Donal Collins - High Calcium Score - Case Study III
I met S this morning who travelled down to see us after viewing an Ivor Cummins podcast with Gabor Erdosi and myself. S wanted a Kraft Curve.
History and Journey
“I have a backstory” S said. "I love back stories", I said.
3 years ago S went for a routine medical at age 62.
He wanted to have a heart health check so he went to a cardiologist in a well known street in London.
He was completely well and asymptomatic.
Physical exam -- all normal. Bloods – all normal. ECG, treadmill stress test and echo -- all normal.
For some reason the cardiologist says “let's do a Calcium Artery Score.” It comes back at 4600 (off the scale according to S and the cardiologist). S did another calcium scan just to be sure – it came back higher, at 5100! With that number, the probability of a heart attack was high.
This leads to an urgent angiogram. This revealed that he had 90% narrowing in three coronary arteries. The cardiologist recommendation was revascularisation. He had an immediate quadruple bypass .
The good news is he feels the same as he did before the operation and still has no symptoms
“What now?” was S's question.
The cardiologist advised: “see how you feel. If you get any symptoms , come back, and we could do an annual ECG?” “See how I feel?” S said to the cardiologist. “I was feeling fine right up to the point I was wheeled into the operating theatre for open heart surgery!”
“But why in a non diabetic, non smoker, non hypertensive, non obese and no family history are my arteries clogged up? And what is to stop the new plumbing blocking up?”
There was no advice to this question, which I would not have answered 5 years ago. All the cardiologists and heart surgeon could say was “genetics.”
S is a bright engineer who has gone on a journey of root cause, inflammation and metabolic health. Ivor Cummins “Eat Rich and Live Long” was his first book. He has now read 35 books and one hundred papers. Including Krafts original book on the subject in the 1970s.
S has been on a low carb/Keto diet for the last 2.5 years. He has been struggling to shift the last bit of visceral fat. He wanted to know what his insulin was doing. But this should be really low having been on Keto over the last few years.
Yes is the answer, but we would have loved to have measured your insulin resistance before you had the bypass!
"No one in London does Kraft Curves!" This was a big surprise to the engineer who spent his whole career collecting data and measuring stuff. "That is how you make decisions and measure how good or bad those decisions were" S said.
Diagnostics
Here is a graph of todays results:
The key to getting a sensible result was to “wake the pancreas up a bit, so for four days before his visit, he ate what is standard fare in the UK, i.e. fish and chips, beer, bread and pastry.
Like waking a bear up at the end of hibernation, the first day or two may have a groggy response.
So what we both agreed and learned was there was a higher than anticipated response to 75g glucose.
He has some residual insulin resistance. To correct this he will introduce two fasting days per week, and cut back on cream and cheese which might be holding up his waist circumference.
S has some insulin lateral flow devices and the plan is he will repeat a 1-hour post 75g glucose in 2-3 months time to see if there has been a positive response.
Management
We had a great morning, great conversation. I love meeting engineers who like to ask why? And keep asking why till we get to where we need to. It is possible to edit!
I advised S to avoid dairy food and to favour steak and to fast for two days in the week
Looking ahead
S has reported the experience has empowered his significant knowledge base, and in fact S would like to get involved in our project. So you may be hearing more from S in the future!?
