Angina patient Herb Faulkingham won’t mind having his body jolted every few seconds, like a corn kernel in a popper, for the next hour. He was here yesterday, and he’ll be back tomorrow. Faulkingham knows that the medical procedure he’s undergoing, called ECP, has the power to make him feel young again.
ECP stands for External Counter Pulsation therapy, a noninvasive medical treatment offered at Northeast Cardiology Associates (NECA) in Bangor. It’s a therapy that takes one hour a day, five days a week for seven weeks—a commitment the 74-year-old diabetic is willing to make. Faulkingham has had ECP therapy once before. He knows that, over time, the procedure will create new pathways for blood to flow around a blockage in his heart, so that once again he’ll be able to take a walk or work in his yard without feeling chest pain. “I can’t wait,” he says.
External counter pulsation therapy is not new—it’s been available for more than 15 years in the United States—but it didn’t become available in eastern Maine until a few years ago. External counter pulsation therapy was developed in China as a low-cost treatment for individuals who could not afford bypass surgery or medicines for angina. But because the equipment is expensive to buy in the United States, not many hospitals or doctors’ offices spend the money to have it as a medical option.
Angina is caused by a blockage that decreases oxygen flow to the heart and the rest of the body. ECP therapy will not remove the blockage, explains Alan Wiseman, MD, CM, FACC, who heads Northeast Cardiology’s ECP program. It will, however, create an alternative route of blood vessels for blood flow, bringing “significant relief for about 80% of the people who have the procedure."
Just before 1 p.m. every Monday through Friday, Faulkingham arrives at NECA’s cardiac care center, where he gets hooked up to a machine that, with every heartbeat pushes his blood up through his legs and into his heart.
The ECP process resembles squeezing toothpaste up from the bottom of a tube, but at split-second speed. By the end of the procedure, and hundreds of jolts off the bed later, Faulkingham’s face is flushed and his body feels warm. But his smile remains fixed.
“Beautiful,” he says.
Eighteen years ago, Faulkingham underwent bypass surgery for angina, and that worked remarkably well through the years, but a later diagnosis of diabetes presented a setback. Less than two years ago, another blockage surfaced and Faulkingham’s doctor put him on medication and suggested ECP therapy. Faulkingham was scared at first, but grew to love it.
External counter pulsation therapy typically is recommended by cardiologists like Wiseman when medicines, angioplasty, or bypass surgery haven’t curbed the angina—primarily people who have advanced disease or elderly individuals who cannot tolerate another surgery. The procedure takes a lot of energy, both physical and emotional, and it can seem like a daunting task to people who already are struggling with chest pressure just when taking a walk.
“It’s a big commitment,” Wiseman says. “But most of these patients are quite disabled by their conditions so they’re desperate for relief.”
For Faulkingham, receiving his 35 treatments over seven weeks means pulling a trailer from his Jonesport home to a camp in Clifton each Sunday afternoon, a trek he calls his “journey to better health.” He lives in the trailer during the week so he doesn’t have to drive as far for his daily procedure. It takes several weeks before patients start noticing significant improvement.
Basically, the procedure is painless, says Wiseman, and the side effects may include increased body warmth or a flushed face. The jolting action eventually becomes unnoticeable. ECP patients are known to read books, sleep, watch movies, and chat with medical assistants during the hour-long procedure.
For Wiseman, that hour with NECA’s medical personnel is in some ways as valuable as the treatment itself. “It’s a great opportunity for us to educate and motivate the patients regarding diet and exercise,” he says. “The benefits of the treatment last many years for those who make corresponding lifestyle changes.” While people like Jane Hall, a certified medical assistant who is one of Faulkingham’s aides, does her share of educating, she also does a lot of listening. “A lot of times patients come in and just talk,” she says. “It makes the hour go by a lot more quickly, and they know that what they say stays here. It’s nice. It’s nice to get to know these guys.”
Hall says she thinks Faulkingham is an “exceptional” patient. He’s been able to stop taking nitroglycerine tablets and is receiving good pressures to his heart from the ECP machine. Faulkingham likes counting down the days until the treatment is over.
“I hope to feel 16 again,” he says.


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