The Amazing Ellsworth Wareham, M.D.

I just happened on this awesome video on YouTube while I was looking for YouTube videos on how to guide my kids to learn computer programming languages.  Wow!  The Internet is amazing!!!!!

Dr. Ellsworth Wareham has been a cardiothoracic surgeon at Loma Linda until at the age of 95.  He retired in 2010  "to spend more time with my family".

He became a vegan about 40 years ago.  He said he never really had a huge taste for meat, but grew up on a farm where it is readily available.  I'm posting this fantastic YouTube video for you to watch.  There are many priceless gems of truth in what he not only says, but has earned the right to say with his 98 year-old vibrance......

Interview with Ellsworth Wareham, M.D.

Like Caldwell Esselstyn, M.D. who save my husband's life with his dietary advice, he states that keeping our cholesterol numbers low, he stating 140, Esselstyn stating 150, makes having a heart attack at those levels very, very rare.

He says that since his cholesterol is 117, when he has chest pains, he knows that it's his esophagus causing the pain, or some other structure like a hiatus hernia, which I have found for myself to be true.  My cholesterol is 150.

He also addresses that he recommended to all of his patients a diet change, but most were unwilling to change.  I have also found this to be true.  With my celiac's, I have seen many people with the same symptoms refuse to consider a celiac antibody test for fear it will be positive and they would have to give up bread.  My cardiologist says that his patients wouldn't give up meat unless he chained them to the basement, even with his promises for reversal.

Dr. Wareham states that tastes can be changed in three months time, a person just has to be willing to do it.

The only people that he knows of who have demonstrated the capability of reversing heart disease are Dean Ornish, M.D., and Caldwell Esselstyn, M.D.  and they have done it through recommendations of following, primarily, a low fat plant based diet, and exercise.

Just to point out, when DH had his last stent placed, his cardiac interventionalist told him he'd back in not a long distance of time for another procedure.  What kind of hope that gives to a person as they are leaving the hospital, having just had a traumatic experience.

Dr. Ellsworth Wareham and his message, and those messages of Drs. Esselstyn, and Ornish provide tremendous hope for past heart surgery patients, patients with no surgical options, and people of all walks of life who are genuinely concerned about their heart health.  I believe that God has placed these wise, old, healthy men, on the earth at this time to bless His children with hope in a time when "men's hearts shall fail them."

God bless them for willingly and freely providing their messages of hope and their fine examples of healthy living!

Mastic Gum Got Me off of Omeprazole

A year ago, I was hospitalized with severe and continuous chest pains.  All heart tests showed that my heart was very healthy, so the doctors headed into my stomach with an endoscopy and found severe gastritis and a duodenal ulcer.

Ulcers and gastritis cause a lot of gas and chest pressure.  This is what I was experiencing, but I also had a sick and burning pain in my stomach.

I was put on Omeprazole 40 mg.  The prescription was to take it for a year, but by January, having been on Omeprazole, I was starting to show signs of nutritional deficiencies in the form of my fingernails becoming very brittle.  I would just bump my hand on the wall or something and the tip of the fingernail that got hit would just bust off.  I have always had very strong fingernails, so I soon blamed the Omeprazole.  I do need to say here, however, that the Omeprazole was effective in decreasing my symptoms, and I would take it again if I didn't have other options.

Having celiac's disease already makes me vulnerable to deficiencies, so I'm always focusing on identifying signs that I am developing them.  I have tried several times to wean off of the Omeprazole by going 40 mg one day and 20 mg the next, and then 40 mg the next day, and then going 20 mg the next week on the first day of the week, nothing on the next, and then 20 mg on the next.  The doctor said this weaning process was important to prevent rebound acid production that would be at higher levels than there was previously.

I would do fine with the 40/20 weaning program, but the stomach acid would come back, as well as the gastritis on the the 20/0 plan.

I was still having some pain, while not severe, it was clear I wasn't progressing as well as I wanted in my healing, and the Omeprazole was making me feel dopey.

Being sick of taking the Omeprazole, I finally decided to do something else.  I ordered Jarrow's Mastic Gum after reading about it on Amazon.  It had so many positive reviews!  I tried it for some time with just 500 mg. and it did nothing for me, so I went back on the Omeprazole for a time, and then when my pain became more manageable, I dropped the Omeprazole, and went back on the mastic gum but went on a higher dose than I had before, to 1000 to 1500 mg. depending on how I felt for the day, which was up from 500 mg. the first time I tried it.

I have now been taking it for a month.  I went cold turkey off of the Omeprazole, which one should probably never do, which was against my doctor's advice, but I had had it with the Omeprazole and couldn't take it another day.  Just like with the Omeprazole, I take it on an empty stomach 1 hour before breakfast and with 16 oz. of water.

In this month's time, my stomach has improved dramatically!  I have no more ulcer pain or gnawing pains in my stomach or duodenum, and if in the afternoon, I feel a little nauseous, I take an extra 500 mg.

I have known about mastic gum for a year, since I started the Omeprazole, but I didn't take it because at the time I was on the Specific Carbohydrate Diet, and mastic gum is forbidden on that diet.  That diet, by the way, never cured me of my digestive problems, but did send me into the need of a gallbladder surgery, and clogged my husband's arteries necessitating the stents placement and the birth of this blog.

I believe the mastic gum is working because, although I did have triple therapy for H.pylori, and although I asked my doctor for a follow-up test 3 months after therapy because I was still having symptoms, I believe that I was one of the 15% that didn't have a complete eradication.  Mastic gum has been proven to kill
h. pylori in studies (click here to read the studies), and taking it, I believe, has brought bacteria numbers down that were re-colonizing in my stomach.

Why do I put this post on a heart blog?  Because chest pains that are non-cardiac in nature caused by gastritis and stomach ulcers can cause the same type of pain as a heart attack.  I know from my own experience that this is true.  Having had a spouse with chest pains, his description has helped me to know that some non-cardiac chest pains can be hard to decipher from heart related chest pains.

This knowledge can help those with health anxiety to calm down about their heart health if they have had a clean bill of health placed on their hearts, but still have perplexing pain.  But, if you do have chest pain and haven't had at least a stress-echo done on your heart, I would not dismiss cardiac reasons for chest pain, until you have at least been on the treadmill.   CT angiography is even better if you can get somewhere that has an CT angiography machine like our cardiologist has.  And by the EKG's do nothing for ruling out heart disease.  DH had many of those as recent as two months before his first angioplasty.

