Doctors & Doctor's Advice (Ranting)

This will be a LONG post. Grab something to drink.

Saturday morning after writing and posting this around 2:18am last night, I added two links of reference at the bottom of the post. There are many more links I could post but just too many links to add here. These two will help those that are interested though. Thanks for stopping buy.

No photos with this blog post, just straight out late night (after midnight --- finished at 2:18am) rambling. A cord was struck within my brain a few minutes ago when I saw someone mention "doctors advice" .... see lately I have found a group of people in my age group 65 - 71 that have talked about NOT following their doctors advice after doing it for 30 some years. I found them on Twitter because Twitter thought I might be interested and fed me their tweets ... if that makes any sense.

Person after person "testifies" how they were unhealthy for years with things like obesity, diabetic type II, heart issues ... the normal stuff. Their doctors had kept them on meds for decades ... not years ... decades. They ate the USA Recommended Diets, the Triangle of foods. They claim they never got better, never felt better all those years UNTIL they went off on their own path and basically said "screw it, Im tired feeling this way".

They went against the grain. Something I have done most of my life. Meaning ... doing the unexpected in work, location, etc ... living life basically and driving my parents crazy.

Some of my friends, the few I have left, have complained for decades that I never go to the doctor, I never get a physical, I never follow orders, blah blah blah .... 

Well, they are right.

Until I had that bike wreck at 1mph as I turned onto a bike path and broke my femur and shattered my hip as the surgeon relayed the info to me that Saturday morning in September 2019 ... IF that had not happened I would have never gone to a doctor for anything because I hadn't in the past.

Oh in 2000 I had to because with the type of work I was doing, they required a physical. There I weighed 32 more pounds than I did this morning. I was a work-a-holic, no vacations and planned then to work until I was 70. That doctor told me at the age of 48, "if you don't change your diet and do some sort of exercise program you will not be working until you are 70 because you will be dead by 62" .... I agreed.

My dad had quad bypass surgery at the age of 58 but lived another 31 years when they said he would do 20 more. I was a high school athlete and then a bicyclist in my 20s (racing and one cross country trip) but once I was a workaholic all bikes were pushed out of site ... I had to work.

Back to that 2019 story. 

The following month in September 2019 I experienced doctors, doctors advice, cardiologists and their advice ... I read the 37 page report I had picked up the day they released me from the hospital after my hip replacement. Some things in that report were in capital letters, which I assumed was for emphasizing certain data they had found.

The surgeon that did my hip replacement was and is top notch. He told me that Saturday morning he would give me a new hip Sunday morning 7am local time and I would be home with my hounds by noon on Monday.

I was. 

With a walker but I was home with the hounds. Luckily I had someone to feed them the two days I was gone and to feed the for the next two weeks or until I could do it "safely" without messing my leg and hip up.

But what followed with other doctors and a couple of cardiologists made me follow MY intuition and say NO to them. They had the same report I read about my heart because I gave them a copy. Yet if you heard them speak they probably didn't read a word of it.

Doctors are like vets ... they don't really care to be given information from their patients because I had the feeling that they thought I did not know jack shit about anything. 

How did the my heart come into play while getting a hip replaced??? Well I found out AFTER THE FACT ... the night before my hip surgery the hip surgeon called a local cardiologist because from the echocardiogram they took, as required, before the surgery ... they had found I had a heart murmur and my aortic valve was not flapping open and closed at it should be. They call it Aortic Valve Stenosis.

I was told that story AFTER my surgery, months later.

Did they tell me that story because I asked? No .... Did they tell that story because they offered it? No.

I found out that story at my appointment with my first cardiologist in December 2019. I was told the day I was released from the hospital I needed to talk to a cardiologist. The one at the hospital could not believe I was riding a bike 85 - 250 miles in a week, 3-5 days sometimes 6 days in a week, climbing Ramsey Canyon Road ... and still averaging 13-15mph average ... "AT YOUR AGE" ... 

