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  • What if I don’t live in Southern California? Can arrangements be made for me to have EECP therapy?
    Yes. We can provide out-of-town patients with a list of nearby accommodations and a free shuttle service (within a 5 mile radius of Buena Park Heart Center) to and from their EECP treatments.
  • How can a treatment used for heart patients benefit a long COVID patient with no history of heart disease?
    Although EECP was originally developed in the 1960s to treat heart conditions and is today most commonly used to treat angina, a number of studies have demonstrated the therapy’s efficacy in treating a wide variety of non-cardiac conditions, including erectile dysfunction, ischemic stroke, ischemic eye disease, hearing loss, kidney failure, restless leg syndrome, and more recently post-COVID conditions.
  • How long will it take for me to know if EECP is working?
    In the two published research studies in which EECP was employed specifically to treat long COVID symptoms, patients began noticing improvements to exercise capacity, chest discomfort, cognitive function, and general quality of life after 10-15 sessions. Some patients may notice improvements sooner, while others may require more treatments before they begin feeling better. There is no magic number; however, in general we recommend a full course of 35 EECP treatments, which may be adjusted according to each patient’s individual needs and symptomatic presentation.
  • If EECP is such an effective therapy, why haven’t I heard of it before, and why do so few medical centers use it?
    While it is true that relatively few medical centers in the United States are equipped to provide EECP to patients, globally (particularly in Asia) the therapy enjoys widespread use. In China, where preventive medicine is favored over reactive medicine, EECP is employed to stop various cardiac, pulmonary, vascular, ocular, and even dermal conditions from developing or worsening. EECP is also widely used throughout India, and is gaining popularity in Europe. The sad reality of EECP’s underutilization in the United States is that it is simply more profitable for our medical system to favor invasive procedures over outpatient treatments that do not require hospital stays and aftercare.
  • Will I be forced to participate in studies conducted at your facility?
    No. You are under no obligation to participate in studies conducted by the Clinical Research Department at BPHC. It is only with your express written consent that your data will be used in our research projects and publications. You may choose at any time to opt in or out of our clinical research.
  • Can I repeat EECP if my long COVID symptoms come back?
    Yes. Additional cycles of EECP may be ordered if a patient’s symptoms return. Some patients are so pleased with how they feel after finishing a treatment cycle that they continue with the therapy for maintenance.
  • What is EECP?
    EECP is short of Enhanced External Counterpulsation, a safe, non-invasive, outpatient treatment option most commonly used in patients suffering from ischemic heart diseases, such as angina/coronary artery disease and heart failure. EECP therapy has helped thousands of patients. In fact, clinical studies show that over 75% of patients benefit from EECP therapy and sustain improvement for up to three years post-treatment. ​EECP therapy works by increasing the blood and oxygen supply to the heart muscle and decreasing the amount of work the heart must do to pump blood to the rest of the body. While the heart is at rest, treatment cuffs inflate from the calves to the thighs to the buttocks, which increases the blood supply to the arteries feeding the heart muscle. Just before the next heartbeat, all the cuffs simultaneously deflate, decreasing the heart’s workload. The above process triggers a number of complex physiological responses in the body, including angiogenesis, improvement of endothelial function, decrease of advanced glycation end products and proinflammatory cytokines, and improvement of arterial wall shear stress. EECP also provides a "passive exercise" effect, wherein the treatment simulates the effects of light cardiovascular exercise, with no affect on the sympathetic nervous system and no increase in body temperature.
  • Why is the cost of EECP so high?
    At P-CCCOC it is not. A typical 35-session program at our closest competitor costs $9,800, or $280 per treatment. Our patients pay significantly less for significantly superior service at a state-of-the-art facility staffed exclusively with EECP experts.
  • I don’t know if I have any of the conditions that would exclude me from being able to receive EECP treatment. How do I find out if I’m a candidate?
    Before beginning EECP treatment, you will have a consultation with our Medical Director, who will assess your candidacy for EECP treatment and determine, based on your symptoms, whether you are likely to benefit from the treatment. You will receive an honest assessment based on his expertise as a cardiologist and the latest long COVID research available. You will only be prescribed EECP treatment if we truly believe it will be helpful to you.
  • How exactly does EECP work? Why would helping the heart do its job have any effect on long COVID symptoms?
