SECOND OPINION | Reversing Heart Disease Episode | BCBS



PETER SALGO: (Dr Salgo) THIS IS "SECOND OPINION," AND I'M YOUR HOST, DR PETER SALGO THIS WEEK — Special guest Dick Dubois He was diagnosed with heart disease and got something that he believes saved his life

(Dick) I was concerned about the complications of surgery, but that was never really discussed I was told that by going through with the surgery it would probably, but not necessarily increase my life expectancy (Dr Salgo) Thanks again Dick for being here with us It's nice of you for joining us

(Dick) Thank you for inviting me (Dr Salgo) I must say, you have a fascinating story and this is your second opinion panel; they're here to hear it too So let's introduce them to you We have primary care physician, Dr

Lisa Harris, and Dr Pacos, both from the from the Rochester University of Rochester Medical Center We have Dr Colin Campbell from Cornell University Thank you for joining us

You're sitting here You look great And I believe you recently did a triathlon Is that right? (Dick) Yeah (Dr

Salgo) Alright, well that doesn't parson out the other term to describe you when I spoke to you And that's heart disease You have heart disease, triathlon, let's step back in time a little bit Tell me about your past history (Dick) I grew up an overweight child and was overweight most of my adult life, but I was an exerciser

I ran many marathons and a couple ultra-marathons (Dr Salgo) When you say overweight, you're 5 foot 6 How much did you weigh? (Dick) When I graduated from high school I weighed about 210 (Dr

Salgo) 210, okay you weren't massively over-weight, but you were large What were you eating at the time? (Dick)I was eating a lot of pasta, eggs, ice cream, the good things Hamburger, yes Not a lot of vegetables (Dr

Salgo) Then something happened to change everything What happened? (Dick) In 2004 I started to get exercise induced angina (Dr Salgo) What does that mean? Describe it (Dick) When I was running I would get chest pain, some pain down my arms and I would have to stop running It would go away, but as soon as I started it would come back

(Dr Salgo) And you saw a doctor? (Dick) Yeah (Dr Salgo) And, what did the doctor do? (Dick) I had a stress test and it showed that I had some blockage in the right coronary and I decided to try to control it with diet and exerciser (Dr Salgo) Did that work? (Dick) No (Dr

Salgo) So they put you on medicine If I recall they put you on metoprolol and nitroglycerin (Dick) Yes, but I never used the nitroglycerin (Dr Salgo) You're the doctor's worst nightmare

They give you the medicine and you don't take it anyways At any event your angina got worse or did it get better? (Dick) It got worse To the point where I could not run, hardly at all (Dr Salgo)You had been so active, that must have disturbed you

(Dick) Yeah, very mush so (Dr Salgo) So here we have another typical story Your wife pushed you to do more And, what happened? (Dick) She basically required that I go see a cardiologist and get and angiogram in September of 2005

This showed that I had an 80% blockage on the left side and nothing on the right (Dr Salgo) As I recall it was actually at the left anterior descending artery 80%, which in medical terms is known as the widow maker A bad artery to have an obstruction in

So, you have a family history of heart disease (Dick) Yes (Dr Salgo) Mom and dad and with this obstruction documented, what did your doctor sugest you do? (Dick) They suggested that I have bypass surgery (Dr Salgo) That sounded rational, it was reasonable at the time, right? (Dick) Yup (Dr Salgo) But, in the meantime your wife had a book

(Dick) My wife had read Dr Campbell's book "The China Study" and she suggested that I should read it also The timing was amazing I read the chapter on broken hearts, just about the time I had the angiogram and realized that there were options that I had not ever been offered (Dr

Salgo) Tell us a little bit about "The China Study" The book that he was reading that changed his plans (Dr Campbell) Well it was back to my work starting more than half a century ago And I was largely focused on a question to cure cancer and eventually concerning the effects of food on cancer

During that process, mostly through the years at Cornell University we learned how diet can relate to these kind of diseases in a remarkable way– heart disease being one (Dr Salgo) So change your diet and you can actually reverse heart disease and effect the incidence of cancer All these good things, but you have to make radical changes in the way you ate (Dr

