In late 2019 I inadvertently discovered I had a bifascicular block. The rate of progression for this disease is 1-4% annually. By the end of 2020 I showed a dramatic halting of the progression of this disease and by July 2021 I had definitive evidence that I had indeed not only halted the progression of my heart disease -but began to actually reverse it. I believe I have reversed it, but I want the evidence to be clearly overwhelming that this has occurred. If this trend holds by my 58th birthday I will be able to declare reversal.
I will present the results first and then discuss the history, treatment and results.
The Agatston Score was in part developed by cardiologist Dr. Arthur Agatston, author of the celebrated South Beach Diet. This Agatston Score is an automated score based on a CT Coronary Arterial Calcium (CAC) scan of one’s heart and it measures the hard plaques created by calcification or those plaques that had calcified. It generates risk factors based on an algorithm and this score predicts the likelihood of a heart event at some point in the future. A drawback to the test is that soft plaques remain undetected and sometimes provide a sense of security. The risk stratifications are these:
Grading of coronary artery disease (based on total calcium score)
- no evidence of CAD: 0 calcium score
- minimal: 1-10
- mild: 11-100
- moderate: 101-400
- severe: >400.
and here are my four scores since 2018:
To help alleviate any type of error I used the same 64 slice CT scanner at Ascension St. Joe’s Milwaukee Campus on Chambers Street. The reliability of this test is that it rarely produces any type of false positive, it is merely a picture of the actual calcified blockage in one’s heart. You can see then between March of 2020 and December of the same year I effectively halted the progression.
Halting progression is unheard of without intrusive interventions. The American College of Cardiology has this to say about hard plaque progression- it will advance by 20% annually . In particular “CAC progression is associated with a higher risk for myocardial infarction and all-cause mortality. CACS increase by about 20-25% per year and about 20% of subjects with a CACS = 0 progress to CACS >0 in 5 years and increases markedly with age, but less so in women. Analysis of CAC progression did not add benefit to risk prediction models based on the most recent CACS and most recent traditional risk factors. The best CHD prognosis is in patients with a CACS = 0 at baseline and 5 years later. ‘Double zero’ was associated with a 10-year risk of 1.4% followed by new-onset CAC at 5 years of 1.8%. A repeat scan after 5 years appears to be of additional value except for those with a double-zero or high risk because of a CACS >400. (Journal Scan author comment: Unless used to improve compliance with prevention measures, I don’t see value once the patient is considered at high enough risk to warrant maximal prevention therapy).”
I first heard of a CAC through the work of The Irish Heart Foundation and the potential usefulness of a CT scan through its documentary “The Widowmaker” Being someone concerned about heart disease as my Dad died at 57 and my paternal line all suffered debilitating heart disease and early mortality, I had stress tests rendered when I was in my 30s to create a baseline and to have any signals of progression. When I learned of a CAC and that I could find and pay for one for $49? Damn that’s cheap, sign me up. I had started Keto January 1st, 2017. A year in a thought I would be surprisingly good as Keto cures everything right? HA!! I scored a 76. Huh, not as good as I wanted but still, I thought I could improve this. However, my main focus had been fat loss and spinal repair. I did not place heart disease high on my list. This ignorance almost proved to be costly.
Houston, we have a problem…
As a reminder I have been Ketogenic since January 1, 2017. I have since reversed my osteoporosis from a –T1.9 to a +T1.7. I lost over an inch of height which I will never see again and I had 7 herniated disks, the worst was at L5-S1 10 x 10 x 12mm into my sciatica. A 2019 MRI scan showed all of these herniated disks were no more than bulges. A new disk may have ruptured recently but we will deal with that next week. An average day might look like this:
On December 26th I awoke to both arms being numb. As if I had slept wrong on them. I expected the tingling to fade but it did not. It was stubborn throughout the day. Pinched nerve? I had fallen the day before on Christmas and had a statue fall and hit my head. Cervical Issue? The 27th I called the Doc and panic ensued. “OMG STROKE get to the ER”. “ It’s not a stroke I demurred” but still I went. In the ER they could find no evidence of stroke and declared sudden onset carpal tunnel. However, my EKG did have a little hiccup. A wide array sinus issue. Technically a bifascicular block. This was confirmed two months later by the same cardiologist that read my ER scan, although this time he was far more threatening with his bluster:
Dr. B “YOU MUST BE ON STATINS”
To his credit my LDL was alarmingly high at 449 while Cholesterol was 550. Too much fasting. A month later LDL was back to 183 and Cholesterol was 220. I do not want to say these lipid markers are irrelevant however they must always be seen as a movie and he looked at it as a Polaroid. This would be like judging a movie by its Lobby Card.
