Strange stuff that Lp(a).  The TYP protocol worked well for me a dropped my Lp(a) from 21 to 3.  But, was the reduction due to fish oil alone or the combination of fish oil and other TYP strategies?  If you had to rank each of the following strategies in order of effectiveness (from 1 to 10) for reducing Lp(a) what would they be?  5,000 MG EPA + DHA, 5,000 IU D3, 1,000 MG Slo-Niacin, low carb/high fat/high protein diet, elimination of grain, sugar and starches?

Maybe PUFA's 2yr/life?

Post got lost again, said "error" ....
11 humans (rheumatoid arthritics) blocked their interleukin 6 (Il-6) signalling by regularly saturating the alpha chain of Il-6 receptors with  Tocilizumab reduced their Lp(a) as a side benefit;  relevant data:
* starting Lp(a) = 34.5 (+/- 12.8) mg/dL
* 1 month Lp(a) = 24.3 (+/- 7.6) mg/dL
* 3 month Lp(a) = 19.9 (+/- 6.3) mg/dL
EPA/DHA from anti-inflammatory fish oil also blocks Il-6;  so this may be operating mechanism where it too can lower Lp(a).

my cardiologist believes in many of your protocols, but forbids me to take large dose of omega 3 epa/dha. i am on plavix/aspirin since stents in two arteries one year ago. i have thrombocytopenia, lower than threshold platelet count and lower rbc and hgb levels. his thoughts are this addition could cause bleeding episodes that could cause even more trouble. i understand and agree with him. my supplement intake has been limited, even ubiquinol because of my situation. no chance of ending plavix because of recently diagnosed mitral valve regurgitation during echo. any thoughts on your part or the community thoughts. i feel as if i am losing control of my health as i hold distrust for most traditional medical community.

My research of lipids & Essential Fatty Acids has taught me that the "insightful lesson to be learned from the incredibly slow response" of fish oil in the treatment of CAD & CVD is that fish oil is:  1.) the wrong substance (there are BETTER ones!) and dosage levels,  and 2.) largely ineffective in the face of continued intake of high carb & TRANS fat containing processed junk, fast & restaurant "foods" and grocery store vegetable oils.   Failure to make changes to correct bad dietary habits and failure to stop the intake of TRANS fats is the single cause of re-stenosis in CVD patients, which guarantees further atherosclerosis, thrombosis, strokes & heart attacks.

Dr. Robert Rowen recently wrote about his re think of the whole fish oil thing in his June Second Opinion newsletter that somebody (not me) posted here: http://goo.gl/rPvRx  
which he based on this:  http://goo.gl/uAiv2  
and this:  http://goo.gl/j9MgY    
and mostly this:  http://goo.gl/ZdORy  

In regard to the drop in Lp(a) comment it should be noted that LDL, VLDL & their  fractions will correct in response to reducing carb intake alone, even without further dietary correction or supplementation.  There is also a nutritional supplement protocol known as the Linus Pauling therapy that is reported to lower Lp(a) by using vitamin C, L-lysine, and L-proline, but Joe Mercola advises the regimen "is ONLY for people with established CVD and/or elevated Lp(a) levels."

easybleeder:  Check with your doctor to see if you may be a candidate for the newer antiplatelet meds  Prasugrel or  Ticagrelor.  Both have been reported to have a lower risk profile and mortality rate than Clopidogrel.  Prasugrel is reported to be useful for those with high thrombotic risk.  Go to: http://www.escardio.org/communities/councils/ccp/e-journal/volume8/Pages/antiplatelet-agents-alegria-barrero.aspx

Oops, I posted the search for Rowen's article, it's the top hit, but here's the real link:  http://goo.gl/DDp8P

Atherosclerosis is a slow process, so I am not surprised that strategies to halt or reverse it are also slow (but powerful).

From "Omega-3 Fatty Acids in Inflammation and Autoimmune Diseases"

There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.

I wonder, what is exact reason that some doctors don't recommend large doses of fish oil (and 5g EPA/DHA is large dose, its around 25-50 ml of liquid fish oil equals 2 - 4 tbsps), because that is what I heard as doctors response from several people with cvd problems. I always thought its because of rancidity. I put extra 200 IU of mixed tocopherol in my 100 ml liquid fish oil and keep it in fridge just to be sure.