Campbell) Yes, as far as the heart disease research is concerned, that was my good friend in Cleveland Clinic Dr Esteson I was a researcher But we could do remarkable things with food if we did it the right way Actually treat disease, not just prevent it

Same strategy (Dr Salgo) But before we go any further let's be clear what we are talking about We are talking about an extraordinary change in diet for most Americans We are getting rid of meat proteins, you going onto a mostly vegetable based diet, and cooking these things has to be done in a very special way

(Dr Campbell) Right (Dr Salgo) If I recall, I remember you mentioned the 80% legion But you had a 60% blockage (Dick) Yeah, a 60% blockage and a 5 years after that time we did find that reduction (Dr Salgo) Well we are not going to go there yet

But that first study showed 2 big ones (Dick) That's right A 60% kind of big and an 80%, everybody agrees, that's big And here is Dr Campbell and his associates saying not only can you stabilize your heart by eating right, but you can reverse heart disease if you eat right

Jason, Lisa, what do you think? (Jason) I think that there is certainly a lot of research and definitely Dr Campbell has done a great job demonstrating this and that certainly prevention of this is dietary (Dr Salgo) Ahhh, don't weasel here Prevention is not the same as reverse

Or treatment (Jason) You are absolutely right As a cardiologist, I can say that I have never treated anyone with diet for their coronary disease, alone (Lisa) And again, I think that you can mitigate disease with dietary changes (Dr

Salgo) Let me call you You used the word mitigate What does that mean? (Lisa) It means that you can improve some of the symptomatology I don't know that we can permanently reverse disease I say that, not that I don't believe that diet can do that, the problem is our western society and the way that we live does not allow for patients to continue on that type of diet

And many patients, folks that live in urban areas don't have access to some of the foods we are talking about (Dr Salgo) Dr Campbell, you've heard skepticism You have lived with that your whole life

How do you answer that? (Dr Campbell) Well first off, if 26 years isn't reasonable time When people stay on this diet it goes away and it stays away You know for as long as you like We have records now for 27 years actually

Now, with 100% and all the people can who can do that, it just disappears The remarkable thing about this from my perspective is that the reduction of angina pain goes away so fast With Dr Estonsin, I was telling her that I relying on his experience particularly Now within a week or two angina is gone

Cholesterol drops by 50-100 to 150 points (Dr Salgo) That being said, you're reading this book You get excited and you e-mail Dr Campbell

Then what happened? (Dick) I actually got a call the next day by Dr Estelson in Cleveland and within 3 or 4 days my wife and I were at his home in Cleveland (Dr Salgo) Okay, and what happened? (Dick) We spent most of the day with Dr Estelson and his wife Ann

He reviewed the possibilities by going on the diet and I think a big part of it was his wife Ann taught us how to prepare food so we can go on the diet and stay on the diet (Dr Salgo) You got a second opinion (Dick) We did get a second opinion, that's right (Dr

Salgo) What did you do with the proposed surgery? (Dick) I made the discussion at that time to at least postpone the surgery and try the diet (Dr Salgo) I can tell you that right now hearing that, I don't know about you two, there are doctors in our audience that are cringing (Dr Harris) Just a few palpitations

(Dr Salgo) What do you think of that decision? (Dr Pacos) There have to be a few things that we are clear about The The chest pain and the angina that you were having at very high levels of excursion, you were running marathons So we would classify that as rather stable angina, at a very, very high work load

So you could do your daily activities and have your normal life without having any symptoms That's a vastly different situation from people we see, or people that I see come to the office and hospital with chest pain So, I think certainly in that situation, we know that you have an 80% blockage which is significant, meaning more than 75% blocked, but it is certainly not in that critical range where you have to do something about it in that moment You have time, and that's really what was to your advantage And if you use that time to start medications, diet changes, whatever you use in that time, I think that that is important and we need to clarify it's not that you came in with a heart attack or having chest pain at rest

