ADDRESSING, REDUCING HYPERLIPIDEMIA

Elevated blood cholesterol data obtained in June, discussed with my Geriatric Specialist Dr. Jarrod Faucher in July led to imaging of coronary artery calcium (1) to assess my risk status, (2) to consider remedial options in August.  

STILL REGAINING

UPPER BODY STRENGTH

I am now in my sixth month of recovery since the March 23rd accident that was responsible for the extensive soft tissue trauma to my upper torso along with arms, wrists  - injuries to each from forceful contact with the steering wheel resulting in compromised skin, bleeding. 

Despite still experiencing discomfort in my shoulders and back along with lingering referred pain daily in my upper right arm, I have been able to raise my body weight recently in various asanas including the ELEVATED FULL LOTUS shown above - taken by me in condo yoga studio using smartphone camera with a ten second exposure delay.

HEALTH STATUS UPDATE

HYPERLIPIDEMIA

(HIGH BLOOD CHOLESTEROL)

Earlier this June I had blood taken for various lab assays including a lipid panel before my sixth annual scheduled meeting to discuss ongoing medical concerns with Dr. Faucher.

The lipid panel measures Total Cholesterol, LDL Cholesterol, HDL Cholesterol, Triglycerides and, at times, other lipid markers used by physicians to help evaluate health risk factors. 

Since enrolling in Medicare at 65, my Total Cholesterol and LDL Cholesterol values have been elevated - exceeding the recommended guidelines* - despite eating mostly plant food sources, maintaining my high school weight.

* Total Cholesterol below 200 mg/dL

 LDL Cholesterol under 100 mg/dL

Data from these past six years provide evidence that my body naturally produces levels of Cholesterol that exceed medical guidelines - this year my Total Cholesterol was the highest during this period as I ate more dairy foods during 2020, 2021. 

My June lipid panel data along with the low to high value ranges during 2016 to 2020 are presented below. 

JUNE 3, 2021

LIPID PANEL DATA

(mg/dL)

• Whole Cholesterol .... 276  (199 to 232)
• LDL Cholesterol ........ 193  (120 to 150)
• Triglycerides ............ 109  (67 to 119)
• HDL Cholesterol ........  64  (55 to 69)

WHOLE CHOLESTEROL/HDL: 4.31

The lipid panel also provided values for non-HDL Cholesterol (212 mg/dL) and Apoliprotein B (140 mg/dL) - both very high, exceeding recommended ranges.

I was aware of potential silent risk factors like hypertension and diabetes that often led to serious negative outcomes.

These lipid panel data were 'red flags' that could no longer be addressed sufficiently via physical activity, nutrition.

More important,

they could not be  ignored.

ACKNOWLEDGING

 THE 

'RED FLAGS',

WHAT TO DO ?

Consuming more dairy foods during the six to seven months to complement my daily selections of veggies, nuts, seeds, fruits, legumes, other plant sources was intentional.

I had not anticipated the significant increase in Total Cholesterol, LDL Cholesterol values revealed from the blood assays.

It was obvious my daily walking had little or no effect on lowering my blood Total Cholesterol, LDL Cholesterol levels but likely did contribute and improve (lower) my blood pressure. 

A PRODUCTIVE CONVERSATION,

A DIAGNOSTIC IMAGING REFERRAL

Taking a prescribed statin is something Dr. Faucher knew I long wanted to avoid due to concerns about the many potential negative side effects based on my readings over many years.

However, I know from experience that taking two prescribed vitamins (B12 and D2) after discovery of extremely low levels prevented negative consequences from their absence.

I was seeking additional and more direct, empirical evidence to warrant using medication to reduce the high Cholesterol levels naturally programmed and mostly synthesized within my liver hepatocytes.

It was obvious I was one among many producing Cholesterol, variations that could not be controlled by my actions: largely independent of my nutrition choices, physical activities, adolescent weight.

Our conversation led to a known coronary calcium artery scan that would involve a brief, relatively minimal radiation exposure.

Dr. Faucher  authorized approval for this diagnostic test not covered by Medicare - an out-of-pocket cost of $257.00 - that I paid in advance of the procedure. 

COMPUTERIZED TOMOGRAPHY

OF 

CORONARY ARTERIES

This brief, non-invasive diagnostic scan of four heart arteries documents the absence, presence of  calcium in plaque within the blood vessels.

