Tuesday, November 15, 2011

The "Spooky Science" of Heart Rate Variability (HRV)

Over at Track Your Plaque we are always pushing the envelope on heart disease prevention and reversal.  I have been in the program so long that (barring another ground breaking find of which there have been many over the years) I am near the end of what I can do physically.  However, I have always been intrigued by how the mind might be used to alter the body.

Throughout history there have been many wild claims of yogis and mystics doing incredible things with their minds and living to ripe old ages disease free so I have always kept on the look-out for some hard science to back it up.  But I am a skeptic and, like Houdini, skeptical of whether there was any scientific truth to the wild claims - until recently.

I started to read about findings that the heart and other organs have clusters of neuronal cells (rudimentary "brains") and independent nervous systems that interact with the brain.  In fact, the heart has been reclassified in some precincts as an endocrine organ because of research that indicates it produces hormones.  Sound a little spooky?  Hang on, it gets even spookier.  I have begun to uncover literature that suggests these "brains" in conjunction with the "master brain" in our heads can even alter the transcription of certain genes.  It does not change your DNA but the suggestion is that these "brains" can "order" the body to either up-regulate or down-regulate the production of specific proteins created by DNA, proteins that literally govern how our body behaves.

So where does HRV come in?  Recent research has revealed that the beat to beat variation in heart rate (the time between "T to T" peaks in the QRST waveform of a typical EKG) is an exquisitively sensitive measure of the functioning of the Sympathetic Nervous System (SNS) and Parasympathetic Nervous System (PNS), the two major components of our body-wide Central Nervous System (CNS).  In a nutshell, when all the body's "brains" are communicating coherently they exert minute variations in the heart rate.  However, in situations of stress or disease the heart essentially runs on auto-pilot with little beat to beat variation.

We were so intrigued at Track Your Plaque over the possibilities we approached the HeartMath people, the leaders in HRV monitoring, to provide us with their HRV product so we could put it to the test - and it did not disappoint.  Once again, I was the guinea pig.  The next few posts will chronicle my personal experience with the basic PC Desktop version of the HeartMath emWave HRV monitor and training device.

The graphic below illustrates my baseline HRV waveform and it is very instructive of what most people will experience.

Notice how choppy and irregular it is which is exactly how the HeartMath people said it would be for a "noob" like myself.  A "coherent" nervous system, with the brain in your head in coherence with the rest of the body's "mini-brains" produces a smooth, sinusoidal trace.  The HeartMath "emWave" device is essentially a training tool with a built-in "coherence coach" to help you practice reaching a coherent state )with multiple challenge levels (kind of like resistance training for the body.

After several sessions and a little frustration at not be able to instantly master it (what can I say, I'm impatient) I did indeed improve coherence - but that will be the subject of my next blog!

Looking out for your heart health,


Tuesday, September 20, 2011

Miracle Pancakes: No Wheat, No Rise in Blood Sugar (as in zero, nada, bupkus)!

The real challenge in going wheat free is to find suitable food alternatives.  I've had little problem with lunch or dinner.  I love sub sandwiches and Jimmy Johns make the UnWich (lettuce wrap instead of bread) and a good Cobb salad always works for me.  Dinner is even less problematic with lean red meats, chicken, fish, and any number of vegetables which I love anyway.

But breakfast?  What to do about toast and pancakes and hashbrowns.  And let's face it, bacon and sausage ain't exactly health food despite being low carb.  Doc Davis convinced me (I was a doubter and an affirmed Ornish low-fat guy at the time) to go low-carb long before his Wheat Belly book burst onto the scene (the numbers don't lie - see this post).  In the process we both began working on recipes just for ourselves (many ended up in his new book and also the Track Your Plaque program cookbook).

But, the low-carb Holy Grail for me was a "miracle batter" that could replace wheat and allow me to eat things like muffins and pancakes.  Well, after months of testing and tasting, back and forth between Doc Davis' and my kitchen I think we may have it.  Doc D's Miracle Batter as I like to call it (although I tweaked it plenty it was still Doc D's basic recipe - and really - Doc D's Miracle Batter is much catchier name, don't ya think?).

So, where am I going with all this, seeing as how the "recipe" is not quite ready for prime time just yet?  Now that it passes my basic taste test it is ready for the real test.  What would it do to my exqusitely sensitive blood sugar.  Sound the horn please, as I have just completed the first test and the results blew my mind.

Fasting Blood Sugar at 10AM: 87mg/dL (not too bad for a pre-diabetic)

Prepared one serving of pancakes consisting of

1/2 cup of "miracle batter"
1/4 cup almond milk
1 Grade A Jumbo egg
1/4 cup artifically sweetened maple syrup (sweetened with sucralose)

I added the syrup just to "push the envelope" and, well, that's the way I used to eat pancakes as do many others.

Post-prandial Blood Sugar 11:15AM (one hour after consumption): 86mg/dL

WHAT?!  I couldn't believe it so I tested again.  The retest results: 87 mg/dL !!!


Now, one test on one person does not a miracle make.  But it looks awfully good so far!

Looking out for your health,


P.S. Did I mention they taste fantastic?  Pictured above is one test recipe made with blueberries.  Man, like a long cool drink of water to man thirsting in a low-carb desert!

Saturday, September 17, 2011

Bride of Franken-Wheat: New Wheat Protein Kills Aphids, Attracts Parasites

This just in!  A new strain of genetically modified wheat ("GM Wheat" as they euphemistically call it in the industry) is about to hit the fields for testing.  You can read more here.  But, let me synopsize the report for you.

I kid you not, a new genetic modification is being introduced to wheat that will allow it to "release a chemical which will deter aphids, and attract the insects' predators and parasites."

Now, I gotta tell ya, I've had this small personal problem with aphids for a while now.  Little critters don't really eat that much but they are kinda itchy.  So my first thought was, "Heck, why not give this new wheat a try?  Switch to Frosted Mini-Wheats for breakfast,  ham sandwich on whole wheat for lunch, kick back with a pizza, a few pretzels, maybe a honey-wheat lager or two for dinner and, BAM, say good-bye to my "aphid dandruff!"  But, wait a minute!  Attract predators and, gulp, parasites?  No thanks, I already have too many lawyers, politicians, and aluminum siding salesman chasing me.

