Test Results Are In From Stress Test!

Here we go.  Results are in.  I need to look up some new vocabulary to understand results!
Here is the summary from the stress test:

TECHNOLOGIST STRESS SUMMARY
The patient underwent an exercise sestamibi imaging study. The patient 
exercised for 10 minutes 56 seconds reaching 139 beats per minute which is 
86% of the predicted maximum heart rate. This is the equivalent of 13.2 
METs. The blood pressure ranged from 138/104 to 169/101. The test was 
terminated secondary to fatigue. The patient had no symptoms during 
stress. The patient was imaged on the CZT camera. The patient received 
5.6 mCi of sestamibi IV at rest and 15 mCi of sestamibi IV at peak stress.

Now, first what is "exercise sestamibi imaging study"?

 This test requires the intravenous injection of a radioactive blood flow marker followed by imaging of the heart.   The test is a well-established noninvasive method of assessing coronary blood flow.   The test is capable of identifying regional abnormalities in coronary artery blood flow and determining their physiological relevance to myocardial function and viability.

So, the radioactive marker (I now glow in the dark) allows the doctor to view the blood flow!

The test lasted 11 minutes & the final 2-3 minutes were "butt kickers!"  Had to get my heart rate to 139!  And with my beta blocker this is difficult!!!  I did it, but was huffing & puffing!!!  139 is 86% of my maximum heart rate.  I had no symptoms, but still had some PVC's.  Good news is the most I had was 3!!

The rules have changed with my stress test.  In the other tests I had, if I had 3, they stopped the test - know the person giving the test said the new rules say 10!!!!  Need to ask my cardiologist about this!

Other comments were:

IMPRESSION 
1. Good functional capacity with patient exercising for 10 minutes and 56 
seconds on the Bruce protocol. 
2. Normal hemodynamic response to exercise.
3. Patient did not have any chest pain on the treadmill.
4. No ST depressions diagnostic of ischemia were noted with exercise.
5. The patient had frequent PVCs including ventricular bigeminy, 
ventricular couplets, and two 3-beat runs of nonsustained VT at peak 
exercise.
6. Uniform perfusion was noted. There is no evidence of ischemia or 
infarction.
7. Septum is hypokinetic, likely related to postop state. Ejection 
fraction is 50%.

This added some new concepts!

What is the Bruce Protocol?  According to wikipedia:
The Bruce protocol is a diagnostic test used in the evaluation of cardiac function, developed by Robert A. Bruce.

ST depressions?  Again Wikipedia:
In a cardiac stress test, an ST depression of at least 1 mm after adenosine administration indicates a reversible ischaemia, while an exercise stress test requires an ST depression of at least 2 mm to significantly indicate reversible ischaemia

And ischaemia?  Ischaemia is a restriction in blood supply to tissues, causing a shortage of oxygen and glucose needed for cellular metabolism (to keep tissue alive).^[3] Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue. 

Well, how about infarction?
infarction refers to tissue death (necrosis) caused by an obstruction of the tissue's blood supply, which leads to a local lack of oxygen

What is ejection fraction?   This is a test that determines how well your heart pumps with each beat.  Mine was 50%, Below Normal!

Overall not bad!  That is the highest I had my heart rate in more than 3 years!!!  After my heart surgery I have been afraid to "take it up a notch".  Now these results go to my cardiologist and I meet with him in March!!

Cardio Rehab on the Conewago Trail

Today I did my cardio workout on one of my favorite trails - The Conewago Trail!  Today I parked along Route 743 and walked southwest.  Walked to Mill Road and back!  About a 50 minute walk.

Top of map show start of walk at Route 743

Lower Part of map shows Mill Road Crossing

It was a great walk - check out the pictures from Mill Road back to Route 743!

Here is were I turned around - Mill Road is the road you see.

On the way back I pass a cut that was made through the rock!

At the mile mark 1.5, a small stream goes under the trail.

Around marker 2.0, I walk across Old Hershey Road.

