Dr Backs in CrossFit Instinct Longevity

As many of you are aware, Dr Backs doesn't just talk about making lifestyle changes for improved health and a healthy outcome, he has lived it.  Dr Backs is a member of the CrossFit Instinct's Longevity class; in his interview for this article, he talks about his personal story and how to has shaped his commitment to the patients in his practice.  

Check out this article that appeared in this month's issue of Crossfit Journal!

STROKE: Detect and Treat or Prevent?

May is Stroke Awareness month.  If you’ve had a stroke or known someone who has suffered a stroke, you know that the results can vary from mild change in function all the way up to severe paralysis, loss of speech or even death.  The recovery from a severe stroke can take months or years and costs huge sums of money, not to mention lost quality of life or earning potential.

Not all strokes can be prevented.  Some are due to congenital issues beyond our control. 

But most of the same conditions that increase the risk of heart attack also increase stroke risk.  These conditions include high cholesterol, high blood pressure, atrial fibrillation, diabetes, smoking and lack of exercise.  This list is not all inclusive, but controlling these conditions would save many lives. 

Given the cost of treatment once a stroke has occurred, prevention is key.  Don’t wait for symptoms to appear to act.  If you have one or more of the above listed conditions, take care of it.  If you really want to know if you have atherosclerosis, consider having a carotid ultrasound that identifies plaque and measures the thickness of the artery wall.  This is called a Carotid Intima Media Thickness Scan or CIMT.  The results can motivate you to act to save your own life.

We offer these scans in our office for under $200.  If you have more disease than you should, you will be motivated to make the changes necessary to improve your results. 

A word of caution:

Many of you have heard of or had the Lifeline Scan.  Though the same technology is used in both Lifeline and CIMT.  Lifeline is focused on blockage.  It is best to act long before there is blockage.  Any plaque should prompt more efforts to improve arterial health.  The CIMT costs a bit more, but you get what you pay for.  You can act much earlier and less invasively. 

So, if the signs and symptoms of a stroke appear, act FAST.  But don’t wait for the symptoms to understand your arterial health.  And don’t wait for arteries to be blocked before you act to make them healthier.

For more information on The Center for Prevention Heart Attack and Stroke, visit our website. Schedule your 15 minute CIMT screening right away by calling 217-321-1987.  15 minutes can save far more than money on car insurance; it could save your life.

 

 

How is the CIMT different from a Treadmill Stress Test?

Stress tests have been used for decades in the assessment of coronary artery obstruction or blockage. These tests are useful to sort out symptoms, especially when attempting to determine whether chest pain or shortness of breath is related to coronary artery atherosclerosis. 

Stress tests, however, are not good at detecting early atherosclerosis that isn’t blocking blood flow.  Plaque that is new and unstable may not block flow but could rupture and cause a clot to suddenly and completely block flow and result in a heart attack. 

It is not rare for a person to pass a stress test and have a heart attack a short time later. 

Despite these facts, stress tests continue to be used to reassure patients that they are “OK.”  A negative stress test means you aren’t going to be helped by a stent or surgery to address blockage.  It does not truly reassure that no atherosclerotic plaque is present.  A false sense of reassurance can be bad.

Carotid Intima Media Thickness (CIMT) identifies the earliest stages of atherosclerosis.  This is important because when you know you have a disease and are given the tools to prevent its progression, you can avoid the complications of late stage disease, including death and disability without warning.  You can also avoid the costs and complications of expensive and invasive treatments.

To sort out symptoms that could be related to your coronary arteries, a stress test is helpful. But to determine if you should take measures to improve your arterial health to avoid heart attack or stroke and their complications and treatments, Carotid IMT is far more useful. 

CIMT is also less expensive, less time consuming and does not require effort to be evaluated. 

 

I had a coronary calcium score. Should I have a Carotid Intima Media Thickness too?

In other words, does a coronary calcium score and a Carotid Intima Media Thickness (CIMT) scan give the same information? 

Although they both detect atherosclerosis, they do so at different stages of disease.  Costs for both tests in our community are comparable, and the CIMT scan is far more portable.

In addition, I have 2 concerns with coronary calcium score.  First, it is not useful for measuring the effects of treatment.  Without going into great detail, it does not improve when artery health improves because calcium deposition occurs late in the development of plaque and will not decrease with treatment.  It represents old scar. 

The second concern is that early, new, soft, non-calcified, dangerous unstable plaque is not detected because it has not yet become calcified.  A test that misses the most dangerous form of the disease is not as useful as one would hope.

The Carotid Intima Media Thickness Scan detects plaque at all stages, including the more dangerous non-calcified plaque mentioned above.

Granted, it is a surrogate sample measurement used to measure atherosclerosis generally.  It does not look directly at the arteries supplying the heart. 

But if you have plaque in your carotid arteries, you should assume you have plaque elsewhere, including the coronaries.  Treatment that improves the carotid artery health improves arterial health generally. 

And improvement (or progression) can be measured and documented.  The effects of treatment to reduce atherosclerotic burden can be seen.  If improvement isn’t seen as expected, treatment can be adjusted. 

Coronary calcium score is not useful for serial measurement of atherosclerosis development.

At the Center for Prevention of Heart Attack & Stroke, we do CIMT first.  If no disease is detected in an individual where it is expected due to a high risk profile, coronary calcium score is a consideration to be more sure the coronaries are not diseased before the carotids.  

I hope you found this answer helpful!

 

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