What Mr. Clinton did NOT do

You've likely already heard that former President Bill Clinton underwent a heart catheterization today during which one of the bypass grafts to his coronary arteries was found to be occluded. The original coronary artery was therefore stented.

Dr. Alan Schwartz, Mr. Clinton's cardiologist, announced to the gathered press that Mr. Clinton had followed a good diet, had adopted a regular exercise program, but that his condition is a "chronic disease" like hypertension that is not cured by these efforts.



Needing a stent just 6 years after four bypass grafts are inserted is awfully soon. I would propose that it has less to do with having a "chronic disease" and more to do with all the things that Mr. Clinton likely is NOT doing. (In addition to all the other things that Mr. Clinton did not do.) In other words, in the Track Your Plaque world, procedures are a rarity, heart attacks virtually unheard of. I would wager that Mr. Clinton has been doing none of the following:

--Taking fish oil. Or, if his doctor was "advanced" enough to have advised him to take fish oil, not taking enough.
--Vitamin D--Followers of the Heart Scan Blog already know that vitamin D is the most incredible health find of the last 50 years, including its effects on reducing heart disease risk. Unless Mr. Clinton runs naked in a tropical sun, he is vitamin D deficient. A typical dose for a man his size is 8000 units per day (gelcap only!).
--Eating a true heart healthy diet. I'll bet Mr. Clinton's doctor, trying to do the "right" thing, follows the prudent course of advising a "balanced diet" that is low in fat--you know, the diet that causes heart disease. Judging by Mr. Clinton's body shape (central body fat), it is a virtual certainty that he conceals a severe small LDL pattern, the sort that is worsened by grains, improved with their elimination.
--Making sure that hidden causes are addressed--In addition to the "hidden" small LDL, lipoprotein(a) is another biggie. Lp(a) tends to be the province of people with greater than average intelligence. I believe Mr. Clinton qualifies in this regard. I would not be at all surprised if Mr. Clinton conceals a substantial lipoprotein(a) pattern, worsened in the presence of small LDL.
--Controlling after-meal blood sugars--Postprandial (after-eating) blood sugars are a major trigger for atherosclerotic plaque growth. There are easy-to-follow methods to blunt the after-meal rise of blood sugar. (This will be the subject of an in-depth upcoming Track Your Plaque Special Report.)
--Thyroid normalization--It might be as simple as taking iodine; it might involve a little more effort, such as supplemental T3. Regardless, thyroid normalization is an easy means to substantially reduce coronary risk and slow or stop coronary plaque growth.


It's not that tough to take a few steps to avoid bypass surgery in the first place. Or, if you've already had a procedure, a few additional steps (of the sort your doctor will likely not tell you about) and you can make your first bypass your only bypass.

Comments (36) -

  • Cheryl

    2/12/2010 4:27:19 AM |

    Dr. Davis,

    You mentioned gelcap VitD. Isn't the liquid form administered via dropper easier to take, and better assimilated?

  • Marc

    2/12/2010 11:20:09 AM |

    Would Pres. Clinton have the courage to go against the grain of conventional wisdom? I don't know the answer to that question, my hunch is that it is just "easier" to get treated then to take charge and responsibility.

    My sister 46 (highly highly educated) will not listen to me at all. Won't even take the time to read some of the resources I point her to. Result? She just has been put on beta blockers for high blood pressure and a heart that beats to "fast and erratically" (her words)

    Thank you Doc., for the wealth of knowledge and information you so freely share.
    Have a great weekend.

    Marc

  • Anonymous

    2/12/2010 2:47:26 PM |

    Thank you for this post!

    I am getting so tired of the pontificating statinators who practically blame the patient, or say there is no cure for heart disease, this can't be arrested, interventional cardiology is the only way, etc., while they either withhold the vital therapies you mentioned, or worse yet, don't even KNOW about them.

    I just keep wondering how such a smart guy can have so little intellectual curiosity about the origins and ALL the modes of treatment of the disease that has come to rule his life.

    Each of his events is a teaching moment, but unfortunately, what is being taught is intervention oriented, not oriented to stopping or reversing the progression of his disease, and that's just a pity.

