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    My Journey From Heart Attack to Primal Health

    Primal Fuel
    I started posting on another similar forum recently but it wasn't nearly as good a match for me as this one, so I'm glad I found it. I'm in the middle of reading Mark's book, "Primal Blueprint". It's refreshing to find a book that puts together so much of what I've learned over the past few years from various sources, and adds to that knowledge in a practical way. Mark has done an excellent job of putting together the research on various aspects of health, fitness, and nutrition, and especially on the particular issues men face.

    First I'll tell my story, but I also want to find ways that I can help to finally put to rest the nutrition myths that have been ruining our collective health for the past 40 or 50 years. Just trying to convert family and friends (and especially my registered nurse fiance) often feels like rowing upstream when all the mainstream authorities still cling to the old, bad science. It's frustrating that I now know more about managing my health via diet than my doctor and insurance company do. I'm sure this is a common frustration among this audience. People like Mark are really helping to educate the public and turn the tide.

    When I see older family members with metabolic syndrome (including diabetes and high blood pressure) getting bad diet advice from their doctors and taking drugs to combat symptoms only, and I see children growing up eating the "normal" diets that rely on refined carbs and grains for energy and that require them to feed that blood sugar monkey every few hours, it's frustrating. But I have to choose my battles carefully else I'm seen as the fanatic with fad diet ideas. But we'll come back to that.

    I'll use several posts to tell the story of my personal journey as I have time to write it. I'll talk about my heart health, weight loss, and fitness, but also about one of the most important factors for a man's health and fitness, his testosterone level. I've fought that battle as well and conquered it, without drugs.

    Here's the first post of several to come.


    Part 1, The Wake Up Call

    I begin this story with a brag in the hope that it gets the interest of other men who might benefit from my experiences. Today I'm in the best health I've known since I was a teenager. I'm 52, 185 lbs., 12-13% body fat (work in progress), great lipid profile including large fluffy LDL particles, and I have good hormone levels and a great sex life. I can run 10 miles and can do a mile in a little over 6 minutes (as long as I get to pause after the first mile), and my body looks better than it ever has in my life. I've totally reversed my coronary artery disease and expect to live a long healthy life. And I'm still learning and working on it every day, with the best yet to come. Getting to where I am now has been a journey of enlightenment, and I hope it's a story worth telling. It begins with a life-changing event.

    ---

    In May 2010 I turned 49 years old. At 6'1" in height I had hovered around 225 to 230 lbs. for years, and had inched up to over 240 a couple of times. This was one of those times. So I'm sure my body fat was over 30%. I was also a smoker of 35 years or I probably would have been heavier. But I was living without too many ailments or complaints, I just wasn't very pretty to look at naked. And little did I know that it was much uglier on the inside (I hadn't even heard of visceral fat yet).

    My life was pretty sedentary overall, and my exercise consisted of occasional golf, walking, and yard work. And of course my diet was typical, with lots of high carb pasta and bread included, and I loved sweets and desserts. The last time I had put any real effort into fitness was after my divorce about 10 years earlier. Being single usually motivates men to work on their fitness and appearance, and I was no exception. But now I had gotten fat and complacent again.

    So I decided to put some effort into health and fitness that summer. I quit smoking cold turkey (and never touched another one since) and I bought a bicycle. I began taking long rides regularly, and I lost some weight that summer, getting back down to maybe 230 in a few months. But the big thing that I didn't do, and which I now know should have been the top priority, was to drastically change my diet, and I mean more than just cutting out a few sweets, which I did. But the exercise, stopping smoking, and minor change in diet turned out to be too little, too late.

    In October 2010, 4 months after quitting smoking and buying a bicycle, I had a 100% blockage of my right coronary artery due to a ruptured plaque. A heart attack.

    I didn't even know what it was for a whole day, so I was pretty lucky it didn't kill me. When I finally I called my family doctor and described my symptoms, he told me to immediately go to the emergency room. And to not drive myself. Well, I drove anyway, in pain, and made it alive. With a 100% blocked coronary artery, as you can see in the x-ray photos below.

