This could all be in my head...

Since my last series of catch ups with The Doc and The Cardiologist we have decided I should be taking a full dose of my statins, Vytorin. That's an 80mg dose. And since then my motivation to run, exercise etc has been at an all time low. There are some reports that the side effects of statins can range from nausea to fatigue and so I'm wondering if that is the case here or ... It's just in my head.

There is some substance to this. For the past couple of years I have been taking a half dose of the prescription (40mg) and been doing fairly well in the excise/weight regime. Occasionally hitting under 80kg (target is 78kg) and hovering around the 82kg mark. Currently 85.5kg.

Until recently I was running home from work at a pace of 10kph. However, just thinking about that now makes me tired.

We've been waking up fairly naturally (if you count the alarm of our greyhound whimpering) around 4:30am and the obvious thought pops into my head: turn the coffee machine on and head out for a run/walk. Aaaand, back into bed I go.

So, what's a guy to do. As we head into the Christmas season there will be food, alcohol and watching cricket in the couch. I'm also due for another blood test!

It may all be in my head but is there just the slightest chance these statins, designed to lower my cholesterol levels, are also lowering my desire for exercise?

Daily Stats - Day 2

Certainly an improvement but let's not get ahead of ourselves. 

Weight: 84.7 (-0.4) 

Fat%: 19.8 (-0.1) 

Steps: 5802 (10,000) 

Cinnamon: 6g (please read the Case for Cinnamon here) 

im not getting excited because I think the previous day was an aberration. A little on the high side of normal.  The key to this is the longer term trend.  

Tonight I am planning to run home or at least run for an hour and see how far I get. Either way it's exercise and will bump up the daily steps beyond the 10,000 target.

Daily stats - Day 1

Thought I'd start putting some stats in here to track my progress. No miracles here. Plenty of failure to come. 

The interesting part will be: will the outside be reflected on the inside? That is, will weight loss and diet affect blood and cholesterol readings?  

13/10/14 (goals in brackets)

Weight: 85.1 (78) 109%

Fat: 19.9 (15) 132%

Steps: 6,244 (10,000) 

Stress: more than its cracked up to be?

"I have spent most of my life worrying about things that have never happened" 

- Mark Twain

While a lot of this blog is about the medical/diet/exercise side of Cardiovascular Disease (CVD) there is some research that suggests that stress may be a significant cause as well. As I have said in a previous post it perhaps isn't just the stress that is the issue but how the body reacts to it.

I remember my mum saying that dad used to get so stressed about work that he'd vomit. But to this day dad is alive and well with little to no CVD. He has other issues at 87 but CVD isn't one of them.

And that isn't to say a little stress is harmful.

There are two types of stress: distress, the bad stuff, and eustress, the better stuff.

We understand being "in distress" and it's not pleasant. The odd times of stress, like the occasional unhealthy meal, probably does little to affect one's health. But ongoing chronic stress may have troubling effects on the cardiovascular system.  

In his book, "The Great Cholesterol Con", Dr Malcolm Kendrick signs off with a chapter on stress and its negative effects on the heart. It's an interesting read and definitely food for thought. Perhaps more particularly when it is not acknowledged in the day to day medical world. And what I mean by that is, when I mentioned it to my GP and it's pretty much dismissed out of hand. Perhaps it's just not in the mind of GPs when statins can so easily lower your cholesterol levels.

It's probably also something GP cannot treat. Stress, to my way of thinking, is just that, your way of thinking. And if we can learn to think about issues differently, perhaps we may be able to manage the stress better. And by reducing it, positively affect one of the causes of CVD.

AFL Grand Final Day

The Australian Rules Grand Final is like the USA Superbowl, just a lot smaller in scale. It's the final of the season of Australia's version of football. And it's not always easy to understand if you haven't seen it before. Even yesterday's game between the Sydney Swans and Hawthorn showed at times that the umpires didn't understand the game! ;) (thats because the team we followed, Sydney, lost.)

Truth be told Hawthorn played brilliantly and Sydney probably had their worst game in a couple of years. Hawthorn monstered them, were quicker and, when Will Langford kicked a goal from the sideline - what we call the "impossible angle" - you realised it was just Hawthorn's day.

And, like many major events, diet took a back seat. 

Sausage rolls, meat pies (pepper steak meat pies) and beer! All pretty bad for you and in copious amounts doubly so. (Note: the beer listed here comes from the oldest brewery in the world, Weihenstephan, founded in 1040!)

We decided to have a drinking game. You pick a player from each side and each time they get the ball - drink! It lasted the first half. Sydney were so far behind the fun had gone out of it.

These "rare" days where diet is not of the highest quality is not such an issue.

Mark Sisson takes a view of 80% Primal. Try for 100% but be satisfied with 80%.

Even Tim Ferris in his book the 4 Hour Body allows a day of 100% carb. So much so that you immediately regret it and reform for the next six days! He goes on to say that after such a large intake of carbohydrates it's common to lose them in the next 48 hours.

My weight as of this morning was 84.3 kg. We'll check in again Tuesday morning! :)

So the odd days of "rubbish" food isn't going to kill me. (The reverse might!)

The Run Home

Part of managing high cholesterol and cardiovascular disease is exercise. The more you move the better chances you have of not having an "episode". There are no guarantees of course. 

However, I have this mantra that goes like this: "I don't love running but I do love having run." 

And so I run. Not as often as I might but at least once a week.

