Dash man
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
So...best of luck and interested to hear how it goes!
Pete
Thanks for the info!
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So...best of luck and interested to hear how it goes!
Pete
Don't panic, everything I've read about calcium CT scans considers them only a "predictor" of heart disease. Somewhat questionable at best.
My own journey down the CAD rabbit hole started last November, during a routine annual visit with my MD, during which I mentioned that I was experiencing "caregiver" stress from providing the daily care for my 89 yr old mother. I mentioned to my doctor that I'd started occasionally waking up at nite in a cold sweet with the feeling of someone squeezing on my chest. I was dealing with it through controlled breathing and relaxation techniques but wanted to know if any medication was available that migh assist.
Because of my age, 2 months from 60, and a family heart disease history, he felt it was best to eliminate heart disease as a potential problem even though all my indicators (weight, lipids, blood pressure, daily exercise and a near vegetarian diet) were in my favor. He even performed a quick EKG in the office that day, which he said was normal.
Fast forward two months later, following a second more thorough EKG, a cardiac stress test (failed this one!), a chest X-ray, an echocardiogram and a complete updated lipid profile and I found myself in the cardiologists office being offered two treatment options: 1. Schedule an angiogram, which would more then likely lead to stents or bypass surgery, followed by ongoing medication and lifestyle adjustment. 2. Medication (statins, beta blocker and Nitrostat for pain), stress reduction, exercise and lifestyle (diet) adjustment.
Based upon everything my DW and I had researched, option #2 is considered the current most progressive way to treat CAD unless the patient is in severe pain or suffering a current complete or near complete blockage, in which case option #1 preserves the heart function; however, it does not lead to any additional length of life, which still requires the patient follow option #2 post surgery. So, with the incouragement of my cardiologist, we chose option #2 with an open invitation for option #1 if I started experiencing any increase in chest pain or in the frequency of my chest pain; or, if I just lost my nerve and wanted to definitively know the percentage of my blockage/s and wanted them physically treated.
Note: While I initially only recognized the squeezing feeling that I'd experienced upon waking some nights, I subsequently learned that I been suffering angina on an almost daily basis during strenuous exercise, work and times of heavy stress. The chest pressure I was feeling was very subtle and I thought it was just part of getting older! It was only after I started taking Nitrostat whenever I experienced chest pressure, and experiencing immediate relief, that I was finally able to recognize that I'd been experiencing angina for over a year! Scary stuff
150 days later on a very strict low fat vegan diet, daily Lipitor (generic), beta blocker twice a day, and a gradually increasing level of daily exercise (currently 45+ minutes a day on an elliptical trainer), I'm free of chest pain, 20+ lbs lighter and feeling great! My total cholesterol is now 94 (down from 204) and my LDL's are 34 (down from 138) My Dr. personally called me following my last lipid profile and told me to go have something to eat! My LDL level is that of a newborn, below what statins can achieve on their own and definitely a response to fully embracing all aspects of option #2 and a low fat vegan diet. Prior to my last lipid check, my Dr. was planning to increase my statin dose to the maximum level since I was tolerating the medication well without any side effects. Now she is considering reducing my statin level in 6 more months if I continue to maintain my current low blood lipid levels.
She did mention to me once again that MD's and hospitals really do like doing angiograms, stents and bypasses. Quote: "that's where the money is!" Patients like me don't pay for the new Cardiac wings on hospitals.
So be cautious, proceed slowly and read everything you can about treating CAD. Read the COURAGE trial results comparing medication/lifestyle adjustment vs medical intervention (stents/surgery). There are also a growing number of studies similar to the COURAGE trials with similar results. Read Dr. Ornish and Dr. Esselstyn's books on reversing heart disease through diet and lifestyle change. We all die of something. Very few of us have to die of heart disease if we choose not to early enough in our lives!
putting me in the greater than 95 percentile for men my age (59) and an extreme risk.
Yes, be aware and yes make changes, but please also be careful. I good friend of ours was in his 40s when he had a heart attack and died. He had just had a physical, but it didn't show any problems. He was a pilot. Turns out he had 90% blockage. He was in great shape and training for a marathon.
Chris -- :O)
Being in the 95th percentile equates to a >4.5% annual risk of a heart attack. Not bad for one year, but multiply that X10 for your 10-year risk, and we're at 45%.So what's the risk that you are in the 95th percentile thereof? The medical industry does this all the time. They just use scary buzz words like "risk" without associating it with 50-50? 99% chance? 4 out of 5? Risk to a doctor, especially when they are using "latest studies" is like T-shirts. Small-medium-large. Smaller than what....? Larger than what...?
