FAP and Cardiovascular Risk; Open letter to FAPers on J-Pouch.Org

Does anyone know about the increased risk of cardiovascular disease and FAP? (also related to the question I asked about colectomies/j-pouches, enterolactone and bifidobacterium).  However, this is more specific because of the FAP risk of adrenal carcinoma (benign) that can cause the excessive production of both cortisol and aldosterone, which elevates blood pressure.

Ross

As for the moment I received only one response (now, a few hours later, two) which, in the way it was phrased, I would consider it a bit sarcastic.  Maybe "sarcastic" isn't the correct descriptor; cynical?  The quotation marks around the word "proof" hint towards Chuck's tendency towards doubting the veracity of any possible publishings on the subject before those publishings appear infront of his eyes.

I've never heard of any correlation.........never read anything that showed this either. I'd be curious to see what "proof" there is of this.  

The problem I've encountered with internet forums be it the J-Pouch, FAP/Gardners, Magnesium Deficiency, Adrenal Fatigue, Hypothyroidism, MTHFR etc, those most responsive tend towards falling into two groups:  1) the informed, concerned and in the groups to help orient other members. 2) the sarcastic, cynical and skeptical seeking a battle and the ability to feel better by stepping upon others...  When the first response is the skeptical, a tone tends towards being set for the conversation.  What's worse is that in J-Pouch.org, the FAPers are a signifant minority with the majority of the community being sufferers of Crohns and IBD/Colitis.  

The "proof" I offer Chuck for validating my concern is from organizations that are pilars of cancer research and virtually indisputable.  Understanding an emphasis on "Virtually" is very important when considering their political stances and their polital-economic alegiences that may limit their perspective and the research they support.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518080/  

If you scroll down to the section of FAP And Adrenal Tumors you'll read this:  

"...This is especially important since recent reports suggest that up to 20% of patients with adrenal incidentaloma (which means 1–3% of all FAP patients) have some form of subtle and subclinical hormonal dysfunction resulting in an increased risk of metabolic disorders and cardiovascular disease."

And then there is this publication by the American Cancer Society:  http://www.cancer.org/acs/grou...ntent/003081-pdf.pdf

Although the general statistics say that FAPers are at a 1-3% risk for adrenocortical carcinoma, this book (click on the link):

https://books.google.com.mx/bo...cortisol&f=false

claims that two large studies claim that the risk is between 7.4 and 13%...  In my family, my younger sister fell into the "1-3%" who developed thyroid cancer.  And my cousin and then my other cousin's daughter (a generation apart) fell into the "1-2%" who developed medulloblastoma (brain tumor); the 18-year-old daughter of my cousin was just stricken down a few days ago.  So, for us, it is easy to worry about understatements of risks in the statistics. 

And then there is this this from the Endocrine Society: http://press.endocrine.org/doi...10.1210/er.2013-1029 

"the relation of adrenal tumors with FAP led to the discovery of the role of β-catenin signaling in adrenal tumors."

I guess I'll leave you with this.  I imagine they are sufficient amount of scientific studies connecting FAP with the possibility of adrenocortical carcinoma to bring up the question of the risk of the production of excess cortisol or aldesterone leading to hypertension, hence cardiovascular disease.  So, the question to the community of FAPers is if anyone has stumbled across studies focussing almost exclusively upon FAP and cardiovascular disease.  

As you know, I can never "just leave it at that..." and I continued writing, leaving behind my reaction to his "tone" and continuing with my concern about understanding what may happen with us (me), our atypical genetics and other possibly related health issues; especially cardiovascular disease.

Since I haven't been writing much these days, you may not know that my concern about dying of FAP/Gardners related cancer disappeared with the major risk of sudden death caused by cardiovascular disease.  However, in the 9 months since the heart attack on March 12th, I haven't rested from reading all there is to understand about cardiovascular disease, risk, prevention, intervention and exaggerations etc and have stumbled across a lot of very interesting information that may have brought me full circle back to questions related to FAP/Gardners/J-Pouch.  For instance: J-Pouch restructuring of part of the small intestine, Vitamin D deficiency--hypertension, SIBO--TMAO--LDL cholesterol stickiness--Arterial plaquing, Lack of colon and potentially low levels of enterolactone and that relationship to increased risk of cardiovascular disease AND what led to this blog entry: FAP, Adrenocortical cancer and heightened production of cortisol or aldesterone leading to cardiovascular disease.

Truthfully, I can't imagine that those living within the FAP microcosm at such risk also living within a society or world at such publicized high risk of death caused by cardiovascular disease, reading the prior paragraph the FAPer/J-Poucher wouldn't have their interest peaked...  

First you must read what is fascinating about Enterolactone, cancer (especially breast cancer) and cardiovascular disease.  And then you must read the connection between SIBO and TMAO and how TMAO relates not only to our arteries but also to all forms of cancer. You may have read the argument against red meat causing heightened production of TMAO leading to cancer.  However, it goes way beyond red meat consumption and cancer. Plus, the Paleos show studies proving that fish are the animals with the highest levels of TMAO precursors in their muscle. Supposedly (and strangely; although even my cardiologist mentioned this) the small intestine is the immunological center of the body.  So, if you read about TMAO, you'll also read about SIBO as the main cause of TMAO (although normal-high levels of testosterone are protectors against the production of TMAO) and that J-Pouchers and those with only colectomies may have a tendency towards SIBO.  The Paleo doctors/research scientists claim that the issue with TMAO is SIBO and urge that people consume probiotics especially in the form of fermented vegetables.

But back to the letter to J-Pouch FAPers:

As many of the studies mention, since the past two generations of FAPers have had prophylactic surgery, we are just entering a moment in history or analysis where FAPers aren't dying of cancer of the colon and now approaching middle age or passing through that period when we can see the prevalence of other diseases that may appear...  For instance: my father died from cancer of the colon metastecized to the liver at the age of 34 (he was an eye surgeon).  Due to his suddenly becoming ill, his older brother (the father and the grandfather of the two cousins who developed medullablastomas--brain tumors) was diagnosed with FAP and immediately had his colon and rectum removed.  However, it turns out that my paternal grandfather (not of the FAP/APC line) died of a heart attack at the age of 62 and my father's brother also died of a heart attack at the age of 62--but directly related to his Diabetes I.  Now, had my father lived into middle age, would he have been diagnosed with heart disease?  As you know, speaking of my uncle, Diabetes doesn't strike everyone the same.  Not all diabetics develop heart disease.  So, we can't say that his was caused by diabetes.  We can assume that it was not FAP related and possibly his father gave him gene mutations for heightened risk of heart disease...  

I'm not diabetic.  Unlike my younger sister, I didn't develop thyroid cancer.  But, it seems that only female FAPers develop thyroid cancer.  I have osteomas.  No one else in my family has that...  My male cousin (father of the 18-year-old with the medullablastoma) has horrible desmoid tumors that no one else suffers.  My younger sister also developed rectal cancer at the age of 43.  But the rest of us had J-pouch surgery years earlier than did she...  I'm very health conscious and informed, proactive etc.  But, at the age of 46 I had a heart attack, although my lipid profile was near perfect and I was exercising regularly (I was running between 30 and 40 miles [40 and 66kms] per week; at the moment I'm running 4 miles [6.5kms] 4 times per week, while rowing 1-2 days [30 minutes] per week).  

