My family history regarding heart disease is fantastic. Here's the short of it:
- My fraternal grandmother had it, i suspect my fraternal grandfather had it.
- My maternal grandmother had it and passed away from it.
- My maternal grandfather passed away from cancer and I suspect he had heart disease too.
- My maternal uncle has it, and has had several stints placed. On more than one occasion his measured total cholesterol has topped 600.
- My father has it. He underwent a triple bypass at 55.
- My mother has it.
- My younger brother has it. His cholesterol measures 300+ without medication.
- My elder brother had it. He died of a heart attack at age 31, not entirely due to heart disease, but certainly a contributing factor.
Following my brother's death, and knowing well from previous test that as a teenager my cholesterol topped 200, I underwent a cholesterol test at age 29.
- My total cholesterol level measured 495, this was in the fall of 2000.
I'm better than you. My body is genetically superior to yours at absorbing and producing cholesterol. It just so happens that in today's society that isn't a good thing. Back when times were tough and food was scarce this trait probably would have been great. In modern America, with a government that subsidizes multiple industries to ensure the production of a protein-rich diet, this really isn't an advantage, in fact it's more of a death sentence.
Over the next 10 years, my cholesterol level would fluctuate; 358 (HDL 49/LDL 285) in 2002 to an all time low of 171 (HDL 43/LDL 111) in 2003, depending on my regiment of lipid lowering drugs, exercise habits and diet. I was dieting and working my butt off to get to 171.
I have tried numerous diets and exercise programs; low calorie, low carbohydrate, etc. always with success, however typically with little staying power. I tried the Atkins diet, filling my body with eggs, meats, cheeses and fats, abstaining from carbohydrates and as advertised, without any change in medications, my cholesterol dropped a whopping ~60 points just in the induction period. However, for me that particular diet is not sustainable over the long term and I have concerns that there may be other significant risks in its application. I am not convinced that ketosis is really a steady state for the human body.
A cholesterol of 171 doesn't really sound that bad does it? After all the American Heart Association AHA still recommends a total cholesterol of less than 200mg/dcl as desirable [ reference : http://www.americanheart.org/presenter.jhtml?identifier=183]. So what was I doing to get it that low?
My prescription regiment included:
- 1 x 80mg Lipitor daily
- 1 x 10mg Zetia daily
- 3 x 625mg Wellchol daily (6 prescribed, but I only took 3)
Within that year I stopped doing the Atkins diet and found that my lifestyle and preferences just didn't mix well with exercise. Not that I don't believe in exercise, I do enjoy it, especially when I am in shape, but it just wasn't something that I had grown up doing nor did I have the inclination to seek it out independently.
As such, I have never exercised regularly and my diet has been quite atrocious, i.e. the typical American diet. I ate what I could afford, what I wanted really, and ate when ever I wanted to eat. There are many American's out there who are eating similarly under the protection of lipid lowering pharmaceuticals, "no worries, I'm on cholesterol medication...".
To compound things further I started having problems with my thyriod in 2007 which resulted in fatigue and weight gain. At my peek weight, measured upon my physician's scale, I weighed 194 pounds, on a 5'9'' frame. With a BMI calculation of 28.65 this places me at the high end of the overweight category and precariously close to the edge of the obese category [reference : http://www.americanheart.org/presenter.jhtml?identifier=3048134]
As I approach 40 I have found this whole ordeal to be quite tiresome. There are so many things going on in my life; health, family, work, finance, spiritual, friendships, just to name a few, all of which compound the stress that each creates individually. That and those prescription medications all add up to a quite handsome sum
To cut down on (read: rebel against) those stresses, I decided that I just wasn't going to take my prescribed medications any longer. Now, I know that this doesn't sound like a smart decision and quite frankly it isn't given that I seemingly had no alternative way to control my cholesterol problem. In my own defense I admit to being human, and we humans, well, we don't always make the best decisions no matter how intelligent we are summed up to be.
On May 4th, 2009, after some significant goading by my wife (thanks honey!) I had my cholesterol checked. I naturally suspected that it was going to be high again and decided to go in to the doctor for the blood work and to get more prescription medication to manage it. During the visit, the doctor mentioned a procedure that was being done called a Cardiovascular Calcium Scoring (CCS). She had mentioned this to me the year prior. This procedure appears to utilize an MRI to measure the calcium deposits in the major arteries around your heart. These calcium deposits are indications of plaque buildup within your arteries. Plaque or rather plaque rupture accounts for some 87% of heart attacks in the US. It's not the blockages that kill you, it's the bursts fellows.
The CCS measurement scale is as follows:
0-0 - No identifiable plaque 1-10 - Minimal plaque burden 11-100 - Mild plaque burden 101-400 - Extensive plaque burden (danger Will Robinson!)
Keeping in mind that the total score is the sum of the 5 values presented as measurements of plaque burden within each artery, my total score was 128. Now, that's bad but not too bad given my history. It puts me at the low end of the Extensive plaque burden range, which is probably to be expected given my age, my history and my atrocious diet. One of my physicians put it to me one time as "your arteries and veins have been bathed in this stuff for so many years now". However, there is just this one little problem.