Walked under Route 283 & found a dear that did not make it across the road!

Just before Route 743 is a Watershed Project - 15 acres!

Just before Route 741 is mile marker 2.5!

Great walk - TRY IT OUT!

Second Week Off Atorvastatin!

This is my second week off Atorvastatin and my energy level is up & legs feel great.  As noted last week, the 40 mg of Atorvastatin I have been on for two years really changed my daily energy levels & I really thought it was me aging!!!!

During my cardio workout today my 45 minute run/walk had my heart rate up to 115 & without any PVC's.  Now the experiment is dealing with the Statin and my PVC's.  Next week I have another stress test to check out my PVC's.  And in March I will have my blood work to see how 2 months without my statin changes my cholesterol levels!

Here are thr suggestions from the Mayo Clinic!

Total cholesterol (U.S. and some other countries)	Total cholesterol* (Canada and most of Europe)
Below 200 mg/dL	Below 5.2 mmol/L	Desirable
200-239 mg/dL	5.2-6.2 mmol/L	Borderline high
240 mg/dL and above	Above 6.2 mmol/L	High

LDL cholesterol (U.S. and some other countries)	LDL cholesterol* (Canada and most of Europe)
Below 70 mg/dL	Below 1.8 mmol/L	Ideal for people at very high risk of heart disease
Below 100 mg/dL	Below 2.6 mmol/L	Ideal for people at risk of heart disease
100-129 mg/dL	2.6-3.3 mmol/L	Near ideal
130-159 mg/dL	3.4-4.1 mmol/L	Borderline high
160-189 mg/dL	4.1-4.9 mmol/L	High
190 mg/dL and above	Above 4.9 mmol/L	Very high

HDL cholesterol (U.S. and some other countries)	HDL cholesterol* (Canada and most of Europe)
Below 40 mg/dL (men) Below 50 mg/dL (women)	Below 1 mmol/L (men) Below 1.3 mmol/L (women)	Poor
40-49 mg/dL (men) 50-59 mg/dL (women)	1-1.3 mmol/L (men) 1.3-1.5 mmol/L (women)	Better
60 mg/dL and above	1.6 mmol/L and above	Best

Triglycerides (U.S. and some other countries)	Triglycerides* (Canada and most of Europe)
Below 150 mg/dL	Below 1.7 mmol/L	Desirable
150-199 mg/dL	1.7-2.2 mmol/L	Borderline high
200-499 mg/dL	2.3-5.6 mmol/L	High
500 mg/dL and above	Above 5.6 mmol/L and above	Very high

My levels were:
Total Cholesterol - 175                This is OK
LDL Cholesteril  - 100                Ideal for people with heart disease

OK, now the bad stuff!
HDL Cholesterol  - 31                Poor - NEEDS WORK!!!!!!!!
Tryglycerides  - 221                   High - NEED TO STOP EATING COOKIES & CHOCOLATE!!!

The Experiment Continues

This is my first entire week without Atorvastatin (Lipitor generic)!  My legs feel great!  One of the issues with take this medicine is muscle issues!  This is the best my legs have felt in 2 years!  Remember, after my open heart bypass surgery my atorvastatin went from 10 mg to 40 mg.

The big question will be, what will my cholesterol be like in two months????????

Fatigue?  Yes!!  I have had less energy when I was taking Lipitor or Atorvastatin!

Check out this study at:  Study Links Statins to Excessive Fatigue

It stated:

The study found that participants on statins were significantly more likely than those on placebo to report at the study’s end that their energy levels had worsened and that they were experiencing greater fatigue after physical exertion. The effects were stronger in women and among people given simvastatin (which also was found in this study to lead to a greater decrease in cholesterol levels).

Need to keep track of this!

New Experiment - No Lipitor for Two Months!

Here we go!  Another chemistry experiment!  Here is were I am two years after open heart by-pass surgery!

I had my cardiologist visit last week and some of my numbers were high, especially my liver numbers!  For the next few blogs we will look at my blood tests and the NEW game plan!

