Don’t you want to know what’s in your
arteries? Don’t you want to know if you have inflammation? Don’t you want to know
if you’ve got this process where your immune system is attacking plaque? Now, I talked with a lady a couple of
days ago. She was in her late 60’s, and she said, “Well, I just want to get a CIMT.”
She had missed the CIMT event in LA. She was close enough to have driven in, but
she wanted to know when the next one was available. And I worked with her to call Heidi. I found a couple of physicians offices which Heidi and
Todd send text to and maybe we can get her in there. For sure, we want to know.
But there’s an interesting thing. I started to have more conversation with
her, and I said, “Well, you know, you’re at an age where probably you’ve got like
2/3 probability of having a positive calcium score.” She said, “Oh well, yeah, I
already had a calcium coronary calcium tests, and I do have calcium.” So we knew
that she had plaque. But then again, the question is: Does she has soft plaque?
And the other question is very much related: Does she has inflammation? And don’t you want to know if you have inflammation? Don’t you want to know
if you’re if you’ve got myeloperoxidase, high sensitivity CRP, microalbumin
creatinine ratio, if your body’s spilling microalbumin, whether you’ve got
active plaque too? And she sort of paused for a minute. I said, “Did Cliede talk with
you about the webinar series?” She said, “Oh, yeah, he talked with me about the webinar
series. But we don’t really need that. We’ve got plenty of information. We don’t
need to pay for more information.” And I said, “This is our fault. We
could have done it better.” Instead of labeling it the webinar program, a
lab screening program which we should have done,
we call it the webinar program. But here’s the point. That’s what this
webinar program is about. It’s getting your own labs, finding out “Do you have
inflammation?” So the first test… let’s talk for just a minute about some of the
tests. The first test is microalbumin creatinine ratio. What does that mean?
How does that tell you if you’ve got inflammation? Well, here’s the thing.
Real quick, each kidney has about a million filters, and it filters the blood.
So arteries get tinier and tinier to your arm you’re about at a capillary
level the there’s a special type of capillary level going through a one of
those million filters and that filter is called a glomerulus. This is a
picture of it here. Every filter has a filter membrane. And here’s the filter
membrane for the glomerulus in the kidney. It’s the intima. So if your kidney
is spilling microalbumin protein at a microscopic level, we know that you’ve
got problems with your intima, that critical lining of the artery. We talked
about this lining in multiple different places. That’s what causes plaque. Again, this is the heart, the large arteries, and veins. This is a
clear look at a clean artery. What we’re talking about is the media, which is a
muscular layer which holds it together. But most importantly, the intima… if the
intima is damaged, it will let LDL go through and lodge in between the intima
and media. It gets down to a thing called the glycocalyx. The glycocalyx is like a
hairy lining of small orders. And here’s the thing. If that glycocalyx is in good
shape, then LDLs not going to get through. But this is a little schematic. Here’s a
few image… a couple of images of glycocalyx. Here’s an actual picture.
But then here’s that an image. This is a healthy glycocalyx. And this is one
that’s been has had injury. Smoking can cause that kind of injury to the
glycocalyx. Having (and most commonly) having a blood sugar 180 or more for hour after hour starts damaging this glycocalyx. It’s
like coming through and cutting grass with a lawn mower. That’s what causes LDL
build-up, that injured glycocalyx. That’s what we want to know is going on. Now
here’s a couple of different views of plaque.
The plaque that the left side has inflammation.
It’s got hemorrhage in here where there’s bleeding. It’s got a lot of cells.
This has a few cells, but this is not something that’s going to break open and
bleed in and leak into the artery flow the blood flow. That’s what happened here.
In this real picture, prior to this crack, here in the intima,
this was just a brown space where you had a little bit of bleeding, a little
bit of hemorrhage, a little bit of inflammation, and softening that intima
lining cracked. And this is a clot. This is not soft-like anymore. That black
thing is a clot. The rest of it broke off and went to the heart and killed
this patient. So yes, I would think we’d want to know, “Do we have this process
going on?” You can somewhat tell with IMT. Yes, that’s very important. But why would
you not want to get testing? Why would you not want to make sure you can say,
“Well, you know, I got a test at the lab a while back with my doc.” Or, “You know,
what I’ve got my crab you, I’ve got test strips.” These things don’t work. They’re
looking at less than 30 milligrams per gram and that’s not what we’re talking
about. That’s kidney… that’s full-blown kidney disease. We’re talking about
microscopic levels. Here’s another couple of tests. A PLA2 test. I won’t go
into detail on it, but it’s monocytes. They come in, they find problems in the
plaque. With plaque, they start releasing plaque to Lp-PLA2. We can
actually test for that. And as you can see here, oxidized LDL actually drives
plaque to microfiber expression. You get this with myeloperoxidase as well. It’s
another enzyme. It’s released by the cells. So if you’ve got this going on
microscopically, this is what it looks like. You’ve got immune cells. You’ve got
monocytes. You’ve got what we call polymorphs. They’re releasing what we
call “cytokines.” They’re releasing the… polymorphs or neutrophils are
releasing MPO. And monocytes are releasing PLA2. And guess what? That’s
what we see on this blood test. Wouldn’t want to know if that’s what’s going on,
assuming you do. Let me suggest that you consider that webinar series. In other
words, the lab screening program. Thank you very much for your interest. This is Ford Brewer. I started off my career
as an ER doc. And that can be frustrating because most of the things bringing
patients into the ER can and should be prevented, like heart attack and stroke.
So I went to John Hopkins for training in prevention. Did well ended up running
the program, trained dozens of docs there, and have trained hundreds and even
over a thousand doctors since then in preventing disease. What’s even more
important is I’ve helped thousands of patients prevent heart attack at stroke
rather than waiting for the devastation and hoping for a cure.