14 months after: progress report

Last week, I had my 1 year checkup with my cardiologist, following an echocardiogram and stress test. The stress test was interesting, and I got to really work my heart while they took EKG, blood pressure, and imaged my heart before and after to see where muscles were strong and weak.  I have the reports here and made sure I knew what they meant.

The good news is good:

• My heart is in great shape
• I can work out at pretty high intensities, and am OK'd to go for it
• My cholesterol has really turned around in the last year
• The Doc has no major concerns

The bad news is not that bad:

• I have to stay on all of my meds, including the beta blocker Atenolol.  This has some interesting side effects, including lowering my max heart rate, and encouraging weight gain.
• The lowered heart rate limits my max exertion in the gym, but I'm adapting to it.
• My weight is up, about 15 pounds since I started the beta blockers. I'm not the picture of post-cardiac health that I wanted to be.

So I know what I need to do this year:

• Keep it up at the gym - high aerobic and anaerobic workouts to burn fat and built muscle
• Cut back on the calories and start to reign in the waistline.

Before the cardiologist appointment, I studied up on all of the medications.  It felt like cramming for an exam, but I really understood his discussion and I knew why he kept me on the medications.

Here's my Christmas wish:  Everyone should get the present of being present with their loved ones.  I saw two people close to my age both die suddenly of heart failure this fall.  It literally can happen to anyone with little warning.  So do these things:

• Get checked up.  Cholesterol, stress and other conditions can be managed to lower your risk.
• Love the ones you're with.  Sad to say, but you or they could be taken tomorrow.
• Be prepared. Have a will. Know the warning signs.  Don't be Superman (/woman).

Sorry to be a downer, but I have to use my Round 2 for good.  Make a resolution to get checked up, and hit the gym for some heart-healthy stress-busting sweat-generating fun!

Happy Holidays!

John

Happy Birthday to Me!

I turned 1 today...not a birthday but a rebirth day.  One year ago I got rebooted 3 times, received stents in my artery, and started life over again.  I haven't missed a dose of meds yet, my cholesterol is good, and last week I ran 19 miles, including 2 high-intensity sprint workouts.  Yes, I need to drop 20 lbs and be better with food and drink...but I'm doing much better than a year ago.

So I made it out of the tough part.  You...reader...have you held up your side?  Do you know your cholesterol?  Do you get out of the car/couch often enough, and get your heart rate up?  It is not hard once you start.  Do it!

Heart Health: 6 months after medicine

I just got my blood work back from my September labs.

Here is the March values:

Lipid panel:
   cholesterol, total               173  mg/dl         <200    (GOOD!)
   HDL cholesterol               37  mg/dl            >39    (CLOSE!)
   cholesterol/hdl ratio           4.68                 <5.00 (GOOD!)
   LDL cholesterol, calculated   (can not be calculated when the
triglyceride exceeds 400 mg/dl).
   triglyceride                        712  mg/dl         <150>(BAD!)

Here is my September Values:

Lipid panel:
   cholesterol, total               153  mg/dl         <200    (20 pts improvement)
   HDL cholesterol                 50  mg/dl            >39    (13 pts improvement)
   cholesterol/hdl ratio           3.06                 <5.00    (50% improvement)
   LDL cholesterol, calculated   76                   <100     (good)

   triglyceride                        133  mg/dl         <150    (nearly 600 pt reduction!)

Clearly, the cholesterol meds, Omega 3/6 and food/exercise have worked!  

The reduction in triglycerides is amazing.

So, thanks to medicine (mostly) and lifestyle (somewhat), 

I have some really good lipids.

The Tricor, Simvastatin and Atenolol were a bit tough to get in balance, 

but they worked out fine in the end. 

The bad news is that my Glucose is 96 for a healthy range of 65-99, 

and my Hemoglobin A1C, a longer term measure of glucose levels, is 5.7, 

right at the boundary of healthy and risk.  

So I need to continue the weight loss and exercise to keep that in check.

There's hope for me.  

Now, get your butt out there and get a lipid profile.  

It takes 5 minutes at a lab.  Do It!  

Still, Stayin' Alive

It's been a bit since I posted on the heart blog.  I've been crazy busy at work and with my photography business.