First one of the concerns:

Hepatic Function Panel       Your Value  Reference Range  Units       Flag
Protein Total Serum               6.9               5.6-7.9                 g/dL         None
Albumin                                 4.5               3.5-4.9                 g/L           None
Bilirubin Total >21 Days       0.9               0.2-1.2                 mg/L        None
Bilirubin Direct                      0.2               0.0-0.2                 mg/L        None
Alkaline Phosphatase            67                 34-104                 U/L          None
AST (SGOT)                        67                 13-40                   U/L          High
AST (SGPT)                         122               7-52                     U/L          High
Gamma GT                           49                 9-64                     U/L          None

Found some answers to what is AST (SGOT & SGPT)!!!

Normally, where are the aminotransferases?

AST (SGOT) is normally found in a variety of tissues including liver, heart, muscle, kidney, and brain. It is released into the serum when any one of these tissues is damaged. For example, its level in serum rises in heart attacks or with muscle disorders. It is therefore, not a highly specific indicator of liver injury as it can occur from other injured tissues.

ALT (SGPT) is, by contrast, normally found largely in the liver. This is not to say that it is exclusively located in liver, but that is where it is most concentrated. It is released into the bloodstream as the result of liver injury. Thus, it serves as a fairly specific indicator of liver status

Liver Blood Test

My liver is damaged!  Why?  One is the use of lipitor!

See this article - Statin Drugs Found to cause Liver Damage

So what is the game plan - No lipitor for 2 months & watch my diet!!!  And exercise!!!

Cardiologist Check Up

It is two years after open heart surgery and my yearly cardiologist check up!

Here is the good news!

1 - Still breathing!  I feel pretty good & I am able to do almost anything I want to do - golf, walk & exercise, travel, etc.

2 - Blood Pressure today 115/75 - great!  Happy with that!

3 - Total Cholesterol - Total 175  Not Bad, remember my high 10 years ago - 300!!

4 - Almost all other levels are great!

Bad news?

1 - Total Cholesterol is 175 which is OK, but HDL is 31, needs to be above 40 & LDL is 100, Doctor wants it 75 or below!

2 - Liver results not good - AST (SGOT) at 67, should be between (13-40) & ALT (SGPT) is at
122, should be between (7-52).  So, diet change!

3 - Still getting PVC's -seem to still be exercise induced as the heart rate gets to 110-120.
Game Plan?

Go back in two months!

Eat better - veggies & fruits!!!
Lose weight - At 195, try to get to 180!

Will have another Stress Test in March & wear a Holter Monitor to check PVC's!

Let the FUN begin!!!

25 Months After Open Heart By-pass Surgery!!!

Here we are, a little more than two years after open heart by-pass surgery!  This is doctor week - Tuesday meeting with cardiologist & Thursday a physical with my family doctor!  Got my blood tests and I have a few "flags"!  This week I will focus on the areas I need to improve!

First RED FLAG - Triglycerides!  The normal reading is 60 - 150 and mine was 221.

To review Triglycerides I went to:

Triglycerides and How to Lower Them

What I need to do?

• Moderate exercise on five or more days each week can help lower triglyceride levels.
• Losing 5%-10% of your weight can lower triglycerides. People with a healthy weight are more likely to have normal triglyceride levels. Belly fat is associated with higher levels.
• Reducing saturated fat, trans fat, and cholesterol in your diet can improve triglyceride levels and help manage cholesterol. Eating less carbohydrates in your diet will also help lower triglyceride levels.
• Drinking alcohol can raise triglyceride levels. Some studies show that drinking more than one drink a day for women or two for men can raise triglyceride levels by a lot. Some people with high triglycerides may need to cut out alcohol entirely.
• Eating more fish high in omega-3s can lower triglyceride levels. Fish like mackerel, lake trout, herring, sardines, albacore tuna, and salmon are high in omega-3s. It may be hard to get enough omega-3s from food to help lower your triglycerides. Your doctor may recommend a supplement or prescription omega-3s.