    In the hospital they went in through a femoral catheter, cleared the blockage, and inserted two stents. During the procedure the other coronary arteries were checked and didn't show any significant blockage. And although we didn't know right away, it turned out that I luckily had enough secondary circulation from capillaries feeding that part of my heart muscle, that I suffered very little permanent damage. Which is why I now refer to this event as my wake-up call, and I say that my heart attack came with a huge silver lining. In hindsight it was probably the single most important event in my life.

    Of course I was immediately put on a statin drug, a beta blocker, a blood thinner, and aspirin, and I was given the standard heart-healthy diet advice. Which I now know was pretty much 100% wrong (and I take zero drugs today).

    As a lifelong avid reader, while recovering I soon began devouring everything I could find on heart health. These books soon led me to start studying more about nutrition, as it became obvious that the root of my problems started there. And that led to learning a whole lot about insulin and hormones, lipid chemistry, cholesterol, blood sugar, inflammation, fatty acids, exercise, and a lot of contemporary research that went against everything I thought I knew about diet and fitness. I'll mention some of those books, good and bad, in future posts.

    So begins my journey of enlightenment.

    -----------

    Here's the before and after images of my blocked artery. I was awake and viewing these on the x-ray screen while they cleared it. Dye is injected to make the blood show up on the fluoroscope. I included the heart diagrams for reference.

    My 100% blocked RCA:



    Blood flowing again after catheter and stent:


    To be continued...


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    Last edited by NewOldGuy; 10-22-2013 at 08:35 AM. Reason: removed attachments

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    Part 2 - Heart-healthy baby steps

    A night in the hospital for observation after the procedure, and I'm sent home with my handful of new drugs and lots of literature about how to care for my CVD, Cardiovascular Disease. It contains lifestyle and diet advice to "treat" my condition, with the tacit assumption that it's now a chronic disease and that once you have CVD you never get rid of it. The doctors even told me that I'd be taking some of these drugs for the rest of my life.

    I was taking pravastatin (Pravacol) for cholesterol reduction, Effient and aspirin to prevent blood clots, and metoprolol (Lopressor), a beta blocker, for... well basically just because it's a rule to give it to everyone who has had a myocardial infarction whether they need it or not. There was no real discussion yet about any of these, about the need for them, the side effects, or anything.

    During all of 2011 I took the drugs as instructed. My drug side effects included joint aches, short term memory loss, and very easy bruising. And as I eventually realized, the drugs (and my diet) also contributed to a drop in testosterone levels, which creates a whole new set of health problems all by itself. More on that later.

    As a baseline for future reference, shortly after the heart attack my total cholesterol was measured at around 220, with horribly low HDL of 28, LDL of around 175, and triglycerides of a little under 100 (I've lost the exact numbers). I know now the triglycerides weren't a lot higher only because I had already cut out some of the worst refined carbs over the summer when I was trying to lose weight. But at the time I had no idea of the direct relationship between excess carbs and triglyceride levels and my cadiologist didn't explain it either.

    I already knew that I could lose weight simply by cutting out breads and pasta, white potatoes, beer, and sweets, and had been doing just that for a few months even prior to the event. But I didn't yet know anything about the importance of HDL and how to increase it, or about different kinds of LDL particles. I also didn't really know the connection between refined carbs and health problems, just that you could lose weight by cutting them out.

    Anyway my cardiologist's goals were for me to get my HDL over 50, and get my total LDL under 80. Triglycerides weren't a big concern, he said mine were OK. So to get to these numbers I had to take the statins, exercise, and follow the diet guidelines given to me by the hospital.

