Biological vs Mechanical -- what does the ACC think?

[Nocturne]

Exactly, it can get to the point where you're average simpleton like me can get a bit bewildered.

"Eat eggs! DON'T EAT EGGS!!! No! Wait! Eggs are OK! Just DON'T EAT GRAINS!!! Or saturated fat! Go for heart healthy trans fats instead -- NO, WAIT, DO *NOT* EAT TRANS FATS!!! Stay away from ALL fats! No, wait -- stay away from all carbs! From all carbs AND fats! And cholesterol laden foods -- no, wait, those are OK now! But wait! Maybe not! Eat nuts, they are good for your heart! YOU *FOOL*, *WHY* are you eating NUTS?!? Drink coffee! Stop drinking coffee! Did you have any chocolate today? Do you even CARE about your health? Take these supplements! IDIOT! Stop taking those supplements! Is that an EGG I see you eating?!? Eat salmon instead! NOT farmed salmon, MORON!!! WHY are you eating animal protein anyway?!? You really want to DIE, don't you? GOOD GOD, did you just LOOK at a hamburger? FIFTY DEMERITS!!!"

 

[Paleowoman]

Just read around as much as you can. Read opposing views. Read critically. Anything you read look for studies which confirm the bias of the author. Make sure the author gives lots of references for what he or she states. Then look at yourself. See what you've been doing diet wise and lifestyle wise. If you have a problem then make some changes which make sense to you. None of us will ever know exactly what is 100% right for ourselves becasue there is not a parallel universe where our parallel self is having a slightly different diet or living a slightly different lifestyle - there's too many vairables (ever see that episode of Star Trek TNG called Parallels ?).

Just do your best. Here's an exampe from my life. From age 30 for the next 23 years I embraced the wholefood way of eating - I made my own wholemeal bread, ate brown rice, wholewheat pasta, made my own pizzas with wholemeal dough, was mostly vegetarian. I thought I was pretty healthy. Then I was diagnosed with diabetes. Ha, all those carbs I'd been eating ! They might have been whole complex carbs but carbs they were regardless. So with the aid of my blood gluocse meter I discovered that there was another way of eating which had few carbs apart from the few in non starchy veggies and nuts - that was the 'paleo' way of eating, lots of meat, fish, eggs, nuts, non-starchy veggies and lots of fats, especially coconut oil. I also do a lot of exercise which I wasn't doing much of before. Maybe one day I'll discover that this curent way of eating/living isn't right for me and I'll try something else.

I'm reminded of Woody Allen's very funny film 'Sleeper': he wakes up in the future after being criogenically frozen, he had run a health food store in the 1970s, here's a hilarious clip: https://www.youtube.com/watch?v=3iG6Hrh4v08

"Eat eggs! DON'T EAT EGGS!!! No! Wait! Eggs are OK! Just DON'T EAT GRAINS!!! Or saturated fat! Go for heart healthy trans fats instead -- NO, WAIT, DO *NOT* EAT TRANS FATS!!! Stay away from ALL fats! No, wait -- stay away from all carbs! From all carbs AND fats! And cholesterol laden foods -- no, wait, those are OK now! But wait! Maybe not! Eat nuts, they are good for your heart! YOU *FOOL*, *WHY* are you eating NUTS?!? Drink coffee! Stop drinking coffee! Did you have any chocolate today? Do you even CARE about your health? Take these supplements! IDIOT! Stop taking those supplements! Is that an EGG I see you eating?!?"

 

[neil]

I agree pellicle, nobody wants repeat ops for fun, but some choose to go along with having a re op instead of warfarin for very good reasons, in saying that if I was young I would properly go mech , just my opinion

 

[dornole]

This was actually interesting because I didn't really realize that statistically I may still die earlier post-surgery. Eat my dust, retirement planning! I'm goin' to Disneyworld!

 

[JulienDu]

I have been reading Davis' book as well. As Paleogirl mentions, he seems to have gotten out of the CAC regression biz and into grain exclusion. Not sure what to make of that but it is too bad as the only docs left in CAC regression are people like Esselstyn who advocate vegetarian, if not vegan, diets and eschew even things like nuts and olive oil. A true "low fun" diet.

Don't worry you can get grain free burgers !!

