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...