Heart Health

>> ON "HEALTH MATTERS" TELEVISION FOR LIFE... CAN THIS REALLY HAPPEN? YOU BET IT CAN. A SPOKANE MAN WITH A FAMILY HISTORY OF HEART PROBLEMS. >> I WAS FEELING FINE, NO CHANGES NOTED, JUST GOING ABOUT MY DAILY LIFE. >> GETS THIS DIAGNOSIS: QUADRUPLE BYPASS. HIS STORY OF HOPE AND A LESSON FOR EVERYONE AS WE DISCUSS HEART HEALTH AND ANSWERS TO YOUR QUESTIONS. RIGHT NOW ON "HEALTH MATTERS." >> "HEALTH MATTERS" IS MADE POSSIBLE BY VIEWERS LIKE YOU, THE FRIENDS OF KSPS. AND BY THE FOLLOWING: >> PROVIDENCE'S MOTTO IS "KNOW ME, CARE FOR ME, EASE MY WAY" AND PROVIDENCE DOES THAT. I'VE SEEN IT OVER AND OVER AGAIN. I AM DR. STEVEN MURRAY, AND I CHOSE PROVIDENCE BECAUSE I BELIEVE IN THE MISSION STATEMENT, AND WORKING TOGETHER WITH OTHERS OF LIKE-MIND IS A POWERFUL WAY TO TAKE CARE OF PATIENTS. >> MY NAME IS BETH PEREZ AND I AM A REGISTERED NURSE AND I WORK AT HOLY FAMILY HOSPITAL ON THE LABOR AND DELIVERY UNIT. I AM ABOUT TO HAVE MY SECOND CHILD AND I CHOSE PROVIDENCE BECAUSE I LOVE AND TRUST THE PEOPLE THAT I WORK WITH, AND WHY WOULDN'T I SEEK CARE FROM THE PEOPLE I LOVE AND TRUST. >> GOOD EVENING. I'M YOUR HOST TERESA LUKENS. THANKS FOR TUNING IN. WE KNOW THAT AMERICANS SUFFER 1.5 MILLION HEART ATTACKS AND STROKES EACH YEAR. SO TONIGHT OUR FOCUS IS ON HEART HEALTH. HERE TO SHARE THEIR EXPERTISE, OUR PANEL FOR THIS BROADCAST. DR. SEAN SPANGLER IS WITH PROVIDENCE SPOKANE CARDIOLOGY. HIS AREAS OF INTEREST INCLUDE: PREVENTATIVE CARDIOLOGY, TREATING PATIENTS WHO HAVE HEART VALVE PROBLEMS, HEART FAILURE, CORONARY ARTERY OR HEART DISEASE, OR HEART RHYTHM PROBLEMS. JENNIE JOHNSON IS A REGISTER NURSE, BOARD CERTIFIED, A LIFESTYLE CONSULTANT, AND COFOUNDER OF LIVING FOR A HEALTHY HEART. SHE IS ALSO THE AUTHOR OF THE BOOK "WAKE UP CALL 911. IT'S TIME TO REDUCE YOUR RISK FOR A HEART ATTACK AND STROKE." DR. MATTHEW FORRESTER IS WITH PROVIDENCE NORTHWEST HEART AND LUNG SURGICAL ASSOCIATES. HIS AREAS OF EXPERTISE INCLUDE: AORTIC ANEURYSM SURGERY, AORTIC VALVE REPLACEMENT AND REPAIR, MINIMALLY INVASIVE CARDIAC SURGERY AND CORONARY ARTERY DISEASE. DR. MATT TAYLOR IS WITH KOOTENAI HEART CLINICS NORTHWEST. HIS SPECIALTY IS CARDIOVASCULAR DISEASE. WE ENCOURAGE YOUR PHONE CALLS THIS EVENING, ASK OUR PANEL ANY NUMBER OF QUESTIONS YOU'D LIKE ABOUT HEART DISEASE. WE ALSO ENCOURAGE YOUR EMAILS, IF YOU PREFER. SO WE'LL START TAKING THOSE AS SOON AS THEY COME IN. DR. FORRESTER, I WANT TO START WITH YOU. WE ARE TALKING ABOUT AN EXTREMELY BROAD TOPIC OF HEART DISEASE AND CORONARY DISEASE. NARROW THE FOCUS A BIT FOR US AND LET'S TALK ABOUT SOME OF THE CONDITIONS MY AFFECT MOST OF OUR VIEWERS TONIGHT. >> AS YOU MENTIONED, HEART DISEASE ACTUALLY REFERS TO A VERY BROAD NUMBER OF DISEASES. MOST PEOPLE THAT WE SEE IN THE OFFICE HAVE HEART DISEASE THAT I WOULD CATEGORIZE IN A FEW DIFFERENT CATEGORIES. ONE WOULD VALVE CEIS, AORTIC VALVE, MITRAL VALVE. THAT ENCOMPASSES A LOT OF THE DISEASE WE SEE. CORONARY ARTERY DISEASE, WHICH IS COMMONLY ASSOCIATED WITH HEART ATTACKS FOR PEOPLE, AND ESSENTIALLY OBSTRUCTIONS OF THE ARTERIES THAT SUPPLY THE HEART MUSCLE ITSELF IS A BIG TOPIC THAT I THINK ENCOMPASSES A LOT OF WHAT PEOPLE THINK OF AS HEART DISEASE. THEN WE HAVE OTHER THINGS LIKE ANEURYSMS, AORTIC ANEURYSMS AND OTHER ARTERIES IN THE BODY AND CERTAIN 30 THERE IS AN -- THERE IS AN ELECTRICAL SYSTEM OF THE HEART AND WE CAN GO ON AND ON. I THINK THOSE THREE OR FOUR CATEGORIES ENCOMPASS MOST OF THE THINGS PEOPLE THINK OF WITH HEART DISEASE. >> DR. TAYLOR, WE KNOW THERE ARE SOME THINGS WE CAN CONTROL, AND OTHER THINGS WE CANNOT CONTROL. TALK ABOUT SOME OF THOSE. >> YOU BET. YOU CAN'T CONTROL YOUR AGE AND YOU CAN'T CONTROL YOUR GENES, AND BESIDES THAT, EVERYTHING IS IN GAME, IT'S FAIR GAME. I TELL PEOPLE THE BIGGEST THING WE CAN CONTROL IS LIFESTYLE OF ACTIVITY AND A DECENT DIET. BASICALLY IN AMERICA WE'RE TRAINED TO AVOID THAT DIET AND EAT STUFF THAT'S EASY AND QUICK AND ANYTHING THAT'S EASY AND QUICK IS PROBABLY -- SHOULD BE AVOIDED. SO YOUR LIFESTYLE ACTIVITY, 30 MINUTES A DAY OF EXERCISE, IS WORTH -- GOES A LONG WAY. YOU DON'T NEED TO BE DOING TRY AT-LAWNS BUT JUST TO GET STARTED AND AS YOU START AN ACTIVE LIFESTYLE YOU GET A LOT OF BENEFIT JUST FROM GOING FROM NOTHING TO A LITTLE BIT. THAT'S WORTH A LOT. SO YOUR LIFESTYLE WITH EXERCISE, DIET AND MAKING GOOD CHOICES WITH SOME OF THE STUFF THAT YOU DECIDE TO GET IN IN THE FORMS OF FOOD AND PROCESSED STUFF IS FILLED WITH THINGS YOU DON'T WANT IN THERE. SO YOU TRY TO AVOID THAT AND GO NATURAL WITH LOTS OF GOOD STUFF INSTEAD. >> DR. SPANGLER, WHEN WE DO START TO HAVE A PROBLEM, WHAT KIND OF WARNING SIGNS WILL WE GENERALLY SEE? I KNOW AGAIN WE'RE TALKING ABOUT A BROAD TOPIC HERE, BUT WHAT ARE SOME OF THOSE WARNING SIGNS? >> IT DEPENDS ON WHAT DISEASE IN TERMS OF -- DR. FORRESTER WAS TALKING ABOUT A COUPLE DIFFERENT DISEASES. SPECIFICALLY I THINK HEART DISEASE, CORONARY DISEASE LEADING TO HEART ATTACK AND STROKE ARE WHAT MOST PEOPLE ARE WORRIED ABOUT. EARLY SIGNS CAN BE AN ACHE OR PRESSURE OR TIGHTNESS IN YOUR CHEST. IT'S NOT NECESSARILY PAIN. IT CAN BE THOSE TYPES OF SYMPTOMS PEOPLE MAY FEEL. SOMETIMES IT DOES GO DOWN TO THE LEFT ARM. OFTENTIMES THAT'S NOT NECESSARILY THE HEART. THAT CAN BE A SIGN. YOU CAN START TO FEEL SHORT OF BREATH WITH THINGS YOU ARE DOING. YOU MAY HAVE INTOLERANCE FOR ACTIVITIES YOU NORMALLY DO. IF YOU COULD NORM LAY WALK UP A FLIGHT OR TWO OF STAIRS YOU MAY NOT BE ABLE TO DO THAT NOW AND THAT COULD BE A SIGN YOU'RE DEVELOPING HEART DISEASE. FEELING DIZZY OR LIGHT-HEADED OR POTENTIALLY BLACKING OUT OR PASSING OUT ARE SIGNS. FEELING IRREGULAR HEARTBEATS, PALPITATIONS, SOMETIMES SWELLING IN THE LEGS. THERE ARE A LOT OF SIGNS THAT CAN BE AN EARLY WARNING THAT YOU HAVE HEART DISEASE OR HEART FAILURE. >> IF YOU HAVE -- SOME PEOPLE HAVE A NUMBER OF THOSE INDICATORS. OTHERS MAY HAVE ONE OR TWO OR SOMETHING. SO AT WHAT POINT DO YOU OFTEN SEE A PATIENT WHEN IT'S TOO LATE OR WILL THEY RECOGNIZE THOSE SIGNS? >> IT DEPENDS. UNFORTUNATELY I THINK SOME PEOPLE -- WE DO SEE TOO LATE BECAUSE THEY DO COME INTO THE EMERGENCY ROOM AND THEY ARE HAVING A HEART ATTACK. AND THEY MAY HAVE HAD SOME WARNING SIGN A WEEK OR TWO BEFORE THAT THEY WERE HAVING A LITTLE BIT OF AN ACHE OR PRESSURE IN THEIR CHEST. SO CERTAINLY IF YOU HAVE SOME RISK FACTORS AND EVEN SOME PEOPLE THEY DON'T HAVE RISK FACTORS, YOU SHOULD PROBABLY PAY VERY CLOSE ATTENTION TO THOSE TYPES OF SYMPTOMS. AND