I have reached a decision with regard to my practice direction. It comes out of the frustration of treating patients for diseases without getting to the core cause of their problem or dancing around the real elements of disease prevention and getting nowhere. Heart disease is the number one killer in this country. It is associated with peripheral vascular disease, stroke and erectile dysfunction. The causes are multi-fold but relate to cholesterol, triglycerides, the different kinds of cholesterol, the inflammation of your blood vessels and the viscosity of your blood to name but a few causes.
Heart (cardiologists) and vascular surgeons focus their attention on those things that they are reimbursed for like bypass surgery, stents, cardiac catheterizations, etc. That is where they make money (big money) and can enjoy the social/community recognition for their skills as “specialists”. They are, as well, brainwashed by the companies that make the devices they use and supported by institutions where these procedures are done (hospitals and outpatient surgical centers) because likewise there is a lot of money (hundreds of billions) to be made. Of course, these same physicians prescribe, prescribe, prescribe because after procedures that makes them money they have been trained to use medications to lower your cholesterol, to dilate constricted arteries, change your heart rate, increase the pumping action of your heart and on and on.
Here is the problem, all of this does next to nothing to prevent cardiovascular (CV) disease, REALLY treat it and to reverse it. What we do is throw very expensive band aids at a life altering and life threatening situation. With some exceptions, stents DO NOT prolong your life if you have CV disease. Furthermore, they often need to be replaced over time and there are complications including infection and bleeding associated with their placement and subsequent medications required to keep them patent (Keep the blood flowing through them without clotting). Bypass surgery has its place but there are many possible complications- none the least of which is death. A great concern in heart surgery is possibly permanent cognitive changes and depression as a result of effects on the brain during the procedure. I do not need to discuss with you the myriad of side effects of the CV medications- too numerous to discuss here. If you are taking nitroglycerin for chest pain and you have erectile dysfunction which is not uncommon in men with heart disease, you cannot take Viagra because it could kill you! BANDAIDS!!!!!!!!!
By the way, none of these medications and procedures, including cholesterol lowering drugs alone slow the progression of CV disease – let alone reverse it. Lots of people have subsequent heart attacks and strokes even after being on cholesterol and triglyceride lowering drugs and having had bypass, stents, etc. Oh yes, and remember what happens in the heart blood vessels happens everywhere- legs, brain, penis, kidneys, etc. Lastly, do not forget that a lousy diet (fat laden) increases the risks of cancer, diabetes and dementia. So, what I am about to explain is far reaching in our lives and bodies.
First, I want to explain why I am frustrated if you haven’t figured it out already. I am really tired of sitting and explaining to patients that they either will have a heart attack or stroke or that they will have another CV event unless they make changes in their diet- radical changes in their diet. I explain that they will pass this on to their kids through epigenetic changes that actually change the genetic structure of themselves and their children. Most of my patients smile and either lie to themselves or to me and say they are going to “work on it”. Others say honestly that they “can’t do it”, it’s “too hard”! Then we do a dance and they get herbs or prescription drugs for their existing or impending CV disease. Over a number of visits I have exhausted myself trying to motivate. I explain how CV disease occurs and what they can do and then they come back months later- NO CHANGE! No matter if it is natural or prescription or a vascular roto-rooter that I suggest, if you do not deal with your diet, you are not going to decrease your risk of the number one killer in our country! I am not sure that I want to sit any longer and watch people kill themselves. I am not like every other doc that plies you with meds. I give my patients the REAL information and I really care for them and I am not sure that emotionally I can sustain the anguish of watching them commit suicide.
So, I am now offering a program that will prevent CV disease from ever showing up; stop the progression of CV disease and REVERSE it if you already have it. It is intense. It’s based on a 10% fat diet which has been well studied and written about. It’s not a boot camp but you can’t do this in moderation (a little bit pregnant- no such thing). No meats! No oils! You see me and our nutritionist together weekly for the first 2 months. Our nutritionist comes to your home. She shops for food with you. She helps you prepare the food. She goes through your pantry and removes unhealthful foods. The frequency of visits with us tapers slightly with time. There are monthly classes for participants. Participants will meet with chefs periodically to share ideas and pick up new healthful recipes. There are no unhealthy foods and wherever possible we will teach you to eat organic. There are no “shakes” to take or meal substitutes. This is not a gimmick- this is the rest of your life. We will teach you where to get healthy food reasonably priced. We will teach you what to eat on a trip- work or pleasure. In the end, you will have cut your chances of a heart attack or stroke dramatically. If you have symptoms of CV disease they will more than likely be eliminated. I will not replace your primary care provider or your cardiologist. This is a very focused program to save your life.
By the way, heart disease is not known in many parts of the world because they eat a plant based diet. You have been suckered into the Western diet (The killer diet.) because there is a lot of money in selling you fatty foods, artificial flavors, pesticide laden foods, etc. Low fat, reduced fat, no fat. 2% milk, skim milk, etc. make no significant change in your body chemistry. Don’t even fool yourself if you think that they do anything healthful.
So there you have it. I am not leaving primary care, but, shifting to medicine that makes a difference - diet.