Here are my individual arterial measurements:
17 - Left Main Artery (LMA) 78 - Left Anterior Descending (LAD) 18 - Left Circumflex (LCX) 15 - Right Cornoary Artery (RCA) 0 - Posterior Descending Artery (PDA)
Cue ominous music... my Left Anterior Descending (LAD) score is 3.5 times the other scores, meaning that I have one artery that is king, the LAD. My doctor's physician assistant tells me that the LAD is also known as "the widow maker".Nice.
So, what do the measurements tell me then? We'll not much without further analysis.
My take on it says that there's some significant plaque buildup in that artery that is being detected by the presence of the mineral calcium via an MRI procedure. It doesn't give any information regarding the plaque distribution or density, it just gives a relative measure. That plaque could be spread throughout the artery in a way that distributes it evenly (unlikely in my opinion) or it could be all bunched up in one spot forming a tiny little hole for my blood to flow through (more plausible, but also unlikely in my opinion). So what does it say? My guess is that it's somewhere in between. Having seen pictures of clogged arteries on the internet and books I have a fairly good idea of what it might look like. Hills and valleys. Frankly I'm not about to have an angiogram to find out what it looks like for real.
What is definitely certain is that it is dangerous and something that I need to take action upon. So what now?
Well now, I embark upon something that I hope will change my life.
I'm going to try to reverse my heart disease. I'm going to take up something that I've read about and for which there is compelling evidence to support, that heart disease can be stopped and in fact reversed through changes in diet and eating habits.
There are a few books available to the general public that provide references to medical studies that support this assertion. Some of those are among the ones that I've read so far. These include:
Prevent and Reversing Heart Disease - Caldwell B Esselstyn, Jr. MD The China Study - T. Colin Campbell, PhD with Thomas M. Campbell II Program for Reversing Heart Disease - Dean Ornish, MD Healthy Heart Handbook - Neal Pinckney, PhD Eat to Live - Joel Fuhrman, MD
My objectives include:
Drop my total cholesterol below 150mg/dL Drop my BMI to 22 (5'9'' x 155lbs) Ween myself off of pharmaceuticals as possible Avoid open heart surgery, stints, and angiograms like the coward I am
I made the decision to lose weight around the time of the CCS test. I adopted a calorie counting approach which I've done in the past. With 1 pound of fat containing ~3500 calories, buring 300 calories a day of my body fat it would take me the better part of a year to lose 30 pounds, putting me at 165. But as I started to read, I realized that just counting calories would not be enough. To actually lose the weight and in fact lose the plaque, there would need to be an entirely different approach to this problem.
By the time that I realized that plant-based nutrition was the only way that I could effectively stop, and possibly reverse my heart disease I had already lost about 6 pounds, this over a three to three and a half week period. Calorie counting does work for me. And mind you I was never really hungry, nor did I work out during this period. However, calorie counting requires discipline in tracking everything you eat and then determining the caloric content of that food. I did it for almost a month. It takes time.
Having switched to an plant-based diet I am today at 182 pounds, having lost 13 pounds in about 5 weeks. Some folks may say that rate is a little too high and that I am not consuming the number of calories that I should, but I suspect that my body will help me out there when it needs to. I do eat when I am hungry and I will say that I have only been hungry once or twice and when I was, it was no big deal for me to go and grab some fruit or a piece of whole wheat bread (I can have certain brands). The foods that I'm eating taste great, and I find that I can eat my fill.
I have a Dr. appointment scheduled for June where I'm going to ask to have my cholesterol taken again. My hope is that it will be low, in fact fantastically low, so much so that it will result in a reduction of my medication dosage. But that's just an initial goal. The proof will be in the numbers.
So what does it mean to be on this diet. Well, I would say that my diet is vegan, but that's not saying everything as there are all kinds of variants on the term vegan. My diet is in fact more strict than the average vegan diet. Here's the basics, paraphrased from Dr. Esselstyn's book (buy it)
no animal protein - nothing with a face or a mother, that includes eggs no dairy - cheese, yogurt, etc. none of it no oil - not a drop, including extra virgin olive, canola, etc. no nuts - nuts are mostly fat no refined grains - no white bread, typical pastas, etc. no avacado or coconut - too high in fat content
few if any refined sugars few if any juices
I plan on keeping a periodic tally of things and update this as I go along
Here's the staring point:
May 4th, 2009
Weight: 194 lbs
Cholesterol: Total: 471 LDL >350 HDL 49
Tryglercides: 149 mg/dL
CCS: 128 - LMA(17) LAD(78) LCX(18) RCA(15) PDA(0)
Here's today:
June 4th, 2009
Weight: 183 lbs
Cholesterol: Total: n/a LDL n/a HDL n/a
Tryglercides: n/a mg/dL
CCS: 128 - LMA(17) LAD(78) LCX(18) RCA(15) PDA(0)
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