How to Help Yourself Reverse or Stop Heart Disease - Part 1 - 7.21.18

Because I've had my completely "worth it" EECP treatment in March and April of 2018, my exercise tolerance is greatly, greatly improved in spite of  my coronary artery disease.  I'm back at my gym (Team 44 in Phoenix) once a week for a hard workout "lifting heavy sh**" with my amazing trainer and superior athlete Tony Rice, who does not see my age or limitations as anything but a pleasant challenge.   I'm on the tennis court two and sometimes three times a week even in July in Phoenix where it's 95 degrees by about 7 am at The Phoenix Tennis Center, a city facility with some great pros (shout out to Tom Hauser).  I love the goofy good people of all sorts of levels of psycho-social dysfunction who play there--I suspect normal variations of human behavior to full blown classifiable abnormalities.  I'm hiking again and can scamper up the trails at the Phoenix Mountain Preserve again without stopping for chest pain to subside.  Thanks to Michael Gratch and his wonderful team at Legacy Heart Care in Tempe.  He's also got Legacy EECP treatment centers in Texas, Kansas City, Charlotte and I hope he will be able to expand and expand until every cardiac patient (and every athlete seeking better VO2 max) has the chance I had to get better.  I'd support anyone else in the game with integrity as well, and have no financial interest there.  But, as David Nierle of VasoMedical (the company who makes these amazing machines) cautioned me, I still have Coronary Artery Disease, and I need to be careful.  Which sucks.  Really.

So, using President Eisenhower's brilliant decision matrix, I'm off of urgent and important, and on to important and a little less urgent,  maybe, but still kinda urgent.  What's up for today?  Well, as I was digging around trying to find the relief I needed from my angina, I made my discovery of the miracle of EECP by going down a number of paths to better health.  I re-discovered nutritional ketosis (having been an Atkins fan back in the 90's), and came across a number of wonderful challengers to the science of heart disease prevention and longevity and began to understand a new link I thought I was not a part of, insulin resistance and Type 2 Diabetes.  No way, I thought, I'm NOT overweight...oops.

Now, I am not a scientist, and frankly have always been a bit intimidated by science, but the urgency of my situation, and the inability (maybe they have no time to think, per Peter Attia MD) of my doctors to help me more than they did, forced me to help myself.  And I'm not the least bit daunted by research or learning when I'm motivated.  Nothing quite so motivating as survival, right?   So on the way to finding EECP, I found longevity researchers (Valter Longo and Rhonda Patrick, Jason Fung, Peter Attia, Dave Feldman, Joseph Kraft interviewed by Ivor Cummins, and the entire tribe of keto eaters for health.  This, after plowing through lots of material, of course, from the fitness exemplars of every ilk, and the biohackers (and a few bioquackers too) from High Intensity Interval Training advocates to distance/hours advocates.  The latest on that from Benjamin Bikman PHD

When I began to google "how to reverse coronary artery disease"  I first went down the confusing and overwhelming path of trying to understand cholesterol (remember I'm a tax lawyer, logical in the extreme, but not a scientist, although another post will address scientific thinking by us humanists), and it's measurement and it's role in my disease.  My first choice, of course, with my disease was to REVERSE IT.  I want that cholesterol or calcium or inflammation or whatever is in my Left Anterior Descending Artery GONE!  (Second choice of course is to HALT it's progression, like TODAY!) It turns out I do have to understand cholesterol better to make that happen.  But boy, howdy, is that a nasty set of complicated learning, with a bunch of words I don't understand and don't/didn't really want to.  Basics I learned:

1.  My cardiologists want to lower my "cholesterol" because it is "high".  

2.  "How high" and "what kind" apparently matters.  You start with two kinds, LDL and HDL, stupidized for public consumption as bad and good.  Which it turns out is a lie, neither one is good or bad, no more than oxygen or carbon dioxide are good or bad, they just are what they are.  We like to breathe oxygen and plants like carbon dioxide.  Point of view from being a human or a plant, not right or wrong.

