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Tuesday, December 31, 2013

Explanations of Benign PVC's from a Heart Doctor

I have great appreciation for doctors who post their explanations online for free, just to help out members of the general public like me.

In this post, I will be directing you, dear reader, to a wonderful post from Dr. John M, a cardiologist, for his comforting post on PVC's.

Thank you, Doctor!

Benign PVCs: A heart rhythm doctor's approach......

Tuesday, December 17, 2013

Our Cardiologist's "180"

Yesterday was a very discouraging day.  It was my dh's one year annual review with his main cardiologist.  DH was happy to go this appointment knowing that he had lost 48 net pounds over the past 13 months, and knowing he had lowered his total cholesterol 60 points and raised his HDL 10 points, not to mention also that he got his blood pressure under control and had been taken off of his blood pressure medications.

I sat in the office in a amazement as I watched the doctor "ream" out my husband for not getting his HDL up to 50.  And who in the past year has even told him how to accomplish that?  NO one!

There was absolutely no acknowledgement that he had a total cholesterol of 138, which we now know to be a level which renders the patient heart attack proof.  There was no acknowledgement that he was three sizes smaller, and had been able to been taken off of his blood pressure medications.

He was told he was a man of no self-control, a glutton, and that if he didn't change his ways he would be a cardiac cripple by the time he was 60.

Change his ways!!!!?????

What more could he change?  He has given up all sweeteners, sugar, agave, honey, sucralose, nutrasweet, saccharine, syrup, jam and jellies, any form you can name of an derivative of any sweetener, except a small amount of stevia.  He has given up all oils, even whole food vegetable oils, including avocados.  He has given up breads, cakes, pancakes, muffins, tortillas, refined pastas, etc. He has given up alllll meat and fish. This is a man who has watched his five children at home celebrate their birthdays in front of him as he passed up the birthday cake.  He has not had one piece of cake in over a year; not one cookie, not one bowl of ice cream, not one piece of pie.  Could the doctor say the same?

On top of all of the sacrifices he has made to give up the foods he loves, the doctor wanted him to give up calories too; 200 more a day. and his before bedtime snack; a bowl of oatmeal.

Is there no joy in living anymore?  At what point does it not become worth it anymore.  If I were him, I would be close to that point right now.

After the appointment my husband felt like a kicked puppy.  He temporarily lost his desire to comply to anything.  He feels his ability to choose to do anything as he pleases in his life has been taken away from him.

Unlike no other patient, he chose changes in lifestyle to manage his disease not medication, and he is meeting with success.  Prior to this success his doctor seemed supportive of the lifestyle change.  He acted like he was interested in the research, that he was also experimenting with it himself, but has something changed this past year?

Last year he said to me, the doc, that is, "I believe that the low-fat plant based diet works, but I can't chain my patients to the basement and make them eat that way."

Now I'm wondering, was he really converted to it, did he really do the research? or what he just beginning to learn about it, experimenting with it and it became too hard.

 He had only dabbled a bit in Ornish's research.  Am I too much lower than he on the education totem pole, to be taken seriously in my recommendation to read the Esselstyn studies?   Has he been caught back up into pharmaceutical backed studies that all people would benefit from a low dose of statins for a lifetime?  Studies that were done on meat eaters, not whole foods plant based folks?

What happened to the discussions of mutual interest and excitement and understanding of solid studies that have gone on and have been increasingly embraced since Pritikin?  There was none of that to be had yesterday.  He would not hear of it.  He would not let my husband get in a word edgewise, nor myself, for that matter.

And yet, he too has gained weight since I saw him last.  Was he too busy to keep his vegan lifestyle going?  Had he fallen off the wagon?  Was he lashing out at my husband because of his own experience?  Or was he just recuperating from a weekend hangover, or a fight with his wife?

It feels like the doctor is trying to whittle dh down, belittle him and make him feel like he needs medication. I won't get into the possible connection between that and drug company perks.  It just seems like it.

We are stymied by our doctor's "change of heart" and striking lack of support.  We don't know where to turn next.

Friday, December 6, 2013

New Findings from the Cleveland Clinic on the Connection Between Red Meat and Heart Disease, plus other animal products but not as strong

I am posting an article below that I just read about the connection between heart disease and eating red meat as presented by a study done by the Cleveland Clinic, the same clinic where Dr. Esselstyn works.  It supports a theory that I have had for a long time that most diseases are caused by an inbalance in gut bacteria.

