Archive for 'heart'

Best Hospitals: Heart And Heart Surgery

 US News and World Report lists the best hospitals for heart disease treatment and surgery. Topping the list is the Cleveland Clinic, which also has a heart disease forum where you can ask the experts.

My lipid panel indicated very low total cholesterol and even LDLs were lower than my cardiologist was happy with. At the time my Crestor intake of 20mg a day, coupled with 1 gram of Niaspan, and a strict diet and heavy exercise problem lead to these results.

The high reverse t3 levels (rt3) are a result of a restricted diet with over training. To verify there was no issue the reader will note in the results a lab draw on 10/12 that measured Iodine. The link discusses the relationship between Iodine and the thyroid gland.

Very low cholesterol has been tied to issues with memory loss and dementia, as well as other health issues. While many TRT specialists aim for a total cholesterol of 180 mg/dL I believe the body can function with lower levels. The thinking goes something like this. See the hormone tree below:

Note the cleaving enzyme that cleaves cholesterol into pregnenolone and then on down the steroid pathway. Without enough cholesterol there is not enough fuel for the remaining hormonal system, right? True – to a point.

The reality is everyone is different and that 180 mg/dL is not some magic number or target. For some, 120 may work fine, or even lower. The worry is that patients will remain non-compliant with cholesterol lowering medications without doctor supervision in an effort to “jump-start” their own testosterone or maximize hormone fuel by boosting cholesterol. The warning here is…be careful.

I lowered my dose to 5mg of cholesterol and purchased a cholesterol meter that measures Total Cholesterol, Triglycerides (TG), and HDL. This allows LDL to be calculated using the formula LDL Cholesterol = Total Cholesterol – HDL – (TG / 5). I ensure I am always above 120 and I am doing just fine. If I hit 180, I don’t panic. I get by without any problems with frequent exercise and some sanity in my diet.

Not shown in this lab that did show up on previous labs is an increase in hematocrit and RBC leading to polycythemia – an increase in red blood cell count per unit blood volume. This increases the risk of clot formation. If you have heart disease, watch out for this side effect. More often seen on shot therapy for TRT, it can happen even with gels. Treatment usually involves blood letting, a procedure that can be ordered by your doctor. Also, it helps to cease TRT treatment every 12-18 months for a short period of time.

As far as the testosterone levels go, I was on 1.5 tubes of Testim for this test, applied in the morning, and the blood work done 2 hours after application. My testosterone was screaming high at over 1400ng/dl. This level is a false reading as a future lab would indicate.

WARNING: Never apply Testim or any gel to the area where the blood draw will occur. This can taint the results. This is what happened for this particular test. I had to ignore the results.


Taking Control Of Heart Disease

Heart disease covers several conditions which affect the heart. This includes ischemic heart disease, heart failure, heart arrhythmias, heart valve issues – this list is not exhaustive. Causes of heart disease often include a history of high blood pressure, smoking, high levels of bad cholesterol, low levels of good cholesterol, a sedentary lifestyle, drug abuse, genetics, and other diseases. For my wife’s father, a virus attacked his heart leading to heart failure and eventually death. The list of causes in developing heart disease are long. Knowing the warning signs can be the difference between life and death, affect the quality of your life and impact family members as well. From the CDC:

Heart disease and stroke are the most common cardiovascular diseases. They are the first and third leading causes of death for both men and women in the United States, accounting for more than 35% of all deaths. More than 870,000 Americans die of heart disease and stroke every year, which is about 2,400 people dying every day. Although these largely preventable conditions are more common among older adults, more than 148,000 (17%) of Americans who died of cardiovascular diseases in 2004 were younger than age 65 years. Heart disease and stroke also are among the leading causes of disability in the U.S. workforce. Nearly one million people are disabled from strokes alone.

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Testosterone Renormalization Protocol Day 45

The results are in – my total testosterone is 265ng/dl. This is lower than I would have liked. I get tested again in 1 month. Two weeks of the orals clomiphene citrate and tamoxifen are left and then I take a two week break.

Depending on my next test results, I have a few options according to the Houston doctor who specializes in treating hypogonadism. I could just accept the new number, take another month of clomiphene and tamoxifen once per day as opposed to two and then re-measure after being off the orals for two weeks, or go back on Testim gel for 12-18 months and then repeat the protocol of HCG, clomiphene, and tamoxifen.

What my Houston doctor found amazing is that, when he did this, many of his patients with numbers similar to mine bounced back to 500ng/dl, which is exactly where I would like to be. I think I will be taking this approach if my results are not satisfactory in one month.