3.  If you have CAD, or risk factors, such as family history,  overweight, sedentary, and are over 40 or so, doctors will recommend you to take a class of drugs called statins to lower your total cholesterol to below 200 milligrams per Deciliter.  (Honesty compels me to admit I have no visual on a deciliter, that's the sort of thing I would google.)  They will give you a statin and expect you to take it forever.  There's a lot of fuss and heated (heated shouldn't happen in science, should it?) controversy about this, and statins have sometimes dangerous side effects that themselves can be deadly.  Like most policy decisions in my field of tax law, and human relations, using a blunt instrument for delicate work is, well, it's own problem.  The devil, or god, they say is in the details.  Yay!  

4.  Total cholesterol and the two kinds, LDL and HDL, are the tip of a very deep iceberg in the role of lipids, or fat, in our bodies.  To learn about it, I strongly recommend you read anything you can, and contrast the substandard BS provided by our most eminent institutions with researchers who challenge simplistic and unrevealing tests with meaningful questions. 

Dave Feldman, Ivor Cummins, Peter Attia, and others are exploring this in wonderful depth and making the research accessible for patients and future patients.  Personally I found Peter's 9 part explanation of cholesterol excellent and pretty much understandable. Or you can read the junk that dumbs all the way down to wrong for the more gullible or less discriminating victims of information overload: 

5. Because I've already got the disease, I want to get rid of it.  So I need to know if that is possible.  That means I'd need to understand just what has narrowed my artery.  I found variously referenced terms like calcification, plaque, foam cells, macrophages, endothelial damage and inflammation as explanations of my disease state.  The ignorant explanation is that cholesterol lines the interior of your arteries and "clogs them up" kind of like bacon grease in your kitchen plumbing.  Not so at all, and if your explanation of the problem is not quite right, do you think the remedy you come up with is going to help you?  I don't. 

6.  If I know what is in there that shouldn't be, and how it got there, maybe I can figure out how to get it out?  Maybe some brilliant scientist somewhere has already figured that out?  And we don't know about it because his or her intelligent life-giving work is buried in obscurity?  Just like Dr. Ozlem Soram's multi-decade revelations about EECP have been inexplicably ignored by the AHA and ACS and mainstream cardiology.  Need a bit of documentation for that claim?  Here you go:  The Cleveland Clinic is willing to offer massage therapy to heart patients and mention it on patient information pages.  (Where are the CLINICAL TRIALS for that in reducing hospital admissions or nitroglycerine use for crushing cardiac chest pain experienced by hundreds of thousand of patients annually?)  This is akin to listing a mother's kiss on a broken bone as a remedy without mentioning that you could set it to heal.  

I figure I don't need to get cholesterol out of my blood stream as urgently as I need to get it out of the lining of my artery.  But this depends on whether any particle of cholesterol flowing through my arteries will continue to create more disease for me and how quickly that will happen (my urgency matrix!).  Turns out I might be really more correct in that assumption than is currently accepted. This tempting rabbit hole was pointed out by Ivor Cummins in a recent tweet, wow, I got a big education in one read of Dr. Subbotin.   Thanks, gentlemen, for each of your noble missions.

7.  I'm left with a number of great questions.

• Re: heart disease, what is in my control (and yours) to contain or reverse?  Do I need to do the same things or different things for prevention vs. contain or halt or is this all overlap, just degrees of diligence? 
• What role does how and what I eat play in reversing or halting my disease?  
• What role does my sleep play in reversing or halting my disease?
• What about exercise, and what kind and how much and how often?
• When I make a lifestyle decision to halt or reverse my disease, what cost might there be to other organs or systems or my quality of life? 
• What do I need to know about angiogenesis?
• What ARE the laboratory "NUMBERS TO KNOW" about my heart or health status?  Are they different for people who don't have CAD? 
• What is a macrophage and is understanding it helpful to me in my mission? 
• How can I safely achieve/encourage autophagy, in my case of arterial foam cells?
• How can I know if what I'm doing is reversing or halting my heart disease?  How do I measure efficiently and accurately?
• How can I find a cardiologist or internist who can and will seriously help me with these very difficult unknowns and unknown unknowns?   
• Other than EECP, nutrition, exercise, meditation, medication, sleep, psycho-social meaning and connection, neuro-stimulation, shock wave therapy (lithotripsy), autologous IV stem cell therapy,  what else is out there (before trans-cather re-vascularization, stent, surgery or transplant) that NOBODY TOLD ME?  
• How can I best share from my experience and research to the benefit of the most people?