Experiencing The Down Spiral of Life

One of the most difficult concepts for me to fully understand and work with in college is the concept of entropy.  I remember sitting in my physics, thermodynamics, and computer information courses at the university and thinking of how difficult such a simple concept really was.   The one important thing that I learned at the university is that one can never stop entropy. It will conquer our thoughts, our health, our lives, in fact, eventually it will conquer the universe.   Entropy, of course, is the degree of disorder or uncertainty in a system.  In a very simplistic and generic sense, it is the measure of a system's energy available for doing useful work.  It does not matter if you are a biologist, a chemist, a physicist, a psychologist, or a philosopher, it applies to you.

 

One interesting trait about me, and maybe everybody has the same trait, is that every morning I wake up with a song or music theme in my mind and/or a topic, concept or idea that gnaws at my brain until it dissipates and eventually I don't think about it anymore.  These thoughts could last a few minutes, or a few hours,  or sometimes the song or idea can stay with me all day until I go back to sleep in the evening.  The song in my mind this morning was "Over the Rainbow," and the topic was entropy and how it is contributing to the downward spiral of life.

 

Having gone though heart surgery, and most recently, a cardiac catheterization to unclog and open up my arteries, I can see entropy at work in my blood circulation system.  In almost 76 years, my system's ability to do useful work has been compromised and it is getting worse.  Sure, friends try be optimistic and give "good" recommendations on what to correct the problem.  These usually fall in two categories:  healthy diet and exercise.   But at my age, "that ship has sailed,"  or "That train has left the station."  That doesn't mean that I might not be able to get some benefit from  a healthy diet and exercise, but not to a point where you reverse the process.   Entropy is a bitch and it's going to beat you. 

 

I have read several studies from the NIH National Library of Medicine and many of them come to similar conclusions:  What you eat has some influence on the cholesterol levels in your blood, but not that much (see excerpts below).   In fact, "only about 20% of the cholesterol in your bloodstream comes from the food you eat. Your body makes the rest."  Nonetheless, I am going to modify my diet so as to reduce the entropy of my circulation system, and maybe extend my life by a few percentage points.  I know what needs to be done, but it requires changing habits and reducing the types of  food that really make me happy.

 

The main problem is that I have a system that is too efficient in producing cholesterol.  I have been told by several doctors in the past thirty-five years that my body produces more cholesterol than what it needs.  That leads me to conclude that my body produces a lot more than 80% of what it consumes and it could be as much or more that 100%.  In fact, my cholesterol levels thirty years ago were in the 400 mg/dl range.  Even if I could live on lettuce, carrots and water, my cholesterol levels would still be about twice the average.   In my case, the recourse is statin medication.   I am taking a high dosage of atorvastatin now but for many years my dosage was below what I needed.   Of course, with that medication comes side effects then you have to take other medication to counteract the side effects.  This can get to be a never-ending story of medication and counter medication, and it does not even include the many other medications I have to take for other medical conditions such as high blood pressure.

 

In addition to the entropy in the circulatory system that I am trying to reduce, I have to be concerned about the entropy in cell duplication and cell production.  The body is an extremely complex system, made up of very complex subsystems and more complex sub-sub-systems down to the cell level.  They are all affected by entropy at every level.  Cancer is a fundamental product of entropy in cell replication, and yes, I have that condition as well.  What is the strategy for controlling entropy in cell replication?   At this stage, it is a "wait and see" approach.  And, what is a "wait and see approach" you ask?  At my age, I have to risk projecting the number of years I have to live given other ailments, and compare that to the rate of cancer growth where it would develop to a point it would severely impacts my health or kill me.  If it's the former, no treatment required since I would not be alive to see the final effect of cancer.  If it's the latter, go for some treatment.  Of course, treatment also has side effects and those mean more medication and higher entropy rates in other organs.  You can't escape the old saying:  Life's a bitch and then you die.

 

The second recommendation that friends like to give you is "exercise and lose weight."  Losing weight is more associated with the diet and not so much with the exercise, but I'll talk about that later.  Exercise is an interesting thing that entropy seems to effect.  When I was young, in my college years, I, like most people my age, seemed to have unlimited energy and could do almost unlimited things.  For example, a typical day during my college years consisted of working full time, going to school full time, train and play soccer with the university team, swam a couple of miles per day, play several games of racquetball per week, was married and had a child and attended college parties.  Do I do that now?  No.  Could I do that now?  Possibly not.

