I had a calcium score scan on a 64-slice machine at the Morristown Hospital in New Jersey. No contrast was injected. The technician did three separate scans that included the lung, even thought I didn't for a lung scan. I wonder why three scans were taken. Does it mean that I had three times the radiation?

Hi,
Of course I can't comment specifically on what was done, but it is common practice to perform 1) a "scout" film for the technologist to identify the location of important "landmarks" like the sternum and the top and bottom of the heart to minimize the window of exposure, and 2) lung imaging as a routine part of  heart imaging, not necessarily an additional scan.

If an additional and unrequested lung scan was performed, you may want to call and ask why this policy is in operation.

What do you feel about yearly nuclear stress tests for people with CAD?  The radiation exposure seems high and the ability of a stress test to pick subtle changes in flow is low.  In the absence of symptoms it would appear that the common practice of nuclear stress tests for people with CAD is a questionable practice.

I agree. The radiation is excessive. I tend to follow that route only when nothing else is possible. An alternative for stress testing is stress echocardiogram in its various forms, none of which involve radiation. They still suffer the other pitfalls of stress testing, of course, but do not involve radiation.

I just launched a webiste that may answer some of your questions.  www.xrayrisk.com. It allows you to calculate your cancer risk based on studies you have had and answers some faq on radiation exposure and cancer.

There are several ways to estimate your cancer risk - the best site for background information is probably the Image Gently campaign.

The American College of Radiology has similar information pages for patients and the general public.

To track your exposure, as Mike said there's the xrayrisk website.
There's also a program for the iphone called Radiation Passport that tracks all of your radiation exposure and gives you the associated risk of developing cancer from your radiation exposure.

CT coronary angiography presents a different story. This is where radiation really escalates and puts the radiation exposure issue in the spotlight. As Dr. Cynthia McCullough's chart shows above, the radiation exposure with CT coronary angiograms is 5-12 mSv, the equivalent of 100 chest x-rays or 20 mammograms. Now that's a problem.

The CT scanner was originally designed to take pictures of the brain. Now it is much more advanced and is used for taking pictures of virtually any part of the body.

The scanner is particularly good at testing for bleeding in the brain, for aneurysms (when the wall of an artery swells up), brain tumours and brain damage. It can also find tumours and abscesses throughout the body and is used to assess types of lung disease.

I often soak raw almonds (and other nuts) about 24 hours in filtered water with sea salt, then dry them a day or two at about 150°F in the oven.  I doubt the studies take this kind of "processing" into account, but any idea how that might change the absorption scenario?

I'm glad you posted this.  A few women I know have been wary of eating many nuts for fear that fatty nuts would cause them to gain weight.  

Really like the little bit on healthy gut flora caused by almonds too.  A healthy gut is important to me.

I would certainly agree that it is possible to eat enormous quantities of nuts without absorbing all of their calories. I noticed I could remain weight stable while sedentary and eating 3,500 calories back when I used to eat large quantities of nuts. Even when well chewed a proportion of them end up you-know-where! Just flush...

Peter

Dr. Davis, this is a great example. Thanks for posting it. I have a question on the 88 calories. I tried to work through the calculations to demonstrate this to one of my clients. I couldn't come up with 88 calories per ounce.

I kept coming up with 80 and here's how. 50% calories from fat is 63. I used 50% for protein and digestible carbs - based on the info provided. For protein, that leaves 3 gms or 12 calories. For carbs, half of 2.5 gms is 1.25 gms, which equals 5 cals. These add up to 80 (63 + 12 + 5).

I’m probably making a silly mistake but I’d like to come up with the same numbers when demonstrating this to clients – makes me feel kind of silly.

Thanks again for the blog, I greatly appreciate the information you post.

Brian

Does pasteurization affect the positive effect almonds have on gut bacteria? Last year it became manditory that all California almonds must be pastuerized by one of these methods: fumigation with propylene oxide, blanching and oil roasting. This is to prevent salmonella. http://www.almondboard.com/Programs/content.cfm?ItemNumber=890&snItemNumber=450

I eat a handful of almonds just about every day. I have wondered if there benefits have been compromised.