GET CHECKED OUT. POTENTIALLY THEN WE COULD FIND YOU HAVE CORONARY ARTERY DISEASE OR HEART DISEASE AND BE ABLE TO IMPACT UPON THAT WITH MEDICINES OR LIFESTYLE CHANGES OR STENTS. SO, YES, ANY OF THOSE PARTICULAR SIGNS OR SYMPTOMS CAN BE A WARNING AND YOU MAY WANT TO GET SEEN BY ONE OF US OR YOUR PRIMARY CARE PHYSICIAN AND HAVE IT CHECKED OUT TO SEE IF THERE IS MORE TESTING THAT MAY BE WARRANTED. >> JENNIE YOUR AREA OF EXPERTISE IS IN PREVENTION. GOING THROUGH YOUR BOOK, I NOTICE THAT YOUR OWN FATHER HAD A MASSIVE HEART ATTACK AT THE AGE OF 46. IS THAT WHERE YOUR PASSION TOWARD HELPING PEOPLE PREVENT HEART DISEASE STARTED? >> PROBABLY. I LOVED HIM DEARLY. HE HAD EVERY RISK FACTOR KNOWN TO MAN NOW. THAT WAS BACK IN THE '70s. 80% OF ALL HEART ATTACKS COULD BE PREVENTED. THIS IS A STATISTIC THAT WAS REPORTED IN THE AMERICAN HEART ASSOCIATION STATISTICAL UPDATE, IF PEOPLE QUIT SMOKING, ATE A HEALTHIER DIET, INCREASED PHYSICAL ACTIVITY, MANAGED RATE AND CONTROLLED THEIR CHOLESTEROL, BLOOD PRESSURE AND BLOOD SUGAR. 80% COULD BE PREVENTED. CHANGING BEHAVIOR IS EASIER SAID THAN DONE. I WENT BACK AND STUDIED AND GOT MY PH.D. TO WHAWRN ARE THOSE THINGS THAT WORK WHEN PEOPLE LEARN TO CHANGE BEHAVIORS AND I HOPED IN THE BOOK TO ADDRESS THOSE THINGS IN SMALL SIMPLE STEPS. IF PEOPLE CAN'T EXERCISE FOR 30 MINUTES A DAY, MAYBE THEY CAN TAKE A FIVE-MINUTE WALK AWAY FROM THEIR HOUSE AND BACK. MAYBE THEY CAN ADD AN APPLE TO THEIR DIET. THERE ARE A LOT OF SIMPLE THINGS PEOPLE CAN DO THAT MAKE HUGE BENEFITS AND THERE ARE NEW SCREENING TOOLS TO FIND OUT SOMEONE LIKE MY FATHER WHO IS AT RISK. I WRITE ABOUT THAT ON MY WEBSITE. THEY'RE STILL UNDERUTILIZED. EVEN MOW THE AMERICAN HEART ASSOCIATION AND AMERICAN COLLEGE OF CARDIOLOGY RECOMMENDS SOME OF THE TESTS FEW PEOPLE ARE GETTING THEM. YOU CAN GET THEM IN SPOKANE, COEUR D'ALENE. I'M NOT TAKING ABOUT THE CALCIUM SCORE WHICH MEASURES THE DISEASE THAT'S BUILDING UP. THEN IT CAN TELL THE CARDIOLOGIST OR DOCTOR, I NEED TO WORRY ABOUT THIS PERSON. SO I'M TRYING TO GET THE WORD OUT TO TAKE ADVANTAGE OF THOSE TESTS. >> WHAT HAVE YOU FOUND WORKS? HOW DO YOU REACH PEOPLE? >> MEDICINE DOES A GREAT JOB OF DIAGNOSIS AND TREATING HEART DISEASE WITH YOU PSYCHOLOGISTS HAVE TAUGHT US A LOT ABOUT THE MOTIVATION PEOPLE. PEOPLE GO THROUGH STAGES AS THEY'RE TRYING TO CHANGE A BEHAVIOR FROM DENIAL WHERE THEY DON'T KNOW THEY HAVE A PROBLEM, THEY'RE NOT CONNECTING THEIR HARMFUL BEHAVIOR TO I'M WEIGHING THE PROS AND CONS, I KNOW I NEED TO CHANGE, I KNOW I NEED TO INCREASE MY EXERCISE OR EAT BETTER BUT BARRIERS ARE TOO GREAT. I'M TAKING BABY STEPS BUT I'M NOT COMMITTED TO IT. TO ACTUALLY DOING IT, WHICH IS THE ACTION STAGE. FINALLY THEY HAVE BEEN AT IT SIX MONTHS AND IT'S BECOME PART OF THEIR LIFE. MOST OF OUR MEDICAL ADVICE IS DIRECTED AT THAT 20% WHO GET IT AND ARE DOING IT. WHAT DO WE DO WITH THE 80%? OUR MISTAKE IS WE GIVE THEM LIFESTYLE PRKSTIONS THAT ARE TOO HARD -- PRESCRIPTION THAT ARE TOO HARD TO DO. SO SMALLER, SIMPLER STEPS THAT PEOPLE CAN DO AND FEEL GOOD ABOUT IS SHOWN TO BE MORE EFFECTIVE. THAT'S HOW WE GET THEM MOVING AND STARTING TO TAKE BETTER CARE OF THEMSELVES. >> DO YOU FIND IT TAKES A MAJOR EVENT BEFORE PEOPLE START TO MAKE CHANGES? >> UNFORTUNATELY, IT DOES. WE OFTEN SEE PATIENTS THAT COME TO US IN THE OFFICE WITH A FAMILY MEMBER THAT HAS ESSENTIALLY A NEAR-DEATH EXPERIENCE. THESE PEOPLE CAN ALSO BE VERY, VERY SICK. THEY NEED SURGERY. THAT'S A BIG DEAL. AND PEOPLE REALIZE THAT THEY NEED TO CHANGE SOME THINGS AND QUIT SMOKING AND LIVE HEALTHIER AND EXERCISE AND IT'S A CHALLENGE. PEOPLE KNOW THESE THINGS. THESE ARE NOT THINGS THAT HAVE BEEN JUST BEEN DISCOVERED YESTERDAY OR LAST WEEK OR EVEN LAST YEAR. WE KNOW HOW TO BE HEALTHY, BUT IT'S OFTEN HARD TO MAKE OURSELVES DO THAT. >> WE ALSO KNOW, THOUGH, THAT DR. -- DR. DAY TAYLOR, THERE IS A GENDER GAP. WE ARE FINALLY LEARNING THE DIFFERENCE BETWEEN MEN AND WOMEN AND WE TALKED ABOUT SOME OF THE BASIC WARNING SIGNS, BUT THAT GENDER GAP IT DOES MAKE A DIFFERENCE BETWEEN MEN AND WOMEN IN INDICATORS? >> MY UNDERSTANDING AND SEAN WOULD HAVE EXPERTISE MORE HERE, BUT YOU HAVE MUCH HIGHER RISK OF HIGHING ATYPICAL SYMPTOMS -- FEMALES ARE MORE LIKELY TO HAVE SYMPTOMS THAT DON'T MAKE YOU THINK OF HEART DISEASE. IT'S PARTICULARLY WE TELL PEOPLE ABOUT CHEST PAIN THAT'S CRUSHING AND RUNS DOWN THE LEFT ARM, AND IN FEMALES YOU'RE MORE LIKELY TO HAVE SYMPTOMS THAT MIGHT GET BRUSHED OFF. FEMALES -- SIMILAR TO DIABETICS WHERE YOU CAN HAVE HEART ATTACKS AND PERHAPS NOT FEEL ANY PAIN AT ALL. AND THE RED DRESS IS APPROPRIATE AS WE ADDRESS WOMEN'S HEALTH AS WELL, AND THERE IS LOTS OF RESEARCH BEING PUT INTO THAT AND HOW THE GAPS CAN BE CLOSED. BUT THERE ARE GAPS THAT ARE SIGNIFICANT FROM MEN AND WOMEN IN TERMS OF THE SYMPTOMS THEY CAN FEEL WITH CORONARY DISEASE IN PARTICULAR. >> IT STILL SURPRISES PEOPLE TO FIND OUT THAT HEART DISEASE KILLS MORE WOMEN IN THIS COUNTRY THAN ANY OTHER DISEASE. THAT STILL IS A SURPRISE TO PEOPLE BECAUSE WE TEND TO THINK BREAST CANCER, OTHER DISEASES THAT ARE TAKING WOMEN, BUT IT'S HEART DISEASE. >> YEAH, HEART DISEASE IS THE NUMBER ONE, I THINK, KILLER OF WOMEN WITHIN THE UNITED STATES. IT'S NOT A SURPRISE TO US, PER SE, BUT, YES, IT IS A A SURPRISE TO A LOT OF NONMEDICAL FOLKS. BREAST CANCER GETS A LOT OF ATTENTION AND I THINK WE NEED TO PAY MORE ATTENTION TO HEART DISEASE. CERTAINLY I THINK WOMEN MAY PRESENT AT AGE LATER AGE THAN MEN IN RESPECT TO 2K0E68ING HEART DISEASE, BUT UNFORTUNATELY, THEY TEND TO CATCH UP AS THEY GET INTO THEIR 60s AND THE INCIDENT OF HEART DISEASE BECOMES FAIRLY EQUAL TO MEN. I WOULD SAY MOST WOMEN ARE AT EQUAL RISK OF DEVELOPING THIS LARGELY OVER THEIR LIFETIME AND THEY NEED TO PAY ATTENTION TO RISK FACTORS AND MODIFY THOSE TO PREVENT HEART DISEASE. >> I WANTED TO ADD A STATISTIC TO THAT. WHEN I GO UP AND SPEAK TO GROUPS OF WOMEN, ONE IN ABOUT 32 WOMEN WILL DIE FROM BREAST CANCER. ONE IN THREE WILL DIE FROM HEART DISEASE. BUT WE WORRY ABOUT OUR MAMMOGRAMS WHEN THEY'RE ABNORMAL. WE DON'T WORRY ABOUT OUR CHOLESTEROL AND BLOOD PRESSURE. WE MINIMIZE THAT. THOSE ARE HUGE RISK FACTORS FOR OUR LIFE. FOR MEN, PROSTATE CANCER IS ABOUT 1 IN 35 WILL DIE FROM PROSTATE CANCER. 