But.... if you have been checked out properly, the use of stomach healing nutrients like mastic gum may help eliminate some or all of that pain.  I am not earning any profit from Amazon on this blog.  I want to keep my pledge to not earn any kickbacks for providing my own experience to help others out through my blog posts, but I am including the link to the Jarrow mastic gum for your convenience.  Here is the link.

I sure hope this helps someone out, because the information was not easy for me to find, and it would float my boat, if someone was able to get relief sooner than I did.

Digestive Gas and Chest Pains

I have had chest pains off and on for the last year and a half.  I've had everything checked out through a half dozen ekg's at various times, a stress echo, heart monitoring in the hospital for 24 hours, plus during two minor surgeries, and in an ambulance when I was being transported for SVT which wouldn't convert.

My cardiologist says I have a structurally sound heart and no heart disease, and it has been determined by him and my gastro doctor that the chest pains are digestive in nature.

Through endoscopy it was determined that I have severe gastritis which produces a lot of gas and burping, and a hiatal hernia which allows that gas into my esophagus.  I don't really have reflux, in that I don't have heartburn going up into my throat, like I used to before I went gluten free, so I know what that feels like, and no that's not happening anymore, and hasn't for three years.  I do believe, however, that gas bubbles are gurgling up and down my esophagus and causing pressure and chest pain.

The other night, another non-cardiac chest pain sufferer suggested this little trick to relieve gas related chest pain.  I tried it, and it works!

1.  Put both hands above your head, and clasp your hands together, interweaving the fingers of your hands.

2.  While clasped, lower your hands behind your head slowly and as far down as you can get them.

This puts pressure on the bottom of the gas bubbles while opening up space for their escape at the top of your torso, causing a burp each time you do it.  You might want to do this in private.

It works for me!  In every case, so far, I've been able to relief myself of my chest pains with this exercise.  

Magnesium Helping with PVCs

Last week I had horrible PVCs.  They got so bad they were even, at times, at bigemeny frequency, and this is the first time I have ever experienced them.

I have taken magnesium for heart arrhythmias for two years, but had to switch from magnesium taurate to magnesium glycinate because the magnesium taurate was increasing my stomach acid, causing chronic gastritis.

I have had no trouble controlling my PVC's with magnesium taurate, but apparently magnesium glycinate is not as effective since the taurate was probably effecting the benefit on my heart as much or more as the magnesium.

This week, I decided to increase my magnesium dosage from 240 mg. to 480 mg. and I seem, so far, to be doing much better.  I only notice about 5 pvc's a day instead of 5 per hour, and they don't seem to be as strong when the strong heartbeat responds to the extra beat.

I'll keep you posted on my progress!

Three Months without an SVT

I just have to say that I'm celebrating today that I have gone three months without an SVT.   Now watch, I'll get one tomorrow, because tomorrow will April 1st, and my last one was February 2nd, the one prior to that was October 6th, and the on prior to that was July 12th; just about three months apart.

I can't say why I have been having SVT's every three months, but I'm glad they aren't happening more frequently.

This last span, I have tried several things to keep myself from having an SVT.....

1.  Drink 8 glasses of water per day.
2.  Eat at least one banana a day to keep potassium levels up.
3.  Take 350 mg. magnesium glycinate in divided doses per day.
4.  If my stomach hurts, try not to allow myself to get too stressed out, because I believe the SVT's are being triggered by a nervous stomach, meaning that the nerve (vagus nerve) that wanders through the heart and the stomach might be getting irritated by the stomach and which, I believe, triggers the heart to beat crazy, and each SVT episode has happened when my stomach has been irritated.  Stress makes my stomach even more irritated.
5.  Eat a balanced gluten free low-fat plant based diet (and no sugar)
6.  Try to get enough sleep each night (that is nearly impossible for a mother of seven, but I try)
7.  Try not to get angry.  This goes with not being stressed out.  Every SVT has happened on a day when I have been upset with someone or about something, accompanied by very strong emotions.

So far so good, and I hope to say "so long" to SVT's.

That being said my PVC's have been very frequent this week, but they don't seem to be triggering SVT's which I thought they did.  They are being triggered by being tired.  I can tell.

I'll just keep crossing fingers and report again three months from now if I make it through the next three months without an SVT.  Wish me luck!

PVC's and the Vagus Nerve

Without taking the time to go back to my numerous blog posts, I think I have written my theories on the connection between SVT and the vagus nerve.

Luckily, I haven't had an SVT in two months.  I'm so grateful!

But!  I continue to have annoying bouts of premature ventricular contractions (PVC's), none yet today, thank Goodness!

The past few days have been particularly stressful and I have had a lot of PVC's.  After a long trying day and a PVC loaded day, I came home a Googled, PVC's Vagus Nerve because I have noticed that my PVC's ramp up with my stomach hurts and I theorized that the stomach upset was triggering the vagus nerve to trigger the heart to add extra beats into the rhythm.  While I do not know who wrote this explanation, it makes a lot of sense, and although I don't know who wrote it, and if the person is even really an M.D., or qualified to write it, he explained me to the T.

The following e-mail came from a Yahoo group discussing SVT and PVC phenomenon.  A person has posted this on another PVC forum and I am copying and pasting it here, for my benefit, so I can have it more accessible to read for comfort and for others who may want to consider this person's explanation as cause for PVC's.  I truly believe this explanation is accurately describing my issues and it has given me an extreme amount of peace.

So without further adieu, I'm now posting the link where I found this e-mail and the e-mail itself.  Hopefully, someday someone can let me know who to give credit to for this.....

Here is the link....

http://heart4pvc.webs.com/letterfrommd.htm

And here is the letter.....

Letter from MD

I want to start by talking about a very special part of the human anatomy that does not seem to appear in the collective messages I've reviewed; The VAGUS nerve. The vagus nerve, also referred to as the 10th cranial nerve, is appropriately termed a "mixed" nerve. It provides a sort of two-way communication of nerve impulses back and forth between the brain and the pharynx,larynx, esophagus, stomach and associated abdominal viscera(basically, your throat, windpipe, your tummy and guts), the heart, lungs and several more complex but irrelevant body organs or functions. The vagus nerve is the longest and most complex of the cranial nerves in the body.

