IGX "...overflowing with foulmouthed ignorance."

IGX "...overflowing with foulmouthed ignorance."
It is currently Tue Oct 16, 2018 6:59 pm

<


All times are UTC




Post new topic  Reply to topic  [ 36 posts ]  Go to page 1 2 Next
Author Message
PostPosted: Tue May 08, 2018 8:08 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
I had a cardiac calcium scan a couple weeks ago and the results aren't good. My score was 595. Anyone here familiar with turning this around? My doc is putting me on a statin and baby aspirin. I've seen some online stuff, including from the wheat belly guy. I'm willing to put in the work.

Here's what I've been doing:
* running for about 10 years now and usually do 30+ miles/wk (have a streak of 13 months over 100 miles)
* lifting now is limited to mostly maintenance, it used to be my focus
* started eating at least 4 fruits and vegetables daily back in nov (previously I might not have had that much in a month, I was the kid who wouldn't eat his vegetables and I stayed that way as an adult)
* started taking magnesium, potassium, and coq10 back in nov
* blood pressure is 110/70 - 130/90 range at home
* body fat per bodpod was just under 20% in September (~180 lbs @ 5'7")
* cholesterol, LDL 243 and HDL 64
* I've never smoked
* I'm not a drinker


Top
   
PostPosted: Tue May 08, 2018 8:18 pm 
Offline
Jesus Christ®
User avatar

Joined: Mon Jan 03, 2005 4:54 pm
Posts: 36743
Location: 鬼ヶ島
Does your family, or you personally, have any history of heart disease? Also, how old are you?

_________________
"One's actions alone define whether one belongs to a good family or a bad family, valiant or arrogant, and disciplined or undisciplined." -Lord Rāma, Rāmāyaṇa


Top
   
PostPosted: Tue May 08, 2018 8:43 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
Both of my grandfathers died from other things when I was pretty young (black lung for one, some cancer for the other). My maternal grandmother and my mother died from GI issues (at 92 and 81). Mom was on some heart meds including a statin. My dad, now 82, is on some heart meds (blood pressure, angina, and statin). It seems we all have high cholesterol #s.

This is the first I've had heart disease identified.

I'm 49.


Top
   
PostPosted: Tue May 08, 2018 9:01 pm 
Offline
Jesus Christ®
User avatar

Joined: Mon Jan 03, 2005 4:54 pm
Posts: 36743
Location: 鬼ヶ島
Does your doctor have any sense of what could contribute to the calcification?

_________________
"One's actions alone define whether one belongs to a good family or a bad family, valiant or arrogant, and disciplined or undisciplined." -Lord Rāma, Rāmāyaṇa


Top
   
PostPosted: Tue May 08, 2018 10:01 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
He's thinking some combination of genetics and a lifetime of poor eating habits.


Top
   
PostPosted: Wed May 09, 2018 4:57 am 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
You are a peculiar case, not many risk factors. Do you actually have obstructive lesions in your cororaries?

Opinions regarding calcium score in healthy people vary considerable. Check this out:

http://www.acc.org/latest-in-cardiology ... y-calcium

You can play with the cardiac risk calculator on the American Heart Association website and see if calcium score assessment was indicated for you in the first place.

Anyway, reversal of coronary atherosclerosis is possible:

https://www.sciencedirect.com/science/ ... 215008445

https://www.nejm.org/doi/full/10.1056/NEJMicm1609054

You can email the authors of these articles and ask for advice.

_________________
Image


Top
   
PostPosted: Wed May 09, 2018 5:31 am 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
Here it is, the calculator.

http://www.cvriskcalculator.com/

If your risk is below 10% calcium score testing is not indicated in the first place.

_________________
Image


Top
   
PostPosted: Wed May 09, 2018 12:01 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
How is it determined if you have obstructive lesions? I only know my basic cholesterol counts, the CAC score, and that I feel fine... Seeing the stories of active people having heart attacks or straight up dropping dead makes me pretty nervous.

Thanks for the links!


Top
   
PostPosted: Wed May 09, 2018 12:46 pm 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
There are ways to actually visualize the coronaries. CT Coronary Angiogram is one. Involves injection of contrast intravenously. Most radical and golden standard - coronary angiogram. I am surprised your doctor didn't send you straight to CTCA.