The study was sponsored by The Californian Almond Association

In the era of the 64-oz. soda, the 1,200-calorie burger, food companies now produce enough each day for every American to consume 3,800 calories per day as compared to the 2,350 needed for survival. Not only adults but kids are also consuming far more calories than they can possibly use. http://www.phentermine-effects.com

For a long time I've suspected that some foods are very inefficiently absorbed. I've particularly suspected that raw nuts are relatively poorly absorbed and thus yield only a fraction of the calories ingested.

Great post, and painfully true for me; my father had to undergo his 2nd coronary bypass operation this past April 2007, and despite the strangely 'status-quo' or 'business as usual' attitude of both the surgeons and assisting doctors and nurses involved in my dad's procedure (yes, the whole thing seemed like such a regular day at the beach to them because Holy Cross in Fort Lauderdale performs so many of these operations on a daily basis, with success, of course) did nothing really to quell my family's fears of the severity of this operation; this is still a monstrous operation that not only takes a heavy toll on the patient, but on the family sitting in that waiting room as well.
I still cry at the memory of having to tell my dad, "hey Pop, you need another CABG" after an invasive angiogram revealed disaster after disaster in his arteries.
And this is why your message is so important, and why it needs to get out every day, and loudly.

I'm rooting for you. And I'm thankful you're here.

A few thoughts about this post:
The first is a question. What do you think about ultrasound screenings for carotid artery plaque, abdominal aortic aneurysm, and peripheral arterial disease? A company called Life Line offers these, saying that they show evidence of plaque build-up in the arteries. Are they useful in conjunction with a heart scan, or can they indicate risk similar to a heart scan? It sounds like they are intended to be early detectors of stroke risk. Are they worth the investment?

The second comment is an observation. Those of us not in the medical field tend to assume that anyone who is knows what he or she is talking about on the subject of the human body and illness. However it is apparent that those with M.D.'s can come to very different conclusions about what causes us to get sick and what we should do to prevent illness. Dr. Dean Ornish is an M.D. You are an M.D. Dr. Atkins was an M.D. Yet the dietary advice differs noticeably, so how do we know who is right and who to listen to? I've learned not to believe something just because a doctor says so, because when I followed the low-fat high-carb advice I got fat and felt horrible, but now that I am following a low-carb plan with plenty of protein and fat, I've lost 25 lbs. and feel great. My bloodwork also supports your claims: low triglycerides, high HDL, and low fasting blood sugar. It's kind of sad in a way that I actually get better medical advice from doctors whose blogs I read on the internet (I'm also a Dr. Eades fan) than from my personal physician. And finally, a thank-you: since reading your advice about Vitamin D, my flower garden is in the best shape it's been in in years, since I have a new knowledge about why it's so important spend some time in the sun and a new motivation, therefore, to be outside pulling the weeds.

And concerning your recent post  about breakfast cereals,congratulations are in order: I've broken my husband's cereal for breakfast habit. (I broke my own years ago.)

I have had good results with the Lifeline service, but only when used in conjunction with a heart scan. It cannot replace a heart scan. This is because, while atherosclerosis is a body-wide process, this disease does not perfectly track in parallel in all arteries of the body. You can, for instance, have lots of plaque in the carotid arteries while having only a modest amount of plaque in the coronary arteries, and vice versa.

I agree with your second comment. In fact, I have posted on this Blog about this.

We are all swimming in a sea of information and mis-information, and blind alleys along the way to the truth. We can only educate ourselves as best as possible and then come to our own judgements about the value of this or that argument.

I have a comment too: I think one reason there is so much confusion is because dietery connection with heart disease hasn't been sufficiently studied. We only saw some partial studies by Drs Ornish, Agatston, Atkins, Hayes but not much independent verification, AFAIK. For example there are some studies done by now on the effects of a high fat low carb nutrition in diabetes and epilepsy but virtually nothing that I know of for cardiac patients.  The only one such study I heard of was halted half way through (after showing very promising results) when the funding was cancelled, 27 years ago.
Stan (Heretic)

A somewhat updated comparison of old care versus new care: I was on American Airlines this week, and looked through their magazine. There was a full page ad from the Cooper Clinic in Texas; a 46 year old woman pictured said "I had no idea I had heart disease, but had a family history...an EBT scan and four stents later, with some lifestyle changes, I'm a new woman".