1 FOR 3 MY DIE FROM HEART DISEASE. OUR SYMPTOMS ARE -- CAN BE SHORTNESS OF BREATH, FATIGUE. WHAT -- WHAT WOMAN BUSY DOESN'T GET TIRED? THAT'S HOW WE PRESENT TO THE ER. OUR DISEASE IS DIFFERENT. ONE OF YOU GUYS CAN SPEAK TO THAT BETTER. WE DON'T HAVE THAT CRUSHING PAIN. IT'S EASILY MISSED BECAUSE IT'S SO MILD. >> WE KNOW THAT ONE OF THE SIGNS OF A HEART ATTACK IS THAT EXTREME PAIN, THE CRUSHING PAIN IN THE CHEST, BUT FOR A LOT OF PEOPLE IT'S SIMPLY THE FAMILY HISTORY. WE WANT TO INTRODUCE YOU TO ONE SPOKANE MAN WHO ACTUALLY UNDERSTOOD HIS FAMILY HISTORY. HE RECOGNIZED IT. AND IT'S PROBABLY WHAT ENDED UP SAVING HIS LIFE. >> TOM GRAINGER HAS PLENTY TO CELEBRATE. AT AGE 63 HE'S THINKING ABOUT RETIREMENT AND SPENDING MORE TIME WITH HIS GRANDKIDS. FAMILY IS IMPORTANT TO HIM FOR MANY REASONS. ESPECIALLY WHEN IT COMES TO HIS HEALTH. >> MY DAD HAD A HEART ATTACK WHEN HE WAS 64. MOM WENT THROUGH TWO TRIPLE BYPASSES IN HER LIFETIME AND MANAGED TO LIVE TO AGE 97. >> ABOUT EIGHT YEARS AGO, TOM STARTED SEEING A CARDIOLOGIST. THE CHECK-UPS WERE TOM'S WAY OF BEING PROACTIVE. >> AFTER THE FIRST VISIT, RESCHEDULED EVERY TWO YEARS. >> WHEN HE SAW THE DOCTOR IN JUNE HE WAS FEELING FINE. >> I WAS FEELING PERFECTLY NORMAL, ACTIVE, I MOUNTAIN BIKE IN THE SUMMERTIME, SKI IN THE WINTER. >> TOM HAD NO SYMPTOMS, BUT TWO DAYS OF TESTING TURNED UP SERIOUS HEART PROBLEMS. >> WE'RE FINDING OUT THERE IS FIVE MAJOR BLOCKAGES, ONE AT 100% AND FOUR AT 90%, AND WE NEED TO CUT THE CHEST OPEN AND TAKE CARE OF IT. >> A FEW DAYS LATER TOM WAS IN SURGERY UNDERGOING A QUADRUPLE BYPASS. >> THE PROGNOSIS AT THAT POINT WAS I COULD KEEL OVER TOMORROW, OR A WEEK, WITHIN A MONTH. WITH THE MAJOR BLOCKAGES I HAD, MY LIFE WAS A TICKING TIME BOMB. >> THE SURGERY WAS SUCCESSFUL AND 10 WEEKS LATER TOM RETURNED TO WORK. THERE WERE UPS AND DOWNS DURING HIS RECOVERY, BUT TOM CAME THROUGH FEELING PRETTY MUCH THE SAME AS BEFORE. >> I THOUGHT THAT AFTER FIVE BLOCKAGES I SHOULD FEEL LIKE A 20-YEAR-OLD, BUT THAT DIDN'T SEEM TO HAPPEN. >> TOM IS BACK TO THE THINGS HE LOVES, LIKE SKIING AND MOUNTAIN BIKING. AND WHENEVER HE CAN, SHARING THIS MESSAGE WITH OTHERS. >> CAN THIS HAPPEN TO YOU? YOU BET IT CAN. SO WHAT DO YOU DO ABOUT IT? YOU BECOME PROACTIVE. YOU GET YOUR FAMILY DOCTOR TO GET YOU A REFERRAL TO A CARDIOLOGIST. WHATEVER IT TAKES. >> SO, DR. FOR ESSER, YOU WERE ONE OF TOM'S DOCTORS, AND SO HIS BEING PROACTIVE REALLY DID SAVE HIS LIFE. BUT IS THAT A RARE CASE WHEN SOMEONE TAKES THAT SORT OF ACTION? >> TOM'S STORY IS UNIQUE. HE DIDN'T REALLY HAVE CHEST PAIN OR ANGINA OR ANYTHING CLASSIC. HE JUST HAD A FAMILY HISTORY HE KNEW ABOUT AND HE WAS A RESPONSIBLE INDIVIDUAL. HE TOOK CARE OF HIMSELF AND HE WAS ACTIVE AND EVEN WITH THE ACTIVITY AT A HIGH LEVEL HE WASN'T HAVING SYMPTOMS. THERE ARE TESTS THE CARDIOLOGIST CAN DO THAT CAN PROVE YOU HAVE A SUSPICION FOR THESE BLOCKAGES AND ALSO PROVE THAT THE MUSCLE ITSELF ISN'T GETTING ENOUGH BLOOD SUPPLY AND THAT LEADS DOWN TO A ROAD THAT LIKE TOM ENDS UP IN MY OFFICE. BUT I DON'T SEE THAT MANY PEOPLE WHO DON'T HAVE ANY IDEA THAT THEY HAVE A PROBLEM. SO IT'S A LITTLE BIT UNNERVING THAT SOMEONE LIKE TOM CAN GET THERE AND GET THAT. THERE ARE PEOPLE THAT DON'T KNOW AND DON'T DO ANYTHING ABOUT IT UNTIL IT'S A PROBLEM. TOM WOULD BE BACK AND ALREADY IS TO A NORMAL LIFE. I'M NOT SURPRISED HE DOESN'T FEEL ANY DIFFERENT BECAUSE HE DIDN'T FEEL POORLY IN THE FIRST PLACE. >> WHAT WOULD YOU SUGGEST PEOPLE DO, THEN, AS FAR AS STARTING THAT PROCESS OF LEARNING A FAMILY HISTORY AND THEN TAKING PROACTIVE ACTION? >> WELL, SO I THINK EVERYBODY IN GENERAL, EVEN IF YOU HAD JUST A WONDERFUL FAMILY HISTORY WHERE YOUR PARENTS LIVE UNTIL 90s AND THEY NEVER HAD ANY HEART HISTORY, I THINK YOU SHOULD BE PROACTIVE AND EAT A HEART HEALTHY DIET AND TRY TO BE THE HEALTHIEST PERSON YOU CAN BE. BUT IN THIS CASE I THINK IT IS INTERESTING IN THE RESPECT HE DIDN'T HAVE A LOT OF TRADITIONAL RISK FACTORS IN TERMS OF HIGH BLOODER, CHOLESTEROL OR DIABETES. HE HAD A GENETIC PREDISPOSITION. FOR THOSE PAY VUNTS WE HAVE THIS KIND OF LOW SUBMISSION THEY MAY HAVE A HEART PROBLEM BECAUSE WE THINK THEY'RE LIVING HEALTHY BUT UNFORTUNATELY THEY HAVE THIS ABILITY TO DEVELOP HEART DISEASE BECAUSE THEY INHERIT IT. SO GOING BACK TO WHAT JENNIE SAID EARLIER, I THINK A HELPFUL TEST IN THIS PARTICULAR CASE WHERE THEY DON'T HAVE A LOT OF RISK FACTORS IS THAT CORONARY CALCIUM SCORE. BECAUSE FAMILY HISTORY IS NOT INCLUDED IN OUR TRADITIONAL -- WE HAVE THESE CALCULATORS THAT SAY WHAT IS YOUR HEART RISK. IT DOESN'T INCLUDE FAMILY HISTORY. I FOUND THAT TO BE A VERY HELPFUL TEST TO SAY FOR -- FOR, SAY, A 50-YEAR-OLD MALE WHOSE DAD HAD A HEART ATTACK AT 49 WHO DOESN'T SMOKE OR HAVE HIGH CHOLESTEROL, WE GET THAT AND THEY HAVE A LOT OF CALCIUM IN THE HEART ARTERIES ALREADY. THAT CAN BE A GOOD CLUE TO SAY YOU ALREADY HAVE DEVELOPED HEART DISEASE, EVEN THOUGH YOU'RE DOING WHY THE BEST YOU CAN. SO THAT'S A TOOL I WILL SOMETIMES USE IN THESE FOLKS, IS TO HELP KIND OF TEASE THIS OUT. UNFORTUNATELY WE CAN'T PREVENT ALL HEART DISEASE AND SOMETIMES PEOPLE DO THE BEST THEY CAN, THEY HAVE NO SYMPTOMS AND IT STILL HAPPENS. BUT THAT WOULD BE ONE THING I WOULD HAVE PEOPLE THINK ABOUT OR ASK THEIR DOCTOR ABOUT, IS SHOULD I SCREEN FOR THIS IF I HAVE A STRONG FAMILY HISTORY. THAT CAN ACTUALLY BE EVEN MORE HELPFUL THAN A STRESS TEST. >> IS THAT A FAIRLY SIMPLE TEST THAT. >> IT IS A SIMPLE TEST. IT'S A SIMPLE SCAN OF THE CHEST. YOU DON'T NEED CONTRAST, DON'T NEED AN I.V. TAKES JUST A FEW SECONDS. AND YOU CAN GET A SCORE THERE. SO IT CAN TELL YOU WHETHER YOU'RE LOW OR HIGH RISK. PEOPLE WHO HAVE SYMPTOMS, A STRESS TEST IS THE MOST APPROPRIATE TEST, BUT IN ASYMPTOMATIC PEOPLE THIS IS THE BEST TEST. >> PATRICIA, THANKS FOR WAITING. >> HI. THANK YOU FOR TAKING MY CALL. A LITTLE BACKGROUND. I WAS A PREVIOUS SMOKER. A COUPLE YEARS AGO I HAD A HEAD AND NECK CANCER I WAS TREATED FROM AND GOT A LOT OF RADIATION FROM MY UPPER CHEST THROUGH MY THROAT AREA. JUST THIS LAST APRIL I GOT DIZZY AND FAINTED, WENT TO SEE A CARDIOLOGIST, THEY DID ANGIOPLASTY AND THEY FOUND A BLOCKAGE OF ABOUT 75% OF THE CAROTID ARTERY THAT GOVERNOR INSLEE EZ INTO YOUR BRAIN. AND EVERYTHING WAS GOING FINE. I THOUGHT I WAS FINE. AND THEN THIS LAST JANUARY I HAD FAINTED A COUPLE MORE TIMES IN MY KITCHEN, GOT BACK TO THE CARDIOLOGIST AND FOUND OUT THAT THIS STENT HAD FAILED. SO THEY WENT IN, AND I BELIEVE HE REPLACED IT. MY QUESTION IS, SHOULD I ASK FOR A STRESS TEST AND GET A COMPLETE EVALUATION? SHOULD I BE WORRIED ABOUT BYPASS SURGERY AT THIS POINT? WHERE SHOULD I GO NOW? I DO HAVE A HEALTHY DIET. I'M NOT REALLY