Thank you, CTN cardiologist

[devildeac]

I recently had a physical and my cholesterol was little high. I had to let the doctor know that I was appalled that the very first thing out of her mouth was a prescription for medication - where were the suggestions for OPTIONS like diet and exercise?! So then she suggested a visit with a nutritionist, which I accepted. The nutritionist and I talked about my eating habits and the suggestions she made were pretty easy and very common sense - nothing too drastic. Basically, I switched to a low-fat, high fiber diet and changed my eating habits so that I eat at regular intervals (never more than 4 hours without eating something) and I lost 16 pounds and dropped 20 points off my cholesterol in 3 months.

DD - why is a pill the first thing some doctors suggest?

Come sit in my office sometime and see the girth of some of the folks who try to waddle through my door.

Seriously, it depends on the level of the total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein, henceforth, on this thread, and as is standard in laboratories and medical journals just about everywhere to be abbreviated, TC, TG, HDL and LDL, respectively. Most dietary changes will only yield about a 10-15% drop in the bad lipids, TC, TG and LDL and a 3-5% rise in the good one, HDL. In some folks, that may be enough. Many of the lipid disorders I work with, either primarily, or, in conjunction with the PCP, involve TC >250, TG >250-300, HDL <35 and LDL >150-160. Those values need to be reduced at least 30%, and, if you have a cardiac event such as a myocardial infarction (not a dbr infraction ), aka as a heart attack, coronary artery bypass grafting/surgery (CABG) or a stent (my favorite procedure ), those values need to be reduced 40-50% or more. Then, diet and meds are needed. National goals are TC<150, TG<150, HDL>45 and LDL<70. Those are pretty tough standards to attain, especially when the pils, err, pills we prescribe cause myalgias and arthralgias (aka aches and pains) in about 40% of patients and the meds get stopped.

Hope that helps.

May I take this response over to the My Ass Hurts thread?

Absolutely.

[devildeac]

May I take this response over to the My Ass Hurts thread?

I think anything and everything should be allowed in the 'My Ass Hurts' thread.

Not so sure, Capt. The cardiologist wants pictures!

[captmojo]

Not so sure, Capt. The cardiologist wants pictures!

The Dude abides.

[shereec]

Come sit in my office sometime and see the girth of some of the folks who try to waddle through my door.

Seriously, it depends on the level of the total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein, henceforth, on this thread, and as is standard in laboratories and medical journals just about everywhere to be abbreviated, TC, TG, HDL and LDL, respectively. Most dietary changes will only yield about a 10-15% drop in the bad lipids, TC, TG and LDL and a 3-5% rise in the good one, HDL. In some folks, that may be enough. Many of the lipid disorders I work with, either primarily, or, in conjunction with the PCP, involve TC >250, TG >250-300, HDL <35 and LDL >150-160. Those values need to be reduced at least 30%, and, if you have a cardiac event such as a myocardial infarction (not a dbr infraction ), aka as a heart attack, coronary artery bypass grafting/surgery (CABG) or a stent (my favorite procedure ), those values need to be reduced 40-50% or more. Then, diet and meds are needed. National goals are TC<150, TG<150, HDL>45 and LDL<70. Those are pretty tough standards to attain, especially when the pils, err, pills we prescribe cause myalgias and arthralgias (aka aches and pains) in about 40% of patients and the meds get stopped.

Hope that helps.

I see your point. And I guess for many folks, they want a pill to solve the issue. Plus, all of my close acquaintances who have been on statins claimed that the meds made them feel bad and did just as you said - stopped taking the pills. So I was predisposed to resist taking a pill. Still am. I'll change it the hard way - diet and exercise - or at least that's my goal.