I understand you can't generalize from one case, and while this seems to represent cutting edge treatment, it also gives me the creeps thinking about the obvious drive for revenue here. Couldn't they have tried your approach for awhile before invading? Thanks.

I think that they tell the stories that have a "WOW!" factor. The Cooper Clinic does indeed engage in a low-level grade of preventive care (AKA Lipitor, etc.)

But I really hate those stories, too.

Saw a lady at shul today, she is convinced of Dr. Esselstein's more carbs- is- better method. Ornish, Esselstein.....hard to refute the drumbeat of eat carbs, cut meat and fat.

What about Pulse Wave Velocity (PWV) and Digital Pulse Analysis (DPA)?  
From the Townsend Letter May 2010 article "Breakthrough in Clinical Cardiology: In-Office Assessment with Pulse Wave Velocity (PWV) and  Digital Pulse Analysis (DPA) by Brian Scott Peskin, BSEE, with Robert Jay Rowen, MD":  http://goo.gl/vihZO
"This article explores an exciting, noninvasive, easy-to-use, and economical method of assessing patients’ cardiovascular physiologic status that is backed by more than 25 years of advanced research in medical physics. A 2007  Clinical Medicine article points the way to better clinical treatment of CVD, stating: “Arterial stiffness measured by pulse wave velocity (PWV) is an accepted strong, independent predictor of cardiovascular events and mortality.” 1   Anesthesiologists are well aware of this technology, used for monitoring purposes. While pulse oximetry became standard in the operating room and in other critical care areas as a detector of hypoxemia – all pulse oximeters are fundamental photoelectric plethysmographs – PWV has been largely ignored. This is unfortunate, as PWV (plethysmographic) information itself may provide important clues regarding the CV condition of the patient.2  With this advanced technology, cardiovascular science has moved forward, but many physicians have yet to appreciate these advances. As stated in the 1993 issue of the Journal of Hypertension, “Wave reflection is not a subject with which most physicians are familiar and only given mention in undergraduate physiology courses.” Little has changed.

As this article was going to press, however, “Arterial Stiffness
and Cardiovascular Events: The Framingham Heart Study,” by
Gary F. Mitchell, MD, et al. (Circulation. 2010;121:505–511)
was published and featured on Medscape, stating: “In this
study, we assessed the incremental value of  adding pulse
wave velocity [PWV] ... to a risk model that includes standard
risk factors for a first cardiovascular event. … Adding pulse
wave velocity led to significant reclassification of risk and
improvement in global risk prediction. … [W]e need to focus
our efforts on identifying and implementing interventions that
can prevent or reverse abnormal aortic stiffness in order to
prevent a marked increase in the burden of disease potentially
attributable to aortic stiffness.”  The specific intervention/
solution will be given later in this article."

Also, "This video is a preview of a lecture given at the 2010 18th international A4M conference in Orlando."  http://goo.gl/S1xth

Disclosure: I have no known conflicts of interests in conveying this information, I do not own stock or any financial interests in any of the companies making or distributiing this equipment.

Hi Dr. Davis, I had a CT scan done about 5 years ago and the results were frightening, it was 1050. I was shocked because I ate healthy, low fat, plenty of healthy  wheat, how could this happen. My Dr. sent me for an EKG ultrasound and ever test possible and all  the tests were perfect. As you know I have changed to no wheat, high fat, low carb way of eating and I gained 5 lbs but my triglycerides came down to 61, LDL is 153 . My other numbers are high but I read that can happen when you have hypothyroidism c reactive protein is 0.7 MG/L. My Dr. said that the clinic that tested my CT scan are no longer in business in Michigan so I don't know if the plaque improved or got worse, any suggestions?