Anyway, did you try the Calculator? Very interesting exercise. As far as active people dropping dead, this is how it is. All you can do is to assess your risk and try the best to improve it. Still, even if your risk is 1% it can happen any time. At the end we are all dead.

If you believe in meds take a statin. I personally am not convinced of their benefits in healthy people, and apparently data says that one in 250 people benefits taking them ( NNT). But if you can tolerate them it can give you some peace of mind.

_________________
Image


Top
   
PostPosted: Wed May 09, 2018 1:31 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
Is there any point to a CT angiogram at this stage? I'm guessing treatment is going to be the same regardless.

I did try the calculator and had actually looked at it when I first got my blood test results. My total cholesterol is just outside of the range (max there 320, mine 338). If I use 320 it gives me 4.5%.

I'm definitely not big on the drug side of things and I've heard differing opinions on statins at work (I'm an IT guy but my office does clinpharm and pharmacometrics). I'm fine with doing aggressive lifestyle changes on my own and would try the wheat belly guy's stuff but I cannot judge if he's a bit of a quack or not (https://blog.undoctored.com/reduce-heart-scan-score/).

Thanks!


Top
   
PostPosted: Wed May 09, 2018 2:13 pm 
Offline
Sgt. Major

Joined: Tue Oct 02, 2007 1:53 pm
Posts: 2900
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s. Add soluble fiber (beans, oatmeal, etc.) to you diet and see if your blood lipids improve.

The calcium score just measures calcium in the arteries which may or may not be obstructive.

I would see a cardiologist. They would help you determine if the CT is necessary or possibly a stress test (preferably with some type of imaging- echo or nuclear), if you insurance would cover it, or even straight to a coronary angiogram (catheterization).

_________________
“Think of how stupid the average person is, and realize half of them are stupider than that.” -George Carlin


Top
   
PostPosted: Wed May 09, 2018 8:29 pm 
Offline
Lifetime IGer
User avatar

Joined: Thu Jan 06, 2005 10:08 pm
Posts: 10628
Quote:
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s. Add soluble fiber (beans, oatmeal, etc.) to you diet and see if your blood lipids improve.
Over what time period did this happen?

_________________
//:=)


Top
   
PostPosted: Wed May 09, 2018 9:37 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
Yeah, I'm thinking about seeing a cardiologist. How to find a good one though? I'm in the dc area so there should be some good ones around. I'll get to researching.

I can definitely be more intentional about eating beans. I had a couple types at lunch yesterday...


Top
   
PostPosted: Wed May 09, 2018 10:39 pm 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
Seeing a cardiologist is not a bad idea. Stress test in your situation is not likely to show much - you are a runner and are likely to show good numbers. Your calcium score is high enough to warrant coronary angiography, and I am almost sure this is what your cardiologist will suggest to you. Donwsides are cost and possible complications, though their likelihood is low. If this is what you need for a peace of mind - why not?

This whole exercise illustrates my point in the blood work thread. Testing without pre-test indications brings unnecessary worries.

Now when you talk about various foods in order to reduce your cholesterol - my question would be why. Your calculated risk as it is is very low, even with the existing cholesterol numbers. It will never be zero anyway, and as I said, even the risk of 1% is a general number, and it is impossible to tell when this one percent will click, and that you won't get a heart attack this afternoon. One thing you may think of is reducing body fat somewhat, and this will get your cholesterol down as well. Otherwise - I don't see much room for improvement in your case. You can start eating broccoli sprouts, beans and turmneric, if it makes you feel you are doing something proactive for your health. Will that make you live longer - remains to be answered.

I am in a similar situation. I have no risk factors except for high cholesterol (currently my total is 309). Moreover, I had two CTCAs in the last 5 years that show lesions in my coronaries (up to 60% narrowing in the left main). Mind you, calcium score is 99. Still, I don't take statins, simply because the data shows no significant benefit of doing so in my situation. However, my cardiologist friends call me mad, and you have to decide for yourself what you are comfortable with.

Therefore, seeing a cardiologist is not a bad idea. Don't agonize too much about finding a "good one". You don't need anything sophisticated done, and every Board certified cardiologist will be able to handle your situation. You can always get the second opinion anyway. Good luck, man.

