Heart Scan and Calcium Score

heart-263x263

I had a heart scan a week ago.  It’s something I’ve been wanting to do for a long time because of my familial history of heart disease, combined with the bazillion risk factors I have that indicate I’m likely to have a heart attack.

A summary of my risk factors:

  • High cholesterol
  • High triglycerides
  • Type 2 Diabetes (but maybe I can lose this diagnosis soon!)
  • High blood pressure
  • Abdominal obesity
  • First degree relative with heart disease
  • Genetic risk factors, according to 23andme, that make me more susceptible to heart disease than other people in my demographic.  Check it out23(FYI- 23andme no longer offers this kind of health report – they’ve evolved by necessity, due to government intervention.  But before they shut down these reports I made PDF copies of everything in my profile.  I’m apparently also genetically vulnerable to Alzheimer’s, Atrial Fibrillation, Colorectal Cancer, and Rheumatoid Arthritis.)

So, when I say I’m trying to avoid having a heart attack, I’m pretty serious.  It’s a legit concern for me.

I had heard about getting a coronary calcium scan (heart scan) done in order to get a calcium score – a direct measurement of the severity of heart disease.  They measure the amount of calcified plaque buildup in your coronary arteries.  I wasn’t sure how to do it – do I have to find a cardiologist?  Do I have to convince my doctor to look at something other than my total cholesterol?  I hate trying to convince doctors of things.  Actually, I hate trying to convince anyone of anything.  That’s why I’ve gone rogue and order my own damn tests.  Anyway, I finally just googled it and found a local clinic that does heart scans for $99, direct to patient – no cardiologist required!

So I set it up for a couple days later.  They instructed me: no caffeine or exercise the day of the test.  Well, that was a long day with no caffeine, lemme tell you, but I managed.  It’s essentially a CT scan of the heart, so there is some radiation involved.  I didn’t care.  I wanted the test, and I don’t plan on doing this very often.  My results:

scan1.jpg

My coronary calcium score is 23.  On a continuum starting at 0 (no plaque present) to scores in the hundreds for people with lots of plaque, 23 doesn’t sound so bad at first.  This score correlates with “mild heart disease” (which doesn’t sound like good news to me), and my chance of having a heart attack is “moderate”.  So, only moderately awful then.

The supporting materials go on to say:

The total calcium score of 23 is between the 90 and 100 percentile for females [my age].  This means that 90 percent of people this age and gender had less calcium than [me].

Hm…also less awesome than I would prefer.

And the notes from the doctor who evaluated the test:

1. A calcium score of 23 implies presence of definite at least mild atherosclerotic plaque with the risk of mild or minimal coronary arterial narrowings considered likely.
2. Small pericardial effusion with mildly prominent mediastinal lymph nodes. These correlate clinically.

Pericardial effusion means fluid around the heart.  I don’t know if this is a lot bad or only a little bad.

At least I have a baseline.  I’m hoping this can be reversed or at least stopped.

Cron-O-Meter

Crono

It’s humbling when you realize your own sloppiness is the reason you’re not getting the results you want.

A comment-conversation yesterday with Meme made me aware that I really stopped losing weight after I stopped tracking my food with Weight Watchers.  I did it daily for 2 months, and then figured “I know what I’m doing – I’m good.”  Well, 2 months later I’m stalled, paying little to no attention anymore to the details of my dietary intake, and plagued at times by cravings that feel biological rather than psychological.

So I’m following Meme’s lead on this and I’m going to be entering all food eaten into Cron-O-Meter.  I upgraded to their fancy Gold membership so I can divide the food into meals, save my eyes from the advertising on the site and get recommendations for foods high in specific nutrients.  Also the Gold membership gives you access to a cool visual representation of some critical nutrient balances:

balances

I just love it!

My goals are to maximize nutrient density daily (99%+ of nutritional targets met) and lose another 30-40 pounds.

Of course this means I’ll have to measure what I eat again too.  I have a conversation in my head about this that is really dis-empowering.  It goes something like this:

Me:  Ok, lunch time….guess I better get the scale and measuring cup out.

Devil on my Shoulder: Really?  Can’t you eyeball that shit yet?

Me:  Well maybe, but I really want to do it right.

Devil on my Shoulder:  You know who measures food?  People who are slaves to food.  Remember Overeaters Anonymous?  Those people were insane.  They would bring a scale to a fancy restaurant and sit there at the table weighing their Filet Mignon.  That shit is just weird.

Me: Yeah, I know it’s a little weird but it’s really the only way to get accurate data and to know what I’m actually putting in my mouth.  I have a tendency to “forget” half the stuff I eat if I don’t measure.