    EECP’s precise mechanisms of action are not known. The effects seem to be derived not from a single mechanism of action, but through a complex system of multiple interactions throughout the body. There are three prevailing theories as to how EECP produces beneficial effects in patients across multiple systems: 1) the Central Mechanism Theory, 2) the Endothelial Shear Stress Theory, and 3) the Simulated Exercise or Improved Vascular Reactivity Theory. In Brief: The Central Mechanism Theory posits that EECP’s effects are derived from diastolic augmentation leading to the promotion of angiogenesis, or the growth of new vessels in the heart. The Endothelial Shear Stress Theory posits that the shear stress caused by the squeezing effect of EECP increases vasodilation and inhibition of atherogenesis, and is accompanied by an increase in nitric oxide (NO) levels, recruitment of endothelial growth factors, and capillary sprouting. The Simulated Exercise or Improved Vascular Reactivity Theory suggests that EECP’s benefits are the result of the treatment’s ability to produce effects in the body similar to a light cardiovascular workout. Important: It is not the effects of the above theories that are suppositional in nature—they are clinically-proven and reproducible in and out of laboratory environments. It is whether the above effects are directly responsible for the benefits patients receive from EECP treatment that is theoretical. In other words, we are not supposing that EECP improves endothelial dysfunction—this is clinically proven. We are supposing that it is that improvement that is responsible for the favorable results patients receive from EECP therapy. Important: The above theories are not mutually exclusive; on the contrary, it is likely that all three work together to produce EECP’s beneficial effects. More research into EECP’s complex mechanisms of action is needed to understand precisely how and why it works, but there is no question that it works. References: Caceres J, Atal P, Arora R, Yee D. Enhanced external counterpulsation: A unique treatment for the "No-Option" refractory angina patient. J Clin Pharm Ther. 2021 Apr;46(2):295-303. doi: 10.1111/jcpt.13330. Epub 2021 Jan 7. PMID: 33410549; PMCID: PMC7986429;
  • Why was P-CCCOC created?
    P-CCCOC was created to address a growing global problem. The COVID-19 pandemic is now more than two years into its lifecycle, and we are beginning to see a large number of COVID survivors who continue to suffer from lingering or even new COVID symptoms long after their initial infection. Because long COVID is a new phenomenon, there are no specific guidelines for treating patients suffering from the condition. Furthermore, there are over 100 symptoms associated with long COVID, making it very difficult to develop treatment protocols. Doctors must examine and treat each patient on a case-to-case basis, based on the patient’s unique combination of symptoms. This can result in patients who were healthy before becoming infected with COVID finding themselves on several different medications aimed at treating individual symptoms months or even years later. The P-CCCOC approach to long COVID treatment is different. In lieu of prescribing multiple medications to treat our patients’ symptoms, we use EECP therapy, which is proven in clinical trials to be effective in treating some long COVID symptoms, and is expected to be effective in treating several other symptoms that have not yet been tested.
  • Who can benefit from P-CCCOC?
    Patients who are experiencing persistent or new symptoms 12 weeks after COVID-19 infection are considered to have long COVID, and may benefit from treatment at P-CCCOC, depending on the nature of their symptoms. A consultation with one of our providers will be required to fully assess a patient’s candidacy for EECP treatment and determine whether the therapy is likely to benefit the patient, based on his/her symptom profile. In general, EECP therapy has potential benefits for long COVID patients complaining of any of the following symptoms: Fatigue Shortness of breath Chest pain Cognitive impairment (“Brain fog,” difficulty concentrating, etc.) Post-exertional malaise (Feeling unwell after physical activity) Headache Body aches, joint pain, swelling Dizziness and/or lightheadedness upon standing Postural orthostatic tachycardia syndrome (POTS, a collection of symptoms including the above dizziness/lightheadedness, cognitive impairment, headaches, fatigue, chest pain, shortness of breath and sometimes fainting)
  • What is P-CCCOC?
    The Post-COVID Cardiovascular Center of Orange County, or P-CCCOC (pronounced like the animal peacock), is a subsidiary of Caceres Medical Group, dedicated to treating patients who are suffering from post-COVID symptoms. The primary focus of P-CCCOC is to offer enhanced external counterpulsation (EECP) therapy as a non-pharmaceutical alternative to long COVID patients whose symptoms are typically treated with medication and/or physical therapy.
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