5 Steps to prevent Heart Disease

Monday, December 30, 2019

Medical disinformation about LDLc is like the Russian's propaganda routine.


I watched a Meet the Press episode yesterday. 
I thought the disinformation could be confronted with the way Putin confuses the public. 
1-Dismiss the truth
2-Distort the truth
3-Distract from the truth
4-Dismay about the carriers of the truth 



link to Meet the Press











Sunday, December 29, 2019

Medication compliance






I am writing a chapter on Medication compliance in the Alzheimer patient today for my next book:
Alzheimer's Pursuit of Happiness YEAR THREE

I also made this cover photo: 


I have sent the manuscript of TRAVELING WITH ALZHEMIER'S YEAR TWO to the publisher last week.  I hope it will be on sale in Feb 2020

I gained weight on Intermittent fasting




I reached a low weight of 205.1 lbs on 12-22-19 on Intermittent Fasting
Today, 12-29-19 I gained 7 lbs over 7 days on Intermittent fasting.
I have only coffee and cream for breakfast and again at noon.
I try to not eat a salad or soup till 1 PM or 2 PM
My fasts easily last 14 hours.
I am in nutritional ketosis all the time. 
My Hgb A1c has improved by 2 points which is my main objective.
I walk 5,000 to 8,000 steps a day
I have not done any weight lifting. 




 I began Intermittent Fasting on Nov 9, 2019, I weighed 214.4 lbs.



Friday, December 27, 2019

Added Lipitor 5 mg to Zetia and Niacin




This is a non-fasting lab with triglycerides of 117.
Lovaza 2,000 mg/d
Zetia 10 mg 
Endur-acin 1,000 mg

Lab on October 11, 2019




I started 5 mg Lipitor (atorvastatin)  on Oct 22, 2019
added to Zetia 10 and Enduracin 1,000 mg

December 21, 2019

This is a fasting lab with  with triglycerides 50
Lovaza 4,000 mg/d


The point of this personal experiment was to show extremely low lipid levels with triple therapy
Lipitor 5,
Zetia 10 mg,
Enduracin 1,000 mg.

This should be tried with maximum dose Lipitor or the stronger Crestor before PCSK9 IV is tried.

My LDLp is >300 on Lipitor 5 mg.
I will increase my Lipitor to 10 mg/d then check my apoB (a particle level different than LDLp) level in Feb 2020.

I am doing this for my personal experiment where I want to get my apoB as low as possible for
my theory of getting apoB and LDLp as low as possible
to prevent progression of my Alzheimer's.


Effects of changing drugs over last year link










My next experiment is to stop Zetia today.
I will be taking 
Atorvastatin 10mg/d
Endur-acin 1,000 mg/d
Lovaza 4,000 mg/d







Can cholesterol be too low?  link

Thursday, December 26, 2019

How to use very low dose statin in sensitive patients



I think this lab it important the National Lipid Association to recognize, as achieved very low levels on Atorvastatin 5 mg. (I break the 10 mg tablet in half)
I also take OTC dose of nicotinic acid (Endur-acin) 1,000 mg and Zetia brand name 10 mg.

I reached PCK9 levels of LDLc at 31.

This was a fasting lab and my TG was 50.

My nonHDLc was 41 (115-74)

My remnants was 10 (115-74-130)

Monday, December 23, 2019

My Hgb A1c went down 2 points with Intermittent Fasting


Hgb A1c 8.8 on October 11, 2019

I started Intermittent Fasting on Nov. 9, 2019



I had my Hgb A1c  done on December 21, 2019












Sunday, December 22, 2019


“The self in dementia is not lost, and can be reached with care”
Muireann Irish


I edit for easier reading here link

Memorable excerpts:

Many people see memory as providing the foundation upon which a stable sense of self is constructed.
 Our autobiographical memory, in particular, seems crucial to weaving a life story that bridges past and present, and permits us to extrapolate how the future might unfold, all within a meaningful and coherent narrative.

The view that without our memories we are no longer ourselves is pervasive, and has led to the use of stigmatising language, even within the dementia-care setting, such as 
‘Loss’,
 ‘disintegration’ and
 ‘unbecoming’. 

There remains a recalcitrant perception that in parallel with the progressive pathological onslaught in the brain is the inevitable demise of personhood, akin to a ‘living death’.

Of course, people with dementia experience significant changes in their 
1-self-concept,
2- self-knowledge,
3- social relationships,
4- perception of their own capacity, and
5- even their physical appearance

. Yet the essence of the person endures



While the illness is devastating, not all memories are obliterated by Alzheimer’s, and much of the person’s general knowledge and recollection of the distant past is retained. 
There remains 

As the disease progresses and their self-concept becomes more rooted in their past,


Relatives’ knee-jerk reaction is often to ‘reorient’ the family member who has dementia, to help reconnect that person with the present.
 A classic example of this is when the person with dementia enquires where their deceased spouse is, only to be told that they have passed away and that the family home has been sold.
 While factually accurate, these efforts to correct more often than not result in extreme emotional distress, which persists long after the information itself has faded. 



