A brief recap of the visit with my PCP:

My BP was through the roof. White coat syndrome was more than evedent today. I hadn't heard it wrong from the lab technician. My score was 343 which puts me in the 90th percentile for my age and gender. I'd be in the 50th percentile if I were 74 years old. Not good news. We discussed the results. I was prescribed a statin and she recommended daily low dose aspirin and COQ10. She said that only 5% of patients have side effects from statins and that she'd be happy to work with me on the dose should that be the case for me. She is referring me to a cardiologist and wants me to have a stress test done. They were going to do a resting EKG but couldn't get the equipment working. That is pretty much the nuts and bolts of the visit.

There was some back and forth discussion. I told her of my current 'no dairy' tweak and desire to wait on the statin until I see what this does for my LDL. She said that there is no LDL number I could have that would override the recommendation of a statin. So, she did not recommend waiting. We discussed my exercise, including the cardio I've been doing on the elliptical and my plans to run in the Richmond 10K in April. Surprisingly, she had no problems with it provided I was not showing any CVD symptoms and was prepared to stop at the first sign of trouble. She views my fitness and daily exercise regimen as a positive. I told her that I had been ending my elliptical workouts with a few 30 second sprints - getting my heart rate up to 170 or above. She said that is what they will do in the stress test and it sounds like I will do fine.

When talking about the CT Heart Calcium Scan results, I would have found it quite interesting if it were not a discussion of my personal results. My score is very high, BUT - given the distribution of the calcium and the fact that it was everywhere - a larger number would be expected. She said that most results show a large amount of calcium formation around one or two arteries (referring to one of them as the Widow Maker). I don't have a massive buildup in any one area. It is more like a coat of paint on all arteries and not a major clog on one or two. So when they added up all the scores for each artery, my number was high. I'm not sure if that is a good thing or not. It seems like it might be better than the classic situation where a bypass is done. I don't know. I'll have to ask the cardiologist. My doctor told me that for my type of plaque formation they are now thinking it has more of an association with hyperinsulinemia than with LDL cholesterol. For me that makes sense. I'm sure that high insulin levels have been behind my weight problems all along - way before the diabetes diagnoses. Dang. Only 25 years too late.

She did not say much about diet recommendations so I asked. I said I was looking to do more of a lower carb paleo-ish diet -- whole foods, high fiber, more fruits & veggies, olive oil, fish, less added fat, leaner meats, etc. She finally showed her true colors... She said that she recommends the Mediterranean diet (even though her husband eats paleo). I don't think she wanted to tell me to change what I've been doing that worked for me - so she had kept mum on the subject. That is just my guess. Perhaps she knows something that I don't. Perhaps I'll be directed to change what I eat by the cardiologist. I am willing to work with it within the context of what I now know I can do. But if they want to go Ornish on me, well - then I will be going rogue.

So that is the scoop. I'd like to keep the details and discussions here - away from my journal. I won't completely avoid the subject there, but I don't want to squelch the inspiration that one may have received by reading my journal only to end it with a thud (No offense, Thud).