California hospitals.

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