Accidental Health

9. October 2008 William Davis (2)

"I shall never have smallpox for I have had cowpox; I shall never
have an ugly pockmarked face."

Such was the idle comment made by a milkmaid to Edward Jenner in 1768 when Jenner was 19, a remark that later prompted his investigations into using isolates of cowpox injected into humans as the first vaccination against the devastations of the European epidemic of smallpox.

(A caricature of Jenner administering cowpox vaccine to people, causing them to sprout bovine appendages. Image courtesy Wikipedia and the Library of Congress.)

When I look back, something similar has happened here.

Although the Track Your Plaque program is intended to stop and reverse coronary plaque using the only available means of tracking coronary plaque, i.e., heart scans, an unintended panel of benefits follow:

--People lose weight, often dramatically
--People gain greater energy
--Thinking is clearer, emotions more stable
--Sleep is deeper
--Bone density increases
--Physical strength and coordination improve
--Winter blues dissipate
--Blood sugar drops dramatically
--Blood pressure drops

Cholesterol (lipid) panels also settle to values that most physicians deem impossible or impractical, given our target of 60:60:60, i.e., LDL 60 mg/dl or less, HDL 60 mg/dl or higher, triglycerides 60 mg/dl or less. And medications are not always necessary to achieve these values. (When I show these values to my colleagues, they declare them flukes, unobtainable only in select people with high doses of medications.)

I didn’t set out to find the next weight loss solution, nor the key to boundless energy. My goal was "simpler": create a program of heart health. I am, after all, a cardiologist.

I was so intently focused on achieving incremental improvements over the steps leading to heart disease prevention that I failed to recognize the profound phenomena that accompanied it: people were quicker, smarter, thinner, and healthier.

In other words, I believe that we have inadvertently created a program of super health and performance.

Ironically, most people don't want to talk about heart disease, let alone reversal of heart disease. They do want to talk about getting thinner, feeling more energetic, living longer, better cholesterol values, etc.

Perhaps there's a lesson in this.
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Comments (2) -

  • Anonymous

    10/9/2008 1:05:00 AM |

    Dr. Davis:
    You are providing miraculous advice for people who have lost all hope for the medical profession and all hope for recovery from their ills.

    I come from a very long line of heart-attack/stroke victims. My entire family on my Dad's side has died (young and middle age) from heart related ailments. I myself had a stroke at age 46.

    Lying in bed in the hospital, thanking whatever gods came to my rescue that my mind seemed intact even though my body was not responding as well as I'd hoped, my priorities shifted. I had only one goal, to recover and find a way to become healthy again.

    It was a long road. The neurologist could give me no advice on diet. I started shunning all doctors and started researching and reading all I could on nutrition. I was sure it was nutrition. Once I discovered the low-carb community and implemented low-carbing in my life, I was saved. And the truth shall set you free and it did for me.

    Dr. Davis, you are a pioneer who saw that conventional methods were not working with your patients. You did not blindly turn your back on them and continue doing what almost every doctor was doing, you began your own truth-seeking journey.

    For this you stand with very few other doctors who did the right thing and I thank you. It is because of you and others like you that I am still alive.

  • Joe D. Goldstrich, MD, FACC

    10/9/2008 12:18:00 PM |

    Nathan Pritikin had a similar experience almost 50 years ago. He started his program to try to reverse heart disease and ended up naming his facility the "Pritikin Longevity Center" after seeing a wide range of dramatic health benefits. Pritikin's coronary arteries were free of plaque at his autopsy. Diet and exercise rule!!

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Collective wisdom

Collective wisdom

12. October 2007 William Davis (5)

As public consciousness and knowledge about health issues grows, thanks to the internet and other media, I predict that:

1) Hospitals will recede into a role of acute and catastrophic care ONLY, dropping the charade of providing health, which they do NOT.

2) Doctors and other health professionals will begin to see themselves as providers of acute and catastrophic care, also. They will stop providing day to day care, such as treating high blood pressure, cholesterol, breast exams, and other preventive maintenance.

3) Instead, preventive care will be self-provided. The public will have acquired sufficient savvy and know-how to manage issues like blood pressure themselves. They will need the assistance of helpful information resources, web-based for the most part. Much preventive care can, in fact, be algorithm-driven, just like following a simple recipe.

All the worries about runaway health care costs will be much reduced, since excessive testing driven by liability worries will disappear, repeated office visits for day-to-day issues will go away. Yes, you will need a doctor and hospital for a broken leg, car accident, unexpected cancer, or non-compliance or neglect of prevention.

But osteoporosis, high blood pressure, nutrition, weight loss, hormone management, cholesterol issues, minor complaints will all be managed by people themselves with the assistance of web-based knowledge systems.

I already sense this sort of phenomeonon developing, though in its infancy, in venues like the Track Your Plaque Forum and other health portals, places where the information being discussed exceeds the quality of information you can obtain from your doctor. Over and over again, for instance, the sophistication and knowledge demonstrated by our Track Your Plaque Forum discussions shows that the public is capable of far more understanding of health issues than many previously believed. Most of our members could carry on a credible conversation with trained lipid experts. The knowledge base of our members exceeds that of 98% of most of my colleagues when it comes to heart scans, lipoproteins, and nutrition.