The key point here is to make note that this nerve involves the "heart," the "lungs" and basically the whole digestive system of your tummy and intestines. Now let's pair that with some real specific and limited physiology about the heart and its rhythm. We also need to bring clarity to some of the medical jargon being talked about by many of you in your messages. The term PVC, or Premature Ventricular Contraction, is just one of many arrhythmia and not necessarily isolated to what many term as "palpitations." When we speak of palpitations, what we really mean is the presence of "ectopic" beats (heartbeats where there should not normally be) and the precise induction of these beats is felt by us as dancing of our heart or a flutter sensation in our chest, the prominence or intensity of which is determined by the precise moment of the extra beats in proximity to the most recent beat and the upcoming beat or contraction of the heart ventricles or atria.

       

Think of it in relation to your memory of your worst date, where the guy you're with has no rhythm whatsoever but wants to impress you with all the right moves and clumsily tries to introduce his own dance-step into your otherwise smoothly flowing and natural pace with the music. Depending upon his rather untimely entry, he can cause awkwardness that either simply causes you to quickly pause and regain your rhythm or literally trip you repeatedly until you're forced to leave the dance floor. Well, the same holds true for the heart in our example. The extra beat, or palpitation might come at a point that's subtle, or it might be at a point where the heart stumbles repeatedly until normal sinus rhythm is regained. Now let's get to "why" palpitations occur.

The key point here is to make note that this nerve involves the "heart," the "lungs" and basically the whole digestive system of your tummy and intestines. Now let's pair that with some real specific and limited physiology about the heart and its rhythm.

Think of it in relation to your memory of your worst date, where the guy you're with has no rhythm whatsoever but wants to impress you with all the right moves and clumsily tries to introduce his own dance-step into your otherwise smoothly flowing and natural pace with the music.Depending upon his rather untimely entry, he can cause awkwardness that either simply causes you to quickly pause and regain your rhythm or literally trip you repeatedly until you're forced to leave the dance floor. Well, the same holds true for the heart in our example. The extra beat, or palpitation might come at a point that's subtle, or it might be at a point where the heart stumbles repeatedly until normal sinus rhythm is regained. Now let's get to "why" palpitations occur.The heart has a natural pacemaker called the sinoatrial node among several less distinct and similar pacers, which is stimulated by guess which nerve? You guessed it; The VAGUS nerve.

The vagus nerve helps regulate the heart in comparison to other functions taking place with other areas and is doing its job right now in each and every one of us. In fact, the variability of your heart rate during inspiration and expiration of your lungs is an effect of the vagus nerve. We've all noticed that when we take a breath in, our heart tends to beat just a little faster and when we breath out, a little slower. It's an entirely normal bodily function and is connected to the need by the body's system to respond to the environment.Now that we kind of have a little medical background under our belts, let's take one of the complaints by many of you regarding the proximity or timely appearance of palpitations and indigestion.
Remember that we said the vagus nerve is linked to both the tummy, the throat and the heart. Let's assume that we've eaten meal and it's caused us to experience some gastrointestinal discomfort, or in other
words, gas. The irregular presence and activity by your tummy and intestines stimulates, more appropriately irritates, the vagus nerve which sends a rather inappropriate signal back along the pathway to
guess where? That's right! The heart. Move to the head of the class. The heart is busy pacing away regularly and is relatively unconcerned with all the food you poured into your tummy, when all of a sudden in comes a signal from the vagus nerve because it has been inappropriately stimulated and tells the heart to beat. Well, just like our bad date example, the signal to beat is rather untimely and awkward but the heart has to accept it and respond. The result is extra beats that make the heart feel like it is stumbling. The degree to which it stumbles oftentimes depends upon the extent to which the vagus nerve is irritated and the relative state of indigestion present as the causative agent.

There is most often no pain associated with this occurrence because it is not the result of a lack of blood or oxygen that creates the palpatation, but rather just a simple additional electrical impulse or series of impulses. Pericardial pain, or pain adjacent to the heart, can sometimes accompany palpitations or exist exclusive of any arrhythmia, but is not necessarily considered pathologic or harmful to us. Remember that we're dealing with inappropriate electrical impulses and muscle tissue other than the heart that is partially
innervated by the vagus nerve and can respond inappropriately, causing a jabbing or shooting pain than many describe as a "catch" in their chest. We'll talk more about chest pain in a bit.

Let's discuss the sensation that some of you described as a warm flushing sensation of your face and perhaps other body areas that accompanies the palpitations. Recall our anatomy lesson. The vagus
nerve stimulates many areas of the body in response to our environment or internal conditions caused by the outside environment, ie. a meal that produces indigestion. The vagus nerve provides all of us with a stable process called vagal tone. This tone or stability keeps us in a state of balance so to speak with our environment. In response to environmental cues or situations, that tone or stability changes to prepare for what may be required. You've probably all seen a guy that makes your heart "skip a beat." Ever wonder why that phrase ever came about? Think for a moment. If you've ever been emotionally overcome, your heart races or feels like it pounds in your chest, we begin sweating, our blood pressure rises, we feel nervous and at some point our face is overcome by a warm flushing sensation that we attribute to nervousness or embarrassment. Well, guess what nerve plays a very big role in that entire process? Right Again!!! The VAGUS nerve.

The above scenario would be a case of increased vagal tone. Well, if there's an increase, there's likely to be a case of decreased vagal tone as well. Indeed there is. decreased vagal tone can make us weak, nauseated, tremble, and even faint. It happens in cases of being excessively startled or frightened. Other conditions, such as diabetes can cause decreased vagal tone, but for our purposes we'll stick to conditions that by what I've read from all of you are non-disease provoking conditions, with the exception of one individual with Mitral Valve Prolapse but we'll touch on that in a bit.

Anyway, the point is that our body doesn't always accurately recognize proper environmental cues and the vagus nerve doesn't always know when and how to act. In other words, it misbehaves once in a while as a result of inappropriate stimulation. All sorts of things make the vagus nerve act out, including stress, anxiety,
depression, illness and even idiopathic causes(origin or cause is unknown). In fact, there is work going on right now using electrical vagus nerve stimulation to treat depression, anxiety and even seizures.