I have been staying on my medicine and extras (Omega 3 and 6 supplements).  We'll see how my September blood work turns out.

I have hit the gym 2-3 days per week all year.  It's a bit lighter now, but hopefully I can keep it up.  I really need to burn some more calories or cut back on the intake to lower the body weight.

So dear readers, try to eat right, get a lot of exercise, and keep taking your medicine.  And if you haven't been in for a checkup in the last year, you owe it to your family to go!  Yes it will be uncomfortable. Yes it will be something you don't want to face.  Yes they will find something odd, and you will have to go for more tests.  But it's better than the alternative!

And speaking of that, make sure you have good term life insurance if you have a family.  And get a will.

And, have a nice day.

Stayin' Alive

A very busy spring so far, with my youngest graduating from high school (with tons of honors and awards - congrats Jen!).  Also I played in the pit for GMHS' production of Grease, and we had a crazy busy second quarter at work.  I'm also getting into Wedding and Senior photography season in Erie.

My challenge 8 months into this, is keeping the healthy aspects of my post MCI life going strong.  I'm 100% compliant with the medicine and trying to keep up with the fitness, but some fatigue still remains from my Tricor/Simvastatin inner battle.  I'm hoping it works itself out.

Diet-wise, I'm still getting a lot of fiber and flora.  I do occasionally have a bit of fried food or a steak, but I'm doing pretty good there.  We joined a farm cooperative - Wild Winds Farm out in the Harborcreek area, and we are already starting to receive lots of organic produce, which will continue each week into the fall. They include some recipe ideas, which will help us use the new items creatively.  We also put in some peas, cukes and green peppers in our tiny 32' garden.

I'm also thinking of getting a road bike and riding to work when I don't have events after work.  That will be exciting, and keep my fitness going.

So no news is good news I guess.  I haven't made it back to my Cardiologist but my PCP is working with me on medications and such.

A reminder to all you dads out there:  Next weekend is Father's Day.  Schedule a checkup so you will be around for many more of them!

Starting Tricor

I have been on Tricor for a week now, and am doing fine. I have not seen any of the complications of Tricor's interaction with Zocor, the Simvastatin that I'm taking.

I have to say that Tricor and Plavix, the anticoagulation drug I take, are very expensive. The new insurance where I work is marginal at best, as it requires me to pay out of pocket at pretty much list price for medications until I hit a very high deductible (thousands). My Plavix and Tricor are over $200 each month.

I suppose the alternative is worse, but I bothers me that our new medical plan is supposed to encourage good health practices. I'm paying out of pocket for my follow up PCP visits and most everything else.

On the positive side, I had a couple of milestones this week: a 29 mile week running, and a 9 miler on Friday morning. I'm getting back into that running rhythm. I've also been taking Omega 3,6,9 supplements - one of fish oil and two of flax seed oil. Still no chicken wings or fries!

6 Months After Flatline

"The reports of my death are greatly exaggerated."
  -- Mark Twain

It's 6 months since the amazing crew at Affinity Hospital in
Massillon Ohio put life back into me.

It seems like regular life came back pretty quickly,
and the time has just zipped by.

Have I changed my lifestyle?  I can say yes:
- I take all my meds every day
- I'm eating better - no chicken wings and very little fried food. 
  Lots of flora.
- I see my doctors on a regular basis
- I'm getting a lot of exercise

This week marked my first week of more than 20 miles running.
I'm hitting the gym 3-4 times each week on average, and mixing
aerobic and weight training.

Tomorrow I start on Tricor, a medication designed to
reduce triglycerides.  It has some interaction with the
Simvastatin (Zocor), so I have to be careful.

We'll let you know how that goes.

I can still do better.  My weight is a bit high. 
But I hope that I can continue to reduce my cholesterol
and improve my fitness and health.

I'm glad that I'm still around.  I want to see my youngest
graduate this year, and I have a TON of photography work
lined up this summer.

If feels good to be 6 months old!

TRI, TRI Again

My PCP says my Triglycerides are too high. I expected that and would have whacked him had he said anything else, given the evidence. I read about the two main drugs to treat it, Tricor and Lopid, and was not surprised when he prescribed Tricor, which I'm trying to set up through mail order.