Plaque is composed of substances including cholesterol, calcium, white blood cells with a region of the artery identified as the tunica intima - reflecting the role of immune cells, the inflammation process in its production.

Accumulated plaque hardens and, over time, can restrict blood flow required to maintain heart muscle functions with a number of deadly possible consequences

The medical community refers to this occurrence as atherosclerosis, a disease of the arteries.

ATHEROSCLEROSIS

  from

 Greek

 [athero = gruel or paste, sclerosis = hardening]

CORONARY

ATHEROSCLEROSIS

Data of four blood vessels, their calcium score and the statistical risk* of each are listed below:

1. Left Main Artery, 196.2, Moderately High
2. Left Anterior Descending Artery, 318.9, Moderately High
3. Left Coronary Artery, 35.2, Mild Risk
4. Right Coronary Artery, 184.6, Moderate Risk

* Atherosclerotic Plaque Burden

A 

SOBERING

TOTAL CALCIUM SCORE

My total calcium score was 734.9 - the radiologist wrote: "Extensive atherosclerotic plaque burden. Risk is high."

This high risk data from my scan is a five year risk predictor.

The calcium score does not take into account what physicians refer to as 'soft plaque' which may be present and represent another source of risk.

NOTE

These data are a reminder of a process that undoubtedly began decades ago when my daily nutrition choices were poor - in stark contrast to my focused and improved food selections coinciding with my reconstructive thoracic surgery when I was 50.

 MITIGATING FACTORS

Acknowledging this risk, I also know my lifestyle choices focusing on yoga mobility and making more informed nutrition choices this past decade have led to significant, positive health outcomes.

At 70

. Among the positive: I have maintained my adolescent weight, am lean, strong and mobile, eat mostly plants, am physically active daily, do not smoke, drink, or use drugs recreationally, am not diabetic, without hypertension and get rest, reduce exposure to harmful stress, engage in daily social activities of interest, enjoy quiet time, being alone, enjoy reading, sharing experiences on my yoga blog, able to "quiet racing thoughts", enjoy body-mind connection (Thank you Ray Hoyt!). 

Significantly, I have a heathy relationship with my Geriatric Specialist, Dr. Faucher - able to talk openly on topics of concern - and continue to value his role these past six years in improving the quality of my life.

ACTION  TAKEN

I began taking both Rosuvastatin, Aspirin on August 4, 2021 - having the benefit beforehand of a lengthy and informative conversation with my physician friend, my legally appointed health care proxy with over three decades of experience. 

To RB, an acknowledgment of appreciation for listening and sharing your empirical experiences - a welcomed and valued gift.

REDUCING

ELEVATED

CHOLESTEROL 

LEVELS

AFTER 

22 DAYS

 OF

 STATIN, ASPIRIN

I requested Dr. Faucher order blood and urine samples:

• to obtain baseline lipid panel levels to compare with the June 3rd values

• to evaluate possible negative side effects to muscle, liver, kidney, other body organs

• to check blood glucose levels, evidence of bleeding, 

My request to have both blood and urine samples taken were approved.

On August 26th the samples were provided at St. Vincent's Hospital after I had fasted for over 16 hours, also taken a morning walk - my morning weight was 118.4 pounds. 

AUGUST LIPID PANEL

 USING 

ROSUVASTATIN, ASPIRIN

(mg/dL)

• TOTAL CHOLESTEROL .. to 131 from 276
• TRIGLYCERIDES .......... to 58 from 102
• LDL CHOLESTERO L....... to 59 from 132 
• VLDL CHOLESTEROL .....13 
• HDL CHOLESTEROL ...... 59

* WHOLE CHOLESTEROL/HDL: 2.22

* A significantly lower risk ratio

 

NO OBVIOUS SIDE EFFECTS

I was smiling reading the data of the five lab reports  all providing empirical assay evidence my muscle, liver and kidney functions were all within 'normal' ranges.

 

Especially noteworthy was having a glucose reading of 82 - my lowest value in the past six years.

There was no evidence of any internal bleeding documented.

LOOKING FORWARD

WITH

OPTIMISM

IMMEDIATE

NUTRITION
IMPLICATIONS 

I will continue to consume the 95+% of plant foods daily as I have been doing for years.

Sources of foods that will increase my Total Cholesterol, LDL Cholesterol will be monitored and likely further reduced, avoided totally to help lower my high current risk, future risk factors.