He actually said "there was no way you ride a bicycle with what he saw in my echocardiogram."

I replied I have the proof on an app called Strava which tracks all my rides, all my speed, all the distance and my heart rate along with a detailed map of where I rode/ride.

So the bullshit flag was slowly moving up the pole past half mast ... I went home and ate healthy food and followed my hip surgeon on how to walk again.

47 days after my surgery I rode my bicycle, a road bike they call it, that looks like a racing bike ... back out "to the scene of the crime" ... where I fell. Believe me, every time I rode past there or made any turn at a slow speed I concentrated at all times in making the complete turn and and not taking it for granted.

I do that even on my rides today.

So I have an appointment to see my first cardiologist in December 2019 after the one in the hospital told me straight told me I did not ride a bike like that at my age and with my heart condition.

The thing was ... they didn't know I had read that report page by page, word by word ... it said out of 70% max my heart was pumping at 67% ... next to that was a handwritten note ... "excellent". It said my resting pulse rate was 49 when they took it and normal was 68bpm ... 

But the eye opener ... in capital letters it said "NO ARTERIAL BLOCKAGES" ... could they tell that from an echocardiogram ?? I didn't know if they could and I don't know now but all I saw were those words.

I get to my appointment. I have been back on the bike for about two months at that time but also very aware of my hip and the femur that was still healing. I was careful when I rode but I was feeling great.

A nurse assistant takes my vitals ... I get moved to another room where the nurse practitioner asks me a million questions and was impressed that I was a bike rider. I guess when people see someone that is balding with white hair they assume the worst ... and I admit ... the people in that doctors waiting room didn't look like me ... they were younger and looked like they were literally on their last days. Really, that bad.

If I was going to have heart issues my legs below my calf and ankles would be swollen. She asked me to take off my shoes and socks and roll up my pant leg so she could take a look. She saw normal feet, ankles without any swelling and a calf that was well defined from my cycling.

As we concluded our interview with her typing all this information into her laptop computer .... her parting words were ..... 

"Keep riding your bicycle"

Remember that as I tell you what the cardiologist is about to tell me less than 30 minutes later.

We move to another room and in walks the cardiologist while the lady I just spoke with is sitting at a table with her laptop open and taking more notes as the doctor spoke.

It might just be me but I am old enough to know when I get a bad or good vibe, if you know what I mean.

He wasn't that room a minute, when bad vibes overwhelmed me. I thought to myself "well this is going to be interesting". I sat there and listened, answered his questions honestly and he too thought my bicycling story/riding was suspect.

Now ... how does all this tie into the story about a hip surgeon calling a local cardiologist ???? 

Well I made an appointment with this one because I was told he was the best ... the best cardiologist in Cochise County. 

As he walked into the room glancing at some papers he said .... "so you are the guy I heard about"

I replied ... "excuse me" ?????

He said "Dr XXXXXX called me a few months ago telling me he was due to do a hip replacement at 7am the next morning but your echocardiogram showed you had a heart murmur and aortic valve stenosis. He also mentioned you were a serious bicyclist."

He wanted clarification on if he could go ahead with hip surgery or would heart surgery have to come first. 

Just to interject a note here in the middle of this story ... I found out from reading a medical journal about AVS from Harvard Medical Journals after this appointment .... it stated heart surgery was required to fix any issues with the heart before a surgery for a hip replacement could be performed.

True story .... 

I am not sure or I can't remember how or why he got the okay to proceed with the hip replacement but I am sure damn glad he did without any kind of heart surgery first.

I DON'T NEED HEART SURGERY !!!!

Yet this cardiologist had me all lined up ... as he told me MY SCHEDULE the following week right before New Years .... His instructions were:

1.  ... stop bicycling IMMEDIATELY     (remember the NP told me to keep riding my bike)
2. "next Thursday I will have you scheduled for a catheterization 
1. I told him "but the report stated in capital letters NO ARTERIAL BLOCKAGES
3. "after that catheterization, I will schedule for by-pass surgery ASAP where I will also install a pacemaker"

My smile was probably more of a smirk by that time. (sure you will) I had a million thoughts going through my head and at the same time I am trying to bottle up and lock up my Irish temper I could feel building up inside because I could hear those little voices in my head telling me to tell him what I really thought of "his expertise" my heart health.