    The "heart healthy" diet guidelines they gave me actually weren't terrible, but I now know there were some big issues with them. The recommendations included instructions to eat lots of whole grains instead of refined carbs, eat a lot of fruits and vegetables specifically including all kinds of beans, and eat lean meats and fish. To their credit, they included this statement: " Healthy fats from nuts, fatty fish such as salmon, olive oil, and avocados should be included daily in small portions."

    So I basically followed this for most of the first year, but I also cut out all red meat, cream, most cheese, and white potatoes from my diet. Red meat and dairy because I still believed saturated fat was one cause of my heart disease (and because of reading Esselstyn and Campbell below, unfortunately), and white potatoes just because I knew they were too starchy and fattening, and I needed to lose weight. I kept eating pasta but used the whole grain kind, thinking it was good for me. I also thought Ezekiel bread was the greatest thing ever, that I could still eat all the bread I wanted if I simply used the magic of sprouted whole grains. I'm sure lots of readers here also thought that at one time, particularly since Atkins famously endorsed it. It's false. Wheat is wheat, but I was still ignorant.

    Oh, and of course I also cut out those deadly eggs! Heart patients can't have those.

    I also started taking some supplements, including high dose Niacin to help get my HDL up, and CoQ10 for inflammation (the ordinary kind, I hadn't yet found out about Ubiquinol). No supplements were recommended by my cardiologist, I learned about them on my own and told him about taking them. His response, was simply, "fine, no problem with those." I got my first supplement recommendations from Stephen Sinatra's "Reverse Heart Disease Now", recommended below this post.

    So after about a year of this, along with a lot of bicycle riding, I was down to maybe 220 lbs. or so. My HDL got up to about 50, and LDL down to about 85 (we were still just looking at the calculated total LDL with no regard to particles). I wasn't yet very healthy at all by my current standards, but my weight was improving, I felt pretty good, and the doctor let me stop taking the Effient and switch to baby aspirin. So I was still on the statin and the beta blocker going into the second year post- heart attack. And still eating no red meat and very little saturated fat, and still eating whole wheat pasta and Ezekiel bread.

    And I was beginning to realize I had developed quite a problem with low testosterone too, both from taking the statins, and from cutting out most saturated fat from my diet. This manifests in a number of ways, not just in libido. Yes, that was down, as was the ability to perform. But I also found it was hard to build muscle, hard to lose body fat, and that my overall confidence levels and self-esteem were way down too.

    I had a lot to learn. Below are some of my early education steps and missteps. The two books about heart disease are ultimately about diet, hence their inclusion here.

    -----

    Some of the books I read during that first year (2011):




    Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure by Esselstyn Jr. M.D., Caldwell B. (Feb 1, 2007)
    Not recommended. Although Esselstyn's book is probably helpful advice to recover from severe heart disease (and I initially followed a lot of it) he gives bad diet advice for good health in general. He believes that animal fat and animal products cause heart disease. The diet is total vegetarian, with some supplements, and too much wheat and fruit. He's a lot like Ornish, the other famous doctor/author (and sometimes fellow evangelist) who believes heart disease can be reversed by eliminating animal foods and saturated fat.

    Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before It's Too Late by Sinatra, Stephen T., Roberts, James C., Zucker, Martin and Martin Zucker (Nov 3, 2006)
    Recommended. This author gets it, mostly. Sinatra is big on supplements and has some good info on several, particularly if you have heart disease. But the eating advice is also pretty sound. This book at least got me started going down the right research path. It still has a few flaws, like being too cautious about saturated fat, and recommending some highly estrogenic foods like soy, which aren't great for men. But overall I'd recommend it for anyone with CVD or who had a heart attack already.

    The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet... by Campbell, T. Colin, Thomas M. Campbell II, John Robbins and Howard Lyman (Jun 1, 2006)
    Not recommended. The research conclusions Campbell's diet is based on have been thoroughly discredited by now, although a lot of the actual data is useful and interesting. It's unfortunate that this mega-bestselling book and the author's influential foundation at Cornell, continue to strongly reinforce the saturated fat and cholesterol myths started by Ancel Keys. Of course he recommends a vegetarian diet that is far from optimal for health (although you will probably lose weight). I think it's unforgivable that a major, highly respected research institution is still unequivocally reinforcing the bad science of the last millennium.