EXERCISING A WHOLE LOT RIGHT NOW BECAUSE I REALLY HURT MY FOOT WHEN I FAINTED, BUT I'LL GO AHEAD AND WAIT FOR YOUR ANSWER AND YOUR ADVICE. THANK YOU. >> THANK YOU, PATRICIA. WHO WOULD LIKE TO ANSWER PATRICIA'S QUESTION? >> DO YOU WANT TO TAKE THIS, SEAN? >> A COUPLE THOUGHTS ON THIS. ONE IS THAT IT SOUNDS LIKE SHE HAS VASCULAR DISEASE INVOLVING -- THE CAROTID ARTERY GOES TO THE BRAIN AND ANY TIME YOU HAVE DISEASE INVOLVING ANY BLOOD VESSEL, WHETHER IT TO BE YOUR BRAIN, YOUR LEGS, UNFORTUNATELY YOU CAN ALSO DEVELOP THE SAME KIND OF DISEASE WITHIN THE BLOOD VESSELS TO YOUR HEART. RIGHT THERE THAT MAKES ME SOMEWHAT CONCERNED. ON RADIATION THERAPY UNFORTUNATELY DOES INCREASE YOUR RISK OF DEVELOPING VASCULAR DISEASE. THAT MAY HAVE PUT YOU AT RISK, THE PREVIOUS RADIATION YOU HAD, AND CERTAINLY IF THE RADIATION WENT INTO THE CHEST THAT WOULD MAKE ME MORE CONCERNED. SO IN THAT RESPECT I'M A LITTLE CONCERNED AND SAY, YOU MAY HAVE CORONARY ARTERY DISEASE OR HEART DISEASE AND YOU MAY WANT TO BE SCREENED. IF YOU HAVE NO SYMPTOMS AT ALL, IT'S NOT THAT IMPERATIVE YOU HAVE TO GET A STRESS TEST. I WOULD WANT YOU TO BE ON GOOD MEDICINES TO TREAT THE DISEASE THEY HAVE ALREADY FOUND IN THE CAROTID ART REAZ. IF YOU DO THAT YOU WILL GIVE YOURSELF THE BEST CHANCE TO PREVENT A HEART ATTACK AND STROKE. AS LONG AS WE ARE DOING EVERYTHING WE CAN. TRY TO WORK OBJECTING MORE ACTIVE EVEN THOUGH IT'S HARD FOR PEOPLE, IT'S HARD FOR PAW TRIRN A, BUT TRY TO SEE IF YOU CAN INCORPORATE SOME OF THAT INTO YOUR LIFESTYLE AND TRY TO DO THE BEST YOU CAN WITH A HEART HEALTHY DIET. TAKE THE RIGHT MEDICINES THE DOCTOR IS RECOMMENDING. YOU MAY NOT NEED A STRESS TEST. IF YOU'RE FEELING GREAT, YOU MAY NOT NECESSARILY NEED IT. IT DOES RAISE A LITTLE CONCERN IN MY MIND GIVEN HER HISTORY. >> WE HAVE ANOTHER PHONE CALL FROM MARY. GOOD EVENING. >> Caller: HELLO. >> HI, MARY. >> Caller: YES, I HAVE A QUESTION ABOUT A TEST. I WAS FEELING PERIODICALLY LIGHT-HEADED, A LITTLE BIT DIZZY, AND I WAS SENT FOR A CAT SCAN OF MY HEART AND GOT THE REPORT THAT I HAD A SCORE OF 41 AND WAS RECOMMENDED TO SEE A CARDIOLOGIST BECAUSE OF MY RATHER EXTREMELY FAMILY HISTORY, WHAT DOES 41 MEAN? >> DR. FORRESTER? >> THIS ONE I'M GOING TO HAVE TO DEFER TO MY CARDIOLOGIST -- >> IN CHICAGO WE BROUGHT THIS NEW TECHNOLOGY INTO THE HEART INSTITUTE AND I WAS THE NURSE THEY HIRED TO GO OVER THE PRELIMINARY RESULTS AND SO EDUCATING PHYSICIANS ABOUT THE TECHNOLOGY. A 41 SCORE IS A VERY SMALL AMOUNT, IN THE EARLY STAGES OF THE DISEASE. YOUR CHOLESTEROL NUMBERS NEED TO BE UNDER CONTROL. YOUR BLOOD PRESSURE, YOUR RISK FACTORS NEED TO BE TREATED AGGRESSIVELY. DOESN'T NECESSARILY MEAN YOU HAVE A BLOCKAGE IN THERE BUT YOU'RE BUILDING UP DISEASE. IT'S IN A SMALLER EARLIER STAGES AND YOU DON'T WANT IT TO GET WORSE. SO YOU WANT TO SEE THAT DOCTOR AND GET THOSE RISK FACTORS UNDER CONTROL. ABOUT HALF OF PEOPLE WILL HAVE A ZERO SCORE, AND THE ACCURACY RATE IS A 99%. WE CALL IT NEGATIVE PREDICTIVE VALUE. THAT MEANS THEY DON'T HAVE VERY MUCH DISEASE. TO THOSE PATIENTS I SAY, YOU JUST DODGED A BULLET. YOU NEED TO REALLY BEHAVE YOURSELF OR THAT WON'T STAY THAT WAY AS YOU GET OLDER. WHEN THEY GET UP TO ABOUT 10 TO 100, WE'RE GETTING THEIR CHOLESTEROL NUMBERS AGGRESSIVELY UNDER CONTROL. BUT IT'S STILL A SMALL AMOUNT IN THE EARLIER STAGES. AS IT GETS CLOSER TO 400 AND HIGHER, THEY'RE RUNNING ADDITIONAL STRESS TESTS TO SEE IF THIS AMOUNT OF DISEASE THAT THE TEST IS INDICATING, THE SLUDGE THAT'S BUILDING UP IN THE ARTERIES, ISN'T CAUSING A BLOCKAGE SOMEWHERE. SO IT'S NOT A PERFECT TEST. THE ACCURACY OF THAT POSITIVE SCORE IS 98, 99, 100%. IT'S A VERY ACCURATE TEST, WHICH I'M VERY MUCH IN FAVOR OF PEOPLE GETTING SCREENED AND SEEING WHAT THEY'RE DOING. IT TELLS YOU DO YOU HAVE A SMALL OR LARGE AMOUNT OF DISEASE. >> GOOD QUESTION. >> CAN I ADD TWO THINGS. THE CALCIUM AGAIN IS SO YOU HAVE PLAQUE BUILDUP IN YOUR BLOOD VESSELS. OVER TIME THE PLAQUE BECOMES CALCIFIED. SIMPLY THAT'S WHAT WE'RE LOOKING FOR. IT GIVES A SCORE HOW MUCH OF THAT THERE IS. IT'S A -- A DEGREE OF HOW MUCH PLAQUE BUILDUP YOU HAVE. >> IT'S A STARTING POINT FOR YOU AS A DOCTOR AND THE PATIENT. >> THE SECOND THING TO BE AWARE OF IF YOU ARE A 40-YEAR-OLD WOMAN YOUR SCORE SHOULD BE ZERO. IF YOUR SCORE IS 41 THAT'S ACTUALLY VERY HARD. IF YOU ARE A 70-YEAR-OLD MAN, 41 MAY BE LOW FOR YOU. THE REGULAR 70-YEAR-OLD MAN WOULD ACTUALLY HAVE MILD TO MODERATE AMOUNT OF PLAQUE BUILDUP. IT DOES DEPEND ON HOW OLD YOU ARE AND WHAT YOUR SEX IS IN TERMS OF THE MEANING OF THE SCORE. >> CHRIS FROM SPOKANE VALLEY, HI, CHRIS. >> Caller: HI. I HAVE A QUESTION ABOUT THE PLAQUE. YOU WERE TALKING ABOUT PLAQUE BEING CALCIFIED IN THE ARTERIES AND I WAS JUST WONDERING, WOMEN ARE ALWAYS BEING TOLD THEY NEED TO TAKE AT LEAST 1200 MILLIGRAMS OF CALCIUM SUPPLEMENTS WITH D3 IN ORDER TO AVOID OSTEOPOROSIS. NOW DOES EXCESS CALCIUM IN THE BLOODSTREAM BECOME MORE PLAQUE -- I MEAN, CAN THAT BE DEPOSITED AS PLAQUE? THAT'S MY QUESTION. >> THANK YOU, CHRIS. HOW -- WE ARE ENCOURAGED TO TAKE OUR CALCIUM. DOES IT BUILD UP IN THE -- >> THAT'S OKAY. NO, YOU CAN DO THAT. YOU CAN TAKE YOUR VITAMIN D AND YOUR CALCIUM. THAT'S NOT -- THAT DOES NOT INCREASE YOUR RISK OF CALCIFICATION OF PLAQUE. >> I THINK PEOPLE GET REALLY CONFUSED ABOUT THIS PROCESS AND WHAT HAPPENS IS WHEN I EXPLAIN IT SIMPLY IS WHEN YOU HAVE A BLOOD PRESSURE THAT'S TOO HIGH IT CAUSES A SANDPAPER EFFECT ON THAT ARTERY ON THE INSIDE LINING. YOUR SUGAR IS TOO HIGH BECAUSE YOU ARE OVERWEIGHT, THAT SUGAR BOUNCES OFF THE WALL, THIS IS HOW I TALK TO PATIENTS, IT SCRATCHES THAT INSIDE LINING. IF YOU SMOKE IT CAUSES ALL KINDS OF TRAUMA. THEN IMAGINE CHOLESTEROL TRAVELING THROUGH THE BLOOD. IT'S LITERALLY GOING TO GET HUNG UP THERE MORE EASILY. THE BODY SAYS, OH, MY GOSH, SOMETHING IS WHERE IT DOESN'T BELONG AND IT STARTS THIS -- IT SENDS WHITE BLOOD CELLS TO THE AREA. INFLAMMATION IS WHAT THIS IS CALLED. WHEN IT'S GONE ON LONG ENOUGH LIKE A CANCER THAT'S BEEN IN YOUR BODY FOR TOO LONG, IF IT'S BEEN IN THERE A LONG TIME, CALCIUM IS JUST WHAT FORMS AS PART OF THAT INFLAMMATION. SO HARDENING OF THE ARTERIES IS THE LAY TERM FOR CALCIUM DEPOSITS. IT'S PART OF THE PLAQUE. AND IT'S JUST A MARKER, AN ESTIMATE OF HOW MUCH DISEASE IS BUILDING UP. >> SO SHE SHOULD NOT BE CONCERNED AT ALL ABOUT HER CALCIUM SUPPLEMENTS, THEN? >> NO. >> WE HAVE JACKIE FROM SPOKANE. GOOD EVENING, JACKIE. KAIL -- >> Caller: HI. I HAVE