Thrombocytopenia and anemia - have you looked into a possible connection to gluten. Anemia is a very common problem in those with any kind of gluten sensitivity. If you do a PubMed search for "thrombocytopenia" and "gluten" you will bring up some references. There are also some references in The Gluten File - just scroll down to the bottom of this page

Have you stopped eating wheat as recommended by Dr. Davis. It may be important for you to go 100% gluten free. Gluten can damage any and all organs and systems and you don't have to have celiac disease for this to happen.

HI, Might-o--

As always, a fascinating suggestion. Sadly, there are no investigations that shed any light on precisely why. An anti-inflammatory mechanism is a very good possibility. I also wonder if there is an effect at the transcription level, given the modification of apo(a) tail length.

Hi, Easy--

It sounds like you need an explanation for your thrombocytopenia.

Putting the question of thrombocytopenia aside, I have never seen any excess bleeding when adding fish oil at any dose to aspirin and Plavix.

prasugrel, while having a better cvd profile, in studies, i believe, has  a worse profile in bleeding episodes. it is usually given to those who are non-responders to plavix as determined by genetic profile (ususally done at time of angioplasty and afterwards). ticagrelor, unfortuneatly, has yet to gain FDA approval. maybe soon though. drs. will be slow to adopt to a new drug.

Hi c-classes,
That tweaked edible oil is a  formulation from Brian Peskin not the link's Rowen, M.D. remarking on Peskin's product inducing  better elasticity of blood vessels in comparison to fish oil.  There are other effects of fish oil's  EPA/DHA that  are not related to vascular elasticity;  such as the benefit of reducing Lp(a) that Doc Davis reports.  If you have decided to personally set a limit on fish oil intake it would be interesting to hear your experience.

Hi Might-o,
Yeah,  that oops comment is a correction to a comment I submitted which has not yet passed the moderation.  You can find my original comment here:  http://goo.gl/fyVfH   and a related comment here: http://goo.gl/WrQKK

As I note in the related comment I started taking fish oils around 2002 for shoulder pain due to 30 years of heavy construction work.  They were effective, but after researching Peskin's & MANY others work re lipids I found something better & stopped taking the fish oils, moved higher up the metabolic pathway and now follow Peskin's protocol & take around 2 or 3 grams of organic O-6 in either evening primrose, sunflower, safflower or hemp seed oils & 1 gram of O-3 organic flax to maintain his recommended 2.5 or 3 to 1 O-6 to O-3 ratio.  

Haven't had a workup since my 45th b'day 9 years ago, but I have no health issues at all that I am aware of.   I occasionally check my bp with the free machine in drug stores, it's always within normal range between 117/77 to 121/81-82, no palpitations, angina or other symptoms at all.

Only problem I've noted since starting that regimen is I seem to always be clipping my hair & nails, growth seems to have accelerated.

Is it safe to presume that adding  Dr.Peskin's edible oil formulation to my intake along with 2.5 Gm of fish oil would be beneficial?  Does fish oil not affect the vascular elasticity as well?  BTW, what is the recommended amount of fish oil   one should take daily?  I too am afraid of the potential of oxidation.  Is there any way to measure the level of oxidative stress related to taking too much fish oil?

"Server Error" keeps eating my comments ... anybody else?

Hi Mary A,
Peskin is not a medical doctor, although some medical doctors use his protocols and products; Peskin thinks "parent"  omega 6 & omega 3 fatty acids are all that is needed for anybody to make enough "derivative" omega 6s & 3s (inc. EPA/DHA). His theory is taking fish oil is giving us the incomplete benefit of a "derivative" and incurs an excessive level over-loading in un-natural way  ;   claiming risks potential lower natural tumor cell killing, increased bacterial infection, worse  insulin resistance, less glucose tolerance, "resting" blood sugar rises, brain damage and discounts lower triglycerides as "irrelevant".  Doc Davis probably has heard of Peskin and still finds fish oil useful.

Does fish oil (or Borage oil)  to a regimen of Crestor (currently prescribed 20 mg/d) & Niancin ER (1g/d) make sense?   ...Have read that high doses of oils & statins taken together effectively cancel benefits of both.

Peskin did not invent the theory of the dangers of taking pharmacological overdose levels of omega 3 derivatives, it is a well known biochemical fact that has been thoroughly researched by many other groups.  Check any of his writings & you'll see he always cites the sources of his findings.  

Peskin himself has only been led to his conclusions by simply analyzing ALL the available literature from many research groups, separating the true wheat from the false chaff, then he simply republishes the results of his analysis of the literature to make it understandable to all, some of which has been known & available for decades but has been either suppressed, discredited, discounted, sidestepped, ignored or just not talked about or publicized by the mainstream media because it's contrary to the financial interests of the medical & pharmaceutical "sick care" industries.