(Dr Salgo) Lisa? (Dr Harris) And I have a question that pops into my mind is, is it truly food that's exerting the effect or is it the reduction of the adiplus tissues, which in and of itself is a hormone and can exert inflammatory effects (Dr Salgo) So you're going to say that the weight loss contributes to it? (Dr

Harris) Absolutely (Dr Salgo) What did your cardiologist say when you told him this? (Dick) They were not happy about putting off the surgery (Dr Harris) But Jason has a very valid point This is very stable angina and for most patients we would not run into surgery

We would give you an option to try medical or dietary measures (Dr Salgo) Dr Campbell, you've heard the MD's responses and you've heard his MD's response

What do you say? (Dr Campbell) Well I have to say that this effect of this kind of diet is so remarkable, not only at reversing heart disease for years and years, as long as people continue to do it, but it's not just that, it's what it actually does for a whole variety of diseases and illnesses And the effect is so rapid I mean I came form the other side of the coin with my research, believing the opposite But the repeatedly and the breath of the effect, the profoundness of the effect is far greater than any drug can do, I must say

(Dr Salgo) Alright, then you are on a heart healthy diet then Can you describe it for me? (Dick) Umm, Yeah, it;s strictly plant based Very low fat We use no oil

No dairy, no eggs It's strictly plants, vegetables, grains (Dr Salgo) I know there are people out there saying "my gosh, there is no protein in this diet!" Is there protein in this diet? (Dr Campbell) Absolutely, the ideal level of protein is found in a whole food plant based diet

I mean that's ideal Most people think of protein as being meat, but it's not Protein is found in plants as well as animals And so if you have a whole foods plant based diet the level of protein is ideal and the level of antioxidants and complex carbohydrates, and dietary fat, I mean all of that from a research perspective come together (Dr

Salgo) This is a very good place to stop for a moment Stay where you are and we'll be right back because we're going to pause for this week's "Myth or Medicine" (male voice) The key to good health is nutrition Research has show that making lifestyle changes can reduce the risk of heart disease but is it possible to actually go beyond reducing the risk to actually reverse heart disease all together through diet alone? Is that Myth or Medicine? Diet alone can reverse heart disease That is generally a myth and I'm going to tell you why

Hi, my name is Ryan and I'm a cardiologist at Highland Hospital and the University of Rochester Medical Center We are very unlikely to clean out the narrowings or blockages in the coronary arteries We know that we can prevent them from happening or getting worse and prevent future events through the lifestyle modifications and dietary modifications and medication We never completely remove the fact that a patient has coronary artery disease They are never cured

But it is something that is managed as a chronic illness, compared to how you manage high blood pressure for years by taking a blood pressure pill Elizabeth from Seattle, WA asks:"I follow a healthy lifestyle and I'm doing great Can I go off my medication?" That is an individual discussion that needs to be undertaken on patient to patient basis But generally, most cardiologist will tell their patients that the answer is usually no to going off of the medications We know that it is unlikely that anything that is done, whether it be medication or dietary modifications or vigorous exerciser is going to completely clear up or remove blockages or narrowing in the arteries

The focus of our therapies is to holt any progression of coronary disease, prevent future events, heart attacks, or heart failure and control blood pressure And that's medicie (Male voice) Not sure if it's myth or medicine? Connect with us online We will get to work and get you a second opinion (Dr

Salgo) And we are here with Dick who was found to have coronary heart disease, he was scheduled for surgery, read a book and discussed to follow a different path- a diet, and see what happens as you go along and your primary care physician was going to follow along with you So, you didn't have the surgery and you went on this diet Tell me about what happened there after (Dick) Dr Richardson told me to follow up with a lipid profile within, think about three weeks after I started, and we started to see a pretty signification drop in the LDL

(Dr Salgo) The LDL is a so called "bad" cholesterol And what else? (Dick) I also started seeing a pretty rapid weightless I was loosing weight pretty quickly (Dr

