Friday, November 30, 2012

Took my most recent lipid profile after getting back from two months in China. I'd lost ten pounds, as expected, so I was curious to see what my results would be. I hadn't made a projection this time but it would have been along the lines of Overall Cholesterol - 150; HDL - 45; Triglycerides - 125; LDL - 100. I had not been taking Niaspan but had been pretty conscientious with the 2.5 Crestor. I had run out of Trilipix for a few days, though restarted it before the test on 11/21/12. In fact, I did not do as well. Overall Cholesterol was up to 187; HDL a mere 35 (lower than it had been for some time), while Triglycerides were up to 153. LDL: 126! My doctor, however, thought these were just fine and didn't recommend any changes of medication. However, I doubt that I was at the "reversal" level that I had hoped for. I still toy with the full body scan at Orange County, but that's $600 and a lot of radiation. But it is the only way to "see" whether the medication is actually working. Decisions: I'm most surprised about the 35 HDL. It could be because I was light on the Trilipix. But it could also be the "training" or habituation effect that I've been expecting at some point. I think I will start taking 500mg of Niaspan at night. That will at least begin the build-up process and may be enough to have an effect. I won't take more Omega-3. I'm tolerating 4 grams well. I had been skimpy on the Zetia before the test. I don't think that was the difference but it couldn't hurt and may be good for bowel health (results similar, but less, to psyllium). No more Crestor than 2.5/day. I'm glad 2.5 has an effect. I'd rather not be on statins at all. Same with Trilipix. Glad my prescription is only one/day. That leaves Niaspan, so I'll give it go. Psyllium as a sequestant might be helpful, too. Maybe I can start with a low dosage, say a tablespoon a day with half a Kalenite pill. Build up to 2 tablespoons/day (in juice) by the time of the next test, which will probably be in eight months, or some time in July, 2013.

Monday, February 13, 2012

Yearly Meeting with Cardiologist

Last Thursday I made my yearly visit to my cardiolgist. I've been seeing him yearly since my GP got me to do the heart scan a little over two years ago. I've had a thalium stress test with my cardiologist about that time also.

He did take the initiative to put me back on Crestor at 2.5mg/day. That was a key, along with my GP's recommedation of Trilipix, also about two years ago. Along with Omega3, I've had the best lipid profile for years and it has been consistent over the past two years. Nor has this caused real problems with my liver enzymes. Thus I can hold back a bit on Niaspan and use it when (and if) I need to; for example, when the system becomes habituated with the current levels.

The outcome of my visit? Ok EKG, stress test next year. He also discouraged me from doing the full bodfy scan. Not on the basis of radiation, but general need. He drew a diagram on the exam-table paper showing calcium both on the inside and outside of an artery. He says that with the calcium scan, you don't know which side. That is why he gave me the thalium test to check for obstruction.

The weekend before the visit I did the 35 mile Cal Poly ride, then a 5K on Superbowl Sunday. It's my conjecture that a stress test wouldn't have shown anything that wouldn't have shown up on those events. This is the issue of predictability. This is not to say that there couldn't be real problems to be discovered, only that the stress test isn't a good predictor with individuals who have a certain level of fitness.

I asked what the obstruction level was with the calcium stress test, and he didn't answer, saying that it doesn't show real obstruction. I asked for the results of the thalium stress test hoping for millimeters dialation of some such, but only got "not obstructed". I also asked for the "picture" generated with the thalium test, and got something like "noted" and "I don't see a picture in your file." Yet the results were based on a picture. I'd like to see it and may follow up. VitalImaging faxed the results directly to my cardiologist and said they would mail be hard copy. Need to look at their point system again.

Ownindex now 36 on 725; 40 on 810. Biggest disparity between the two that I've seen. Will check again with the 725 today. I want to see if I can detect any consequences of the Palm Springs ride or my increased exercise level over the past month or so.