A perfect example of that is M.D., Ph.D. biochemist Otto Warburg who was awarded the 1931 Nobel Prize for his work in defining the prime cause of cancer.  But who has ever heard of him & the prime cause?  It's staggering how few M.D.'s & oncologists have ever heard of him, or have ever been taught about Warburg in med school. And if the medical profession doesn't teach their students, it's a slam dunk guarantee that people will never hear about Warburg & the prime cause of cancer from their doctors.   I'm 53 years old & I had never heard of him or his work, & if I hadn't stumbled across Peskin I most likely would have lived my entire life, contracted some kind of cancer along the way, most likely prostate, then later would have died & STILL would never have known about Warburg.

Anyone that wants to do more in life than just parrot the opinions published in the popular & "peer reviewed" press can find the true facts.  I find it quite ironic that at our point in human history, when we have even freely available to us the most powerful information & truth gathering tool ever devised by man, science is DEvolving into the realm of belief, tradition & superstition, and people are being polarized into affinity groups based on those beliefs, traditions & superstitions instead of gathering together to honor real scientific truths.

Hi c-classes,
Warburg is famous enough for describing cancer cells proclivity for performing aerobic glycolysis as an edge to thrive; I think this is best described as a modality of function and modern research is showing the causes  of cancer are complex. You may be interested in this weeks published details of the molecular development promoting cancer  cells replication; see journal Molecular Cell, vol. 43, issue 1, 122-131 "Failure of Origin Adaptation in Response to FORK Stalling Leads to Chromosomal Instability at Fragile Site".

A synopsis : Kerem, et.all.,  give 1st details of how fragile sites of a single DNA molecule breaks in early cancer due to "perturbed" DNA replication; normally DNA copying slows and sometimes stalls at fragile sites so that the cell sometimes has to shift to use stress mechanisms in order to finish single molecules DNA copy. But, in the case of an incipient cancer cell which has already utilized the stress mechanics  that cell has no more stress mechanisms to call on that can do enough at a fragile site to keep proper replication going; then the DNA molecule actually breaks whereby normal protein expression suffers, functional changes occur and cancer defects particular to that type of cancer replicates.

I guess my question still remains does the edible oil formulations of Dr. Peskin hold any health benefits for a person and if so, then how much would a person take and with or without fish oil?  Are there any other blogs or websites that are dedicated  to his research?   BTW, great info Might-o'chondrl-AL and cancerclasses.

Forgive me for asking the previous question before I read Dr. Peskin's  website. I am not a scientist but the research he identifies seems to support his conclusions.  Cancerclasses, you seem to be a supporter of his.  Are you following his protocol and, if so, what have you experienced?  I would appreciate others opinions regarding Dr. Peskin and his protocol.  I think this is a very important area especially since many physicians and PhDs (i.e. Dr. Sears et al) encourage the use of fish oil in the dietary regime.

Hi Mary A:
I have submitted several replies to this article that have not passed moderation and have not been posted here, just click on my name at the top of my comments & it will take you to my Twitter channel where I have posted my comments. Click on the link at the comment that starts with "My study & research of..."  then also click on the one 2 posts down about  bursitis & arthritis.  You may also scan my posts for anything else that interests you, as I post info there from a wide variety of subjects & sources I find interesting & relevant while conducting my own research.

Hi Mary,
Peskin refers to 1988-1992 rodent studies showing brain "damage" from  extra EPA/DHA; maybe elsewhere he cites newer brain damage indications. The extrapolation to humans is not certain ; since we have +/- 1,100 million synapses per cubic mm. , while rodents have 1,397 million synapses per cubic mm.  Humans gain not only from having astrocytes 2.5 times wider than rodents, but also we function with 1 astrocyte for each 270,000 to 2,000,000 synapses in a neurological domain; while rodents must use 1 astrocyte for each 20,000 to 120,000 synapses in a neurological domain.

As for Peskin's assertion that lowering triglycerides is "irrelevant" Doc Davis elaborated for us why they are worth controlling; when more trigs going into circulation hitched to VLD Lipid  this morphs into trig rich LDL and small LDL particles increase in numbers. The same trig laden VLDL  contributes to formation of some HDL,  but the result is rapid degradation of that HDL; so the HDL circulating is small HDL particles and the net amount of HDL is also reduced.  Doc Davis has been seeing human clinical success using fish oil (EPA/DHA) to lower the VLDL and co-administering niacin to act on reducing the number of small LDL particles (to ideally maximum 10% of total LDL number of particles);  while the fish oil & niacin combination work synergisticly to keep down circulating  triglycerides  (to ideally 60 mg/dL). This is a synopsis of what I l learned here.