When I was diagnosed with FAP at the age of 12 in 1981 and had the colectomy at Memorial Sloan Kettering Cancer Center in New York the following year, I was told that with the removal of my colon, the polyps in the rectum would disappear and we would be basically "free" the rest of our lives.  When my younger sister developed thyroid cancer in 1996 and I did the research, the only medical research scientists connecting thyroid cancer with FAP was a group from New Zealand.  However, the American Medical Association smashed their study as being too small, calling it inconclusive evidence.  At that time, the medulloblastoma that killed my beautiful cousin at the age of 16 in 1978 was NOT considered an issue of FAP.  However, if you go into the Cleveland Clinic website and any other dedicated to FAP/Gardners today, you'll find that both Thyroid cancer and brain tumors are part of the syndrome.  

What if the parents of a 12-year-old carrier of the APC gene were told that their child would be at a lifetime risk of heart disease?  Then maybe the child could be taught techniques for preventing or decreasing the risk of having a heart attack.  One thing is having cardiovascular disease.  Another thing is having a heart attack.  And, contrary to popular belief, controlling saturated fat intake is NOT near the most important method for preventing heart attacks.  There's a whole slew of other lifestyle factors and dietary considerations for decreasing arterial inflamation and plaquing etc...  Although having a heart attack does not signify the end of one's life, it is the edge of an important precipice that we would be much advised to avoid nearing at all cost...  Prevention is much more advisable than is intervention.  

Are we as FAPers preventing adequately?  Are we adequately informed?  Is there enough research into the field?  And if there was enough research and information out there, are we sufficiently proactive with our personal health and that of our children?

That's why I ask the questions and do the research.  

And then Jan, who always responds scientifically to my postings and is a moderator and a retired nurse, responded:

I guess my thinking is that it is pretty much a moot point. The FAP associated risk with adrenal tumors is quite low, since they are found incidentally in the general population. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147036/

Plus, only a percentage of those have an associated heart disease. I think you are extrapolating too far. In addition, having normal lipids and blood pressure does not guarantee avoidance of coronary heart disease or other causes of heart attack (such as arterial spasm). Those are simply factors that can be controlled. You cannot control your genetic makeup. Sure, you may have FAP genes, but you may also have heart disease genes. Heart disease is very widespread in the general population. 

You are better off dealing with your state as it presents rather than trying to figure out how you got there. But, I can understand your curiosity and desire to unravel the mystery. Just don't make yourself crazy about it.

Jan 

My response may appear a bit harsh or intense.  But, I'm hoping you'll understand my point.  If this were an academic, religious or political debate, it wouldn't be void of harshness and intensity and in the end, if we are thoughtful and educated people we would understand that what is important is the information being shared and if it is helpful or destructive or possibly neutral.  The problem with Jan's response is that it lends towards inactivety, complacency and the status quo.  We must ask in who's best interest is addressing illness and disease with blinders limiting our vision... like carriage horses that pass through centers of major cities...  I guess if you don't look around you, at the moment there is nothing at your sides that could possibly startle you...  Until you are diagnosed and it's a bit too late... But what if it isn't?

And here's my response to Jan:

Hi Jan, nice to hear from you again.  

In all that I've read about cardiovascular disease, especially what I'm currently reading in the British epidemiologist Dr. David Grimes' book "Vitamin D and Cholesterol; the importance of the sun" that addresses not only cardiovascular disease, but tuberculosis, hepatitis, diabetes and gastric ulcers, it is just as important to deal with the cause as it is with dealing with "the state as it presents itself"...  

For instance, if the issue is SIBO causing high levels of TMAO combined with low levels of Testosterone (Testosterone turns off the FMO3 gene responsible for the production of TMAO), the logical response would be to both remove the SIBO and raise testosterone levels.  And then we could see if the cardiovascular disease decrease or if the arterial plaquing stops.  Sometimes the illness isn't just the current diagnosis, such as cardiovascular disease or diabetes II or kidney disease.  Sometimes it is actually something else that wasn't diagnosed or attended towards.  And, as you said, sometimes it is a bunch of factors.

As you may have read in my other posting, J-Pouch experts have made the correlation between J-Pouches and Vitamin D deficiency.  But they don't understand the mechanism.  Now, Vitamin D deficiency is widely connected to hypertension which is directly connected to cardiovascular disease.  In my genetic testing I have one mutation of the VDR gene, otherwise known as Vitamin D Receptor...  

I have 4 gene mutations related to glutathione deficiency also directly related to cholecystitis (that I had in 2006 and investigated how to avoid having my gallbladder removed by naturally removing the gallstones) and atherosclerosis.  

For a 46-year-old male, my testosterone levels are that of a 75-year-old, meaning that they are very low.  Originally, the medical scientists did not understand what came first--cardiovascular disease or testosterone deficiency.  But what they did notice is the tendency of people who've had heart attacks having low levels of testosterone...  I read about that in May.  In November, I stumbled across a bunch of studies connecting testosterone with TMAO and cardiovascular disease. So, normal-high levels of testosterone are cardiovascular protective.  

Also, in my blood testing over the past 2 years there is one nagging constant: Immunoglobin M deficiency (IgM).  It never rises.  So, I did a search for IgM deficiency and cardiovascular disease and was surprised/amazed to find that IgM is not only responsible for protecting us against Antigens but more importantly IgM is responsible for removing from the blood stream oxidized LDL cholesterol and apoptosized cells...  So, maybe my LDL cholesterol level is normal.  But, over the years, if my IgM isn't working adequately, then I am accumulating oxidized LDL cholesterol and what is considered the true "lipid" cause of cardiovascular disease.

Now, when you address cardiovascular disease as it presents itself, especially if you had a heart attack, you are addressing it with a Cardiologist.  And when you mention SIBO to a cardiologist... If they know what it is and believe what you say, they say that's the realm of the gastroenterologists... If you mention Vitamin D deficiency, they mention a nutritionist.  If you mention low levels of Testosterone, they mention an endocrinologist.  If you mention IgM deficiency they mention an immunologist... Now, if you mention FAP/gardners do they mention a gastroenterologist or a geneticist?  

What I'm saying is that addressing cardiovascular disease as it presents itself is done with a cardiologist.  Ignoring the possible causes would be blatantly irresponsible.  

As Dr. Robert La Porte, professor of epidemiology at the University of Pittsburgh says, "We need to examine and model the evolution of patterns of disease. We need to break away from our orientation towards single disease and begin to focus on the big picture."

If FAP places 7-13 percent of the FAP population at risk of adrenocortical carcinoma (which is actually very high) and even if a small percentage of those 7-13% experience heightened levels of cortisol or aldosterone, AND if those people also have genes for cardiovascular disease (although most people don't check their genes, so they don't know if their heart attack was genetical determined), it's still sufficient reason to address the concern.  

How do you address that concern?  With abdominal ultrasound to see if there are growths on the adrenal glands.  If so, you must check aldesterone and cortisol levels.  But, if no one is asking these questions, and making these statements, no one will decide, "Maybe I should have an ultrasound done of my kidneys!"  Plus, as I've read today with these articals: most people discover adrenocarcinoma when they are having an ultrasound for something else, since the adrenocarcinoma normally is symptom free.  If the person suffers hypertension without knowing it's cause, the cardiologist will prescribe anti-hypertensives without addressing the true problem.  Maybe it is as simple a solution as laproscopic surgery for removing the benign tumor from the adrenal gland instead of having to take anti-hypertensives (that cause possibly unnecessary side effects and also have the tendency to stop functioning adequately later on) "For the rest of your life" as the cardiologists love to say.  