But seriously, is it just me or does anyone really think it's a good idea to eat a plant that exudes a chemical that will "deter aphids, and attract the insects' predators and parasites?"  Keep in mind that this is not the first genetic modification to be made to wheat.  It already has 3 times as many chromosomes as what good old mother nature intended (42 versus 14).  With every bite we consume a plant with special genes designed to kill fungus and other bugs.  I mean, c'mon, where does it end?  Frankly, I wouldn't spray myself with bug killer let alone eat it!

Looking out for your health,


Franken-Wheat: My Own Mad Genetic Experiment!

The numbers don't lie.  Nature's own original wheat has 14 chromosomes.  Modern wheat has 42!  Those extra 28 chromosomes are all genetic codes cross-bred and genetically engineered to produce proteins to kill fungus, bugs, bacteria, make wheat shorter, faster growing etc.  We all know abouts the devasting effects of the wheat protein gluten on celiacs - but what the heck are all those bug-killing proteins doing to you when you eat wheat?

Dr. William Davis presents some provocative theories about what disease conditions wheat may provoke in his new book "Wheat Belly."  However, the ones that caught my are are the the effects about things like blood sugar and lipoproteins - the things that affect the heart profoundly and cause heart disease.  So I did my own test.  Here are some numbers from a test I did on myself - personal numbers before and after wheat - that blew my mind!

I see myself as the perfect test subject because, up until then I had been on a low-fat “Ornish” diet and was taking 3g of prescription niacin daily to lower my LDL Cholesterol and raise my very low HDL Cholesterol (the “good” cholesterol). Here are my lipids before doing my own wheat-free test.

LDL Cholesterol: 84 mg/dL
HDL Cholesterol: 55 mg/dL
Triglycerides: 24 mg/dL
Total LDL Particles: 598 nmol/L
Small LDL Particles: 290 nmol/L

Here are my numbers after six months on the low-carb, no-wheat diet where I added back a significant amount of fat (including a fair amount of saturated fat) to replace the carbs. Note that I also STOPPED talking the prescription niacin during those six months.

LDL Cholesterol: 76 mg/dL
HDL Cholesterol: 55 mg/dL
Triglycerides: 26 mg/dL
Total LDL Particles: 550 nmol/L
Small LDL Particles: 92 nmol/L

Just look at those eye-popping numbers. My LDL Cholesterol went down while my HDL Cholesterol and Triglycerides stayed virtually the same. Most importantly, not only did my total number of LDL Particles drop, my dangerous Small LDL Particles dropped a whopping 68%! That was all accomplished with nothing but dietary changes that also allowed me to eliminate one of my prescription meds to boot! Not a bad day’s work for doing little more than giving up bread, noodles, and pretzels (although I must admit I still miss the pretzels)!

The numbers don't lie.  When Franken-Wheat's stalking, dont waste your time talking, just keep walking, or better yet, run!
Looking out for your health,

Thursday, September 15, 2011

Wheat-Zilla Conquers the World! Rampaging Monster Kills Every 7 Seconds!

Just yesterday, the Associated Press reported that, "An estimated 366 million people world-wide now suffer from diabetes, and the global epidemic is getting worse ..."  This is according to the International Diabetes Federation which described the situation as "staggering" with one person dying from diabetes every seven seconds.

It is widely acknowledged that obesity rates and the chronic ingestion of high-glycemic index carbohydrates are a major factor in the development of diabetes.  It is the amylopectins in plants that carry the bulk of the carbohydrates of which their are three, amylopectin A, B, and C.  Amylopectin A, the form found in wheat, is the most easily digestible and therefore raises blood sugar more than the other forms.  In fact, two slices of whole wheat bread can spike blood sugar higher than two tablespoons of sugar.  It is also believed that these high surges in blood sugar coupled with the high insulin response they provoke are involved in the epidemic in obesity, especially the creation of visceral "belly fat" that is considered the most dangerous kind.

Other chilling data and statistics regarding Wheat-zilla were revealed in the groundbreaking book "Wheat Belly" recently released by author and cardiologist Dr. William R. Davis.

Looking out for your health,


Wednesday, September 14, 2011

The "Big-Wheat" Empire Strikes Back: Attack Begins on Dr. Davis and Wheat Belly

The Grain Foods Foundation, Wheat Foods Council, Go with the Grain, GrainPower, SixServings, you know them by many names but they all have one goal.  To fatten you you up with wheat before the slaughter - by your own bagel-laden hand - while making a buck in the process.

This collection of dubious organizations has recently gone after Dr. William R. Davis and his new book "Wheat Belly" in what I believe will be a vain attempt to discredit him before the truth gets out.  A truth that could cost them billions of dollars.  Judging by the overwhelming online response and support of Doc Davis they may have bitten off more than they can chew.  Here is the link.


After reading it I thought I would do a quick investigation into their so-called "Scientific Advisory Board."  It ain't pretty.  This is what passes for independent scientific advice?  Yikes!

Glenn Gaesser, PhD: Author of "Big Fat Lies" a book that promotes the concept that actual weight (how fat you are) is not as important as (surprise) dietary fat.  Not surprisingly, the book recommends a diet of complex carbohydrates. Most humorously, it rails against the so-called "experts" who produce healthy weight/height charts. Gee, isn't it the Grain Foods Council who admonishes us to believe the "experts?"

James R. Gavin III, MD, PhD:  This disclosure gem is precious. "Served as an advisor or consultant for: sanofi-aventis; LifeScan, Inc.; Eli Lilly and Company; Daiichi Sankyo, Inc.; Abbott Diabetes Care; AstraZeneca Pharmaceuticals LP; Served as a speaker or a member of a speakers bureau for: Novo Nordisk; Bristol-Myers Squibb Company; AstraZeneca Pharmaceuticals LP; sanofi-aventis: Owns stock, stock options, or bonds from: Amylin Pharmaceuticals, Inc.; Served as member of the Board of Directors for: Amylin Pharmaceuticals, Inc."  Care to guess on what ALL the above drug companies have in common?  Surprise, surprise, surprise, they make diabetes drugs!  LifeScan, Inc. makes blood glucose monitors.  Hmmm, does it seem that ANY of these companies is particularly interested in reducing the number of diabetics?

Ronald Kleinman, MD: Yeah, it gets better!  Kleinman, who is known to accept compensation for his opinion, "serves on scientific advisory boards for General Mills, the Grain Foods Foundation and Burger King. He is a member of the Board of Directors for Project Bread in Boston; a member of the Board of Directors Global Child Health Foundation; and a consultant for Mead Johnson Nutritionals."  Hey, guess who owned Mead Johnson for 42 years?  Bristol-Myers Squibb!  Guess what the first item is in the Mead Johnson Food Pyramid For Pregnant Women.  If guessed "grains" give yourself a gold star!  And whats with: General Mills?  Burger King?  Project Bread?  LMAO!  You're kidding, right?

