I can only say, “Thank you God”. It seems like being put on the prayer list at my church really worked a miracle. Only two minor blockages were noted on my heart nuclear stress test, something of little significance, especially given my diet for the last four months. Steaks, hamburgers, nachos, cheese, Scotch – you get the picture.

My total cholesterol did increase from 99 mg/dL to 141 mg/dL, with my Triglycerides topping out at 197 mg/dL (140 is the maximum). HDLs were 44 (they were 41 last time). LDLs were 58 (they were 33 last time). CRP was still very low at .3 mg/L (anything less than 1 is great).

My kidney function was off (creatinine of 1.54 mg/dL and eGFR of 50L). Creatinine should top out no higher than 1.34 mg/dL, but I have often seen numbers higher than this. This is the first time for an eGFR measurement and it registered low (it should be greater than 60L). My physician did not seem too concerned, given that I lifted weights the day before and was taking my wife’s Naproxen for a pulled muscle for the week previous to the test. I concluded after studying eGFR lab online in medical journals that it is on shaky ground as far as viability is concerned. My physician’s greater concern was my A1C – a measurement of the average blood sugar for the past 6 months.

My fasting glucose is usually around 95-99 mg/dL – right near the high end. This time it was 85, but my A1Cs were 5.9. They have always been a little high, 5.7-5.9. A value of 6.0 is indicative of diabetes. In my past are multiple glucose tolerance tests, and I usually fail only one of the four blood draws over the two hour period; or pass all four. One could say I suffer from pre-diabetes, also known as glucose intolerance, also known as metabolic syndrome X. Scary name, that last one. I recall the first time I was told I may have metabolic syndrome X. I remember thinking, “My God, they don’t even have a name for it yet! This does not bode well”. Well, suffice to say this is just a fancy name for glucose intolerance. No laughing matter, mind you, but not as sinister sounding as “metabolic syndrome X”.

My physician wanted me to clear with my cardiologist the use of Byetta – a twice a day injection just prior to breakfast and dinner. The needle is very small and given subcutaneously. There is little chance of hypogonadism unless the user is simultaneously on other medications that contain a sulfonylurea – a pill that increases insulin release from the beta cells in the pancreas

The purpose of this medication for me is to lower my A1C (the value of 6.0 basically translates to the loss of 50% of my pancreatic beta cells responsible for metabolizing sugar). The medication also has a bonus side effect – weight loss.

Which brings me back to my testosterone. Last time, my last measurement was 550 ng/dL for total-T. This time it was a meager 317ng/dL. As abdominal fat aramotases testosterone to estrogen, I believe I know the cause of most of the reduction – my 12 lb. weight gain.

So here is the plan of action. Take the Byetta for blood sugar control to stop the onset of full-blown diabetes. Start Niacin to boost my HDLs. Then there is diet and exercise, which along with the Byetta should substantially reduce my weight and bring my testosterone back up into a better age-matched range. All of this will be accompanied by blood work to monitor the status of my liver, A1C, lipids, and testosterone.

The conclusion? I am responsible for my low testosterone, weight gain, and accompanying increase in lipids. Still, it is also within my power to bring all of these back under control. With Niacin, if I can lower my lipids to their previous levels the chances of reversing my heart disease are good.

My stress test is final proof that it was tolerance to 75mg of Plavix (I now take 150mg daily) that lead to the multiple stent procedures. Since I have started 150mg of Plavix, I have passed three stress tests. This does not mean that re-stenosis is not in my future, but that my current heart health is directly within my control.

However, that is not the miracle I referred to in my opening. My previous stress test indicated a left ventricular ejection fraction of 40. This was so stunning my previous cardiologist ordered an ECG (sonogram of the heart) to discern my real LVEF (it was 52). Anything below 50 is considered the beginning of heart failure. This time my LVEF was 65 (the range is 50-70) – the highest it has ever been. Also, my left ventricle – which experienced minor thickening over the past four years is now within the normal range.

So the prayers were answered; along with a friendly warning from above. The things that were within my control were I consciously ignored (with the exception of exercise). I indulged in food and a little too many drinks – hence the higher lipids. However, a silver lining to my self-induced cloud appeared. My physician, not knowing of my fall from discipline, thought I was going diabetic. He had just come back from a symposium on Byetta and immediately recognized the benefit it would have for me, even though I was not diabetic. How lucky for me that my physician saw the potential in this new drug and offered me something that will change the course not only of my glucose intolerance, but also my heart disease.

The Lord helps those who help themselves. I have been given a reprieve and seen a miracle occur in my own body. The rest is up to me. I put myself in this predicament with poor self control in the face of genetic factors that had heart disease warning signs flashing in my face since my early twenties. It will take discipline and a love of the temple that God has given me to keep going strong. Depending on your perspective, I have been either very lucky or very blessed. Did I die when my LAD was 100% occluded? No – my life was spared by a collateral artery that kept me barely alive. Did I die when I had an aneurysm in my LAD due to lifting too much weight to feed my vanity – no. It was caught just in time by the same cardiologist who saved my life the first time. Was I lucky to be sent to a cardiologist who is the only one is Austin possessing the knowledge and skills to keep me alive during my first procedure?

Thank you one and all for your prayers and thanks to Shepard of the Hills members for their prayers. My aunt in Toronto lit a candle for me at a Catholic church, so I like to think that Protestants and Catholics coming together are a force to be reckoned with!

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