Ready to Quit

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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Jan18
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Re: Ready to Quit

Post by Jan18 »

mike wrote:If you are insulin sensitive and your A1c is good, then you can have more carbs, whereas if you are like me with 20 years of T2D, then you should probably cut them out of your diet.
I see.

Well, I'm working on insulin (it has been going down, but have 3 pts further before it is optimal) and my A1C is good. No T2D.

Thanks!
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Re: Ready to Quit

Post by mike »

Jan18 wrote:Well, I'm working on insulin (it has been going down, but have 3 pts further before it is optimal) and my A1C is good. No T2D.
Have you ever measured your Insulin Resistance? You measure both fasting glucose and fasting insulin and use HOMA to calculate your IR. If your A1c is good, but insulin is high, then that means you may have pre-diabetes. Your body is fighting harder than it should to maintain your glucose levels. If this is the case, then you should still work to lower carbs - particularly fast acting ones. Believe you me, you don't want to go to full blown diabetes.
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Re: Ready to Quit

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mike wrote:
Jan18 wrote:Well, I'm working on insulin (it has been going down, but have 3 pts further before it is optimal) and my A1C is good. No T2D.
Have you ever measured your Insulin Resistance? You measure both fasting glucose and fasting insulin and use HOMA to calculate your IR. If your A1c is good, but insulin is high, then that means you may have pre-diabetes. Your body is fighting harder than it should to maintain your glucose levels. If this is the case, then you should still work to lower carbs - particularly fast acting ones. Believe you me, you don't want to go to full blown diabetes.
Yes. I am working with a functional medicine doctor who has taken Bredesen's training and is speaking and teaching with IFM. I think I'm in good hands, but always do my own research as well.
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Re: Ready to Quit

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Jan18 wrote: . And I'm slowly accepting the fact that a big part of my old socializing, going out to eat with friends, has to go by the wayside. I occasionally go out, but restaurants are just so damned stingy with vegetables. They do meals backwards with huge slabs of protein and small portions of veggies. And their veggies are most often a million ways to cook potatoes and so few other one. So if I eat out, it's usually at egg places for my first meal of the day not for dinner. That's why I need to start embracing cooking dinner more!
Just one suggestion: Remember that restaurants are in the service sector! Low carb and keto diets are extremely popular now and in every restaurant where I have asked, and that has been many, I have been able to substitute additional serving of vegetables or a salad in lieu of the starch. The server is there to make sure your dining experience as enjoyable as possible (and thereby get a good tip). I regard requests for substitutions as an opportunity for the server and the chef to shine in the customer service area and am never shy about asking.
In a restaurant where I was dining with friends and there was literally nothing that I felt came close to meeting my needs/desires, I was prepared to just have water and a side salad. I explained my dilemma to the server, who relayed my concerns to the chef. The meal he prepared for me was the envy of the table. Not on the menu and absolutely delicious. That was a rare treat, once in a lifetime perhaps, but just my way of conveying that in most places, I think the policy is that they want to feed you and have you leave happy, so it is worthwhile to ask for what you want!
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Jan18
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Re: Ready to Quit

Post by Jan18 »

floramaria wrote: Just one suggestion: Remember that restaurants are in the service sector! Low carb and keto diets are extremely popular now and in every restaurant where I have asked, and that has been many, I have been able to substitute additional serving of vegetables or a salad in lieu of the starch. The server is there to make sure your dining experience as enjoyable as possible (and thereby get a good tip). I regard requests for substitutions as an opportunity for the server and the chef to shine in the customer service area and am never shy about asking.
In a restaurant where I was dining with friends and there was literally nothing that I felt came close to meeting my needs/desires, I was prepared to just have water and a side salad. I explained my dilemma to the server, who relayed my concerns to the chef. The meal he prepared for me was the envy of the table. Not on the menu and absolutely delicious. That was a rare treat, once in a lifetime perhaps, but just my way of conveying that in most places, I think the policy is that they want to feed you and have you leave happy, so it is worthwhile to ask for what you want!
Hi Floramaria,
Thanks for your input and yes, I always look to add vegetables or substitute. Most of the restaurants around here have very few selections of vegetables that we can have (they count mac and cheese as a vegetable) and it's always the same ones, broccoli or potatoes in five different ways! I don't eat corn (GMO issues) and I thought Gundry said we couldn't have peppers, tomatoes... And I get so sick of broccoli as a restaurant choice because I eat it probably 4-5 days of the week at home.