And here's a little extra for those who cough when experiencing a palpitation. Recall your anatomy lesson again. Remember we said the vagus nerve stimulate the pharynx, larynx, bronchi and esophagus. Well, what do you know. Those are exactly the processes involved in the cough reflex. So when the vagus nerve inappropriately stimulates the heart and causes a palpitation it also stimulates in some cases the cough reflex. How about that!So we begin to see that the cause for palpitations and the palpitation itself is not a life-threatening occurence at all. It concerns us for several reasons. First, it has to do with our heart and hey, that's the thing that keeps us alive basically. Big concern! Secondly, we've been bombarded by all the medical revelations and awareness about heart disease. But a case for heart disease does not make for every condition the heart demonstrates, especially palpitations. If you've ever had a cramp in your hand from typing too much, it probably never gave you pause to think you might not make it, so to speak. You reason in your mind that the cramp is caused by repetition fatigue and you need to take a break, massage your hand and rest momentarily. Well, palpitations can be considered sort of a cramp and nothing more. Under stress and other factors we talked about, the vagus nerve gets irritated or fatigued and acts out. Just because the heart is affected, doesn't mean that you've got heart disease or vascular problems that are looming. They're annoying, worrisome and even frightening, but knowing where they come from and why will help go a long way in knowing that they are non-injurous and if we respond appropriately, will subside and we can go about our lives with far less worry.

Let's touch on anxiety for a moment. Anxiety, and depression too, can definitely cause a state of dysfunction in many areas of our body. Many patients who have these disorders are exhausted from constantly presenting themselves to the medical community with real and valid symptoms of pain, fatigue, bowel problems, vision problems, tinnitus or ringing in the ears, difficulty swallowing, excessive saliva, dry
mouth, sore or sensitive tongue, and many many more troublesome circumstances only to have repeated tests all return normal. How can that possibly be?!! It's there, we feel it, we experience it, we hate
it. Why doesn't the test confirm that it's there? How frustrating is that???? 

Well, here's some news that should make you feel a bit less frustrated and even comfort you. Most all tests are based upon the algorithmic, or sequential processing, of certain symptoms and signs that are all conclusive of various disease and illness. When someone with anxiety, depression or other condition that has somatic features (felt physically)undergoes these tests, the components that underlie the actual diseases which have similar symptoms simply does not add up and no presence of the actual disease is evident. So it's a case of false identity, sort of like having a biopsy of a mole that turns out to be benign. Looks like cancer, but is not cancer. Well, that same thing can happen to us with regard to all sorts of disorders and diseases. They look similar in presentation, but one reveals true disease and the other a nonpathologic condition or illness. So the next time your doctor tells you he can't find anything wrong, be glad for that much at least. Many people get far worse news! So with regard to depression and anxiety, these conditions impart disturbance upon body functions. I suppose you're already guessing that the vagus nerve is not exempt from those circumstances and you're exactly right. So when you have an episode of anxiety, rest easy when you have a palpitation or two, or three or even four. The vagus nerve is irritated and needs a break or to reset. No problem whatsoever and you needn't worry any longer that a palpitation is sure indication of worse things to come. Nothing else happens. Just an extra heartbeat or two where there should not normally be. What a relief!!!!! And the caveat I promised to the one individual with Mitral Valve Prolapse, your heart condition, while not necessarily life-threatening at all, does predispose you to panic disorder which I'm sure you are probably already aware. Okay, so now we know what these palpitations are and what causes them. What the heck do we do about them? Well, there are several techniques that can help. Firstly, let me say that if a run of palpitations makes you feel faint or weak, don't panic and try to make it somewhere less embarrassing. Be safe and think smart. Squat to your knees or sit down until the feeling subsides. No sense in cracking open your skull by trying to make a mad dash for privacy. Anyone can feel faint and people in your company will always rally to your aid more often than not. So relax. The conditions will quickly pass and you'll be back to yourself in a jiffy.

Secondly, if you sense indigestion and gas, discomfort and bloating when the palpitations are present, try merely changing positions which often causes the distention to realign from its offending position proximal to the vagus nerve.

If you're pregnant, well indigestion or gestation. It doesn't matter. What's important to realize is that both conditions represent a temporary rearrangement and limited space downstairs. That means proximity or closeness to the nerve receptors of the VAGUS nerve and you're going to get palpitations when conditions are right. As for the palpitations themselves, taking slow, deep breaths repeatedly will typically cause the palpitations to cease. Recall your anatomy lesson. The vagus nerve stimulates the lungs as well as the heart, so this purposeful stimulating of intention-breathing will often interrupt the irritation signal.

If you're experiencing tachycardia(racing heart), then if a fountain or bathroom is nearby, apply cold water from your hands to your face and while holding your hands against your face, press gently, repeat GENTLY, on your eyes. This will invoke what is termed the "dive reflex" and will cause your heart rate to decrease in most cases. Regardless, tachycardia, like palpitations is not harmful in of itself, just a bit unnerving.
The key in all cases is to do your best to remain calm and rational. Know from our little lesson what it actually taking place and that you'll be fine.

Finally, we'll save a lot of space here by simply stating that with regard to any of the conditions either described or that you're experiencing, do not substitute a support group for responsible notification of your symptoms to your personal primary care doctor. We live in an age where medicine is oftentimes scoffed at by many who fail to realize the benefits they expect. Yes, it's true that medicine is not a perfect science, but neither are human beings. It is difficult at best to create perfection from imperfection. But even so, we all must give recognition that many thousands of people are being cured of certain cancers that just a decade ago would have meant their demise. Simple penicillin saves hundreds of thousands in third world countries that would otherwise perish from infection.

So don't become discouraged that medicine doesn't find something wrong with you. Feel blessed that they don't have less encouraging news for you. I exist in an occupational environment where disease and illness is very concentrated. It is of great joy and optimism that I can walk from conditions such as those to the sanctuary of my private life and know that I'll return tomorrow.

You too, all of you, need to be thankful that your condition is benign and that you have the power of influence over its effects.

So kick up your heel, give a shout, grab the keys and your husband's credit cards with the highest limit and PREPARE TO SHOP! Those pesky palpitations are but a mere nuisance and you have the rest of your
life to live, so get busy and do the voodoo that you do best! best regards and good health. Feel free to write if you care to and I'll do my best to answer, but no promises...

