Get Involved

“In this world nothing can be said to be certain, except death & taxes.” In 1789 when Benjamin Franklin penned this phrase he may not have been aware of the role genetics would play in this matter. In fact, neither did I.

After my 50th birthday and returning from a New Zealand hunt, I made an appointment to have my annual physical, along with other age appropriate tests. A couple days later I went back to go over my test results with my doctor and made plans to lower cholesterol that was beginning to creep into the mid 190s. He also suggested that I should have another test done based solely on my family history. The carotid artery ultrasound that the doctor ordered was to check if I had any blockage or plaque buildup. Click the url to seek out much more information on the subject of it.

I was hoping that I had avoided the health issues that my parents were currently dealing with. Dad had two heart attacks, a stroke and a pacemaker by the time he was 60. Mom had a stroke at the age of 62. Both were heavy smokers, and lead a very sedentary life. My hope was based on a lifestyle that was very different than theirs. I was much more active with sports, and had already begun shedding some pounds put on over 20 years of marriage. Working out a couple of days a week would certainly cheat genetics, right?

A few days later I was to receive a phone call, and subsequent meeting with my doctor informing me that I had advanced C.A.D. He said I had the arteries of a 75 year old man. Genetics are certain. Without any warning signs, no symptoms, no apparent physical limitations. I was told that I was a time bomb, and had a 90% chance of an event within the next 18 months.

Blood samples were sent to the Berkley Heart Lab and a plan of attack was launched. A goal to reduce the plaque buildup, by lowering my total cholesterol level to 70. A number I didn’t think possible. But with the help of Lipitor, Niaspan, diet and exercise we were able to achieve 58!

Spinning classes were my main source of exercise for a year before someone asked if I rode outside. Not having owned a bike for 20 years, I decided, what the heck. Five bikes later, lessons a 500 mile bike tour, I’ve been told I’m hooked. The thought of exercise just to stay alive was too morbid for me, cycling has changed that. I have new goals, new plans and a new outlook. Death, taxes and genetics may be certain, but now time is on my side and new adventures are there to be experienced.

A soldier’s mantra is “never quit.”  Most of the time this is a good mantra, a tough mantra, a mantra that allows people to push forward.  For () John Fairbanks, there were times when a bit of quitting might have been the best action.  Fairbanks suffered years of symptoms that portended a MI episode that he ignored.  “ I ignored symptoms for years and it wasn’t until I talked with my friend Dr. Robert Brust who asked me what I felt.”  Fairbanks, a fit endurance athlete, felt pain when exercising.  The tingling pins and needles that underscored his efforts ended up being the beginnings of a blockage that affected his cardiovascular output.  “I know what the symptoms are now.  When exercising, I feel only my breath, not pain.” 

Visit the following link for more on John’s incredible story. http://www.chron.com/disp/story.mpl//4724528.html

On Todd Melinger’s 41st birthday, he raced and qualified for the Ironman World Championships. It was the culmination of a significant racing career: 13 Ironman events, 20 years of endurance racing and a year of great events. What happened next surprised Todd: after another race like any other, his ears hurt. “I figured it must be something post race so I take a nap and it goes away.  Two days later I head out for a hard training ride, notice my heart rate is 10 beats higher then it should be and just can’t quite push the power as I (normally do.)” The day wears on and Todd’s ride and lower power gives way to a feeling of doom and anxiety. He just doesn’t feel right. A virus? General fatigue? He finds his way to the doctor thinking bronchitis but even en route Todd is losing focus and feeling progressively worse. When he gets to the Doctor, Todd realizes that there is something seriously wrong with his heart. He’s instructed to take five Aspirin. He’s given a shot of nitroglycerin. Even with the signs and symptoms of heart disease, Todd’s lifestyle is something that obscures the truth of what’s happening. “I spent the afternoon in the ER, everyone thinks that I have a virus attacking the heart lining, not uncommon among athletes and they nearly send me home until tests reveal something different.” Todd’s doctor came in and told him that he had a 50% blockage in his coronary artery that he needs and angiogram and that he has coronary artery disease. Todd explains his surprise, “ I couldn’t understand how someone who is young, doesn’t smoke, doesn’t drink, is a top ironman age grouper, with virtually no risks, has heart disease??” I think ‘ This can’t be happening to me, I’ve done everything right!”  Todd’s heart was 85% blocked in the LAD. He had a STENT placed immediately. Todd missed warning signs and though he was able to escape with no heart damage, Todd’s life was interrupted by a heart attack. “A few simple tests could have identified my issue early, I could have prevented that heart attack.  That alone could have been worth a lifetime” Todd Melinger is MIaware. Are you?