Robert S. Rosenson, MD: The beat goes on. He "Served as an advisor or consultant for: Abbott Laboratories; Amarin Corporation plc; Amgen Inc.; Genentech, Inc.; LipoScience Inc.; Roche; sanofi-aventis; Received grants for clinical research from: Amgen Inc.; Genentech, Inc.; Roche.  We covered some of the other drug makers.  Amarin is finalizing development of drug to treat high triglycerides.  Guess what one of the leading causes of high-TGs is.  Roche make anti-diabetes drugs and the famous Accu-Check blood glucose monitor.

Shelley Case, RD: Can't say much about Ms. Case.  Her financials are clean but her laser-like focus and expertise is restricted to the gluten protein and celiac disease.  What about all those other proteins manufactured by the extra 28 chromosomes in the cross-bred and genetically engineered "Franken-food" we call wheat.  To quote Ms. Case, "Patients should be thoroughly tested for Celiac if they present with conditions such as anemia, bone issues, thyroid and liver dysfunction, and arthritis."  Hmmm, any chance those conditions -  as mentioned in Wheat Belly - could be due to one of the other proteins in wheat?

Julie Miller Jones, PhD, LN, CNS:  This quote from Ms. Jones and a group of her cronies enlisted by grain growers in response to the USDA altering the food pyramid logo says it all.  " ... we will provide input on the science behind the new icon and ways to achieve the key goal of getting consumers to eat more healthfully, ensuring they are getting their six servings of grains daily, making at least half their grains whole and the rest enriched grains."  Does that include celiacs?  Do you suppose Ms. Case and Ms. Jones ever talk?

Sylvia Melendez-Klinger, MS, RD, LD: From Ms. Klingers corporate website, "Ms. Klinger is also culinary consultant to food and beverage companies such as The Coca-Cola Company, Kellogg’s, Hormel Foods, Ross Laboratories, GlaxoSmithKline, Dannon, AztraZeneca, Uniliver, Mc Neil Nutritionals, and Weight Watchers International were she completed numerous administrative and communications projects."  I think that just about covers Ms. Melendez-Klinger's credentials as an "independent" expert!

Bruce Young, MD: Dr.Young is an obstetrician and gynecologist with credentials in programs for mid-wifery and fetal medicine but I have no idea what his standing is as a grain expert.  Best I can tell "Big-Wheat" wants so-called experts to push wheat from conception to our untimely and miserable deaths.

Yeah, if this is an "independent" board then I'm Batman (I'd settle for Bruce Wayne, hell, I'd settle for Adam West).  But what did you expect?  Let the battle begin.  If this is the best the competition can offer I'm betting on Doc Davis!

Looking out for your health,


Saturday, May 7, 2011

The 89 Cent Heart Attack?

While I was driving down the highway this billboard happened to catch my eye and gave me a chuckle (the added text and arrows are mine, of course).

This burrito looks exactly like the cross-section of an artery in the midst of a heart attack.  The similarity is absolutely uncanny!

Remember, you are what you eat, lol!


Thursday, May 5, 2011

Healthcare Industry is Hopelessly Behind the Customer Service Technology Curve

One of the great things about technology is that it has vastly improved customer service.  I can order products, pay, track shipments, get support, do just about everything from my laptop to smart-phone.  So, why is it that some medical facilities are still hopelessly behind the technology curve?

Mind you, not all are.  For example, I can get all my test results online which is far faster and more convenient than it used to be.  But this post is about simple, run of the mill, customer service - the sweet spot if you will - of this blog.  Although it has been awhile, alas, I come with yet another story of healthcare customer service gone awry!

I practice Informed, Self-directed Healthcare (ISH).  I take responsibility for my health! I consider doctors as specialized consultants I pay to keep me informed and help me make decisions - not dictators who tell me what I MUST do.  This is not unlike the way I characterize lawyers.  I see a lot of doctors, take their advice, do a great deal of independent research, and render my own opinion.

Recently, I saw a functional medicine doc.  He did a fecal analysis test to delve into my stomach problems (after my GI doc threw up his hands and could not provide a diagnosis) which came back with suspicious results for heavy metals.  We followed up with a Urine Toxic Metals test that revealed high levels of mercury and lead and an elevated level of arsenic.  I thought, in the interest of continuum of care, that I should share these results with my hematologist (I have macrocytotic anemia), gastroenterologist (for my stomach problems of unknown etiology), and my GP.  This is where the "fun" starts.

I contacted my hematologist's nurse who asked if I could fax the results.  "Fax?," I said, "Who uses a fax anymore?  How about if I scan the results and sent it to you as a PDF via e-mail?"  She promptly provided an e-mail address and said she would print out a copy and enter the file into the electronic system (they have a completely digital records system but some docs STILL like paper).  Then I contacted my GP's nurse who is at the same facility.  She would not even consider an e-mail and refused to provide an e-mail address (which I could have guessed since they use the first initial and last name "at" the center name ".com."  She had to have a fax.  Keep in mind that this is the same medical center with all the same systems.  Seems to me that she would have to scan the paper fax to create the electronic record I was willing to send her.  What, is she trying to protect, someone's scanning job?  My GI's nurse did not even have external e-mail!  How in God's name can you run ANY business without the ability to accept external e-mail?  Yikes!

Now, you may be thinking this is a HIPAA issue so I checked with a lawyer.  Since I am sending the info willingly by e-mail it is a de facto waiver of any expectation of privacy.  I explained that e-mail is actually more secure!  The e-mail goes ONLY to the person I send it to when a fax just sits on a machine for ANYONE to see.

The bottom-line is that I am e-mailing to the hematologist's nurse who offered to make a paper copy for my GP's nurse who will turn around and scan it into their digital system.  Ya, that's REAL efficient.  Since my GI's office is just down the road from my cardiologist's office (Doc Davis of Track Your Plaque fame) I will drop it off the next time I am at his office (which is thankfully frequent as we talk often).

And people wonder why healthcare is so expensive!  Sheesh!

Looking out for your health,


Tuesday, November 23, 2010

JUPITER to Earth: It's the Calcium Score Stupid!