And this article is complete ****, I do not know how you get a degree and write so much crap

 

[cldlhd]

I can see how carbs are converted to sugar but I'm not giving up

 

[Paleowoman]

Some great grain free recipes here: http://www.marksdailyapple.com/primal-paleo-recipes/#axzz4HVzGn5uM

 

[pellicle]

Hi
Neil

... but some choose to go along with having a re op instead of warfarin for very good reasons

indeed, and its those "very good reasons" which I always attempt to tease out ... so that the person is making informed decisoins. You will note that I always ask about co-morbidities and preculusions of having warfarin ... right?

you'll also note that frequently there is a misconception of how warfarin therapy can be managed around issues. I've certainly helped my fair share of people to see that and to manage through what would have otherwise been problems.

my assertion is that warfarin can in the main be managed by us ... Structural Valve Degradation (SVD) can not be managed by us and can only be managed by surgical intervention. Which puts you back in the waiting room straight away. So a lot depends on on the nature of the person ... one who is independent and wants to manage themselves or one who wishes to be managed

in saying that if I was young I would properly go mech , just my opinion

and if that's ever in your future I'll hopefully be here to assist (or someone else competent) with managing your AC therapy.

 

[Nocturne]

And this article is complete ****, I do not know how you get a degree and write so much crap

Well, since it was published in a reputable medical publication, I had been giving it some credence, but now that some guy on the internet said that it's "complete ****" with no explanation why, I guess it's not worth considering.

 

[pellicle]

Well, since it was published in a reputable medical publication, I had been giving it some credence, but now that some guy on the internet said that it's "complete ****" with no explanation why, I guess it's not worth considering.

well my observation is that you seem to choose to believe what you want, ignore stuff that does not support your world view of "I'm going to die young" , go with the morose and bleak and disregard all the positive suggestions from people here who may actually know more than you ... but we're all just opinions on the net.

I want to live a long healthy life ... or even just s short one ... being healthy is my choice and I work my lifestyle towards that ... you may of course do what you want.

What I don't get is why you just post bleak stuff and don't energise yourself

 

[Agian]

Just because something is published in a journal does not mean we blindly accept the article's conclusions. The challenge is to look at the evidence presented.
The article may not be wrong, but....
Take 200 people with ingrown toenails. Half have Diabetes, half don't. More people with diabetes get subsequent infections, than those without. Uncontrolled infections can lead to sepsis and multi-organ failure... yada yada. OMG, ingrown toenails kill diabetics!!!

 

[pellicle]

Just because something is published in a journal does not mean we blindly accept the article's conclusions. The challenge is to look at the evidence presented.
The article may not be wrong, but....

exactly ... its always (always) good to read the article in question not just the abstract ... it may be that you disagree ... always read with questions in mind about "why did they do that that way??"

Its when no data is presented or just buffed up ******** is presented that you put it in the dunny next to the sawsdust

 

[Agian]

Although, it may not be 'complete ****' (you've got to give it some marks for grammar), I tend to agree with Julien. If readers can't even work out what the point is it's trying to make, then it falls into the buffed-up-******** category.

 

[Agian]

From age 30 for the next 23 years I embraced the wholefood way of eating - I made my own wholemeal bread, ate brown rice, wholewheat pasta, made my own pizzas with wholemeal dough, was mostly vegetarian. I thought I was pretty healthy. Then I was diagnosed with diabetes. Ha, all those carbs I'd been eating !

Curious. Do you think your previous high-carb diet contributed to your diabetes? Has it improved since you changed your habits?
The reason I ask is that a lot of vegetarians replace protein and fat with carbs, as a source of energy. There are plant-based sources of protein that keep you satiated for much longer than carbs.
Some of the cardiology gurus advocate cutting down on carbs as a way of reaching your target weight, and replacing this with healthy proteins.

 

[pellicle]

... advocate cutting down on carbs as a way of reaching your target weight, and replacing this with healthy proteins.

I'm no guru, but I recommend replacing them with healthy fats and proteins ... like gently roasted smoked pork belly

 

[Paleowoman]

Curious. Do you think your previous high-carb diet contributed to your diabetes? Has it improved since you changed your habits?
The reason I ask is that a lot of vegetarians replace protein and fat with carbs, as a source of energy. There are plant-based sources of protein that keep you satiated for much longer than carbs.
Some of the cardiology gurus advocate cutting down on carbs as a way of reaching your target weight, and replacing this with healthy proteins.