I am in awe of Wikipedia, the popular online encyclopedia. Five 20- and 30-somethings have created a knowledge base that has now eclipsed Encyclopedia Britannica in size and scope, with equivalent accuracy, and relatively little cost. I'd like to see the same phenomenon occur in health care information, helping to usurp the current paternalistic "I'll tell you what to do" model.
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Comments (5) -

  • wccaguy

    10/13/2007 2:14:00 AM |

    Hey Doc,

    A terrific vision to strive to make happen.

    One problem is...  How are we supposed to rollback the control that doctors have over key elements of our own preventative health programs if all them are devoted to crisis management.

    The intersections Doctors currently control include at least the following

    1) ordering blood tests,

    2) ordering CTAs when required

    3) delivery of CT calcium score scan info to doctors (I've been told no doctor is required to get a CT scan.  Is that true?

    4) prescribing drugs like statins in situations that aren't emergencies but still critical.

    Moreover, if a doctor's approval is necessary to get reimbursement for these more costly tests, how is interfacing with the doctor avoided?

    Thoughts?

  • Gary Greenfield

    10/13/2007 9:17:00 AM |

    I recently came across your blog and I greatly appreciate and agree with what I have read thus far.  It is indeed refreshing to cross paths with an allopathic physician whose views  run contrary to popular brainwashed opinion. It seems as though our culture has removed God from His rightful place in society and replaced Him with physicians.  The average patient today is willing to pay any cost for treatment to prolong his life and hospitals are willing to allow no ceiling on costs to save a life.  In the meantime, what price is a man willing to pay to save his soul and what price are hospitals, (once religious institutions) willing to pay to address the salvation of the soul?  I'm afraid the tables have turned and what you are observing  and writing about is a direct consequence of this delema.

  • jpatti

    10/13/2007 6:44:00 PM |

    It won't happen like this.  

    Sure, motivated patients will largely provide their own health care and manage it themselves.  I just bought an endocrinology textbook and ordered some lab work before coming to your blog today.  But I am not most people; most patients are not motivated.

    There are 6 diabetics in my family.  I'm the only one willing to give up *sugar* let alone wheat and other problematic grains.  I've given copies of Bernstein's book to them, made homemade sugar-free chocolate, etc.  This has almost no impact on their life choices.

    I've sat and listened to my husband's stepmother talk about how much her feet hurt WHILE eating cookies and cake.  I don't choose to be a nag, and have already provided the necessary information, so there's nothing to do for her but sit and listen and be sympathetic.

    This is the reality of the vast majority of patients: they do what they want to do and count on their doctors to fix them.  

    Heart disease is very similar to diabetes, 99% of the outcome is in the patient's hands.  Doctors can't actually do much to effect the course of the disease other than provide recommendations.  

    The doctors you criticize for not empowering their patients have an awful lot of stupid patients too.  Some of these patients *deserve* some of these doctors.

  • Dr. Davis

    10/14/2007 1:41:00 PM |

    Yes, unfortunately, there is a substantial segment of the American population who will never mind their own health. But the "bell curve" will shift to the right over the next 50 years. I don't have illusions that this will happen next week. This is a evolutionary process that will affect our children more than us. But it needs to happen.

  • Dr. Davis

    10/16/2007 10:51:00 PM |

    I think the path to self-empowerment will require decades and come from a variety of changes, such as increasing availability of direct-to-consumer laboratory testing; reduced price barriers for imaging tests; more medications transferred into over-the-counter status; more info and more powerful nutritional supplements. Also, the growth of medical savings accounts and similar tools that allow self-directed health care purchasing will introduce greater consumer choice into the equation. But it will evolve over time.

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"Flying in the fog"

"Flying in the fog"

2. March 2008 William Davis (3)
I received this wonderful response to The Heart Scan Blog post Hammers and Nails:

I am 65 years old. I had a stent inserted in the "widow-maker" artery (80% blockage) a year ago. I had passed out a couple of times (heart rate dangerously low - 30s). I rode to the hospital in an ambulance. Tests revealed short LBBB episodes; mild mitral regurgitation, mild tricuspid regurgitation. Catherization showed 3 vessel CAD. I was told that a medicated stent was absolutely necessary given the situation; regardless, I have to accept that. A pacemaker was installed to prevent bradycardia and keeps heart rate from dropping below 60. I have 20% L distal main blockage and 90% lesion of the high first obtuse marginal at the takeoff. The right coronary had 60% posterior lateral branch stenosis.

Since then I have reduced TG from 360 to 60, LDL from 89 to 82 (although a few months ago it was in the mid-70s), and increased HDL from 30 to 46. I went from 265lbs to 190lbs and hope to eventually get to 180lb this Spring. I did it by progressing from walking to trotting (slow run) and dietstyle changes (low-GI veggies, fruits, etc.) .