    Dr. Davis, you are a voice in the wilderness. Keep on Tracking, because many of us ARE listening, even if Mr. Clinton and his doctors aren't!

    madcook

  • Kyle Schneider

    2/12/2010 3:45:20 PM |

    Dr. Davis:

    Re: Vitamin D, why do you recommend only the gel capsules and not the liquid drops (Carlson's drops are in coconut oil I believe)? Much thanks, great great blog.

    -Kyle Schneider

  • Michael R. Eades, M.D.

    2/12/2010 4:12:39 PM |

    Great post, Dr. Davis.  Just about everything one needs to know to avoid heart disease all in one short list. Should be read by everyone. Thanks for taking the time to put it up.

  • Pascal

    2/12/2010 4:37:17 PM |

    Dr. Davis, it would appear that people with heart disease risk fall into two categories.
    1. Metabolic Syndrome: High TG, low HDL, high fasting glucose etc. In these people small LDL is very high contributing to heart disease risk.
    2. High Lp(a): These people may not have high blood glucose levels yet because of their high Lp(a) levels they are at risk for heart disease.

    Mr. Clinton's triglycerides were at around 53 many years back. While he clearly has coronary artery disease he does NOT appear to exhibit signs of metabolic syndrome, i.e. high TG, low HDL, high fasting glucose etc. There are many people in this category that do not have metabolic syndrome yet show advanced coronary artery disease (possibly due to a high Lp(a) level).

    Now Dr. Davis, you have stated that one of the ways to track small LDL and other risk coronary risk factors is to track blood sugars. However, in Mr. Clinton's case it appears (from his TG numbers) that both his fasting and possibly postprandial glucose levels are reasonable. His small LDL should thus be reasonably normal. He may very well have significantly high Lp(a) levels which appear to be independent of whether a person has metabolic syndrome. Therefore in Mr. Clinton's case heart disease appears to be a result of a high inherited Lp(a) than his value of small LDL.

    Please correct me if you disagree with any of the above.

  • escee

    2/12/2010 4:38:07 PM |

    It is a sad testament to cardiac care in the U.S., but I  completely agree with everything you commented on. I would be willing to bet that at his last check-up he was told he was doing  well and everything was fine.

    I wish you could do a Q&A session with his cardiologist and we could see just what had been done or not done.

  • Lori Miller

    2/12/2010 5:56:15 PM |

    Thanks for posting this. I'll print it and show it to my father.

    Slightly off topic, but I took advantage of Porter Hospital's $99 CT scan special since four generations of my family have had strokes. They seemed confused because I didn't have a doctor's order for the scan.

  • Barkeater

    2/12/2010 8:02:54 PM |

    I bet he trusted his heart to Lipitor, or some such statin, and presented with a nice low LDL-C of 105.  That is the average LDL-C of people hospitalized for heart issues (see G. Fonarow et al).  (I am not saying the statin didn't help him, but it ain't the be-all and end-all, and neither is low LDL-C.)

    Further in the direction pointed by Dr. Davis, I bet bubba's triglycerides are consistently well over 100, suggesting issues with carbs.  So, eating low fat would lead him (like others) to higher carbs, leading to where he ended up.  Probably wheat -- "healthy" whole wheat -- in particular.

    I hope he was taking niacin to do what help he could to HDL.

  • Tony

    2/12/2010 8:06:52 PM |

    I'd be interested in your thoughts on this recent article in The New York Times, particularly regarding calcification in blood vessels:

    excerpt: "The scientific community continues to debate the optimum level of vitamin D. In general, people are considered to be deficient if they have blood levels below 15 or 20 nanograms per milliliter. But many doctors now believe vitamin D levels should be above 30. The ideal level isn’t known, nor is it known at what point a person is getting too much vitamin D, which can lead to kidney stones, calcification in blood vessels and other problems."

  • Barkeater

    2/12/2010 8:11:29 PM |

    Celebrity medicine -- a celebrity gets the most esteemed doctors, but they may not be the best.

    April 14, 1865 -- Lincoln was shot in the head with a low velocity bullet.  His celebrity doctors then went probing around in the wound.  He died.  The case has been made that Civil War battlefield doctors had learned not to probe a head wound, and if Lincoln had been treated by one of those doctors there was a decent chance he could have survived.

    Dr. Davis and other preventative cardiologists are the battlefield doctors of the current generation, desperately seeking that which works and rejecting that which doesn't as fast as possible, in the midst of the carnage of heart disease.