 

Somewhere between 20 years old and up to about when I was 65 years old, the useful use of my energy was reduced tremendously.  Entropy snuck in there without me realizing what was happening.  Although up until a year ago, I was still very active, walked six to ten miles per day, carried out tasks with lots of physical activity around the house, read, wrote and travelled during inactive times and generally maintained a higher than average level of productivity for my age.  The arterial blockage caused me to have a lower level of productivity and just about stopped all physical activity.  This resulted in two things, I had more time to eat and I gained weight.  So, lack of exercise does results in weight gain, not because exercise made you lose weight, but because lack of exercise gave you more disposable time that you used to eat, and because eating became a substitute for exercise.  So here you have a 75 year-old man, unable to do physical activity because of a heart condition and with a lot of disposable time and opportunity to eat.

 

The heart condition accelerated the entropy of the body, and that accelerates the downward spiral of life.  You would think that those conditions would sum up the deterioration of life, but nooooo!  The deterioration of your organs and body systems only accelerates other entropy effects in your life.  For one thing, you become more isolated, not only because you have less physical stamina to do things that have to be done like household maintenance; taking care of the home yard and garden; travel to see friends and family; and participate in recreational activities such as hiking, swimming, biking and outside games.  You also become more isolated because some of your life-long friend began to die.  Week by week and month by month your circle of life-long friendships and family members is reduced.

 

Communication links that you took for granted are no longer there.  You may find value and meaning to your life in supporting your spouse, parent, family member or friend with their medical problems.  You provide hope as much as you can with the realization that you will lose them.  Althought you read and are told it is not important, but your sex life is reduced or eliminated and you have no one, or few people left with whom you can communicate your concerns, your fears, your thoughts and your wishes.  Entropy hits your psychological make up in ways that you least expect it and in ways that you are not prepared to handle.  Some relationships that you had since childhood, over seventy years, can never be replaced or rebuilt.  Feelings of isolation, depression, and even rejection begin to enter your mind.  Strength of will, and in some cases, connections with family and the remaining friends help you keep psychological entropy from accelerating, and for some time, maintain control of your sanity.  Some people my age or older reach release of this psychological pain through an onset of dementia.   Not a desirable solution, since you have no control of it and it brings its own problems.

 

Entropy always increases with time.   This is the second law of thermodynamics, and it is telling us that no matter how healthy you eat, how well you maintain your body through exercise and  how well you maintain your psychological state, sooner or later the entropy in cell regeneration of the body and  the function of your body's systems and subsystems will no longer be capable of maintaining order and you will cease to function. 

 

Does the end come when the energy in our body can no longer be converted to useful work?  For our being, yes, for our fundamental elements, No.  For some of us the next stage is to be "recycled" into the earth and might be absorbed by some living organisms; bugs, trees, animals, possibly other human beings in some near future time.  For the farther future, our component elements, will be scattered throughout the universe in about five billion years.  With luck, will be combined with "stardust" from other stars and possibly be combined to form other living systems somewhere else in the universe.  With luck, we might be recycled to be part of other beings' fragile, short lived systems.  After that, trillions of years in the future, we will be just dark cold matter scattered loosely throughout the universe.

 

However, for the present, I will try my best to slow down entropy in my body's systems with the objective of allowing me to extend my body's functions for at least for a month or two, maybe a year more than the average functioning time for a human body, I would like to celebrate my youngest son's 30th birthday.  I feel very bad for my dog Milo.  Entropy is claiming his body seven times faster than me.  I often wonder what I can do to get maximum satisfaction of my remaining time. 

 

I can see why people write autobiographies and start giving away things they value to family and friends they think will enjoy them.  Maybe I'll start an autobiography.  I wonder if anybody would be interested in reading it.  But for now the best thing I can do is visit with family and friends, and without being too obtrusive soak up some of their excess energy and share some of mine.  As for the song in my mind that I awaken with this morning, I can still hear Judy Garland in my mind singing: "…Birds fly over the rainbow, why then, oh, why can't I?"

 

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Excerpts  from a couple of NIH articles.