Tuesday, February 7, 2012

Postscript - Liver Enzymes, Own Index

I hadn't been taking more than 1 Niaspan/day before this last round of tests, Nevertheless, I did have an elevated SGPT (ALT) of 49 where 39 is the high end of normal. The Dr. noted this, but did not seem concerned.

In 1984, I overdosed on Niacin and drove this reading way up. Hard to forget it. I had nausea and vomitting with that. No symptoms this time. The Trilipix and Crestor may have caused this.

My ALT PHOS is low, but Dr. said no problem to that when it happened before. (39 when 50 is the lower end of normal.)

My OwnIndex is 40 on my Polar i810. Hard to get that much higher. I got up to 43 around the time of the last Cycle Oregon.

January Tests - Follow Up

Generally good news. My Triglycerides are fine at 110; VLDL at 23.

I might be able to get the HDL up a bit from 44. Probably 50 is MAX, 60, just dreaming. That is the VitalImaging goal. My Dr. believes anything over 45 is okay.

The blood work (Hematology) showed elevated MCV and MCH levels. This COULD indicate Vitamin B12 and folic acid deficiency. Or not. I am, however, increasing my TJ's folic acid (under the tongue) pills to 2 a day.

I also showed a relatively low (45.5 where 50 is the low end of normal) Neutrophil % reading. This could indicate low white blood cells and hence less immunity. The Dr. didn't mention this as an issue, however. Not sure how best to build up immunity. Will be thinking about that.

I haven't been taking enough Vitamin D. I will up the amount to 4 capsules a day from 2 of my non-prescription TJ's source.

Interestingly, the test shows that I have been supplementing my Vitamin D, but not enough. 17 is my result where 30-100 is the normal range. I am diagnosed as deficient in D.

The result, 17, is a sum of both endogenous and exogenous sources. The latter is shown as <4 for me, so the most D I am generating is (17-4) or 13. So I will work on this. There is no issue with going up to more than 4/day.

Saturday, January 28, 2012

January Tests Preview

I need to pick up the full lab sheets, but so far:
147 Overall Cholesterol
80 LDL
44 HDL

My prediction was that these results would be within 15% of the previous results. Looks like they are within 10%. Dr. said they were good results.

I need the Triglycerides and the metabolic panel. I have an elevated ALT reading and a Vitamin D reading. Will up my Vitamin D to 4000/day (4 capsules).

Tuesday, January 17, 2012

January 11 Doctor Visit

Clean bill of health (except for a suggestion to lose 10-15 pounds). Tests scheduled for later this week and will include a metabolic panel, lipid profile (no VAP test though), PSA, Hemoglobin A1C, Vitamin D and a CBC (L) (which I haven't been following).

In terms of predictions, I think I'll have a lipid panel within 15% of my very good August tests. I'm doing the 4g Lovaza, 1 Trilipix, 2.5mg Crestor, Zetia, and 1 Niaspan daily. For the record, I'm also taking trandilopril, Q10, folic acid, melatonin, Vitamin D (2) and a baby aspirin daily.

The doctor did recommend a full body scan which includes a heart scan like the one I had done about two years ago. To this point he has resisted just the heart scan because of the radiation dose for no reason -- i.e., the results would not change the medication in any way, so what's the point? (Aside from the $300 for the test.)

I of course am interested in whether I've slowed or even reversed the plaque buildup. What puts all of this in play this time is that the full body scan reveals possible problems that aren't discovered through palpitation. The doctor was curious enough though about what he couldn't feel to recommend the full body scan. It's $650 but I'm interested in doing this sometime this year and it includes a follow-up heart scan. I may contact RCOG to check the radiation safety, which the scanning agency describes in terms the number of dental X-rays.

The doctor also reminded me of my yearly appoitment with my heart doctor, whom I will see in early February. He may recommend the thalium stress test which I'll decline if I'm going to do the full body scan. He will probably do a simple stress test, which is fine with me.