  • Anonymous

    2/12/2010 8:47:12 PM |

    An old article of Clinton's health report just before the 1992 election:

    TC: 184
    TG: 59
    Normal BP
    Normal treadmill ECG

    http://www.nytimes.com/1992/10/15/us/1992-campaign-candidate-s-health-doctors-call-clinton-healthy-campaign-offers.html?pagewanted=1

  • Anonymous

    2/12/2010 9:15:36 PM |

    Tell us more about thyroid normalization, please?

  • sonagi92

    2/12/2010 10:00:00 PM |

    "Unless Mr. Clinton runs naked in a tropical sun, he is vitamin D deficient. "

    Mr. Clinton, like me, has very pale skin that is not well-suited to the tropical sun.  I recall reading that either the Norwegians or the Swedes had very high levels of D owing to fish consumption.  I supplement with D, but my Irish ancestors did not, and they didn't get much sun either.

  • Ludwig Johnson

    2/12/2010 10:13:32 PM |

    MAGNESIUM. Thats what fmr prsident did not do. Did not take 500mg of Magnesium Oxide daily. With all the above he would have had his heart problem anyway. But not with Magnesium. Wigh is the mineral that his metabolic Type does not handle well. Cops of GENETICS.
    www.ludwigjohnson.blogspot.com

  • Ludwig Johnson

    2/12/2010 10:13:32 PM |

    MAGNESIUM. Thats what fmr prsident did not do. Did not take 500mg of Magnesium Oxide daily. With all the above he would have had his heart problem anyway. But not with Magnesium. Wigh is the mineral that his metabolic Type does not handle well. Cops of GENETICS.
    www.ludwigjohnson.blogspot.com

  • Anonymous

    2/13/2010 12:19:17 AM |

    Today the PMRI (Preventive Medicine Research Institute) announced:

    "Dr. Dean Ornish will appear on the Larry King Live show on CNN tonight to discuss new findings in heart disease."

    No doubt that he will be asked about his take on Mr. Clinton's situation.  I would hazard a guess that it will probably involve advocating an extremely low fat diet, liberal amounts of grains, but perhaps there will be new input from the Doctor, i.e. those "new findings".

  • bronkupper

    2/13/2010 1:38:05 AM |

    Hi Guys - Clinton's diet doctor is non else than "ultra low fat" Dr. Dean Ornish!

  • Anne

    2/13/2010 6:03:31 AM |

    A couple of years ago, the pastry chef at the White House published a book about his 25 year experience. I have heard that in the book he said Pres. Clinton was allergic to wheat and chocolate. I wonder if he has been sticking to a wheat/gluten free diet? Of course if you have a pastry chef, sugar intake is probably very high.

    I am working hard to make my bypass my last heart procedure. I am 10 yrs out and doing great...I hope.

  • Richard A.

    2/13/2010 6:08:50 AM |

    A Simple Health-Care Fix Fizzles Out

    http://online.wsj.com/article/SB10001424052748703652104574652401818092212.html

  • Anonymous

    2/13/2010 11:24:40 AM |

    Dr. Davis, did you get a chance to read this article?
    http://www.cortlandtforum.com/Healthday-Article/section/955/?CID=8D70113C&NFID=P&articleId=635663

  • Eddie Vos

    2/13/2010 2:09:51 PM |

    What is Clinton's homocysteine level??  That molecule, as opposed to cholesterol that is essential for health, is universally accepted as an artery structure corrosive and underlying cause of slowly building heart disease.

    The ONLY therapy to reduce it is a multivitamin pill with high levels of  the B vitamins.  Nobody argues this, nobody.

    So, they "bypassed" the problem areas but the disease process continues unabated.  This is the medical equivalent of bypassing Bin Laden by invading Iraq.

    Clearly, the amount and the diameter of LDL are not the problem; it is what you put INSIDE the LDL emulsion globules that matters: omega-3 or trans fat, good or evil.  Also, LDL is a Trojan Horse for homocysteine.  

    Clinton may be taking a statin to reduce the amount of LDL but that does not alter its composition or homocysteine level.  My independent take on cholesterol and homocysteine are here:
    http://www.health-heart.org/cholesterol.htm and
    http://www.health-heart.org/why.htm

    Did Clinton take such multivitamin? Agree: a multi does not quickly repair existing damage but it slows the process of decline while some repair [first seen in fewer strokes] DOES take place.

