SECOND OPINION | Reversing Heart Disease Episode | BCBS

SECOND OPINION | Reversing Heart Disease Episode | BCBS

January 5, 2020 45 By Bertrand Dibbert


Child: THERE ONCE WAS A TIME WHEN WE WERE
TRULY FREE — FREE OF WORRY, FREE OF FEAR, FAR FROM DOUBT. THAT IS STRENGTH. THAT IS POWER. THAT IS FEARLESS. “SECOND OPINION” IS BROUGHT TO YOU BY BlueCross/BlueShield,
ACCEPTED IN ALL 50 STATES. LIVE FEARLESS. “SECOND OPINION” IS PRODUCED IN ASSOCIATION
WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NEW YORK. 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
M.D’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. The web address is second opinion dash tv dot O R G. I’m Dr. Peter Salgo and I’ll see you next time for another second opinion. Child: THERE ONCE WAS A TIME WHEN WE WERE TRULY FREE FREE OF WORRY FREE OF FEAR, FAR FROM DOUBT THAT IS STRENGTH THAT IS POWER THAT IS FEARLESS “SECOND OPINION” IS BROUGHT TO YOU BY BlueCross/BlueShield ACCEPTED IN ALL 50 STATES LIVE FEARLESS. “SECOND OPINION” IS PRODUCED IN ASSOCIATION
WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NEW YORK.