[bjornolf]

Hey, thanks for the tips. I know that I'm WELL overweight, but I wish somebody could tell me what I SHOULD weigh realistically. I look at all these scales and these books that say I should weigh like 180 lbs. for my height, and I just can't believe I would be healthy at 180 lbs. When I've had xrays, my bones always show up very thick and dense and my skeleton is supposedly just large in general (yes, I've gotten comments from radiologists on that...I've had many injuries skiing and playing rugby/football/basketball/baseball that they told me should have broken a bone, including hitting a tree while skiing at about 25mph, yet never broken anything...usually the joints take the damage instead). I also seem to be stunted in growth from a milk allergy as a kid (I've been told this by doctors as well...my legs are short compared to my torso...my 5'7" wife's hips are at the same level as mine when we stand...I was told as a kid from growth plate xrays at different ages that I should have been closer to 6'5" than my actual 6'0"...my wingspan is almost 6'5"...I constantly find that my legs are too short for pants that fit everywhere else). I currently weigh 300 lbs., but I have 20" biceps, 64" shoulders, a 54" chest, and a 47" waist. My chest and shoulders are only about 2" bigger than they were in college, when I had a 36" waist, weighed 235 lbs. and played tons of sports. I KNOW I need to lose weight, but I just get so discouraged when books and even doctors (general physicians, not specialists) tell me I need to lose like 120 lbs. Like I said, I just don't see how I could be healthy at that weight.

Thanks for the diet advice. I'll try that. What's a DFH?

[captmojo]

Come sit in my office sometime and see the girth of some of the folks who try to waddle through my door.

Seriously, it depends on the level of the total cholesterol, triglycerides, high density lipoprotein and low density lipoprotein, henceforth, on this thread, and as is standard in laboratories and medical journals just about everywhere to be abbreviated, TC, TG, HDL and LDL, respectively. Most dietary changes will only yield about a 10-15% drop in the bad lipids, TC, TG and LDL and a 3-5% rise in the good one, HDL. In some folks, that may be enough. Many of the lipid disorders I work with, either primarily, or, in conjunction with the PCP, involve TC >250, TG >250-300, HDL <35 and LDL >150-160. Those values need to be reduced at least 30%, and, if you have a cardiac event such as a myocardial infarction (not a dbr infraction ), aka as a heart attack, coronary artery bypass grafting/surgery (CABG) or a stent (my favorite procedure ), those values need to be reduced 40-50% or more. Then, diet and meds are needed. National goals are TC<150, TG<150, HDL>45 and LDL<70. Those are pretty tough standards to attain, especially when the pils, err, pills we prescribe cause myalgias and arthralgias (aka aches and pains) in about 40% of patients and the meds get stopped.

Hope that helps.

So...in essence, I should avoid that deep-fried bratwurst with bacon and cheese, washed away with 4 beers?

Christmas/Thanksgiving made me weak a couple of years ago but I'm gonna get strong again right after this Dec25. In '08, I went from 275lbs down to 220 over a period of 8mos. I've done it once so I know my formula will work again. It shall be done. This time IT WILL BE MAINTAINED.

[devildeac]

Hey, thanks for the tips. I know that I'm WELL overweight, but I wish somebody could tell me what I SHOULD weigh realistically. I look at all these scales and these books that say I should weigh like 180 lbs. for my height, and I just can't believe I would be healthy at 180 lbs. When I've had xrays, my bones always show up very thick and dense and my skeleton is supposedly just large in general (yes, I've gotten comments from radiologists on that...I've had many injuries skiing and playing rugby/football/basketball/baseball that they told me should have broken a bone, including hitting a tree while skiing at about 25mph, yet never broken anything...usually the joints take the damage instead). I also seem to be stunted in growth from a milk allergy as a kid (I've been told this by doctors as well...my legs are short compared to my torso...my 5'7" wife's hips are at the same level as mine when we stand...I was told as a kid from growth plate xrays at different ages that I should have been closer to 6'5" than my actual 6'0"...my wingspan is almost 6'5"...I constantly find that my legs are too short for pants that fit everywhere else). I currently weigh 300 lbs., but I have 20" biceps, 64" shoulders, a 54" chest, and a 47" waist. My chest and shoulders are only about 2" bigger than they were in college, when I had a 36" waist, weighed 235 lbs. and played tons of sports. I KNOW I need to lose weight, but I just get so discouraged when books and even doctors (general physicians, not specialists) tell me I need to lose like 120 lbs. Like I said, I just don't see how I could be healthy at that weight.

Thanks for the diet advice. I'll try that. What's a DFH?