It's much better to treat the disease instead of the symptoms.  But, first you must understand the disease as it pertains to you.  As for FAP/Gardners; it's a multifaceted syndrome also known to be an enigma in many ways.  As you may have read in my earlier response, it "presents" in different forms with all members of the family...  Why?  Who knows?  Maybe it never would have killed me through my colon. And maybe it will kill me through my heart.  Maybe all of what I wrote above about the different possible factors are genetically independent; maybe they are interconnected.  If you read about the APC gene, you will also read that the APC gene mutation is related to other gene mutations...  

When did medical scientists suddenly start believing that the information at hand was all the information we need to know for addressing the related situations?  When did they suddenly decide that there was no need for more questions and alternative perspectives and also continued challenging of the veracity of popular theories?

Who are we protecting when we decide that we don't have to continue asking questions and looking for more or better solutions?  Certainly not the patient.

The J-Pouch forum is for J-Pouchers to obtain additional information related to their experiences with their body AND their experiences with their doctors.  Many questions are not answered because as you know, there are many fewer explanations for what causes and how to "cure" a disease than there are questions.  

FAP is hereditary.  But, today 30% of FAPers are first timers.  Sounds like an anomaly/paradox to me...  That means for those FAPers, it wasn't hereditary.  Maybe it was epigenetic...  

Maybe my questions and statements and the scientific information I offer periodically will aid one of the FAPers who reads this...  So, I guess it really isn't moot.  Is it?

For instance; 2+ years ago I wrote about running and bleeding during or afterwards.  It turns out that many J-Pouchers responded that they had to stop running due to excessive bleeding during or after.  I discovered in Runners World Magazine something called intestinal ischemia that occurs with maybe 13% of marathoners...  For the half marathon J-Pouchers, this may have helped them understand that maybe it had nothing to do with their J-Pouch per se...  However, my bleeding stopped after greatly changing my diet.  Not only that, I stopped having what so many J-Pouchers suffer: Pouchitis.  Why?  Could it be that many people with a J-Pouch or before having the surgery have problems with all forms of wheat and not just wheat gluten?  Could it be a combination of wheat and other traits of the modern commercial food industry/diet?  Could it be as simple as increasing lignans in our diet, especially from flax seeds?

Does anyone really want to remove their ailments naturally? 

At the moment it means a greater sacrifice than they already are doing, AND it means that it isn't as simple as taking a pill or drinking metamucil...  But, mabye in the long run they would be sacrificing much less...

Thanks for your response.  Hopefully there will appear other types of strong opinions that help us expand our knowledge of the situations.

As for FAP associated risks; they are low for ALL other FAP related cancers after colon cancer.  My younger sister developed Thyroid Cancer at the age of 26 (1-2% risk) and rectal cancer at the age of 43 (was considered low risk).  My cousin died of a Medulloblastoma at the age of 16 (1-2% risk) and who would have been her niece was just rushed to the hospital for having a sudden medulloblastoma removed (she's 18-years-old).  In 1996, the American Medical Association smashed the study that came out of New Zealand connecting FAP with Thyroid Cancer.  Brain Cancer wasn't connected with FAP until the turn of the 21st century, even though my cousin died of it in 1978...  FAPers aren't the general population.  And as I've noticed during my lifetime living with this "disease", it's like living with a stalker hiding out there, visiting you every once in awhile and saying "if you don't give me $100,000 tomorrow, your daughter may not return from middle school or your wife may not return from work or the gym or from shopping sometime in the future..." Read about non-War Veteran PTSD and hypervigilance...  Come to think of it, you could tell me to see a psychotherapist claiming that also my cardiovascular disease is psychological trauma related.  My father died at the age of 34; I was 4.5-years-old.  His sudden death "destroyed" our family.  I had my colectomy and emergency return to Sloan Kettering at the age of 13...  The heart attack appeared at the best time of my life, when I was "healthiest" and in an economic position for planning for a future with my wife in ways I never had dreamed of.  And now, with the heart attack, those plans were shattered.  

But, what gives me most comfort is finding all of this information that helps me understand the possibility that maybe not everything is inevitable... and if we understand the multifaceted causes of the individual's disease (since, when it comes down to it, there is only one disease and one person being treated. Although the statistics of humans as groups help us direct our attention for being able to incorporate possibilities and for removing them from the list with educated analysis or "guesses"), we can see if we can remove/alter variables one by one... instead of saying "this is what the doctors said and it's this and THAT'S IT... if it doesn't work, than I guess am F---ed.  Dump all of your savings into THIS and CROSS YOUR FINGERS!"

But what if the doctors are looking through a bottle...?  What if they haven't been well informed?  What if their perspective and training only looks at 2 of the 240 possible causes of cardiovascular disease?  What if there are many other options of possible cures but the investigations require heavy funding and most of the medical research is funded by pharmaceutical/medical technology companies not interested in non-chemical/non-surgical responses to illness/disease?  What if the gastroenterologists were taught in medical colleges not funded by the farmaceutical industry and understood that gallstones can be removed with changes in diet without removing the gallbladder?  What if they understood that Hiatal Hernia, cholecistitis (gallstones) and diverticulitis were directly related and that cholecistitis and atherosclerosis were also directly related (low glutathione)?

In 2006, had I had $2000 for removing my gallbladder, I would have followed my gastroenterologist's recommendation.  However, considering that I didn't have that money, I decided to research alternatives.  9 years later I don't have cholecistitis.  But I do have my gallbladder.

How are the gastroenterologists attending to pouchitis?  Considering that I have never met a gastroenterologist that understands J-Pouches and FAP here in Mexico, I had to attend to my pouchitis alone...  If I don't ask questions and read scientific literature along with a lot of alternative medicine and compare, I wouldn't have found the solution to what much modern medicine turns a blind eye...   

Ross

Me against all sides of the medical "community"?

...whit's end decisions?  Since we can't know if we will find someone in the traditional medical community willing to address the issue of low testosterone and deficiency of Immunoglobin M (IgM) and cardiovascular disease, we decided to continue being as proactive as possible and giving our alternative nutritionist the green light on intravenous Chelation Therapy for removing arterial plaques and certain heavy metals...  

At the moment, it seems that no matter what I do, diet 90% vegetarian (animal protein limited to natural yogurt, fish and eggs), fats limited to olive oil, coconut oil, avocados, and what is in the natural yogurt, flax seeds and Pacific Mackerel), daily exercise of 3+ miles running or rowing (30-38 minutes depending upon the activity), supplementing and drinking certain "teas" or extractions... my blood pressure rises and doesn't fall to the levels as before and the heart palpitations appear at any given time, along with certain aches or pains from the upper abdomin to the chest, shoulder, throat, teeth and head...  

When considering visits with traditional doctors, I encounter myself immersed in heavy concern.  The problem is that I don't want to butt heads with these people and their need to practice exclusively "pharmaceutical" medicine...  I'd prefer they practice medical science and look at my lab results and the literature connecting low testosterone levels and IgM deficiency to plaque build-up. Although my stance is uniquely related to my need to truly and adequately address my personal health situation (to find a cure; to save my life; to prevent unneeded suffering--unnecessary destructive side effects), they see me as telling them that they don't know how "to do their jobs" or that I believe I know more about cardiology or medicine than do they... as you'll see with the nutritionist's response...