Well, well, well!  A funny thing happened on the way to the "statin forum."  Astra-Zeneca, in a bald-faced attempt to broaden the narket for its statin product Crestor, ended up proving beyond a shadow of a doubt that heart scans and calcium scoring is the most powerful predictor of heart attacks in asymptomatic people.

A post hoc analysis of the MESA study population using JUPITER criteria revealed at 25-fold increase in risk for persons having a positive calcium score.  These two studies were fairly large so it was adequately powered to deliver results with a high degree of confidence.

For years docs like Bill Davis and Bill Blanchet have been screaming this from the hilltops and it something every Track Your Plaque practitioner knows.  If you have a positive calcium score you have coronary artery disease and your risk of a heart attack skyrockets.  Fortunately, it also gives you often decades of warning so you can actually DO something about it.  Coupled with technologies like advanced lipoprotein you can find the root causes and correct them.

So, "thank you" Atra-Zeneca.  I know you did it for the money - but what the heck - you might end up having helped save some lives in spite of it!

Now darn it, go out talk to your doc about getting that heart scan if you have any doubts about having the seeds of heart disease in your arteries.

Looking out for your health,


Wednesday, November 10, 2010

Diabetes? You Gotta Exercise! It Works - Big Time!!!

Ever since I was diagnosed as prediabetic I have been looking for ways to stave off the inexorable march to full-blown diabetes and its many heart related complications.  As I wrote earlier, the words of one of many endocrinologists I went to keeps wringing in my ears.  "You gotta exercise.  I has been shown to work better than any else."

Well, as a numbers geek I have been tracking things in different situations.  Like many prediabetics my fasting blood sugar is pretty stable - about 83mg/dL in my case.  My problem is after eating - postprandial blood sugar.

To do yet another test I went out last Sunday and ate a large meal on an empty stomach.  This included some nasty stuff like an abundance of french fried eggplant, a rack of ribs (which I'm had plenty of sugar in the sauce), three massive french fried shrimp (oh but were they good) with tartar sauce, a few veggies, and a small side salad (with a dressing which also likely had HFCS).  Like I said, not a praticularly healthy meal but, then again, my intention was to cheat and see what the consequences were.

One and one-half hours after the meal my blood sugar was a still a nasty 135mg/dL so I fired up the old recumbent stationary bike and did my typical ride - about 44 minutes, 600 calories, and 7 miles (yeah, I know the calorie counter is reading high but it is just a reference number to help me track and compare rides).

So, 45 minutes later I take another reading - BADDA-BING! 77mg/dL, I dropped 58 points in 45 minutes.  WOW!  Like the doc says, "You gotta exercise!"  Take it from me, it seems like magic and it works.  I guess all those old-timers who take their evening "cosntitutional walk" after dinner knew what they were doing.

The bottomline here simple - after you eat - move.  Walk stairs, walk around he block, heck do jumping jacks.  It all adds up.  You don't have to drop your blood sugar a whopping 58 points to have a dramatic effect.  Every point you shave makes you a little healthier!

Looking out for your health,


Sunday, August 29, 2010

Kidney Stones and Lithotripsy: More Lessons Learned about Healthcare

Yes, there will be blood!

You know, the older I get the more I am inclined to believe that heart disease is just another symptom of a more systemic problem - getting old!  Since I became consumed by heart disease I have gone down the rabitt-hole of thyroid function (Hashimoto's in my case) and diabetes (currently prediabetic with Impaired Glucose Tolerance and an HbA1c of 5.9).

So now what?  KIDNEY STONES!

Ole, HeartHawk finally went in for Extracorporeal Shock Wave Lithotripsy (ESWL) for a collection of stones in my right kidney that I have known about for over two years.  A visit to the emergency room with nasty renal pain several weeks earlier prompted me to visit my urologist to reschedule the lithotripsy I postponed the previous year.

I want to take this opporunity provide a series of bullet-point observations about my personal experience with kidney stones and ESWL and use them to further illustrate even bigger observations about the shortcomings of traditional healthcare (just do what the doctor says) and the need for everyone to practice what I call "Informed Self-directed Healthcare" (ask many questions, do your research, get many opinions, don't blindly trust any single doctor) no matter what condition you are treating!

1. I discovered my kidney stones quite by accident during an ultrasound for a still undiagnosed (despite repeated scans and tubes shoved up and down both "ends") bouts with episodic and debilitating stomach pain.  The test showed a 16mm stone.

2. After an ER visit for another bout with whatever was ailing my stomach, a CAT scan confirmed the stone but put it at 8mm.  By the way the gastroenterologists finally decided that what I had was Cyclic Vomiting Syndrome which is thought to be a "migraine" of the stomach.  The pattern of attacks, symptoms (no vomiting actually) and fact that I had a history of migraines all contributed to the diagnosis - although they don't REALLY know but I haven't had an attack in over a year.

3. I saw a urologist who wanted to perform a KUB (Kidney, Ureter, Bladder x-ray) of the stones.  When I asked why - noting I have a CAT scan of the damn thing he suggested the KUB was a "better modality" for "seeing" the stones.  After the KUB this doc wanted to do a percutanous nephrolithotomy (PCNL) where they cut into you and extract the stone(s) with a scope.  This is an invasive 1-2 day surgical procedure which requires a stent in your incision to drain the kidney for 24 hours - hence the hospital stay.  This same doc then wanted to do a CAT scan before the procedure.  When I asked why he said because it provided better information about the stones than a KUB - ahhh, wait a minute - I thought you said ...! I dropped this doc like a hot rock!

4. I saw another urologist who suggested ESWL so I decided to research lithotriptors.  I chose the Storz Modulith SLX based on a combination of treatment efficiency and ability to pulverize stones.  Here is a link to one of the studies I reviewed.  You CAN dictate which machine will be used by your doc.  I actually had it written into the waiver I signed at the hospital.  Now, it does complicate scheduling because the machine needs to be available (more on that later).

5. After procrastinating for a year I ended up at the ER with renal colic (pain) that is typical of the stones I KNEW I had.  Right lower back pain that was bad but not the "child birth like" torment I had heard - but still bad enough to take the morphine they offered!  At the ER a nurse showed up to take me for a CAT scan.  I refused.  Wouldn't a much lower radiation dose KUB confirm things?  Hell, one urologist told me (at one point) it was superior - and certainly cheaper (another example of why healthcare is so expensive)!  I actually sat in the imaging room until the attending physician came in.  After a brief discussion she agreed with me!