Saturday, December 21, 2019

My photo after excision of some dysplastic cells on cheek.

This photo was taken on Sept 16, 2019
Not much to see. But I knew it was there. 
It is visible on the right side of check just under my sunglasses. 


I circle the lesion below






The lesion (a cluster of dark spots) is just under my right sunglass. 



My plastic surgeon was young but good. 
She injected my skin with pain killer before the excision. 
It hurt.
I said if you let the alcohol dry first it doesn't hurt as much when you put the needle in. 
 I told her I learned that from doing phlebotomy.
I learned from my dentist it is also important to inject the fluid slowly. 
I was nice and said kindly, "but I know surgeons are in a hurry."
She replied that they are in a hurry but she would try my tip.
At the end she said she took off my 'dog tails'
I asked what that was that?
She told me it is the end stitches. 
I was surprised I didn't know about it. 
She said why should you know about it?
I said I have been around but
 I don't know what I don't know. 

Stay tuned for stitches out in 2 days and pathology report. 



Friday, December 20, 2019

If I can still twitter do I still have sense of self with Alzheimer's diagnosis



I love to twitter and blog.

I am publishing YEAR TW0 and writing YEAR THREE series of having Alzheimers.

If I can tweet I don't have loss of self from Alzheimers.

This is an amazing discovery in the study of Alzheimers.

It is similar to "I think therefore I am"



If I tweet I am link

I think this is a bold discovery 

Review of article: What I wish I knew before my My Mother's Alzheimer's death

What I Wish I Knew Before My Mother’s Alzheimer’s Death
“They say the disease takes a big downward step and then stabilizes, but that those periods of stability get shorter and shorter.”
 “she had lost the ability to walk
“we finally encountered the real killer with Alzheimer’s—forgetting how to swallow.” 
 “She hated those—even in her advanced state, she refused those pastel, toddler sippy cups. I could get her to take one or two sips of water from a normal glass, but her eyes would go dark when I tried with a sippy cup. I clung to that.” 
“She may have been in the grips of the last stages, but by gosh, she wasn’t going to lose what shred of dignity she still had by drinking from a plastic pink sippy cup!”
 “Why is Alzheimer’s so cruel to steal memories and awareness, but leave the emotions?”
“she had forgotten how to cough, forgotten that coughing would clear the airways, that it was important to spit or swallow the phlegm. Instead, she sputtered. It was distressing to see her like this, and we asked, like we always did, “Are you in pain?” For the first time in the eight years that she battled the disease, she nodded yes, yes.”
 “I didn’t understand that when she still did a slow tap-tap-tap on her head, it would be the last time she would move. Either I misunderstood the doctor, or I didn’t want to understand the doctor—I thought she would be comfortable, without pain, but still awake.” 
“I learned that there is a silver lining to the disease. By the end, the patient is unaware of their condition, unaware that they will die from it. Not like a cancer patient, that is fully aware of the terminal nature of their disease until the end. An Alzheimer’s patient isn’t aware and that is a blessing”
“And that is the one good thing about Alzheimer’s, it makes saying goodbye at the end easier for the family and for the patient.”

Plateau success over Holidays with Intermittent Fasting



I finally decided to try Intermittent Fasting on November 9, 2019
I was never against IF except for concern of nitrogen balance. 
The main reason I didn't advise it in my book 
THE CHRONIC DISEASE OF OBESITY
was because I thought IF was too restrictive for long term dieting. 
Also the usual belief was that breakfast was essential. 
I thought for myself when I skipped breakfast I overate at lunch.
I skipped  breakfast through High School. 
With coffee I find I can do IF and cope with the hunger. 
I am motivated to stick with it because IF has improved my glucose levels
Today I am impressed that IF broke through my plateau to 208 pounds
I achieved this with only walking 4,000 to 7,000 steps a day
I do have the advantage of taking 
Belviq for hunger
Victoza for hunger
Invokana to urinate glucose 
Metformin for DM

I want to control my glucose better as I have Alzheimer's.
I hope to slow the progression of my disease. 
I also keep my LDLp down to extreme low of 333.
This is a unique approach to Alzheimers. 
I have done well with my CIMT's due to my low numbers despite 
poor control of Hemoglobin A1c.







Monday, December 16, 2019

I have obtained much better glucose levels with intermittent fasting





I have obtained much better glucose levels with intermittent fasting as determined by multiple glucose checks with Continuous Glucose Monitoring. 

I have coffee in AM and again at Noon to put off food as long as possible. 