Devil on my Shoulder: Don’t you think you’re a little old for this adolescent obsession with food?  How about mellowing out in your middle age?  You know, be cool.  Be laid back.  Get a tan and do yoga.

Me: Hm…yeah, I’ve always wanted to be cool and laid back.

Devil on my Shoulder: Exactly.

Me: Ok, I guess I can just eyeball it.

Devil on my Shoulder:  Why don’t you have some of those potato chips while you’re at it.  That’s what cool laid back people eat, you know.

Me: That does sound good.

So you can see why I’m in this situation.  Stupid devil.  Kind of a foul-mouthed bastard too.

Alpha Gal – An Infectious Allergy

This article has been making the rounds on social media.  Apparently, a bite by the Lone Star Tick can give you an allergy to red meat.  The tick injects a substance into the blood – galactose-alpha-1,3-galactose (“alpha-gal” for short) that is also found in the meat of non-primate mammals (e.g., cows, pigs, lamb/sheep, buffalo) – i.e., in red meat.  After the tick bite the body sees this molecule as an invader and creates antibodies.  Then when you eat red meat the body perceives the same substance and launches an immune system/histamine reaction.  What you have then is an allergy to red meat that can last years (or forever).  And weirdly, when the affected person eats red meat, the histamine response hits about 3-4 hours after eating the food – not immediately, like other Ig-E allergies (e.g, to peanuts, shellfish, etc).

I’ve done some reading on this – mostly because I’m into all things “histamine” these days, but also because I’d like to rule out that I have this issue.  I have noticed that my worst histamine reactions are to beef and pork – and in fact, since writing this post on 1/1/17 I haven’t eaten much of either one until fairly recently, due to the problematic histamine reaction I had when I ate it.  And in doing so, I felt great for a long time.  In the last 4-6 weeks or so I’ve added both pork and beef back to my diet – for variety, mostly – and I’m not feeling as good anymore – my mood is more anxious, my body itches, and my hot flashes have become angrier.  I hadn’t associated that with meat at all, but if there’s a delayed reaction of 3-4 hours, it would be easy to miss the connection to the offending allergen.

There is a test for this – you can get a blood test to look for antibodies to the “alpha gal” substance.  I can’t order it for myself anywhere though – I’d have to go through my doctor, and I get really tired of trying to convince doctors to order tests for me based on crap I’ve read on the internetz.  I’ll call and ask anyway.  In the meantime, I’m going to lay off the red meat again for a while to see if these symptoms dissipate.

For more information about Alpha Gal, listen to this very amusing and informative podcast by Radio Lab or go to the Alpha-Gal Allergy Awareness website.

Friends In Health

I changed the name and url of the blog to Friends In Health.  The old link/url will still work for a while.  “Against the Grain” and “sanscarbs.wordpress.com” were both based on low-carb ideology, and I don’t think I’ll ever be low-carb again, knowing what I know now. Also, I wouldn’t be where I am now – with a generally positive mood and a fasting blood sugar of 86 without the help of others on the same journey.  If you’ve commented on this blog or shared yourself in an effort to help others in a health-oriented Facebook group or forum, I’m talking about you.  Thank you.

In my last post I mentioned that I now love appreciate my hot flashes because I’ve realized they’re the canary in the coal mine, letting me know when something is biologically amiss.  At first I thought they pointed just to histamine release triggered by diet, but I realized yesterday that it’s much more than that.  In fact, now that I’m paying attention to it, I realize that hot flashes are – for me – a signal of stress.  Could be emotional stress, dietary stress, GI system stress.  All of these cause a stress response in the body, which then causes a hot flash for me.

A comment yesterday got me thinking about this – Trebbie said the following in response to my post about eating watermelon:

When I eat watermelon without protein it lowers my blood sugar very fast. I then get a reaction that is like a hot flash. It is actually a histamine response to low blood sugar.

That could very well be why I had hot flashes after eating watermelon.  The hot flashes didn’t come about right away, but rather after about 45 minutes or so – about the amount of time it would take for my blood sugar to rise and fall after eating fruit with no protein or fat to slow the absorption of the sugar.

Another theory from N2P about the watermelon-induced hot flashes:

The watermelon rind has [Nitric Oxide]….
https://www.ncbi.nlm.nih.gov/pubmed/27378312
NO can cause hot flashes on its own. Cortisol is another one. I guess they feel different.

One way to test would be to have watermelon with protein and fat rather than alone.  Maybe I’ll do that today.

