There is a fine line between proactive and reactive medicine. My 80 year old cardiologist put me through all the tests, even though I didn't show any significant signs. . The only data point was and still is, my grandfather had a heart attack at 50, my dad at 60. . that's it for me. . borderline hypertensive . . framingham heart study said low risk, exactly the same score for another friend who had a heart attack. .

:boom:

the calcium scan came back at 94. . . where the 100% score is total fossilization .. . . but agreed that there were no invasive tests. . . or at least these did not appear to me to be invasive. .

the smoking gun. . so I am on the same meds as those who have had heart attacks. .

the body is still a black box . . . until genetic medicine and AI is perfected, it will always be a black box. . and humans are humans. . the data and more data is great, but a human can only handle so much data, and that's where AI will really change medicine . . . being able to test thousands of data points for better predictors. .

AI Predicts Future Pancreatic Cancer | Harvard Medical School

OpenEvidence

full disclosure. . . i am a certified data junkie in the corporate world, building corporate data warehouses and building forecasting models. .

Good story, and it shows that your cardiologist applied risk factors of family history, hypertension, gender, age, and ? LDL to appropriately evaluate risk. That's evidence based medicine, kudos to you and him.

That's quite a bit different that shot gunning a large array of unnecessary tests, usually for profit, or in the case of "holistic" or "alternative" practitioners, ignorance.

Also different than someone with no knowledge base being critical of the standard of care.

Stay healthy.

A calcium score of 94 is not that bad depending on age. It is not 94 out of a 100. It is called an Agaston score and can be well into the thousands. Per the American College of Cardiology, it should only be used to determine need for a statin in a person of intermediate risk (5%-20%) of developing coronary disease. No need to repeat once the value is above zero.

:bigbow:

Absolutely agree. The only time I ever ordered it was to make a borderline decision re: a statin easier. Interestingly, my wife actually had a Ca++ score (before we got married) for a high LDL. However, her entire family history would be suggestive that it was more likely a marker for A Milano protein that a type IV hyperlipidemia. Combine that with her statement that she would never take a statin and I wouldn't have even ordered it for her.

Statins seem like a very good drug with the only major side effect pain in legs (my wife had it and doc switched her to another one and no problem.

What reason did she have for not wanting to take a statin? Or if you would rather not answer about your wife, is there a good reason for not taking it if medically indicated?

Sorry, I should have clarified. My wife is a RN, BSN, and has a Masters in nursing and another masters in health administration. She knows the criteria for treatment with a statin and knew she was not likely to be at high risk for CAD. If she met criteria, she most certainly would accept treatment with a statin.

As an educational aside, there are patients who are afraid of taking statins because of "muscle damage"
Here are approx. risks:

Rhabdomyolysis (severe muscle damage): 1 in every 500,000 patients
Statin induced myositis (let's call it muscle inflammation): 1 in every 3500 patients
Statin induced myalgia (aches and pain, no damage) about 2% (1 in 50)

So, if anyone out there meets criteria for treatment, don't be afraid of that "side effect". If you take it and get muscle aches, it can always be withdrawn. But the risk reduction for AMI (heart attack) is tremendous.

Statins not only lowers LDL but have a "pleiotropic" effect by improving endothelial function and lowering inflammation

And not only that, statin is both easier to spell and pronounce than hydroxy-methyl-glutaryl-coenzyme-A reductase inhibitor :1rotfl::1rotfl::1rotfl:

I should have cited references of which there are so many but an article from Stanford Med should suffice.

During four years of medical school, most students spend fewer than 20 hours on nutrition. That’s completely disproportionate to its health benefits for patients.
Why Medical Schools Need to Focus More on Nutrition | School of Medicine | Stanford Medicine.

And medical professional opinions can vary greatly depending on the subject just like in politics. So as a layman I listen to all sides. I referenced Dr Kahn and listen to most of his podcasts as he goes to great lengths to provide supporting information. So if you can poke holes in his arguments then I will keep an open mind.

I do believe that people who are raised on a whole food plant based and exercise regularly probably never need a routine checkup. But there very few of those.

Other Doctors whose advice I have great respect for are Alan Goldhamer, Joel Fuhrman, Garth Davis, Michael Greger, George Guthrie, T Colin Campbell, Neal Bernard and Caldwell Esselstyn.

Golfing Eagles very interested in your take about what is taught in medical school on nutrition and vitamins. I am under the impression (and could be wrong) that the average doctor is not as knowledgable as he or she should be about vitamins.