Salgo) That was Lisa's point How are you feeling? How is your exercise going? (Dick) Well, I never really stopped exercising I continued to walk, but i started to add a little running and I stated to notice a regression of the angina I got pretty quickly (Dr Salgo) How quickly? (Dick) Within a few weeks (Dr

Salgo) After a year, what was you exercise tolerance? (Dick) In a year I was back running At first I might get a little bit of angina but I would stop and walk a little and go on without angina (Dr Salgo) And after a year did you get a repeat angiogram, did you not? (Dick) It was actually a few years afterwords (Dr

Salgo) What did it show? (Dick) The angiogram showed reduction in the 60% blockage to 30% The main blockage, the 80% showed no reduction (Dr Salgo) So here we have an angiogram, which shows objective evidence that at least one of the blockages in your coronary artery shrank and you have subjective evidence that you are exercising and you don't have angina anymore Are you guys still skeptical? (Dr

Harris) Well, I'm glad that his symptoms have reduced but I'm still concerned that he has an 80% blockage in the LED (Dr Pacos) The 60% to 30% is fairly insignificant change We know that a blockage of less than 75% probably don't matter and are best treated with medications and lifestyle changes That 80% legion clearly did not change and was really the cause of all your symptoms, the culprit that we need to be concerned about

(Dr Salgo) But wait, if it is the cause of all the symptoms and now he doesn't have them, and in fact you just finished a triathlon, his symptoms did get better (Dr Pacos) Right, I think that will angina it's kind of a demand and supply type phenomenon You clearly have a lot of weigh reduction and improved cardiovascular health and efficiency of your heart in that time period and training

It's pretty classic We see people that have claudication and pain in their legs and one of the best thing they can do is walk and get exercise and the more that they do the more they are able to do (Dr Harris) And again, I'm concerned that there is a blockage in one of the main arteries and the issue is that if he is excising at a high work load is that blockage going to com to a point where it is critical, and there is no blood flow through that artery (Dr

Salgo) You've heard these skeptical doctors, what do you say? (Dr Campbell) Well, every case is individual and we know that But people respond differently over different periods of time But, it is almost uniformly true that 100% of the people respond in such a way, that 5, 10, 15 years later they don't have evidence of the problem The data I'm familiar with, there is the case of heart disease but also diabetes and a number of other diseases

As long as one stays on this, some of that evidence may be there and it may not go away in some cases, but the fact, the reality is you are doing well (Dr Salgo) But wait, let me just put it on the table In your view, based on his symptoms has his heart disease reversed? Which is the key word, reversed heart disease ((Dr

Campbell) It all depends on how you define the word There is a bit of a nuance when using the word But, it's symptoms go away and people recover their normal lifestyle, do dishes What do you call that? (Dr Salgo) Do you guys agree with this? That he has reversed heart disease, that his symptoms have gone away

Compared to where he started, he's better Isn't that reversed? (Dr Pacos) He still has heart disease We know he still has blockages, he still has acrothosis and based on that his disease is still present He is not cured of heart disease

It is very well controlled at this time Whether that is from medication, lifestyle, or diet all those play a role in controlling it (Dr Harris) He still has a blockage I think that his symptoms are controlled and that's important

He's regained the normal lifestyle and that's really what we want to achieve with anything we do in medicine, whether it's diet, medication, or otherwise (Dr Salgo) Alright, so let me ask this What's the harm? What's the harm of going on this diet, feeling better, having better exerciser tolerance what's the harm? (Dr Pacos) In this case there was very little harm to start with because his symptoms start at very very high levels of exercise

Again, I think I came back to this He didn't come in with a heart attack, he didn't chest pain at a very low level of activity This was a very high level, so we know that he was in pretty good physical shape to start with and that with the dietary changes he improved So I think it would be a reasonable approach when he first to say “let's try somethings and reassess down the road Now if you came back to the office a month later and were having chest pain

I think we would know that things were not working and I think we would have to revisit that (Dr Campbell) I think we are getting too technical and are parsing words And we have to go back and look at our definitions and assumptions basically I could say the same thing for cancer

