Re: This is annoying - results of nuclearr stress test

Bill wrote:
>
> "Andrew B. Chung, MD/PhD" <andrew@xxxxxxxxxxxxxx> wrote in message
> news:4260E62D.55C567D8@xxxxxxxxxxxxxxxxx
> > Bill wrote:
> >>
> >> "Andrew B. Chung, MD/PhD" <andrew@xxxxxxxxxxxxxx> wrote in message
> >> news:425FA0A0.E2A66102@xxxxxxxxxxxxxxxxx
> >> > Bill wrote:
> >> >>
> >> >> I noticed a few weeks ago that I was experiencing some chest pain when I
> >> >> got
> >> >> going a little bit on the tread mill - not too high, 3.2 mph or so - and
> >> >> then
> >> >> it diminished when I backed off.
> >> >>
> >> >> Talked to my cardiologist and we scheduled a nuclear stress test for
> >> >> yesterday. The Dr. saw nothing significant on the EKG except for the
> >> >> results
> >> >> of old MIs. Got the results today and the nurse said there was a change
> >> >> since
> >> >> last time and I should make an appointment with my cardiologist.
> >> >> Unfortunately, she is out until next Wed. and the earliest appt. I could
> >> >> get
> >> >> is the Wed. after that.
> >> >>
> >> >> I suspect this is a stable plaque which is building up and I suspect it
> >> >> may
> >> >> be
> >> >> in part due to me backing off on the amount of exercise I do for the
> >> >> last
> >> >> few
> >> >> months.
> >> >
> >> > How well controlled are **all** your risk factors for progression of
> >> > occlusive coronary disease?
> >> >
> >>
> >> Weight admittedly needs some work. (It is embarrisingly high) But I have
> >> lost
> >> 30 lbs over the last 6 months or so.
> >
> > Excellent :-)
> >
> >> Diabetes is mostly under control with
> >> meds.
> >
> > Why is it not better controlled?
> >
>
> Don't know. Ha1C was in the mid 6s last time.

Not too bad.

> Blood sugars usually between 110
> and 160.

Not that good.

> >> Cholesterol is somewhat under control with meds. I forget the exact
> >> numbers but LDL was a little over 70, HDL was in high 40s or low 50s and
> >> triglyclicerides were too high.
> >
> > Why was the latter not addressed?
> >
>
> Good question. What are possible ways of doing this and I'll bring it up with
> the cardiologist.

Would suggest you ask about fenofibrates. Larger amounts of omega-3
fatty acids can help. So will continued weight loss.

> >> I'm now up to 80 of Lipitor.
> >
> > That won't address the high triglycerides.
> >
> >> BP Is well controlled. Typical is 120/80.
> >
> > Excellent.
> >
> >> Maleness, 62 years of age, and family history
> >> on fathers side I can not do much about. I've been cutting way back on the
> >> amout of gym time for the last 2 or 3 months. Maybe bacause the treadmill
> >> was
> >> my best aerobic exercise and that is where I started to get the chest
> >> pains.
> >>
> >> I often do eat less than 2lbs a day - which probably accounts for the
> >> weight
> >> loss.
> >
> > It sure does.
> >
> >> But that is because the food around the house is often boring.
> >
> > If you choose to befriend hunger, the food will no longer be boring.
> >
> >> I take
> >> lots of suppliments.
> >
> > Such as?
> >
>
> The list is huge. CoQ10, Ginger, Fish Oil, lots of vitiams but not E.

Hopefully there is no iron in the multivitamin.

> Calcium - was diagnosed with bone depleation,

Hopefully with magnesium else you will be low in this mineral which can
moderate insulin resistance.

> Gloucosamine/Chondroitin, MSN,
> Lysine, Garlic, Chromium Picolinate, DHEA,

The DHEA may not be helping the triglycerides.

> Saw Palmento, folic acid, Hawthone
> once a week, Alpha Lapoic acid once a week,and low dose niacian.

The niacin may not be helping the insulin resistance.

> I think the most likely scenario - though there are many others - is that the
> cardiologist will send me for an angiogram, during the angiogram they will see
> one or two partially blocked arteries with stable plaques, and recommend
> angioplasties with stents. My inclination would be to go along with that.

That would be your choice.

> In
> general, does that make some sense?

You will have to weigh risk versus benefit in your specific case.

> Thanks.

You are welcome :-)

At His service,

Andrew

--
Andrew B. Chung, MD/PhD
Board-Certified Cardiologist

**
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.

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