We'll see how that drug works out for me. It does have some interactions with my other drugs, meaning I will have to take it in the AM and watch out for complications such as muscle pain.

He also was a bit concerned about my blood glucose at 106. All told, my vitals put me in the category of having Metabolic Syndrome, a precursor to all kinds of disease including heart disease and diabetes. I'll be getting a Hemoglobin A1C test next time around to check my long term blood glucose readings. Perhaps I'll cover Metabolic Syndrome later, as many of my contemporaries doubtless have this condition.

I'm continuing 4-5 days at the Gym in the early AM, alternating between heavy aerobics on the treadmill and weight lifting. I did get to run outside last week, which was lovely.

I'm taking care of myself to the best of my capabilities. How about you?

Johnny's Report Card

Well my lab results of my Lipid Profile are back. Here's what they say:

Lipid panel:
   cholesterol, total               173  mg/dl         <200    (GOOD!)
   HDL cholesterol               37  mg/dl            >39    (CLOSE!)
   cholesterol/hdl ratio           4.68                 <5.00 (GOOD!)
   LDL cholesterol, calculated   (can not be calculated when the
triglyceride exceeds 400 mg/dl).
   triglyceride                        712  mg/dl         <150>(BAD!)

So, my overall cholesterol is well within the recommended limits. My "good" HDL is close to the recommended minimum of 39, but my Triglycerides are very high.

The National Cholesterol Education Program guidelines for triglycerides are:

• Normal Less than 150 mg/dL
• Borderline-high 150 to 199 mg/dL
• High 200 to 499 mg/dL
• Very high 500 mg/dL or higher
• These are based on fasting plasma triglyceride levels (I was fasting for 12 hrs).

Current recommendations are to keep the triglycerides well below
500mg/dL, and low enough to reduce your VLDL to safe levels. Your VLDL
level is considered safe if it plus your LDL level are no higher
together than 130mg/dL. Doctors do not routinely measure VLDL, but if
you subtract your HDL cholesterol from your total cholesterol, you can
get the LDL plus VLDL sum.

So in my case, total cholesterol less HDL is (173-37) or 136. So I'm close on total VLDL+LDL, but the Tri's are way out of the safe range.

Triglyceride levels are very sensitive to diet, exercise, and health habits. It is common to have high triglycerides if you are overweight, if you are physically inactive, if you drink alcohol or smoke, or if you consume a high-fat and high-carbohydrate diet, particularly if your carbohydrates are not whole-grain foods. Triglycerides are also elevated in people with diabetes, kidney disease, thyroid disease, and certain inherited cholesterol problems. High triglycerides are one sign of the metabolic syndrome, a collection of health risks that indicate a very high risk of heart disease. It is important for you to be tested for diabetes and to have your blood pressure evaluated, because these are other features of the metabolic syndrome.

It is possible to substantially improve triglycerides by increasing your exercise and sharply cutting the amount of saturated fat and rapidly absorbed carbohydrates (processed flours or simple sugars, including milk sugar) in the diet. You should substitute whole grain foods, fruits and vegetables, skim milk and reduced-fat foods wherever possible. Medications are also available to lower triglycerides, including statins, gemfibrozil (Lopid), fenofibrate (Tricor), niacin, and omega-3 fatty acids.

In the last post I mentioned the recommendations for lowering Triglycerides.

In my case, I'm eating pretty well, getting 3-5 intense workouts each week, taking Omega-3 fish oil caplets (yuk), and tearing up the produce department. So I think I have two causes left:

1. I have a hereditary disposition to high Triglycerides
2. I need to cut back or eliminate alcohol

I have an appointment with my PCP this week. We'll see what he says about all of this.

Demon Rum - How Alcohol Affects Heart Disease

Last post we talked about Triglycerides, the Very Low Density Lipoproteins. Too much of them is bad. We mentioned that alcohol and carbohydrates increase triglycerides, while Omega-3 and Omega-6 oils and exercise reduce levels.

Alcohol's impact on Triglycerides

Alcohol are a source of excess calories which are being turned into fat - usually, triglycerides, so the fat levels in your blood go up. But that’s only part of the story. Researchers have found that apart from adding calories to the diet, alcohol also prevents the burning of fat. According to a Swiss study reported in the Journal of the American Medical Association, alcohol in the bloodstream can slow down fat metabolism more than 30 percent.