6. I scheduled a followup with my new urologist who says the stone "cluster" now looks much smaller (possibly to small for lithoptripsy - or GONE) and wants to do a repeat KUB.  Right now I feel like an x-ray pin-cushion.  I suggest we first verify it with ultrasound (no radiation) and if we find something then do a KUB.  He agrees.  See a pattern here?  Seems like docs are handing out radiation like candy.  Why?

7. The first ultrasound tech (who was a trainee) had equivocal findings so the test was repeated on the spot by a more experienced tech who found the stones so I had the pre-procedure KUB (this would be the fourth).

8. The doc says the stone "cluster" is now only 4-5mm and is marginal but suggests going ahead with the ESWL to avoid future problems and I agree.  I go several rounds with the schedulers to get a Storz SLX-F2 lithotripter in a hospital setting as the procedure is done under general anethesia (I won't settle for receiving general anesthesia anywhere but in a full hospital).

9. I get to the hospital and everything goes smoothly until a nurse shows up to take me for - ANOTHER KUB!  Of course, I refuse (I always like the look of bewilderment on the faces of medical staffs when I do this - they are practically speechless).  I just had one a week ago!  So they call the urologist who agrees to bring the last one to the hospital.  After a little prodding of the staff it became clear the final KUB was ordered simply for the convenience of the urologist!  Let's see, I get another blast of x-rays so the doc can squeeze in another latte?  Bite me!

10. Did I mention an ESWL is done under flouroscopy (x-ray) so they can aim the lithotripter?  I was not amused when the lithotripter tech could not tell me what my radation exposure would be (mSV) but noted that my doc put on a lead flak jacket as I was dozing off.

11. The rest of the procedure went well with little pain but I am starting to get concerned about "peeing cherry Kool-Aid" (blood in the urine) for two and one-half days post procedure.  I heard it can last a week but usually subsides in two days.  The doc called and said I'd received the the max number of shocks (about 3000) so I am certain my guts got a little "tumbled!"  Still, somehow I doubt I will ever get used to red urine!

12. Of course, I also have to strain my bloody urine for three days.  What fun!  No rocks yet which may mean the stones got completely pulverized but it could also mean they're stuck!

13. Now, here is the kicker that REALLY pisses me off.  I am doing some post-op research about how long to expect blood in the urine and come across another study that suggests ESWL greatly increases the risks of diabetes and high blood pressure.  WHY IN GOD'S NAME WAS THIS NOT DISCUSSED WITH ME PRIOR TO THE PROCEDURE?  This is unconscionable!  I am prediabetic with heart disease!  Ya think this might be pertinent to my decision?  To be fair there are competing studies that found no such association but that is beside the point.  It should still be disclosed!

14. So here I sit, three days later, peeing red into a bucket, and wondering whether the "benign" procedure I just had is going to raise my blood pressure and accelerate my diabetes years down the road.  Sometimes I wonder - maybe ignorance is bliss - NAAAHHH!

Looking out for your health (and mine),


Sunday, May 23, 2010

Body by Track Your Plaque?!

Although there are several exercise guidelines there really is no "Track Your Plaque" exercise program, but if there was one it would probably be a lot like the one that produced the picture at left. Yup, that is skinny, old (and getting older every day) HeartHawk after just 90 days (one with my head chopped off and one with my trademark sunglasses, to remain incognito). No "P90X" discs, no personal trainer, no high tech equipment, just some basic Track Your Plaque principles and a scare followed by a commitment. Read on!

I recently saw my endocrinologist who looked at my OGTT and HbA1c and proclaimed, "You're insulin resistant and prediabetic!" Looking for him to prescribe some new wonder drug, supplement, or spartan diet recommendations I asked, "So what can I do about it?" "Exercise!" was his one word reply which he repeated often. What? As a Track Your Plaque devotee I am used to heart scans, advanced lipoprotein testing, exotic supplements and all the bleeding-edge science that comes along with it. The more I objected and insisted there must be more we can do beyond "exercise" the more he insisted, "Exercise!" Finally, as the frustration grew in both of us he loudly blurted, "Look, you GOTTA exercise!"

Now, I had always gotten SOME exercise. Heck, at 55 years old I still kept up with guys on the basketball court one-third my age - once a week - and there was the problem. How much exercise was needed? A lot more: 30 minutes, 5 times per week, at 70% of my maximum heart rate. Well, like everything else I thought I might as well go "whole hog" and see what I could do. I was going to do 45 minutes per day, a minimum of 5 days per week (averaging closer to 6 days) and I was going to throw in some resistance training every other day.

Guess what, my blood sugar is lower and I even got a little muscle definition after a life of being a "bean-pole." I may actually take my shirt off this summer! The point I am trying to make is that exercise is an ESSENTIAL part of Track Your Plaque or any health program for that matter - and you don't need expensive DVDs or equipment, just a commitment to developing a daily habit to just do it!

Now, I won't kid you. It is often boring and tiring (but not a lot after a few weeks), and it is definitely not as much fun or easy as other things you might do instead (like eating and sleeping). But, if an underweight, old enough to join AARP, sit on my butt behind a computer all day kind of guy like me can do it, so can you! Vigorous exercise lowers your cholesterol, your blood pressure, your blood sugar (to name only a few benefits), and damn, just plain makes ya look better (oh yeah, I can rebound better too - though it didn't help my shot much unfortunately)! What else can do all that?!

Looking out for your heart health,


Friday, May 21, 2010

American Heart Association Exposed "Selling" Endorsements

I have been critical of the AHA in the past for their stodgy, politically correct perspective on heart disease but this takes the cake. No longer satisfied to endorse sugary, diabetes-inducing foods as heart healthy, they have expanded their coveted "Heart Check" endorsement to the Wii video game console on the premise that several of its games promote fitness. As one of my contemporaries titled it in his post on the Track Your Plaque Forum, "AHA whores for Nintendo." I could not have said it better myself!

What is stunning is that AHA has made selling their endorsement big business. Get a load of this brochure on the AHA website. Here is the AHA pitch . . .

"Shoppers want clear, simple purchase guidance from a trusted source. The American Heart Association heart-check mark increases product sales because seeing the mark on a package assures shoppers they are making a smart choice."

SMART CHOICE?!! OH REALLY?!! The AHA has figured out that they have created a trust factor among consumers (misplaced trust in my humble opinion) and want to cash in on it - big time.