We need many more debates like this:
ROBERT ATKINS & USDA NUTRITION DEBATE
https://www.youtube.com/watch?v=zJ-2M02ON5E

I'm not sure how this thread went from the OP looking to have unnecessary testing performed to a diatribe on nutrition, but OK, let's play:

You state Dr. Joel Kahn is your "go to" guy? well, here's a headline from the journal "Science based Medicine":

“Holistic cardiologist” Dr. Joel Kahn is amplifying misinformation and conspiracy theories about COVID-19 vaccines and VAERS
Dr. Joel Kahn is a “holistic cardiologist.” There was a time when he seemed to me at least semi-reasonable, but recently he has been peddling COVID-19 conspiracy theories and antivaccine misinformation, particularly misrepresentation of reports to the VAERS database, which makes this a good time for an update about how antivaxxers are weaponizing VAERS for propaganda purposes."

This "so-called" doctor has a series of books similar to the other quack, Dr. Oz who promotes power food groups and some other nonsense.

And as if he didn't make enough money from selling his garbage, here another headline from the Detroit free press:

"Three doctors named last week in Beaumont Health's $84.5-million settlement with the U.S. Justice Department insist they did nothing wrong and have hired an attorney to defend their reputations.

The trio — Dr. Joel Kahn, Dr. Dinesh Shah and Dr. Renato Ramos — were among the eight Beaumont doctors identified in the settlement agreement as having enjoyed improper pay arrangements with the hospital system and other perks in potential violation of federal laws."

Then we have that wonderful article and assessment from Stanford Med, "which should suffice"---NOT

Stanford, CALIFORNIA medical community supports avocados, fruits and nuts---gee, what a surprise. Didn't see anything of the sort in the NEW ENGLAND JOURNAL OF MEDICINE. And they state "That’s completely disproportionate to its health benefits for patients."---now, talk about an OPINION rather than FACT. Wow, just Wow. Maybe they could quantify those "health benefits" and do a double blinded placebo controlled multi-centered prospective study and prove their case----but don't hold your breath, it will never happen.

So much for "poking holes" at "Dr." Kahn-----he just took a torpedo broadside.

Next on your list:

Dr. Alan Goldhamer is the founder of TrueNorth Health Center---except he is NOT a doctor, he is a chiropractor, also selling books and whatnot

Dr. Joel Fuhrman: His practice is based on his nutrition-based approach to obesity and chronic disease, as well as promoting his products and books He is a self proclaimed naturopath and alternative medicine practitioner (= QUACK)

Garth Philip Davis is an American bariatric surgeon, physician and author. Davis specializes in weight management and is known for his advocacy of plant-based nutrition. Yep, plant based nutrition---Res ipsa loquitur

I'm sorry I didn't finish reviewing that entire list of charlatans, scam artists and quacks, but it was starting to turn my stomach

I'm also sorry if I disillusioned you about those "doctors" that you "have great respect" for, but you asked.

Bottom line: If you see the word holistic, alternative, naturopath or nutritionist or any combination of the above, please RUN in the opposite direction as fast as possible. I can 99.9% guarantee that they are selling something---a book, a proprietary diet, a weight loss clinic and may, and this is a big red flag, have their name on their building---or worse yet, a TV show, a radio show, or a podcast.

Thank you for the reply. I left out Dean Ornish who runs a program to reverse heart disease that can be reimbursed by Medicare. It may still be the only one.

The Centers for Medicare and Medicaid Services (CMS) has determined that the Ornish Program for Reversing Heart Disease meets the intensive cardiac rehabilitation (ICR) program requirements set forth by Congress in §1861(eee)(4)(A) of the Social Security Act and in our regulations at 42 C.F.R. §410.49(c) and, as such, has been included on the list of approved ICR programs available at Medicare Approved Facilities/Trials/Registries | CMS.

NCA - Intensive Cardiac Rehabilitation (ICR) Program - Dr. Ornish's Program for Reversing Heart Disease (CAG-00419N) - Decision Memo

Is he a quack?

What about Dr Esselstyn of the Cleveland Clinic, rated as number one hospital for heart disease. He has a program to reverse heart disease. Is he a quack?
Best Hospitals for Cardiology & Heart Surgery
Access Denied

The Esselstyn Heart Disease Program | Cleveland Clinic

And for Dr Kahn there are always more than one side to a story

3 Beaumont doctors claim innocence over $84.5M settlement

The whistleblowers identified numerous Beaumont doctors and administrators. Yet none of the three doctors were accused of wrongdoing in the whistleblowers' lawsuits against Beaumont, which were unsealed last week.