_________________
Image


Top
   
PostPosted: Thu May 10, 2018 12:13 am 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
Here is the link to the stats for statins in low risk population.

http://www.thennt.com/nnt/statins-perso ... r-disease/

_________________
Image


Top
   
PostPosted: Thu May 10, 2018 12:32 am 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
Just a comment on the Wheat Belly cardiologist. His diet calls for the elimination of all grains and sugars, as well as limited dairy, potatoes and corn. What does it achieve? That's right, reduced calorie intake. Every elimination diet achieves that, and that's why all of them work. For a while, until appetite compensation or metabolic adaptation kick in. Sure, some people may benefit from eliminating this or that food from the diet due to the personal intolerance, but marking particular food as the cause for anything is silly.

It amuses me time and time again how some foods get vilified and others glorified. Fat was evil, then it split into good and bad fat, not bad fat is actually good, and you should eat butter and bacon. The red arrow is now turned to sugar, high fructose corn syrup, wheat and processed meat. Everything above has happened without any meaningful evidence.

Call me crazy, but it is way easier to count calories for a few weeks and get an idea of the intake. Very quickly calorie calculation becomes a habit. Rice - 100 g=100 calories (roughly), a slice of bread - 70 cal, 100 g of steak - 240 cal, 100 g of apple - 70 cal, 100 g of pumpkin - 50 cal, 100 g cottage cheese - 100 cal and so on. How many different foods do you eat anyway? Measuring the amount also becomes visual very quickly, and you don't have to be precise by any means, unless the goals are extreme. Very simple mental accounting, and you keep track of your intake better than most nutritionists and way better than lots of severely overweight patients who invariably claim "Doc, I don't eat much at all!"

_________________
Image


Top
   
PostPosted: Thu May 10, 2018 12:51 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
Yeah, I'm really thinking of this kind of like I do motorcycling (which has been my main form of transportation for 25 years). It's more of a risk but wearing good protective gear, practicing skills, not riding when I'm not alert, etc. makes it reasonable to me while I'm aware that nothing can save me from a freak event.

It's too late to put the lid back on the testing bottle. ;) I've got an appointment with the cardiology folks at johns hopkins monday.

Thanks!


Top
   
PostPosted: Thu May 10, 2018 3:28 pm 
Offline
Sgt. Major

Joined: Tue Oct 02, 2007 1:53 pm
Posts: 2900
Quote:
Quote:
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s. Add soluble fiber (beans, oatmeal, etc.) to you diet and see if your blood lipids improve.
Over what time period did this happen?

About 6 months and they've stayed down.

_________________
“Think of how stupid the average person is, and realize half of them are stupider than that.” -George Carlin


Top
   
PostPosted: Thu May 10, 2018 9:13 pm 
Offline
Top

Joined: Wed Sep 26, 2007 2:48 pm
Posts: 1289
Quote:
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s.
Does it matter what type of beans?

Does preparation matter? (ie canned, dried and you soak them or whatever)

_________________
“War is the remedy our enemies have chosen. Other simple remedies were within their choice. You know it and they know it, but they wanted war, and I say let us give them all they want.”
― William Tecumseh Sherman


Top
   
PostPosted: Fri May 11, 2018 12:38 pm 
Offline
Sgt. Major

Joined: Tue Oct 02, 2007 1:53 pm
Posts: 2900
Quote:
Quote:
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s.
Does it matter what type of beans?

Does preparation matter? (ie canned, dried and you soak them or whatever)
I prefer kidney beans and lentils. I don't think it matters.

Most of the time I would just rinse and eat out of the can. I usually mix the kidney beans with salsa, but have also done with white rice depending on how I wanted to keep my carb intake.

_________________
“Think of how stupid the average person is, and realize half of them are stupider than that.” -George Carlin


Top
   
PostPosted: Fri May 11, 2018 1:38 pm 
Offline
Top

Joined: Wed Sep 26, 2007 2:48 pm
Posts: 1289
Quote:
Quote:
Quote:
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s.
Does it matter what type of beans?

Does preparation matter? (ie canned, dried and you soak them, or whatever)
I prefer kidney beans and lentils. I don't think it matters.

