I LOVE my cardiologist. Although we might not agree on everything, he is willing to sit and discuss stuff with me in detail as no other cardiologist has ever taken the time to do. He is 86 years young, and still practicing medicine at the Mayo Clinic Rochester. Talk about an inspiring person. I hear from all the staff he works with, about how he sees more patients in a day than most other doctors… Not because he spends less time with his patients, but because he never sits still, often working through lunch, and staying late into the evening. On the day of this last visit, he worked through lunch to see me, still spending upwards of 45 minutes discussing my case. There is no doubt in my mind that he does what he does because he has a passion for saving lives, and he loves people. Not all doctors are created equal in this respect and I would urge anyone not happy with their current doctor to look for one they feel is truly interested in their recovery, not one just going through the motions of meeting their quota of patients and scripts.
I think it’s also important to realize that no matter how well-intentioned our doctors are, they have many limitations placed on them by the medical system. If they do not tow the line so to speak and stay within the pre-described boundary’s set by the institutions they work for, they will not be allowed to practice medicine anymore. So don’t expect to find any doctors willing to support and prescribe healthy lifestyle measures alone, not because lifestyle measures do not work, but because this is simply not how your doctor has been trained. They must use only the tools given them in the toolbox provided them so to speak. Any variance from this could very easily ruin their career. therefore, do not expect them to jump up and down for joy when you start seeing result they can’t reproduce since your using a tool unavailable to them. Good intentioned or not, they can’t offer to the rest of their patients a tool that’s not in their toolbox, just because it worked for you. When I first started seeing results, I really thought the doctors would share my enthusiasm but this wasn’t the case, instead, the results I was getting through the tools I was using actually drew discouragement from some of them. I found this very disappointing/disheartening in the least, but, like it or not, this is just the way this medical system is set up. Not always the fault of our doctors.
For the record, I personally think our current health care system is in complete crisis and needs a makeover. It has evolved into a serious money-making machine while the definition of “health” and “average”, has been continually redefined, setting the bar lower each time. Not because the doctors are greedy, but because the controlling 1% are. That greed is the reason most doctors are forced to practice using only the studies published and approved by the status quo so to speak. Do not expect to see your doctor interested in chasing after or mining results from the few people actually seeing RESULTS in long term cardiac care if those results came only through the adoption of a healthy lifestyle and were not the result of medications and medical procedures. Results obtained through lifestyle measures are very unprofitable. The corporate quagmire our health care industry has shortly exploded into has completely tied the hands of most good-intentioned doctors. The top priorities of these corporate beasts are to their shareholders, not your health. According to the law of the land, at least here in America, the officers of these corporate money making machines have a fiduciary duty to their shareholders. Part of that duty, again, according to the law of the land, is to turn a profit. The care we receive is secondary to these profits.
While strolling through the Mayo Clinic, (a not for profit corporation), It’s hard to not admire the assembly line type precision they have brought to medicine, whereas 100’s’ of people are able to move through all sorts of various appointments so quickly and efficiently, accomplishing in half a day what would take many days and visits to accomplish at most regional healthcare facilities. I also can’t help but notice all the lavish appointments. The place is simply breathtaking to anyone checking out all the architecture and art that is present on every wall, nook and corner. Seeing all these lavish architectural appointments and beautiful art hanging through out the place and I can’t help but think to myself, “what a money-making machine the mayo clinic is”. I’ll bet if they had shareholders they would be very pleased. But what about the rest of us…? Should we be pleased with the obvious amount of wealth this institution has generated off sickness…? (11.6 billion in total revenue at the Mayo Clinic last year alone). How many people have been turned away because they could not afford the price of this care…? How many of them may have died in the process…? I can’t help but ask myself these questions, and a lot of others along these lines.