Truthfully, there is no less of a reason to perform EDTA chelation therapy than there is to do an angioplasty/stent proceedure...  The issues existing in my body treated by EDTA are clearly diagnosed.  However, upon reading about the proceedure, I found myself with certain concerns and I sent the nutritionist a small blurb from the University of Maryland Medical Center:

For heavy metal toxicity: EDTA chelation therapy is often given intravenously with calcium, magnesium, and vitamins B and C over a period of 1 to 3 hours. The recommended adult dosage varies depending on the size of the person and the amount of lead or other metal in the body. The amount used would be determined in a hospital setting.

Precautions

The most common side effect is a burning sensation at the site of the injection. In addition, some people may have an allergic reaction to EDTA. Other serious side effects that have been reported include low blood sugar, diminished calcium levels, headache, nausea, dangerously low blood pressure, kidney failure, organ damage, irregular heartbeat, seizures, or even death.

According to the Centers for Disease Control and Prevention (CDC), there have been deaths associated with hypocalcemia (low levels of calcium) from intravenous chelation therapy.

A qualified health care provider will monitor blood pressure, blood glucose, cholesterol, organ function, and other vital statistics during treatment with EDTA. EDTA may lower levels of nutrients such as calcium, zinc, and potassium. Your provider will perform blood tests to monitor vitamin and mineral levels before, during, and after EDTA chelation therapy. Your doctor may recommend supplemental vitamins and minerals, either orally or intravenously.

I wasn't surprised by the nutrionist's response:  

hi

you send me this information as If I did not know what I am doing? is this your point? I am ACAM certified and never ever have had any incidents.

If there is so much distrust, please do not come

...and responded to her calmly:

I thought you would respond so... It's more a question of fear and heavy nervousness these days.  

The interventionist cardiologist was highly certified and I'm certain he did the angioplasty/stent proceedure impecably...  However, I almost died on his table from an allergic reaction to the resonance ink...  I don't know what they injected me after I had lost consciousness with the heart rate over 200.  However, when I came to, I was blind for at least an hour...  Nothing is written on the paperwork what happened and what they gave me to stop the reaction...  All I know is that the cardiologist said that this had NEVER occurred in his experience as an interventionist cardiologist and that someone just informed him that the risk of an allergic reaction to the resonance ink is 10%.

Maybe it is best for you to not risk having a very bad experience that has never occurred... I've wondered what would happen if I had a reaction in the middle of the proceedure...  I find the University of Maryland Medical Center very liberal in their medical/scientific perspective... When everyone else in their world writes against spirulina and chlorella, they write in favor.  They're the only ones who I've read express the belief that people with lymphoma should avoid all sugar, especially bread, meaning that they see a connection between celiac and lymphoma, although no one has qualified that possible connection.  I didn't share with you their belief of the effectiveness of EDTA for cardiovascular disease... since I believe that at this moment most health care is a crap-shoot, much like alchemy--sorcery...  

I won't be able to look into my arteries to see if the EDTA removed the plaques...  just as I can't look into the stents to see if they are half full or about to become blocked and about to kill me... Yes, you can check with an angiogram.  But, that means spending at least $50,000 pesos and injecting resonance ink.  I don't know if you can imagine how I feel about that day when I should have another angiogram...  A form of Russian Roulette, but with more odds against me...  

Maybe you can understand my position enough to not allow your ego to dictate your behaviors...  ;-)

It's more a question of feeling her ego stepped upon and bruised.  But the truth is that she is NOT asking me for laboratory tests before beginning the EDTA proceedure... She will NOT know how are my potassium, magnesium and calcium levels before Friday.  So, it is possible that the therapy will drop my electrolyte levels too low.  And as you know, heart rhythm has all to do with Calcium, Potasium, Sodium, Chloride and Magnesium levels...  PLUS, like what is written about resonance ink and angiograms, that the doctors must first ask their patient if they have a tendency towards allergies no matter what... in order to be prepared for the possible alergic reaction event, the nutriologist should be equally prepared, since that's what the UMMC says;  risk of allergic reaction to EDTA.  

The thing is that the nutritionist is not working in a hospital.  So, if something goes wrong...?  Margarita was waiting on the other side of the door (in small waiting room) of where the angiogram was being performed and says that suddenly the cardiologist left the proceedure room running and returned a few minutes later with a woman (who must be the specialist in allergic reactions in the operating room).  

Who knows?  Maybe I am just protecting myself and she is doing me a favor while protecting herself from something exploding in her face...  

Truthfully, reading the UMMC page made me a bit anxious last night; enough so to raise my bp and cause insomnia...  

I was going to say back to the drawing board.  But that's not true.  We just find ourselves exactly where we always were...  The EDTA chelation therapy is just one possibility...  Maybe there aren't really any adequate solutions and we've just gotta accept what is evolving inside my body.

Who knows?

On revisiting past events or regurgitating difficult histories...

While showering after terminating Amy Tan's most recent novel "The Valley of Amazement" (read in Spanish) I had this sense that I had dreamed something connected with my childhood last night...  The feeling was surprising, since I hadn't awakened thinking about the dream and had passed 5 hours awake without thinking about what I may have dreamed last night...

It turns out that I was "revisited" by my first childhood bully (outside of my household) who began the ball rolling of my ostracizement, alienation and anti-Semitism in the second grade.  Of all the children who picked on me in elementary school and middle school Tommy Murray frightened me the most.  And when I think of the stereotyped faces of Nazis, Russian or Polish anti-Semites I imagine a face like his... Although, truthfully, his face was that of Scotts-Irish decent with the red hair and pinkish freckled face...  

In the dream we were adults in an adult world somewhere between Mexico and New Jersey... Somehow I had stumbled across Tommy and his henchmen (all bullies are surrounded by henchmen) in public space and it was announced that I must fight him later on in the day causing a dilemma I had experienced with another bully in 8th grade, certainly described in this blog.  You may ask, "why dilemma?"

The children picked on in school or on the play ground or the bus stop etc, don't seek out the bullies for creating conflict.  In as much as the bully generates hate in the picked-upon kid, and that child may have fantasies of being able to KO the bully, the picked-upon would prefer avoiding potential contact and attention by the bully.  Plus, bullies generally select children who are already suffering something or another, showing a certain amount of insecurity in their stance...  

In 8th grade, when Mike Szmanski gave me a time and place for fighting him after school, although I hadn't done anything that required a "duel" between the two of us, I found myself in a dilemma... The dilemma of fleeing or fighting...  But, truthfully, I didn't want to fight...  

Regarding Tommy Murray and comparing him with Mike Szmanski at the time, I know that Mike wouldn't have fought Tommy because Mike wasn't truly aggressive... He was one of those semi-popular kids who wanted more attention.  He was just a semi-athletic cream puff... He was full of hot air.  Tommy on the other hand was clearly dangerous...  and he had developed the reputation of being a fearless fighter...  I wasn't a fighter... In fact, at the time I was just trying to "fight back" against my mother and my sisters and the small bullies my size...  