You oughtta be happy/healthy at the weight you were when you played rugby/FB in HS/college. 225 sounds reasonable, especially if you can get your body fat down to ~15%.

DFH=DogFish Head, a brewery in Delaware ;) .

[lawgrad91]

Hey, thanks for the tips. I know that I'm WELL overweight, but I wish somebody could tell me what I SHOULD weigh realistically. I look at all these scales and these books that say I should weigh like 180 lbs. for my height, and I just can't believe I would be healthy at 180 lbs. When I've had xrays, my bones always show up very thick and dense and my skeleton is supposedly just large in general (yes, I've gotten comments from radiologists on that...I've had many injuries skiing and playing rugby/football/basketball/baseball that they told me should have broken a bone, including hitting a tree while skiing at about 25mph, yet never broken anything...usually the joints take the damage instead). I also seem to be stunted in growth from a milk allergy as a kid (I've been told this by doctors as well...my legs are short compared to my torso...my 5'7" wife's hips are at the same level as mine when we stand...I was told as a kid from growth plate xrays at different ages that I should have been closer to 6'5" than my actual 6'0"...my wingspan is almost 6'5"...I constantly find that my legs are too short for pants that fit everywhere else). I currently weigh 300 lbs., but I have 20" biceps, 64" shoulders, a 54" chest, and a 47" waist. My chest and shoulders are only about 2" bigger than they were in college, when I had a 36" waist, weighed 235 lbs. and played tons of sports. I KNOW I need to lose weight, but I just get so discouraged when books and even doctors (general physicians, not specialists) tell me I need to lose like 120 lbs. Like I said, I just don't see how I could be healthy at that weight.

Thanks for the diet advice. I'll try that. What's a DFH?

Get your body fat measured, and use that as a guideline. Weights don't take into account musculature and bone density.

[colchar]

I guess I should start reading this thread since I just got home from my family doctor who described my cholesterol as "a bloody disaster." Strangely enough, although I never drink any more, he also suggested that I quit drinking. Well not completely, but I should only drink a little bit here and there and should stay away from the hard stuff except for a drink or two at the holidays. He said my liver is sensitive to alcohol.

Fuck me running - the cholesterol thing fine but being warned off the booze even when I never drink was a bit of an eye opener. Apparently you can only party like a member of Motley Crue and treat your body like a rental car for so long eh?

[OZZIE4DUKE]

although I never drink any more

Wait a minute. What? You ... never ... drink ... anymore? You, who would routinely would pull extended drunks of legendary proportions? Really? When did this happen? You never told us before! Congratulations!

[colchar]

although I never drink any more

Wait a minute. What? You ... never ... drink ... anymore? You, who would routinely would pull extended drunks of legendary proportions? Really? When did this happen? You never told us before! Congratulations!

Yeah, I haven't drank in ages. I didn't quit drinking or anything, I just haven't bothered drinking. I had a rye & coke and two pints of Guinness one night about three weeks ago (that doesn't count as 'drinking' for me) and that was the first alcohol of any kind I had had in almost three months. I can't even remember the last time I went on a bender.

He said a whisky (rye) now and then on special occasions was ok and that a pint here or there in moderation was fine too. He said I didn't have to abstain, just that I shouldn't become a boozer. Damn, there goes that career choice

[captmojo]

Be careful. This is one of the major food groups.

[colchar]

Be careful. This is one of the major food groups.

It used to be for me!

[Lavabe]

Even though I sort of won on my most recent blood test, the changes I made have been more permanent. The changes affected holiday food choices, but they are certainly ones that I can live with. And honestly, given my background, the Christmas meal isn't about the food, so much as it's about the people... sort of like Thanksgiving.