  • Nevermind that they are hopelessly behind the the cutting-edge of heart health science (they continue to push dietary cholesterol and saturated fat as the keys to heart health - NOT!).

  • Nevermind they endorse foods like "Berry Burst Cheerios-Triple Berry" (22 grams of wheat and sugar, the top two ingredients). There is an epidemic of childhood obesity and diabetes and the AHA pushes sugar and highly-processed carbs into the veins of children as sure as if it were drugs through a needle.

  • Nevermind that regardless of whether your product is heart healthy or not THE ONLY WAY YOU CAN GET THE AHA ENDORSEMENT IS TO PAY FOR IT!
The AHA now seeks to expand their misuse of this misplaced trust to other dubious product groups and are putting the hard sell out on the streets. They charged Nintendo a whopping $1.5 million for their "endorsement." Think about it, the AHA and Nintendo are teaming up to put the outrageous notion in the minds of consumers that buying a video game is heart healthy because in certain, non-representative situations, you could get some aerobic exercise.

I do not doubt that you can work up a real sweat playing several different video games - but is that the norm? Will Nintendo put a label on "Super Mario Brothers" that states "Nevermind?" This is the same sort of outrageous claim the FDA has recently outlawed for other products. If your claim is not representative of typical results you can be sued! Any hungry lawyers out there?

I am sad to have come to now hold the opinion the once proud AHA has indeed become a "whore" to the almighty dollar. They have lowered themselves to the level of "used car salesmen" and "snake oil peddlers." There is a lot of talk about boycotts these days. How about we start with the AHA and the disreputable companies that buy into their hucksterism to push their products on unsuspecting consumers!

Yeah, that means you General Mills and Nintendo. Consumers have lots of options for breakfast foods and entertainment. What do you think their reaction will be when they find out you and the AHA have been distorting the truth?!

Looking out for your heart health,


Saturday, May 15, 2010

Nattokinase Revisited

I had one of my regular meetings with Doc Davis of Track Your Plaque book and website fame today where he remarked about a patient he encountered that nearly died of a pulmonary embolism after going off prescription anti-thrombotic medicine in favor of nattokinase.

Doc Davis has been a critic of nattokinase and endured the slings and arrows of its promoters and those statistical "n of one" users who swear by it. (Interesting to note that Doc Davis is part Japanese and is not without experience with natto as a food his mother made him eat - childhood trauma perhaps? LOL!).

I was curious enough to take a look at the debate on his blog and do a little of my own research. As most readers of my blog know I am a "numbers" guy. Normally, the ridiculous bloviating and hyperbole I found on some sites pushing nattokinase would be enough to turn me off but just because "bad" people say "good" things about a product does not preclude it from actually being good! On the other hand, there is some pretty damning science against the concept that nattokinase works (the small problem of any protein surviving the gut) as well as common sense that suggests if it did work it may be a dangereous way to self-medicate (at least with a prescription drug like Coumadin you are under supervision by a doctor).

For better or worse I decided to go to my trusted sources at PubMed and look at some of the more recent studies to see if there is anything new that supported casual and chronic oral adminstration of nattokinase to prevent heart disease. Here is what I found in a highly summarized (and editorialized) form so as not to induce boredom (use the links for more info).

Bioproperties of potent nattokinase from Bacillus subtilis YJ1.
Yup, nattokinase is still fibrinolytic - if it gets into the blood stream.

Purification and Characterization of Nattokinase from Bacillus subtilis Natto B-12
Now if we could only get this stuff to work orally as a functional food!

Combined nattokinase with red yeast rice but not nattokinase alone has potent effects on blood lipids in human subjects with hyperlipidemia
Nattokinase does not appear to exert its effects (if any) via lipids.

Enhancement of oxidative stability of the subtilisin nattokinase by site-directed mutagenesis expressed in Escherichia coli
Hey, we are getting closer to at least limiting oxidative degradation - still no panacea.

Purification, immobilization, and characterization of nattokinase on PHB nanoparticles
Nanoparticles are all the rage these days and may have some utility with stabilizing nattokinase but still no oral in vivo data.

Nattokinase decreases plasma levels of fibrinogen, factor VII, and factor VIII in human subjects
Now we're talking - hard data with oral nattokinase in humans! Unfortunately, this was an open-label, self-controlled sudy with 45 people (15 in each arm). Can you imagine trying to get a prescription drug past the FDA with a study like this? Still, at least SOMETHING for proponents to hang their hats on.

Effects of nattokinase on blood pressure: a randomized, controlled trial
Hey, hey! More human data and this time randomized, controlled, and with almost twice as many participants as the previous study. Too bad the end point was blood pressure data - but it did show improvement.

Effect of nattokinase on restenosis after percutaneous transluminal angioplasty of the abdominal artery in rabbits
Reminds me of Judah Folkman's comment when the media overhyped his results and declared he had cured cancer, "If you are a mouse and you have cancer we can take good care of you!" Lucky rabbits!

Cerebellar hemorrhage provoked by combined use of nattokinase and aspirin in a patient with cerebral microbleeds
Oh yeah, just when you thought everything was rosy this booger shows up. Just because something is not classified as a drug by the FDA does not mean it is safe for general use. First Doc Davis relates a story about nattokinase putting a patient at risk because id did not bust a clot and now here is someone who "over-busted!"

Nattokinase-promoted tissue plasminogen activator release from human cells
More geek science. Yeah, if you get it in the blood nattokinase has numerous effects. So do a lot of chemicals!

The fibrinolytic activity of a novel protease derived from a tempeh producing fungus, Fusarium sp. BLB
Here is an even more powerful natural product. Should everyone abandon nattokinase and rush out to buy tempeh - the next wonder supplement?

Here is what (I think) we know.

1. Nattokinase exhibits lytic effects in vitro.
2. It MAY have some effect taken orally in vivo.
3. If it does work no one knows the mechanism of action for certain. Consider this, maybe it is some component or action OTHER than the lytic effect seen in vitro. Why take the risky components to enjoy the effective components?
4. There is a tiny amount of evidence for nattokinase taken orally but certainly nothing conclusive.
5. There is absolutely NO safety data on it other than small study and anecdotal experience. Remember torcetrapib the wonder HDL drug? I couldn't wait for it to hit the market so I could take it! It did everything Pfizer said it would - then downstream the data showed it killed more people than it saved. No way would nattokinase be FDA approved based on existing HARD data.