In the dream I found myself in my Nissan pick-up in a parking lot soon to fill up with "neighborhood folk" appearing for a public event I believe was a rock concert.  Unlike Tommy, I had no henchmen surrounding me, encouraging me, supporting whatever move I made.  Part of me said that I must fight him and hopefully it wouldn't turn out so bad, although I knew what those chances were... Not fighting him wouldn't resolve the problem because it would only fuel the ostracizement and they would return repeatedly until he had the chance to plaster me...  It's better to get the inevitable over with...  and not prolong it... I didn't understand that in childhood and tended to procrastinate and make things linger on and on...  In the dream there was a certain sense of relief upon thinking about just getting it over with, although the eventual beating immediately slipped into my mind...  

The strange thing is that at the moment I was supposed leave the pick-up to meet with Tommy and his group, I noticed that cars had parked so close to my pick-up that I couldn't open the doors enough to leave, nor through the windows...  

My immediate destiny was determined for me... It wasn't my decision...  But, it was inevitable...  There was nothing I could do for the moment.

Truthfully, the story doesn't interest me in as much as the placement of the dream:  I'm 46-years-old, so far away from that reality, laying asleep next to my wife Margarita who hasn't had the fortune of being able visit the places of my youth to get a little bit of a sense of where I came from...  

Why have such intense, vivid and difficult dreams about things you would say have nothing to do with the present... That aren't my current interests.  I don't think about Tommy Murray frequently...  But, it is clear that he had a certain important role in part of my childhood development.  And because of that, he appeared in the dream as he did... the only form in which I knew him... so long ago.  

One of the diagnostic criteria of Post Traumatic Stress Disorder (PTSD) is recurrent nightmares... or flashbacks...  Last night's dream was a flashback...  What role does it serve?  In my current health situation...

At the moment I don't have the "luxury" of spending time on the far past and those difficulties.  Truthfully, the difficulties that have arisen since March render all past traumas virtually obsolete, with the exception of those events' possible contribution to the lesioning of my coronary arteries....  But aside from that, I don't believe I have space, time or energy untangling certain knots created in my childhood, adolescence and early adulthood.  There isn't anything of the past to "resolve"...  There aren't bye-gones to let be bye-gones...  Time has been cut short.  All that's truly important is how I feel today and what comes tomorrow... short-term planning, if I have that luxury.

Yesterday José "Montaña" said to me, "don't worry.  You'll find that you still have many years left of life and will see your 70s..."  I responded, "José, you know I don't appreciate trite, insignificant statements... It would be different if I knew that person was psychic and they could see into my future.  But, you weren't making that statement based upon something you truly sensed..."  He didn't contradict me...  And I said, "I'm not complaining or whining.  It's just something I know.  My body was created with a self-destruct button or programmed premature death...  It's something I must try and accept."

How much does it have to do with past experience? I don't know.  Maybe the time bomb would have exploded regardless of what occurred in my childhood and adolescence; what was done to me and what I did to myself..."  We can't know this stuff.  I believe the impetus to fill one's life with dense quality and production increases the velocity towards death, as I believe I see in my father's and my uncle Henry's stories.  Although my Uncle Henry outlived my father 22 years...  But, I do believe that those who don't fill their days with productivity and learning, thinking and developing themselves or their families or careers or business etc, who spend their time just watching the leaves fall from the trees or engage in frivolous activities, live longer lives...   The pressure to use every possible minute of the waking hours constructively/productively brings us closer to our deaths, although we believe that maybe we are more satisfied with our lives...  

I believe that I wasted a lot of time in childhood into adulthood... Who knows?  Maybe that's part of what allowed me to live to the age of 46...  In as much as I may feel regret of not having accomplished more in my life or accomplished something more important, such as having become a doctor, I now realize that it really doesn't matter, because I would have brought my death that much earlier...  Afterall, it's programmed in...  

What can we say about the bullying in school and at home?  The abuse by my uncle or my mother?  The death of my father... the inheritance of his illness or illnesses...  Maybe they were just necessary distractions or other spiritual lessons...  I don't know if it really matters...  I guess it does in some form... at least for those studying the outcomes of PTSD, especially for those connecting childhood trauma with adulthood heart disease...

How many times in childhood did I have my heart broken?  The broken heart is both symbolic and metaphorical.  But, those medical anthropologists studying PTSD and how it affects the body physiologically may see that it is much more literal than symbolic and metaphorical...  Truthfully it doesn't really matter if my heart was broken when my father died or when my mother became as she did or when the family neglected my small child fears and needs within the situation and never wanted to understand my side of the horrible experience...  Truthfully, it doesn't matter because no understanding of the situation will change the damage it produced on my heart...  No one will return me to the reality I was living upon returning from Sayulita last March 11th; what Margarita and I were talking about; the hope and the planning...  Little did I know that it was too late...  

How many times in childhood did you find yourself riding your bike and then without any warning you feel a thumping of the back tire because a bubble had appeared suddenly.  And before you know it, the bubble suddenly pops and you've gotta walk your bike miles back home to fix the flat...?  Did you know that the tube inside the tire had a defect or was worn?  Absolutely not!

I guess that's what I discovered between March 12th and March 14th...  I couldn't believe it!  I didn't want to believe it...

Now tell me:  What experience of bullying or child abuse/neglect/alienation/isolation is more important than this?  Tommy Murray?  Chris Love and Sheri or Craig and Sheri or Todd Golub and Tommy Murray or Mike Szmanski or all of those kids in summer camp or the other kids who ostracized me in elementary, middle and part of high school?  My uncle Stan...  A lot of histories... But, nothing is as traumatic and destructive as what truly destroys hope for the future and the present...  

Can you imagine walking around believing that your motor is about to blow?  If it were the brain, that would be a different story because its dysfunction would cause you to lose sense of reality, possibly relieving you from suffering, like with Alzheimers Disease...  

The palpitions appeared while working in San Luis Potosi.  And they got worse as the fair progressed.  Fortunately for me, the park within which I ran 3+ miles was a 10 minutes drive from where we lived and the fair and was in the middle of my shopping route... I didn't lose time in order to go out of my way for running...  It didn't cause me stress.  And when we closed the coffee bar at night, we walked relaxingly home to bed...  However, for some reason or another the palpitations began upon laying down to sleep.  And they increased in intensity... and caused problems falling asleep... And then I found them starting up again in the mornings upon awakening...  

So I'd go to the wonderful parque Tangamanga where I've run every August for 3 summers now and I would begin the run with a mantra:  I'd rather die running than die sleeping  It's true... It's about feeling that you are in "control" or proactive until the end...  Exercise is the only thing that gives me "a piece of mind"...  

When things became so much worse this past October during he fair of Guadalajara and the palpitations were begun or caused by the late night drive home from the fair, I found that the only way I could fall asleep in the wee hours of the night was if I did between 60 and 70 fast push-ups...  You would think that that is a bit risk considering the pressure the push-ups would place on my heart.  But I believe it is better to die of a heart attack doing something that makes you healthier in other ways and understanding that you did all you could... than to die of a heart attack feeling vulnerable and scared, relinquishing all your "power" to the problem...  

In childhood I didn't fight the bullies and the other kids... I didn't fight back.  I didn't know how to defend myself... This time around, although I may not find the solution/answers, there isn't one moment that I'm willing to procastinate encountering an adequate solution for improving the situation.  I refuse to be defenseless, allowing others to determine my destiny...  Yes, it's possible that two trucks parked too close to the doors of my pick-up all my life or ever since we returned from Sayulita... And my hands are tired... However, I will still consider kicking out the windows and sliding between the two vehiculos, even if that means I will fall face first into a mud puddle below...  

Fighting back feels much better than helplessly awaiting the other person's next move, the return of the bully and his henchmen...  