Peskin's PEO, "parent essential oils", are touted as offering measurably better vascular membrane flexibility in comparison to fish oil; this may not  (may be, I don't know) necessarily translate to reduction &/or protection from the circulating small LDL molecules that oxidize and foster plaque.  He quotes USDA that only 0.05 % of alpha linolenic acid we ingest is made into DHA and 0.20% made into EPA; extrapolating from there that supplementing EPA/DHA radically exceeds what we are designed to need.  The fact that age remodels many of our functions to me suggests that  taking extra EPA/DHA is akin to dosing one for  therapeutic purposes (ie:  reduce VLDL, trigs &  Lpa the theme of this thread) that are more critical to survival  from sudden death than vascular flexibility alone is.   If someone on Peskin's PEO protocol has before and after Lp(a) & NMR lipid profile data that would be interesting to see.

Peskin exclaims fish oil raises blood sugar and insulin resistance; my own experiment 4 months after adding large dose of EPA/DHA  (also started niacin) laboratory data show I did  elevate my fasting serum blood sugar an extra 5mg/dL,  with HbA1c going up 0.3; yet had fasting insulin measuring only 4.1.  Personally I was happy to trade that  blip in  glucose tolerance for the drop in number of small LDL particles from 1,021 nmol/L (out of  1,676 nmol/L total) down to small LDL particles numbering 96 nmol/L ; and triglycerides dropping from 90 mg/dL down to 42 mg/dL.  Blood sugar control seems ammenable to more dietary interventions to compensate  against  and  I'm relieved to see Doc Davis'  advice worked for my unruly small LDL.

Thank you Cclasses and Might-o for your responses.  Could something so simple be so valuable as PEO.
I did read Prof Peskin's Iowa study along with a couple of posted letters from physicians supporting the benefits of PEO found in their patients along with the results of an actual scan taken of Brian Peskin's heart  which showed NO plaque at all--.  Correct me if I am wrong but it is my understanding that if the intimal lining is healthy there is less /no inflammation. A healthy intimal lining prevents the events that cause a thrombus from occurring thereby preventing plaque build up and the adverse sequelae from developing. I know this is a simplistic understanding but, like I said, I'm no scientist.  It seems like it would be worth a good controlled study since Prof Peskin says positive results can be seen in as little as three months.   Hopefully, any study would include looking at various inflammatory markers as well as the total cholesterol profile.
Might-O..I have been reading lately about the effectiveness of delta and gamma tocotrienols in reducing LDL, Lpa as well as increasing insulin sensitivity.  There is some research to support this.  I don't know if Dr. Davis utilizes this in his Tx protocols.

Yes, fats ARE simple, but you don't have to be a scientist to know that fats are crucially important to have as a regular part of our diets.  I find most people are seriously deficient in knowledge (which is intentional & by design) of the critical physiological & biochemical importance of regular dietary intake of essential fatty acids & good saturated animal fats, and thus are seriously deficient in those EFA's & natural saturated animal fats.  

The medical & pharmaceutical "sick care" industries both perpetuate & exploit the public's fear of fats, cholesterols, protein, salt, etc, the very same substances that every one of our 100 trillion cells are made of, and this is why the average American is chronically sick & tired, diabetic, dehydrated, cancerous & cardiovascularly compromised.  As even you have learned & now know, there is NO omega 3 or derivatives in arterial intima & media, or even in human skin, it' all omega 6.  Yes it's true that a healthy arterial intima indicates less inflammation & vice versa, but EFA's & PEO's only facilitate healing & proper structural conformity, they won't PREVENT arterial damage if a person continues the high carb & TRANS fat intake that leads to the elevated serum glucose & LDL & VLDL levels that damage & alter the structure of endothelial cells & cholesterol.

The studies you would like to see have been done, they are out there, Peskin writes about & references them all the time.  His book The Hidden Story Of Cancer and his website are not just about cancer, he includes a large amount of information about heart disease, statins, nutrition & related issues. Go to brianpeskin dot com & see Reports & Publications, and in particular go to Reports - Medical Reports - New Look LDL

Thanks CClasses for your help.  You are so right....the public at large have been taught to be afraid of so many things regarding their health.  Some try to seek out valuable information and others don't.  Many people look to their physicians to tell them all they need to know and that is a mistake.  Maybe with this new crisis going on in health care, people will begin to take an even more active role in their health.

