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In high risk Stroke patients, stents increase future strokes
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engineerguy posted:
Hi folks,


Is anyone having a heart attack or stroke RIGHT NOW? OK, no. Good. But if someone is having a heart attack or stroke right now, get to a hospital right away, because an interventional surgeon may be able to actually reverse the heart attack or stroke, and prevent permanent damage. They may do this by a stent or bypass surgery, in a modern medical miracle.


But, if you are concerned about a heart attack or stroke next month or next year, should you investigate having a stent or bypass now?
This study(1), concerning stroke, just now published in Lancet, and all other similar studies, say NO.


This study showed that stents actually increased future strokes, compared to medical therapy alone. Medical therapy is statins and other medications.


This study also points out that medical therapy is generally inadequate. The conditions gradually worsen and patients do not get well, using medicines. The first line of the abstract: "Given the historical inadequacy of medical therapy for symptomatic intracranial atherosclerosis, ..."


High risk patients that suffer recurrent strokes, were randomized to receive stent plus medical management, or medical management alone. 30 days later, 14.7% of the stent group had another stroke or died. 5.8% of the medical management group had a stroke or died.


But what about long term benefit? Some strokes were due to the stress of the procedure. Would the stent prevent future strokes, and provide a long term benefit?


After 3 years, 23% of the stent group, and 15% of the medical group had a stoke or died. The stent had no benefit for reducing future strokes, and actually increased future strokes.


So what to do? Pick the therapy that has the best results. The best therapy is the plant based diet. Continue medications as necessary, but work like heck to improve your health, by removing the problems that caused the poor health, and also do things that actually benefit health. As your health improves, work with your physician to get off your medications.


Best regards, EngineerGuy


(1) www.pubmed.com/24168957
Reply
 
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max9821 responded:
Thanks for the good news about stents. It brightened my day. You also left out that within 90 days of stopping plavix which is always prescribed after stent placement, a certain percentage of people will have an MI. Also that with stents, especially drug eleuting stents, there is a chance of late stent thrombosis seven years down the line.

Of course, in addition to what might be an in built problem with the stents themselves, we also have to consider that hardly anyone uses a plant no fat diet after surgery. The cardiac rehab teachers do not recommend it but stick instead with cut the skin off the chicken, drink skim milk, eat three eggs per week and limit that butter that you are slathering on your white bread type of advice. So do we know if the problems with stents are from the stents alone, from the diet or from a combination. We do know that the arteries of by pass patients often clog up. They are also in the same rehab classes as the stent patients. Not a single person in my rehab group was willing to give up meat, fats and eggs.

dolores
 
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engineerguy replied to max9821's response:
Hi Dolores,


Always fascinating and thought provoking insights. Thanks.


Re: " Not a single person in my rehab group was willing to give up meat, fats and eggs."


I just have to think that the doctors, nurses and patients just are not informed of the alternatives (Fuhrman diet or similar).


Re: " So do we know if the problems with stents are from the stents alone, from the diet or from a combination."


Good news, Dolores. In the first 30 days after a stent, the stent group had roughly 9% more strokes than the non-stent medical treatment only group. 3 years later, the stent group was still roughly 9% ahead of the medical treatment group. In other words, if you get past 30 days, the remaining problems are about the same, between the stent group and medical treatment only group. So, you made it past 30 days. You are home free.


You can be confident that your efforts to improve your health are paying off abundantly. You lost 30 pounds, and that was certainly no accident. That is very beneficial.


The heart attacks and strokes come with our rich western diet and lifestyle, and reverting to a natural lifestyle (Fuhrman diet or similar) reverses heart disease, diabetes, hypertension, etc.


My point is that we can be confident that the problems with stents, after the first 30 days, are due to the combination with the diet. I believe this, because the stroke risk, after the first 30 days onward, is similar between the stent group and medical treatment only group. There would be very few or no strokes in the medical care group, on a truly excellent lifestyle. We know this from Esselstyn's study, where 18 very ill heart patients, 5 of whom were given less than a year to live by their cardiologists, and had no cardiac events for 22 years later. They had 48 cardiac events in the 8 years prior to the Esselstyn diet.


So, this is a list of things that I believe are important, based on Fuhrman (especially), Esselstyn, Ornish, Pritikin, McDougall, Barnard, Amen, etc. How much anybody incorporates into their lifestyle, is a personal decision.


Be diligent to have no salt, except the salt naturally present in eating lots of veggies, beans. I am speculating that salt can increase clotting of blood, among many other issues.


