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    A funny thing happened
    DoloresTeresa posted:
    A funny thing happened on the way to the rest of my life. On the morning of Friday the thirteenth at about 5 am, I had a heart attack. I was already in the ER because I had back pain all week which got worse when I ate so at 10:30 the night before I had my daughter drive me to the ER. At first the doc thought it was gastrointestinal and the heart enzymes were normal. After four hours the heart enzymes were not normal and they recommended an immediate stent. Of course I refused. People make mistakes in labs and I insisted they take more blood and redo the tests. Besides, except for a few indulgences I eat right. Right? Before any tests came back I passed out, went into v fib and that is the last I remember until I woke up after chest compression and the use of the defibrillator. This time when they wanted to use a stent I said yes. Believe me I do not know if I did the right thing to agree. They did not offer me a stalk of broccoli instead.

    On Easter, I indulged in ham and I eat fish and clams a couple of times a week. I do not think that the 100% blockage they stented happened over night. Another artery was also 100% blocked but that one had built collaterals. Yet another artery was 50% blocked and another between 60 and 70 % blocked.

    Diabetics frequently die of heart disease. But I was lulled into complacency because my blood sugars were pretty good after 20 years and on no meds--just diet and exercise. I had an HbA1c of 5.4. Of course now I am determined to get it lower. Cholesterol was 166, LDL 103 and triglycerides 88. Eating as much fruit and starches as I do I was surprised at the trigs. A couple of my doctors assumed I was only borderline diabetic. No.

    OK guys. Now what? Strictly eliminate all animal food? I was already not eating dairy, fats or oils (do we count the occasions at my daughter's when I help myself to the snack foods she always has around?)
    Esselstyn says moderation kills. It almost did with me. Or do I take a closer look at H's diet and give up rice, potatoes, a diet of mostly vegetables, fruits, beans and use a stick of butter on the few vegetables I would eat and eat the end of the roast beef with mostly fat? The doctors did not talk at all about diet and gave me a booklet with what looks to me like a version of the standard american diet. Neither H nor EG would follow such a diet. This is America. We take pills.

    As you can see this is not merely an academic problem for me and I cannot afford to speculate. Because here I am--someone whose drug use amounted to maybe 10 tylenol in the last couple of years, stuck with taking plavix, aspirin, pravachol, lisinopril and metropolol. I am afraid to be non compliant which is my inclination. So I am now subject to all the stupid side effects of these drugs. So much for courteous debate. What do I do?

    P.S. The only pain I suffer now is from the chest compression. Evidently it is not done in real life the way you see it in the movies. They have to make sure the chest compresses 2 and a half inches down. I am going to get a medic alert bracelet that reads--start with the paddles.
    jc3737 responded:
    I am very sorry to hear this and I wish you a speedy recovery.

    In 1989 my father in law had a heart attack and had triple by pass surgery.Since then he has had one stent put in after a second heart attack last year.He takes medication and still eats a horrible diet with ice cream and chips every day but is still here at age 87.The point being there are many ways to survive many decades after a heart attack.

    Answers,What do you do now?You and I both follow Fuhrman/McDougall closely and your diet is what I would call excellent so I don't know what to advise,but I would look beyond the vegan approach of McDougall perhaps to some of the recommendations of cardiologists like Dr Sinatra who rely on supplements like CoQ10 and D Ribose.Whatever you decide it can't hurt to look.

    Keep us posted on the steps you take and the ideas you have.I wish you the very best. JC
    jc3737 replied to jc3737's response:
    I just re-read some of Dr Sinatra's book and have a few questions.....I'm hoping we can track down what went wrong or at least get some clues.

    What was your reading for fasting insulin level on your last blood test?

    What was your last your last hs CRP reading?(C reactive protein...measue of inflammation).

    What supplements do you take...everything?