@ easybleeder:
Plavix CAUSES Thrombotic thrombocytopenic purpura (TTP).   From Wikipedia search Plavix,
"Clopidogrel is an oral, thienopyridine class antiplatelet agent used to inhibit blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease. It is marketed by Bristol-Myers Squibb and Sanofi-Aventis under the trade name Plavix. The drug works by irreversibly inhibiting a receptor called P2Y12, an adenosine diphosphate ADP chemoreceptor. Adverse effects include hemorrhage, severe neutropenia, and thrombotic thrombocytopenic purpura (TTP).

Also Google Brian Peskin, aspirin.   From the cover of his article "Aspirin Is Awful":   “...Low-dose aspirin, which enhances platelet adhesivity, increases thrombosis (clotting) when platelet adhesion dominates as the response to injury.” Buchanan, MR and Jejana, E, Journal of Clinical Investigation, 67503-508

So your doctor has you on Plavix which ostensibly prevents thrombosis, but also causes thrombosis, and also has you on aspirin which causes thrombosis?!?!  His theory must be that the effects of the two drugs cancel each other out, so theoretically you should be perfectly healthy.  No wonder you feel so out of control.

Hi Might-o,
Yeah, that oops comment is a correction to a comment I submitted which has not yet passed the moderation. You can find my original comment by clicking on my name at the top of my comment.

I started taking fish oils around 2002 for shoulder pain due to 30 years of heavy construction work. They were effective, but after researching Peskin’s & MANY others work re lipids I found something better & stopped taking the fish oils, moved higher up the metabolic pathway and now follow Peskin’s protocol & take around 2 or 3 grams of organic O-6 in either evening primrose, sunflower, safflower or hemp seed oils & 1 gram of O-3 organic flax to maintain the biochemically optimum recommended 2.5 or 3 to 1 O-6 to O-3 ratio.

Haven’t had a workup since my 45th b’day 9 years ago, but I have no health issues at all that I am aware of. I occasionally check my bp with the free machine in drug stores, it’s always within normal range between 117/77 to 121/81-82, no palpitations, angina or other symptoms at all.

Only problem I’ve noted since starting that regimen is I seem to always be clipping my hair & nails, growth seems to have accelerated.

Mary A:  Sorry I didn't reply to this sooner.  Taking fish oils along with Omega-6 & Omega 3 would be redundant & that much Omega-3's would negate the effect & benefit of the O-6 by dominating the desaturase & elongase enzymes the body uses to produce the derivative forms of the fats that are further down the metabolic pathway, as PhD lipid researcher Mary Enig explains in her article "Tripping Lightly Down the Prostaglandin Pathways."  Just google the title of the article & also study the metabolic pathway chart there, I can't include the links here or this comment won't pass moderation.

If you take a look at the O-6 & O-3 metabolic pathway chart in that article, it becomes readily apparent that by taking any single derivative form of O-6 or O-3 you are jumping into the pathway at the point of that particular derivative, creating an oversupply & IM-balance of that derivative, and you are also cheating your body & yourself out of ALL the other derivative forms your body needs & would otherwise use for the formation of the critical BALANCE of prostanoids, leukotrenes, lipoxins & thromboxins you'd have if you instead just took the parent base substrate Omega-6 & Omega-3 at the top of the pathway. People just don't understand the importance of supplying your body ALL and complete, natural organic forms of the materials it needs for ALL it's metabolic processes, and that's why people are sick & diseased.  

To be completely truthful, there is a list of diseases & conditions that deactivate the desat & elongase enzymes necessary for the breakdown & utilization of the base substrate oils, so some  persons with those conditions require & will only benefit by taking the derivative forms.  However, in analyzing that list of diseases it's also easy to deduce that many of them only exist because of a primary & earlier deficiency of essential fatty acids.

Hi,

DR Davis recommends taking fish oil for curing heart disease, but I also read somewhere that fish oil is also anti-inflammatory and inflammation is the real cause of heart disease, not high cholesterol.

What you think of that? Is inflammation more dangerous than high cholesterol?
Thank you!

I'm new to the site, and I just wanted to say how much I'm appreciating it.  I began taking krill oil capsules a month ago, and haven't had a single heart palpitation since.  In fact they stopped after only two days of taking it.