The article reports on studies that show that most red meat eaters produce a chemical in their gut called TMAO, which is produced by the gut flora in the intestines which feeds on carnitine in red meats, including both beef and pork.  The article also states that the studies show that other animal products also promoted this chemical production, but not to the degree of red meat.

The process occurs when TMAO allows cholesterol to enter into the arteries.  The amount of cholesterol ushered in by the TMAO into the arteries is as individual as fingerprints and the gut bacteria balance, I would suppose. Because of this, I think more research should follow for trends in digestive trouble, antibiotic use, and TMAO levels in meat eaters. I think it would do a lot of good to take deeper look into the role of gut bacteria to discover why some meat eaters seem to escape heart disease until their senior years while others,  like DH, succumb in their early years.

Having studied the effects of gut bacteria on health, because I am a celiac, and have studied the effects gut flora has on the management of celiac disease, I have come to the idea, myself, that many conditions result from having too many antibiotics that kill good bacteria and lead to an overgrowth of bad bacteria.  Here's why I say this.  I had antibiotics every two months the first 12 years of my life.  Two of my seven children also had extensive antibiotic therapy.  They are my two children that also have celiac disease.

My husband's heart disease certainly supports the theory that the ruining gut flora balance through antibiotic use creates an environment for carnitine to feed bactera which make TMAO, which allows cholesterol to effect the arteries.

 Ten years ago he was diagnosed through calcium scoring with a small spec of hardening of the arteries on his right coronary artery.  It was also at that time he was called to be an LDS bishop, a lay pastoral position in the LDS church, that resulted in many nights away from home and many hamburger meals out for five and 1/2 years.

I would get after him for this, but we both felt he was being moderate.  Afterall, he wasn't eating them every day like many people do.

Also, during this time he had been treated twice for strep, due to the fact that bishops go into many homes to bless the sick, and shake many hands on various days of the week.  He had had several courses of antibiotics as a teenager to treat secondary infections which allowed an overgrowth of yeast in his body which he later controlled by taking acidophilus and watching sugar consumption, thereby starving off the yeast, but he had also had a lot of antibiotics while bishop.

Am I saying that antibiotic use causes the growth of TMAO?  Not necessarily, but it would make an interesting study.  One reason I couldn't totally commit to the idea that antibiotics had anything to do with TMAO production is because I don't know whether good bacteria burps out TMAO and don't know whether it's the bad bacteria that does or both.

Also,  my dad also ended up with heart interventions, a quintuple bypass, but I don't recall him ever needing antibiotics, so I just don't know.  But, perhaps good bacteria would be protective, or perhaps the antibiotics in the meat causes an imbalance in the gut, thereby making more bacteria that are prone to burp out TMAO.  It might be helpful to discover if good bacteria is preventive.

Anway, back to DH, it was at that time as bishop that he gained 50 pounds, and he suffered from bowel issues, particularly loose stools, and bleeding hemorrhoids, and a resurfacing of yeast problems.

 He was also hospitalized for an abnormal EKG after having had a fainting spell while biking with the cub scouts around a local lake.  I watched him grow in weight (and I did too from eating baked goods for comfort that had a "little sugar and oil" in them).  I also watched him grow in fatigue as he served, literallly, with his whole heart.  I do believe because of this, God preserved and renewed his body through the growth of collateral circulation, but as he probably ate red beef about twice a week out, and probably once a week at home,  he was also subjecting himself to a higher amount of TMAO than he was years before.

On the other hand, I have pretty much kept on my vegetarian diet since 1996, but grew in size during that time because of the inflammation from the celiacs and comfort eating baked goods.  However, I still only ate about 1 serving of meat a week, except for this last year where I have been 100% low fat plant based.  I am now 72 pounds lighter, I might add.

Another study that would be interesting is how TMAO responds to estrogen, and could that be why most women that have established heart disease don't present with problems until they are at least 55.

The TMAO studies give me a lot of hope because.....

1.  I probably don't have heart disease because I don't really like red meat, and when I did eat it, it was probably 1/4 pound a week at the maximum, if at all for decades.

2. Maybe DH is going to be fine the rest of his life now because he is a 100% plant based vegan, and we know exactly what his arteries looked like going from December 3, 2012, which were good after the stents were placed.

3.  The one time a week my kids eat meat is probably not going to be enough to change the their gut into producing TMAO because the meat has to be eaten on frequent basis to created the flora environment for lending itself to artery damage, and they all individually, at least those still living at home only eat red meat probably once a week.