  • Alfredo E.

    2/13/2010 2:58:35 PM |

    Very opportune post Dr. Davis. I would like to have an idea to how much fish oil you have to take per day in order to keep your omega 3 Index above 10%. Just a practical example.

  • Anonymous

    2/13/2010 3:47:53 PM |

    Some years ago, Clinton said he was following Dean Ornish's plan. He isn't much of an advertisment for the success of that.

    Jeanne S

  • Dr. William Davis

    2/13/2010 10:59:47 PM |

    I wasn't aware that Dean Ornish was part of the Clinton picture.

    It will be interesting to see what his comments will be.

    Just as lungs would be removed to treat tuberculosis, or heart disease treated with removal of the thyroid gland, so low-fat diets like Dr. Ornish's need to be sent to the junk heap of failed practices.

  • Mike

    2/14/2010 1:28:43 AM |

    The iodine suggestion makes me wonder if the push to eliminate table salt from diets is resulting in abnormally low iodine levels. Putting iodine in table salt was done to fix the problem of low iodine levels in the food that most Americans were eating. Eating lots of seafood will fix the iodine and omega-3 deficiencies.

  • Myron

    2/14/2010 5:56:09 PM |

    Nice summary of things to do for a really healthy cardiovascular life style.   Specifically for Billy, I'm suggesting that his chronic is Wheat Allergies [beer and bagles].  All chronic inflamation is cause for any degenerative disease, certainlly cancer, cardiovascular, arthritis etc.  

    Each person has to address their chronic inflammation--often it comes from the dirtiest part of the body, the mouth [some say the brain] both need to be well.

  • Anonymous

    2/14/2010 6:09:33 PM |

    John McDougall, MD has written an open letter to Bill Clinton (one of a series over the years) regarding the care he receives from his intervention-oriented cardiologists.

    I was absolutely right there with Dr. McDougall... well until the last two paragraphs, where Dr. McDougall gets to the point of his letter and advocates a "healthy low-fat diet" like Pritikin, McDougall, Ornish, or Esselstyn.

    OHHHHH... I thought Mr. Clinton HAS BEEN on such a program... under the tutelage of Dr. Ornish, who as much as said so on the Larry King program the other evening.

    Dr. McDougall makes some very strong points regarding the interventional care Mr. Clinton has received and will continue to receive... it's just that extremely low-fat, vegetarian to veganish focus where we diverge.

    http://www.drmcdougall.com/misc/2010other/news/clinton.htm

    Happy Valentines Day... may all our hearts be strong and healthy!

    madcook

  • Myron

    2/14/2010 6:11:10 PM |

    Interesting comments, thank you for including the homocysteine and B vitamin perspective, and usually the allergy to chocolate is milk not the bean.    Bill should definitely eat more fish and more curry foods for the Turmeric, COX-2inhibitor.  Mag Oxide is great diarrhea, does it even absorb?   Chlorophyll is a chelated Mg and rebuilds the mitochondria.  Concerned about Abd. fats and Metabolic syndrome--get you Free Testosterone normalized!

  • Peter

    2/15/2010 2:04:34 PM |

    Re: wheat, it's curious to me that in northern India where people eat lots of wheat they have a fraction of the heart disease that they do in southern India, where people eat rice.  If anybody understands this, please reply.

  • Eduardo

    2/15/2010 4:30:35 PM |

    Dr. Davis: Your comment about a possible link between higher Lp(a) and higher intelligence sent me on a very brief ego trip, as tests showed that I do have both, but a more rational explanation may be that those of higher intelligence are more likely to get engaged in their own health, search for answers (as the readers here do) and find out that they have a elevated Lp(a), while others may never know they have it. Also, the March 2010 issue of Men's Health has a positive article about a pro-cycling team's switch to a gluten free diet, a favorite subject of yours, thanks for the blog.

  • Jen

    2/15/2010 9:13:09 PM |

    I would like to know more information regarding this statement;

    "Lp(a) tends to be the province of people with greater than average intelligence."

    Can you point me in a direction that would explain more about this?

