Angina therapy renews life of Springfield man.

Byline: Tim Christie The Register-Guard

Last year, Joe B. Long of Cedar Flat was having a rough time of it.

A lifetime of hard work - which included lugging rocks from all over the West back to his barn east of Springfield - had left him at age 87 with two artificial knees and a fused back, but that's not what was slowing him down. Rather, plugged-up blood vessels were causing him severe chest pain and shortness of breath.

"I was taking pills to get dressed," he said.

But not even a steady dose of nitroglycerin pills was enough to keep his angina in check: He wound up in the hospital four times, which brought him finally to Dr. Jay Chappell, a Eugene cardiologist.

Chappell told Long his arteries and veins were so clogged, he wouldn't dare recommend bypass surgery or angioplasty. But Chappell had another idea: enhanced external counterpulsation therapy, or EECP.

Every weekday for seven weeks, Long showed up at Oregon Cardiology, where nurses would strap inflatable cuffs, like the kind used to check blood pressure, around his calves, thighs and buttocks. For an hour, he would lie in bed, maybe watch television, while the cuffs inflated and deflated rapidly in sync with his heart and generated a wave of pressure through his arteries.

Today, Long is about as spry and active as an 88-year-old man can be. He spends most of his waking hours each day outdoors, working his 2 1/4-acre farm east of Springfield, where he keeps an immaculate garden with roses, dahlias and a wide assortment of vegetables.

"I'm able to do things now I was never able to do before," he said. "It did wonders for me."

EECP has emerged in recent years as an effective, non-invasive treatment for patients with chronic angina, a painful symptom of coronary heart disease that occurs when vessels that carry blood to the heart become narrowed and blocked by deposits of calcified fatty deposits. Coronary heart disease is the leading cause of death in the United States.

EECP helps patients who have already had bypass surgery or stents to open clogged arteries, but are still afflicted with angina.

The treatment was first studied in the 1950s as a way to help patients suffering heart attacks, but the procedure fell by the wayside, at least in the United States, when more invasive procedures such as stents, angioplasty and open-heart bypass surgery came to the fore in 1970s, said Becky Bellingham, the nurse coordinator of Oregon Cardiology's EECP program.

Chinese doctors and researchers, however, refined the treatment and discovered that it helped patients with chronic angina, Chappell said.

Western researchers got interested and began conducting their own studies, which confirmed EECP's effectiveness in helping angina patients. A 1999 study in the Journal of the American College of Cardiology split 139 patients into two groups: One received standard EECP therapy, and the control group received a similar treatment, but the pressure of the device was not strong enough to affect blood flow.

After 35 hours of treatment, the patients who received EECP had fewer episodes of angina, were able to exercise longer and required less nitroglycerin than patients in the control group.

Evidence like that persuaded Chappell, who said he was "more skeptical than most" about EECP, that the treatment could help his angina patients. Oregon Cardiology started offering the treatment in June 2002, and now are fully booked with a three-month waiting list.

Patients undergoing EECP wear a kind of pressure suit around their legs connected to a computer. At the moment the heart relaxes, the suit rapidly and briefly inflates, causing a significant increase in the return of oxygen-rich blood to the heart. With each inflation, the device reduces the immediate workload of the heart and helps increase its pumping efficiency.

Chappell said EECP works through at least two widely accepted mechanisms. First, it helps develop and grow collateral arteries, which are new pathways for blood that the body creates to get around blocked or clogged arteries.

Second, it stimulates the release of hormone-like substances that improves the health of the delicate linings on the inside of the blood vessels, called endothelium, which are critical to coronary health.

Other factors may be at play as well, he said. One is that patients get intensive, daily meetings with health professionals who talk to them about some aspect of their health. The patients who have had the most success with EECP are the ones who stay active after the treatment, he said.

Of the 100 patients Oregon Cardiology has treated with EECP since 2002, only five have had to come back for a second round of treatment.

Joe Long had the treatment just over a year ago and hasn't looked back.

His wife of 62 years died three years ago, so he does his best to keep himself occupied. He's up at 6 a.m. most days and out in his garden, his favorite crooked straw cowboy hat on his head and cordless phone on his hip.

If he's not in his garden, he's in one of his workshops, fixing or making something, or maybe in the barn he built when he was 18. Or maybe he's in the kitchen, baking a casserole or a pie with the King apples he grows.

"I make a rhubarb Betty that's out of this world," he said.

Sometimes he's taking a rest in the shade of the 110-foot black walnut tree he planted as a boy. But not for long.

Long worked as a logger as young man until he carried too many of his co-workers out of the woods.

Then with his parents, he ran Long's Grocery, Fountain and Lunch in Cedar Flat. For most of his working life, he was maintenance engineer for Medo-Land Creamery.

When he wasn't working, he roamed the West, looking for agates, thundereggs and chunks of petrified wood. He once spent four days excavating a 1,700-pound piece of petrified wood from Eastern Oregon.

His barn is stockpiled with bins and boxes full of rocks. Inside his house, in a corner of his living room, is a museum-like space exhibiting the countless stones he's cut and polished. Against another wall is his collection of more than 500 oil cans. Against another is a grandfather clock and a secretary he built with English walnut.

He's never lost that drive to fix and create.

"I've worked hard all my life. If I don't have this place to take care of, I go crazy," he said. "I have to be busy."

CAPTION(S):

Because of Joe B. Long's angina, his doctor recommended enhanced external counterpulsation therapy, which Long says has done wonders. Joe B. Long underwent EECP therapy at Oregon Cardiology, where nurses strapped inflatable cuffs at various points along his lower body. Patients in the program also attend meetings with health professionals who talk to them about some aspect of their health. Oregon Cardiology