When alcohol is present in the blood, the liver prioritizes removing alcohol from the blood over other metabolic processes. The liver can detoxify about one ounce of alcohol per hour, which is about one serving of an alcoholic beverage - equivalent to 12 ounces of beer or 4 ounces of wine. In the meantime, however, any sugars present in the drink will also be further processed into triglycerides which raises their blood levels. Additionally, alcohol reduces the amount of the enzyme that breaks down triglycerides and spurs the liver to make more triglycerides. Some people have increased susceptibility to developing raised triglycerides in response to alcohol. So if you do not require insulin, or are not diabetic, and consume alcohol regularly, you may be able to lower your elevated triglycerides just by avoiding alcohol.

By taxing the liver and reducing the ability to detoxify blood, alcohol causes more harm to blood vessels. When the liver is busy processing alcohol, it is less able to process cholesterol. As a result, LDL-"bad" cholesterol levels go up. In addition, alcohol will potentiate the toxicity of cholesterol-lowering medications much more than the drugs would do alone. Actually, this is the major problem with the statins. By drinking alcohol daily, you may increase your chances of serious statin side effects, especially liver problems. Therefore, to protect your liver, you should go easy on alcohol or avoid it completely while taking a statin.

Lowering Triglycerides

Changes in lifestyle habits are the main therapy for high triglyericdes. These are the changes you need to make:
* If you're overweight, cut down on calories to reach your ideal body weight. This includes all sources of calories, from fats, proteins, carbohydrates and alcohol.
* Reduce the saturated fat, trans fat and cholesterol content of your diet.
* Reduce your intake of alcohol considerably. Even small amounts of alcohol can lead to large changes in plasma triglyceride levels.
* Eat fruits, vegetables and nonfat or low-fat dairy products most often.
* Get at least 30 minutes of moderate-intensity physical activity on five or more days each week.
* Substitute monounsaturated and polyunsaturated fats —such as those found in canola oil, olive oil or liquid margarine — for saturated fats.
* Substituting carbohydrates for fats may raise triglyceride levels and may decrease HDL ("good") cholesterol in some people.
* Substitute fish high in omega-3 fatty acids instead of meats high in saturated fat like hamburger. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in omega-3 fatty acids.

The National Cholesterol Education Program guidelines for triglycerides are:
Normal Less than 150 mg/dL
Borderline-high 150 to 199 mg/dL
High 200 to 499 mg/dL
Very high 500 mg/dL or higher
These are based on fasting plasma triglyceride levels.

I get my blood lipid tested next week. I'll report on my cholesterol numbers once I have the results back!

Lipids and Heart Disease

We've been learning about atheroma (artery disease) and what causes it. A major driver is the cholesterols that go zooming through your blood stream. HDL = "High Density Lipoprotein" (eg the Good kind); LDL = "Low Density Lipoprotein". Lipoproteins are fatty acids, or giant molecules that move cholesterol throughout the body. Also present are Very Low Density Lipoproteins, also called Triglycerides, and they are perhaps more bad than LDLs. The key is trying to get the body to produce more HDL, and less LDL and VLDL.

Here's a bit more research on Lipids, mostly from Wikipedia.

Because LDLs transport cholesterol to the arteries and can be retained there and can start the formation of plaques, increased levels of LDLs are associated with atherosclerosis, and thus heart attack, stroke, and peripheral vascular disease. For this reason, cholesterol inside LDL lipoproteins is often called bad cholesterol. This is a misnomer. The cholesterol transported on LDL is the same as cholesterol transported on other lipoprotein particles. The cholesterol itself is not bad; rather, it is how and where the cholesterol is being transported, and in what amounts over time, that causes adverse effects.

Increasing evidence has revealed that the concentration and size of the LDL particles more powerfully relates to the degree of atherosclerosis progression than the concentration of cholesterol contained within all the LDL particles. The healthiest pattern, though relatively rare, is to have small numbers of large LDL particles and no small particles. Having small LDL particles, though common, is an unhealthy pattern; high concentrations of small LDL particles (even though potentially carrying the same total cholesterol content as a low concentration of large particles) correlates with much faster growth of atheroma, progression of atherosclerosis and earlier and more severe cardiovascular disease events and death.

