I have coronary artery disease


#142

Re statins… thats probably a subject I’d listen to a doctors advice on, whether they advise you to or not,… particularly in light of your recent exams… but that’s just me


#143

Interestingly, coronary artery disease is a damned if you do, damned if you don’t situation, since both hyper- and hypoglycemia can damage the heart. Consider this article:

Anigiology 2016 Oct;67(9):802-9

The Impact of Hypoglycemia on the Cardiovascular System: Physiology and Pathophysiology.

Yang SW, et al.

Intensive glycemic control may increase cardiovascular (CV) risk and mortality due to hypoglycemia. The pathophysiology of glucose counter-regulation in patients with type 1 or type 2 diabetes for over 15 years is characterized by impairment of the defense mechanisms against hypoglycemia. Hypoglycemia causes pronounced physiological and pathophysiological effects on the CV system as consequences of autonomic system activation and counter regulatory hormones release. These effects provoke a series of hemodynamic changes that include an increase in heart rate and peripheral systolic blood pressure, a decrease in central blood pressure, reduced peripheral arterial resistance, and increased myocardial contractility and cardiac output. Cardiac electrophysiological changes including flattening or inversion of T waves, QT prolongation, and ST segment depression were observed in both insulin-induced and spontaneous hypoglycemia. Sympathoadrenal activation is the main cause of these changes through mechanisms that involve, but are not limited to, catecholamine-mediated hypokalemia. Hypoglycemia is also involved in platelet activation. There is growing concern about the long-term effects of hypoglycemia, especially as related to inflammation and atherogenesis.


#144

Are you aware of the concept of “number needed to treat”? It basically asks the question, “How many people would need to be treated with this drug to change the outcome to a good result for one patient?” That is then followed by an analysis of how many people might be harmed by negative side-effects if that many people are treated. I’ve never heard this subject raised by any doctor I’ve consulted with.

Here’s more info.


#145

No I’m not particularly aware of that… but I am aware that my own doctor had specialized for decades in treating a disease of which heart disease is an elevated concern… has managed the health of tens of thousands of patients, attends medical conferences all over the world, is a board certified lipidologist, and stays up to date with all the current best practices… and therefore I’d trust his judgement to asses the subject as relevant to me as an individual than I would trust anything on the internet… he doesn’t currently recommend that statins are appropriate for me, but when he does I’d take them without question. If I encounter any side effects I’d discuss it with him and see if we could find a better formulation/ dose that accomplished the goals with less or no side effects.

You only get one cardiovascular system… the stakes are too high to try to self-manage cardio vascular disease against medical advice imo


#146

We went to Scotland last Summer. The Gilmour side of my family was from Strathaven, a small community SE of Glasgow and my Paternal Grandmother was a Campbell. We did a formal tour around Scotland, then rented a car for 10 days to trace down areas than might have been traversed by my ancestors along with interesting out of the way areas not covered by the formal tour (Iona and Islay Islands). I highly recommend going there and hoe that you find it as rewarding as I did. Dave Gilmour, Central Point , Oregon.


#147

There was a time in my life when I completely deferred to doctors’ “considered expert judgment” and then found them to be wrong. I was left to clean up the mess and live with life-long consequences, the doctor moved on to the next patient.

I also realize that doctors are fallible human beings, too. Medicine can be slow to adopt new ideas and change, even in the face of new evidence. As owner of this one body, with a clearly vested interest in the outcome of any treatment or drug, I will not likely surrender that over-riding authority without at least considering opposing points of view. I think a second opinion constitutes due diligence.


#148

Completely agree that seeking second opinion is due diligence, but think that it should come from another doctor with equal or more specialization in the field who’s actually seeing someone as a patient. We all, as humans, tend to seek out information on our own that reinforces our own biases, which we all have…


#149

I look forward to my 10-day tour next April. The Iona Island is one of our stops. I felt the same resonance you describe when in Scotland that I felt when I visited Ireland. By the way my mother’s side of the family are the Gilmores.


#150

Your fish story didn’t upset me any more than any other food choice. It’s all as per culture. Somewhere people are beating tambourines and putting tarter sauce on live-fried grasshoppers, I suppose or monkey brains in cream. Garlic sauce on strawberries for desert. As a vegan, I picture little fish in an aquarium making tiny bubbles with their little mouths begging please don’t eat me, I wanna swim and live.