    Thank you,
    JenE

  • Amelia

    2/16/2010 1:19:54 AM |

    Re North India:  They do use quite a bit of mustard seed oil in N. Indian cuisine.

    http://www.ajcn.org/cgi/content/full/79/4/582

  • EddieVos

    2/16/2010 1:37:48 PM |

    Mustard seed oil has antiarrhythmic omega-3  It is in that respect like canola/rapeseed .. or any brassica family seed oil [turnip, et al].

    The northeners may also get more vitamin B12, allowing homocysteine to be lower, a MASSIVE problem in India, massive.  In New Delhi in early 20 year olds, homocysteine is about 3x higher than currently in Americans youth in their teens.

  • Bob

    2/16/2010 5:24:05 PM |

    I second JenE's question re lp(a) - correlation with IQ. Thanks!

  • buy jeans

    11/3/2010 9:14:28 PM |

    It's not that tough to take a few steps to avoid bypass surgery in the first place. Or, if you've already had a procedure, a few additional steps (of the sort your doctor will likely not tell you about) and you can make your first bypass your only bypass.

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Wheat withdrawal: How common?

Wheat withdrawal: How common?

In response to the recent Heart Scan Blog poll,

Have you experienced fatigue and mental fogginess with stopping wheat, i.e., "wheat withdrawal"?

the 104 respondents said:


Yes, I have experienced it: 26 (25%)

No, I stopped wheat and did not experience it: 65 (62%)

I'm not sure: 3 (2%)

I haven't tried it but plan to: 7 (6%)

I haven't tried it and don't plan to: 3 (2%)



So 25% of respondents reported experiencing the fatigue and mental fogginess of wheat withdrawal. This is similar to what I observe in my practice.

I counsel many patients to consider the elimination of wheat, as well as cornstarch products, in an effort to regain control over:

--Weight
--Appetite
--Low HDL
--High triglycerides
--Small LDL
--High blood sugar
--High blood pressure

All of these issues respond--often dramatically--to elimination of wheat and cornstarch.

Why would there be undesirable effects of eliminating wheat?

One clear issue is that elimination of wheat and other sugar-equivalents deprives your body of glucose. Your body then needs to resort to fatty acid metabolism to generate energy. Apparently, some people are inefficient at this conversion, having subsisted on carbohydrates for the last few decades of their lives. However, as fatty acid metabolism kicks in, energy generation improves. That is my (over-)simplified way of reasoning it through.

However, are there other explanations behind the mental fogginess, drop in energy, and overwhelming sleepiness? Some readers of this blog have suggested that, since opioid-like sequences (i.e., amino acide sequences that activate opiate receptors) are present in wheat, perhaps withdrawal from wheat represents a lesser form of opiate withdrawal. I find this a fascinating possibility, though I know of no literature devoted to establishing a cause-effect relationship.

Whatever the mechanism, I find it very peculiar that this food widely touted by the USDA, American Heart Association, and other agencies actually triggers a withdrawal syndrome in approximately 25% of people. Spinach does not trigger withdrawal. Nor does flaxseed, olive oil, almonds, and countless other healthy foods.

Then why would whole wheat grains be lumped with other healthy foods?

Comments (11) -

  • Anonymous

    10/7/2008 12:29:00 AM |

    Eliminate wheat and cornstarch, check.

    What about other grains?

    Is it necessary to eliminate ALL grains to get control of small LDL, etc., etc.?

    What about oats, as oat bran is a mainstay fiber of the TYP program?

    Are cooked oat groats (whole oats) an acceptable grain on TYP?

    So many questions... perhaps better to post these on the TYP members forum.  Smile

    Thanks for this informative blog!

    Terri
    madcook

  • Anonymous

    10/7/2008 2:45:00 AM |

    Well somebody should invite a "Wheat Patch" -
    The withdrawals are very very strong for me and have taken some time to subside.

  • Peter

    10/7/2008 10:57:00 AM |

    Hi Dr Davis,

    Here's an intro

    the peptides

    more on the peptides

    male breast enhancement?

    behavioural effects

    Insulin effects

    I like that last one as it provides a link through exaggerated pancreatic response to carbohydrate, subsequent hyperinsulinaemia leading to reactive hypoglycaemia. Then hunger triggers another bagel, more hyperinsulinaemia and then an anticipatory bagel becomes habitual as hunger is unpleasant and can be avoided. This sets up for chronic hyperinsulinaemia with pathological insulin resistance as a survival tactic for muscles to avoid sugar poisoning. Chronic hyperinsulinaemia equals metabolic syndrome, small dense LDL etc etc...