From:  The Role of Dietary Cholesterol in Lipoprotein Metabolism and Related Metabolic Abnormalities: A Mini-review

Fatemeh Ramezani Kapourchali  ¹ , Gangadaran Surendiran  ² , Amy Goulet  ² , Mohammed H Moghadasian  ^{1   2}

 

"Clinical studies have demonstrated that in humans consuming a typical Western-type diet, decreasing the amount of dietary cholesterol intake results in only small changes in low-density lipoprotein (LDL)-cholesterol and little or no change in the ratio of total cholesterol to high-density lipoprotein cholesterol. These findings are better appreciated when all sources of cholesterol entering the intestinal lumen are considered. Only a third of intestinal cholesterol per day is derived from the diet. Cholesterol from endogenous sources, including the bile and intestinal epithelial cells, represents the majority of cholesterol absorbed and subsequently formed into chylomicrons and secreted into the circulation."

 

From:  How it’s made: Cholesterol production in your body

February 6, 2017

Only about 20% of the cholesterol in your bloodstream comes from the food you eat. Your body makes the rest.

Cholesterol has a bad reputation, thanks to its well-known role in promoting heart disease. Excess cholesterol in the bloodstream is a key contributor to artery-clogging plaque, which can accumulate and set the stage for a heart attack. However, the role of cholesterol in your body is not all negative.

To fully explain cholesterol, you need to realize that it's also vital to your health and well-being. Although we measure cholesterol production in the blood, it's found in every cell in the body. The Harvard Special Health Report Managing Your Cholesterol explains cholesterol as a waxy, whitish-yellow fat and a crucial building block in cell membranes. Cholesterol also is needed to make vitamin D, hormones (including testosterone and estrogen), and fat-dissolving bile acids. In fact, cholesterol production is so important that your liver and intestines make about 80% of the cholesterol you need to stay healthy. Only about 20% comes from the foods you eat.

 

Experimentando la Espiral Descendente de la Vida

Uno de los conceptos más difíciles para mí en la universidad fue entender el concepto de entropía y poder trabajar con él.   Recuerdo estar sentado en mis cursos de física, termodinámica e información informática en la universidad y pensar en lo difícil que realmente era ese concepto tan simple.   Lo importante que aprendí sobre entropía en la universidad es que uno nunca puede detenerla. La entropía conquistará nuestros pensamientos, nuestra salud, nuestras vidas, de hecho, eventualmente conquistará el universo.   La entropía, por supuesto, es el grado de desorden o incertidumbre en un sistema.  En un sentido muy simplista y genérico, es la medida de la energía de un sistema que es disponible para hacer un trabajo útil.  No importa si eres biólogo, químico, físico, psicólogo o filósofo, se aplica a ti.

 

Un rasgo interesante que tengo, y tal vez que todos tenemos, es que cada mañana despierto con el tema de una canción en mi mente y / o un tema, concepto o idea que roe mi cerebro hasta que se disipa y eventualmente se borra de mi mente.  Estos pensamientos pueden durar unos minutos, o unas horas, o a veces la canción o la idea pueden quedarse conmigo todo el día hasta que vuelvo a dormir por la noche.  La canción con que desperté  esta mañana es "Over the Rainbow,"  y el tema, entropía, y cómo está contribuyendo a la espiral  descendencia de la vida.

 

Después de haber pasado por una cirugía cardíaca y, más recientemente, un cateterismo cardíaco para destapar y abrir mis arterias, puedo ver entropía en la función de mi sistema de circulación sanguínea.  En casi 76 años, la capacidad de mi sistema para hacer un trabajo útil se ha visto comprometida y está empeorando.  Claro, los amigos tratan de ser optimistas y dar "buenas" recomendaciones sobre como puedo corregir el problema.  Estas recomendaciones generalmente se dividen en dos categorías: dieta saludable y el ejercicio.   Desgraciadamente, a mi edad, "ese barco ya se fué" o "ese tren ha salido de la estación".  Sin embargo, eso no significa que no pueda obtener algún beneficio de una dieta saludable y ejercicio, pero no hasta un punto en el que se revierta el proceso.   La entropía es una perra y te va a vencer.

