Cac


(Bacon for the Win) #1

I found an imaging center nearby to have a CAC scan done and they want a doctor’s order. So I messaged my doctor and she tells me I can have it done at our hospital, but why do I want it? She added the in house-cardiologist to our messages and he provided the following link. Interesting read.

https://www.acc.org/latest-in-cardiology/articles/2019/08/20/11/06/2018-cholesterol-guideline-and-the-judicious-use-of-coronary-calcium-score

I understand I am low-risk for a cardiac event. I am 57 y.o., and just want this done for a baseline reading. My mother died from a cardiac event in 2014 that we never saw coming.

I’m going to push for having this done. We do a bazillion tests on patients who realistically are not going to live through the week, they can run a test on someone who plans on being around for a few more decades.


(bulkbiker) #2

Statins, statins, statins… make money… CAC scans make far less?


(Bacon for the Win) #3

eh…my doc isn’t pushing statins on me. She knows I wouldn’t take them anyhow. She knows my thoughts on 21st century medicine and I think she secretly agrees. She calls me a “naturalist.” I take that as a compliment.


(Full Metal KETO AF) #4

I would start with that. Also tell them you’re on a high fat keto diet and you want to be sure you aren’t creating an issue maybe. :cowboy_hat_face:


(Full Metal KETO AF) #5

Funny bit Nelle, I had a CAC scan 3.5 years ago before KETO while eating a fairly crappy diet so I could get a kidney transplant. I have atherosclerosis in my lower body bad enough that I lost a leg at 40, 20 years ago. So my CAC scan score was zero. Three years later I get a new doctor because my Carnivore doctor stopped practicing here. So new lady doc is livid about my cholesterol and tells me KETO is going to kill me. I said three years ago my CAC was zero, let’s test again. Nope, we can’t do that. You should start eating the DASH Diet. She didn’t notice that I had lost 100 lbs since the last scan, reversed blooming diabetes and that I was overall very much healthier than before with a lower body weight in a very healthy range as recorded in my medical records, :face_with_raised_eyebrow: I don’t see her anymore and currently am without a GP doctor. :cowboy_hat_face:


(bulkbiker) #6

The article you linked to was statin pushing… I found it frightening not interesting hence my comment.


#7

When I had my first CAC in 2016, I pretty much told my general practitioner that I was on a high fat diet. He was a eat less move more advocate, so was keen to see my clogged arteries. The score was zero.

I had a repeat CAC in 2019, new primary care physician, I just asked if I could get it done as I had been on a high fat diet for 4 years. he was keen to show me my clogged arteries. The score was ‘1’ (a 100% worse result).

It’s nice that the cardiologist provided some reading material for you for the waiting room.


(Bacon for the Win) #8

I find it interesting that I’m even having this conversation with them. I didn’t mention it before because I don’t like naming where I work and receive care, but this is the VA. Of course they’re pushing statins. The fact they even do CACs surprised me.


(UsedToBeT2D) #9

I’d tell my doctor to order it or find a new patient.


(Bob M) #10

This is one of the reasons I had mine done. I had been low carb/keto over 5.5 years at the time and wanted to see if “saturated fat” “clogged” the arteries. I also have an extremely high Lp(a), which is the latest blood lipid that apparently will KILL you.

I got a score of zero. 90% of the people my age (55) have higher scores.

Getting a zero score does not mean you have zero risk, just low risk. The other benefit to getting a low score is that statins don’t do anything for those with low scores. I can find a study if you want it, showing that if you have a low score, statins are useless.

You should note that “1” is not a bad score at all. And, like all tests, there is some error in these.

If you do get a higher score, you can think about getting more vitamin K2 (cheese, fermented butter, natto if you don’t mind plants, etc.), magnesium, and more. There have been some reversals of the score (or at least slowing or stopping progression) using these types of vitamins/minerals.

The real issue is the LDL, Lp(a),LDL-p, or anything else that’s considered to be “bad”. If you get a “high” value for those, what does it really tell you about risk? Nothing. The CAC scan is a more objective test of risk.

In my case for instance, my Lp(a) is so high it’s in the highest 2% of the population in some studies. My LDL usually isn’t bad, nor is my LDL-p, but I can make these “bad” by doing things like fasting multiple days.

Since I got a score of zero, I can at least know for the time being my extremely high Lp(a) does not appear to be affecting calcification. And I can argue intelligently (and show studies) about how statins are no benefit to me.


(Jane) #11

I just searched for a CAC near me and I can have it done at a nearby hospital, no doctor’s referral needed and the website said the would collect $49 at the time of the exam. No mention if that was the total cost. I may follow up when I get back home from Illinois.


(Bacon for the Win) #12

I don’t need to give her an ultimatum. She’s a forward thinker and respects my values and opinions. We wound up together by chance but I think I’ll keep her.


(UsedToBeT2D) #13

I hope she lets you get it done.


(Bob M) #14

The place I went to did not need a doctor’s order. $100 out of pocket.

In fact, my GP referred me to my cardiologist, who refused to give me a prescription because “I did not have high LDL”. Based on what I’ve seen from Ivor Cummin’s feed, LDL is meaningless for CAC. (Which means it’s likely meaningless, period; other than perhaps a marker for something else.) Tons of people with “great” lipid values had high CAC and vice versa.


(Joey) #15

@FrankoBear I think that going from 0 to 1 is an infinitely worse result, algebraiclly speaking. Run the numbers and be scared. Be very scared. But please stay safe, my friend! :vulcan_salute:

@NelleG At 57 yrs old and a maternal history of cardiac disease, given the non-invasive and inexpensive nature of CAC tests, your physician is risking malpractice by NOT ordering one at your request. I do like @David_Stilley’s swell idea of pointing out that your keto diet might be killing you :skull_and_crossbones: … give that line a try.

Perhaps your “guideline-following” doctor will see why this makes you an exception to his/her “60+ yr old guideline” for ordering CAC tests. Please keep us posted.


#16

OMG you are right Sheriff Joey it is an infinitely worse result!


(Kirk Wolak) #17

First, YOU have to pay for this out of pocket. So it’s 100% your call…

Next, you SHOULD have a baseline. Can you doctor tell you how much plaque you HAVE? You won’t know until the test!

And WHEN they recommend a test is typically when it’s a bit late. I think ALL smokers by the time they are 40 should have one! (and one shouldn’t smoke)!

Trust me. we had to pay $1,300 for friggin’ blood work for our daughter… I’d much rather buy a couple of CAC scans!