If I die running 3.5 miles today or on the rowing machine in our bed room tonight... I will not die a loser.

However, I do believe that we will have lost something very important... And I greatly worry about Margarita and her loss.  That's what worries and confounds me most these days... about preventing that loss for her... I lost my hope and wonderful expectations of 10 months ago...  I can't change that.  But, I'm battling the best I can so that she doesn't have to experience that loss so soon.  

Why did I dream with Tom Murray while sleeping alongside Margarita in our wonderful bed here in Guadalajara, Jalisco Mexico... especially if it has so little to do with our life here and our relationship?

Or is it that I'm missing a certain point?  Maybe its an important message to continue fighting for what is most important to me...  Something I hadn't done during childhood and adolescence...  I guess I didn't know what I would have been fighting for...

Ross  

Hollywood Medical Dramas, success stories and pop culture mind...

...something constantly evolutioning within my mind... Doctors and their responsibilities... to me...  But the truth is that they're humans living with responsibilities to themselves and to their families...  Now what does this have to do with me?  Always re-calibrating... putting things into perspective...  

Truthfully, what were the doctors' responsibilities when we were diagnosed with Familiar Adenomatous Polyposis?  What were their responsibilities when my father was dying of liver cancer caused by FAP?  And what were their responsibilities when his mother (my paternal grandmother) died from what was not at the time understood as FAP caused illness?  

What the doctors don't understand or have no possibility of knowing is not their encumbrance...  If you didn't teach me the answer to question #5 on whatever exam, should I have known the answer?  

So, here I am with a lot of questions and doubts... And the incredible notion that something else is occurring within my body that no one is taking into account when they diagnose me and suggest treatments...  For 3 years now I'm beating my brain for asking myself the correct questions, questions more apt for encountering responses that come closer to the truth within my body.  

Without adequate questioning, without random miracles falling from the sky, we can't respond adequately to difficult situations.  

We're about to enter the process of third opinions of medical "experts" here in Guadalajara.  But, before entering their consultation rooms, I must have all the data infront of me, along with the themes they typically do not consider.  For instance while perusing the laboratory results of 3 years, I noticed that the year before removing all wheat products from my diet, I was repeatedly shown to be experiencing Basophilia (high Bosaphile levels)...  Basophiles are white blood cells that respond to allergic reactions...  Allergy to mold spores... allergy to pollen... Allergy to cats and dogs... allergy to peanuts...  We've lived in a heavy mold spore situation for 4 years now due to heavy water damage to the ceiling of our house to which the "landlord" responded inadequately and with which we repaired the best we could over the past few years... Hence, I've had respiratory issues on and off over the past 4 years... some very serious accompanied with hives and swelling...  That said, the basophilia went away with the removal of wheat... It didn't go away with the removal of mold spores because the mold spores are still here as shown with my most recent bout of respiratory problems in October--November...  But, the basophiles returned to normal with the removal of wheat.  So, does this mean that I'm allergic to wheat?  I wouldn't know.  I haven't been tested for wheat allergies...  

This is important.  With the removal of wheat, I dropped over 30 pounds... of inflammation...  My pouchitis (a type of Irritable Bowel Syndrome) went away...  But what doctors would have suggested removing wheat for treating Basophilia?  What J-Pouch experts are talking about wheat as a cause of pouchitis?  What is pouchitis?  The equivalent of colitis...  meaning that it can cause horrible bowel issues such as ulcers, obstructions, varicose veins and cancer... leading to more preventative surgeries.  But, before the surgeries the "patient" lives in misery...  And what if the "patient" doesn't have the economy for more surgeries?  And what if the "patient" doesn't live where j-pouch specialists exist?  If a tree falls in the woods and you didn't see it fall...  Did it fall?  Does it matter who experiences what if they aren't who you truly care about? or if they didn't appear on the big screen like the boy in the bubble or Lorenzo?  Would we care about the probability of success of Will Smith's character in "Pursuit of Happiness" if we hadn't seen the story within a Hollywood movie?

The problem is that I grew up within the "American" television/Hollywood movie popular culture.  So, it seems that my expectations of doctors and life is based upon a Hollywood fantasy medical success drama.  I expect them to become intrigued by the information/data and ideas I share with them... They should see a wonderfully interesting and satisfying medical challenge infront of them...  But, what I think they truly see is a headache...  They should see a challenging medical/scientific puzzle with a very great possibility of solving...  The other day Margarita mentioned that what I've stumbled across over the past few days or so reminds her of Dr. House episodes...  What would it take for Mexican intellectual youth planning on studying medicine to be truly inspired or influenced by the medical/scientific perspectives of Dr. House?  Who inspired scientists and doctors to pursue responses to difficult medical situations?  Were they only pursuing fame and fortune?  all of them?

So, putting everything into perspective for me has much to do with trying to understand why people are doctors and what is their true pursuit, what that has to do with my own personal situation (what is the probability of truly resolve my own personal medical issues), and truly what is my existential reality...  

If a tree falls in the woods...  If the patient isn't related to someone who is wealthy, popular or important...  How many people are we on this planet?  How many of us have the same issues or worse issues...?  How many suffer worse issues of social justice etc?  How many are more "deserving" of humanitarian aid and who will not receive anything?

Humanitarianism doesn't have to refer to "Live Aid" or "Wave Aid" (responding to the various tsunamis)...  We all can be humanitarians... at times... and decide to help someone momentarilly (like helping an elderly woman cross a busy intersection...) 

The question is what is the possibility of a doctor having the time and focus for listening to me and understanding what I've placed infront of them and decide that they "should" assist me in my personal health "project"... But, that brings up the question of what are their own personal responsibilities to themselves?  

It's frustrating... because the information is very clear... and it is all found within the scientific liturature...

The problem is that endocrinologists, cardiologists and gastroenterologists see Inmunoglobin M and Basophiles as being outside their focus and related to allergenists and immunology specialists...  So, those data are ignored...  

The problem is that the wonderful project created between Amherst College, Smith College, Mount Holyoke College and the University of Massachusetts/Amherst called Hampshire College in that they believed in the 60s that interdisciplinary studies was a more affective way of addressing social, political, technological and scientific problems for one reason or another was not grasped by the rest of the intellectual/academic/scientific and innovative "world community"...  Although I understand what it is I'm doing and the connections at which I'm looking, that doesn't mean the doctors can understand interdisciplinary focussing and looking at things from "outside the box"...  

You have no idea just how exhausting this battle and project is...  Granted, you also may not understand just how satisfying are the discoveries and connections I've made.  And, that's why I've been writing about this...  Sometimes I think that maybe it isn't the outcome that matters as much as knowing that I've been on the right track for almost 3 years now... although the doctors haven't been much of help...  Actually, I don't believe that there is a success story with a happy ending for me...  But, at the very least you will have the documentation here... someone will know where I was standing all the time... Maybe this information will be of service to someone...  

My father was a doctor.  He was diagnosed with FAP when he was dying of liver cancer...  None of his education and the science was of service to him...  His story or our story is a fable... a trajedy and a story of survival.  But, truthfully, how important is it?

And that's where I am at this moment.  Should I continue battling within the investigation and spending money on mediocre science and medicine?  Or should I see destiny as being what is out of my hands and beyond my control and just allow to come what is coming and go on vacation...? Not a vacation in a metaphorical sense of the word but truly on vacation...

