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Last Updated: Monday, 1 December, 2003, 01:00 GMT
'They wash the cholesterol out of my blood'
Stephanie White
Stephanie has the cholesterol washed from her blood
As part of a series of articles BBC News Online reporter Jane Elliott looks behind the scenes of the NHS.

This week we focus on the story of how cholesterol washing is helping to prevent premature deaths.

Two years ago Stephanie White feared she was dying.

Her arteries were clogging up and her heart was unable to cope.

She suffered from angina and needed two angioplasties and a heart by-pass.

In an angioplasty surgeons insert a small balloon into an artery which has become partially blocked and narrowed, restricting vital blood flow to the heart muscle to unblock it.

But doctors knew the root cause of Stephanie's problem was her high cholesterol.

Treatment

An increase in cholesterol and fatty substances inside blood vessels can lead to blockages. This, in turn, can trigger a heart attack or a stroke.

Many cholesterol problems can be solved by an improved diet, but this was not the case with Stephanie, who had a genetic predisposition towards it, which no amount of dieting could solve.

I know that if I had not had it, it would have been just a matter of time before I had a heart attack
Stephanie White

Without treatment Stephanie would probably have suffered further heart problems and could have died prematurely.

But she was one of the lucky few to be accepted for the LDL APHERESIS treatment.

Once a fortnight nurses at Harefield Hospital, in Middlesex, wash the cholesterol from Stephanie's blood with a machine similar to a dialysis machine. The blood is then put back.

But the treatment is expensive, costing 1,000 a time and so far it is limited to just 24 people in the UK and carried out at just five centres, including the Royal Brompton and Harefield NHS Trust, which specialises in cardiac problems, such as those caused by high cholesterol.

Now after 18 months of treatment Stephanie's cholesterol levels are showing considerable improvements and her arteries are recovering.

"At its worst my cholesterol levels were 13, now they are down to five, which is the normal level for someone to have.

"The treatment is fantastic.

"When I was not having the treatment I was in a bit of a pickle. The treatment is very important to me.

Genetic

"I do eat a low fat diet. But my liver makes extra cholesterol and there is nothing I can do about it.

"But I know that I am in a fortunate position because I can get this treatment, which is very expensive and I know that if I had not had it, it would have been just a matter of time before I had a heart attack."

Stephanie's father also had familial high cholesterol, but so far it seems as if Stephanie's two daughters have escaped the genetic problem.

Stephanie had originally been told she would need the treatment for the rest of her life, but she has responded so well medics are going to try stopping it.

Cardiology Nurse Consultant Alison Pottle who runs the LDL APHERESIS said the service was a life long treatment.

"They need it for life. With most people you can get them to change their diet, but these cases are out of the ordinary.

Therapy

"And their treatment can take anything up to three hours.

"It is a labour intensive treatment, but has shown good results."

Ms Pottle, one of only 25 cardiac nurse consultants in the UK, said that the treatment did not have any major side effects, but that patients often felt tired after a day's therapy

But she stressed that without the treatment many of the patients were looking at a premature death.

"If they don't have this treatment there is a chance they will die prematurely.

"The most severe cases of the disease die in their teens or early 20's before it has been diagnosed.

"Our patients do say they are lucky because they have been offered this chance."



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