Questions and Answers on How to Prevent and Reverse Heart Disease from Dr. Esselstyn

I am committed to the Prevent and Reverse Heart Disease Diet developed and clinically proven out by Caldwell Esselstyn, Jr. M.D.    With DH and I now walking this earth with optimal blood pressure, blood sugar, and cholesterol in our middle ages, after having suffered from blood pressure, blood sugar, and cholesterol issues, not to mention weight problems in the past, we can't deny that eating a low fat plant based diet reverses many conditions that plague middle aged Americans.  I only wish we had been as committed sooner because I might have kept my gallbladder, escaped other digestive damage from the bile issues caused by my gallbladder troubles, and Dh would be stent free.  But, we can look forward to a more product future life thanks to Dr. Esselstyn's research.

I am posting his Q & A here for my friends and family for their convenient reading of the basics of his diet and encourage anyone that has health concerns, not just heart health concerns to buy and read his book Prevent and Reverse Heart Disease.

Please note, I am not earning and will never earn a penny from this blog.  So while I am providing book titles, they are not linked to any money making systems.  I am not in cahoots with Dr. Esselstyn to promote his book either.  I am providing a copy and paste of his Q & A from heartattackproof.com  because I believe in his work and want to make the information easily accessible to all people who can benefit from it.

Just to note, as and LDS person this diet is a great companion to the dietary counsel given in the Word of Wisdom in Doctrine and Covenants 89.

I encourage anyone who is serious about healing the physical heart from the food born illness caused by the American Diet to buy his book or check it out at the library and comb through it several times.  You can even go see Dr. Esselstyn at a seminar at the Cleveland Clinic, the nation's number 1 rated heart care facility.    Just e-mail his secretary, Jackie.  Her e-mail is on his web site.  She will answer within a day or two and send you all of the information.

We haven't gone to see him yet, but we have talked to him on the phone and plan to see him in the future if we need more guidance, but so far the book has been adequate for us.

By the way, look at his picture.  He is 79 years old.  He is vibrant, healthy, and very kind.

Here is the Q & A from his web site.....
http://www.heartattackproof.com/qanda.htm