#151

Nevermind.


#152

I just made a delicious beef tongue in my instant pot just about 4 days ago actually. It was really nice because normally you have to simmer a tongue for hours and hours but in the instant pot it was tender and delicious in only 45 minutes. We ate it fajita style with vegan tortillas.


#153

I respectfully request that plant-eaters versus meat eaters take the debate to another thread. You may branch off of this one or just start a new one. I think plenty has been said already here and I sense a rising temperature. Please stand down.


#154

Thought we were back to instant pots… oh well, pm me if you want recipe. Totally worth it.


#155

Genetically, I also have Irish genes in my Gilmour heritage, but I haven’t made much headway in making a linear connection. My bd related to the “killing times” in the mid 1660s when many in SW Scotland were killed or excited to Ireland during religious strife. If you have been to Ireland, you might have seen the Book of Kelly at Trinity College in Dublin. If was written on Iona and taken to Ireland when Vikings invaded Iona and slaughtered most of the Galic Christian monks there.

There is much to see in Scotland.

The spelling of Gilmour/ Gilmore/ Gilmer was not set in stone until the mid 1880s, with the development of dictionaries that moved spelling away from individual phonetic interpretations. My ancesters’ spelling changed constantly, even among siblings.

Enjoy your trip! Dave Gilmour


#156

Hi Terry, I’ve a long history of home make kombucha. So easy. Haven’t done it recently while kitchen remains in renovation. But look into it. Find somebody to show you. Somebody will give you a scoby (or mother) to start it, or grow your own from a bottle of kombucha you just buy as a starter. Scobies are for sale freeze dried on internet. I cannot recommend that becasue I don’t know. Sauerkraut couldn’t be easier to make at home. Mine basically comes out like kim chi. Right now I eat a jar of mild kim chi each day (brand name at $5 each) and love it. Never made that officially but think it’s just kraut-plus, although the flavor is different. I used nappa for the kraut but some people add other things to it. In the winter I make bread too. Here a pic of a multigrain I made that could offend the

anti-grainers. But so good. Note: my tissue transglutamase IgA and IgG were zero and I do not have celiac dis/sprue enteropathies/dermatitis herpetiformis or related entities.


#157

You buy this at the grocery store? I need to look more closely next time I shop. I see eating fermented foods regularly as one of the large improvements I can make to my health. I will pursue that path soon.

My sister tells me she enjoys grated fresh ginger steeped to produce a ginger tea. That sounds nutritious, too.


#158

We got one earlier this year, and we love it. Kind of a glorified pressure cooker but the digital enhancements are genuinely helpful and worth it.

Kinda fun while it lasted. I think we still have our ceramic cups around somewhere.


#159

Just want to wish you well. For encouragement you can teach an old dog new tricks and I don’t mean Norm. I was diagnosed as T1 at age 69 and am still plodding along.


#160

Ouch Terry. This for me was my most shocking and frightening news since Type 1 was diagnosed. Strokes and heart disease on both sides of my family too. Here is a piece of good news. It seems that this is a condition that takes years to develop and that sometimes our bodies bypass areas that are blocked with new pathways…This is true for me. In my case, stents are not an option. Open heart surgery would be the next step. However, it’s been almost ten years since I was diagnosed and I am still walking every day, eating well (except for when I blow it) and have a full and productive life. Sometimes, I think about people who have terminal conditions like untreatable cancer and wonder how they muster hope and ways of not living in the disease. We can all learn from each other. Thank you for sharing this difficult diagnosis. So clearly, you are not alone. Hugs to you. Kim


#161

That reminds me of an old humorous saying, “It’s not hardening of the arteries that kills us, it’s the hardening of the attitude!”

That must be quite the shock to get a T1D diagnosis at that age. I know it happens. I had coffee last week with a person who was diagnosed at the age of 58. The remnants of labeling T1D as “juvenile diabetes” has done lasting damage to our cultural knowledge, surprisingly so to many medical professionals who should know better.

Good for you for staying up to date and participating here. Thank-you for wishing me well. I appreciate your support. Good luck to you!