I didn't.

I calmly told him it seemed strange because I have never in my life felt any of the symptoms of aortic valve stenosis ... ever. "If my heart is as bad as you say it is I would never be able to ride the way I do." 

I told him while I ride I can glance at my Apple Watch which is synchronized to that Strava app and see my pulse rate at that moment. I mentioned I monitor it after I ride and when I wake up the morning after a ride. I bought the watch just for that, in case something happened.

Of course being a doctor he was obviously ignoring everything I was saying. I did not want to get the NP in any kind of trouble so I DID NOT tell him anything she had said to me. She had also told me from the data she had seen plus my blood work ... I was in great shape for a man my age and didn't see any signs of heart issues.

So I ignored him.

As he turned to walk out, I stood up and the NP led me to the front desk to make all those appointments he had wanted ... the catheterization next Thursday, the by-pass a week or two later depending what was available.

So she and I walked to the front desk to get checked out and to make those appointments. I did check out and then told the girl "I'd like to get all the notes or report about my appointment today, mailed to my house". (She verified my address and I had them in two days) Then I turned to the NP and told her "I will not be making any of those appointments nor will I ever come back to talk to this doctor"

I walked out.

I knew I needed a second opinion and made arrangements to see a cardiologist at the VA hospital in Tucson. There I took another echocardiogram. There I was given a clear and long explanation of EVERYTHING that was going on with my heart.

It was like the other extreme in cardiologists and heart care. It was so different It was hard to actually believe.

They concluded there was no need for a catheterization. Yes, I did have a murmur. My heart was pumping strong like the report said. All of my data looked great for someone my age. THEY LISTENED WHEN I ANSWERED THEIR QUESTIONS. 

They wanted to know about all of my bicycling background from racing in my 20's, not riding for 20 years and then picking it back up in 2019. They believed I rode like I told them I did, in fact she said she also used the Strava app for her bicycling rides.

They said the measurement of the opening of my aortic valve was an "interpretation", not an actual measurement. The hospital before my hip surgery had it at 0.9cmxxx which fell into the "serious" category for AVS ... but they felt it was 1.1cmxxx (the xxx means I can't remember the exact unit of measurement) and that make it not serious.

They recommended we do an echocardiogram every six months and see what the measurement is before we make any decision on replacing the valve. But at that time they didn't think it was anything to freak out about.

"KEEP RIDING YOUR BIKE ... because you will be able to feel the symptoms faster rather than going home and being a couch potato. They LIKED that I was riding my bike that much and the way I rode it. They BELIEVED ME when I told them I had NEVER felt any of the symptoms for AVS.

The story continues ....

I am in the bike shop one day after these two appointment talking to the shop owner about what they are saying while I stand there in bike clothes with my bike after riding 35 miles and feeling great with no symptoms.

A younger man, but not that young, is in bike clothes with his bike looking around the shop and overhears our conversation. He apologized for butting into ours but wanted to tell me his story.

"18 years ago I was told I needed immediate heart surgery replace my aortic valve because I had a backfill issue every time that  aortic valve closed and opened with every heart beat. I was told to stop riding my bike also and even after surgery to fix this backfill issue I would never be able to ride again ... I told them to go to hell and I have never stopped riding this bike and I have never had surgery nor any heart problems".

Hmmmm intersting.

I talked to some of my college friends that had worked in the medical field. Some had friends that had heart surgery for one reason or another. But we are all different. (I know you don't start sentences with "but"). A few of those friends, the same one that complained that I never went to the doctor or had an annual physical, wanted me to get the valve replaced no matter what.