I have been thinking about the subject of getting back to the basics a great deal lately.

Trying to synthesize everything into one concept made me realize how complex this whole process of prevention is. I too have been peering into windows on the road of better health.  What a complex and wonderful set of the diversity our homeostatic responses convey.

What are the basics to me now? I'll serve it up in one word, food . . .

What we eat determines profoundly how our body responds to the many factors contributing to heart disease (and other systems dysfunctions). One thing I learned along the way is over 50 different species of bacteria have been identified in arterial plaque (in addition to other pathogens).

Going back to the basics tells me to eat foods that not only reduce markers associated with heart disease but also considers dietary factors that may optimize immune responses and pathogen suppression. Cutting out wheat provides great capital in healing the gut. It sets the groundwork for improved cellular communication and neurological feedback mechanisms.

. . . and that's getting back to the basics. It sure isn't simple, but learning to prepare and serve up the right type of foods sure can sweeten the journey even if it gets us of track every now and then.

I have a friend who had a 16 slice scan and had a 0 calcium score.Several week after the scan he had a heart attack.Can you point out some studies which show the correlation of calcium scores to cardio incidents?What is the data to suggest it's a better marker than the others such as cholesterol,CRP,etc.

I'm on a near vegan diet as recommended by Dr Joel Fuhrman.It did not solve all my medical issues but it did tame my blood glucose(from the 130s to the low 80s)and my blood pressure(from 210/110  to 125/70).When I tried a diet heavy in meat and fat and low in carbs(50G/day)my blood pressure went up to 150/85.I have a type of salt sensitive hypertension(low renin) that may be a factor.Comments?

I have a friend who has had a stent, bypass and several cardiac incidents.  I find it tough to persuade him to follow your regimen and he's terrified that areas of his heart muscle have died and that there is no hope for him.

Do you have examples of people who have successfully recovered from such a dire state of health in their 60's?  

Nina

My 54-year old husband also received a score of 0 on his 64-slice CT scan.  He's had no heart issues, however, he is overweight, has hypertension, he's insulin resistant and he has low HDL and elevated ApoB and LDL-P.  Because of his 0 score he feels he's not at risk.  How can I convince him otherwise?

Yes, I have, Nina. But the answers cannot be found in conventional healthcare with yet more procedures and drugs.

There's no comparison. Coronary calcium scores as a measure of coronary atherosclerosis wins, hands down.

But it is not perfect. While heart attacks at a score of zero are distinctly uncommon, they can happen.

For a full discussion of the studies documenting this, I would invite you to read the Track Your Plaque book available through the www.trackyourplaque.com website.

Hear, hear, Donald! You are singing my tune.

Hi, Anne--

Yes, simply find another center that performs heart scans. They are actually done fairly widely now. It's often not advertised since, like mammograms, they don't make any money.

HI, Cancer-

You are getting in to issues like endothelial dysfunction that are beyond the scope for this discussion.

Perhaps something to talk about in future.

Well to me it''s kinda all the same but I''m also not a practicing cardiologist, and I may have been influenced by this: http://goo.gl/lfsQ7
"Endothelial dysfunction is thought to be a key event in the development of atherosclerosis and **predates** clinically obvious vascular pathology by many years. This is because endothelial dysfunction is associated with reduced anticoagulant properties as well as increased adhesion molecule expression, chemokine and other cytokine release, and reactive oxygen species production from the endothelium, all of which play important roles in the development of atherosclerosis. In fact, endothelial dysfunction has been shown to be of prognostic significance in predicting vascular events including stroke and heart attacks. Because of this, endothelial function testing may have great potential prognostic value for the detection of cardiovascular disease, but currently the available tests are too difficult, expensive, and/or variable for routine clinical use."  

I know tests have real costs associated with them, but is seem like DPA/PWV  plus the 64 slice MDCT plus coronary calcium would give a fairly complete picture.  I notice two of the three used in this report with the DPA performed at a later date. http://goo.gl/MS6Gp

The Oxidized LDL Triple Marker test?