    Have you had any tests done such as IMT thickness or a calcium score done by scan?Was it a 16 or 64 slice scan?
    DoloresTeresa replied to jc3737's response:
    I have had none of those tests done and no one ordered them at the hospital. However, the kitchen was aware I am diabetic and insisted on my increasing carbs. So to make the kitchen happy I ordered an extra potato. The practice I will go to is not the least interested in diet and uses the standard handout. I take no supplements because the latest seems to be (from McDougall) that except for B12 you do not need them. Essy always prescribes certain vitamins for his patients: a multi, B12, calcium, D3, flaxseed for omega threes, cholesterol lowering drugs.

    I have to go in one week for a Holter monitor and in two weeks for blood work. After that I intend to see as little of these guys as possible. There are about thirty guys in the practice and I refuse to see people who will never get to know me. I foresee arguments.

    jc3737 replied to DoloresTeresa's response:
    Don't hesitate to see what the guys on the McDougall board have to say.Likely they will point to the fish you have twice a week as the culprit but that seems unlikley to me.You don't have much of it and most data says its helpful in cardio health.But there are some well informed posters on that board,that may have some ideas about what went wrong.I'll start to monitor it daily if you post there.

    You might want to tell your doctor you want some complete bloodwork that looks at everything.The two books mentioned below will give the specific types of tests you will need and what to do to correct problems,and supplements that are helpful.

    I recommend you get several books ASAP:Track Your Plaque by William Davis

    Reverse Heart Disease Now by Stephen T Sinatra

    Those two will cost you about $30(Amazon) and will give you another look at how those two cardiologists treat heart disease.

    Can you go over your typical daily and weekly die?.Someone here(or on the McDougall board) may be able to pick up some clues that may be helpful in solving the mystery.Be thorough and Include everything.I'm sure Heretic will jump in also.

    Copy and paste your posts so you can post here and on McDougall.

    heretk replied to DoloresTeresa's response:
    I am sorry to hear of your ER ordeal. My first reaction when I read your story was that a half of your forum friends would probably think that you ate too much meat and fish, while the other half would probably think you ate too much plants and starches. I suggest to ignore both camps. I agree with JC that fasting insulin test would be very useful to know, because a high insulin level (hyperinsulinemia) is an independent heart risk factor. Independent on the high glucose (which you did not have).

    I am sending my healing energy and positive thoughts to you.
    jc3737 replied to jc3737's response:
    Here are some of the tests recommended by Dr Davis:
    LDL particle number
    LDL,HDL,VLDL,and IDL particle size profiles
    Lipoprotein (a)
    C-reactive protein (high sensitive)
    fasting insulin

    Supplements recommended:
    fish oil....(if taking blood thinners you may have to skip the fish oil)
    raw almonds
    raw walnuts
    L carnitine
    vit D3
    sunflower seeds
    soy protein
    oat bran
    L carnitine
    DoloresTeresa replied to jc3737's response:
    Many thanks to all for your good wishes and advice. My heart is sinking though, at the thought of dealing with the cardiology group. There are twenty or thirty doctors listed on the card they gave me, I didn't see the same person twice when in the hospital, I have no idea who I will see at my first appointment. I have an appointment for a blood test in two weeks and do not know if anyone will listen to any requests I might make. No nurse or doctor in the hospital thought that any diet makes any difference and the solution is in the "five pack" of drugs I must take.

    In the book, "Eat to Live", Dr. Fuhrman says for diabetics to eat fish twice a week. I think if I contact Dr. Esselstyn he would say to NOT eat any fish at all--look where it got me--and Dr. McDougall would say no fish. All these guys recommend one or another non standardized, non regulated supplement, especially B12 and Fuhrman and Esselstyn recommend D. Some recommend flaxseed instead of fish oil.

    I am going to try to get the suggested blood tests above. Possibly another long, frustrating argument with the strangers who are in charge of my life at the moment. But you guys are the best. You are helping me keep my head above the water.

    jc3737 replied to DoloresTeresa's response:
    Don't hesitate to stand up to them and tell them you are in charge of your life and you are hiring them to help out,not to become dictators.Tell them about different approaches... Dr Essee....Forks Over Knives,Dr William Davis,and Dr Stephen Sinatra.

    Don't let them bully you.You can let them know whose in charge while still remaining polite.

    But insist on what you want done in the way of tests.