There is a magnificent 28 foot, 6900 pound, cast bronze statue of a man that hangs off a glass wall down on the subway level of the Gonda building at the Mayo Clinic, Rochester. It is supposed to represent freedom and self-expression according to the little bit of history I read about this statue. Personally, when I look at that huge hanging statue, I see health, fitness and wellness, all rolled into one. I see a statue of what I perceive as a near perfect looking human body. But then I lower my eyes, seeing the 100’s of people all around me, and they seem to have nothing in common with this statue. Sickness is all around me, even much of the staff look sick in comparison. Based on what I am seeing, I can’t help but wonder if we have sold ourselves short, accepting a lower standard of health that does not even begin to match our potential or depict what I see that statue standing for. This is not only sad, but appalling in the least.
Before going to this appointment, I knew my cholesterol numbers would most likely be considered SUPER UGLY to anyone not following all the rapidly emerging science on the subject of statin use and cholesterol numbers. Most of the newer science on this subject disputes the current standards, but is not mainstreamed and in fact marginalized at best within the medical communities. Just so everyone knows, I love intelligent discussion/debate on this subject, but before I will discuss statin use and cholesterol numbers with someone, let me please first insist/urge them to personally research and follow the money trail being generated from these statins, while comparing who holds all the financial gain and wealth from the sales of the statins, along with who’s studies are being used to set/vet the current standards for statin use, both in academia, and in health care as we know it. Then, please educate yourself about the dark side of statins, learning all you can about the deleterious side effects and deaths that often accompany their use. By doing this, you may very well start seeing a very different picture then what the doctor and currently published information has painted for you. From there, read some of the many books now written on the subject from the many authors opposing statin use. Many of these authors are highly regarded, fully credentialed Physicians, and Biochemist’s. It is by no means an open and shut case when it comes to statin use, or cholesterol numbers. My personal experience seems to collaborate a lot of what some of these authors are claiming in their books on statin use. I personally experienced just how debilitating statin side effects can be. No secret there either. All the side effects I experienced are listed in the handout. Thankfully I only experienced 3 of the many side effects listed on the hand out including but not limited to, muscle pain, liver damage, neurological damage, increased blood sugar, type 2 diabetes, ect. Once damage to the body is sustained in the form of these side effects, again speaking from personal experience, I can tell you it is very hard to reverse this damage and it’s a lengthy process. The damage may not always just go away upon discontinuing statin use. In the case of the muscle damage I incurred, I lived with the consequences for another 4-5 years after discontinuing the statin.
Under current guidelines for cholesterol numbers, my numbers have always been considered dangerously elevated. Even after compliantly consuming a whole foods plant based diet for a good number of years, my numbers we’re still notably higher, then the range considered acceptable under current health care standards for a person with my history of cardiac maladies. Prior to following the plant based diet, I followed the make-believe heart healthy, low fat, low sodium version of the “standard American diet” as now recommended by most cardiologists under USDA, and AHA recommendations, along with 80mg of Lipitor and an assortment/cocktail of 12 other prescribed medications. The cholesterol numbers produced when I was tested back then were actually elevated more than my current numbers. So even though the numbers from my latest lipid panel are considered dangerously elevated according to current standards, these numbers are in fact lower than any numbers ever noted during both my early days of doing nothing, and my days on statin therapy, back when I followed the current recommended low fat/low salt standard american dietary guidelines.
I was diagnosed hypercholesterolemic in my early 20’s, although no statin therapy was ever used until just a couple years prior to having the infarction that kickstarted this journey. That fact alone should spar/provoke serious discussion/debate into the effectiveness of statins, but it never seems to. Two years on a statin and then out of the blue a heart attack at age 42…? I’ll save that discussion for a later time. Might be a little too deep for some who have not taken the time to read both sides of the science now being presented on this subject.
As much as I love my doctor at the Mayo Clinic, we do not always see eye to eye and this time was no exception. He made it very clear that he was unhappy with my cholesterol results this time around. He urged me to stop following a ketogenic diet, and return to a plant-based diet. Maybe I should consider this a win, since that last visit two years ago, I was discouraged from following a plant-based diet and encouraged to follow the standard American diet. My total cholesterol numbers as tested on that visit two years ago, Total Cholesterol 202, Tri 59, HDL 52, LDL 138. On that visit, same as this visit, he recommended statin therapy, and I declined.