Plenty of sleep.


Be very lean. Pinch 1/2 to 3/4 inch for guys. 1 inch for women. Some people are very sensitive to belly fat (including me), such that 5 extra pounds can promote diabetes and other problems.


The salad is the main meal.


Eat 2 or 3 meals daily. For 30 years, I practiced eating 6 meals and snacks daily, per Pritikin beliefs. I finally understood Fuhrman when he said that diabetics concerned with diabetic neuropathy, should eat 2 meals a day. It is very healthy for the body to be drawing from it's reserves, instead of constantly drawing from food continuously digesting. This is contrary to common belief, I realize. Read Dr Fuhrman's book Eating and Fasting for Health. It was all news to me.


Do not eat for several hours before going to bed. Drink only water. This is very healthy. Digesting food while sleeping, maximizes the high blood glucose damage to the body.


Eat only vegetables, fruit, beans, nuts & seeds, and whole grains. Minimize meat, fish poultry, dairy, oils, processed foods. After a while it is wonderfully delicious. Eat a wide variety, but emphasize some super foods.


Exercise daily.


Best regards, EngineerGuy (Stacy)
 
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engineerguy replied to engineerguy's response:
Hi Dolores,


Oh, and interesting comment on the placebo discussion.


thx
 
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max9821 replied to engineerguy's response:
no salt from the salt shaker but do use tobasco or chipotle hot sauce on everything except salads and even then I use honey mustard in the dressing which does have some sodium. Really having a hard time giving up all salt. Tobasco has about 35 mgs sodium per tsp and chipotle sauce about 130. I even use tobasco on my breakfast oatmeal because I eat it with spinach and trader joe's tomato sauce diluted with very low salt crushed tomatoes.

I have actually found that if I eat a bit of starch late in the evening my morning sugars are lower than if I do not. I think the reason for this is that not eating late or having a big salad as my last meal causes such low blood sugar during the night that the liver pours out sugar to raise it in the blood.

I have also read that you are in ketosis after a long night of fasting. Is this true? Is it good?

dolores
 
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engineerguy replied to max9821's response:
Hi Dolores,


No question about it, that salt can be hard to give up. It takes time, but tastes do change. Most people take one week to start to appreciate food without added salt, but some take months. It's just individual variation. Blue cheese dressing and bacon used to be favorites for me. After years of no added salt, it was a shock to me that blue cheese dressing and bacon are bitter to me, and distasteful.


My only message here, is that there is hope, and just be patient. You could try jalepeno peppers or ceyenne pepper or chipotle pepper flakes. We both know it will not taste as good at first. LOL. I do still like lightly salted chips, fries, cheese, etc, but only when I am cheating.


Salt contributes to many many problems(1).


The book Eat Right Electrolyte, made a large point that salt contributes to macular degeneration and diabetic retinopathy, and circulation in general. The Kempner Rice diet folks, were emphatic that low sodium was essential, for their patients who were successful in reversing diabetic retinopathy. The Kempner rice diet had a 50% success rate for diabetics with retionopathy.


In another study(2), in women with well-preserved kidney function, higher dietary sodium intake was associated with greater age related kidney function decline, as measured by GFR(3), which is consistent with experimental animal data that high sodium intake promotes progressive kidney decline." Studies also show, that in older age, it is valuable to have healthy kidneys (that's a poor joke).


It is very worthwhile to cut salt to healthful low levels. If I made the rules, it would not be so.


Re: "I have actually found that if I eat a bit of starch late in the evening my morning sugars are lower than if I do not. I think the reason for this is that not eating late or having a big salad as my last meal causes such low blood sugar during the night that the liver pours out sugar to raise it in the blood."


How much does the blood sugar raise, if you do not have a bit of starch late at night? May I return to this later?

We see a contradiction of ideas here.


The body works best when we eat food, digest it, secrete a bit of insulin to help the muscles and liver to store blood glucose as glycogen. Then, between meals, the body draws on the stored glycogen.


An opposing idea: Diabetic medical treatment is today based on the idea of digesting continuously, with a continuous level of glucose being produced by digestion, with a continuous low level of insulin required to absorb the blood glucose into the body cells. Conspicuous by its absence, is the time when we draw on our stored glycogen reserves, and also the time when we store glycogen to replenish the glycogen reserves. Insulin is a hormone that stimulates the appetite, stimulates saving glucose as fat, and promotes inflammation. Many physicians feel that a diabetic goes onto a downward spiral, when they get placed on insulin, because the insulin promotes appetite and fat storage, the diabetic gains weight, and gets worse.