It seems what we have in nattokinase is an interesting agent - but nothing more. Since it is unregulated we are all free to experiment (and I experiment plenty). But don't kid yourself - it is nothing more than an experiment with an unknown outcome! "Natural supplement" does not equal "safe" any more than "drug" equals "effective!"

As always, I remain a fan of Informed, Self-directed, Healthcare (ISH). But, stay informed, remain a skeptic, and play safe!

Looking out for your heart health,


Sunday, February 7, 2010

Advanced Lipoprotein Testing and the Fallacy of "Average"

I use http://www.nutritiondata.com/ quite a bit to determined carb content of various foods now that I am tracking my blood sugar. I am prediabetic and like all good TYP'ers this is one more thing I am tracking to reduce my heart disease risk.

While at the site today I stumbled across a blog written by their so-called heart disease expert, Dr. Steve Parker, titled, "Advanced Lipoprotein Testing: Not Quite Ready for Prime Time" In it, Parker essentially said that advanced lipoprotein testing (ALT) such as that offered by NMR has, "never been shown that such testing offers any additional benefit over traditional risk factor assesement and management."

Now, I am certain that Dr. Parker is a very nice man who means well but for people like me and many others he is wrong - possibly dead wrong. It all has to do with applying common sense and the statistical fallacy of assuming what is good for the average person is good for all persons, more importantly, what is good for teh many is necessarily good for the one -YOU!

Dr. Parker starts with an argument that is perhaps the most powerful reason for using using ALT, "The Centers for Disease Control reports that half of all heart attacks occur in people with 'normal' cholesterol levels." If this is true (it is) one must come to the conclusion there must be some other factor besides standard lipid values (i.e. LDL, HDL, and Triglycerides) that can ferret out which person is likely to have a heart attack and which is not. Unfortunately, this is where Dr. Parker's deductive reasoning and intuition shut down. In fact, he contradicts himself based on an earlier blog he wrote praising ALT!

Here is the "killer" paragraph where Parker forgets all reasoning and statistical training he may have ever had.

"It's never been shown that such testing offers any additional benefit over traditional risk factor assesement and management. And all of the established clinical management guidelines utilize LDL cholesterol rather than LDL subfractions. Physicians know what to do with LDL cholesterol. We don't have evidence-based protocols that tell us what to do with these subfractions."

Let's dissect this statement to get to the truth.

1. It has never been shown that if I shoot myself out of a cannon wearing a parachute over Lake Michigan in February that I will die of exposure. What I do know is that a typical cannon with enough power to propel me from Wisconsin to Michigan (so I do not land over water) will kill me instantly and that even if shot from a lesser cannon with a parachute I will land far enough offshore that I will be unable to swim back in 36 degree water to safety. Sometimes one has to apply deductive reasoning. If I employ ALT and discover I have a dangerous lipoprotein subfraction such as Small LDL or Lipoprotein(a) (which I do) I am now in a better position to do something about it! I don't need a study to deduce this.

2. Just because "all of the established clinical management guidelines" use LDL and "Physicians know what to do with LDL cholesterol" does not mean I MUST be limited to antiquated methods applied by ignorant and behind-the-times physicians. I could go further and suggest Dr. Parker himself is ignorant. Many physicians DO know what to do with ALT and use it effectively to treat their patients using the most advanced technologies available.

3. The term "We don't have evidence-based protocols" is often shorthand for "I am too stupid or too lazy too engage in critical thinking so someone please tell me what to do." I do not need someone to do a study on taking common sense actions. I have high Lipoprotein (a) with an otherwise world-class lipid panel. My own physician (whom I fired) told me I was fine! If I had not done ALT I would not have discovered I had this independent risk factor for heart disease and would not be in a position to do something about it. I mean, c'mon, this is not rocket science!

4. The final and most crushing indictment of Dr. Parker's logic is the fallacy of extending information about statistical averages to an entire population. On average, a person with my traditional lipids (LDL, HDL, Triglycerides) would be in a low risk group - except I am among a few in this group who have high Lp(a). Yes, it might not be cost-effective to test EVERYONE for Lp(a). The cost of the test for everyone might not save enough lives to be cost-effective (this is the danger of national healthcare rules that rely on "evidence-based" medicine for the masses). BUT LET ME MAKE THIS CLEAR! I do not give a DAMN about the average guy - I care about ME! If I had followed "evidence-based" medicine and good old Dr. Parker's advice I might be dead. Instead I am proactively fighting my extraordinarily high Lp(a) - but only because I got the test and fought my insurance company to test my son (I won the battle and now my son knows 30 years before I did so he can take action even sooner).

So there it is. If you are a "good little soldier" willing to sacrifice your life for the "good of the many" and save a few bucks then great - more power to you. But, if you want to "pull out all the stops" to make certain you stay alive and your children live long lives then you will do everything possible to know your risks and take appropriate action.

No thanks Dr. Parker. I think I'll continue to track my lipoprotein sub-fractions using ALT. Just because most docs are stupid or lazy does not me I have to be. And, just because many people may not benefit from ALT does not mean ALL - specifically ME - won't benefit IMMENSELY. So, take your pick. Go with the flow or get aggressive. Practice Informed, Self-Directed Healthcare (ISH). Heck, it's your life. YOU decide!

Looking out for your heart health,


Wednesday, January 20, 2010

Fish Oil and Omega-3 Index: A Feather in the Telomere Cap

And just when you thought it couldn't get any better another compelling reason for knowing your Omega-3 Blood Index and optimizing your fish oil dose is uncovered. A new study among patients with coronary artery disease (CAD) has discovered an association between fish oil and the rate at which telomeres shorten (January 20, 2010 issue of the Journal of the American Medical Association, Dr. Ramin Farzaneh-Far et al).

We all recall from high school biology (yeah, right) that the rate of telomere shortening is thought to determine the number of times a cell can replicate thus limiting the life of a cell. This shortening of telomeres has been shown to independently predict morbidity and mortality in patients with CAD.

According to lead researcher Dr. Farzaneh-Far, "This suggests the existence of a novel mechanism for why omega-3 fatty acids are effective in this patient population—an area that has not been well worked out previously; it suggests they could be acting through telomeres . . . It's also the first study that shows that a dietary factor may be able to slow down telomere shortening . . . This is yet another reason for cardiologists to try to convince their patients to take either a fish-oil supplement or eat regular fatty-fish meals."