The eat meat sparingly idea that Dr. Hazel in the article presents supports LDS scripture D&C 89 where it says that meat is ordained for the use of man but must be used sparingly.  In other words, an occasional piece of meat for a person without heart disease is not going to ruin health.  However, for one with heart disease, it has been found that it can be deadly, as proven by the Esselstyn studies, also done at the Cleveland Clinic.

The TMAO studies lead me to some theories of my own....  Does TMAO destory nitric oxide which then allows the cholesterol to take root and harden in the arteries?  Do people,who have been subjected to many antibiotics, have a greater risk of heart disease?  And then I wonder, could heart disease be controlled with the measurement of TMAO in the blood and gut flora management through some sort of supplementation?

And then I think, well, Dr. Esselstyn has already found the key, no supplementation needed, just eat a low fat plant based diet if you want to be heart attack proof.  The studies have proven that vegans do not produce TMAO.  Let me say that again.  Vegans do not produce TMAO.  Now I have an explanation to give at the church potluck that makes more sense.

I can't wait to see what comes out with these new findings and theories coming from the Cleveland Clinic.  I feel like they have given me a leg up on helping my boys to prevent what happened to their dad from happening to them.

Here is a link to the article......

It makes me wonder, if DH and I had gone vegan and stayed vegan in our early 20's, or maybe had just cut out red meat, and ate the other animal products sparingly, like the recommended 4 oz. per week that Dr. Stanley Hazen has put himself on, could we have avoided DH's heart disease altogether, and could he still get away with eating turkey on Thanksgiving because the environment for TMAO production had not been created?

The studies show that the vegans who were fed one meal with steak did not have any TMAO in their bloodstreams after the animal product meal, and the theory is because they have not subjected their gut flora to the meat on a regular basis.  That the bacteria that "burps out" the TMAO has to be built up over time and that one meal is not enough to create environment.

Maybe that is why some studies show that those who have been on the Mediterranean diet don't get heart disease, and maybe that is why some who have established heart disease, like DH, still progress to potentially catastrophic heart events despite changing to the Mediterranean diet.

Maybe those who never were red meat eaters can stay healthy on the Mediterranean diet, but that moderated type of diet is ineffective for reversal in those who grew up as frequent red meat eater.  So in others words, maybe the Mediterranean diet is preventive for those with no disease but deadly for those with "velcro arteries" (that's what I call them to illustrate to my kids what they are like) caused by years of eating red meat.

Maybe that's why "moderation kills" when there is established heart disease as Caldwell Esselstyn, M.D. has observed from his studies.

I love the information in this study because it helps me to have peace of mind about my own health, as I continue to eat a 100% low fat plant based diet, and gives me guidelines that are manageable for the generations coming up behind us.  In the words of our pediatrician, "It's not a matter of if but when your boys will develop their dad's condition because of his family history.  I recommend the diet you have discovered for them, the low-fat plant based diet, but let them have fun once every few weeks for a day.  They will be fine."

We are really blessed to live in this day and age where we know so much more about heart health.  When my 2nd great-grandpa first learned he had heart disease, he was already leaned over his chair in agonizing pain and he died the next day.

These days we know the warning signs of heart disease, and we know so many ways to prevent it.  It's not a perfect science or system, but we have gotten really good at fixing hearts for those who have established disease, and we have the knowledge we need to prevent it.  It's a matter of taking the time to educate oneself, then caring enough to focus on it.

My next idea is.....does exercise have an effect on TMAO production?  I wouldn't think so, but maybe.  I know that exercise does effect nitric oxide levels, so who knows?

Lots to chew on.  I may not get any sleep tonight just thinking about it.

Thursday, December 5, 2013

One Year Past Heart Surgery

I can't believe that I have had this blog up for over a year and that my husband's chronic total occlusion procedure was a year ago this past Tuesday.

It has been an amazing year.  He is still doing very well and still has not had a chest pain since the procedure last December 3rd.  I would say, in that light, that the procedure was a huge success.

We have been living on a low fat plant based diet  for a year now.

DH has since lost 50 pounds, has gotten off of his lisinopryl, bystolic, and had his Simvastatin decreased to 20 mg.  In two weeks, he will go off of his Plavix, and will only maintain a regular medication regimen of the statin and a baby aspirin.

He has grown in his vitality and happiness over this past year.

I feel healthier too, being able to exercise with more vigor, and sleeping better, although my hiatal hernia still gives me fits and makes me think I have heart trouble.

I am so grateful for this extra productive year we have had together and I'm hoping and looking forward to many more to come.