Q&A with Caldwell B. Esselstyn, Jr., MD Caldwell B. Esselstyn, Jr., MD, F.A.C.S. Please note: If your question is about finding a doctor in your area who supports a plant-based diet, please see this link: How to Find a Plant-Based Doctor. 1. How is your approach to treating heart disease unique? My program is a nutrition-based therapy that has been scientifically-proven to reverse heart disease. There is no other treatment plan backed by a study as long as the one I conducted, or a study that has produced such dramatic, visible results. Coronary angiograms (X-Rays) of the patients in my study show an actual reversal of the disease. To experience these benefits, my patients must stick to my plant-based diet program strictly, but the effects are more than worth the effort. For those that are very sick, it is the most effective treatment option--far less dangerous and more effective than invasive surgical procedures such as stents and bypass (except in acute emergencies), and much more effective than drugs alone. Traditional cardiology has relied on technology to ease the symptoms of heart disease, but has not addressed its causes. My approach is not another stop-gap solution, it prevents heart disease from occurring in those who don't yet have the disease, and it heals the body and reverses the disease when symptoms are present. Best of all, over time the benefits endure and continue to improve. I am always excited when I see arrest and reversal in patient after patient and their joy and relief when they are free of the disease that was destroying them. 2. What would you say to someone considering a stent or other surgical procedure or drug therapy, to treat their heart disease? All heart patients who are not absolute emergencies should first have an aggressive opportunity at non surgical medical therapy. This is not just my opinion but that of expert cardiolgists from Boston, Hartford, Houston, Stanford, San Diego, Seattle and Cleveland. The difference in my case is that I advocate an aggressive plant based nutrition program to arrest and reverse the disease and to avoid all surgery. Drugs alone do not prevent heart attacks and stop symptoms of heart disease. 3. How do you encourage your patients to stay on the diet? There is no question it is hard at first. And it is hardest eating out at friends' houses. However, I am always impressed how well my patients do once they experience the relief of chest pain, weight loss, and the improved feeling of well being they have eating a plant-based diet. Then the motivation comes from within. It also helps that within 8-12 weeks of starting the program the fat receptor in the brain down regulates and they lose the craving for fat. And as they start feeling better and better, they know that they are the ones-- not their physician or their surgeon--that have control over the disease. It is a powerful feeling! 4. Why does the diet eliminate oil entirely? NO OIL! Not even olive oil, which goes against a lot of other advice out there about so-called good fats. The reality is that oils are extremely low in terms of nutritive value. They contain no fiber, no minerals and are 100% fat calories. And above all they contain saturated fat which immediately injures the endothelial lining of the arteries when eaten. It doesn't matter whether it's olive oil, corn oil, or any other kind of oil. You should not consume any oil if you have heart disease. This is so important I have detailed oil in Chapter 10. 5. Can you actually enjoy food on the program? We LOVE our food. Our children and grandchildren love our food and the patients love the food. Everyone loves the food once they give it a try. It is all a matter of attitude--and you do need a positive attitude to get started and to understand that this new way of eating is the best thing you can do for your body. Then, the body will help you adjust. You actually begin to lose your physiologically-based craving for fat. Once that occurs, you can fully appreciate the natural taste of plant foods--the colorful tastes and textures are difficult to surpass. 6. Why should I change? My health is excellent. No one escapes in the end--eventually the traditional western diet guarantees some form of disease in all of us. While it may not be heart disease at the moment, eventually it will be or hypertension, diabetes, stroke,obesity, gall stones, diverticulitis, rheumatoid arthritis, lupus, multiple sclerosis, or a greater likelihood of breast, prostate, colon, ovarian and uterine cancers. Even erectile dysfunction and dementia. The world famous Framingham Heart Study now approaching its 60th year looked at 1,000 people at age 50 who had normal blood pressure. They looked at the same group at age 70, and 90% now had high blood pressure. But there is something that you can do now to stop the cascading events that occur in the body and lead to disease. You can change your diet and begin safeguarding your health for the future. More Commonly Asked Questions Protein - Where do I get my protein / What protein drink is best?  Extra protein powder and shakes are truly unnecessary and have the potential for harm if they contain animal protein. The protein available through plant-based nutrition is adequate to nourish professional champion athletes such as the iron man, professional football, mixed martial arts, track and field, etc. Calcium – Where do I get calcium? Calcium supplementation is unnecessary. There is more than adequate calcium in a plant- based diet of whole grains, legumes and grains and especially the green leafy vegetables. Vitamins – What Vitamins should I take? A multivitamin is a reasonable way to be sure of obtaining the full spectrum of vitamins, but my preference, especially if one is eating copious amounts of green leafy vegetables, is to limit supplements to Vitamin D as necessary to maintain blood level in the normal range and B -12. Fish Oil - Should I take fish oil? Fish oil is not essential. Fish get their omega 3 from plants. It is difficult to be deficient in Omega 3 if eating 1-2 tablespoons of flax seed meal and green leafy vegetables at several meals. There is also research that suggests that those on plant based nutrition become highly efficient in their own manufacture of omega 3. Patients on fish oil are also at increased risk for bleeding. Flax Seed Oil/ Flax Seed Meal – What about flax seed oil? Flax seed meal is well tolerated and supplies a bonus of omega 3 using 1 or 2 tablespoons on cereal daily. Avoid flax seed oil. Olive oil, canola oil, coconut oil, Sunflower oil, soybean oil, peanut oil, any oil – Which oil is best? Avoid oils. They injure the endothelium, the innermost lining of the artery, and that injury is the gateway to vascular disease. Lotions with oil – Is it all right to use lotions with oil on my skin? It is fine to use lotions with oil on your skin. Omega 3 – How do I get my Omega 3’s? Omega 3 ‘s are essential fatty acids supplied in adequate amounts in people consuming plant based nutrition with plenty of green leafy vegetables. Family history –I have a bad family history? Does it matter? Family history can shed light on whether one has an increased risk, but multiple autopsy studies of the young confirm that all who are consuming the standard western diet have established, albeit early, vascular disease. Family history loads the gun but lifestyle pulls the trigger. Nuts – What about nuts? I hear so many different opinions. For those with established heart disease to add more saturated fat is inappropriate. For people with no heart disease who want to eat nuts and avocado and are able to achieve a cholesterol of 150 and LDL of 80 or under without cholesterol lowering drugs, some nuts and avocado are acceptable. No nuts for heart disease patients, includes peanuts and peanut butter, even though peanuts are officially a legume. Chestnuts are the one nut, very low in fat, it is ok to eat. (For a clarification of misinformation about nuts and this diet, see here.) Seeds (sunflower, pumpkin, sesame) Are seeds ok to eat? Some seeds sprinkled on bread or crackers, etc., are acceptable. Just don’t eat handfuls. Coconut water – Is it all right to drink coconut water? Coconut water is 8% saturated fat  (If the fat is less than .5 per serving it does not have to be listed on the label) and about 50% sugar.  So save your money and don't use it. Prostate cancer- Does plant based eating help prostate cancer? Prostate cancer is greatly lessoned by plant- based nutrition as best exemplified by the 1958 report confirming by autopsy 18 deaths in the entire nation of Japan. Egg whites, fat free milk, yogurt – So What is wrong with egg whites, fat free yogurt, skim milk? Egg whites, fat free milk and yogurt are ALL animal protein, and animal protein injures the lining of the arteries. Do not eat. Cholesterol Number fluctuation – Why do my cholesterol numbers fluctuate?  Fluctuation of cholesterol is normal. It is nice to have it fluctuating in a range that would indicate you are unlikely to have cardio vascular problems. Losing weight –What can I do to stop losing too much weight? If you are losing too much weight, EAT MORE calories. Increase portion size. Eat snacks. Eat more whole grains and beans. Tired, no energy - Why am I tired and have no energy since eating plant-based? If you feel tired and lacking in energy, be sure you are eating enough calories. Also exercise because you need to use energy to make energy. Depression also contributes to lack of energy. But first of all eat more. Not losing weight – Why haven’t I lost weight/ Why have I stopped losing weight? If not losing enough weight, eliminate flour products like bread, pasta and bagels. Instead, eat whole grains like rice, quinoa, barley and farro, etc. Reduce portion size. Increase leafy green vegetables and exercise. Triglycerides– Why did my triglycerides go up? If your triglycerides are high, cut back on simple carbohydrates which would include alcohol, wine, beer, white flour products, sugars including dried fruit, honey maple syrup, molasses, rich desserts, fruit juice or an excess of fruit, HDL- My doctor is so concerned because my HDL has gone down It is not uncommon for HDL to fall when cholesterol falls. Do not be alarmed. The capacity of HDL to do its job has been shown recently by scientific research that there is no relationship between the capacity of the HDL molecule to function optimally and its blood level. Recent research has confirmed that the HDL molecule can be injured and weakened when one is ingesting a pro inflammatory western diet and conversely it appears despite a lower than normal level to be optimized by anti inflammatory plant based-nutrition. LDL - Where should my LDL be? LDL is the bad cholesterol. The closer it can be to 80-85, the better. However, if one is unable to take statin drugs and eating plant-based nutrition, and the LDL won’t go lower than 95-105, it would appear that they will still be fine. The lesson we learned from the Tarahumara Indians, who never have cardiovascular disease, is that the most key protective element is not so much the pure LDL number as is knowing that nothing ever is eaten which is a building block of vascular disease or can injure endothelium. Statins - Should I take statins or not? Statins are not the reason that cultures such as the Tarhumara and the Papua Highlanders do not have cardiovascular disease. Statins appear to have no benefit in primary prevention but are of some help in slowing disease progression for those who already have an established diagnosis of cardiovascular disease. Clearly some of our most profound successes in arresting and reversing disease were with patients who either refused or were incapable of taking statins. Nothing is as powerful for the prevention of cardiovascular disease as plant based nutrition. Coumadin – Can I eat leafy greens when I am on Coumadin? Coumadin (Warfarin) is an anti clotting drug shown to have significant benefit in protecting people with atrial fibrillation from having a stroke. Can patients on Coumadin eat all the green leafy vegetables with vitamin k, which may shorten their clotting time? The answer most emphatically is YES! Merely inform the physician who is monitoring the Coumadin and clotting time that you are regularly going to be eating copious amounts of healthy green leafy vegetables. He/she will appropriately adjust the Coumadin dose. Juicing- Is it all right to juice? Do not juice. You lose all the fiber and its benefits. Fruit juice – What about fruit juice? Drinking fruit juice is like pouring the sugar bowl down your throat. It is fine to eat the whole fruit. Do not drink the juice. Smoothies – How about smoothies? I love them!  Avoid smoothies. The fiber is so finely pureed that its helpful properties are destroyed. The sugar is stripped from the fruit, bypasses salivary digestion and results in a surge of glucose and the accompanying fructose contributes to inflammation and hypertension. A Fib- Will plant nutrition work for A Fib? While A Fib is largely independent of nutrition, and is a heart rhythm abnormality, there are some subset of cases which are presumably related to less than optimal heart circulation. While it would be totally inappropriate for me to suggest plant - based nutrition would cure atrial fibrillation, the many ancillary benefits would indicate plant based nutrition would be of value. Calcium score- Is a calcium score helpful? With cardiac CT you get a big hit of radiation. If you have been eating the typical American diet, you have heart disease as autopsy studies have shown. Erectile dysfunction- Will erectile dysfunction reverse with plant based nutrition? We have seen erectile dysfunction reverse on multiple occasions. Those who follow the program most closely have the best results. How long it takes varies. Do Cholesterol Numbers Matter? What you eat matters most. LDL 85 or under is the ideal but it can vary if you eat plant based. Sugar- How much sugar is safe? Newer information suggests that excess sugar is harmful, especially fructose, one of the most commonly ingested sugars, which can contribute to inflammation and hyper tension as well as weight gain and exacerbating diabetes Coffee – Can I drink coffee? Avoid coffee with caffeine. Several studies indicate it may contribute injury to the lining of the artery. Soy products – What about soy products? Soy products are 40% fat and most of them are highly processed. An excess of soy protein may stimulate insulin growth factor, which is a tumor promoter. Eat soy products cautiously. Does eating plant based help with congestive heart Failure? There are multiple components in  the treatment of congestive heart failure.   It is our experience that when all the usual therapies have been instituted, there can be additional improvement with the introduction of whole food, plant based nutrition. There are so many different diets out there…Paleo, blood type, how do I know which one to choose? That is not as challenging as it may appear. You can separate hype from scientific reality by seeing if the author has done peer reviewed scientific research prior to bringing the ideas to the public. What is the difference between plant protein and animal protein? While the precise mechanisms need to be elucidated, animal and epidemiological studies as well as the brachial artery tourniquet test, confirm that animal protein accelerates both atherosclerosis and cancer,  whereas plant protein does not.