    To be continued...


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    Last edited by NewOldGuy; 10-16-2013 at 05:38 PM.

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    Interesting read... Looking forward to the rest.

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    Welcome. I had an MI in 2009 and have been drug free with an anti-inflammatory diet since early 2010. Second best decision I ever made

    Sent from mobile
    Four years Primal with influences from Jaminet & Shanahan and a focus on being anti-inflammatory. Using Primal to treat CVD and prevent stents from blocking free of drugs.

    Eat creatures nose-to-tail (animal, fowl, fish, crustacea, molluscs), a large variety of vegetables (raw, cooked and fermented, including safe starches), dairy (cheese & yoghurt), occasional fruit, cocoa, turmeric & red wine

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    Wow...Your information and story so far is amazing. I worry about my hubby. He is on statins and aspirin but continues to eat a SAD diet. His testosterone is low to say the least and we are suffering because of it. I wish I could get him to stop taking them!!

    I look forward to reading more about your story as you put it here.

    CONGRATS on your success!
    44 F 5'5
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    CW 180.4
    GW 150

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    Quote Originally Posted by Kris T View Post
    Wow...Your information and story so far is amazing. I worry about my hubby. He is on statins and aspirin but continues to eat a SAD diet. His testosterone is low to say the least and we are suffering because of it. I wish I could get him to stop taking them!!
    I'll be posting more soon about how I stopped taking statins. That is surely one factor in his low T, but there are other things he can do. Ultimately, your husband will have to change his diet and get some of the right kind of exercise (described on this web site) to fix his testosterone. In the meantime I have a couple of suggestions.

    First, I'd recommend he read this book: "Cholesterol Clarity" by Jimmy Moore. It's filled with the latest research and a panel of experts, and hopefully it will get him moving in the right direction diet-wise, and off the statins.

    Here's a tip that might give you some temporary help in the bedroom, if he is open to supplementation. L-arginine is a simple amino acid available at any vitamin store or even many grocery stores. It is necessary for your body to produce nitric oxide, which is necessary for a healthy sexual response (and healthy arteries). I took 1-2 grams a day for a while. It is sometimes called poor-man's viagra. Discovering this saved my relationship before I fully got my health back. Some people use L-citrulline instead for the same effect because it gets converted to L-arginine in the body. Research these yourself, they are well studied.

    Lastly, if he is into studying to help himself, check out this $6 ebook on low T, which I read and reviewed on Amazon. It's not very well written but it covers all the bases and has good info. Well worth the price.
    Last edited by NewOldGuy; 10-16-2013 at 08:33 PM.

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    Wow - synergies!! I was reading about L-arginine in the drs waiting room this morning. One endo has all his diabetic patients on it, and in the last 5 years has had not one of them go for cardiac surgery. Looking forward to your next instalment!!
    Started Feb 18 2011

    Journalling here

    "There's a difference between knowing the path, and walking the path" - Morpheus

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    Thanks for the suggestion. I will go and buy some tomorrow after work.

    Hubby is fine with supplements, but right now he is not open to changing his diet or doing any research. I have been Primal for just over 60 days and have seen so much change in myself health wise, and body wise I am amazed. I am hoping that my example will help him to see how much better life can be.

    I cook a good egg breakfast each morning since we leave for work at the same time, and I am working in more primal meals. He still has his crap though, and I am not sure when that will change.

    I appreciate the information you posted and will continue to read and be encouraged by your changes.

    Thanks again so much!
    44 F 5'5
    SW 205.4
    CW 180.4
    GW 150

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    Part 3 Ė Running like Forrest Gump

    Caveat Ė Iím not recommending that anyone do everything I describe in this post, and some of it definitely isnít an ideal program for either optimal health or for recovering from CVD. Itís just what I did at the time, as I tried to fix myself.