There is some new diabetes drug that attempts to inhibit the liver from outputting glucose. This seems like a mistake.


Fuhrman advocates 2 meals a day, for diabetics concerned about diabetic neuropathy. Fuhrman advocates getting hungry between meals, for everyone. I eat 2 (or 3) meals a day on weekends, because I believe that is healthy for everyone. I ate 6 meals daily for 31 years (Pritikin and my 1st yr of Fuhrman), and 2 or 3 meals for 5 years. I believe fewer meals is very healthy.


Pritikin advocated 6 meals a day, and was / is very successful with diabetics.


So, how do we evaluate between these competing theories? We can discuss this for a while.


Have you read "Eating and Fasting for Health"? (For those reading, diabetics taking diabetic medication, should not fast.)


Have you read "The End Of Diabetes"?


(continued...)
 
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engineerguy replied to engineerguy's response:
continued...


Hey, I know it is not easy to have a fully healthy lifestyle. Get lots of sleep. Exercise every day. Eat lots of veggies, fruit, beans, whole grains. Eat nuts & seeds, limiting to 1 oz, if weight loss is a concern. Greatly limit meat, fish, poultry, dairy, salt, processed foods. Be very lean. At the navel, pinch 3/4 inch for guys, 1 inch for ladies. Stress reduction.


If it is of any consolation, all of our difficulties in having a healthy lifestyle, are due to our modern society. If we lived in a "native" or "primitive" society, all of these things would be completely easy and natural, and would be the only way people knew. The only difficulties would be food availability.


An exception would be that societies on the sea shore, would probably have lots of sea food available. Some societies would have lots of meat available, sometimes, such as the plains Indians, when they had a buffalo kill. The Masai had lots of meat and cholesterol available, but they also had lots of atherosclerosis, even in their native environment.


So, I am surmising that lower blood glucose in the morning with a bit of starch late at night, will correct itself over time.


Re: "is it normal to go into ketosis after a long night fast?" (paraphrased)


We go into ketosis typically after 2 or 3 days of fasting. So, ketosis after one night of fasting, might happen for a person who practices 6 meals daily, for continuous digestion. Continuous digestion is not healthy, as Fuhrman has well supported.


Best regards, EngineerGuy

(1) http://www.drfuhrman.com/faq/question.aspx?sid=16&qindex=1


(2) www.pubmed.com/20299364


(3) "Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney." http://en.wikipedia.org/wiki/Glomerular_filtration_rate
 
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deadmanwalking57 responded:
EG:

A majority of patients believe stents and bypass surgery allow them to NOT need to improve their lifestyle, and the surgery works miracles throughout their body. They do not want to believe it is simply a plumbing patch that MUST be matched by a change in diet and lifestyle.

That is why my surgical cardiologist gave me almost no chance to make it even two years after bypass surgery. But I was an ideal patient, taking all my meds and recommended supplements EVERY day, and taking exercise rehab very seriously. Plus doing extended research to find what foods are truly beneficial for heart disease, not just what is in popular sources. Plus I believe I found the entire sequence of events that occurs with development of blockages that lead to heart attacks and death. I have yet to see it all listed in one article or book, unless I wrote it on one of these posts. Which I know I have done in the past.

I am as fit, or better, than I was 30 years ago. I am 61 now. As mentioned in the post on pomegranates, I can play volleyball hours and hours with people half my age. I scull a heavy boat for the workout. I can ignore hot weather because I eat a diet high in potassium.

A key to exercise is to use a heart rate monitor so you know when the heart starts to beat harder and faster to compensate for the heart tiring, and that is time to slow down in that workout, not push harder. That is a key to avoid fatigue.

Most people try to do too much too soon, and declare exercise to be not possible for them. When with patience and a graduated step plan, they could take their fitness to almost any level they want, as I have.

People don't have more strokes and heart attacks because of stents and bypass surgery. They have more strokes and heart attacks because of hubris that a plumbing patch makes them immune to other required changes they have to make in diet, exercise and lifestyle.

My doctor thought I could not do what I have done even if I tried. But I was smart enough, wise enough, and patient enough to take his prognosis seriously, do extended research, and apply everything I found to my diet, my nutrition, my lifestyle, my exercise rehabilitation.

The "magic bullet" to recover from arterial disease, is the idea that change is mandatory.