Hello there! This is my first visit to your blog!
We are a team of volunteers and starting a new initiative in a community
in the same niche. Your blog provided us beneficial information to work on.
You have done a wonderful job!

Dr. Davis,

I know how frustrated you and a few other doctors are relative to the contrariness of some of your colleges.  They hide behind the necessity for long term CYA clinical trials that never seem to take place.  I know that the road to good health and fiscal solvency of health care lies in the direction of supplementation with wild omega 3 fish oil and high dose vitamin D3 along with a low carbohydrate and high fat program.  But a study along these lines will never take place.  After all, you can't get a Patent out of such a program, therefore, pharmaceutical companies will never fund it.  
I am a study of one for the last 9 months.  My forward thinking nephrologist,www.nephropal.blogspot.com  who follows your blog intently, put me on the above mentioned program while reassessing and stopping many of my medications.   One in particular is Staten's. I have achieved a loss of 50 pounds, my Trig/Hdl ratio is 2.73. My hbA1c diabetes type 2 score dropped from 5.9 to 4.6.  Many other health markers have greatly improved.  I tell you all of this because I can't get the notion out of my head that if the above mentioned was a national policy,  Diabetes essentially cured along with heart disease and many other metabolic syndrome diseases brought on by the western healthy diet, would not the financial difficulty plaguing universal health care be over.

Bravo to doctors like you that step out of the box and treat patients with the goal of cure not just a prescription and see you in 3 months.  You doctors are the unsung heroes of the medical profession.

Great results, Billye!

And thanks for the kind feedback.

What timing for your post!  I live in Texas and I am scheduled for my first CT heart scan...tomorrow.  I don't have any outward risk factors, except age and family history, but my doc thought it was a good idea.  I'm glad to know insurance is covering it!

you never seen hearth atach with hearth scan and no calcium even with lpa high?
other dr had never seen hearth atack when magnesium hydroxide was taken routinly is it corelate each other meaning it digests the calcium?

I posted yesterday that I was about to have my first CT heart scan...well, it was an interesting experience for reasons I coudn't possibly have anticipated.  Dr. Davis has commented in the past on the confusion in the media about the difference between a CT calcium score scan, and a CT angiography, the latter requiring a far higher dose of radiation.  I assumed this was a source of confusion only among patients and lay folks, but, lo and behold, I discovered today that doctors--or at least their helpers--can be just as confused.  

Here's my story:

After checking in, I asked the receptionist to see if she had any information on whether my medical insurance was covering the scan.  She called someone, and I heard her say over the phone, "he's here for a CT angiogram."  At that point my ears perked up.  I explained I wasn't here for a CT angiogram, only a regular CT scan.  "Well, do you want to call your doctor and talk about this?" she asked.  No, I said, I would like to ask one of their folks to verify exactly what test my doctor had ordered.  As luck would have it, the technician was walking by at that point.  "Is this a CT angiogram?" the receptionist asked.  "No, it's just a CT calcium score scan" was the reply.  But apparently the technician had been unclear herself, and had called my doctor just to verify.  In other words, the "default" procedure they were accustomed to doing at this august Houston vascular clinic was a CT angiogram.

In fact, my appointment was even listed on their calendar as a "CT angiogram."  For all I know, my insurance will be billed for the same. Later, during the procedure, the technician acted surprised I wasn't doing the "full test."  I explained I had minimal risk factors (actually only one, an HDL of 34 a couple of years ago, which has since been raised to 50 partly as a result of taking advice from this site), but that my doctor was progressive (he is an MD for the Houston Astros) and thought it was a good idea since there is heart disease in my immediate family.  My doctor did indeed prescribe only a CT calcium score scan, but it seems to have been an order that this clinic, at least, wasn't all that used to seeing.

So, I guess the message is: we have a lot of educating to do.  Had I not been a faithful reader of these pages, I certainly wouldn't have known what kind of test I was about to get, or what questions to ask!

As for the heart scan itself, a piece of cake.  If you can hold your breath, you can take this test.  Just be sure it is the right one!

Keep up the good work, Dr. Davis.

Thanks, Roger. And thanks for telling about your near-miss with a CT coronary angiogram!

Your comment is so helpful that I'd like to use your story as the focus for a Heart Scan Blog post.

All in all, while I am not a fan of legislating behavior in healthcare, the blatant and extreme ignorance of this simple tool for uncovering hidden heart disease makes the Texas action a huge success for heart disease prevention. I hope that this success will raise awareness, not just in Texas, but in other states and cities in which similar systemic neglect is the rule.