A 4 minute animation of the atherosclerosis process, entitled "Pathogenesis of Acute MI", commissioned by Paul M. Ridker, MD, MPH, FACC, FAHA, at the Harvard Medical School, can be viewed at pri-med.com By Clicking Here.

Lowering LDL
The use of statins (eg Lipitor, or in my case, Zocor), is effective against high levels of LDL cholesterol. Statins inhibit the enzyme HMG-CoA reductase in the liver, the rate-limiting step of cholesterol synthesis. To compensate for the decreased cholesterol availability, synthesis of LDL receptors is increased , resulting in an increased clearance of LDL from the blood. In other words, these drugs force the liver to create larger Lipid particles which is better for your heart health.

Clofibrate is effective at lowering cholesterol levels, but has been associated with significantly increased cancer and stroke mortality, despite lowered cholesterol levels.

Niacin (B3), lowers LDL by selectively inhibiting hepatic diacyglycerol acyltransferase 2, reducing triglyceride synthesis and VLDL secretion through a receptor HM74 and HM74A or GPR109A. Yeah, what he said. Just know that it works.

Tocotrienols, also called Vitamin E, have been shown to be effective nutritional agents to treat high cholesterol in vitro in recent research programs. They suppress the production of a specific enzyme which results in less cholesterol being manufactured by liver cells. This decrease in hepatic (liver) LDL levels causes hepatic LDL receptor up-regulation, further decreasing plasma LDL levels as it is taken in by the liver.

Dietary
Insulin, driven by the ingestion of carbohydrates, stimulates the production of cholesterols, while glucagon, driven by ingestion of protein, reduces the production of cholestrols. Glucagon levels are very low when insulin levels are high. A ketogenic diet (eg Adkins diet) may have similar response to taking niacin (lowered LDL and increased HDL).

Lowering the blood lipid concentration of triglycerides helps lower the amount of LDL, because Triglycerides (also called "Very Low Density Lipoproteins" or VLDL) gets converted in the bloodstream into LDL.

Fructose, a component of sucrose as well as high-fructose corn syrup, increases LDL synthesis.

Dietary Fiber
The main action of dietary fiber is to change the nature of the contents of the gastrointestinal tract, and to change how other nutrients and chemicals are absorbed. Soluble fiber binds to bile acids in the small intestine, making them less likely to enter the body; this in turn lowers cholesterol levels in the blood. Soluble fiber also reduces the absorption of sugar, reduces sugar response after eating, normalizes blood lipid levels and, once fermented in the colon, produces short-chain fatty acids as byproducts with wide-ranging physiological activities. Although insoluble fiber is associated with reduced diabetes risk, the mechanism by which this occurs is unknown. Not yet formally proposed as an essential macronutrient, dietary fiber is nevertheless regarded as important for the diet, with regulatory authorities in many developed countries recommending increases in fiber intake.

Importance of antioxidants
Because LDL appears to be harmless until oxidized by free radicals, it is postulated that ingesting antioxidants and minimizing free radical exposure may reduce LDL's contribution to atherosclerosis, though results are not conclusive.

Triglycerides
Triglycerides are formed from a single molecule of glycerol, combined with three fatty acids on each of the OH groups, and make up most of fats digested by humans.
Triglycerides, as major components of very low density lipoprotein (VLDL) play an important role in metabolism as energy sources and transporters of dietary fat. They contain more than twice as much energy (9 kcal/g) as carbohydrates and proteins.

Fat and liver cells can synthesize and store triglycerides. When the body requires fatty acids as an energy source, the hormone glucagon signals the breakdown of the triglycerides to release free fatty acids. As the brain cannot utilize fatty acids as an energy source (unless converted to a ketone), the glycerol component of triglycerides can be converted into glucose , via gluconeogenesis, for brain fuel when it is broken down. Fat cells may also be broken down for that reason, if the brain's needs ever outweigh the body's.

The American Heart Association notes that diets high in carbohydrates, with carbohydrates accounting for more than 60% of the total caloric intake, can increase triglyceride levels.