Hi Nina,

It is hard to say what your friend''s future might hold without knowing how much damage has been done by his "cardiac incidents".  However assuming he is not bedridden, I wouldn''t call his situation hopeless.  If he can still walk around and climb a flight of stairs, I would guess there is still a reasonable amount of heart function left to enable him to live a mostly normal life.  He just needs to avoid losing even more.

I am younger than your friend (48), but I also had a (very unexpected) MI and emergency bypass a little over a year ago.  My MI was rather mild, but it definitely did some damage.  I am well aware of the fear and sense of hopelessness that your friend is feeling.

I started following the Doctor''s program about 10 months ago.  I can''t say for sure whether it will help or not, but it definitely makes my numbers look good so I am optimistic.  I would like to have a heart scan to track my own situation, but most places won''t do them if you have already had bypass so I am flying a little blind (BTW Doctor, has there been any change in this situation?).  I also started cardiac rehab a few weeks after my surgery and now exercise at least an hour a day 5-6 times a week.

I''m not sure what to attribute this to (probably a combination of things), but I am pretty much back to normal.  I was never a super athlete, but I feel I can do anything a normal, fit 48 year old man can do and then some.  This was even confirmed by a recent stress test.  

For example, I am currently on vacation and spent my afternoon swimming in the ocean and walking several miles up and down the boardwalk.  If someone had told me something like this was possible a year ago, I would have told them they were full of it.  Yet here I am.  

So do I think your friend could recover? Yes I do.  He may not do as well as I have, but I suspect he can likely do much better than he thinks possible.  However it will take time and effort and may require taking  a few chances like trying the Doctor''s program (his own doctors probably won''t be thrilled).  Sitting at home waiting for a miracle likely won''t work.

One thing I should mention is that resolving your friend''s difficulty may require more than just fixing his heart.  Having a major cardiac event is extremely traumatic.  Depression and anxiety disorders are common afterward.  From what I have heard, as many as 80% experience it.  Unfortunately most doctors won''t tell you this and they definitely don''t want to deal with it.  At best they will prescribe another pill.

I was fortunate to have a sister who is a professional counselor.  She realized how distraught I was after my surgery and immediately recommend I start seeing someone.  It was great advise.

The counselor I saw didn''t have any magical advice that suddenly made me feel better.  What she did  was help me work through what had happened and put it in proper perspective.  Once I could  do that, I started finding increasing motivation to get well.  It took a while (I have had at least 30 sessions over that past year), but it works.  BTW, most insurance will usually cover it.

I agree with you Pete, my husband, mid-50''s had a very serious MI about four months ago, also completely unexpected as he appeared in great health with no risk factors.  And although we don''t have all the answers yet about how much damage was done, we know it was a lot.  He is exercising at rehab (he was a regular exerciser before) as well as on his own and has been feeling almost like himself - and considering how serious his condition was this is pretty amazing.  He was already doing a number of the things Dr. Davis advocates and has since added more.
Pete, if I may ask, do you know what your ejection fraction is now and what it was post MI?  We are struggling to get answers at this stage as to whether this will ever improve and how long it may take.  His is still low despite how well he feels.

Many thanks for the responses.  

I know that conventional treatments aren''t the answer, but convincing my friend of that is another challenge.  I seem to have several friends who think reducing carbs is harmful and unnatural.  (I''m off sugar and grains, substituting almond flour, flax and desiccated coconut without any problem.)

Nina

Why aren''t most doctors doing calcium scoring tests instead of stress tests that only show late stage blockages?  If heart attacks occur when arteries are slightly blocked, it appears that calcium scoring should be the first test done on high risk patients.  Is it because the medical community is slow to accept change from the usual way of doing things?  Or is it the fault of the insurance companies who are notorious for not paying for new fangled tests?  I''m a total layman, but I''m high risk (APOE4) and the only test I received was a nuclear stress test (which was negative).  If I want to know my calcium score, I would have to pay $500 out of my pocket to Princeton  Longevity Ctr to have them do it as my doctor will not order it.

