From The Desk Of Clarence Bass
“Clarence is a pleasant, relaxed, lean, muscular white male who shows very good insight into his health and fitness.” W. Lynn McFarlin, MD (April 25, 2018)
Thirty-Year Report from the Cooper Clinic
With Reader Comments
Carol and I
flanked by Dave Prokop and Dr. Arnie Jensen during our first visit to the
Cooper Clinic in 1988.
This is perhaps the most guarded or mixed report of my many exams over the last 30 years. While earlier reports have been almost uniformly positive, this one has a few chinks.
Good & Bad Without Statin
“His overall sense of health is improved since he stopped statin therapy which was causing body aches, chills and rigors…,” Dr. McFarlin wrote.
That’s good, right?
The fly in the ointment is that my lipid profile has gone from ideal—70s across the board for good and bad cholesterol and triglycerides—to rather good.
“Today’s lab studies on daily omega-3 fish oils shows a recurrent hyperlipidemia with LDL far above goal level at 154 but your HDL is quite good at 77 and as a result, your lipid ratio remains quite healthy at 3.2,” McFarlin wrote. (Chol/HDL ratio under 4.5 is considered good.)
If my earlier numbers hadn’t been so damn good, this would be considered okay. “Acceptable,” at least.
“Today’s heart only [without IV contrast] CT scan shows stability of high burden coronary plaque and I feel quite comfortable deferring your follow-up CT angiogram until 2021,” Dr. McFarlin wrote. (Coronary calcium showing up on this scan is hardened and in my case no longer growing.)
As I’ve written here before, CT angiogram tests with IV contrast have shown my coronary arteries to be "very large." While my coronary calcium level is high, there is practically no narrowing of my coronary arteries. Dr. Ho who oversees the tests—and discussed the results with me at length—said I’ve got practically nothing to worry about.
The problem is that my margin for error is up in the air without the statin. I have considerable wiggle room never the less. If the situation becomes dire there are options, such as the new injectable—and unproven—statin that costs in excess of $14k a year and isn’t covered by Medicare (unless you have a heart attack).
What I still have going for me is healthy living. My relaxed blood pressure is excellent (105/65) and my fasting blood sugar and A1C show “no evidence of diabetic tendency.” Unlike many people my age, I don’t have diabetes or hypertension—and I’m not overweight.
My Omega-3 level is very good at 9.7%. (Anything over 8% is considered good.) The sardines I have with breakfast and fish oil cap with lunch and dinner are doing the job.
Stress Test Results
My exercise stress test—using my own 10 minute interval routine on the Airdyne—was normal “showing no evidence of ischemic heart disease.” While my peak heart rate was a little disappointing at 155, the all-out 30s intervals were perhaps the best I’ve ever done. I was very pleased with my effort. Doing my own routine freed me up to go for broke. (No exhaustion hazard hanging over my head)
The bummer was that my heart rate peaked at 214 during the recovery period. The saving grace is that the peak cleared in less than two minutes—with “no symptoms of lightheadedness or chest pain.”
I didn't feel a thing, and would not have known my heart was spiking had I not seen it on the monitor. I looked away, because it made me uneasy. I didn’t know it cleared so fast until I read it in Dr. McFarlin’s report.
My heart rate spikes are few and far between—and I don’t know they are happening until I see it on my Fitbit. The peaks have never showed up on the Airdyne at home.
My testosterone is going “up” rather than down—at 788. The previous test, at 666, was the highest up to that time.
Dropping the statin could be a factor.
The only other thing that’s new is going for rankings every couple of weeks on the Concept 2 rower—at 100 meters and one minute. After turning 80, I’ve been improving on the sprints almost every time out. I really enjoy the challenge. See http://www.cbass.com/age80ranking.html
High intensity exercise improves or stabilizes testosterone. See “Muscle Talk: http://www.cbass.com/MuscleTalk.htm
Dr. McFarlin calls my serum testosterone level “quite good.”
* * *
Pulling all of this together makes me feel pretty sanguine about the road ahead. Informed by Dr. McFarlin, Cooper Clinic testing, and my own research and experience, healthy living is still paying big dividends.
My bet is that it will do the same for you. Nothing beats self-help.
Readers Comment and Clarence Responds
Psychologist Fears "Too Much Health"
Congrats on your latest Cooper Clinic results. Amazingly positive. I'm going to take issue with your mention of "a few chinks." I see no "chinks," although if you do enough tests on anyone (at any age) you'll always find "something" you could call less than ideal.
I've been meaning to write you a note since I read your The Healing Self piece. I'm a psychologist, so I'm well aware of the massive insights being made into how the mind impacts the body. The effect of stress and depression on the adrenal gland (on cortisol –– hence inflammation –– and adrenaline and norepinephrine) is long established. I often ask people whether chronic stress, for example, is really that different to taking a stimulant drug every day? No one would argue that using drugs daily is likely to be harmful, but is it that different if you're body is manufacturing the drug itself in response to psychological upset?
With that said, here's another thing to think about. While my approach to diet and exercise is very close indeed to yours (based on yours in fact) I see emotional/psychological risks. For many people there's only a narrow line between healthy routines (uniform eating, movement, exercise) and the sort of ritualistic behavior that we see all the time in obsessional eating or exercise disorders. When routine becomes ritual it can cause tremendous psychological distress. Ritual can be a prison. The sufferer is no long free to really live –– rather the body, or so-called "health," become a barrier to experiencing the world.