Update on DH's Chest Pains and Xience V research

Dh is feeling much better today, and I have to blame his chest pains on a non-cardiac cause.  He has been very active today with no chest pain at all, none for the whole day, and this is his first pain free day in over a week.

The family has been passing around a cold, so I'm assuming that his pain was bronchial related instead.  He has had pneumonia the past two winters, so he's vulnerable in his bronchial area.

I did follow up and do research on the Xience V stent.  I'm so glad that Dr. Tannenbaum is the consciencious interventionalist that he is.  He has chosen what seems to be at this point, the drug eluting stent as far as I can tell.   The Xience V is noted to have a very low rate of restenosis and late thrombosis, which puts my mind at ease, especially since Dh is feeling better today.  Ahhhh!  Such is the life of a heartmate.  So much worry, so much relief, back and forth, back and forth.

I'm posting the article here about  the Xience V clinical trials found on the following web site.........

http://www.theheart.org/article/1125257.do

COMPARE and SPIRIT IV: "Durable, progressive relative benefit" of Xience V over Taxus

SEPTEMBER 23, 2010 Michael O'Riordan

inShare

• 0
  Comments
• Read later
  • 
  • 
  • 
• Print
• Font size
  a
  A
  A
• Cite

 Download slides

Washington, DC - Two-year results from the COMPARE and SPIRIT IV trials confirm the superiority of the everolimus-eluting Xience V stent (Abbott) over two iterations of the paclitaxel-eluting Taxus stent (Boston Scientific). In COMPARE, an investigator-initiated, all-comers trial, researchers showed that the everolimus-eluting stent remained superior to the Taxus Liberté stent, with significant differences in the composite end point of death, nonfatal MI, and target vessel revascularization (TVR) observed at two years.

Similarly, the SPIRIT IV investigators, led by Dr Gregg Stone (Columbia University, New York), also showed sustained benefit of the Xience V stent over the older Taxus Express stent. At two years, treatment with the everolimus-eluting stent resulted in a relative 30% reduction in target lesion failure, a composite end point reflecting cardiac death, target vessel MI (TVMI), or ischemia-driven target lesion revascularization (TLR).

Dr Dean Kereiakes

Presenting the results of the SPIRIT IV study during a morning press conference at TCT 2010, investigator Dr Dean Kereiakes (The Christ Hospital, Cincinnati, OH), said both trials show a "durable, progressive relative benefit" of the Xience V stent over time.

"The other revelation is that the very late stent-thrombosis rates with the Xience V are low, either with or without extended dual antiplatelet therapy," Kereiakes told heartwire. "Our trial had 72% of patients taking dual antiplatelet therapy at two years, while their trial [COMPARE] had just about 10% of the Xience V cohort on dual therapy at two years. Either way, the very late stent-thrombosis rates were very low with the Xience V stent. Not so in the Taxus arm."

Dr Stephan Windecker (Bern University Hospital, Switzerland), who was not affiliated with the two trials, agreed, telling the media the message from the COMPARE everolimus-vs-paclitaxel comparison was the difference in stent-thrombosis rates between the two stents at one and two years.

"In terms of efficacy, I don't think we're surprised to see the superiority of this newer-generation stent," said Windecker. "The new message relates to the one-to-two year interval, a very late period, and the significant reduction in very late thrombosis. This is an important advance, because it was the principal limitation of both Cypher and Taxus."

