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Old 04-29-2016, 02:57 PM   #81
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So today I had a nuclear stress test and just got a call from my cardiologist to tell me good news. Though I have a high calcium score, the calcium is apparently spread out thinly throughout the coronary arteries and I don't have anything other than mild blockages. Diet and exercise should keep me going with a follow up calcium score next year to make sure growth is under control. Next week a carotid artery test.


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Congratulations to you - It is great news. I bet you are quite relieved. (I would be.)
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Old 04-29-2016, 03:19 PM   #82
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Congratulations to you - It is great news. I bet you are quite relieved. (I would be.)

Thanks! I was very relieved as is my DW. I'm still going to continue to eat healthier and lose a few more pounds.


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Old 05-17-2016, 12:08 AM   #83
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Dash Man, please consider getting a non-invasive Coronary CT Angiogram (CTA). I am 48, in excellent shape, and have had yearly treadmill stress tests since 2012. Only issue was a high LDL of 170-190 that I spent a few years unsuccessfully trying to lower with diet, etc, even though I was already at an ideal athletic weight (6' 1", 180lbs). It's a genetic issue. On a whim, i had the same calcium heart scan performed in Dec 2014 and was shocked to recieve a score of 202, with 8 lesions in 3 coronary arteries. After my meltdown, my doctor put me on 10mg of Lipitor and throughout 2015 my LDL dropped to 80. In February 2016, I visited one of the top cardiologists on the West Coast, he reviewed the heart scan and strongly suggested I get a CTA so we can see the exact plaque buildup in each artery. I took the CTA at the end of Feb 2016 and was shocked yet again to find my calcium score went up to 303, but even worse was that one of the LAD artery lesions is a 50-69% blockage (the other 6 are scattered 1-24% blockages in the LAD, LCX and RCA). With that info, he put me on Crestor 40mg (the highest dose of the strongest statin) to get my LDL to below 50 as that rate has shown to halt the rapid increase in plaque in those with existing plaque burdens. I'm right around LDL 50 now and just had a stress test which was fine. So, your plaque may be scattered, but with your high calcium score I would want to know if I have any blockages of more than 50-70% that are not showing up on a stress test. My 50-69%'er would probably not have been discovered until it was too late.

The CTA was 2 hours of my time start to finish with the dye being the only uncomfortable part. This is not anywhere near the invasiveness of the standard angiogram.


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Old 05-17-2016, 05:09 PM   #84
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Dash Man, please consider getting a non-invasive Coronary CT Angiogram (CTA). I am 48, in excellent shape, and have had yearly treadmill stress tests since 2012. Only issue was a high LDL of 170-190 that I spent a few years unsuccessfully trying to lower with diet, etc, even though I was already at an ideal athletic weight (6' 1", 180lbs). It's a genetic issue. On a whim, i had the same calcium heart scan performed in Dec 2014 and was shocked to recieve a score of 202, with 8 lesions in 3 coronary arteries. After my meltdown, my doctor put me on 10mg of Lipitor and throughout 2015 my LDL dropped to 80. In February 2016, I visited one of the top cardiologists on the West Coast, he reviewed the heart scan and strongly suggested I get a CTA so we can see the exact plaque buildup in each artery. I took the CTA at the end of Feb 2016 and was shocked yet again to find my calcium score went up to 303, but even worse was that one of the LAD artery lesions is a 50-69% blockage (the other 6 are scattered 1-24% blockages in the LAD, LCX and RCA). With that info, he put me on Crestor 40mg (the highest dose of the strongest statin) to get my LDL to below 50 as that rate has shown to halt the rapid increase in plaque in those with existing plaque burdens. I'm right around LDL 50 now and just had a stress test which was fine. So, your plaque may be scattered, but with your high calcium score I would want to know if I have any blockages of more than 50-70% that are not showing up on a stress test. My 50-69%'er would probably not have been discovered until it was too late.

The CTA was 2 hours of my time start to finish with the dye being the only uncomfortable part. This is not anywhere near the invasiveness of the standard angiogram.


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Thanks!
I see my cardiologist for a follow up in August and will bring this up. Was this covered by your insurance or did you pay out of pocket? Do you know the cost?



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Old 05-18-2016, 10:39 AM   #85
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I had to pay $800 out of pocket as insurance did not cover the test...it was performed at Cedars Sinai hospital in Los Angeles.


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Old 05-18-2016, 10:46 AM   #86
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The best thing about the test is that I no longer have to guess about which arteries are clogged and the amount of plaque. I know exactly where the trouble spots are and my cardiologist can retest in a couple of years to see if those spots got worse or stabilized. I'm obviously concerned about the bad 50-69% lesion, but I'm glad I know it exists and can plan treatment and lifestyle choices in light of this info. Maybe I don't need to run firecalc out until I'm 100 years old given the genetic issues...


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Old 05-18-2016, 12:19 PM   #87
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The best thing about the test is that I no longer have to guess about which arteries are clogged and the amount of plaque. I know exactly where the trouble spots are and my cardiologist can retest in a couple of years to see if those spots got worse or stabilized. I'm obviously concerned about the bad 50-69% lesion, but I'm glad I know it exists and can plan treatment and lifestyle choices in light of this info. Maybe I don't need to run firecalc out until I'm 100 years old given the genetic issues...