At times I want to relax from these issues and leave for places I haven't been or haven't been in a long time... like Oaxaca, Chiapas, Quitana Roo, Guatamala... Puerto Rico... the United States... We have Salvadoran "friends" here in Guadalajara who visit their country of origin 2 times per year...  Yesterday Margarita showed interest in the possibility of visiting El Salvador... We can start working towards her visa for entering the U.S..., since she finally received her revised birth certificate...  The problem is my tendency towards pragmatism here...  Issues of money saved or spent, diet, stress... and being in the position to respond to whatever medical issues arise... Travelling removes the base from where I've been working the past 3 years... working on my health issues...  If we decide to travel, that means we're putting aside aspects of the health project, such as second opinions with cardiologists and trying to connect a gastroenterologist with a cardiologist with the idea of connecting my FAP/Gardners and the digestive structure caused by the preventative surgeries with the coronary issues.  It means putting aside the heavy metals (mercury and lead) detox program or the process of cleaning my arteries of plaque which is another program...  

This is a problem.  It means a measure of giving up upon a possible medical success...  It's the interchange of being chained to an "improbability" and being freed to live free in the time I have... I don't see freedom in lack of hope and not being able to plan for a better future as I've been doing the almost 13 years I've been with Margarita.  Removing the future and planning and hope for something new and improved is the removal from my life what it has been based upon the past 13 years...  I guess it's like what work-a-holics encounter when they consider retirement...  Do you know how many people enter rapid physical and mental deterioration upon retiring?

A new discovery: #10 on the list of possible causes of my heart problems...

10)  Inmunoglobin M deficiency:  

Over the past two years and at least 15 blood tests, there has existed one constant that does not change, my Inmunoglobin M (IgM) is ALWAYS low.  When I notice results outside of the recommended field, I immediately investigate on the internet to see what the science says about low or high numbers.  But, with IgM, I've repeatedly encountered the same lack of understanding, although it is linked with Lupus, Multiple Myeloma and various skin infections/diseases/reactions...  The cause is unknown.  Hence, without understanding the cause, it is more difficult to find an adequate resolution.

Today I decided to return to the investigation. However, I changed the search term to Inmunoglobin M Deficiency and Heart Disease.  

Here are some of the titles that appeared: 

"Primary selective IgM deficiency: an ignored immunodeficiency"

 http://www.ncbi.nlm.nih.gov/pubmed/23760686

"Protective Roles of Natural IgM Antibodies"  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341951/

"Autoantibodies in Heart Failure and Cardiac Dysfunction"

http://circres.ahajournals.org/content/110/1/145.full

Naturally Occuring Antibodies 

https://books.google.com.mx/books?id=BLxyJUquBJEC&pg=PA9&lpg=PA9&dq=IgM+deficiency+and+cardiovascular+disease&source=bl&ots=39gARH3byd&sig=RQ9-eOYB9hjQXfvJca4lkOkYznQ&hl=en&sa=X&ved=0CCsQ6AEwAzgKahUKEwiMkt3qiIrJAhUCKiYKHdkmBwI#v=onepage&q=IgM%20deficiency%20and%20cardiovascular%20disease&f=false

Heart Diseases: New Insights for the Healthcare Professional: 2013 Edition

   

Low levels of Inmunoglobin M leads to atherosclerosis and heart disease.  In the chapter of "Heart Diseases: New Insights..." the authors explain that low levels of IgM antibodies to oxidized cardiolipin increase the risk of cardiovascular disease and high levels of IgM decrease the risk...  In Naturally Occuring Antibodies, the authors explain that low levels of IgM accelerates the process of plaquing in Atherosclerosis.

In one of the articles, rats bred to be genetically IgM deficient given IgM antibodies were found to greatly decrease their atherosclerosis.  

The other day I shared my discovery connecting low testosterone levels to increased levels of TMAO circulating in the blood stream that causes a great increase in cholesterol sticking to the artery walls; meaning that the logical solution to the problem is to increase the person's testosterone levels.

In the articles and books mentioned above, low levels of IgM is linked to higher levels of oxidized LDL cholesterol circulating in the blood stream. It is believed that 30% of the IgM antibodies work is to remove oxidized LDL cholesterol (and dying apoptosed cells; apoptosis is programmed cell death).  Are you aware that with atherosclerosis, the main reason Statins are prescribed is for preventing an Apoplexy, better known as a Stroke.  The statins supposedly cause the plaques to become cemented to the walls of the artery in order for reducing the risk of a plaque breaking off and lodging itself into the brain causing a stroke...  But, what if producing enough IgM reduces the production of plaques and reduces other debris floating in the blood stream reducing the risk of a "log jam"?

The question is how to increase my levels of IgM?

Addressing important issues with inadequate information...

In Dr. David S. Grimes epidemiological study of world disease "Vitamin D and Cholesterol; the Importance of the Sun", he states that medical science has discovered 240 possible causes of Coronary Heart Disease.  However, the industry has the tendency towards focussing upon only 2 possible causes:  Diet and psychological factors (mainly stress).  

One of his statements I find most supportive of my experience with cardiologists over the past 3 years is  "The problem with Coronary Heart Disease is that we do not have a good understanding of it. But this is not generally understood."  

As I've found with my experience since the so-called heart attack of March 12th 2015, (normal cholesterol levels, moderate physical activity, very healthy diet, normal triglyceride levels, low levels of C-Reactive Protein, normal levels of homocysteine, blood pressure easily regulated with diet and sleep and without medication), Grimes mentions that within the medical science world "there are many dissenters from the conventional wisdom" due to important anomalies or paradoxes.  

'Discovery commences with awareness of anomaly'. If interventions based on incomplete understanding are not shown to be effective, then they should be withdrawn, but there is rarely the enthusiasm to do so: Professionals are very ready to apply their dogma to the population, even for the best of motives, but are very reluctant to reverse it.  It has been described well as 'the tyranny of health.'

I don't believe you can better phrase my experience with 3 of the 4 cardiologists I've seen over the past 3 years; 3 of them since March:  "The tyranny of health"... 

The problem with the cardiologists is that they don't want to pay attention to the anomalies...  the very clear and present paradoxes... I feel it very important to enter their consulting offices armed as would a trial lawyer entering the courtroom: with a pile of blood tests, toxicity tests, genetic tests, ecocardiograms and the rest of my medical history that they wish to believe is unrelated to my heart issue and their specialty...  

I'm in the process of creating a list:

1)  Mercury toxicity:  my level increases risk of acute myocardial infarction 30%

2)  Colectomies and J-Pouches create a tendency towards deficiency in Vitamin D (although the cause is not understood) that greatly raises the risk of hypertension.

3) Allergy to mold in water damaged buildings is one of 14 top causes of heart attacks (mercury toxicity is on that list too).

4)  Lead toxicity creates both a hightened risk of hemolytic anemia and pulmonary hypertension.

5)  I have a single mutation on two of my VDR genes that causes the risk of vitamin D deficiency.

6) I have 2 double mutations (from both parents) on the GCLC genes that increases the risk of hemolytic anemia and Acute Myocardial Infarction.

7)  I have 2 double mutations on the GSS genes that increases the risk of Glutathione Synthase Deficiency (which causes Gallstones--I had them 9 years ago--and atherosclerosis), Hemolytic Anemia and Pulmonary Hypertension.  