A QUESTION. I AM 66 YEARS OLD. I DON'T HAVE MY FAMILY HISTORY BECAUSE I WAS ADOPTED. I DO HAVE SEVERAL RISK FACTORS. I HAVE BEEN TREATED FOR HIGH BLOOD PRESSURE SINCE I WAS A TEENAGER. I AM ON CRESTOR FOR MY LIPIDS, WHICH THE CHOLESTEROL IS UNDER CONTROL BUT THE TRIGLYCERIDES ARE NOT. I ALSO AM A STRESS EATER, AND SO I HAVE SOME WEIGHT PROBLEMS. I'M PROBABLY ABOUT 50 POUNDS OVERWEIGHT. AND I DON'T GET A LOT OF EXERCISE EXCEPT WALKING MY DOGS. I HAVE SPINAL STENOSIS AND SOME HERNIATED DISKS, SO IT'S NOT REAL COMFORTABLE FOR ME TO BE OUT EXERCISING, BUT MY DOGS KEEP ME MOVING. AND I WAS WONDERING -- OH, AND A FEW YEARS AGO I WAS DIAGNOSED WITH TWO HEART MURMURS. ONE WAS WITH A TRY CUSPID VALVE AND I'M NOT REAL SURE IF THE OTHER WAS MITRAL OR NOT. ANYWAY, MY QUESTION IS, I HAVEN'T HAD REALLY ANY EVALUATION FOR A LONG TIME AND I WONDERED WHAT YOUR ADVICE WOULD BE. SO I WILL HANG UP AND LISTEN TO YOUR ANSWERS. THANK YOU VERY MUCH. >> THANK YOU, JACKIE. WHO WOULD LIKE TO TACKLE JACKIE'S CASE? >> I'LL TACKLE THIS AND THEN I'LL ASK SEAN OR MATT TO TELL MN MY OFFICE QUITE COMMON. THEY CAN'T DO A WHOLE LOT. THEY SAY, I HAVE BACK PAIN, I HAVE SPINAL STENOSIS, I HAVE LUMBAR BACK -- THAT'S A REALLY TOUGH PROBLEM FOR PEOPLE BECAUSE THEY CAN'T GET OUT BUT I WOULD ENCOURAGE PEOPLE TO DO WHAT THEY CAN. FIND SOMETHING YOU CAN TO TO ADDRESS THAT. REGARDING ALL OF HER RISK FACTORS AND THE FACT SHE HASN'T HAD MUCH OF A WORK-UP, SHE HAS BEEN SEEING DOCTORS AT SOME POINT WHO HAVE TOLD HER THESE THINGS, PUT HER ON MEDICATIONS. THAT'S A GREAT START. IF SHE'S NOT HAVING SYMPTOMS, THAT'S OKAY. BUT I WOULD ENCOURAGE SOMEONE LIKE HER TO GO SEE HER PRIMARY CARE PHYSICIAN, OR IF SHE HAS ONE, A CARDIOLOGIST WHO CAN HELP HER AND COACH HER THROUGH THOSE, WHETHER OR NOT SHE NEEDS A STRESS TEST OR THEY NEED TO LOOK INTO THE MURMURS WITH AN ECHOCARDIOGRAM. PEOPLE CAN HAVE MURMURS AND CHOLESTEROL ISSUES AND CAN HAVE EVEN CORONARY DISEASE. IT DOESN'T MEAN YOU NEED A STENT OR OPERATION OR VALVE OPERATION, BUT IT DOES NEED TO BE FOLLOWED BY SOMEONE QUALIFIED, AND THAT COULD BE YOUR PRIMARY CARE PHYSICIAN, IT COULD BE YOUR CARDIOLOGIST. UNFORTUNATELY, YOU DON'T WANT TO SEE A SURGEON UNLESS YOU NEED ONE. I THINK THE FIRST THING, WHAT THIS LADY IS DO, IS IDENTIFYING SHE HAS SOME RISK FACTORS AND ASKING HER DOCTORS TO TAKE A LOOK. >> SHE SOUNDED A LITTLE OVERWHELMED BY HER CONDITIONS. >> SHE FOWNDZ LIKE A LOT OF PEOPLE. IT'S OVERWHELMING TO HAVE TO DEAL WITH SOME HEALTH PROBLEMS AND EVERYTHING THAT GOES ALONG WITH IT. SO IT'S DIFFICULT. ULTIMATELY THAT'S UNDERSTANDABLE, AND WE SEE THAT A LOT. THERE'S WAYS TO KIND OF TAKE CONTROL OF THESE THINGS AND AGAIN TRY TO BE THE HEALTHIEST PERSON YOU CAN BE, WHICH IS WHAT I WOULD ENCOURAGE HER TO DO, AND CERTAINLY BE IN CLOSE COMMUNICATION WITH THE PEOPLE WHO ARE TREATING HER AS WELL TO MAKE SURE SHE UNDERSTANDS WHAT SHE NEEDS TO DO IN TERMS OF PREVENTING HEART ISSUES IN THE FUTURE, HEART ATTACK OR STROKE. JUST TO PIGGYBACK IN TERMS OF WHAT DR. FORRESTER WAS SAYING, I THINK THERE IS A LITTLE BIT -- THE LAYPERSON HAS KIND OF A MISUNDERSTANDING OF IN TERMS OF WHEN WE DO HEART STENTS OR BYPASS SURGERY, HOW DOES THAT BEEN FIT ME? JUST TO KIND OF UNDERSTAND THAT, LARGELY THAT IS FOR OUR SYMPTOMATIC FOLKS. AGAIN, ALTHOUGH -- TOM DIDN'T HAVE SYMPTOMS BUT HE DID -- HE IS ONE OF THOSE PEOPLE WHO DID HAVE SEVERE HEART DISEASE. SO DID BENEFIT FROM BYPASS SURGERY. LARGELY THOSE TYPES OF TREATMENTS ARE FOR PEOPLE WHO HAVE SYMPTOMS. FOR THE MOST PART IF WE'RE TALKING ABOUT PREVENTING HEART ATTACKS OR STROKES, IT GOES BACK TO THE BASICS, LIFESTYLE THINGS WE TALKED ABOUT, APPROPRIATE MEDICATIONS. AS LONG AS YOU ARE DOING THAT AND SHE IS BEING FOLLOWED AND TREATED AND HAVING HER BLOOD PRESSURE TREATED, CHOLESTEROL TREATED, DOING THE BEST SHE CAN IN TERMS OF OTHER PREVENTATIVE THINGS, SHE WILL GIVE HERSELF THE BEST CHANCE TO PREVENT A HEART ATTACK AND STROKE AND MOST WILL SAY YOU DON'T NEED TO HAVE A STRESS TEST PER SE, IF YOU ARE DOING WHY THE BEST YOU CAN. ULTIMATELY STRESS TEST IS FOR THE FOLKS WHO HAVE SYMPTOMS IN GENERAL. >> YOU PROBABLY HEAR THIS TYPE OF SCORE EARLY RELEASE QUITE A BIT. WHAT WOULD YOU SUGGEST, JENNIE, A STARTING POINT FOR HER? SHE NEEDS A STARTING POINT TO GET ACTIVE, SOMETHING SHE CAN DO PERHAPS SITTING OR JUST TO GET THE BALL ROLLING. >> THE FIRST THING I WOULD WANT TO FIND OUT IS IF SHE IS SUFFERING FROM DEPRESSION. NEGATIVE MOOD STATES LIKE BOREDOM AND FATIGUE THAT CAN SABOTAGE THE BEST OF PEOPLE'S EFFORTS TO LIVE A HEALTHIER LIFE. SECONDLY, SHE IS SKIPPING MEALS. PEOPLE WHO STRUGGLE WITH WEIGHT OFTEN SKIP MEALS. THE BRAIN KICKS IN AND SAYS FEED ME, FEED ME, FEED ME. SOCIAL SUPPORT IS REALLY IMPORTANT. WATER AEROBICS FOR PEOPLE WHO CAN'T DO EXERCISE. TOPS, TAKE OFF POUNDS SENSIBLY, WEIGHT WATCHERS. THOSE PROGRAMS HAVE A LOT OF GOOD EATING AND EXERCISE APPROACHES, BUT I THINK THE SOCIAL SUPPORT IS EVEN BETTER. SO SMALL BABY STEPS. EAT REGULAR MEALS. TRY TO ADD PROTEIN WITH EACH MEAL. REALLY LOOK, ARE YOU SUFFERING FROM DEPRESSION. I THINK SO MANY OBESE ARE SUFFERING FROM THAT AND WE'RE NOT RECOGNIZING IT. THE AMERICAN HEART ASSOCIATION IS ASKING US AS HEALTHCARE PROVIDERS TO ASK -- AT EVERY VISIT TO CHECK THAT OUT WITH PATIENTS. IT'S HARD TO HAVE BEHAVIOR CHANGE IN THE FACE OF THAT. >> YOU PROBABLY KNOW THE STATISTIC. I THINK IT WAS THE NURSE HEALTH STUDY FROM HARVARD, IF YOU GO FROM NO ACTIVITY TAIF TO ONE HOUR A WEEK, EVEN I COULD DO AN HOUR A WEEK, THAT'S DOABLE FOR MOST PEOPLE, THE RISK OF HEART DISEASE WAS DOWN BY ABOUT ALMOST 50% COMPARED TO THOSE THAT DON'T DO ANYTHING. YOU'RE NOT GOING TO FIX THAT IN A WEEK. IF YOU CAN TAKE ONE STEP IN THE RIGHT DIRECTION, YOU CAN IMPACT A LITTLE BIT OF EXERCISE HELPS ALL THOSE THINGS. EXERCISE IS THE BEST THING WE'VE GOT. IT'S NOT AS FUN AS THE SURGERIES OR COOL AS PILLS OR AS EASY, BUT IT'S PROBABLY ABOUT THE BEST THING WE'VE GOT GOING, AND EVEN A LITTLE BIT PER WEEK, AN HOUR A WEEK, IS -- I GIVE THAT STATISTIC OUT A LOT BECAUSE A LOT OF FOLKS FEEL, I'M -- I'M -- YOU MIGHT AS WELL STOP NOW. I -- I CAN'T EVEN GO FORWARD. I SAY, DON'T GIVE UP YET. AN HOUR A WEEK IS DOABLE. >> IT'S INTERESTING, THAT'S WHAT I WAS STUDYING WHEN I WENT BACK TO SCHOOL. IN THE MOST RECENT OBESITY GUIDELINES RELEASED IN NOVEMBER OF 2013, THE PRESCRIBE FOR OBESE PATIENTS, WHICH WE KNOW 70% OF AMERICANS ARE EITHER OVERWEIGHT OR BEAS WAS WOMEN CUT