On a recent visit the cardiologist said the the LDL needs to be 70 or below to "freeze" the 90% blockage and gave me a prescription for Lipitor. I asked if there were alternatives, like diet, supplements, etc. He admitted that he did not know about those alternative but did know Lipitor. When the only tool you have is a hammer then everything is a nail. I understand that the 90% blockage is important but will not take the Lipitor to achieve the 12 points reduction. Seems like an overkill.

I asked him if there was a way to evaluate my current condition. I was told there was no way. Basically, if I have no symptoms, good. If I have symptoms then it will have to be evaluated. Death could be the only symptom. I swear he was about to say bypass surgery ($$$$$$!) was inevitable. Something is wrong with this "fly-in-the-fog-and-hope-you-don't- hit-a-mountain" approach. Hope is not a strategy!

I am confident that I can reduce LDL to below 70 based on eliminating wheat-products in my diet plus increasing oat bran in my diet. I also take fish oil daily (EPA/DHA-2g). I am looking for a new cardiologist. I just recently purchased your book and find it very instructive. In the meantime I have an appointment with my primary care physician to discuss implementing the Track Your Plaque program. I realize that the one stent will skew the scan numbers but can be used as a baseline number.


Phenomenal weight loss! That alone has likely cut this man's risk in half. But is that it? Is the cardiologist correct--take Lipitor and hope for the best?

Of course not. There are many additional strategies to employ. Eliminating wheat from the diet is an excellent idea: HDL will skyrocket, triglycerides drop even further, small LDL will drop like a stone, blood sugar and blood pressure will drop. He will have more energy, get rid of afternoon energy slumps, sleep better.

He has already added fish oil. If his cardiologist did not mention this, I would say he was guilty of malpractice. The data supporting the addition of fish oil to the treatment program of anyone with heart disease is overhwelming. GISSI Prevenzione: 11,000 participants--28% reduction in heart attack, 45% reduction in death from heart attack. The Japanese JELIS trial of 18,645 participants--19% reduction in dangerous heart events. It's also clear that omega-3 fatty acids from fish oil also compound the benefits of statin agents, should this man choose to begin Lipitor.

Vitamin D brought to normal blood levels is his next "secret weapon" that will further boost his lipids and lipoproteins further into not just "normal" territory, but beyond belief. Even though we aim for 60-60-60 for LDL-HDL-triglycerides in the Track Your Plaque program, adding vitamin D can yield numbers you've never seen before. It's not uncommon, for instance, to see a 10 or 20 mg/dl jump in HDL.

Identify all other hidden causes of coronary plaque. If all the causes have not been fully identified, how can anyone hope to gain full control over coronary plaque growth?

Re: LDL cholesterol of 89 mg/dl at the start. Of course, this is a calculated value, not measured. Because HDL was low and triglycerides high at the start of his program, this means that true LDL--if actually measured--was probably more like 180 to 250 mg/dl, and it was probably nearly all small. So his cardiologist might have advised a helpful treatment, though for the wrong reasons.

Our reader has gone a long way on his own in creating his own prevention program. But there's yet more to do, particularly if the goal is reversal. It is shocking to me that a man like our reader, clearly articulate and motivated, gets virtually no advice beyond "take Lipitor" after all the procedural benefits have been reaped.

Even though one artery can no longer be "scored" due to the presence of the metallic stent, a heart scan would still be invaluable for long-term tracking purposes, just as we advocate in the Track Your Plaque program.



Copyright 2008 William Davis, MD
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Comments (3) -

  • Anonymous

    3/2/2008 6:04:00 PM |

    Dr. Davis -

    I am the "anonymous" reader who posted the "flying in the fog" comment.  Thank you for commenting on my adventure!  However, there is one correction I would like to point out and that is my weight.  I typed "365" and that is a typo; it should be 265.  

    Here is before-after pix.  'Before' was about 5 years ago; complete with wheat-belly.  'After' is recent after playing catch with my adult son.  Note the shirt is the SAME.   http://s88082351.onlinehome.us/oldnew.png

    I have to say that after the stent was inserted the only advice I received was to walk daily for at least 45 minutes and follow AMA recommend diet.   I asked how this kind of thing can be prevented from happening again and was told that the walking and exercise would help -- that was IT.  If not for an acquaintance in California who completely reversed his plaque growth I would have been left to think that it was hopeless and just wait for a disaster.  I had the occasion to visit the man in California last June.  It was absolutely mind-boggling learning experience.  He is my age and was overweight when he began his program 5 years ago that he and his cardiologist developed.  What struck me was that he did not look his age but 20 years younger!  

    I am very, very grateful that you have this blog.  I discovered your blog by accident and, as I mentioned, purchased your book.  I plan to join your forum site as well.  Where does one go when a cardiologist does not offer or volunteer information or when trying to get answers to questions seem like trying to chisel granite for a response?   Horrific.  This blog serves as a beacon especially to those like me that discover they have been abandoned -- left in the desert to fend for themselves with no place to go.  

    Thank you, Dr. Davis!  

    Have a great week.

  • Dr. Davis

    3/3/2008 11:51:00 PM |

    Thanks for you wonderful story. I've gone back and added your photo directly into the post.

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