Hi Joanna,

As I mentioned, my MI was rather mild and I don''t think my EF ever went down substantially.  During my surgery (which started about 12 hours after my MI) my EF was measured at 55 percent.  A few weeks ago when I had my stress echo I measured 60 percent at rest and 55 percent under stress (to my knowledge these values are considered normal for most people).  I will admit that overall I was luckier than most people in this area.

However keep in mind EF only gives you part of the picture.  There are many other variables.  A person can have a completely normal EF and still have major problems.  During my surgery my heart rhythm was very unstable.  My surgeon originally wanted to do a triple bypass but he ended up skipping the third one because he decided it was too risky.  On the other hand someone can have a low EF and still live a long and active life.

Even if I had your husband''s full medical record, I can''t tell you exactly what his EF means.  You really need to discuss this further with his doctor.  However the following statement you made I think gives a good indication of where you probably stand:

“He is exercising at rehab (he was a regular exerciser before) as well as on his own and has been feeling almost like himself – and considering how serious his condition was this is pretty amazing.”

You are right.  This is pretty amazing.  Based on my own experience at cardiac rehab this doesn''t always happen.  I know it isn''t very scientific, but if he looks good and feels good he is probably doing just fine.  His EF might be low, but it must be high enough or he would be having all kinds of problems.

While it might be nice to see a higher EF, from what you have described I''m not sure it would make a big difference.  It sounds like he either can or soon will be able to do everything he was capable of pre-MI.  If this is correct, it is fantastic news.  Personally I would probably stop worrying about his EF and instead concentrate on making sure he continues to retain every bit of heart muscle he has left.  

However I am by no means an expert on all of this.  Perhaps the Doctor can weigh in with some better advice.

Now, the most important question:
HOW do we get rid of the calcium in our arteries ???
Does Magnesium help as a calcium  antagonist? Chelation?
Renfrew

Why $500? I paid $85 to have my calcium score heart scan done at a local hospital in the Chicago area. Check with radiology departments in the area hospitals.

Read Dr Davis''s Track Your Plaque book, 2nd edition, to get the answer.

Dr. Davis,
I am living in Germany and cannot get the book. About 6 months ago you said you will make it available in downloadable pdf format. Any progress on this front?
Thanks.
Renfrew

I was thinking that the 64 slice CT scan was  the only test that measured calcium score, and Princeton Longevity charges $500 (give or take) for it.  I could get it there without a prescription; I would think I''d need a prescription to get the test at a hospital.  I''ll look into it, thank you.

Thanks so much Pete.  And you are right, we are doing everything we can to retain as much heart muscle as we can - unfortunately we have been told that with such a low EF, even if he feels great, he is at much greater risk of sudden cardiac arrest and may need an ICD (an internal defibrillator) implanted - something that is both very expensive and may interfere with some of the work he does.  So we wait.  We have been told that his EF may come up over time but no one will give us any odds of this happening (for some people it seems it never does) or over how long a period of time it may take to improve.  

I would also like to tell Nina to urge her friend to do cardiac rehab/exercise as this seems to be one of the differences between people who are successful in their recovery and those who aren''t.

No prescription was necessary in my case. They sent the results to me directly, and also to the doctor who they asked me to specify.

Yes, the book is available for download for TYP members.

Hi Joanna,

I''m going to make a guess here (and hopefully someone who knows more about this will correct me if I am wrong), but I suspect the issue isn''t so much a low EF by itself, as much as it is that a higher EF indicates greater recovery of the damaged heart muscle.  My understanding is that when an MI causes damage to heart muscle, it usually isn''t the loss of pumping capacity that causes death.  Instead the loss of muscle causes an electrical disturbance in the heart''s rhythm causing it to lose its ability to pump  blood.  This is why even a mild MI like mine can be fatal and explains why my surgeon was so concerned (See http://en.wikipedia.org/wiki/Myocardial_infarction#Pathophysiology).

I suspect what your husband''s doctor might be concerned about is that he may be having a certain amount of arrhythmia because of the damage to his heart.  Apparently this is quite common after an MI and it is also something doctors don''t typically explain very well (at least mine didn''t).  