The protocol has certainly not been a failure. My original total testosterone was 185ng/dl and now I am sitting at 265ng/dl. I now understand the possible cause of my maximum heart rate drop. My maximum heart rate while on Testim gel (total testosterone around 700ng/dl) was around 182. When my testosterone bottomed out after the Testim cessation it was around 162. Now it is around 166. I believe testosterone to be the main cause of this result. The most testosterone receptor cells can be found in the brain and the heart, so it just makes sense to me. The real test will be if I go back on the Testim and my maximum heart rate increases to 182 bpm.

Mended Hearts

Most of you have never heard of Mended Hearts. Hope is their charter. From their website:

Hope for recovery. Hope for a rich, full life. For more than 50 years, Mended Hearts has been offering the gift of hope and encouragement to heart patients, their families and caregivers.

Patients, spouses, family members, friends, medical professionals, Mended Hearts brings together all of us who are faced with the realities of heart disease to form a network of caring individuals.

Take some time to browse through our Web site and learn who we are and what we do. If you or someone you know is a heart patient who would like to visit with one of our accredited visitors online, by telephone or in your community, e-mail us now or call 1-888-HEART99 (1-888-432-7899).

Membership is not free, but the amount is very reasonable. My intention is to join the community of Mended Hearts and become a patient visitor. If someone about to undergo any operation, intervention, or other treatment for heart disease wishes to find someone who will listen to their fears and provide comfort, then I would be called to visit that person and provide support to them.

I was very excited to attend my first monthly meeting, but alas the weather caused a cancellation. Still, there is next month. Look for a local chapter in your area and get involved.

Sorry about the light posting.

Hectic has been the name of the game for the last three weeks. First of all, one of our two dogs – Harvey, pulled a disk. Thankfully, he has made a full recovery rather quickly. The surgical cost of handling a slipped disk would have cost over $8000.00.

Next came the news last week that I am going to get a 10% pay cut – across the company I work for. Being over $50,000.00 in credit card debt, this was not welcomed news. I have been paying off about $1200.00/month, but I won’t be able to keep that up now. I may not even be able to make the minimum payments. My father, who lost his job as a consultant geophysicist is in danger of possibly losing his house.

I am also worried about the love of my life. My wife has a odd shaped mole that is on her back. We have a dermatologist appointment this Thurday to get it checked out. It is probably nothing, but it is hard to keep positive and upbeat about this particular situation.

On the heart front, my workouts are becoming more intense and my maximum heart rate is increasing. It is now around 172 beats a minute, while four months ago is was around 180 beats per minute, so I can’t complain.

The testosterone recovery appears to be going very well. It is now day 30 and I am noticing improvements in testicular size almost daily. I get another measurement of total testosterone and luteinizing hormone (LH) this Thursday. Hopefully, the results are positive. There is no guarantee, but it sure would be nice to get off the Testim gel permanently. Fingers crossed.

Which brings me to my final point – stress. For those with heart disease it can be a major enemy – especially chronic stress that seldom lets up. Using meditation in the past has helped and I am now beginning to utilzie this technique again. However, nothing beats a good workout – either cardio or weight lifting. As my Houston doctor says – get your mind focused on something. Good advice all around.

If you feel you may suffer from an axiety or panic disorder, see a psychiatrist as soon as possible. There are a number of good medications to assist you. As always, make sure your pyschiatrist and cardiologist are aware of any medication changes.

Gerald Merits

New Treatment May Halt Heart Failure

CBS news Healtwatch reports on a new experimental technique that could save thousands of lives for those suffering from Heart Failure.

Usually, the only option available for heart failure patients in the advanced stages of the disease is a heart transplant. However, with limited hearts available for transplants and tens of thousands of patients often the patient dies waiting for a heart. This is what happened to my wife’s father, his heart failure the result of a heart virus.

From the CBS article:

…Delong’s heart was failing and was so enlarged that “you could actually see my shirt moving from my own heart, that’s how bad my heart was,” Delong says.

Doctors told her that a transplant would be necessary, assuming they could find a donor heart. Then, they suggested a different approach.

“Over the past five years, the use of mechanical heart pumps has revolutionized the care of some patients with heart failure,” Dr. Simon Maybaum, of the Montefiore Medical Center, says.

Monique had a mechanical heart pump implanted that took over the work of her left ventricle, letting it rest and heal.

But, like other muscles, resting the heart too much will make it weak.

“One suggestion that we had offered them too much of a good thing – that we had rested the heart too much and that it, indeed, had become lazy,” Maybaum says.