And he still has his license. So you haven't proved anything on a medical basis. As far as being critical of the Covid Vax, there are so many prominent health professionals on both sides of the argument, that you could write a book on. Not going to settle that on TOV. The major point is that he cites all references for his recommendations so that people can decide for themselves. In my layman's opinion he doesn't have the winning argument on everything.

As far as nutrition education in medical school, chew on this:

https://www.hsph.harvard.edu/news/hs...ion-education/
“Today, most medical schools in the United States teach less than 25 hours of nutrition over four years. The fact that less than 20 percent of medical schools have a single required course in nutrition, it’s a scandal. It’s outrageous. It’s obscene,” Eisenberg told NewsHour.

https://www.thelancet.com/journals/l...171-8/fulltext
Our analysis of these studies showed that nutrition is insufficiently incorporated into medical education, regardless of country, setting, or year of medical education. Deficits in nutrition education affect students' knowledge, skills, and confidence to implement nutrition care into patient care.

https://www.texasmonthly.com/news-po...ine-nutrition/
Why Doctors Aren’t Taught Much About Nutrition

And I could cite many more.

Can you cite a reputable publication that says nutrition is covered adequately in Med School?

And True North has been around for decades and claim some very positive results with their program for people who have not had good results with conventional medicine. And yes, I believe their water fasting program is very effective for many medical issues including addiction. If they were not successful then they would have been sued out of business or had their state license revoked.

And I would be most interested if you have any dirt on Dr Greger of https://nutritionfacts.org/ other than he once worked for "Patch" Adams.
Dr. Michael Greger | How Not To Die | Talks at Google
https://www.youtube.com/watch?v=7rNY7xKyGCQ

OK, I guess that says it all

I thought I was dealing with a simple case of misunderstanding human physiology. Unfortunately, what we are dealing with is the cult of nutrition----millions of dollars being made on books, seminars, diets, "institutes", TV shows, "infomercials", radio shows and podcasts----all by either legitimate doctors that turned to the dark side or just outright scam artists. They have sold out for $$$ just like LIV golfers have sold out to Saudi sportswashing money. These people are parasites feeding off the public desire for immortality.

I hate to pick on him again, but let's use the example of Mehmet Oz. A well educated physician and surgeon, he attended Yale Univ undergraduate and got a dual MD/MBA from univ of Penn and Wharton business school. He was associate director of cardiothoracic surgery at Columbia-New York Hospital, and could benefit many patients via his talent in the OR, which is what he did---initially. Then he allowed himself to be "Oprahfied"---sold out for a TV show and more $$$$, just like "Dr." Phil. I very much doubt he even believes half the crap he spouts out on TV---too bad he lost his senate race because that might have shut him up.

These "so-called" doctors have convinced millions of gullible people that the secret to health and a long life lies in what they eat. The best analogy is probably James Fixx----you remember him, the author of "The Running Book" that started the cult of jogging in America. Now, there's nothing wrong with getting plenty of exercise, but this "cult" was likewise convinced that THE secret was running. Of course, you'll remember this guru of jogging dropped dead of a heart attack at age 47. But it has been quite a money maker for the orthopedists.

We see above a list of these "so called" doctors, and note they "cite references". Here's a news flash----the astronomers and geologists who belong to "The Flat Earth Society" also cite references. But in a similar vein, they cite references from other members of their society. The cult of nutrition "experts" are like a closed union shop that promote garbage and the slap each other on the back as they head to the bank.

And all this is built on the fallacy that "nutrition will cure all". I particularly like the assertion that medical schools do not spend enough time teaching "nutrition". Just how much time should they waste on a very simple premise. In fact, let me save anyone the 25 hours that are claimed to be inadequate and teach it in 30 seconds:

Eat a balanced diet without large amounts of fat
Don't eat too much of it
If and ONLY IF you are one of the few patients with a SPECIFIC vitamin deficiency, replace that vitamin and only that one.
Exercise regularly.

Oh, yes----before I forget, there's "reversing coronary artery disease". Absolutely been proven----by legitimate physicians and cardiologists---it's called a low fat diet and a statin. Proven by angiographic studies. Don't need a holistic quack to do that. The programs that are "Medicare reimbursed" combine traditional cardiac rehab and statin therapy with a target of reducing LDL to under 70. They DO NOT rely on telling people to eat broccoli 15 minutes before artichokes.

So now the challenge: Show me a legitimate double blinded placebo-controlled multi-centered study by physicians who are NOT a part of nor financially benefit from the "nutrition cult" that has been published in a legitimate medical journal that shows that following any of the garbage promoted by these gurus beyond what is in large bold type just above prevents disease or extends life. Rotsa ruck.