Increased exercise and reduced carbohydrate consumption ameliorate one potential cause of insulin overproduction to help maintain sensible triglyceride levels. Triglyceride levels are also reduced by omega-3 fatty acids from fish, flax seed oil and other sources. Recommendation in the U.S. is that one ingest up to 3 grams a day of such oils. In Europe the recommendation is for up to 2 grams. However, omega-3 consumption should be balanced with omega-6 fatty acids, ideally in a ratio between 1:1 and 4:1 (i.e., no more than four grams omega-6 for every one of omega-3).

Daily ingestion of omega-6 fatty acids, more than 1 gram of niacin (i.e., a mega-dose of vitamin B-3) and statins may also help improve triglyceride levels. It has been found that residents in Western countries do not ingest sufficient quantity of food with omega-3. The ideal ratio is almost never met, and the ratio is often too high, about 12 in France, up to 80 among whites in the U.S. and Canada. Omaga-6 fatty acids can be found in many grain oils such as sunflower, safflower and flax seeds.

Unused saturated or monounsaturated fatty acids accumulate in the body in the form of triglycerides that do not participate in the metabolism of the body.
In some cases, fibrates have been used to bring down triglycerides substantially.

Alcohol abuse can elevate triglycerides levels. (More on that in the next post). Just one drink can increase triglycerides in susceptible people. If you have elevated triglycerides and consume alcohol - a reduced intake or not drinking alcohol at all is strongly advised.

So, let me summarize:

1. Not all Lipids are bad.
2. HDL's are best.
3. LDL's and Triglycerides (VLDL) are worse in terms of heart disease.
4. You can minimize LDL/VLDL with:

• Drugs (statins)
• Suppliments (Niacin/B3, Vitamin E, and Omega-3 (fish oils) and Omega-6 (grain oils) fatty acids.
• Fiber (lots of sources)
• Exercise lowers insulin levels which lowers the LDL/VLDL production.
• Diet (lowering carbohydrates) will have a similar effect.

Next up: Demon Rum!

I Heart You!

Today is the "Heartiest" day of the year! Happy Valentine's Day to everyone I care about!

And a shout out to President Bill Clinton, who had his own heart issues addressed this week.

I'm nearly into month 5 of my “second round” of life after my heart attack. I have been reading a lot about heart disease and what may have caused my problem, not just to reduce my chances of another "big one", but to understand how others may reduce their risk of this kind of event.

What follows is some research I did online, mostly from Wikipedia (I love that place!)

Ather-what?

Technically, my heart attack was caused by a blockage of the Left Anterior Descending artery which provides about 50% of the fresh blood to the Left Ventricle of the heart. It was most likely caused by an atheroma, which is an accumulation and swelling in artery walls that is made up of cells or cell debris, that contain lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue. It is an unhealthy condition, but is found in most humans. The overall result of the disease process is termed atherosclerosis or "hardening of the arteries."

In developed countries, with improved public health, infection control and increasing life spans, atheroma processes (artery hardening) have become an increasingly important problem and burden for society. Atheroma continue to be the number one underlying basis for disability and death, despite a trend for gradual improvement since the early 1960s (adjusted for patient age). Thus, increasing efforts towards better understanding, treating and preventing the problem are continuing to evolve.

According to United States data, 2004, for about 65% of men and 47% of women, the first symptom of cardiovascular disease is heart attack or sudden death (death within one hour of symptom onset.) Read that one again, slowly.

Most artery flow disrupting events occur at locations with less than 50% lumen narrowing (they were not totally blocked before the attack). From clinical studies published in the late 1990s to IVUS (in-the-artery-ultrasound) to visualize disease status, the typical heart attack occurs at locations with about 20% stenosis (narrowing), prior to sudden lumen closure and resulting heart attack. Cardiac stress testing, traditionally the most commonly performed non-invasive testing method for blood flow limitations generally only detects lumen narrowing of ~75% or greater, although some physicians advocate that nuclear stress methods can sometimes detect as little as 50%.

My translation

Most/all people have some atheroma, which begins at a young age. The conditions for a heart attack are difficult to discover before it happens. Most people will have their first indication of heart problems by having a heart attack or dying from it. Our culture lets people live longer, but the lifestyle is conducive to athersclerosis.

Well.

That's not very encouraging.