 

He leído varios estudios de la Biblioteca Nacional de Medicina de los NIH y muchos de ellos llegan a conclusiones similares: lo que comes tiene alguna influencia en los niveles de colesterol en la sangre, pero no tanto (ver extractos a continuación).   De hecho, "solo alrededor del 20% del colesterol en el torrente sanguíneo proviene de los alimentos que se consumen.  El cuerpo produce el resto".  Sin embargo, voy a modificar mi dieta para reducir la entropía de mi sistema circulatorio, y tal vez extender mi vida en unos pocos puntos porcentuales.   Sé lo que se tiene que hacer, pero requiere cambiar los hábitos y reducir los tipos de alimentos que realmente me hacen feliz.

 

El problema principal es que tengo un sistema que es demasiado eficiente en la producción de colesterol.  Varios médicos me han dicho en los últimos treinta y cinco años que mi cuerpo produce más colesterol del que necesita.  Eso me lleva a concluir que mi cuerpo produce mucho más del 80% de lo que consume y podría ser tanto o más del 100%.  De hecho, mis niveles de colesterol hace treinta años estaban en el rango de 400 mg/dl.  Incluso si pudiera vivir de lechuga, zanahorias y agua, mis niveles de colesterol seguirían siendo aproximadamente el doble del promedio.   En mi caso, el recurso es la medicación con estatinas.   Estoy tomando una dosis alta de atorvastatina, pero durante muchos años mi dosis fue menos de lo que necesitaba.   Por supuesto, con ese medicamento vienen los efectos secundarios, entonces tienes que tomar otros medicamentos para contrarrestar los efectos secundarios.  Esto puede llegar a ser una historia interminable de medicamentos y contra-medicamentos, y eso ni siquiera incluye los muchos otros medicamentos que tengo que tomar para otras afecciones médicas, como la presión arterial alta.

 

Además de la entropía en el sistema circulatorio que estoy tratando de reducir, tengo que preocuparme por la entropía en la duplicación celular y la producción celular.  El cuerpo es un sistema extremadamente complejo, formado por subsistemas muy complejos y sub-subsistemas más complejos hasta llegar al nivel celular.  Todos ellos se ven afectados por la entropía en todos los niveles.  El cáncer es un producto fundamental de la entropía en la replicación celular, y sí, también tengo esa condición.  ¿Cuál es la estrategia para controlar la entropía en la replicación celular (el cáncer)?   En esta etapa, es un enfoque de "esperar y ver".  Y, ¿qué es un "enfoque de esperar y ver," que preguntas?  A mi edad, tengo que arriesgarme a proyectar la cantidad de años que tengo que vivir dadas otras dolencias, y comparar eso con la tasa de crecimiento del cáncer donde se desarrollaría hasta el punto de que afectaría gravemente mi salud o me mataría.  Si es lo primero, no se requiere tratamiento, ya que no estaría vivo para ver el efecto final del cáncer.  Si es lo último, iniciaría a algún tratamiento.  Por supuesto, el tratamiento también tiene efectos secundarios y esos significan más medicamentos y mayores tasas de entropía en otros órganos.  No puedes escapar del viejo dicho:  "la vida es una perra y luego mueres."

 

La segunda recomendación que a los amigos les gusta darte es "hacer ejercicio y perder peso".  Perder peso está más asociado con la dieta y no tanto con el ejercicio, pero hablaré de eso más adelante.  El ejercicio es algo interesante que la entropía parece afectar.  Cuando era joven, en mis años universitarios, yo, como la mayoría de las personas de esa edad, parecía tener energía ilimitada y podía hacer cosas casi ilimitadas.  Por ejemplo, un día típico durante mis años universitarios consistía en trabajar a tiempo completo, ir a la escuela a tiempo completo, entrenar y jugar fútbol con el equipo universitario, nadar un par de millas por día, jugar varios juegos de racquetball por semana, además estaba casado y tenía una hija y también asistía a fiestas universitarias.  ¿Lo hago ahora?  No.  ¿Podría hacer eso ahora?  Posiblemente no.