    In the end,after you gather information from various sources, your own intuition will guide you to the best cource of action for you.
    heretk replied to DoloresTeresa's response:
    Dolores, how would you quantify your diet, I presume it would be incorrect to call it only 75% plant based with fish?

    If you ate fish twice a week as I remember reading from your posts, lets say 6oz salmon portions each time, that would make it about 70g protein per week ( 280kcal/week) and 70g fat ( 630kcal/week). Then the fish would add 910kcal/week)

    Assuming your daily caloric intake was probably around 2000kcal (14000kcal/week). Thus eating fish added about 6.5% extra calories of animal origin. Therefore your diet would be considered 93% vegan compliant and still very low fat?

    jc3737 replied to heretk's response:
    By the wat Dr W Davis "Track your Plaque" advocates a mostly plant based diet....he is not low carb at all.The emphasis of his program is mostly in the supplements like vit D3 and K2, flax seed,almonds and some others geared to reducing the size of the LDL particles.

    But he is not nearly as strict as McDougall/Fuhrman about his plant based approach and advocates some animal products.

    Diet is not as big a factor with him as it is with some others.He claims some great results as do some others like Fuhrman and McDougall.

    I often wonder if the vegan diets are really just successful due totally to weight loss and the rest is just honest people fooling themselves.

    Steamed vegetables,beans,lettuce,brown rice,flax,potatoes,a few almonds make up my daily diet.Once per week I have a a small piece of grass fed beef about the size of a half dollar.(for some natural iron and B-12)I eat less meat than 99% of the rural Chineese.

    In other words I eat a more compliant McDougall/Fuhrman diet than 99.99% of the McDougall group.The only difference between me and them is that I constantly question what I am doing and I am always looking at contrary data.

    Despite many doubts I plan to maintain my present diet but I am going to keep up some supplementation of D3 and K2,flax and almonds.
    DoloresTeresa replied to jc3737's response:
    H, I do not eat very much fish. I put a can of drained and washed off minced clams in about 13 quarts of vegetable soup. It takes me four or five days to eat it all. A can is about 2.5 ounces of clams. I eat a small can of salmon and divide it into about 6 one ounce portions. Sometimes I eat one ounce per day and sometimes two and some days I skip it all together.

    About once or twice a week I babysit at my daughter's and lots of times I help myself to the chips or cheese she has there but lately I have been resisting it. I did not get sick overnight and I do not think I will get well overnight.

    JC, Esselstyn recommends B12, D3, calcium, multivitamins and omega 3 fatty acids in the form of flaxseed along with cholesterol lowering drugs.

    Essy cites a study in the New England Journal of Medicine in which huge doses of statins reduced cholesterol below 150 but the diets never changed and one out of four experienced a new cardiovascular event or died withing 30 months.

    The only reservation I have with McDougall's starch based diet is the fact that all the cultures he studied that use starch as the basis if the diet are societies in which people engage in very heavy exercise. If you are out plowing fields or planting rice or walking nine miles a day while herding sheep through the mountains of
    Sardinia, you are unlikely to spike blood sugars as you would if your exercise consists of a long walk and/or an hour at the gym each day. Even the Chinese office workers more likely than not biked back and forth to work (as does my son in law who bikes six miles each way to work each day.) And the first generation farm workers that McDougall treated were much more active than their grandchildren and great grandchildren so one has to wonder about their health even if they had continued to eat the traditional diet but did not engage in farm labor.

    jc3737 replied to DoloresTeresa's response:
    Maybe a very strict Fuhrman diet might be the way to go????

    More vegetables,less starch??
    heretk replied to jc3737's response:
    I don't know, nor I think does he. He thinks he knows and forms his opinions to the public with what appears to be 100% certainty. He has no other choice if he wants to sell his program and make people pay him. The same applies to McDougall, he is not a charity either.

    To really know as opposed to appearing to "know", he would have to try out several approaches and document each one. Until Fuhrman tries out at least a high fat low protein low carb diet on himself, beyond his own vegan diet, then I will continue treat Fuhrman's views less seriously then he perhaps deserves. His choice.

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