Doctors also gave Delong a drug, Clenbuterol, used to treat asthma in Europe. The drug has the added side effect of stimulating muscle to become bigger and stronger. That, combined with conventional heart failure drugs, led to a remarkable finding in a previous British study.

“Two-thirds of those patients had complete recovery of their heart function, to the degree that their heart pumps could be taken out,” Maybaum says. “When followed for up to a period of four years, [they] had stable heart function and [came] off all medications.”

Delong’s heart recovered so well that, two weeks ago, doctors were able to remove her artificial heart pump.

“I feel great, I feel alive again,” Delong says. “I can walk better, [and] I ran up the stairs for the first time in years.”

Monique is the first patient in a new study to recover enough to have her heart pump removed. The multi-center trial is designed to show that this combination drug-and-pump approach is allowing heart failure patients to get better.

Very interesting development for sufferers of heart failure:

Surgeons at The Methodist Hospital in Houston were the first in the nation Thursday to inject highly-concentrated stem cells directly into a patient’s heart, providing an intense, direct hit on damaged heart tissue.

In an investigational study of new heart failure treatments, this promising new technique may be more effective in regenerating healthy heart tissue than current methods that use a catheter to put standard stem cells through the bloodstream into the heart.

The 58-year-old veteran and businessman is resting comfortably and is expected to be discharged this weekend.

“Some patients have such severe heart failure that their only current option is a heart transplant,” said Dr. Brian Bruckner, cardiac surgeon at the Methodist DeBakey Heart & Vascular Center in Houston. “We hope that stem cells will stimulate angiogenesis, the growth of new blood vessels, restore mechanical function in diseased heart tissue, and return patients to a much better quality of life without a transplant.”

In a novel process, the patient’s strongest and most robust stem and progenitor cells, derived from the patient’s own bone marrow, are amplified up to 1,000 times before they’re injected back into the patient’s heart. In the procedure, Dr. Bruckner made a small incision in the left side of the patient’s chest and administered approximately 25 injections of concentrated stem cells into the patient’s heart. All patients in the trial will be followed for 12 months after the injections.

There are currently 5.5 million people in the U.S. suffering from chronic heart failure. A subset of these patients has dilated cardiomyopathy (DCM), a chronic heart disease in which the patient’s heart can not pump effectively enough to deliver blood and oxygen to the vital organs in the body. Patients with DCM typically experience severe limitations to physical activity and shortness of breath.

“Without a new approach to treatment of these patients, they will continue to decline and less than 40 percent will survive five years,” said Bruckner, principal investigator for the trial. “We hope this trial will provide a completely new and viable treatment for them.”

Dr. Michael Reardon, chief of cardiac surgery at Methodist, and Dr. Matthias Loebe, transplant surgeon at Methodist, are co-investigators on the trial. Dr. Kevin Lisman is the patient’s referring cardiologist.

The IMPACT-DCM trial is in phase-II and is seeking to enroll 20 patients with ischemic dilated cardiomyopathy and 20 patients non-ischemic DCM patients at five clinical sites in the U.S.

For more information about the Methodist DeBakey Heart & Vascular Center, see here.

Scientists ‘Grow’ New Beating Heart

Technology never ceases to amaze. From Live Leak (emphasis mine):

It looks like a heart.

It beats like a heart.

And it has the capability to keep someone alive like a heart.

But this amazing organ wasn’t part of someone’s original equipment. Instead scientists grew it in a lab. And they believe it might one day lead to new ways of treating everything from cardiac disease to transplants.

If this sounds almost inhuman, it is. The ticker actually started as the heart of a dead rat, and was taken by researchers at the University of Minnesota and “washed” of its original cells. That left a shell of the organ which the scientists then injected with new cells culled from newborn rodents. Their excitement was unbounded when the organ started beating on its own.

Those behind the project admit it has a Frankenstein-like element to it, but it also holds so much promise that’s its more boon than bane. “We really have the audacity to claim to build a functional organ from scratch so to speak,” outlines Dr. Doris Taylor. “We’re willing to admit that it’s a crazy idea.”

But what it portends is anything but crazy. The researchers admit a rat heart will never be compatible with humans – but a pig heart might be. As distasteful as that might sound, the chance that it could save the lives of thousands of patients waiting for transplants that are in too short a supply makes it worth exploring.

“Three thousand people a year don’t have other options,” Taylor explains. “We want to make a difference.”

She envisions a system where a pig heart could be “washed”, injected with stem cells from a potential recipient and literally grown from scratch, before being inserted back into the patient. Rejection would be unlikely, since the body would recognize it as its own.

Check out the video.