Then last night the family went out for Chinese food.  I tried to stick to something healthy and ordered steamed broccoli and chicken.  When the dish was served the broccoli was basically still raw – steamed just enough to warm it up a little.  I ate about a cup of it anyway and felt pretty bad the rest of the night.  I’ve had that response before after eating too many raw fiberous vegetables, so I’m pretty sure that was the problem.  The point of all this though is that while I was in the midst of the gut pain I was having almost non-stop hot flashes.  The ambient temperature was 73 degrees F – cool by my normal standards, and no one else thought it was hot – but I was sweating and uncomfortable for about 2 hours.  A massive hot flash!  While my gut was stressed!  I was laying there holding my abdomen and thinking, “I’m really appreciating this insight about stress and all…now please make it stop!”

I’m not sure the biochemistry behind all this, but it seems to involves Mast Cells – white blood cells that carry histamine and other inflammatory compounds as part of the immune system.  Mast cell degranulation (breaking open) is complicated and it seems different stimuli can result in different substances being released.  It’s something I’ll probably need to spend some time studying in order to speak intelligently about it.  What I have learned is that for me, hot flashes are an indication of bodily stress.  I also know that I have some control over this.  Eating easily digestible foods, combining foods to avoid sudden blood sugar drops, and managing psychological stress are all strategies that seem to work.

(Ray Peat – right again!)

Hot Flashes Are a Blessing

On Wednesday I had 2 poached egg yolks, rice, sour cream and chives for breakfast.  I arrived at work at 7:45, and by noon I had turned on my desk fan 4 times – so about one hot flash per hour.  They weren’t cute little hot flashes, either.  They were sweaty, angry hot flashes.  They really do have personalities, these hot flashes.  Sometimes they’re like a warm blanket.  Sometimes they’re like the Heat Miser.  And sometimes they’re like the devil incarnate throwing fireballs at me while I tap dance barefoot on hot cement in Texas in August.  Angry.  When they’re angry hot flashes, they’re angry all day and through the night.   I’ve been having angry hot flash days a lot lately – like, most days for the last few weeks.

This morning I had rice and chicken breast for breakfast.  I arrived at work at 7:00AM.  It’s now 10:00 AM and I haven’t had to turn my fan on once.  No hot flashes.  This makes me think maybe the egg yolks and/or dairy are causing me problems.  The part of the egg that is highest in histamine is the egg white, and my All I Can Eat app gave both egg yolk and sour cream the green light – however, my experience today leads me to believe one or both are problematic.  So I’ll be avoiding all eggs and all dairy for a while to evaluate.

Imagine this as a flow chart: With histamine and mast cell activation comes inflammation.  With inflammation comes increase appetite and anxiety, increased immune system activity, and worsening autoimmunity.  With increased appetite and anxiety comes inability to lose more weight.  With inability to lose more weight comes reliance on Big Pharma, high blood pressure, and probably worsening metabolic markers.  Therefore, my primary goal at this point is to contain my histamine problem.  I realized today that my hot flashes, which I’ve been cursing for years, could very well be pointing me in the direction of improved health.  They are my body’s signal that I’ve screwed up!  I love my hot flashes now!

I feel like Helen Keller, when she finally realized that Anne Sullivan’s gestures represented water!!

Update:  I wrote this earlier today.  At about 10:30AM I had some watermelon – universally approved on all low-histamine lists that I’ve seen – and then started having hourly hot flashes.  WTF?  Tomorrow, no fruit.  Let’s see how that goes.

No Go on the No Meat

I tried really hard to eat no meat yesterday, but ended up being ravenously hungry by 5PM.  I’m in the middle of moving to a new home, and my car is having problems = too much to deal with right now.  So learning an entirely new diet is probably ill-advised at the moment.  Instead I’m going to stick to the same low-fat diet that I was having success with previously in the hopes of getting off the Verapamil medication that might be making my histamine symptoms worse.

Time to un-pause the scale and get the weight loss rolling again.  Currently at 190, which is 22 pounds down from my original weight in January.  I’m done with my month-long break of dietary mayhem.

Lichen Sclerosus – Getting Worse?

Evidence that perhaps my Lichen Sclerosus is getting worse, rather than better.  I’ve been sticking faithfully to the prescribed steroid ointment schedule, gradually reducing it over time, but parts of me are itchy now that weren’t before, even a couple weeks ago.

The only lifestyle factor that seems to have any effect on this for me is dietary histamine.  And since meat is a prime offender, I’m going off meat for a while to evaluate the effects.

I’ve eaten meat my whole life.  How does one get protein?  Egg whites and most cheeses are out, as they are high in histamine.  I’m open to all other (especially plant-based) ideas.  I guess I could hit Google, but it’s more fun to ask.