ONE MORNING MEAL

FROM

THE ROSE ROOM

(WEBSTER, MA)

GREEK YOGURT

With

SEASONAL FRUIT JAM

NUTTY BIRD GRANOLA
 

DALIY 

PHYSICAL ACTIVITIES

YOGA AND WALKING

WILL 

CONTINUE

My morning and evening yoga sessions in my condo will soon enter a 12th year and remain a daily source of enjoyment, satisfaction.

I remain grateful for how I can move now. 

DEMONSTRATING

WHOLE BODY JOINT MOBILITY

YOUR COMMENTS ARE WELCOMED

BOB CROWTHER - NUTRITION - YOGA

IMPACT TRAUMA RECOVERY CONTINUES

Five months have passed since the March 23rd car accident resulting in significant impact trauma to my upper body torso and arms.

IMPROVING MOBILITY

 

COMPASS POSE

The extent of the damage done to my mostly soft tissues (muscles and connective tissues associated with the neck, shoulders, back, chest, arms and wrist) and hard tissue (left clavicle) became evident within hours afterwards.

I shared some immediate, alarming mobility consequences during the five days following the incident - contact by another car on the drivers side and being pushed into a wooden utility pole with sufficient force to snap  it, total the vehicle - in a March 28th post, my 70th birthday.

ACKNOWLEDGING 

HEALING TAKES TIME

Every day since March 23rd my morning and evening yoga sessions reflected movements that were possible - accepting the reality of a significant setback, determined to focus on the positive and to appreciate whatever mobility I was capable of at any given time.

I was successful in listening to my body and selecting, sequencing and modifying movements to avoid injury.

It took over four months to do the above COMPASS POSE: achieving and maintaining a relatively good form without any limitations or upper body pain - especially of right and left clavicle, associated muscles.

Yesterday evening I successfully executed the EIGHT ANGLES asana shown below for the first time since being injured and making the transition from  sitting with legs forward to a lateral, elevated  position.

Ongoing upper, lower right arm referred pain likely from one or more rotator cuff muscles (supraspinatus, infraspinatus) continues at this time along with deltoid and trapezius discomfort at times.

Once resolved, I hopefully will add practicing handstands, forearm inversions to my evening yoga sessions.

BENEFITS

OF

DAILY WALKING

My local frequent walks this year in Auburn during January, February and March became a daily activity and were continued into April, May, June, July and August.

In the past five months since March 23rd, I have walked every day with one exception during April.

This was possible by adjusting my start times to avoid record hot and humid conditions and record amounts of rainfall  experience these past months.

It was not uncommon to begin my days before or after 4am - usually doing my morning yoga session first before walking with the exception of the past two days.

My decision to make walking a high priority was informed by the likely cardiovascular benefits to be achieved.

My focus and discipline was rewarded by blood  pressure systolic and diastolic values of 120/78 during my annual visit with my Geriatric Specialist Dr. Jarrod Faucher  - relatively good at 70, my lowest numbers taken in his office during six years.

NUTRITION

STILL A PRIORITY

FORAGED MUSHROOMS

BROCCOLI & ONIONS

ON

FLATBREAD

FROM

THE ROSE ROOM

WEBSTER, MA

Daily emphasis on consuming mostly plant based foods continues and undoubtedly is largely responsible for maintaining my adolescent, high school weight.

On July 20th, the day I met with Dr. Faucher at St. Vincent's Hospital, my morning weight was 119.2 pounds.

I suspect calorie restriction, time-restricted eating and the combination of physical activities (yoga, walking) has collectively contributed to maintenance of my lean yet mobile and relatively strong body.

 

EVALUATING

CHOLESTEROL

&

CORONORY RISK 

I will share data from a recent coronary calcium computerized tomography imaging and scan, ongoing response when additional information becomes available.

 MOVING FORWARD

DO SHARE YOUR THOUGHTS 

 BOB  CROWTHER -  NUTRITION -  YOGA

Appreciating JOHN C. WAIN MD, Role Enhancing Breathing

Today I celebrate a memorable anniversary: 20 years ago thoracic surgeon Dr. John C. Wain at Mass General Hospital (MGH) in Boston operated to correct a congenital chest deformity (pectus excavatum).

SURGERY 

 FACILITATES

BREATHING & MOBILITY

The invasive, major reconstructive procedure I underwent to correct the concavity resulting from an inverted sternum (breastbone) and ribs impacting my heart and lungs was unusual for an individual at 50.