Today after 2 coffees at 12:25 PM
I had CGM 90.
Glucose stick was 99.
Ketones went from 3.2 in AM to 5.3




This improvement in my glucose has motivated me to stay with intermittent fasting.
I have Alzheimers and want to have better glucose control.
If I can do that with skipping breakfast and putting off lunch as long as I can, I will do it. 
I always was taught to not skip breakfast.
I thought when I did skip breakfast I became hyperphagic and overate. 
I am on Victoza and Belviq which helps me with my appetite. 
I also take Invokana which causes me to urinate about 200 calories of glucose/day 

















TEN quotes from Jasja De Smedt Kotterman March 16th, 2018





What I Wish I Knew Before My Mother’s Alzheimer’s Death
“They say the disease takes a big downward step and then stabilizes, but that those periods of stability get shorter and shorter.”
 “she had lost the ability to walk
“we finally encountered the real killer with Alzheimer’s—forgetting how to swallow.” 
 “She hated those—even in her advanced state, she refused those pastel, toddler sippy cups. I could get her to take one or two sips of water from a normal glass, but her eyes would go dark when I tried with a sippy cup. I clung to that.” 
“She may have been in the grips of the last stages, but by gosh, she wasn’t going to lose what shred of dignity she still had by drinking from a plastic pink sippy cup!”
 “Why is Alzheimer’s so cruel to steal memories and awareness, but leave the emotions?”
“she had forgotten how to cough, forgotten that coughing would clear the airways, that it was important to spit or swallow the phlegm. Instead, she sputtered. It was distressing to see her like this, and we asked, like we always did, “Are you in pain?” For the first time in the eight years that she battled the disease, she nodded yes, yes.”
 “I didn’t understand that when she still did a slow tap-tap-tap on her head, it would be the last time she would move. Either I misunderstood the doctor, or I didn’t want to understand the doctor—I thought she would be comfortable, without pain, but still awake.” 
“I learned that there is a silver lining to the disease. By the end, the patient is unaware of their condition, unaware that they will die from it. Not like a cancer patient, that is fully aware of the terminal nature of their disease until the end. An Alzheimer’s patient isn’t aware and that is a blessing”
“And that is the one good thing about Alzheimer’s, it makes saying goodbye at the end easier for the family and for the patient.”

Friday, December 13, 2019

Fish Oil

My lab with history of DM2 since 1999 and obesity




People asked me to stop Lipitor 10 mg to see if it helped my memory. 

 April 10, 2019.
I stopped the Lipitor before my trip to Europe and Mediterranean cruise around

May 7, 2017
I started Zetia 10 mg 

August 3, 2019
I stopped Endur-acin


Stopping Lipitor on Zetia alone. LDLp went up to
LDLp 1033 on 6/12/2019





Non Fasting Routine Lipid Panel Oct 2019



October 2019







BIA weight 12-17-2019


More advanced testing
My first 1993






Tuesday, November 26, 2019

How I survived 5 days of Holiday eating in New Orleans



I flew into New Orleans on Nov. 19, 2019 Tues 
Red Dog Diner  link
I had Old Fashion
Sphagetti Bolonese



Weds 11-20-19
Cooked shrimp scampi in Timeshare
Wine

Thurs 11-21-19
Compere Lapin link
Spiced Pig Ears
Great small oysters from Alabama
Curry Goat
Collards and coconut cream
Sazerac cocktail
Wine
 Amazing restaurant.  Everything we ate was unique and wonderful.

Fri. 11-22- 19
Luke restaurant link
Oyster Happy Hour
75 cents per oyster.
I had cocktails and wine.
I always try to hit this on my trips to NOLA

Sat. 11-23-19
Cooked Lamb and Salmon in Timeshare
Wine
Salad


Sunday 11-24-19
Ruby Slipper  link
I had two vodka bloody mary's.  Excellent with more pepper than spice as do it in NOLA
Migas plate
Only breakfast I ate in NOLA


I survived the Holidays in New Orleans with my new diet approach
 INTERMITTENT FASTING ON LOW CARB HIGH FAT.

I went on stricter IF here link 

Earlier I was able to do below:

 IF with help of Continuous Glucose Monitor link



Notice on the BIA scale below, lower weight had more fat. 







Monday, November 25, 2019

How to get your NON-fasting triglyceride less than 100


I wrote advice to get NON-fasting triglycerides less than 100 link

Now, I want to point out the 3 items to get to that goal:

1- Low carbohydrate high fat #ketosis diet

2- Enduracin (nicotinic acid) 1,000 mg/d

3- Lovaza (omega-3-acid ethyl esters) 1,000 to 4,000 mg a day


I will start with discussing the brand name: Lovaza.

I go to my pharmacy and ask for the generic version of Lovaza. 
It is very easy to do.  
You do need a Doctors prescription.

I like Lovaza because positive trials were done with it in Italy.

I like buying this drug (nutrient) because it has been much cheaper, especially on my medicare with the supplemental drug coverage. 

If no coverage you can find the cheapest SAM's or COSTCO version.  
Just do the math. 
1,000 mg Lovaza = EPA 465 mg + DHA 375 mg


Concerns have been expressed that DHA raises LDLc.
It is a fluffier, larger LDLp.
Thus the LDLp increase was never an issue for me in my practice. 

New great trials with only the EPA component suggest they may be better. 

1-statin
2-Enduracin
3-Zetia. 

All 3 are now generic (inexpensive) and at low doses have few sides effects.

I continue that model with generic Lovaza. 

Now that high triglycerides are receiving much more attention, I give the 3 steps (items) above. 

Try it out, then:

Add Zetia and then statin to get the 
that I write about.

This approach will achieve superlative target values as good as the 
expensive intravenous PCSK9 drug