Former professional triathlete and bicycle racer – Coach and Dad – has FaMIly history and multiple stents

Before Rick Crawford became one of the most recognizable names in elite cycling, before he coached Levi Leipheimer and Tom Danielson, before he redesigned the way training was done for coaching, Rick watched his father slump to the driveway in front of their house and suffer a heart-attack. That was almost 40 years ago.
“My Dad has fought against heart disease ever since. I consider him a living, breathing miracle of science. He’s had a couple more by-pass surgeries, and numerous stents since the day the MI brought him to his knees.”
Witnessing these things impacted Crawford. He made decisions about my his future with the fear that he might follow in his father’s footsteps not far behind. Crawford pursued athletics with all of his heart. A star athlete all the way through college, Crawford became a professional cyclist having never missed a day of vigorous physical activity.
All the training plans, best intentions and forewarning didn’t keep Rick MIaware, however.
“I felt a strange pressure in my chest, like a thumb was being pushed into the back side of my heart. Athletes have strange pains, and I was not overly concerned, as it seemed to pass quickly. As I lay in bed that night, the sensations returned, and they persisted until the morning. It was at that moment that I decided to go to the hospital to know what the problem was. I was suddenly aware of my genetics, and knew that I needed to take these signs seriously.”
Rick suffered two more small MI episodes after the first, believing it was over and without cause or worry.
“I didn’t change my lifestyle at all. I thought I could beat it naturally. I was arrogant.”

Further episodes required stents installed. The man responsible for the cardiovascular depth of the largest hearts in sport was suffering failure in his own. He decided to change it, to take MIawareness to a higher level.
Today, Rick Crawford has tightened up absolutely everything he can tighten up, “The meds, the diet, the stress (or lack of it)… everything with no room for error. I’ve researched the latest publications on reigning in coronary heart disease. I’m doing everything I can to control.”
Control and awareness: they are the bookends of Rick’s business as a coach. They are the markers of a great cyclist. Perhaps most importantly for Rick, they are the foundation for his own MIawareness. Rick Crawford is MIaware. Are you?

Please read MI:Aware? I aM Now! and gain an understanding of exactly who is susceptible to heart disease and pass it along to someone you care about.

Click here to read MI:Aware? I aM Now!

Our partners have done it again!

Tag New Media has just blown us away with this incredible site. Their professional team came up with the idea of utilizing a blog style approach to provide important information quickly and easily. Tag’s idea of using WordPress has enabled us to present important information without a professional team managing our site daily. Please pay careful attention to the twitter portion of our site, as we are always interesting and valuable information not readily available.

We are so grateful for Tag New Media’s support to provide our site and we encourage you to visit www.tagnewmedia.com to serve your internet and social media needs.

w/Heart,

Scott

When John Phillips went to work that summer day, he didn’t realize he was going to become MI Aware. His long time friend had collapsed on the court and needed help. Upon being notified, his team first called 911 and then began Continuous Chest Compression CPR until the EMTs arrived. The EMTs used an AED four times to start his long time friends heart again and he regained consciousness in the ambulance. His friend survived a heart attack with no damage, and the key was the Continuous Chest Compression CPR and John’s quick response.

See the following Video for a how to and why Continous Chest Compression’s only is the new standard for CPR.

http:\\www.youtube.com/user/SarverHeart#

Dr John M

Statins are so misunderstood…
Posted: 29 Aug 2010 06:19 PM PDT
The medical assistant who checked the patient in tells me,

“Dr Mandrola, this guy had coronary artery disease since the 1980′s.  He is 90 years-old now, and his only medicines are that statin and aspirin.” 

One of the more common questions that arises in cardiology is whether a person should take a statin drug. Despite the fact that statins are the most widely studied drug in the history of mankind, there remains widespread misinformation on their use.

Such angst was on full display in the comment section of a recent post from the well known medical blog, KevinMD.  Dr Eric Van de Graaff, a cardiologist and blogger, submitted a very informative and well written piece on the use of statins for the prevention of stroke and heart disease.  (A must read for doctors and patients alike.)

Dr Van De Graaff made many salient points. First, he tells us about the enormity of the science behind the use of statins. No drug has been studied more. He correctly said that in high-risk patients, especially those who have already been diagnosed with blood vessel disease, statins are unequivocally beneficial.

Dr Van De Graaff knows that just saying that statins are scientifically proven to benefit high-risk patients will not be enough for the throngs of nay-sayers, especially those who offer their products to sell.  Thus, he goes on to point out how these drugs were proven successful. In easy to understand language, he explains that the studies (of 120,000 patients) proving statin’s benefits were of the highest scientific rigor: they were prospective, randomized, controlled, and double-blinded.