After my surgery I was put on the drug amiodarone to help control my heart rhythm (which it did).  However this drug has some rather nasty side effects so they try to pull you off of it as soon as possible.  I stopped taking it after about a month and almost immediately developed some arrhythmia.  

Fortunately the type of arrhythmia I developed (PVC''s) are usually considered benign.  But it was still extremely disconcerting since no one really explained to me what was going on.  The only thing I was ever told (or at least ever heard) was probably the same thing you have heard 50 times – “if you have any chest discomfort or shortness of breath, go to the emergency room” (needless to say this is not comforting advice).

I am still having some PVC''s, but they have become increasing less frequent.  The bottom line is that the heart can essentially rewire itself, but it takes time.  Part of the point I am trying to make is that this might occur even if his EF doesn''t change.  

Again this is a guess since I don''t have much information, but I suspect your husband''s doctors may be waiting to see how well your husband''s heart repairs itself (which may take a year or more) and they will then decide if he needs an ICD.  I''m also guessing they are currently controlling his heart rhythm with some type of drug (there are many) and they eventually want to take him off of it.

Unfortunately it is my understanding that all you can do is wait.  There is currently no way of predicting who will fully recover and who won''t.  There are simply too many variables.

However I think there are several factors in your husband''s favor.  The first is that he is young and most of his body''s natural repair mechanisms (which are considerable) are still functional.  

He is also enthusiastic about doing his cardiac rehab.  The gradual stress of exercise essentially helps remodel and strengthen the heart.  Oddly enough many people don''t do this.  I''m sure your husband has already noticed that many patients quit cardiac rehab (and most likely stop exercising)  at the end of Phase II (about 12 weeks).  Just the fact that your husband is willing to continue with an exercise program puts him in a completely different class.

Finally he is willing to modify his lifestyle.  He is changing the way he eats and, unless you are withholding something, probably doesn''t smoke or have some other equally bad habit.  When I was recovering from my surgery, my younger brother was in one of the waiting rooms when another patient, who had obviously also recently had heart surgery, was wheeled into the room next to him and started a conversation.  At some point during the conversation the man turned to my brother and said “I really hope when I get out of here they will let me smoke again”.  Like I said, your husband is in a completely different class.

I know there are at least a few supplements out there that may help heal a heart''s electrical system.  Magnesium and CoQ10 are two that I have heard might help (try googling them for more info).  I doubt they will cause a miraculous recovery, but they might give him that little extra kick that helps him avoid the ICD.  I''m sure there are others on this site that know a hundred times more than I do.  Assuming what I have discussed is even roughly correct, perhaps a few of them can make an even better recommendation.

I know all of this is frustrating, but try not to give up hope yet.  Four months is still early in the recovery process.  I remember being told that recovery would take at least a year and that turned out to be about right.  Also keep in mind (as I''m sure you have already discovered) that the recovery process is typically a series of two steps forward and one step back.

BTW, no matter what might happen, please remember your husband is extremely fortunate to have you by his side.  There are many people who don''t have a person they can rely on to help figure this all out.  I doubt my recovery would have been as successful as it has been without the help I received from my partner and my family.  I now understand why so many people simply give up.  The recovery process simply becomes too overwhelming.

I''ve gotten my calcium score for $50 at a DFW hospital with a 50% off coupon.  The result didn''t take 10 minutes to come out: a big zero! I will be back in 5 years.

Gene, how was your score if you care to share?

No secret here, but unless zero, the dynamics are more important than the absolute number. At least, if I understand the whole TYP program correctly. My score was 213 in Feb 2010 and 191 this time, in Sep 2011.

You''re going in the right direction, Gene.   That''s great!

Hi, Renfrew--

We make the Track Your Plaque Guide available to our members without charge (except our membership fees to cover the costs of operating the website).

Hi, Ronnie--

The laws differ from state to state. You can always call a center and ask.