I had experienced progressive difficulty breathing during my youth into adolescence - most notable participating in my enjoyable high school track experiences with teammates - and unfortunately throughout the following decades.

My quality of life was negatively impacted by the emergence of severe asthma and extensive  allergies requiring medical treatments, even surgery during the 1980's and following years. 

Sinus surgery occurred to open up prolonged blocked nasal passages. 

Exercise and cold induced asthma increasingly limited, prevented various physical activities including running over time.

Memories of having difficulty breathing walking in -30, -35 to -40 with wind chill in Fredericton, New Brunswick, Canada remain vivid.

A PRODUCTIVE MEETING

I was fortunate to be directed to Dr. Wain by my primary care physician while employed at the Pediatric Shriners Burn Hospital for Children - Boston in the research department. 

A

YOUTHFUL

JOHN CHARLES WAIN, MD

THORACIC SURGEON

A

20th

 ANNIVERSARY

APPRECIATION

I have long valued Dr. Wain's response to my initial visit to his Blake 1570 office at MGH to inquire about the possibility of having a corrective surgery often associated with pediatric, adolescent patients.

Dr. Wain understood my concerns about both the physical and  psychological issues associated with this chest deformity.

Why this corrective surgery was not done as an infant, child or adolescent was a source of puzzlement, increasing anxiety originating from my teenage years and continuing as I got older.

Finding a surgeon who agreed surgery was a warranted, appropriate and justified action at my age was welcomed.

POSITIVE OUTCOMES

I knew a titanium bar would be placed in my chest, there would be significant pain given the large incision, trauma to tissues to accomplish the reconstruction, a long time to experience a full recovery.

The more invasive nature of my surgery required me to be in the hospital for a full week - a period of time where I received excellent care from doctors and a skilled thoracic surgery nursing staff.

Sleep was elusive with the hospital bed set in an upright position and having to deal with significant pain (especially by coughing, sneezing), by frequent nursing activities throughout the evenings.

Being capable to walk at night provided relief from pain especially after the thoracic epidural injection was discontinued. 

Dr. Wain came to see me each morning - one patient among many others others now recovering from his skilled efforts and those of his surgical team.

I remember how he kept his word to remove the tight, restrictive wrapping around my chest after several days - necessary given the nature of the operation.

MY PATIENT ID WRIST BAND  

The positive outcomes of the surgery can not be overstated: 

• My breathing was immediately, significantly improved

• Never again during the following two decades did I require any medications to

     facilitate breathing

Likewise, the surgery served as a motivation to better monitor my weight, nutrition and engage in more regular exercise:

•  I was successful in establishing a focus on maintaining a lower weight, eating better 

•  I initially experimented with different physical activities (light weights, treadmill, stationary biking) at a local gym to facilitate my recovery from the surgery

NOTABLY

Dr. Wain restored my ability to utilize lung tissue more effectively; in my case, eliminating the severe and chronic asthma and allergies from my past.

Years later a fortuitous introduction to Ray Hoyt and the yoga he taught during 2010 led to my embrace and lifestyle focus on both yoga and nutrition during the past decade.

YOGA

FURTHER

 IMPROVES

 BREATHING

STANDING BACK BEND

It was through focused yoga activities during my 60's this past decade that I began to further enhance my breathing.

Issues with the cervical, thoracic and lumbar regions of my spine were possible to be addressed through diverse yoga asanas including assisted standing back bends frequently done using the wall ladders, on occasions using the wall ropes.

Use of props including yoga blocks, the two chairs with the assistance of others also were effective means to open my thoracic area.

Likewise, being lifted in Upper Facing Bow by Ray Hoyt  and others safely enabled whole body movements less accessible without assistance. 

I smile thinking about the difficulty, limited mobility experienced attempting to do a basic back bend, to barely move my head backwards without making a loud 'haaaaaaaaaa' sound when I initially began to attend group yoga classes in 2010.

The ability to do the Standing Back Bend variation shown above from 2015 on my own in a deliberate, controlled manner with easy breathing continues to be a source of satisfaction, motivation to both maintain and enhance these movements.

My whole body mobility status at this time is an unanticipated yet welcomed consequence of the reconstructive surgery done by Dr. Wain two decades ago. 

FOREVER GRATEFUL

THANK YOU 

DR. WAIN

BOB CROWTHER   NUTRITION   YOGA