 

En algún lugar entre los 20 años y aproximadamente cuando tenía 65 años, el uso útil de mi energía se redujo enormemente.  La entropía se coló allí sin que me diera cuenta de lo que estaba sucediendo.  Aunque hasta hace un año, todavía era muy activo, caminaba de seis a diez millas por día, realizaba tareas con mucha actividad física en la casa, leía, escribía y viajaba durante los tiempos inactivos y, en general, mantenía un nivel de productividad superior al promedio para mi edad.  El bloqueo arterial me hizo tener un nivel más bajo de productividad y casi detuve toda actividad física.  Esto resultó en dos cosas, tuve más tiempo para comer y subí de peso.  Por lo tanto, la falta de ejercicio si resulta en aumento de peso, pero no porque el ejercicio te hace perder peso, sino porque la falta de ejercicio te da más tiempo disponible para comer.  En realidad, comer se convirtió en un sustituto del ejercicio.  Así que aquí tienes a un hombre de 75 años, incapaz de hacer actividad física debido a una afección cardíaca y con mucho tiempo disponible y oportunidad de comer.

 

La condición cardíaca aceleró la entropía del cuerpo, y eso acelera la espiral descendente de la vida.  Uno pensaría que esas condiciones resumirían el deterioro de la vida, ¡Pero no!  El deterioro de los órganos y sistemas corporales solo acelera otros efectos de entropía en la vida.  Por un lado, te aíslas más, no solo porque tienes menos resistencia física para hacer cosas que deben hacerse, como el mantenimiento del hogar; cuidar el patio y el jardín de la casa; viajar para ver amigos y familiares; y participar en actividades recreativas como senderismo, natación, ciclismo y juegos al aire libre.  También te aíslas más porque algunos de tus amigos de toda la vida comenzaron a morir.  Semana a semana y mes a mes su círculo de amistades de toda la vida y miembros de la familia se reduce.

 

Los enlaces de comunicación que daba por sentado ya no existen.  Puede encontrar valor y significado para su vida en apoyar a su cónyuge, padre, familiar o amigo con sus problemas médicos.  Proporcionas esperanza aunque sabes de que los perderás.  Aunque leas y te digan que el sexo no es importante, reconoces que tu vida sexual se reduce o se elimina.  Más no quedan amigos, o quedan pocas personas con las que puedas comunicar tus inquietudes, tus miedos, tus pensamientos y tus deseos.  La entropía golpea tu composición psicológica de la manera que menos esperas y de maneras que no estás preparado para manejar.  Algunas relaciones que tuviste desde la infancia, por más de setenta años, nunca pueden ser reemplazadas o reconstruidas.  Los sentimientos de aislamiento, depresión e incluso rechazo, comienzan a entrar en su mente.  La fuerza de voluntad y, en algunos casos, las conexiones con la familia y los amigos restantes te ayudan a evitar que la entropía psicológica se acelere.  Y, durante un tiempo, eso te ayuda a mantener el control de tu cordura.  Algunas personas de mi edad o mayores llegan a la liberación de este dolor psicológico a través de el inicio de demencia.   No es una solución deseable, ya que no tienes control de ella y trae sus propios problemas.

 

La entropía siempre aumenta con el tiempo.   Esta es la segunda ley de la termodinámica.  Nos dice que no importa cuán saludable comas, qué tan bien mantengas tu cuerpo a través del ejercicio y qué tan bien mantengas tu estado psicológico, tarde o temprano la entropía en la regeneración celular del cuerpo y la función de los sistemas y subsistemas de tu cuerpo ya no serán capaces de mantener el orden y dejarás de funcionar.

 

¿Llega el final cuando la energía en nuestro cuerpo ya no se puede convertir en trabajo útil?  Para nuestro ser, sí.  Para nuestros elementos fundamentales, No.   Para algunos de nosotros, la siguiente etapa es ser "reciclado" en la tierra y nuestros componentes podrían ser absorbidos por algunos organismos vivos; insectos, árboles, animales, posiblemente otros seres humanos en algún futuro cercano.  En el futuro más lejano, nuestros elementos componentes estarán dispersos por todo el universo en unos cinco mil millones de años.  Con suerte, se combinará con "polvo de estrellas" de otras estrellas y posiblemente se combinará para formar otros sistemas vivos en algún otro lugar del universo.  Con suerte, podríamos ser reciclados para ser parte de los sistemas frágiles y de corta duración de otros seres.  Después de eso, trillones de años en el futuro, seremos solo materia fría oscura dispersa libremente por todo el universo.

