From The Desk Of Clarence Bass
Cooper Clinic Says “Stay the Course”
I’ve just returned from the Cooper Clinic (Dallas), where things are clearly booming. The multi-million dollar renovations of the Cooper Fitness Center and the Cooper Hotel and Conference Center are now complete. Bypassing Obamacare and focusing on fitness and preventive medicine is filling their parking lots and waiting rooms. Dr. Kenneth Cooper and his team of physicians and support staff are providing services that health-conscious people are willing to pay for out of their own pocket.
Dr. Cooper and I are comparing treadmill times in this 1989 photo.
This was my 15th visit (10-7-15) over a 27 year period; my first visit was at 50. Health awareness is paying off for me. My test results were as good as or slightly better than my last visit on May 14, 2014. There were two high points: my A1c is now normal at 5.5 (after hovering at 5.9 over several visits) and the long session I had with nuclear cardiologist John S. Ho regarding the results of my third computer generated angiogram. (The first was in 2007 and the second in 2011).
Computed tomography angiography (CTA) combines x-ray and computer analysis. X-rays are taken from several different angles to create cross-sectional images, which then are assembled by powerful computer software into three-dimensional pictures of the heart and its arteries. Compared to cardiac catheterization, which involves insertion of a sizable catheter and injecting contrast material through a large artery in the groin area, CTA is a much less invasive and more patient-friendly procedure: contrast material is injected into a vein in the arm using a small needle or IV. No tube or catheter is required. CTA is also more cost-effective, usually not requiring hospital admission.
The bottom line is that CTA allows doctors to see the flow of blood throughout the heart.
Dr Ho conditioned his employment at the Cooper Clinic (about 10 years ago) on purchase of the new CTA technology. You might say that CTA is his baby—and I’m a poster boy for the results.
Ho is reluctant to recommend statins or aspirin for primary prevention of heart disease. He believes that healthy living (diet, exercise, weight control, purposeful living, stress control, adequate sleep, and meaningful relationships) is the preferred preventative for people like me who have never had a coronary event (heart attack, stent, etc.).
While I’ve never had a coronary event, I do have a troubling amount of calcium in my coronary arteries; see http://www.cbass.com/CoronaryCal.htm .
Until Dr. Ho arrived on the scene with CTA, there was no non-invasive way to accurately determine whether the calcium is compromising the flow of blood in my heart. Because of my high level of fitness, Dr. Arnie Jensen, my doctor at the Cooper Clinic when the calcium was discovered, surmised that the calcium is in the wall rather than the channel of my coronary arteries and not blocking blood flow.
There was also no way to know how much soft plaque (which does not show up on x-ray) is in my coronary arteries. While calcified plaque (formed from soft plaque) is generally stable, soft plaque can rupture causing a coronary thrombosis or blood clot that blocks the artery. CTA also visualizes soft plaque.
All three of my CTA studies show that Dr. Jensen guessed correctly, that the calcium is in the wall of my arteries and does not block blood flow. My coronary arteries are very large, with little or no soft plaque—and nothing approaching blockage. See http://www.cbass.com/CTAHEART.htm
As Dr. Ho explained to me, the key factor is blood flow. Calcium makes little or no difference if there is no blockage. Free flowing blood also suggests little or no soft plaque.
Ho says my results are very good. My CTA studies show no significant change or progression or worsening since my first test in 2007. My very large coronary arteries also provide an extra margin of safety.
The calcium formation in my arteries has slowed to a crawl. The clinical target (goal) is 10% or less increase in CAC a year—and mine has increased less than one percent a year. Importantly, the rate of increase slowed substantially from 2011 to 2015.
As long as I maintain my current lifestyle, I should have nothing to worry about. The low dose statin I take provides additional insurance.
You can see why Dr. Ho might look on me as an example of fulfillment of his expectations for CTA. CTA strongly suggests that healthy living (and a low-dose statin) is keeping the blood in my heart flowing freely.
I am scheduled for another CTA in 3 to 5 years.
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The largest improvement was in my Omega-3 Index reading, which moved from just below the desirable 8% (7.8 %) to near the top of the reference range at 11.1%. Most Americans are in the 3% to 5% range, while 8% to 10% is considered cadioprotective. Restoring a fish oil cap at lunch and dinner apparently accounted for the jump. Sardines continued to be part of my breakfast. Dr. McFarlin recommends that I continue with my Omega-3 rich diet.
My cholesterol is down across the board. Total cholesterol is 150 (174), HDL “good” cholesterol 77 (86), and LDL “Bad” cholesterol 69 (79). My chol-HDL ratio is a hair lower at 1.9 (2.1). Lower, of course, is better. Anything under 4.5 is considered good.
My triglycerides are 51 (56), near the bottom of the 45-125 reference range.
My PSA is normal at 0.34 (0.30); the reference range is 0.01-4.00. This indicates that my prostate is healthy. Dr. McFarlin found that my prostate is normal, not enlarged.
My testosterone remains in the middle of the 231-735 reference range at 494. It was 514 last time.
Again, my A1c is now in the 4.00 to 5.7 reference range at 5.5. A1c is an indication of average blood sugar for the previous 8 to 12 weeks. My fasting blood sugar was also down at 83 and well within the 70-100 reference range. It was 94 last time. I attribute the improvement to consuming a little more protein and whole milk. I continue to avoid foods with “added” sugar.
It may also be that my red blood cells live longer than the three month average and therefore accumulate more sugar than the test projects. As I understand it, people with normal blood sugar can test with unexpectedly high A1c levels. Whatever the reason, I am pleased that my A1c is now in the normal range, especially in view of my family history of type 2 diabetes.
Finally, my vitamin D level is healthy at 40; it was 34 last time.
Once again, I am grateful to Dr. Lynn McFarlin and the Cooper Clinic staff for showing me in black and white how well I’m doing.
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