YOUR CALORIES, 12 TO 1500 A DAY AND LESS, MEN LESS THAN 1800 CALORIES A DAY. AND EVERYBODY GET UP AND EXERCISE AEROBICALLY ON AVERAGE ABOUT 30 MINUTES A DAY. THE RESEARCH HAS SHOWN THAT ABSOLUTELY WORKS. YOU LOSE WEIGHT. WHY AREN'T PEOPLE DOING IT? BECAUSE IT'S TOO HARD. AND SO WHEN YOU GET THIS LADY WHO IS 50 POUNDS OVERWEIGHT AND I'M TEACHING A WEIGHT CLASS RIGHT NOW, IT NEEDS TO BE SIMPLER. IT MAY BE FOR HER GOING FOR A FIVE MINUTE WALK OUT THAT FRONT DOOR, ADDING AN APPLE TO HER DIET. IF WE GIVE THEM THAT PRESCRIPTION AND DO IT, BOOKS THAT ARE WRITTEN ON THIS TOPIC HAVE THE SAME PRESCRIPTION, THEY'RE GOING TO GET OVERWHELMED, STICK THEIR HEAD IN THE STAND AND DO MORE HARMFUL BEHAVIORS BECAUSE WE'VE INDUCED THIS NEGATIVE MOOD THAT'S UPSETTING THEM. AND THE NEW RESEARCH IS SHOWING US SMALL CHANGES THAT FIT EASILY INTO THEIR EVERYDAY LIFE SO THEY'RE NOT OVERWHELMED. THERE IS NOTHING EXERCISE -- IF THEY COULD COME UP WITH A PILL FOR EXERCISE, SOMEBODY WOULD MAKE BILLIONS OF DOLLARS. >> ON THAT NOTE, MY KIDS WANT A PLUG FOR A DOG -- HAVING A DOG -- IF YOU HAVE A DOG YOU ARE LIKE 60% MORE LIKELY TO GET THE NUMBER OF STEPS PER DAY. THAT'S -- THAT IS A HEALTHY THING. SO, SORRY, HONEY. >> YOU GUYS ALL LOOK LIKE ATHLETES TO ME. I HATE EXERCISE. SO THE AUDIENCE OUT THERE, THEY'RE GOING TO LOVE ME SAYING THIS, THE ONLY THING I FOUND THAT CAN I DO TO GET IT INTO MY EVERYDAY LIFE IS TO MAKE IT FUN. SO I DOWNLOADED PANDORA.COM ON MY PHONE AND I PUT ON THE CRAZIEST MUSIC AND I GET LOST IN THE MUSIC AND I CAN WALK. SO I'M NOT AN ATHLETE BUT I CAN DO THAT. SO WE HAVE TO GIVE THEM SIMPLE STRATEGIES TO MAKE IT FUN. DANCING. WALKING THE DOG, WHETHER YOU HAVE ONE OR NOT. ALL OF THOSE THINGS HELP. >> WE HAVE LYNN FROM DIAMOND LAKE WITH A QUESTION TONIGHT. HI, LYNN. >> Caller: HI, THANK YOU. I HAVE A LIPODEMIA VASCULAR DISEASE AND I SWELL A LOT. I'M HAVING SYMPTOMS AND I'M WONDERING WHETHER TO BE CONCERNED ABOUT IT. THERE'S LIKE A YOU ARE -- IT'S MORE LIKE A BUBBLE INSIDE MY CHEST. MY LEGS ARE SWOLLEN MORE THAN USUAL. MY FEET ARE TURNING DARK. AND I DO EXERCISE THREE TIMES A WEEK. I GO TO WATER AEROBICS FOR ABOUT AN HOUR AND A HALF EACH TIME. THAT HELPS GET SOME OF THE FLUID OUT. BUT THE FLUID IS JUST NOT MOVING VERY WELL ANYMORE. I WONDERED, ARE THESE HEART SYMPTOMS OR SOMETHING ELSE? MY NECK IS KIND OF SWELLING. THAT'S SORT OF THING. >> THANK YOU, LYNN. >> THAT WOULD BE FAIR TO GET CHECKED OUT, I WOULD SAY. I WOULD START WITH YOUR PRIMARY CARE PROVIDER. THAT'S A TOUGH CONDITION. I'M NOT -- I'M NO EXPERT, BUT KIT OFTEN OVERLAP WITH OTHER SYMPTOMS OF HEART DISEASE, SWOLLEN LEGS AND BREATHLESSNESS, A BUBBLE IN YOUR CHEST. I HAVE GIVEN SPEECHES TO PEOPLE TELLING THEM, OH, I'M NOT CONCERNED ABOUT YOUR SYMPTOMS AND YOU GET THE LABS BACK OR EKG AND YOU GO BACK IN WITH A DIFFERENT -- WE HAVE TO HAVE A HIGH SUSPICION GOING IN, BUT THOSE SYMPTOMS I WOULD -- IF SOMEBODY -- A LOVED FAMILY MEMBER CALLED ME AND SAID THAT, I WOULD SAY, I WOULD CALL MY PRIMARY PROVIDER, GET IN TO BE SEEN, GET YOUR BLOOD PRESSURE CHECKED, AND A PHYSICAL EXAM. THE EYEBALL EXAM IS WORTH A LOT. >> WE ARE ALSO RECEIVING A FEW EMAILS. WE HAVE DAN WHO WRITES: WHAT DO YOU LEARN FROM A CARDIAC MRI? DAN DAVIS WOULD LIKE TO KNOW AN ANSWER TO THAT. >> YOU CAN LEARN A MYRIAD OF THINGS. IT DEPENDS ON WHAT THE QUESTION IS. IT CAN BE A VERY USEFUL TOOL TO DIAGNOSE MANY THING IN TERMS OF THE HEART DISEASE. THAT'S A TOUGH QUESTION BECAUSE YOU CAN LEARN JUST ABOUT EVERYTHING. >> WHO DO YOU RECOMMEND HAVE ONE? >> WE DON'T NECESSARILY RECOMMEND ANYBODY IN PARTICULAR HAVE ONE JUST IN GENERAL, BUT KIT ADDRESS ALL OF THOSE THREE OR FOUR BIG BROAD TOPICS I MENTIONED. PRIMARILY CORONARY ARTERY DISEASE. AN MRI CAN BE LOOKING AT THE STRUCTURE OF THE HEART, VALVES, IT CAN BE LOOKING AT THE AORTA, THE MUSCLE ITSELF. IT CAN BE LOOKING AT THE MUSCLE IN RELATION TO CORONARY ARTERY DISEASE. KIT LOOK AT A LOT. SO MANY -- IT'S REALLY DIFFICULT TO RECOMMEND WHO SHOULD HAVE ONE. THAT WOULD BE A DECISION THAT PRIMARY YOUR CARDIOLOGIST OR CARDIAC SURGEON PREPARING FOR AN OPERATION OR SOMETHING WOULD RECOMMEND. IT'S TYPICALLY NOT A SCREENING TEST UNLESS YOU'RE LOOKING FOR SOMETHING THAT'S VERY SPECIFIC THAT ONE EVERY YOUR DOCTORS WOULD BE LOOKING FOR. >> JEN FROM EDMONTON, GOOD EVENING, JEN. >> Caller: HI. THANKS FOR TAKING MY CALL. I'M ACTUALLY CALLING ON BEHALF OF MY MOTHER WHO HAVE BEEN DIAGNOSED WITH PV KRMPLET, WHICH I MEAN BELIEVES LIKE EXTRA HEARTBEATS. SHE ACTUALLY HAS SOME OF HER THYROID REMOVED IN 2007, AND SHE'S ON A BETA BLOCKER RIGHT NOW, BUT SHE IS WORRIED THAT THE DOCTOR MIGHT NOT BE THINKING OF IT AS -- THE EXTRA HEARTBEATS OR PALPITATIONS A AS THYROID PROBLEM AS OPPOSED TO A CARDIAC PROBLEM. >> OKAY. SO SHE WANTS TO KNOW WHAT HER NEXT STEP SHOULD BE, HER NEXT MOVE SHOULD BE? THANK YOU, JEN. >> PVCs, THIS IS LIKE BEING ON JEOPARDY AND FINDING OUT -- THAT IS AN ELECTRICAL PROBLEM. THE THYROID CAN AFFECT THAT. YOU CAN HAVE AN INCREASE OF PVCs, A HYPERACTIVE THYROID IN PARTICULAR. BUT IT DOES STANTD FOR PREMATURE CONVENIENT VENTRICULAR CONTRACTION. THE HEART HAS THE ABILITY TO BEAT AND HAVE ELECTRICITY RESPONSIBILITY FROM THE GROUP OF CELLS AT THE HOP OF THE HEART. A PVC IS AN EXTRA BEAT THAT COMES FROM BELOW IN THE VENTRICLES. THEIR FOUR CHAMBERS IN THE HEART, TOP TWO AND THE BOTTOM TWO. THE BOTTOM ARE THE VENTRICLES. SO THE PREMATURE BEATS FROM BELOW CAN BE HARMLESS. THEY'RE VERY COMMON. I HAVE NEVER HAD A HEART MONITOR WITHOUT AT LEAST ONE PVC OR PAC. BUT IF YOU HAVE TOO MANY OF THEM THEY CAN BE A SYMPTOM OF CORONARY DISEASE, AND SO HER NEXT STEP SHOULD BE -- I SEE PVCs ALL THE TIME AND WHAT I DO, BEFORE I SEE THESE PEOPLE, WE HAVE AN IDEA WITH A 24-HOUR RECORDING AS TO HOW MANY PVCs THEY'RE HAVING AND WHETHER THEY'RE COMING FROM ONE SPOT IN THE HEART OR MORE THAN ONE SPOT. THAT'S A BIG DIFFERENCE. IF YOU ARE HAVING PVCs FROM MORE THAN ONE SPOT, THAT'S A SMOKING GUN. YOU NEED TO RULE OUT ISCHEMIC CORONARY DISEASE. THAT'S A COMMON CAUSE. IF THEY'RE COMING FROM ONE SPOT, OFTENTIME THEY'RE HARMLESS AND PEOPLE DON'T FEEL THEM. YOU CAN WATCH THEM SAFELY. IF YOU ARE SYMPTOMATIC WITH EMTHIS, WE'RE GLAD TO HELP PEOPLE WITH MEDICINES. IF MEDICINES DON'T HELP, IF YOU ARE VERY SYMPTOMATIC AND IN EXTREME CASES YOU WILL HAVE SO MANY PVCs IT CAN WEAKEN THE HEART MUSCLE. INSTEAD OF USING THE NORMAL CONDUCTION SYSTEM OF THE HEART, THE ELECTRICITY IS TRAVELING