Even after this fair and balanced piece on statins, the comments illustrate the public’s tremendous misinformation on statins. We read that doctors overly rely on medicines, and we under-emphasize prevention. (They should ask my overweight patients.)  Even a doctor commented, “I’ve read much of the evidence and I am not convinced.” In her psychiatry practice, she had three patients with possible statin side effects, so she is dismissing the data from 120,000.  Yet another doctor who had a unrecognized statin related side effect admonishes us to “consider ramifications of the most important enzyme pathways in our bodies.”  

Confusing the public with medical misinformation really fires me up. And even more inflammatory is that many entrepreneurs use such misinformation for personal gain.

I have written about statins in the past, and as long as the shark-cartlage-for-health-dot-com-like sites continue to spread misinformation, or, the anecdotal reports of this side effect or that side effect speak louder than the truth, I will be motivated to write.

In an effort to spread the truth about prevention of heart disease, I give you this list of statin-facts…
Making good lifestyle choices are the most important means of preventing heart disease. Eating well, sleeping well and exercising daily should be a given. Good doctors will tell you this, but they shouldn’t need to.
Drugs, procedures or surgery should never replace good lifestyle choices. Taking a statin to counteract cheetos is utter nonsense.
Statin drugs lower cholesterol levels, but this is not likely the primary mechanism of cardiovascular benefit. They are vascular anti-inflammatory agents that work at the blood vessel wall. 
In patient’s with high a risk of heart disease (those with risk-factors like genetic predisposition, diabetes, high blood pressure or smoking), or in patients who have had a vascular event (stent, heart attack or stroke), statins are scientifically proven to be beneficial. The science behind this is second to none.
Even though science proves the benefit of statins in the secondary prevention of vascular events, it does not mean they are devoid of adverse effects. It just means that the side effects are greatly outweighed by the reduction of events (in 120,000 patients.) 
These same trials showed that the side effects of statins were very similar to those of placebo.  Do the nay-sayers tell patients this?
Adverse effects of statins are rarely if ever life-threatening. However, the disease which statins prevent, heart attack and stroke, are definitely life-threatening.
Statin side effects are real, and they are clearly higher than what is reported in the literature. Sometimes they can be mitigated by changing to a different statin, but more often than not, they are a class effect, and these patients cannot take them.
Whether statins reduce CV risk in patients whose only risk factor is a high cholesterol is not clear. Low risk patients have such low event rates, that is hard to show a benefit of any therapy. Statin-enlightened doctors know this. Patients could ask, “Doc, high cholesterol is my only risk, do you really think a statin will alter my long-term outlook?”
If changes in one’s well being are noted after starting a statin, the drug should be considered as a culprit. This is why there is a doctor-patient relationship, and why doctors should have the time needed to listen to the patient’s story.
When reading about your health consider potential conflicts of interest. We all know about big pharma’s conflicts: they make more money if they sell more statins. To me, such conflicts are self-evident and understood. However, the entrepreneurial nay-sayers are also conflicted. Bashing science-based medicine is a fertile field of business. The statin-bashers will frequently have a newsletter, book, diet or supplement to sell you. Conflicts. Be aware.
Doctors do not financially benefit from prescribing statins. We can’t even use pens with industry logos anymore. Doctors recommend statins because we know that the small risk of an adverse effect is out-weighed by the proven benefit. And as a rule, the higher the risk of an event the more the benefit. 
I believe in patient choice. Patients can choose to forego the benefit of statins, just like they can forego any medical therapy. 
Doctors wish there was no need for drugs.  We wish you hadn’t had a heart attack, but since your endothelium has proven to be susceptible, our goal is to prevent another event.  In addition to good lifestyle choices, a statin drug will clearly decrease your risk.

Sore muscles are unfortunate, but not as much as a heart attack or stroke.

JMM

You are subscribed to email updates from Dr John M
To stop receiving these emails, you may unsubscribe now. Email delivery powered by Google
Google Inc., 20 West Kinzie, Chicago IL USA 60610

Saturday’s weather turned out perfect for a little pave colorado style. Congrats to everyone who rode their heart’s out and thank you for participating.

Special thanks to Lisa Kasin, who saved the day with her multiple station support, Tim Young, and Cat Pieck for coming off the couch to make the Midstate Motors / Old Snowmass Conoco aid station a big success.

We had 5 guys put their Widowmaker aspirations on hold to keep everyone safe and accounted for from mile 0 – 50 and to Rob Bordan, Dylan Johns, Chris Klug, Tom Ogden, and Spencer Yates, we say thank you!!

Photo’s coming!