Last night, Wednesday was the day. I've decided on the run  home, I run for an hour and see how far I get. I'm doing okay so far. Around 10km in the hour and I know that if I compete in a race I'll go faster than that. Race pace always seems to be better than training pace. Well, for me at least. And, having said that, it's not all about the speed, that's just a personal goal I have. More on that in another post.

The point about moving though is important. Mark Sisson wrote about it here. When I run I like to build up my pace, but you don't have to. 

I am also trying to do more weights for the upper body. It's also useful to addd weights to your regime. I'm not talking about a 45 minute session. That would do my head in. But doing some weight work will help in running and overall health. Partly to look better naked but also to improve my running. Having a flabby upper body means my legs have to carry that crap around. If my upper body is in good shape, it can contribute to the run a whole lot more effectively. So I get to enjoy the run more, maybe go at a quicker pace and that releases the endorphins.

The run itself is not that spectacular. It's a run from the city (Perth) along the arterial road to my home. There's traffic, peak hour as I'm running after work, the occasional traffic lights and divergent roads all with different rules of use. So you kinda got to have your wits about you when crossing. So far so good. I'm still here! 😜 

If you are not a natural runner, I can understand why this may not (doesn't) interest you. However, I have to say I'm not so sure I'm a natural runner either.  As I said above, it's not that I love running. I do like having run. Maybe it's the endorphins. I actually started on the advice from a frowned of mine who said, just run between light poles, then walk. That;s how I started. I remember coming back from a run then and saying to the FBH (Far Better Half) I ran two light poles! That's about 200m! Maybe not even that. Now I run 10km.

Cardiology follow up

Appointment: 22 September, 8:00am. Mount Heart Care.

The days starts awkwardly when the bus driver takes a wrong turn. Driving to the next roundabout she fixes the route. We're back on track but I am anxious be on time for my appointment. Five minutes later the bus stalls at a stop. She restarts it but not all is well. The bus starts to go at a crawl. I think it is the traffic but it's the bus. It's dead. We have to get off. I look at my watch and I know I'm going to be late. 

We eventually get into town at 8:00. The time of my appointment. The hospital is about 15 minutes at a very brisk walk. Well at least that will be good for my heart!

I call to let them know I'll be late. I arrive at 8:15. It appears the appointment booked after me has been bumped ahead of me. That's fine. A chance to catch my breath.

Eventually at 8:45 I get in to see the doc. 

The stress test was a success. I "broke" the machine and pushed my body hard enough to test the arteries. Even with my calcium score of 2234, there was no adverse effect on my blood flow in my arteries. So basically, little to no blockage.

After the initial shock of such a high calcium score, the stress test has relieved the pressure a little.  The doc says the calcium score is a "surrogate" measure and not as critical as it might seem. Would have been good to know that going in to the test. 

The key measure is still my cholesterol levels. With familial hypercholesterolaemia (FH) I need to get my LDL down to 1.8 or below. Normally this would be around 5.0 for someone without the family history. Ah, mum!

The regime from here? 

I'd been taking half doses of my statins. So they go up to full dose. The doc is content with this, as even with a half dose I've got the numbers down to 3.8. We're confident the 1.8 goal is achievable on the higher dose.

Keep taking the aspirin. Keep exercising - 10km run in 60 mins later tonight.

In addition, maybe the red wine needs to take a bit of a back seat as well. The sugar hit probably isn't helping. 

And then there is the cinnamon which I'm having on my breakfast. Meant to be good in lowering LDL and raising sensitivity of insulin. Both of which would be handy.

Another update next week. 


Why 2234?

I'll start near the end, the day I received my calcium score results.

The calcium score test was to ascertain the level/amount of calcium in my arteries. It came from a conversation with my cardiologist. I was seeing him because I was having challenges with my cholesterol scores. If I didn't take my statins, the score would shoot up to "impressive" levels. If I did take my statins it seemed to come under control.

However, I didn't want to be held to ransom by these medications and wanted to be off them as soon as I could. I had begun reading a lot about how people were flushing their statins down the toilet and I wanted to be one of those people. 

My reasoning with the Cardiologist was this: Yes, I have high cholesterol scores. But what if this has not led to any inflammation in the arteries? Perhaps it was just a number we were getting excited about and there wasn't the reflection of this excitement where it mattered most: in my arteries. Were my arteries slowly being blocked or was there some possibility this wasn't the case?

My cardiologist agreed. Let's do a calcium score test and find out?

So I duly completed the test. It took all of 5 minutes and cost $250 (cough!)

I then followed up with my GP who opened up the test results. I was pretty happy when I saw the scale:

0 - no identifiable atherosclerotic plaque. Annual chance of cardiac event less than 0.11%

Needless to say I was pretty happy. Until I realised it was just the scale, not my result.

The scale then goes on to 1 -100; 101 - 400 and Greater than 400.

The 400 descriptor is: Heavy plaque burden. Annual chance of a cardiac event estimated at > 2%

And my score: 2,234! Just a massive 558% higher than the scale.

My heart sank!

According to what I knew, this type of score meant there was a mass of calcium locked in my arteries just waiting to block up and kill me! I really thought this was the beginning of the end. How long would it be till I just keeled over? Perhaps a little over dramatic but the general knowledge of this stuff is you get this build up and eventually it will block and artery and you'll have a heart attack or a stroke. And at 51, I know I wouldn't be the youngest to have this happen ... But still!

So, I had some questions:

"How can I reverse this?" You can't! 

"What do I do now?"  It's hereditary, so, not much!

I was a little numb to say the least. How do I tell my wife and kids?  Your husband/dad has a real issue.