@JC,

I hope Dr. Davis will respond, and I hope you don''t mind if I respond meantime. (Dr. Davis, please  correct me if my post is not accurate enough)

I am not a doctor but 150/85 that you had on a high meat, fat and low carb, seems still OK!   Its not clear to me why did you have to change that diet?   Have you not quit a LC diet too prematurely  perhaps?  Experiences of other high fat low carb nutrition proponents in Europe (see especially  books by Dr. J.K.)  have shown that it takes about 2 years to see a significant effect upon cardiovascular health for patients with advanced arteriosclerosis.      

I hope Dr. Davis can step in to, clarify this.  I know you are above retirement and male but it may help to provide your exact age and a history of your hypertention.  Even if you were practicing some sport and have clear coronary arteries, your peripheral arteries may still be partially occluded creating a condition conjusive towards a hypertention.   AFAIK it is possible to have clear coronary (heart) artieries and at the same time have occluded peripheral arteries.   Also your pre-diabetes may have been a factor too on the SAD since high insulin makes arteries less flexible.
Stan

Thanks Stan,I looked at my old blood pressure readings to refresh my memory and many of the readings were in the low 170s/90 but the median score was around 156-160/85-88.The rapid rise scared me but it was fun while it lasted because I love butter,meat,cheese,and tons of fat.I don''t know how my low renin hypertension fits into this but I am very sensitive to sodium/salt.The only salt/sodium I get is that found naturally in vegetables,beans,nuts,and potatoes.
Many years ago (around 2006) you posted some data that correlated blood pressure with cornary events and the link was not as strong as you would expect given all the hysteria about blood pressure.I would have to be convinced blood pressure in the 170s and 180s was not that serious before I would go back to the paleo style diet again.My near vegan diet has also tamed my blood glucose which is now consistently below 85.Before that in was in the 97-99 range.A number of years ago before I lost about 80 lbs it was in the mid 130s.

So going back to a plaeo style diet I would have to accept higher blood pressure and blood glucose levels....170sBP and high 90s FBG.If I am convinced that those levels are safe it would change my perspective.

Dr. Davis,

Can you clarify the issue of measuring soft plaque?  My understanding is that soft plaque is more unstable and therefore more of a concern that hard plaque.  Does a Ca score infer soft plaque so gives us some sense of soft as well as hard plaque, or gives us no indication at all of soft plaque?  Would the PLA2 test be a better marker of soft plaque than the Ca score?

Thanks for your great work!
David

Followup to my last question:
wouldn''t a carotid ultrasound give us a better sense of soft plaque?  Combined with results for PLA2?

David

Another form of very dangerous form of LDL...the glycated one:
http://diabetes.diabetesjournals.org/content/60/7/1973.full

Absolutely. See the several blog posts back some time about this.

Also a full length Special Report on the Track Your Plaque website will be coming out.

Can someone clarify which CT scan is the recommended "coronary calcium score"? I have been told by 2 medical centers here that they perform BOTH 1.) a "coronary calcium score" CT scan which costs (approximately) $150 and uses no contrast material. In that test, they scan the area from the top to the bottom of the heart, and visualize calcium that may exist in that field. This would include part but not all of the lungs, plus all of the heart.

2.} a coronary calcium scan CT which costs (approx) $1,700 and does use contrast material, injected into a vein. The scan visualizes the heart aided by the contrast in the vessels. This also is a way to measure calcium.

WHICH test does Dr. Davis recommend? I've been searching the blog and find repeated mentions of "calcium score" but must have missed a way to discriminate which CT test is the right one? Would appreciate any help with this. Thanks!

I take Calcium with Vitamin K2.
Vitamin K2 helps direct calcium to the bones and teeth(where it belongs), keeping the calcium from attaching itself to the arteries.
Natural sources are Natto, egg yolk, butter...problem is I don't like the cholesterol in egg yolk and butter and I don't like the taste of Natto.
I found this online and order it online as well http://tinyurl.com/q8fjc93
It is made in USA; head office is in California. That's why delivery and shipping is free in USA. Delivery took about 3 to 7 days.  It has Omega 3+ as well as CoQ10 and Vitamin K2 and it is Extended release(long-term effect).