COMPARE and SPIRIT IV at two years

Presented last year at TCT 2009 in San Francisco, CA and reported by heartwire at that time, SPIRIT IV investigators randomized 3690 patients in a 2:1 fashion to the Xience V or the Taxus Express 2 stent. Regarding the primary end point at 12 months, there was a 2.6% absolute difference in the rate of target lesion failure between the two stents, statistically favoring the Xience V. A statistically significant difference in stent thrombosis between the two arms was also observed at one year: 1.06% for Taxus vs 0.29% for Xience V (p=0.003).

With the two-year data presented today, there was an absolute 3.0% difference in target lesion failure, again statistically favoring the Xience V stent. There were also significant reductions in ischemia-driven TLR and TVMI with the everolimus-eluting stent, but no significant differences in mortality. The differences in definite or probable stent thrombosis were also in favor of the Xience V stent, with a two-year stent thrombosis rate of 1.23% among the Taxus-treated patients and 0.42% for the Xience-treated patients.

SPIRIT IV: Primary and secondary end points at two years

End point	Xience V (n=2458), %	Taxus (n=1229), %	p
Target lesion failure	6.9	9.9	0.003
Ischemia-driven TLR	4.5	6.9	0.004
Cardiac death	0.9	1.3	0.34
Target vessel MI	2.3	3.5	0.04
Definite or probable stent thrombosis	0.42	1.23	0.008

Dual antiplatelet therapy was maintained in a majority of patients, 72% among patients treated with Xience and Taxus, until two years, note the researchers. They also note that diabetics did not fare as well as those without diabetes. At two years, as with the one-year data, there was no significant difference in the primary end point of target lesion failure among diabetic patients treated with the two stents.

Dr Ian Meredith

Speaking during the late-breaking clinical-trials session, Dr Ian Meredith (Monash Medical Center, Melbourne, Australia) said the sustained benefit of Xience over its Taxus counterpart is an important finding. He stressed, however, that SPIRIT IV was not an all-comers trial and that while investigators treated a wide range of vessels and lesion lengths, many patients were excluded.

"It's important to recognize that there were certain patients that weren't treated in this study, bearing in mind that we can't necessarily generalize the stent-thrombosis rates to these other patients, namely those patients with ostial lesions, chronic total occlusions, calcified vessels, acute MIs, saphenous vein grafts, and patients with thrombus, all of whom have a significant rate of early and late stent thrombosis," said Meredith.

Regarding the diabetes data, Meredith said that the Xience V stent appears to lose some efficacy among diabetic patients, and the reason is not entirely clear. By his interpretation, he said the results suggest that both stents fared equally well in the diabetic cohort.

Taking on all-comers in COMPARE

Dr Peter Smits

In contrast with SPIRIT IV, the COMPARE investigators did take on all patients and included 1800 complex patients, such as those with acute MI and STEMI, as well as those with relatively high proportions of calcified lesions, bifurcations, multivessel disease, and diabetes. As reported previously by heartwire, the Xience V stent performed better than the Taxus stent, with significant reductions in the primary composite end point of death, nonfatal MI, and TVR. Similarly, there were reductions in secondary end points, as well as reductions in the risk of definite or probable stent thrombosis.

Presenting two-year data today, lead investigator Dr Peter Smits (Maasstad Ziekenhuis, Rotterdam, the Netherlands) reported that the difference in the primary end point was maintained at two years, with larger absolute differences between the Xience V and Taxus stents than at 12 months.

COMPARE: Primary and secondary end points at two years

End point	Xience V (%)	Taxus (%)	p
MACE	9.0	13.7	0.0016
Cardiac death, nonfatal MI, and TLR	7.4	11.4	0.0038
Nonfatal MI	3.9	7.6	0.0009
Definite/probable stent thrombosis	0.9	3.9	<0.0001
Early stent thrombosis (<30 d)	0.2	1.7	0.002
Late stent thrombosis, (30 d-1 y)	0.3	0.9	0.13
Very late thrombosis (1-2 y)	0.3	1.5	0.013

MACE=major adverse cardiac events (all death, nonfatal MI, and TVR)

To download tables as slides, click on slide logo above

Unlike SPIRIT IV, where a majority of patients continued to take dual antiplatelet therapy at two years, just 13% of COMPARE patients were taking clopidogrel and aspirin after two years. Despite this, there were significantly lower rates of definite/probable stent thrombosis among those treated with the Xience stent.

Dr Jeffrey Popma

Speaking during the late-breaking clinical-trials session, Dr Jeffrey Popma (Beth Israel Deaconess Medical Center, Boston, MA) said the stent-thrombosis data suggest that "there is something clearly there" with the Taxus Liberté stent. To heartwire, Kereiakes said the relative lack of dual antiplatelet therapy in the COMPARE trial highlights the differences between the two stents and exposes the "relative hazard" of Taxus, especially when patients stop taking clopidogrel.

Like the SPIRIT IV study, there was no benefit of Xience in diabetic patients.

A spokesperson for Boston Scientific noted that the Taxus Express stent, tested in SPIRIT IV, is no longer commercially available in the US. He also said the event rates observed in COMPARE, "specifically for early stent thrombosis, TLR, and MI," are not in line with results observed in other trials.

Stone disclosed receiving research grants from Atrium, Volcano, and TherOx; consulting fees from Osprey Medical, InfraRedx, Reva Medical, Boston Scientific, Abbott Vascular, the Medicines Company, AstraZeneca, Eli Lilly, Bristol-Myers Squibb, Edwards, Evalve, Ortho McNeil, and Otsuka; holding equity in Devax; BioStar I and II funds; MedFocus I, II, and Accelerator funds; FlowCardia; MediGuide;Guided Delivery Systems; Arstasis; Micardia; and Access Closure. Kereiakes reports research support from Abbott Vascular, Amylin Pharmaceuticals, Cordis, Boston Scientific, Medtronic, and Daiichi Sankyo and consulting fees from Abbott, Boston Scientific, Eli Lilly, Medpace, and Reva Medical. Windecker reports speakers' bureau fees from Abbott, Cordis, Medtronic, Boston Scientific, and Biosensors. Meredith reports consulting for Medtronic, Boston Scientific, and Abbott Vascular. Popma disclosed research support from Cordis, Medtronic, Boston Scientific, and Abbott and consulting fees from Cordis and Boston Scientific. Smits disclosed receiving unrestricted research grant support from Abbott, Boston Scientific, and Terumo Medical.