The bottomline of this observational study (which, again, showed association not causation) is that participants (608) with the lowest levels of Omega-3s had the fastest rate of telomere shortening. What is also interesting is that Dr. Farzaneh-Far and his team used what he termed "a relatively new blood test" called the Omega-3 Index test. The test cut-offs were 2.3% for those with the fastest (worst) telomere shortening and 7.3% for the slowest (best) shortening.


I hate to be a total shill (not really) but, come on. Dr. Davis and Track Your Plaque are once again ahead of the curve in bringing the Omega-3 Index test to its Members for some months now. It seems to me TYP also did an extensive treatise on Omega-3 Index testing in its October 2009 newsletter, and, what was the optimal blood level discussed - oh yeah - 7.3%!

Now for the REAL bottom-line! Just like Vitamin D, it doesn't matter how much you take, it matters how much get's into your blood. In fact, you don't even know, in most cases, whether the preparation you may be taking even contains its stated dose! If you do not test your blood level you have no idea if you are receiving optimal treatment - period! It took me three blood tests just to get my Vitamin D level "zeroed in."

In summation, I guess I wholeheartedly agree with Dr, Farzaneh-Far's statements, "from the telomere point of view, this is the first study to show an effect of a dietary factor, that this may be able to slow down telomere shortening" and "The idea is that the omega-3 index, the percentage of fatty acids in the blood, could be measured and that low levels would predict worse outcomes. So the omega-3 index might be useful for risk stratification in the future."

Call your doctor, get the test. If your doc says, "No!" then test yourself to get a baseline reading and decide whether it might be a good idea to get OPTIMAL treatment. I am getting my blood draw today! I'll let you how how it turns out.

Looking out for your heart health,


Sunday, January 10, 2010

The Pizza Paradox

It seems to me that it has been a while since I waxed rhetoric about the roller coaster we all ride while fighting heart disease. One of my favorite rants amidst the rapid changes I encounter particularly with regard to diet and heart disease is what I call "The Pizza Paradox."

I love a good pizza but gave them up early on in my personal battle with heart disease because, let's face it, cheese, Italian sausage, and pepperoni are not high on the list of heart-healthy foods.

Well, with the flood of low-carb indications coming out for fighting heart disease my favorite lament is that I still can't eat pizza but now it is the crust that is going to kill me not the toppings!

Life just isn't fair!

Looking out for your heart heart health,


Wednesday, December 16, 2009

Jumpin' Jupiter: How About a Little Statin Common Sense

Well, by now I am certain most of you have heard that the FDA, based on the results of the JUPITER Study, has approved rosuvastatin (Crestor) for men over 50 and women over 60 with normal LDL-cholesterol levels (LDL <130>2.0 mg/dL), elevated high-sensitivity C-reactive protein (hs-CRP >2.0mg/dL) and triglycerides under 500 mg/dL.

I have had a chance to review both the glowing recommendations and scathing condemnations of this FDA action and find them to be as frustrating as they are amusing. I THINK A LOT OF FOLKS NEED TO GET A GRIP! I advise EVERYONE to read Dr. Davis' well-reasoned, common-sense analysis of the JUPITER results on his latest HealthCentral blog post. He brilliantly dissects the issue for us and calmly separates the useful health info from the useless hysteria on both sides of the aisle.

Here is my take/synopsis and some important things to remember.

1. Always bear in mind the difference between cause and association. Nobody said CRP "causes" heart disease. In fact, it is more likely than CRP is simply an indicator that you have something else that does cause heart disease (i.e. CRP is just "associated" with heart disease). Find that root cause and treat it. A statin may not be the best treatment for the specific root cause of your elevated CRP (but maybe it is).

2. Virtually all drugs have good effects and unwanted side-effects. But, the effects are different for everyone. Statins reduce LDL cholesterol and CRP - no question. They are neither magic nor poison. My advice is to study, analyze, ask questions then make an informed decision. I take Crestor (5mg) - but as little as I think is prudent based on my unique circumstances!

3. It is worth mentioning that researchers found a signficant increase in diabetes among participants. Factor this into your personal equation.

In short, it is nuts to both crucify statins or propose they be put in the water supply. I mean, really, does it a take a rocket scientist to figure this much out?

Looking out for your heart health,


Wednesday, December 9, 2009

New Genetic Link for Vitamin D and Heart Health

And now comes more genetic proof that Vitamin D is an important heart health player. Once it became established that a "Vitamin D receptor" existed in the heart it was only a matter of time before researchers began teasing out why nature put it there.

New research shows that a gene variant of CYP27B1, which blocked production of an enzyme responsible for Vitamin D activation, accounted for a greater than two-fold risk for congestive heart failure (odds ratio 2.14, 95% CI 1.05-4.39). For a quick stats lesson on all that numeric gobbledygook it means that the researchers were "confident" that if they repeated their research 20 times they would get a result showing a increased risk of anywhere from 1.05 to 4.39 in 19 of the trials (95% of 20). The 95% figure is considered the minimum confidence threshhold for accepting a statistical result as valid. You can also look at the "confidence interval" (CI). If the interval does not include "1" (no risk difference) you are fairly certain your experiment determined a greater risk (a range above 1) or a lower risk (a range below 1). We can decipher "odds ratio" another day!

Of note was that a single SNP (the C allele of SNP rs4646536 for all you gene freaks out there like me) was the culprit. The large NIH VITAL Trial will provide more definitive data on both Vitamin D and Omega-3 links to heart disease when it is completed sometime in 2014. Until at least then, I will be taking my 8000IU of Vitamin D (what I need to hit a blood level of 60ng/dL - everyone is different).

Looking out for your heart health,


Monday, December 7, 2009

To Nap, Siesta, Perchance to Sleep?

Time for a "Seinfeld" blog about next to nothing. Which is about how much sleep I got last night. Along with a bottle of 2007 Malbec I just bought, it got me daydreaming about the 2007 EPIC study that drew an association between napping and heart disease. I say association because nothing in the study proved napping causes a reduction in heart disease. The EPIC people (mostly cancer researchers) simply noted that people who napped had fewer coronary deaths. It could be they are just a more laid-back bunch!

Fortunately, the CARDIA study provides some hard data on sleep and calcium scores that supports a good night's sleep. For those who are Track Your Plaque Members the TYP Library provides the best heart disease reversal "Cliff Notes" on the issue (as it almost always does). Here is the link.

Sleep and the Track Your Plaque program:Does sleep quantity or quality cause plaque to grow?

That's all for today. Time for that nap!

Looking out for your heart health,


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