I mean we all have carcinogenic sort of seeds, if you will, that in our tissues most of our lifetime And for those who are inclined to get diabetes, or are inclined to get one of the auto immune diseases, the root causes for that will probably remain in our tissues for their lifetimes because all of this is genetically based (Dr Harris) I absolutely agree that diet is of paramount importance and lifestyle changes are of paramount importance and probably if someone had talked to him about your book earlier on we might have been able to see greater changes The concern that I have is that I don't want patients to think that they are cured and that now there is no risk of any possibility of a heart attack

He still has an 80% legion, and if the plumbing's blocked, the plumbing's blocked (Dr Capmbell) But if you want to argue that the cure is to take you all the way back to baseline to where you don't have any president of legions, that's not what I'm talking about I don't like that particular definition (Dr

Salgo) Let me go right to the source Right now, how are you feeling? Do you think that your heart disease is reversed, cured? What's your take on all of this? (Dick) I'm feeling great I’m probably feeling the best I've felt in many, many years I'm the thinnest I've been since I was a young child and I do feel like I've reversed the heart disease (Dr

Salgo) And you haven't abandoned your doctor and your doctor hasn't abandoned you You're still being followed (Dick) That's correct (Dr Salgo) So again, if things turn around, start going the wrong way you've got backup

(Dick) Correct (Dr Salgo) And last, I promised that you would have a chance to ask a quick second opinion I know you've got a big second opinion Is there anything before you go that you would like to ask any of them

(Dick ) Yeah, I guess, you know when I was first going through this whole process , diet and exercise were never really disused as an option- it was surgery And, I was concerned about the complications of surgery But that was never really discussed, I was told that by going through the surgery I would probably, but not necessarily increase my life expectancy Well, then I'm saying, why go through the surgery if there are other options? And I wasn't offered those options (Dr, Salgo) Should he have been offered some options, do you think? (Dr

Pacos) I think it's a difficult situation because, when you are in the hospital in an acute setting, I think it is very difficult to say, “Go home, don't eat animal protein, eat plants and you'll do fine” In your situation, with a severer legion, but symptoms that are very well controlled, I think that would have been an option Although a very difficult option that I don't think many people are able to make that change in their diet (Dr Salgo) I'll give you the last ten seconds and then we do have to go

(Dr Capmbell) I want to say, don't avoid animal protein That's just one thing I want to say, basically, consume whole food plant based diet That's a very positive message

Avoid animal foods and processed foods (Dr Salgo) I want to thank everybody for being here Thanks to the panel What a dramatic discussion

I want to thank you all Thank you for sharing your story as well And at this point it's time for this weeks second opinion five (Dr Black) Hello I'm Dr

Bob Black and I'm here to tell you the five biggest risk factors for heart disease The first risk factor is your age The older you are, the more likely you are to develop signs of heart disease You can't turn back the clock but you can choose a heart healthy lifestyle that can help your heart keep ticking a steady beat The next risk factor is smoking

It's the worst thing you can do to your body, but quitting, at any age, is good for your body, because your body can repair itself Do what ever it take to quit smoking Smoking causes damage to the blood vessels and creates potentially deadly plaque buildup The third is hypertension Elevated stress puts extra strain on your heart, raising the risk of heart attack and stroke

You can improve your blood pressure by taking your medications your doctor prescribes everyday, cutting the salt in your diet, losing weight, and exercising Another risk factor is high cholesterol Like hypertension, too much cholesterol can build up in the arteries, causing atherosclerosis which can be life threatening Get your cholesterol checked regularly And the last one is family history

If someone in your family, such as a parent or sibling has a history of heart disease this could be a risk factor for you However, if detected early it could be managed And, that's your second opinion five (Dr Salgo) Thank you so much for watching Second Opinion! We hope that you continue the conversation at our website, where you can comment on this show, send us your show ideas or share your health story with us and maybe we'll invite you to be with us on the set




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