8) and now I'm reading about TMAO and its relationship with heart disease but caused by SIBO.  People with "short bowel syndrome" are both at hightened risk of SIBO, malnutrition and disnutrition, which puts them at hightened risk of heart disease...  

9) Testosterone suppresses FMO3 gene expression which decrease levels of TMAO blood circulation.  Hence,. men with low testosterone levels have greater risk of heart attack due to risk of higher levels of TMAO circulating in the blood... In May I had read that there was a connection between low levels of testosterone and heart disease.  But the scientists didn't know if low testosterone caused the heart disease or was caused by heart disease.  So, I had my testosteron levels checked and they came back low, which I showed the endocrinologist who didn't have time for working with me (too many patients).  But, if it the connection between Testosterone, FMO3 gene expression and the production of TMAO is correct, we have another cause of heart disease.  Hence, the cardiologist truly concerned with the health of their patient upon seeing their levels of testosterone should get on the phone with their endocrinologist colleague and suggest testosterone therapy for their patient...  Is this not logical? 

I recently developed a friendship with an investigator for the Guadalajara health department who connected me with his brother-in-law (gastroenterologist) and brother-in-law's wife (cardiologist), since it is very clear to me that the issue of my heart issues is greatly related to my preventative surgeries.  As I said to Margarita, what the cardiologists should first do when I enter their offices is ask themselves what makes me different from the general public of heart patients THE ANOMALY, and start looking at my health (possible causes) from there...  especially if I'm physically fit, my sodium level is low, my cholesterol and triglyceride levels are normal, my diet is healthier than the average person and I exercise regularly.  But, for some reason, the doctors don't want to look at the anomaly and don't want to consider the other 138 possible causes of heart disease.  

The first step to a cure is isolating the cause...  But if you are a doctor without the desire for isolating the cause, it is more probable that you are not being adequately effective for your patients' needs.

The nutrionist says, "Ross, you can't blame the doctors.  They're just a product of their environment.  In this situation, you've gotta be your own doctor.  Because they aren't trained to truly help you."  

So I order the exams they don't order... and I must find alternative ways of detoxifying myself in my household and... and I must experiment with supplements and herbal remedies and more diet changes...  

A friend of mine who sells Yucatan Guayaberas (a type of blouse for men typical of hot and humid Mexican regions) is married to a woman who had open heart surgery 12 years ago due to a heart murmur with the first surgeon to do a heart transplant in Guadalajara or Mexico... One day returning to our coffee bar in the October Fair of Guadalajara, I found Margarita talking to Nacho and his wife... about me... and my intensifying health issues... Nacho's wife suggested I visit with her surgeon... After explaining all of my conflicts with the short sighted cardiologists here, Nacho said, "Look Ross, if you're not going to move back to the U.S. and you're concerned about dying, I don't see how it could hurt going from Cardiologist to Cardiologist until you find one who is willing to truly listen to you.  Afterally, you are very intelligent and informed and giving up on the doctors means that all of your information will go to waste...  And his wife said, "How could it hurt calling my surgeon?  I'm living proof that he knew what he was doing... I've only seen him one time since the surgery, 11 years later as a nostalgia visit since my health has been perfect since the surgery."  

Being the product of my mother, I couldn't help but end the conversation asking for a recommendation of where I can find a pig farm with certified healthy pigs on the off chance that the surgeon suggests a heart transplant...  

A new twist on Heart Disease not connected to circulating cholesterol or triglyceride levels...

Testosterone suppresses FMO3 gene expression which decrease levels of TMAO blood circulation.  Hence,. men with low testosterone levels have greater risk of heart attack due to risk of higher levels of TMAO circulating in the blood...

The truth is...

From my father, I inhereted FAP/Gardners... It's also possible that from my father I inhereted "midlife" heart problems, since his older brother and his father both died of heart attacks at the age of 62.  Considering that my father died from cancer of the Colon/Liver at the age of 34, we can't know if he would have developed heart problems in the following decade of his life...  

Thinking about my past history and my present situation, I can't imagine just how much stress family events, school histories (struggle with peers/bullies) and the inheretance of my father's illness along with the preventative surgeries placed upon my heart... Considering that much of the issue of my heart problems today are related to reactive hypertension (hypertension caused by momentary situations) and lack of sleep (especially during the fairs or years earlier when I painted or read until wee hours of the night) I can imagine that the 20 years of horrible insomnia in childhood and early adulthood along with the horrible homelife situation of childhood and the interpersonal conflicts of adolescence and early adulthood combined with the incredible stress placed upon my body by the preventative surgeries caused irreparable damage to my heart and we don't really need to talk about this anymore... As I've said earlier:  I have the body of a physically fit 46-year-old and the heart of a 72-year-old... 

It's tired... and truthfully, I don't know how much I can do for preventing its failure...  When I say that it is tired, I can feel its tiredness in the center of my chest.  Need I say more?

The other day a friend of mine asked me if I am painting... This friend of mine, Raul, is an artist the age my father would have been had he lived...  He also has heart problems.  But he is 30 years older than me... Another friend of mine, José Luis, Raúl's younger brother, also an artist, also has problems with his heart at least 20 years now... a pacemaker was suggested 20 years earlier and has never been placed... He's a healthy and a happy 69-year-old "schizophrenic" (Bruce and my mother had dinner with him in Puerto Vallarta a few years back)...  I responded to Raúl that painting causes too much stress... He replied that many people use painting for escaping stress.  I acknowledged that use back in NYC 15 years ago.  But, then suddenly, when people started suggesting my selling the paintings with the focus on painting as a measure of personal success or that possibility, painting became stressful.  At this moment I'm trying to avoid anything that raises my blood pressure.  So, I avoid painting... and I avoid writing in this blog...  

I'm writing today because I must respond to histories, experiences, perceptions, perspectives, all that I  "published" on this blog and all that I didn't write or say...  What will be left behind when I leave all behind... What people will be reading about me when I am not here to explain what I truly meant for them to understand...  the truth...  The truth is... that it really doesn't matter... that they read basically nothing... Afterall, I could never put it all down on "paper" in a way that I truly understood my life... and it really doesn't matter.

Where are all of the major "players" in this history?  DEAD.  Everyone dies... and they leave behind memories that gradually fade.  And the funny thing is that those memories began fading even before they died... Much of my memories have faded too, making writing the stories or the better histories or the experiences, thoughts and feelings and how I relate to all of the "players" obsolete...  I didn't become an "important" painter or writer or chef or thinker... I didn't become a father.  I'm only an important person for Margarita and her family... for myself... a little more than a quarter part of my life.  That's important.  Very important.  But not important enough for maintaining this blog...  The rest of my life (the other almost 3/4 part of it) and the people who existed in that part became obsolete when I left New York City for Mexico and never returned... Why write about it..?

The truth is that I only have time or energia for salvaging of my life what I can with/for Margarita...  Today on is about tomorrow with Margarita... or about leaving her behind when my heart can't withstand more...  It's a strange thing.  But a reality we live... anothing more... not a reality we "lived"... Lived is past and past is dead and a memory fading into oblivion...  At these moments, all we have is now and the future we anticipate.  A "five-year-plan"?  But plans all the same...  I must plan with Margarita... I must plan for a Margarita without Ross...  I'm hoping that there is still "adequate" time between the with and the without.  But, at this moment we are day to day...  Maybe tomorrow I will feel better and strong and healthy... enough to have the illusion of being able to plan for a longer future... But at this moment I don't have that luxury...