Despite elevated cholesterol numbers that I knew would be elevated this time around, this trip gave me and my heart something to truly celebrate. It was the first time on this entire journey with a wounded heart, (10 years this October), that I was seeing first hand, clinical proof of improved heart function in terms of my hearts ejection fraction, along with an increase in my max heart rate. On the previous Nuke Stress performed on my last visit two years ago, my max heart rate as recorded was 168. 168 would be considered the appropriate/average heart rate for a healthy male of my age. This time around, my max heart rate was up to 189, a number much higher then average. My ejection fraction, (the amount of blood the heart is able to pump with each beat), remained hovering around 35% for over 7 years, before slightly rising to 37% just two years ago. This visit produced a test result of 45%.
I am very excited with these results. I couldn’t help myself from asking the doctor the question, “how many of his other patients successfully raised thier max heart rate to a level considered above the average, while improving an ejection fraction that had remained unchanged since that first myocardial infarction almost ten years prior”…? His response, (again, short and to the point most likely because of all or some the reasons I wrote about above), was that I was “truly a unique patient”… His smile and the way he was shaking his head while very carefully reviewing the data in front of him spoke more to me then his words ever could have. However, there was also no doubt that he remained somewhat fixated on the cholesterol results , making this point pretty clear. He encouraged me to return to eating plants knowing full well my ketogenic diet experiment was the reason for the high cholesterol numbers while recommending I take two different types of cholesterol lowering medications. I respect his opinion and will see if can lower those numbers a little, but I will do it by making subtle changes to my macro’s/ketogenic diet, not by popping statins. What follows are the posted RESULTS and notes from my recent Mayo Clinic visit… Please stay tuned for my future cholesterol results as I tweak my diet and retest in a couple months.
Mr. Shane Johnson is a 51 y.o. male who returns to see us for follow-up of ischemic cardiomyopathy. The patient continues to exercise in and exceptional manner running marathons and maintaining exceptional fitness. He also has gone on a ketogenic diet which is reflected in his lipid levels. He denies any symptoms of angina, congestive heart failure, or cardiac rhythm disturbance. We had a long discussion regarding diet and risk factor control he has a wonderful approach to life maintaining a very positive outlook I have advised that since he is intolerant of statins we should try with Zetia to achieve a lower LDL cholesterol and if this is not successful we should consider PCS K 9 inhibitor. He will recheck his cholesterol levels in a month at home. I am also to call him after we have the results of his Troponin and natriuretic peptide. We did discuss the stable nuclear perfusion scan which shows a stable pattern of infarction but if anything perhaps some improvement in LV function
General: He appears quite fit. well groomed.
Psychiatric: Normal mood and affect. Oriented to person, place, and time.
Eyes: No periorbital xanthelasma. Clear sclerae.
ENT: No oral mucosal cyanosis or pallor.
Heart: Examination of his heart his normal I hear no murmurs or gallops.
Vessels: Jugular venous pulse is normal. No carotid bruit.
Lungs: Clear to auscultation. Good air movement bilaterally.
Abdomen: No hepatic enlargement. No masses or tenderness.
Musculoskeletal: No clubbing or cyanosis of the digits.
Extremities: No edema.
Skin: No stasis dermatitis or ulceration of the lower extremities.
HDL was 56mg/mL
LDL was… ready for this…? I know… 193 mg/dL
Triglycerides were at 79mg/dL
Troponin 5th gen was 14ng/L Base line <=15ng/L
NT-pro BNP,s was 50pg/mL Base line <61pg/mL
C-Reactive Protein, High Sens, S 0.9 mg/L Base line <2.0mg/L
Glucose, P was 88mg/dL Base line 70-100mg/dL
Sodium, potassium, bun, creatinine serum, all well within range.