I mean, if I had been screened, even including a cardiac stress test, they probably would not have found any reason for alarm. I was reasonably healthy. I ran 20 miles each week but was a bit overweight, with a BMI of 29.4, which is the top of Overweight category. Incidentally, to make it into the "normal" weight category, I'll have to lose 30 pounds. I'm shooting for more like 20, given that I do have more muscle from running. Last time I was that skinny, I was, well, pretty skinny.

Back to the whole prevention thing: My diet was pretty high in fats, particularly those from the chicken wing and burger/fries sections of the food pyramid. I also drink wine and beer which we will see in a couple posts drives triglycerides high...but I'm jumping ahead.

Had I been able to get a PCP checkup before the attack, I don't know if they would have seen this one coming. Other than telling me to lose weight, drink less and eat better, I'm not sure I would have received the kind of medical attention or medications that I'm currently taking, or that it would have prevented the heart attack I had in October 2009.

How to lower risk?

I kept digging. Given that you can't necessarily tell if you are likely to have a heart attack, it's best to follow a path of prevention.

Many approaches have been promoted as methods to reduce atheroma progression:
(a) food choices (like eating fish and fish derived omega-3 containing fats),
(b) abdominal fat reduction (which has a significant effect on cholesterol behavior)
(c) aerobic exercise (burns fat, lowers blood glucose, gives you that nice buzz),
(d) inhibitors of cholesterol synthesis (known as statins, like Lipitor),
(e) low normal blood glucose levels HbA1c below 5.0 (Avoid Type 2 Diabetes onset)
(f) micronutrient (multivitamin and magnesium) supplements

It was mentioned that cholesterol is not the villain that causes atherosclerosis. From clinical treatment trials, changing lipoprotein physiology (good/bad mix), and lowering blood sugar levels have proven to have the most dramatic impacts on reducing cardiovascular events and death rate from atherosclerotic disease.

Summary:

- It could happen to anyone
- Not a lot of warning signs in many cases
- Staying thin, exercising and eating the right stuff lowers risk

In the next posting, I'll get into the dirty details about Lipids (eg cholesterol) and factors that influence the mix of so-called “good” and “bad” cholesterol.

6-dang AM

I have a new job at GE, and am pretty busy. I wanted to get back in shape and knew I couldn't get in the lunch workout or the after work workout. So I started going in early.

Many of you know I'm not a morning person. But I'm trying to get into the AM workout. The good thing is that GE gym is pretty much empty before 8AM.

I'm getting up around 6, heading straight to the gym in my jammies, and hitting the treadmill. I'm showered and ready for work before 8, and burn several hundred calories each day. I am averaging 4+ miles per day on the treadmill followed by some light lifting. Yah, I will PUMP YOU UP.

I can get into the 130's for pulse on a workout. That's Cardio range for a 40-50 yr old, so I consider that good, particularly since the Atenolol is lowering max heart rate and BP.

Sticking to the high fiber diet and meds. So far so good. I think I'm lined up for a stress test in March, so we'll see how I do.

Overall, I feel pretty dang good 3 months after the REBOOT.

Get a checkup.

New Year, New Habits

Finally, past the holidays. I slipped a bit on my diet regimen, but didn't totally go off the wagon. I avoided the prime rib and other really fatty foods, and tried to still get some fiber and vegetables. I didn't miss a single pill and was reasonably active.

Finally, on Jan 2, I hopped back on the treadmill and did a couple miles running. It felt pretty good for a treadmill run. I hate those things, but it's better than not working out.

I'd like to use the gym at work but I know it will be crazy with the "Resolutionaries" for the next 4 weeks. By Valentine's day it usually drops back to the normal levels. Perhaps the roads will thaw and it will warm up a bit so I can get back to running outdoors.

So now it's back to getting 100% of my daily fiber and increasing those vegetable and fruit servings. Works for me...I love the flora.

For all of you who haven't made a decent resolution this year, do this: Commit to getting a good physical and blood lipid profile this year. You don't want to follow in my footsteps. Remember that it was pure circumstance that I was able to receive treatment as quickly as I did last October.

I just received notice that this blog was highlighted as a top 20 Heart blog by MRI Technical Training. Makes me want to post more useful stuff!

Oh, and here is a self-portrait in BW before I got rid of the "Christmas Beard".