 

Sin embargo, por el momento, haré todo lo posible para frenar la entropía en los sistemas de mi cuerpo con el objetivo de permitirme extender las funciones de mi cuerpo durante al menos un mes o dos, tal vez un año más que el tiempo promedio de funcionamiento de un cuerpo humano, me gustaría poder celebrar el cumpleaños número 30 de mi hijo menor.  Me siento muy mal por mi perro, Milo.  La entropía está reclamando su cuerpo siete veces más rápido que yo.  ¿A menudo me pregunto qué puedo hacer para obtener la máxima satisfacción de mi tiempo restante?

 

Ahora puedo ver por qué las personas escriben autobiografías y comienzan a regalar cosas que valoran a familiares y amigos que creen que las disfrutarán.   Tal vez comience una autobiografía, pero me pregunto si alguien estaría interesado en leerla.  Pero por ahora, lo mejor que puedo hacer es visitar a familiares y amigos, y sin ser demasiado molesto absorber algo de su exceso de energía y compartir de la mía.  En cuanto a la canción en mi mente con la que me despierto esta mañana, todavía puedo escuchar a Judy Garland en mi mente cantando: "... Los pájaros pueden volar sobre el arco iris, ¿por qué entonces, oh, por qué yo no?"

 

 

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Extractos de un par de artículos de los NIH.

 

De: El papel del colesterol dietético en el metabolismo de las lipoproteínas y las anomalías metabólicas relacionadas: una mini revisión

Fatemeh Ramezani Kapourchali 1, Gangadaran Surendiran 2, Amy Goulet 2, Mohammed H Moghadasian 1 2

 

"Los estudios clínicos han demostrado que en los seres humanos que consumen una dieta típica de tipo occidental, la disminución de la cantidad de ingesta de colesterol en la dieta da como resultado solo pequeños cambios en el colesterol de lipoproteínas de baja densidad (LDL) y poco o ningún cambio en la proporción de colesterol total a colesterol de lipoproteínas de alta densidad. Estos hallazgos se aprecian mejor cuando se consideran todas las fuentes de colesterol que ingresan a la luz intestinal. Sólo un tercio del colesterol intestinal por día se deriva de la dieta. El colesterol de fuentes endógenas, incluidas las células biliares y epiteliales intestinales, representa la mayoría del colesterol absorbido y posteriormente formado en quilomicrones y secretado en la circulación".

 

De: Cómo se hace: Producción de colesterol en su cuerpo

febrero 6, 2017

 

Solo alrededor del 20% del colesterol en el torrente sanguíneo proviene de los alimentos que consume. Tu cuerpo hace el resto.

 

Cholesterol has a bad reputation, thanks to its well-known role in promoting heart disease. Excess cholesterol in the bloodstream is a key contributor to artery-clogging plaque, which can accumulate and set the stage for a heart attack. However, the role of cholesterol in your body is not all negative.

 

To fully explain cholesterol, you need to realize that it's also vital to your health and well-being. Although we measure cholesterol production in the blood, it's found in every cell in the body. The Harvard Special Health Report Managing Your Cholesterol explains cholesterol as a waxy, whitish-yellow fat and a crucial building block in cell membranes. Cholesterol also is needed to make vitamin D, hormones (including testosterone and estrogen), and fat-dissolving bile acids. In fact, cholesterol production is so important that your liver and intestines make about 80% of the cholesterol you need to stay healthy. Only about 20% comes from the foods you eat.

The Next Two Stents

As I mentioned in a previous blog (http://rgrivera.blogspot.com/2023/01/the-arterial-coronary-stent.html), I had a procedure yesterday to unblock a couple of my heart arteries that were measured as 99 % blocked two weeks prior.  The procedure I had yesterday turn out to be a little more complicated that was planned and it ended up taking about twice as long, almost four hours to perform.  Luckily I got to see the actual procedure, that is, the arteries around my heart, in real time on a large TV screen.  The procedure was successful and I lived to see another day, and with luck and some effort, I may get to see many more days.

 

The original objective was to get inside the two arteries, open them up with the balloon and insert a stent to keep it open.  It sounded simple enough, a guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel to allow a wire meshed tube (stent) to be inserted that keeps the artery open and restores proper blood flow to the heart.  But nooooooo!  Nothing on me could be that simple or follow normal procedure.

