The cardiologist was a good doctor. He did listen well and he shared a lot of information with me. But just so you know, he did get one pretty good lecture from me. I gleaned from our conversation that he was not very interested in my diet. He said that he has had patients improve their health markers by becoming vegetarian, vegan, paleo, etc. He pretty much said that the means of the weight loss didn't matter. He looks at health markers (including weight) and symptoms of disease. I told him that the means matters a great deal. What good does it do to recommend or prescribe a diet that the patient cannot do? I gave him a little bit of history about my diet struggles over the years. I had asked two different doctors and one nutritionist for help with my weight issues. I was told to eat less and exercise more. I was told to eat healthy 'low fat food', cut the fats from my diet and to have treats and other less nutritious foods in moderation. I had tried Weightwatchers - which was simply another approach to eat less and cut the fat. I explained to the cardiologist that these recommendations did not work for me because they did not address my problem. I had to figure myself out on my own. When I learned how to eat to normalize my blood sugar, everything else fell into place - including the weight loss. I went into more detail than this about why low carb worked for me, and I'll spare you the details. I said to him that the system let me down by offering me a weight loss solution that I could not do and then heaped blame and condemnation on me for my inability to do it. Yes - the means of the weight loss matters a lot. I don't know if this lecture did any good, but he caught an earful from me about that subject.

Another element of our conversation that I found interesting was the doctor's take on me doing the kinds of self directed health testing that I've done along my journey. He did not appear to be a big fan of it, believing that at best it is often a waste of money and at worst it can lead to more problems than it solves. His litmus test was to ask "What are you going to do with the information?". "What actionable steps can you take based on the results?" "Do the results help diagnose or confirm a condition in combination with other indications?" This topic came up when I said I was planning on doing another NMR next month and possibly a C-reactive protein test. He didn't think I should bother. He said I will likely get good results and take no action based upon them. So I'd be wasting my money. But what if the C-reactive protein test came back with a higher than expected number? What would I do with the information without some other indication of a problem? I'd take the test again, get normal results and not know why. I'd waste more money. He said my NMR results were good. Do I expect them to be any different this time? So yeah, I think he has a point. I probably wouldn't do anything different based on the results of those two tests, so do I really need them?

Referring to the CT Heart Calcium scan as an example, he thought that it was reasonable that I had it done, although the results were what he would have expected given my health history. However, since I had already done everything in my power to improve my health, what could I change based on the results? Not much. He thought that it would have been much more meaningful to have that test done 3 years ago. That poor score would have confirmed what a doctor already suspected based on my diabetes and other poor health markers. It would have resulted in a boatload of actionable steps... "Hey, dude - if you do not do something about your diabetes and your weight you are going to die of a heart attack sooner rather than later."

I thought these were valid points. I will think a more about what I expect to achieve with such testing. I do see the value of having a heart calcium score done down the road, though. It will be reassuring if the results are as the cardiologist predicts they will be. I'd like the confirmation that my chosen WOE is operating as advertised.