It's getting so that I just don't trust much in restaurants anymore. I bring my own olive oil which I've verified really is pure olive oil, because I don't even trust that when you ask if they have just olive oil that it isn't one of the adulterated ones.

I guess I am still confused about what to eat, because we aren't supposed to eat saturated fat since Gundry says we aggressively oxidize it and my oxidized cholesterol and ApoB and other bad markers for CVD are high. I miss CHEESE! I can do without all the other dairy and without bread and without sugar. Don't you sometimes wonder if our taste buds (mine screams for cheese and cream in my coffee) are telling us what our bodies need? I cannot get near the 1200 mg of calcium we are told we need without it, yet my doctor's mantra is NO DAIRY! I mean, once we are eating clean carbs/high good fats/no sugars/no refined carbs, I wonder if my desire for some cheese is my body's way of telling me I need it? I worry about my lack of calcium and bones/heart!

And one more thing -- we are told to eat a Mediterranean diet. But Mediterranean diets have pasta, have potatoes, have beans, all things I thought we weren't supposed to have. It's such a struggle every day to find variety and flavor in foods we are allowed. At restaurants, even some things that appear healthy, I find myself saying, "Can't have that because there's cheese in it" or "Can't have that because it's made with butter" or "Can't have that because it has bread crumbs in it" -- it is exhausting.

See? I am still confused about what I can and can't eat. And made more frightened of everything by my high lipids and ApoA-B ratio! Julie G thinks I am being too strict, but I am afraid to loosen up a little by letting myself have a little cream in my coffee or an ounce of cheese here and there. Now my doctor has me worried about having a heart attack or stroke. Or maybe it's my own head that has me worried about that.

Here are my lipids with an "I" next to the ones I've improved and a "W" next to the ones that got worse on my last labs:
Total Cholesterol -- 289 "I" still high risk
LDL-C ------------------220 "I" still high risk
HDL-C -----------------59 (was 60) optimal
Non-HDL-C-----------230 "I" still high risk
Triglycerides --------110 mildly elevated
Triglyceride-HDLC ratio ----1.9 (supposedly optimal) and much better

LDL-P -----------------------2030 "I" (down from 2589) still high risk
VLDL-P ---------------------343 still high risk
IDL-P -----------------------48 don't even know what this is
Lp(a)P-----------------------117 "I" still high risk
ApoB------------------------137 still high risk
ApoA------------------------146 "I" optimal
ApoB/ApoA-1 ratio-----0.94 "I" still high risk
sdLDL-C--------------------57!!!! WORSE (last was 35)

Didn't I read somewhere that losing weight could drive up the sdLDL-C and not to necessarily jump off a bridge in that case? Please say it's so....

hs-CRP --------------------------1.9 "W" was 1.4 still mildly elevated
Fibrinognen--------------------575 "W" was 509 still high risk
Uric Acid------------------------7.1 (she has me on a tart cherry extract supplement and an extract from pineapple for this) She said this is gout!

So given those bad CV risk factors, how can my:
Lp-PLA2 Activity (vascular inflammation) be optimal at 175 now, down from 325, high risk????
I don't get how all this goes together and she doesn't really explain that.