The devildeacs provided a holiday set of meals that were a mixture of heart healthy and traditional, so that no one was left out. I avoided most of the Christmas cholesterol/triglycerides at the DD house by doing the following:
1) No stuffing, mashed potatoes: I figured that I'd grad a few carbs from ILJ's cookies, so I eased away from what looked to be delicious carbs. Besides, they'd have taken up space from the other good food. NOTE: I had to avoid latkes during hanukkah season too. THAT was more difficult for me.
2) Loaded up on broccoli casserole: technically, this casserole was low on the soup/cheese, and heavy on the broccoli, so this was a winner. I did have a small amount of the green bean casserole, which was a little more cream-soupy, but delicious.
3) Turkey vs. spiraled ham: This may come as a shock, but I just don't get the spiraled ham thing. I like thin deli ham, but have never gotten into thick cut ham, glazed with whatever (including a root beer glaze one year). TURKEY won out, and my, it was tasty/
4) Cranberry: avoided it. I've never gotten into cranberry congealed with pecans, jello, and whatever. A little taste of the naked cranberry sauce was enough.
5) Steamed carrots vs. sweet potato casserole: Normally, the s.p.c. should win, but the marshmallow & sweetness sort of pushed me over to the carrots (which were prepared by dd, which also played a role in choosing the carrots).
6) Dessert: a little bite of the lemony banana pudding, but for the most part, I opted AWAY from it AND the pecan pie, and chose to have some almonds, a fresh snacking apple (Arkansas Black), and let things digest before the carbs I knew that were coming later on in the day...
7) Beer tasting: A few ounces of the 2006 Bigfoot ale, a 2007 Bigfoot ale, the Goose Island Bourbon County Stout, and the DFH Worldwide Stout. Each of these "few ounces" was 9-20% alcohol. They were paired with an assortment of pretzels, apple, sharp cheese, and the most delicious choco-choco chip cookie on earth (featured in "The Best Thing I Ever Ate" on the Food Network).

The winner? Tough call, but undeniably the choco-choco chip cookie paired with the Bourbon County Stout. And I mean, it was KILLER.

Overall, a big THANK YOU to the CTN cardiologist for a wonderful day of food, fellowship, and fun.

[devildeac]

Even though I sort of won on my most recent blood test, the changes I made have been more permanent. The changes affected holiday food choices, but they are certainly ones that I can live with. And honestly, given my background, the Christmas meal isn't about the food, so much as it's about the people... sort of like Thanksgiving.

The devildeacs provided a holiday set of meals that were a mixture of heart healthy and traditional, so that no one was left out. I avoided most of the Christmas cholesterol/triglycerides at the DD house by doing the following:
1) No stuffing, mashed potatoes: I figured that I'd grad a few carbs from ILJ's cookies, so I eased away from what looked to be delicious carbs. Besides, they'd have taken up space from the other good food. NOTE: I had to avoid latkes during hanukkah season too. THAT was more difficult for me.
2) Loaded up on broccoli casserole: technically, this casserole was low on the soup/cheese, and heavy on the broccoli, so this was a winner. I did have a small amount of the green bean casserole, which was a little more cream-soupy, but delicious.
3) Turkey vs. spiraled ham: This may come as a shock, but I just don't get the spiraled ham thing. I like thin deli ham, but have never gotten into thick cut ham, glazed with whatever (including a root beer glaze one year). TURKEY won out, and my, it was tasty/
4) Cranberry: avoided it. I've never gotten into cranberry congealed with pecans, jello, and whatever. A little taste of the naked cranberry sauce was enough.
5) Steamed carrots vs. sweet potato casserole: Normally, the s.p.c. should win, but the marshmallow & sweetness sort of pushed me over to the carrots (which were prepared by dd, which also played a role in choosing the carrots).
6) Dessert: a little bite of the lemony banana pudding, but for the most part, I opted AWAY from it AND the pecan pie, and chose to have some almonds, a fresh snacking apple (Arkansas Black), and let things digest before the carbs I knew that were coming later on in the day...
7) Beer tasting: A few ounces of the 2006 Bigfoot ale, a 2007 Bigfoot ale, the Goose Island Bourbon County Stout, and the DFH Worldwide Stout. Each of these "few ounces" was 9-20% alcohol. They were paired with an assortment of pretzels, apple, sharp cheese, and the most delicious choco-choco chip cookie on earth (featured in "The Best Thing I Ever Ate" on the Food Network).

The winner? Tough call, but undeniably the choco-choco chip cookie paired with the Bourbon County Stout. And I mean, it was KILLER.

Overall, a big THANK YOU to the CTN cardiologist for a wonderful day of food, fellowship, and fun.