    By December 2011, I was still taking the statin and the beta blocker, and still basically eating the conventional ďheart healthyĒ diet. I was also pretty sure by now that the drugs were causing short term memory loss, and that the statin was hurting my testosterone levels and giving me joint pains. On the low T, I had even had it tested at my own expense, and I was right, it was at the very bottom of the ďnormalĒ range for a man my age. And of course ďnormalĒ in this context really just means average for the population, not really ďhealthyĒ or ideal at all. I knew firsthand that it wasnít (and I know now the ďheart healthyĒ low fat diet is also bad for menís T levels).

    I told my doctor I wanted to get off the drugs as soon as possible.

    His opinion on the beta blocker was that I should probably take it long term if not for life, as a precaution. Wow. And on the statin, after some debate he told me if I got my LDL cholesterol under 70 then I could quit taking it. And of course he was referring to the old-fashioned LDL-C calculated number that I now know is pretty useless as a marker for CVD health or risk. This is a fairly young and very bright cardiologist, who Iím sure read new research sometimes, but who still had to toe the line on standard treatments. He even said that if he took me off the statin, as a patient who already had an MI, then he would have to write a letter to my insurance company because they would be asking why he wasnít following standard treatment protocol. At the time I didnít have the knowledge to know how outrageous this was.

    He did sincerely believe that these two drugs reduced my risk of having another MI. Maybe so, but at what cost to my overall health? Anyway, after I complained about my testosterone level, his eventual concession was to switch me from pravastatin to Crestor, which I could take in 5mg instead of the 10mg I was taking. And he said that maybe this would help, and that it had fewer side effects.

    That wasnít very satisfying so I got serious about getting back in shape as quickly as I could, and getting to the numbers he wanted as quickly as I could. I was still pretty ignorant and still believing the conventional wisdom, but I was going to do whatever it took as best I knew how.

    So without really knowing the best way back to fitness, but knowing I had to do something, I took up running. Serious running.

    In January 2012 I called up my older brother who had run all his life and was a track star in high school, and told him I wanted to run in the annual Peachtree Roadrace that year, on July 4th. Itís a 10K race, and I had 6 months to train for it. But setting this goal for the race would make me train hard and get in shape. When I began I couldnít come close to even lasting the distance at any running pace. I set a goal to finish the race in under an hour, I and worked towards that goal. I started out unable to do much better than a 12 minute mile, and I couldnít finish more than 1 mile nonstop. I was still at least 220 lbs at this time too. But I got better quickly.

    I went through all the beginning runner mistakes, hurting my shins and knees, even using old worn out shoes and then limping on sore hips for a week. After that setback I learned about shoes and got fitted for some real running shoes (first Brooks, then later Newton). I even bought runner's nipple tape for the man boobs I still had at the time (after a long run without it they bled from running in a cotton shirt. Don't.). I learned about proper running form and stopped hurting myself. I learned about aerobic pace and anaerobic pace and HIT, and I bought a heart monitor to run with, and of course an armband to hold my ipod with songs at various timed cadences, and went through multiple sets of runner's headphones to find a reliable one. But this thread isnít really about how to run, just about my quest to get healthy, so I wonít cover those things in more detail here.

    By March I was running over 20 miles a week (OK not quite like Forrest Gump) and I kept that up all the way until a week before the race. I sometimes just ran 3-4 miles straight, sometimes did repeated interval runs or sprints (HIT), and sometimes hill training. Eventually, probably in May, I did a few 10K (6.2 mile) trial runs and was just about able to complete them nonstop, but not yet in an hour.

    Also in March I stopped taking the beta blocker on my own, without doctorís advice. In all my research I could find no justification to keep taking it, particularly after I saw how much stronger my heart and lungs were getting. And a beta blocker does take a little off your running performance. I know firsthand, I tried skipping days to compare. And I also knew by now from an echo-cardiogram that I had not suffered any noticeable permanent heart muscle damage from the MI. So I just stopped. I know the doctor had a standard treatment to follow, so I didn't try to argue with him. Donít be like me, talk to your doctor.