Barbara
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Re: Ready to Quit

Post by NF52 »

Jan18 wrote:...Most of the restaurants around here have very few selections of vegetables that we can have (they count mac and cheese as a vegetable) and it's always the same ones, broccoli or potatoes in five different ways! ... Don't you sometimes wonder if our taste buds (mine screams for cheese and cream in my coffee) are telling us what our bodies need? ...
Now my doctor has me worried about having a heart attack or stroke. Or maybe it's my own head that has me worried about that.
...So given those bad CV risk factors, how can my:
Lp-PLA2 Activity (vascular inflammation) be optimal at 175 now, down from 325, high risk????
I don't get how all this goes together and she doesn't really explain that.

Barbara
Hi Barbara,
I have held off jumping in on your heart-felt topic because I'm about the last person to consult on diet! But, I do feel a smidgen of ability to comment on your worry and fear--which I think is no way for us to go through life! That's because if we were having an Lp(a) contest, mine would beat yours hand-down at 175! And my LDL-P was above 1100 also. I had a long, helpful talk with my doctor who pointed out something I have read since, in discussion of what's called "number needed to treat" for drugs: Not every biometric signals clinical evidence of disease that would be seen on imaging or other tests, and not every clinical sign of disease (say plaque in arteries or even beta amyloid in brains) predicts with certainty an actual event (heart attack, aortic valve stenosis, Alzheimer's). That's why most dense breasts are checked carefully, but aren't hiding breast cancer, and why not everyone with high LDL is ready for a heart attack. It's why even a highly effective drug may need to be given to hundreds of people with biomarkers of disease to prevent disease on 100 (hence the term "Number needed to treat".) You doctor is being cautious, but you get a vote in this also.

Like you, I was worried about my cardiac risk, since my father died at age 67 of cardiac arrest, only 8 months after quadruple bypass surgery. So I paid for a coronary calcium scan 2 years ago, at age 65. My doctor said "If you have a score above your age, we'll talk about what to do." Imagine my surprise as zero calcium plaque in my arteries and a "aardiac age" of 39. I don't expect that to translate to living to 115, but it does tell me that biomarker numbers are not the same as actual disease progression or risk.

If you can afford it, you might want to pay the $150. or so for a coronary calcium scan; it's quick and painless, and possibly for a carotid artery scan if you have a family history of stroke (about $99. I think). I did one other thing, which is controversial, but made sense to me: I started on a 10 mg dose of atorvastatin and have no observable side effects in the 2 years since.

Finally, I think Stavia (author of the Primer) has stated that small amounts of cream, cheese or other treats (she loves a Portuguese cream-filled pastry, I think) are highly unlikely to send you like a speeding train to dementia. Having lived in places where broccoli , canned peas and potatoes were the only vegetables in restaurants, I recommend making a friendly visit to talk to the restaurant manager and suggest that offering asparagus, mushrooms, pumpkin or squash soup, beet salad with feta cheese etc. are ways to beat the competition and appeal to vegans, keto-diet customers, and anyone who wants some variety in life. Either that or take a road trip to the nearest town with an innovative menu!
4/4 and still an optimist!
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Jan18
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Re: Ready to Quit

Post by Jan18 »

NF52 wrote:My doctor said "If you have a score above your age, we'll talk about what to do." Imagine my surprise as zero calcium plaque in my arteries and a "aardiac age" of 39. I don't expect that to translate to living to 115, but it does tell me that biomarker numbers are not the same as actual disease progression or risk.

If you can afford it, you might want to pay the $150. or so for a coronary calcium scan; it's quick and painless, and possibly for a carotid artery scan if you have a family history of stroke (about $99. I think). I did one other thing, which is controversial, but made sense to me: I started on a 10 mg dose of atorvastatin and have no observable side effects in the 2 years since.
Hi NF52,
Thank you for taking the time to tell me all of that! It helps me put this in perspective and answers my questions about her seemingly happy attitude with improved labs, even though there are some that still need more improving.