Most of the time I would just rinse and eat out of the can. I usually mix the kidney beans with salsa, but have also done with white rice depending on how I wanted to keep my carb intake.
Thanks.

I do well with dietary adjustments that involve ADDING something. That tends to work better for me than dietary adjustments focused on TAKING AWAY something. Saying "don't eat cookie dough" (or whatever) sounds like good advice, but it doesn't tell you what TO do. Whereas if I concentrate on adding a salad every other day or something like that — food isn't a precisely zero-sum game, but there's only so much you can eat. If a substantial block is reserved for something planned and beneficial, that naturally leaves less room for junk.

Lentils are pretty good. My wife makes a stew in the Instant Pot, lentils and chicken stock and some other things, including either bacon or Italian sausage, depending on what we have on hand. Fairly quick, and it's fucking fabulous. Very nice with some crusty bread.

_________________
“War is the remedy our enemies have chosen. Other simple remedies were within their choice. You know it and they know it, but they wanted war, and I say let us give them all they want.”
― William Tecumseh Sherman


Top
   
PostPosted: Fri May 11, 2018 2:30 pm 
Offline
Sgt. Major

Joined: Tue Oct 02, 2007 1:53 pm
Posts: 2900
Quote:
Quote:
Quote:
Quote:
My LDLs were in the 120s. My vegetable intake was good, but I added at least a cup of beans/day and now its in the 70s/80s.
Does it matter what type of beans?

Does preparation matter? (ie canned, dried and you soak them, or whatever)
I prefer kidney beans and lentils. I don't think it matters.

Most of the time I would just rinse and eat out of the can. I usually mix the kidney beans with salsa, but have also done with white rice depending on how I wanted to keep my carb intake.
Thanks.

I do well with dietary adjustments that involve ADDING something. That tends to work better for me than dietary adjustments focused on TAKING AWAY something. Saying "don't eat cookie dough" (or whatever) sounds like good advice, but it doesn't tell you what TO do. Whereas if I concentrate on adding a salad every other day or something like that — food isn't a precisely zero-sum game, but there's only so much you can eat. If a substantial block is reserved for something planned and beneficial, that naturally leaves less room for junk.

Lentils are pretty good. My wife makes a stew in the Instant Pot, lentils and chicken stock and some other things, including either bacon or Italian sausage, depending on what we have on hand. Fairly quick, and it's fucking fabulous. Very nice with some crusty bread.
As a note, I usually eat about a pound of beef during lunch and this is the meal where I eat the beans regularly (sometimes with dinner also). I don't know if I would have had the same results if I ate them primarily at dinner.

_________________
“Think of how stupid the average person is, and realize half of them are stupider than that.” -George Carlin


Top
   
PostPosted: Mon May 14, 2018 12:52 am 
Offline
Top
User avatar

Joined: Wed Mar 16, 2005 12:26 pm
Posts: 1994
I am going to take a bit of a contrary position - I don't think a stress test or CCTA / cardiac cath are currently warranted. If you are training without symptoms, you have a vanishingly small chance of having a blockage big enough to need a stent to hold it open. Could you have a small calcified plaque in the artery? Sure, but no cardiologist will recommend a stent for a small plaque. So, if you are already modified to make the lifestyle changes, the additional testing won't add much.

_________________
Rain don't change the sun...


Top
   
PostPosted: Tue May 15, 2018 11:34 pm 
Offline
Gunny
User avatar

Joined: Thu Jun 02, 2005 10:16 am
Posts: 649
Yeah, I wasn't anticipating a cardiologist wanting to do any procedures. However, I do have a fair bit of plaque per the CT scan. The doc wants me to keep doing what I'm doing with the addition of a statin and low dose aspirin. Ask me how I'm doing in 40 years... ;)


Top
   
PostPosted: Wed May 16, 2018 12:23 am 
Offline
Sergeant Commanding
User avatar

Joined: Mon Oct 08, 2007 11:16 pm
Posts: 6313
Have you seen the cardiologist yet?

_________________
Image


Top
   
Display posts from previous:  Sort by  
Post new topic  Reply to topic  [ 36 posts ]  Go to page 1 2 Next

All times are UTC


Who is online

Users browsing this forum: Wild Bill and 4 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Powered by phpBB® Forum Software © phpBB Limited