Like all things, if you read about something enough you will see conflicting information. For instance I was told by the VA doctor that diet would not change my AVS condition. It won't get better by eating healthier food ... "but we would like you to take statins because we noticed your cholesterol I a little high."

I wasn't taking them either and told them I would go to more of a Mediterranean Diet and less beef. They said I could do that and "we will see how your blood work is when you come back and that will determine if you take statins or not."

I guess they didn't understand ... I am NEVER take statins and I told them that. 

Then I find in a medical article "The AVS Diet" ... salt 2-4g per day, brown rice, whole grains, fat 20%-25%, fish, skinless chicken and turkey, all the B vitamins, peas, grapefruit, oranges, bananas, raisins, apricots, NO Vitamin D and K2 might reduce build up of calcium.

I had already been eating all that. I took K2 because a friend recommended it. I figured all the sun in Arizona was giving me enough Vitamin D ... I was al little over the fat limit based on the data Cronometer app tells me as I log in all the food I eat.

Some of those foods give me indigestion though so I quit eating them. Like all grains, oranges, oatmeal ... so at the same time I am analyzing AVS stuff ... I am studying different eating plans during this time.

More conflicting information ... the book about diets based on your blood type has always worked out best for me ... but the list of foods are not what to eat if you have heart issues as per cardiologist. But a cardiologist did write the book about Blood Type Diets. Personally I don't think of myself having heart issue, I have a valve issue. I also think and one cardiologist thinks .... I WAS BORN WITH THAT.

71 years and have never felt even one of their EIGHT symptoms.

In December 2020 I had to cancel my echocardiogram appointment at the VA hospital due to COVID. I didn't have it and I have never had it nor have I taken any of their shots and boosters and never will. That is another blog rant sometime. LOL

But they did want to do a video call on the computer which didn't work so we talked by phone. The doctor I talked to in 2019 was working somewhere else in 2020 and in that February phone call I had found another wacked out doctor that had me ending the hour conversation like this AFTER WHAT HE TOLD ME ... just one thing "you'll be dead within the year doing what you are doing". (riding the bike and what I ate)

I told him I didn't agree ... so let's do this. Are you pretty sure of what you said, feel confident about what you said??? Well I will "offer" you what I did to a cardiologist in 2019 (not the one I talked about) ... I will bet my monthly retirement check against your monthly income that I am right and you are wrong ... "how's that?"

I heard nothing but silence on the other end of the line. Nothing but silence.

I thank him for his time and once I heard he was still there, I said goodbye and hung up.

Long story short ... I FOLLOWED MY INTUITION based on how I felt and what I had read in that 37 page report from the hospital and what the doctor told me about AVS at the VA Hospital in January 2020. To this day I ride my bike the same way. I look at my heart rate while I ride. I record everything in that Strava app. I am not riding as much as I did in Arizona mileage wise but I am getting 3-4 days in per week around the thunderstorms.

I have decided the past month to go back to a low carb high fat high protein diet and have never felt better.  I have lost 8 pounds in the past 3 weeks with plans to lose 15 more after 12 months. Intuition tells me I am eating the right food for me. Other people's testimonies, medical articles and books I have read that were written by cardiologists ... shows me I have made the right decision.

Things change I know but I know I feel better now than I would have if I had let that doctor in December 2019 do what he wanted. YES I know replacing that value is a normal routine now. Replaced one day home the next and back on the bike in 5-7 days ..... 

I have thought about that lately ... yet "if it ain't broke why fix it" .... I would rather following what I have told over 5 cardiologists since 2019 ... "once I feel the symptoms I will call you and we can replace it then, in the meantime I am going to eat what I eat, and ride the bike like I do, I'l mow the yard in the middle of the day when "it feels like 100°" and I will drink a lot of filtered ice water.

But I am not going to follow their advice on anything ... food or the valve.

Here are two of many links that I have read and follow for new information. NO I am not an affiliate of either one and I am not paid for sending you there from my blog ... they are just for reference.

Square1Wellness

Mark's Daily Apple