It's impossible to say exactly what contributed to my diabetes, but certainly once I'd ditched the carbs (complex ones at that) my blood glucose levels came down to non-diabetic numbers. So, yes, my diabetes has improved hugely since changing the diet.

And I'll eat what Pellicle pasted a photo of above - natural healthy fats and proteins. And from organically reared, free range animals, and nothing processed. And with a big helping of cabbage, or brocolli, or asparagus, or kale !

 

[Nocturne]

Just because something is published in a journal does not mean we blindly accept the article's conclusions. The challenge is to look at the evidence presented.

And just because a study that made it into a reputable publication comes to conclusions that we may not like or be comfortable with does not mean we blindly REJECT those conclusions, either. Yes, of course -- look at the evidence presented and try to find what data might require more context to allow for more accurate conclusions.

But that's very different from snorting that it's "horse puckey" and stomping away without explanation.

 

[Nocturne]

Although, it may not be 'complete ****' (you've got to give it some marks for grammar), I tend to agree with Julien. If readers can't even work out what the point is it's trying to make, then it falls into the buffed-up-******** category.

It was pretty clear to me what the point of that article was. It was right there in the Conclusion, and it dealt with the topic of this thread. How did you miss it?

What it looks like to me is that when it comes to longevity after AVR, the actual information out there that is available in peer-reviewed studies comes to some conclusions that are understandably uncomfortable for some people, to the point where they get a bit irrational and maybe even lash out a bit. Calling me a "pessimist" or insinuating that I am a "whiner" who just wants to complain but isn't DOING anything about his health (which is demonstrably false -- how many of you have lost 25% of your body mass?) might help distract you or take the sting away, but it isn't going to change the facts. I'm sorry.

EVERY study that I have seen that deals with survival after AVR has said that the average post AVR lifespan is significantly less than would be expected for the general population, although the gap does get smaller as age at implantation rises. In fact, one study indicated no difference in lifespan if age at implantation is 68 or above. And a person in their 80s who still qualifies for AVR actually has a HIGHER life expectancy than their peers, simply because they were healthy enough at implantation to be deemed capable of surviving the surgery (but THAT is an example of data that needs context if we are to avoid drawing misleading conclusions).

If you can find a peer-reviewed study indicating that AVR has little or no impact on relative life expectancy, let's see it. To date, the only sources I have found that say that are "feel good" blogs. When it comes to peer-reviewed studies, time and again we see the same general conclusions about lifespan after AVR -- much better than without for those who need it, but significantly worse than the general population.

 

[cldlhd]

It was pretty clear to me what the point of that article was. It was right there in the Conclusion, and it dealt with the topic of this thread. How did you miss it?

What it looks like to me is that when it comes to longevity after AVR, the actual information out there that is available in peer-reviewed studies comes to some conclusions that are understandably uncomfortable for some people, to the point where they get a bit irrational and maybe even lash out a bit. Calling me a "pessimist" or insinuating that I am a "whiner" who just wants to complain but isn't DOING anything about his health (which is demonstrably false -- how many of you have lost 25% of your body mass?) might help distract you or take the sting away, but it isn't going to change the facts. I'm sorry.

EVERY study that I have seen that deals with survival after AVR has said that the average post AVR lifespan is significantly less than would be expected for the general population, although the gap does get smaller as age at implantation rises. In fact, one study indicated no difference in lifespan if age at implantation is 68 or above. And a person in their 80s who still qualifies for AVR actually has a HIGHER life expectancy than their peers, simply because they were healthy enough at implantation to be deemed capable of surviving the surgery (but THAT is an example of data that needs context if we are to avoid drawing misleading conclusions).

If you can find a peer-reviewed study indicating that AVR has little or no impact on relative life expectancy, let's see it. To date, the only sources I have found that say that are "feel good" blogs. When it comes to peer-reviewed studies, time and again we see the same general conclusions about lifespan after AVR -- much better than without for those who need it, but significantly worse than the general population.

Not to make it all about me but what about valve repair? I had my aneurysm replaced with a graft last year but still have my original valve.

 

[Nocturne]

Not to make it all about me but what about valve repair? I had my aneurysm replaced with a graft last year but still have my original valve.

I have not been looking specifically into valve repair, but my guess would be that it would be more variable in outcome because of the wide margin of what could be deemed valve "repair". I seem to remember seeing something that indicated valve repair recipients had longer lifespans than AVR recipients, but I'd really have to look that up.