I had my test done almost 10 years ago. Maybe they are more refined nowadays but one of the caveats then was -lots of false positives-. If you get a high score, don't panic. There were stories of guys getting the test and being rolled in to an emergency bypass only to find they didn't have any blocked arteries after all. (Some of that might have been revenue enhancement on the part of doctors and hospitals as discussed in another thread and not an actual false positive.) But in any event, 1057 in a non-smoker who's not that old, with no family genetic oddities seems a bit off the edge.
My report said a 54 score was "Moderate risk" (of course without defining risk, as usual) on a scale that used, I believe, 101 as high risk and 400 as severe risk...? but less than 2 yrs earlier I had had a thalium treadmill test and the cardio guy said "Oh you're doing great! That stuff takes decades to build up!
Do you normally eat any high calcium foods? Did you take anything like TUMS in the days before the test? Those were also listed as things that can cause an inaccurately high score.
Also, what they told me was there is little need to worry about calcified, stable plaque. That is not the cause of heart attacks. It's the softer, unstable plaque that ruptures and causes the sudden choking off of an artery. But, based on how much stable, calcified plaque you have that is an indicator of how much potential unstable plaque you might have but they are not necessarily a 1 for 1 comparison. A high calcium score does not necessarily translate into a high unstable plaque situation.
trained for hours a day, yet still nearly died.
"the cardio guy said "Oh you're doing great! That stuff takes decades to build up!"" .....I would run away from this guy. This is the old "hardening of the arteries" mentality - "no problem, we'll just wait 'till it's bad enough and we'll go in and roto-rooter it out."
PeteYou're spot on with your comments re. unstable vs. stable plaque, and that's exactly why we need to get a second scan at least one year after the first. That's how we know if the plaque is stable or growing.
So what's the risk that you are in the 95th percentile thereof? The medical industry does this all the time. They just use scary buzz words like "risk" without associating it with 50-50? 99% chance? 4 out of 5? Risk to a doctor, especially when they are using "latest studies" is like T-shirts. Small-medium-large. Smaller than what....? Larger than what...?
f 3 people out of 100 die from a condition, but a daily dose of Wonderstuff allows only 2 out of 100 to die from it, then Wonderstuff is marketed as cutting your risk by a third.
Well, yes of course there are side effects from use of Wonderstuff, some of them severe in some people, but look at the huge benefit!
Thank you for all the good input. Even though my cardiologist appointment is a month away, dietary changes started today and exercise tomorrow. Exercise is always a challenge because of my arthritis and neck/back issues, but I'll find a way.
Sent from my iPhone using Early Retirement Forum
Exercise is always a challenge because of my arthritis and neck/back issues, but I'll find a way.
Sent from my iPhone using Early Retirement Forum
For those that had a CT Scan done. Did you have it done because of other symptoms that gave you concern or was it a preventive measure like getting a colonoscopy at 50?
I have been wanting an updated scan but have been holding off due to the radiation. As I recall 10 yrs ago they said it was the amount in TWO chest x-rays. Not exactly enough to turn me into the Incredible Hulk but my rule is: Less radiation is better than more radiation. Have the radiation levels they used dropped? I was surprised that some people mentioned they have had several in just a few years.
No doubt you have consulted physical therapists about this?
I have read of ways in which weight control, strength training, and even therapeutic massage can help deteriorating joints do their job better. It is partly about taking the strain (weight) off them, and partly about strengthening the muscles/tendons that support them and cause them to move.
Still, each of us is individual, and needs individual advice from experts to avoid injury. Good luck!
For those that had a CT Scan done. Did you have it done because of other symptoms that gave you concern or was it a preventive measure like getting a colonoscopy at 50?
Just another comment on relative risk:
A typical modern chest X-Ray exposes you to roughly 10 millirem of radiation.
A flight from NY to LA exposes you to 2-5 millirem (less atmosphere shielding you from cosmic radiation).
Living in a brick house can expose you to an additional 7 millirem every year (from naturally occurring radioactive elements found in clay).
For perspective, the feds estimate that the average American absorbs 620 milligram each year.
Sure, less if better - all things being equal - but avoiding doctor recommended scans and x-rays isn't going to make much of a difference to your lifetime radiation expose.
This has some more comparisons
Patient Safety - Radiation Dose in X-Ray and CT Exams