I'll be honest with you (I'm not proud for that!) and say that at times my own eating and exercise has begun to feel ritualistic. In the short-term, routine feels calming, safe, but that's a false friend if eventually the routine begins to impose rules that circumscribe living. To guard against this, I've long been forcing myself to break routine semi-regularly. I might not allow myself to do a certain amount of walking every day (or a certain number of steps). Beyond that I both eat out regularly and try do so WITHOUT thinking about calories (or about the exercise I might do to compensate for calories!).
Anyway, something to think about. It's a balance thing. Too much "health" might be mentally and as such also physically "unhealthy." The best is the enemy of the good.
Glad you enjoyed our report on latest visit to CC. Thanks for your kind comments.
Good points. No need to eat anything you don't like or exercise you don't enjoy. So many options for every one. The basic message of my book Take Charge.
Thanks for taking time to pass on your insightful thoughts on healthy living.
Doctor Offers Encouragement
Going off statins at this point may be a good thing; the actual risk of specific blood profiles, especially in highly active, healthy eaters such as yourself is controversial and evolving. You may well live 30 plus years in good health. I have numerous patients over 100 without dementia, who are moderately active and they never did anything for their health other than not smoke much. People are living longer and we do not know a lot about long term statin effects, cholesterol rebound effects etc.
The Blue Zone and associated data (i.e. Bama, China etc.) is pretty compelling that aging while inevitable, is not a nightmare in every culture.
Lastly, the LDL level thing is pretty much in flux. You will probably outlive your doctors by at least 10 years!
Heart Rate Monitor Invaluable During Intervals
Thanks for sharing your 30 year health report. It’s good to hear you are doing everything in your power to stay on top with your health and fitness goals. I was interested to learn how your heart rate peaked to 214 after your intervals. Even though you felt fine, that’s where it’s invaluable to have a heart rate monitor to see what’s going on. From now on I’m going to wear one during my interval training instead of relying on perceived exertion. Good to hear you are still fired up with the concept 2 rowing sprints. There are a few guys in your age group that are really close which makes for great racing. Last time I looked I was in about 8th or 9th in the 50-59 age group (307m for the minute, light weights). I’ll have to put this on hold for a while as I have just had shoulder surgery. During the surgery they noticed I had inverted T waves on the ECG which could be from being really dehydrated before the surgery. I’ve done hard intervals on the bike since and everything looks and feels normal. Might get it checked out just to be on the safe side.
All the best!
Glad you found my report of interest. Thanks for letting me know.
Haven't had a heart rate spike for some time and hoping the problem is behind me. Workout that caused the spike in the past are showing nothing unusual on the Fitbit--including the same interval routine on the Airdyne.
I've been including more uphill stretches in my weekday walks and believe this may be helping. Got to be careful not to turn recovery walking into Black Holes. But don't believe I've gone over the line so far.
Good luck with your shoulder and congrats on 307 meters in one minute row. I know how hard each meter comes.
Good training and thanks again.
More on Statin Side Effects
Your June 1 Update on Thirty-Year Report from the Cooper Clinic is an interesting article. In the article it states that the statin therapy was causing body aches, chills and rigors. What I am curious to know is how long after you started statin therapy did these side effects show up? and how long did it take you to realize that the statin therapy was causing these side effects?
I'd been taking the statin for a long time, almost 20 years.
Took better part of a year to decide statin was causing problems. We stopped statin for a time and then tried other statins. We did this several times. Each time the symptoms stopped when we stopped stain and started again when started another statin.
I didn't want to believe that the stain was causing problems after working so well for many years.
If you have more questions about statins, please talk to your doctor or cardiologist. Lots of things involved and varies from person to person. My example may have no relationship whatsoever to you.
Keep in mind that I am not a doctor and not qualified to discuss any case but my own.
More Detailed Lipid Profile?
Hello Mr. Bass,
Been following your site for quite a while now - love the info and evidence-based thinking.
In reading the post regarding the thirty-year report, I was wondering if the clinic has ever suggested having a more detailed lipid profile. It would be interesting to know the LDL particle size and particle count as well as more detail for HDL sub-fractions. The info could be enlightening.
Again, thanks for the great postings.
Thanks, Jim. Appreciate your positive comments.
Cooper has their own lab and I'm not privy to discussions on what is covered. I will tell you that it goes on for many pages, covering much more than mentioned in my report.
My sense is that they are conservative and not inclined to include untested markers. If necessary they refer to specialists, where the tests you mention are more likely to be monitored.
They pay more attention to lifestyle and fitness that other clinics. Patients pay upfront and are more motivated than most.
Thanks again for taking time to comment.
Lab Results Helpful - Questions
This is so helpful compared to the usual anecdotal info!
A few questions: Has your LDL been up your last several lab draws? What explanation do your Drs. Surmise?
You discussed that your heart rate peaked at 155 during your stress test. Then you discussed that your heart rate peaked over 200. Is this a new problem with your heart that is being followed? I was confused because earlier you said (disappointed) with 155. At age 59 I rarely see my hr hit 170 running sprints, so I don’t think my ticker goes any faster-and you said 200+!
Thanks for all you do,
Glad you enjoyed CC report.
Docs have no explanation for LDL; probably genetics.
My high HDL and other good numbers help reduce concern. Doing everything possible short of taking statin.
CAT in a year or so will show if my coronary arteries are staying wide open. Optimistic that this will be the case.
Peaks in HR rate during recovery are a concern; no explanation. Happy to report that no repeat since coming back from CC. Only change is more uphill walking during week. Fingers crossed.
Thanks for writing.
I've been coming to
your site for many years to read the new information you post on
aging and exercising.
So what about it. Join a box and we'll see ya at next year’s games.
Thanks for taking time to tell us of your successful journey.
Continued success and good training.
July 1, 2018
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