Me: “Nah, I’m good”
Dr. B “You’re going to die”
Me: “As we all must”
Dr. B “This is not a joke…”
Me: “Doctor, what is a joke are the studies you cite as science which in fact are nothing more than opinion surveys based on the recollections of people about what they ate over the last year. I am an engineer who uses evidence to make my decisions on…”
Dr. B: “I USE EVIDENCE BASED SCIENCE “he says, loudly as if to cajole me into subservience.
Me: “and If I used evidence like yours to make airplanes 1 in 5 would fall out of the sky and you would be okay with it? You would not. Okay then, explain this study to me and I will consider statins” I said with a sneer and superior attitude while thinking Fuck you, you pretentious asshole.
The study of course was 136,000 people, a sampling size beyond statistical error that shows LDL to be a poor health marker for heart disease. Of course, the authors reached a different conclusion based on what they wanted, as viewed through their particular filters – as if the cognitive dissonance was too great for them to overcome. Still, I kept this Doc for three more months while I made inquiries into other doctors. In the meantime, I made him believe he could get me on a statin if he conducted some tests for me. One showed my ejection fraction was down to 45%. Damn, that is not good at all!! He is right about the trajectory of my mortality just not the why. I need to fix this!
I read exhaustively Dave Feldman and Siobahn Huggin’s The Cholesterol Code, I gobbled up Patrick Theut’s Vitamin K knowledge. I read through those that postulate that Atherosclerosis is advanced scurvy. I read through the American Heart Association’s ideas on ketones and the heart and the College of Cardiology. I also used to a great extent what I learned from Dr. Malcom Kendrick, as well as Dr. Nadir Ali.
It turns out that each case of heart disease is unique. There is not a one size fits all cause or solution. I didn’t think any given theory was therefore definitive. I also began to winnow out anything that had the low-fat mantra. I made a judgment call that low-fat had not helped millions and that my previous years on kept had created such great results, I should go deeper rather than become frightened by one outcome. If true and I then applied this reasoning as well as use some of the concepts from the researchers I used: Could I create harm in my body with everything I currently accept to be true. The answer generally was no, I could not. Plus I could continue to monitor my lipids, heartbeat, stress test, CAC scan etc. and continue to address my poor insulin resistance which is suspected as a driver of heart disease. On top of that I bought an AliveCor 6 to monitor my EKG. I was feeling pretty good about my choices.
I suppose most readers will want to know just how then I applied this information. I will get into that in my next post. However, I will leave you this post with my local cardiologist Dr. Peter Diamond response when I presented my nutrition as compiled in Cronometer, my supplements, training and results. Please keep in mind he is an advocate of a plant-based diet and in particular the so-called Mediterranean Diet. I also asked him to help interpret the increase in calcium burden in my left descending artery which I thought might be calcium floating about, this would be bad and He said:
Very interesting findings. It appears that you have been very fastidious with your diet and your supplements and that is a great compliment to you.
I find it very interesting that your total calcium burden in all 3 major coronary arteries is declining. I wonder if the significantly increased calcium in the left main coronary artery is actually within the aorta rather than the left main. Otherwise, this does not make sense because all of your other coronary artery calcium values have significantly or moderately decreased.
Continue your current protocol. It appears to be working quite well.
Have a blessed weekend.”
My soul heart SANG! “Continue your current protocol” In less than a years’ time I had compiled enough evidence for a cardiologist steeped in plant based nutrition to allow that keto might be helpful for one. AND if it is good for one it might be useful for two…and so on. This is how we change healthcare. One doctor at a time.
Next post: The Plan!