    Both spinach and haemoglobin contain similar sequences, but wheat is verging on indestructable in its structure, plus it opens the tight junctions between eneterocytes to gain access to the systemic circulation, not a feature of many other foods...

    Peter

    The schizophrenia links would be off topic on a CVD blog...

  • Anonymous

    10/7/2008 1:29:00 PM |

    What implications are there for someone to eliminate wheat if they are not overweight and their triglycerides and LDL particle size are both in a good range?

  • Nancy LC

    10/7/2008 2:11:00 PM |

    I was lucky not to have the brain fog on quitting wheat, but I had it when I was abusing wheat!  

    Truly, it feels like I got my old brain back, the youthful, smart one, when I quit eating wheat and all gluten.  Such brain fog that stuff gave me.

  • Anne

    10/8/2008 12:18:00 AM |

    Not only did I have withdrawal symptoms when I eliminated wheat (and barley and rye), but I become fatigued, irritable, foggy brained and red eyed if I get even the tiniest bit of these grains. I have non-celiac gluten sensitivity. Tests by Enterolab revealed my body makes antibodies against gluten(the carrier proteins in these grains).

    The heart connection? For me, I think wheat contributed to or caused the inflammation that blocked my heart vessel. I cannot prove this other than to say my health has improved dramatically since giving up wheat and other related grains. I have also found I need a diet low in carbs to keep my blood glucose low. That eliminated all the other grains.

    How common is gluten sensitivity? There is a growing number of doctors who believe this affects 10-30% of the population. Add to that, the people who have a wheat allergy(wheat is among the top 8 allergens), and you have a lot of people who should not be eating even a smidgen of wheat.

    Peter, thanks for the links.

  • Margaret P

    10/8/2008 2:45:00 AM |

    I haven't eliminated wheat, but after eliminating corn and its derivatives from my diet, my already painful and increasingly serious sinus infection cleared up.  I also went from needing 11-12 hours of sleep to 9-10.

    I think allergies to corn are very common but almost never recognized.  Corn is in almost every processed food.  I was sick for a decade before a friend suggested avoiding corn and it took only two days to see a dramatic improvement in my health.

  • Anonymous

    10/9/2008 12:53:00 AM |

    I can only speak from my own experience, but after eating wheat (all grains) for 50 years, my immune system is shot. Now if I consume even a couple of items (pasta or muffin or bread), within a day my feet swell up and my left knee is so painful I can barely walk nevermind the pain in my back. Those are just the first warning signs. If I dare continue, I know that within a short time I could possibly die. After a week of no grain and sugar, I'm practically jumping out of bed with no pain whatsoever anywhere. I have tested this several times (stupid me) and no longer experiment.

  • Anonymous

    12/12/2008 9:45:00 PM |

    i have been off wheat and soya for two weeks, for the first week i felt fine, but now i feel half asleep, like i haven't got enough energy for anything and could just fall asleep at any given moment.  i though i was alone! I have also dropeed two dress sizes in the past two weeks and am becoming concerned about how quickly i am losing weight? should this slow down soon? I am a little over weight, but not massively so i don't want to lose too much.

  • Anonymous

    6/5/2009 3:46:15 PM |

    i eliminated wheat from my diet and had the  fogginess and headaches.

    very informative blog, thank you

  • Anonymous

    1/21/2011 7:05:42 PM |

    I'm on day 4 of wheat removal and it's very tough.

    I know from experimentation that potatoes, rice, fruit, corn (corn flakes), and even artificial sugars like a chocolate bar don't affect these withdrawal symptoms.  

    I haven't tried oatmeal or barley out of a fear of gluten, but just to add to the discussion that I'm finding wheat uniquely bad for withdrawal even though I'm getting plenty of carbs from white rice and fruit, also getting plenty of meat and fat and veggies.  Adding in wheat makes the withdrawal symptoms go away, although I feel much worse physically.  Thus, I'm having heavy fatigue and headache constantly despite having a moderate amount of carbs with each meal.  Also, from experience, the rice I eat with each meal gives me very mild negative effects physically, so I'm positive all of this headache and fatigue is from wheat withdrawal.  It's become very consistent by now.  I hope this goes away soon...

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