AGAINST THE GRAIN. YOU CAN FIND THAT PVC LITERALLY, PHYSICALLY, WITH THE TIP OF AN ELECTRICAL CATHETER, WE CAN GO THROUGH THE LEG, HUNT THAT THING DOWN, AND IF IT'S IN A PLACE THAT'S SAFE TO OWE BLAIT, YOU CAN TURN ON THE ENERGY, BURN THE SPOT AND HELP PEOPLE WITH SYMPTOMS AND WITH HEART -- WITH A CARDIOMYOPATHY. SO THE FIRST STEP IS THE RECORDING. YOU WANT A 24-HOUR PERIOD, GIVE OR TAKE, WHERE YOU CAN QUANTIFY THE NUMBER AND LOCATION. IT CAN BE A BUNCH OF THINGS BUT THAT'S THE FIRST STEP TO GO DOWN THAT ROAD. >> WE HAVE AN EMAIL FROM JIM, AND I THINK JIM IS ASKING A QUESTION A LOT OF PEOPLE ASK, AND WHEN YOU -- ONE YOU PROBABLY OFTEN GET, SHOULD I TAKE ASPIRIN DAILY TO PREVENT HEART ATTACKS? AND THIS IS -- THIS ONE HAS GONE BACK AND FORTH IN THE LAST FEW YEARS. >> THIS IS TRUE. I THINK THERE HAS BEEN A LITTLE DISCUSSION RECENTLY ABOUT WHO SHOULD TAKE ASPIRIN. I THINK PREVIOUSLY I THINK IT WAS MORE BROAD, YOU KNOW, ANYBODY -- OVER THE AGE OF 40 MAYBE WAS TAKING ASPIRIN. BUT ASPIRIN IS NOT BENIGN. THERE IS A RISK. YOU CAN DEVELOP BLEEDING STOMACH ULCERS OR POTENTIAL OTHER COMPLICATIONS. YOU HAVE TO WEIGH THOSE RISKS. I THINK THAT FOR ME I TYPICALLY WILL RESERVE THAT FOR MEN IF WE ARE TALKING ABOUT PREVENTION. WOMEN IT'S NOT AS BENEFICIAL. IF ANYTHING, SOME BENEFIT IN REDUCING STROKE. THAT'S PROBABLY IN WOMEN OR -- WHO ARE OLDER, MAYBE OVER THE AGE OF 60 OR SO. AND ESPECIALLY IF THEY HAVE HIGH BLOOD PRESSURE. IN MEN, OVER THE AGE OF 50, AND IF YOU HAVE SOME RISK FACTORS. AND -- YOUR DOCTOR CAN CALCULATE WHAT YOUR RISKS ARE AND PLUG INTO IT A CALCULATOR VERSUS SOMETIMES THEY JUST KIND OF GENERALLY DO IT THAT WAY. BUT THAT'S PROBABLY THE PEOPLE WHO I WOULD RECOMMEND AN ASPIRIN FOR IS THOSE TYPES OF AGE RANGES WITH SOME RISK FACTORS. AGAIN, I THINK MUCH MORE -- MORE SO I THINK -- UNFORTUNATELY FOR WOMEN, I THINK THE ASPIRIN HAS BEEN SHOWN TO BE IF ANYTHING HELPFUL IN MEN IS NOT AS HELPFUL IN WOMEN EXCEPT FOR SOME PREVENTION OF STROKE. >> WHAT DOSAGE? STILL A BABY ASPIRIN? >> YEAH, I THINK WE RARELY USEFUL-DOSE ASPIRIN, EVEN IF YOU HAVE HEART DISEASE. SO IT'S PREDOMINANTLY BABY OR TWO BABY ASPIRINS. >> WE HAVE A QUESTION FROM DONNA THIS EVENING ON THE PHONE. GOOD EVENING, DONNA. >> Caller: HELLO. >> DO YOU HAVE A QUESTION FOR OUR PANEL? >> Caller: YES, PLEASE. THANK YOU FOR TAKING THE PHONE CALL. I'M ALMOST 49 AND I HAVE DIABETES TYPE 2, AND I'M ON -- I KNOW EXERCISE WOULD BE HELPFUL FOR MY HEART. SINCE EVERYTHING IS STICKING TO ME NOW. WHAT WOULD BE GOOD VITAMINS IN FOOD FOR MY HEART AND MY BODY AT THIS AGE, PLEASE. >> WE HAVEN'T TALKED ABOUT SUPPLEMENTS AT ALL. JENNIE, DO YOU RECOGNIZE ANY SUPPLEMENTS? >> THAT IS NOT REALLY MY AREA OF EXPERTISE. I'M MORE INTO WE KNOW FRESH FRUITS AND VEGETABLES HAVE A LOT OF WONDERFUL CHEMICALS IN THEIR NATURALLY THAT LOWER BLOOD PRESSURE. BUT I'LL LET ONE OF THE CARDIOLOGISTS TAKE THAT ONE. >> ANY SUPPLEMENTS ANY OF YOU RECOMMEND? >> LIPATOR. >> IT TURNS OUT A LOT OF THE SUPPLEMENTS HAVE NOT REALLY BORE OUT TO BE THAT HELPFUL. I DON'T KNOW THAT THEY'RE HARMFUL, PER SE. I WOULD SAY A TYPE 2 DIABETIC, A PLANT-BASED DIET. I WOULD BE CAREFUL ABOUT THE CARBOHYDRATES, ESPECIALLY SIMPLE SUGARS AND THOSE KINDS OF THINGS. DIETS HIGH IN FISH AND/OR FISH OIL, THAT MAY BE HELPFUL. THAT'S ALSO KIND OF A COMPONENT OF LIKE A MEDITERRANEAN DIET. THAT WOULD BE SOME THINGS YOU MAY WANT TO LOOK IN. TYPICALLY DIETS HIGH IN FIBER. EITHER FIBER FROM FOODS OR FIBER AS A SUPPLEMENT IS USUALLY VERY HELPFUL AS WELL. >> IN YOUR BOOK, JENNIE, YOU ACTUALLY GO OVER SOME OF THE MORE POPULAR DIETS AND YOU MENTIONED WEIGHT WATCHERS EARLIER. IS THAT -- ARE SOME OF THOSE GOOD PLANS FOR PEOPLE TO START? BECAUSE SOME PEOPLE DO NEED A PLAN. THEY NEED SOMETHING TO LOOK AT AND FOLLOW. DO YOU RECOMMEND SOME OF THOSE? >> THAT'S A GREAT QUESTION. THE U.S. NEWS WORLD AND REPORT EVERY YEAR EVALUATES MAYBE 20 OR 30 OF THE TOP DIETS, LIKE THE PALEODIET, GLUTEN-FREE DIET, WEIGHT WATCHERS, THE DASH DIET WHICH IS DIETARY APPROACH TO STOPPING HYPERTENSION. THEY LOOK AT ALL OF THEM AND RANK THEM. SOME OF THE PEOPLE ON THIS PANEL I'M AWARE I KNOW THEY ENDORSE MY BOOK, THEY'RE REALLY SOLID GOOD PEOPLE. SO THAT'S A GREAT REFERENCE FOR PEOPLE -- GOOGLE -- WHEN I LOOKED AT IT AS A GRADUATE STUDENT AND WITH MY CAREER, I LIKED THE DASH DIET. I LIKED THE MEDITERRANEAN DIET. I CUT IT DOWN TO REALLY SIMPLE EAT MORE FRUITS AND VEGETABLES WHENEVER YOU CAN UNLESS YOU'RE DIABETIC AND THEN YOU HAVE TO BE CAREFUL WITH THE FRUITS BECAUSE THE FRUIT SUGARS CAN BE HARMFUL. EAT WHOLE GRAIN BREADS. BEANS. DARK RICE. LEAN MEAT THE SIZE OF THE DECK EVERY CARDS. LOW FAT DAIRY PRODUCTS. AVOID PROCESSED FOODS AS MUCH AS YOU CAN. REDUCE YOUR SALT. REDUCE YOUR PORTIONS. AND THAT'S THE DIET THAT JUST ABOUT ANYBODY CAN FOLLOW AND THE TAKE-AWAY IS ADD FRUITS AND VEGETABLES WHEREVER YOU CAN. DIABETICS ARE A SPECIAL CASE. THEY NEED TO TALK TO THEIR DIABETIC NURSE EDUCATOR. >> WE HAVE DAWN WITH A QUESTION. >> Caller: MY QUESTION, I'M 57, IN FAIRLY GOOD SHAPE. I DO A LOT OF OUTDOOR ACTIVITY. I RAISE ALL MY OWN FOOD, SO I DO VERY, VERY LITTLE PROCESSED FOOD. AND I RECENTLY SUFFERED AN AFFIB AND WAS CARDIOVERSIONED BACK INTO RHYTHM. I HAD BEEN A MODERATE DRINKER IN THE PAST AND I HAVE NEVER SMOKED CIGARETTES BUT I DO SMOKE MARIJUANA. BUT AS YOU SAID EARLIER, THIS HAS BEEN A WAKE-UP CALL, AND -- I'VE CUT BACK ON EVERYTHING -- NO WHISKEY OR BEER OR ANYTHING LIKE THAT, BUT I DO HOPE THAT ONE OR TWO HITS IN THE EVENING OF MARIJUANA IS NOT GOING TO BE DETRIMENTAL AND POSSIBLY A GLASS OF WINE. WHAT DO YOU SAY TO THAT? >> THANK YOU, DON. THANKS FOR YOUR QUESTION. >> AFFIB -- I'M UP TO DATE ON THAT. THERE IS NOT A LOT OF RESEARCH WITH MARIJUANA. THERE WILL BE SOME DAY AS IT BECOMES MORE AND MORE USED AND LEGALIZED AND WHAT HAVE YOU. AFIB, THE BEST THING TO DO TO REDUCE YOUR RISK OF RECURRENCE IS BE A GOOD BODY WEIGHT, GET CHECKED FOR SLEEP APNEA, EXERCISE, HYPERTENSION, DIABETICS, SMOKING IS A RISK FACTOR FOR RECURRENCE. I WOULD GUESS, ALTHOUGH IT'S NOT BE STUDIED IN MARIJUANA, I WOULD BET THAT DOES INCREASE THE RISK OF OCCURRENCE. THAT NEEDS TO BE WEIGHED AGAINST THE BENEFITS WHATEVER THEY MIGHT BE, RIGHT? AND EXCESSIVE ALCOHOL USE. YOU DID HIT ON THAT ONE. PROBABLY THE SINGLE BIGGEST RISK FACTOR, AGE IS A BIG ONE, WHICH WE CAN'T GO BACK ON AND YOUR GENETIC CODE. THE BIGGEST RISK FACTOR IS EXERCISE AND LIFESTYLE AS WELL AS SLEEP