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I've already made significant lifestyle changes based on my calcium score. Haven't eaten any processed or fatty food since the test and have lost 25 lbs, and 50 lbs from what I was a few years ago. I miss sweets and pasta, but have adjusted. I get more exercise too. My primary care doctor doesn't want me to lose more than 5 more pounds.
The $800 isn't bad, so I'll have to investigate the cost here in PA. My calcium CT was only $129.


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Old 07-21-2016, 03:41 PM   #88
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So four months since my lifestyle change I now weigh 163, down from 195 in March, and my recent blood work shows a big improvement. My LDL is 38, HDL 65 and triglycerides 60. Those numbers have never been so good!


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Old 07-21-2016, 03:48 PM   #89
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So four months since my lifestyle change I now weigh 163, down from 195 in March, and my recent blood work shows a big improvement. My LDL is 38, HDL 65 and triglycerides 60. Those numbers have never been so good!

Congratulations! What do you eat now that you didn't eat before?
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Old 07-21-2016, 04:05 PM   #90
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It's more about what I don't eat anymore. I avoid processed foods, pasta, breads, sugar (except in fruits), any sweets or fatty meats (except certain fish like salmon). I do eat lean meats, lots of fruits, nuts, beans and veggies. I also control the portions of the meat limiting it to 4-6 ounces maximum. I only drink water, wine and scotch 😊 (got to have one bad thing on my list).


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Old 07-21-2016, 04:44 PM   #91
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I would definetely get one . My Brother died of heart disease in his early 50's and my sister who is thin,exercises daily & eats right just had a heart attack.
Sorry about your brother. Too young.

I had a stress echo for similar screening (my brother died of sudden death, had massive coronary disease). You may wish to compare the two (Calcium scan v. Stress echo). I think the latter gives better quality information (odds ratios) than the CT calcium.

My stress echo was normal and gave additional information about valve anatomy and chamber functions. Either would provide useful information, assuming that risk factors are otherwise normal (i.e. no other known heart disease, diabetes, coronary symptoms, etc.)
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Old 07-21-2016, 08:07 PM   #92
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Dash man,

Those are extremely good lipid #'s for having the best shot at stopping the plaque from escalating (LDL 38!). I've been on the highest dose 40mg of Crestor for a few months without side effects and I'm at LDL 59, HDL 63, Trig 40. 6' - 175lbs right now. My cardiologist is satisfied that these #'s may slow down my plaque progression...we'll see.



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Old 07-21-2016, 08:27 PM   #93
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So four months since my lifestyle change I now weigh 163, down from 195 in March, and my recent blood work shows a big improvement. My LDL is 38, HDL 65 and triglycerides 60. Those numbers have never been so good!


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LDL 38 - lord almighty, are you on statins?!?

http://www.healthline.com/health/cho...-low#Overview1
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Old 07-22-2016, 08:18 AM   #94
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LDL 38 - lord almighty, are you on statins?!?

Cholesterol: Can It Be Too Low?
Since I am T2, my PCP insists that my LDL be below 70. At my last blood test it was 64, triglycerides 73, but unfortunately the statin I am on also drives my HDL down to 33, although I have always struggled with low HDL despite exercising a lot.

This very low LDL bogey always concerned me, as it was my understanding your body needs cholesterol to maintain good hormone levels.
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Old 07-22-2016, 08:30 AM   #95
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LDL 38 - lord almighty, are you on statins?!?

http://www.healthline.com/health/cho...-low#Overview1

Yes, generic Lipitor 40mg for the past 3 months. I expect my cardiologist will lower it to 30 mg when I see him next month. I have no side effects and have been on a vitamin D supplement for about 18 months for other reasons. The goal is to keep the LDL below 60 and triglycerides as low as possible.


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Old 07-22-2016, 08:35 AM   #96
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Since I am T2, my PCP insists that my LDL be below 70. At my last blood test it was 64, triglycerides 73, but unfortunately the statin I am on also drives my HDL down to 33, although I have always struggled with low HDL despite exercising a lot.



This very low LDL bogey always concerned me, as it was my understanding your body needs cholesterol to maintain good hormone levels.

I've always suffered with low HDL. I have no idea why it is 65 now. My previous lifetime high was 45 while in the military. I do some exercise now, but not that much. My triglycerides at 60 are the best they've ever been. I believe dietary change helped that, but I do miss pasta, cheese, bread and ice cream.


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Old 07-22-2016, 08:40 AM   #97
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My cardiologist is satisfied that these #'s may slow down my plaque progression...we'll see.

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I'm hoping the same. The typical cardiac calcium score increases 30% per year without treatment. I'll get another calcium score next spring to see if my changes make a difference. In slowing things down.


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Old 07-22-2016, 09:25 AM   #98
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I've always suffered with low HDL. I have no idea why it is 65 now. My previous lifetime high was 45 while in the military. I do some exercise now, but not that much. My triglycerides at 60 are the best they've ever been. I believe dietary change helped that, but I do miss pasta, cheese, bread and ice cream.


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You've done a remarkable job with your dietary changes. I need to do much better in that area, but I still love cheese, snacking on popcorn and an occasional couple of DWs oatmeal cookies.

My last calcium score was about as good as it gets and the stress echo was also very good. As Rich pointed out, I also thought the stress echo may be more more revealing of cardio vascular health than the calcium score.
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