When asked my prognosis after bypass surgery, my doctor looked at me as if I was an idiot. He politely did not laugh. He said nothing, just dumbfounded that I thought I had a prognosis, that there even was a chance. He thought I had forgotten I had a dozen additional inoperable blockages. He believed I had a death sentence. He believed I would deteriorate, develop heart failure, and be dead with nothing anyone could do about it. He warned of the heart failure. I was checked every two weeks for six months as they expected it to develop, but it never has.

My bypass surgery was January 13th, 2006. A Friday.

You and I both are proof what what a person can do to recover from serious arterial disease.

If people want to believe what they read on the internet, they need to know what is fact and what is fiction. Fiction says everything is easy. Facts show the way. Some of us follow what we learn from the facts we can discern.
 
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engineerguy replied to deadmanwalking57's response:
For those reading, anyone concerned with heart disease, should read DMW's post.


Hi DMW,


Thanks very much for an inspiring post. Also, referring to another post, I'm excited to check out nutmeg for gas. And I'll check out rinsing beans several times.


Best regards, EngineerGuy (Stacy)
 
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jc3737 replied to engineerguy's response:
I always rinse beans but it does not help with gas.Will try beano and nutmeg.
 
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max9821 replied to jc3737's response:
what do you mean you rinse beans? If you are cooking them from scratch you should soak them overnight. Then throw out the soaking water and then rinse them off.

dolores
 
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jc3737 replied to max9821's response:
I soak for 24 hrs,throw out water, then rinse.

But I have to limit beans due to digestive issues.(now i'm down to 1/2 cup a day)

Beano did not help.
 
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engineerguy replied to jc3737's response:
Hi jc,


Thanks for checking out the Beano.


Why don't you check out the leaky gut test? You are absolutely correct to find the digestive issue involved. It's important.


Best regards, EngineerGuy (Stacy)
 
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jc3737 replied to engineerguy's response:
I guess I have found a solution of a sort....I stay away from(or limit) foods that give me a problem and there is no GERD.

Beans in large amounts give me a problem,so does wheat and even brown rice.....and sugar is the absolute worst...i can not tolerate sugar at all.
 
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engineerguy replied to jc3737's response:
Hi jc,

I'm not suggesting you to try an ilial bypass. I'm suggesting you try a leaky gut test.

Sugar does feed some bad guy type gut bacteria. Or, it could be much more simple, that sugar feeds bacteria feeding on beans, and sugar increases gas and perhaps discomfort from beans. Or not. Just guessing.

The test is harmless and cheap. The treatment is harmless and cheap and potentially life changing. Sounds like a winner. At the least, it can rule out leaky gut.


Here are notes from the video.


Leaky Gut

http://doctorklaper.com/videos/curing-leaky-gut-syndrome/

This 8 min video is especially great, because it tells of a safe inexpensive way to test for leaky gut, and a safe inexpensive way to likely cure it if you have it.

To recap the video: If you have leaky gut,
eliminate alcohol, wheat, dairy and sugary foods and unnecessary antibiotics for 6 weeks.
Take these 3 supplements:
Quercitin 1000mg twice daily for 6 weeks
Glutamine 1000mg twice daily for 6 weeks
Probiotics

Lactobacillus acidophilus: General GI support; Prevents pathogen growth; Decrease URI in children (Upper Respiratory Infection);
Reduce UTI in women (Urinary Tract Infection)

Stacy adds: Eat a cup of beans daily, or work towards a cup of beans. Beneficial bacteria help digest beans, and make short chain fatty acids in the intestine. The short chain fatty acids help nourish the lining of the intestine.


One way leaky gut can be created, is by use of antibiotics, which may kill off beneficial bacteria, and the patient may eat a large amounts sugary food, which may cause harmful bacteria to thrive and perhaps attack the intestinal wall.

The leaky gut test includes lactulose and mannitol, which are harmless carbohydrates. Lactulose is not absorbed, and mannitol is absorbed. Urine is collected, and analyzed for the ratio of the two carbs.


An earlier explanation of leaky gut, also with good info:
(When Dr. Klaper wrote this, he was not aware of the leaky gut test. Note how helpful the test is!)

http://doctorklaper.com/answers/answers07/


Here is are links (from April 2014), which show that Dr. Klaper's information has not become mainstream medical information yet. (Comment: And who would have a financial incentive to advertise information about the test, and inexpensive cure for leaky gut?)

http://www.webmd.com/digestive-disorders/features/leaky-gut-syndrome
http://www.doctoroz.com/videos/could-leaky-gut-be-troubling-you


Best regards, EngineerGuy (Stacy)


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