APNEA, IF YOU SNORE AT NIGHT, YOU'RE OVERWEIGHT I RECOMMEND MY PATIENTS GET A SLEEP STUDY. AND THERE ARE SOME CERTAIN BLOOD PRESSURE MEDICINES THAT CAN REDUCE THE RATE OF RECURRENCE. SIMPLE ONE LIKE ACE INHIBITORS, AND THE ARBs, CERTAIN CLASS OF BLOOD PRESSURE MEDICINES THEY HAVE BEEN SHOWN TO IMPACT THE RATE OF RECURRENCE. YOU NEED TO BRING THAT UP WITH YOUR PROVIDER. THE DOCTOR SAID I COULD THINK ABOUT DOING AN ACE INHIBITOR. >> HE MENTIONED THE GLASS OF WINE. >> A GLASS OF WINE IS OKAY. YEAH. >> RED WINE STILL BETTER THAN WHITE OR -- >> RED -- I'M NOT SURE ABOUT THE TWO COMPARED TO EACH OTHER, BUT, YEAH. DEPENDS IF YOU'RE HAVING, I GUESS, POULTRY OR RED MEAT. >> I THINK THEY'RE SIMILAR IN TERMS OF BENEFITS. IF YOU'RE A WHITE WINE DRINKER, FEEL FREE. >> OKAY. WE HAVE ANOTHER PHONE CALL. WE'RE GOING TO TRY TO SQUEEZE IN A FEW MORE BEFORE THE END OF THE SHOW. FRAN IN CALGARY. GOOD EVENING. >> Caller: HI. THANKS FOR TAKING MY CALL. I HAVE TWO QUICK QUESTIONS. ONE IS, I'M NOW 70. I'M NOT TERRIBLY OVERWEIGHT. I EAT FISH, EITHER CANNED SALMON OR CANNED SARDINES, EVERY DAY, LIKE THROUGHOUT THE WEEK, AND I READ SOMEWHERE WHERE THAT COULD BE A PROBLEM. THE OTHER QUESTION IS, I HAD MY LIP OWE PROTEIN B CHECKED AND IT'S HIGH. MY LDL IS HIGH. WHERE DO I GO FROM HERE? >> THANK YOU, FRAN. >> DO YOU GUYS SEE MUCH -- IT'S BEEN STUDIED AND IT'S NOT -- LDL IS STILL -- >> YOUR LDL IS HIGH. THERE'S OTHER KIND OF CHOLESTEROL PARTICLES THAT CAN'T BE MEASURED. LDL IS YOUR BAD CHOLESTEROL. THE FACT THAT'S HIGH TELLS MOST OF THE STORY. THE OTHER FACTOR BEING HIGH KIND OF SUPPORTS THE FACT THE CHOLESTEROL IS ABNORMAL AND NEEDS TO BE ADDRESSED. DEPENDING ON WHAT THE LEVELS ARE AND IF YOU HAVE OTHER RISK FACTORS, AGAIN, SOMETHING TO TALK TO THE DOCTOR ABOUT. DIETARY INTERVENTIONS IF YOU'RE NOT ALREADY DOING THEM. CERTAINLY THERE WOULD BE CONSIDERATION OF MEDICATION TO TREAT THAT AND LOWER THE LDL IF IT IS HIGH. SARDINES, 'EYE THINK, HAVE HIGH CHOLESTEROL, I BELIEVE. >> SO THERE COULD BE A CONNECTION -- >> I THINK THAT WOULD BE THE CONCERN WITH THAT. THERE ARE SOME TYPES OF FISH THAT ARE A LITTLE MORE FATTY AND WHATNOT, AND SO -- AND SO WHILE THEY CAN BE HEART HEALTHY, THEY CAN HAVE UM SAN FRANCISCO THOSE THOSE -- SOME OF THOSE SIDE EFFECTS. >> THE NEW EMERGING RESEARCH, THERE IS ABOUT TO COME ON THE SCENE A BUNCH -- BASED ON THE GENETIC CODE BEING IDENTIFIED A FEW YEARS AGO, GENETIC MARKERS. FOR INSTANCE, WE KNOW THE SIZE OF THAT LDL CHOLESTEROL, IF IT'S TOO SMALL, IT'S GOING TO WIGGLE INTO THAT WALL WHERE THAT PLAQUE AND DEBRIS IS BUILDING UP. SOME LDL IS MORE AGGRESSIVE. IT WANTS TO WIGGLE INTO THAT WALL MORE EASILY THAN OTHER CHOLESTEROL. WE'RE BEGINNING TO UNDERSTAND SOME HDL HEALTHY CHOLESTEROL DOESN'T WORK AS WELL AS OTHER. WE CALL THAT EMERGING RESEARCH. THAT MEANS IF YOU MEASURE IT IN SAN FRANCISCO IS A 10 ON THAT BLOOD TEST, IS IT THE SAME IN NEW YORK CITY. BECAUSE NOT ALL LABS ARE STANDARDIZED. PHYSICIANS LIKE YOU GUYS AND NURSES, WE'RE WAITING TO SEE THE RESEARCH BEFORE WE GET BEHIND THE TESTS. BUT THAT IS AN EXCITING AREA THAT'S GOING TO BE EXPLODING IN THE NEXT FEW YEARS BECAUSE THERE'S A LOT OF NEAT THINGS HAPPENING. >> WE STILL ARE HEARING KNOW YOUR NUMBERS, WHICH THE CHOLESTEROL NUMBERS ARE INCLUDED IN THAT. WHAT ARE THE OTHER NUMBERS WE NEED TO KNOW AND BE AWARE OF, DR. FORRESTER? >> I DON'T KNOW SO MUCH ABOUT NUMBERS NECESSARILY. CHOLESTEROL. IT'S GOOD TO KNOW YOUR BLOOD PRESSURE. ANY OTHER NUMBERS YOU CAN THINK OF? I THINK IN GENERAL IT'S BETTER TO LIVE A HEALTHY LIFESTYLE. I TEND TO TELL MY PATIENTS THAT YOU CAN GET REALLY CONFUSED WITH A LOT OF DETAILS AND HOW TO BE HEART HEALTHY, AND IN MY MIND IT COMES DOWN TO COMMON SENSE, AND I TRY TO TELL PEOPLE TO SIMPLIFY IT. YOU KNOW HOW TO BE HEALTHY. YOU KNOW HOW TO EAT HEALTHY. IF YOU DON'T, THERE ARE A LOT OF PEOPLE THAT CAN HELP YOU. THERE ARE SO MANY DIETS YOU CAN GET OVERWHELMED WITH WHICH IS IS BETTER. SOMEBODY WHO KNOWS THAT -- EVERYTHING IN YOU MODERATION --I THINK IF YOU KNOW YOUR BLOOD HERB PRUR AND KNOW YOUR CHOLESTEROL AND YOU HAVE A PRIMARY CARE PHYSICIAN WHO YOU CAN TALK THESE THINGS THROUGH WITH, THAT'S WHAT YOU NEED TO DO. I WOULDN'T WORRY TOO MUCH ABOUT WHICH STUDY IS BETTER THAN THE OTHER. BUT THIS IS REALLY -- DR. SPANGLER'S EXPERTISE AND HIS FIELD. IF HE CAN ADD ANYTHING TO THAT. >> I THINK ADULTS SHOULD KNOW THEIR BLOOD PRESSURE. THAT SHOULD BE CHECKED. I THINK CHOLESTEROL SHOULD BE CHECKED PERIODICALLY. SHE THOOF A FASTING BLOOD SUGAR TO SCREEN FOR DIABETES. YOU PROBABLY SHOULD KNOW YOUR WEIGHT OR WAIST CIRCUMFERENCE. YOU MAY NOT WANT TO TELL PEOPLE BUT YOU SHOULD KNOW WHAT THEY ARE. BUT KNOW IT. AND SO I THINK THOSE ARE PROBABLY THE MAIN THINGS TO KNOW ABOUT IN TERMS OF, AGAIN, THINGS THAT WILL PUT YOU AT RISK FOR PROBLEMS IN THE FUTURE. YOU SHOULD BE AWARE OF THOSE AND DON'T IGNORE THOSE. >> WELL, WE HAVE RUN SHORT ON TIME THIS EVENING. IT WAS A VERY GOOD DISCUSSION. I APPRECIATE ALL OF YOUR EXPERTISE THIS EVENING AND OUR DISCUSSION AND ALL THE PHONE CALLS THAT WE TOOK, AND EMAILS AS WELL. WE WANT TO LET YOU KNOW ABOUT AN EVENT COMING UP IN MARCH, AND THAT IS THE "GO RED FOR WOMEN LUNCHEON" SPONSORED BY THE AMERICAN HEART ASSOCIATION. THE DATE IS MARCH 9 AT THE SPOKANE CONVENTION CENTER. THE COST IS $125 PER PERSON. JENNIE JOHNSON WILL BE THE KEYNOTE SPEAKER. IF YOU ARE INTERESTED IN ATTENDING, WE'VE POSTED A LINK ON OUR WEBSITE. GO TO KSPS.ORG AND CLICK WHERE IT SAYS "HEALTH MATTERS." BE SURE STEW JOIN ON MARCH 24th WHEN OUR TOPIC WILL BE THE RISE OF TYPE 2 DIABETES. AGAIN, I WANT TO THANK EVERYONE FOR BEING HERE TONIGHT AND YOUR PHONE CALLS AND QUESTIONS. THAT WILL DO IT FOR THIS EDITION OF "HEALTH MATTERS." WE'LL SEE YOU AGAIN IN MARCH. THANKS SO MUCH. I'M TERESA LUKENS. >> "HEALTH MATTERS" IS MADE POSSIBLE BY VIEWERS LIKE YOU, THE FRIENDS OF KSPS. AND BY PROVIDENCE HEALTHCARE. >> PROVIDENCE'S MOTTO IS "KNOW ME, CARE FOR ME, EASE MY WAY" AND PROVIDENCE DOES THAT. I'VE SEEN IT OVER AND OVER AGAIN. I AM DR. STEVEN MURRAY, AND I CHOSE PROVIDENCE BECAUSE I BELIEVE IN THE MISSION STATEMENT, AND WORKING TOGETHER WITH OTHERS OF LIKE-MIND IS A POWERFUL WAY TO TAKE CARE OF PATIENTS. >> MY NAME IS BETH PEREZ AND I AM A REGISTERED NURSE AND I WORK AT HOLY FAMILY HOSPITAL ON THE LABOR AND DELIVERY UNIT. I AM ABOUT TO HAVE MY SECOND CHILD AND I CHOSE PROVIDENCE BECAUSE I LOVE AND TRUST THE PEOPLE THAT I WORK WITH, AND WHY