    Anyway by June I was down to 200 lbs, which I had not seen on the scale in many years, and my resting heart rate was now 54 from all that running (today itís 48, I still run). My blood pressure, which had always been fine, consistently ran about 110/65. My endurance and stamina had come a long ways back for an ex-smoker. I was looking a lot thinner and fitter. In my final test runs near race day I completed the distance in under an hour. That would suck for a 25 year old, but not too many 51 year-olds could even do it, and I was proud.

    Then three days before the race I came down with flu-like symptoms, with significant fever and body aches. The next day I went to the local urgent care and they determined I was just dehydrated. Temperatures had been averaging 95 degrees F during my afternoon runs, and I simply didnít drink enough to keep up. Running in that heat I would actually lose 2-3 lbs of water routinely, in an hour or so. Anyway, they gave me a fluid IV and of course cautioned me about going through with the race in 2 days. But I did it in a weakened state anyway and finished my first 10K at 1:05:37. I actually had to walk part of the "cardiac hill" section of the race. Not exactly my goal time, but I got the t-shirt.

    I continued my running and got better, and I completed the 2013 Peachtree Roadrace in under an hour a few months ago. And today I could probably do it in 55 minutes. I've made up a new goal of being able to run it once in my life at less than my age, in minutes. That may not happen next year as 53 minutes is tough, but I'll do it in a couple years. I still run about 10 miles a week today, but now I know to do more intervals and more hills and less aerobic distance. You want to do short bursts of anaerobic exercise frequently, for primal health. But I still do a 5-miler occasionally. It's a great stress reducer, and if you feel your cortisol level getting high, which also raises your fasting blood glucose, a run will drop both back to healthy levels immediately. Yes I have a blood glucose meter now too, to go with my Ketostix. More on those later.

    Here's my race badges:


    And here's me at the 2012 finish line, happy to be there:



    And here's one during the 2013 race (yes I wore the same shirt):




    -----

    Also during all this time I kept a chart taped to my bathroom mirror, and every day I would write down my weight, what kind of exercise or running I did the day before, and I rated my diet for the day before as good/fair/poor depending on how much I thought I cheated, and whether I ate healthy vegetables and grains (yeah I know, grains not so healthy). I was eating lots of Ezekiel cereal which tastes like rocks, and was still eating some whole wheat pasta and Ezekiel bread too. I was trying to avoid the worst refined carbs (sugar, white flour, junk) as part of my effort to lose weight, but I was also still on a low-fat "heart healthy" diet and so I was still not eating red meat or eggs or other things high in saturated fat. My meats were mostly fish, and some chicken. So my diet wasn't terrible by any means, and my health was getting better rapidly, especially with all the exercise. But I had not yet discovered how to really eat right. I was just doing pretty much what the medical establishment recommended, and perhaps going a little further on low carbs for weight loss. At this point I also didn't yet know that PUFAs are mostly bad and contribute to inflammation, so I was still eating them. But I did know enough to eat more MUFA.

    I was also taking high dose niacin to boost my HDL, which I know now is artificial and not as good as boosting it with proper diet. And that niacin flush is a bit uncomfortable and made my nose runny too.

    In my next post Iíll talk about the rest of 2012 when I really started researching statins and cholesterol and diet, and particularly testosterone levels. I must have read 20 books that year, and Iíll recommend some. The last time I filled my statin prescription was in September 2012, and I ended up throwing that bottle of Crestor away mostly full. Without telling my doctor.
    Last edited by NewOldGuy; 11-11-2013 at 11:12 PM.

  10. #10
    Tom B-D's Avatar
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    Wow, NewOldGuy, amazing story well told. Waiting for your next installment..,

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