Your CC scan story is so similar to mine!!! Six years ago now, when I first moved to this area and got a new internist, she recommended a statin due to my lipid numbers. I told her how my dad died from Lipitor (his doctor put him on it at age 79 simply because his total cholesterol was 200 -- he was in absolute great health other than that and his generation didn't research stuff, just trusted their doctors.) It led to rhabdomylosis and he died. My internist ran tests and showed me one of my results, which my dad would've had, too -- can't remember what now -- which indicated he (and I) definitely should NOT be on Lipitor, but suggested there were many other types of statins appropriate for me. I asked, "Why don't I actually GO to a cardiologist and let him evaluate me, since I've had high cholesterol a long time and should probably see the condition of my arteries/heart, etc? And then we'll take it from there."

So long story short, cardiologist adamant I should be on a statin, given my labs. Told him dad story. He said EKG, stress test and CC scan and then we'll evaluate. Same as you, my EKG and stress test were fine and my CC score ZERO. Even my carotid artery scans were fine. Amazed, he capitulated, "Well, I guess just diet and exercise. No statin for now." That was back during the time I was biking an hour a day, 4-5 days a week. Kid crashed me, broke my wrist, haven't biked since. Though I do water aerobics, faithfully for weeks then not. Up and down. Anyway all of these details because I wonder if the exercise contributed to the good score and if maybe it has gotten worse?

My internist suggested after these 6 years I have another one to see if things are still the same. My functional medicine doctor says the test is a big dose of radiation and I should only have it every 10 years. She also said if I found out I had some calcium deposits, what would I be doing differently than I am now and if I'm still zero, would I slack off of my eating/exercise program? Well, no, I wouldn't, but yeah, I'm a little worried about radiation.

However, I've read that some of those lipid markers are independent CV or stroke risk markers even without CVD present.

By the way, did we "speak" before? I talked to a former English teacher on this site (I taught secondary English for 32 years.) How lucky to have 3 and 5 yr. old grandkids! Mine are 14 and almost 13 and past the running up to me, arms outstretched yelling, "Nana!!!" (But they still give great hugs...if no friends are watching.)

Barbara
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Re: Ready to Quit

Post by swanlzs »

A bi late here - but I feel that intermittent fasting is a way to enjoy a range of whole/minimally processed foods. I fast 16 hrs/day most days. weekends are a bit lax and I generally follow up with a 20-24 hrs fast afterwards. I eat meat 2-3 times/week and salmon/fatty fish 2-3 times/week. Lots of veggies, some fruit, sourdough bread, dairy (usually fermented - yogurt, cheese kefir). Red wine a few times/week. I take a few supplements. My labs are good. I walk/jog every day. I also meditate. I'm feeling great and my dr. is ok where I am. I'm 67 and still working full time in the IT field. Hope this helps. Best wishes in your journey.
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Re: Ready to Quit

Post by hairyfairy »

Iv`e done plenty of complaining about my apoe4 status, every day I curse whichever parent passed it down to me. I feel cursed!
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Re: Ready to Quit

Post by circular »

Jan18 wrote:I'm TRYING to get into weight-training. I hate going inside the gym and it's a 20 minute drive. But I'm working on pushing through those negatives and going 3x a week.
Thanks for posting your frustrations. I'm quite confident many here who don't and won't post, but do read, feel the same, at least sometimes. I know I do.

Wanted to comment on this. I do more weight lifting by keeping my various PT accoutrements on a towel on the living room floor, towel matching the carpet. It may not be everyone's idea of interior decor, but leaving the weights and other things there I am better able to work it in, usually in the morning with coffee and a good podcast or music, but on the rare occasion I watch TV I do it from the floor while I do various exercises. I also keep a couple weights in my bathroom so I see them and stop for a couple minutes at random times and do some exercises. I prefer this to taking lots of time to go to a gym and worry about picking up viruses. That said, due to some musculoskeletal issues, I can't use very heavy weights anymore. I focus on lots of reps at lower weights and make one of my kinds of meditation. If I could do heavier lifting I just may be using a gym.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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