Archive for April, 2009

From CBS News:

How do you treat something that has no symptoms and goes undetected on standard screenings?

DE-CMR (delayed enhancement cardio magnetic resonance) is a new cardiac imaging technique that can detect if you’ve suffered a silent heat attack, which an earlier EKG might have missed.

Early Show medical correspondent Dr. Jennifer Ashton shared this new method of detection with Early Show co-anchor Julie Chen.

According to Ashton, a silent heart attack is “both silent and potentially deadly,” which is “very scary” because there are no typical signs like chest pain or shortness of breath.

“You as a patient might be unaware that you’re having one and it doesn’t leave its signature on the EKG after the fact so your doctor might not be able to tell that you’ve had one,” she explained.

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Update: In the comment section of this blog, reader Angus asks what supplements I do use. I mention N-acetyl-cysteine (NAC) due to its proven liver protection. I would also like to add to that Resveratrol – basically the stuff you find in red wine but in a pill so you don’t need the alcohol. It does have a great deal of supportive evidence for cardiovascular health, but I would talk to your doctor before trying it just to ensure it will not interfere with current medications. I have noted a slight increase in blood pressure (about 3%-5%). I have tried various brands and have found them to be similar in terms of an increase in exercise tolerance. The only real difference seems to be the price. Some of it costs $80 a bottle, some are less than $50 a bottle. It has been featured on 60 minutes, Oprah, CNN, and a host of other channels. A Harvard study heralded Resveratrol as the best thing in medicine since antibiotics.

Almost everyone believes the main purpose of statins is to lower cholesterol and this lowering reduces the risk of a cardiovascular event. However, how do we explain heart attack victims with normal cholesterol levels? While there are many culprits, one of the main areas of interest is C-Reactive Protein, or CRP for short. Measuring your CRP level can be a good indicator of inflammation, and inflammation leads to unstable plaque. So what if you could lower your CRP levels and stabilize your plaque? Your chances of a cardiovascular event decreases significantly. Read Decreasing Markers Of Inflammation Is As Important For Statin Action As Decreasing Ldl Cholesterol (Jupiter Study). From Medical News Today:

A follow-up study on the JUPITER* trial has revealed that a key component of the action of statins is reduction of high sensitivity c-reactive protein (hsCRP), a marker of inflammation, as well as reducing levels of bad cholesterol. The findings are published in an Article published Online First and in an upcoming edition of The Lancet. Publication of the Article coincides with the announcement of the findings at the American College of Cardiology (ACC) meeting in Florida, USA.

Present guidelines for statin therapy emphasise the goal of reducing LDL or ‘bad’ cholesterol. However, statin therapy works best in the presence of inflammation, which is characterised by increased concentrations of the biomarker hsCRP. It is thought that reducing levels of hsCRP helps prevent inflammatory cell adhesion – the process by which inflammation promotes cells sticking together and forming plaques in arteries. Reducing hsCRP could also help by preventing these cells sticking to the endothelium (or inner lining) of the artery, and favourably affect metal-containing enzymes key to plaque stability.

I still recall the days when the reputation of statins was stained by alternative medicine and even some doctors. I also recall listening to those “reports” which showed that taking more of this or that vitamin or herb would have the same effect. Listening to junk science is why I am in the situation I am today. While I do agree there is some evidence for alternative therapies to treat various illnesses, the lack of FDA control on the quality of these supplements amounts to a patient playing Russian Roulette with their health. That is why I do quite a bit of research and self-testing prior to settling on a brand. For NAC I use the GNC brand and Resveratrol Select is my choice or Resveratrol as it provides excellent benefits for less cost than Resveratrol that has some doctor’s endorsement – which basically means they are getting paid to promote one product over another and that cost is being passed on to you.

I am also aware that statins are not for everyone. However, if one heeds the warnings and regularly checks their liver function, statins are safe. I am far more concerned about the Plavix I am on and any future non-elective surgeries I may require than I am about Crestor. Also, if you read My Story, you will note that my CRP levels are extremely low – .5mg/L, with anything less than 1mg/L considered low.

So don’t listen to the negative talk from so-called experts who are out to sell you their latest non-prescription cure for your ailment without doing a lot of research first. In my opinion, there is nothing wrong with adding an alternative approach as a complement to medical therapy as long as your doctor is aware of any other supplements you are taking. Don’t play around with your health, or you may not have it for long.

It certainly has been awhile. It is good to be back.

A lot has been happening and I know some of you are interested in my current status. As far as my latest testosterone measurements, taken 1 month after stopping the oral medications Clomid and Nolvadex, was 550 ng/dL. Not trusting this number and knowing that increases in my testosterone levels have been accompanied by increased liver enzymes in the past, I asked to be re-tested. However, a severe cold held off the latest blood test until yesterday. This time I am checking my testosterone, liver enzymes, kidney function, C-Reactive Protein, lipid profile, thyroid, vitamin-D, and a few other tests. I should have the results back in two weeks.

Meanwhile, next week on Friday I have a cardiac nuclear stress test. If I pass it, it will be 8 months since the placement of my last set of stents. My cardiologist is taking an 18 month sabattical and assisting a poor area in El Paso, TX to build a cardiology community.

For me, that meant going on a search for a new cardiologist. My previous cardiologist suggested one of his partners. This is my first option. My own research lead me to two well respected cardiologists in the Austin area. No surprisingly, they were unhappy with my number of stents, saying that most of them were probably not medically necessary. However, they both agreed that some cardiologists are more agressive than others with the use of stents.

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