 

The probe that was inserted through my groin and into the arteries around my heart showed that the blockage was made up of vascular calcification.  Vascular calcifications are mineral deposits on the walls of your arteries and veins. These mineral deposits sometimes stick to fatty deposits, or plaques, that are already built up on the walls of a blood vessel.  Vascular calcifications are common but potentially serious.   

 

When the blockage is "soft" it can be expanded with the balloon and the arterial wall will expand without tearing so as to allow the stent to be placed.  But when it is calcified the blockage is hard and it cannot expand, and if it does it might beak and damage or tear the arterial wall.  In cases such as these, the calcium is either cracked or scrapped and removed before a stent is inserted, or you have to have bi-pass surgery to bi-pass the blocked portion of the artery.  these are normally not done due to the possibility of tearing the artery.

 

Lucky for me, the U.S. Food and Drug Administration (FDA) cleared Shockwave Medical's Intravascular Lithotripsy (IVL) system  about two years ago to treat severely calcified coronary artery disease.   Intravascular Lithotripsy uses sonic pressure waves, also known as shockwaves, that pass through soft arterial tissue and preferentially disrupt calcified plaque by creating a series of micro-fractures. After the calcium has been cracked, the artery can be expanded at low pressure and a stent safely implanted to improve blood flow with minimal trauma to normal arterial tissue.  Cool hah?  is sort of the similar process used to safely break up kidney stones.

 

Again, the team of doctors and nurses I had working on me were professional and efficient.  Although the process went very smooth, there were some tense moments when the IVL was being used and the subsequent expansion of the fractured calcium obstruction was expanded to insert the stent.  Again, because of the radioactive dye that was injected, the whole section of the heart and the arteries being worked on was displayed on several large scaled monitors that I could watch.

 

It is an interesting perspective when one is watching our mortality evolve in front on a large TV monitor.  It is interesting to realize that, if not for a stroke of luck I could have been dead.   The calcium could have broken off and blocked the flow of blood and most likely one would die, or the arterial wall could have been torn and again one would die, or at any time during the process the arterial wall could have torn and again one would die.  I did not know how close to death I was until I saw what was going on and realized the implications.  In fact, except for a quirk of fate, I could have died at anytime in the past several years, when unknown to me, when this condition more severe.

 

Of course, I am not out of danger yet.  This "fix" may buy me a few years, If I'm lucky.  Coronary artery calcification is age and gender-dependent. it affects 90% of men and 67% of women older than 70 years of age.  It is possible that I could have calcifications in other parts of the body.  I need to have a series of test to see if I do have this condition.  I get all types of advice on what to do to improve my condition from diet to exercise and stress reduction. 

 

Diet might have an impact, but cholesterol has a bad reputation, since excess cholesterol in the bloodstream is a key contributor to artery-clogging plaque.  However, the role of cholesterol in your body is not all negative.  cholesterol a crucial building block in cell membranes, it also is needed to make vitamin D, hormones (including testosterone and estrogen), and fat-dissolving bile acids. In fact, cholesterol production is so important that your liver and intestines make about 80% of the cholesterol you need to stay healthy. Only about 20% comes from the foods you eat.  Unfortunately, I was told about 35 years ago that my body produces excess cholesterol.  

 

I am also told that exercise is good for me, and I think it is, but I have also read that exercise increases parathyroid hormone levels which could facilitate coronary calcification. Exercise could also increase atherosclerosis by increasing shear stress in the coronary arteries.   That was a surprise, I always thought it was just the opposite.  A more serious factor for coronary calcification could be stress.   Research indicates that chronic psychological stress can increase the risk of atherosclerotic diseases, including strokes and heart attacks. Chronic stress is pervasive during negative life events and can lead to the formation of plaque in the arteries.

 

I tend to believe that the primary factor, at least in my case, is genetics with diet being the secondary factor.  My father's side of the family, including my father, have lived to their 90s and never displayed any signs of heart decease.   In contrast, my mother's side of the family, including my mother, had heart decease and many died of heart-related problems.  There is some genetic factor that seems to be transferred to the offspring that makes us susceptible to heart decease including coronary calcification.   But regardless of the reason, it Is best to follow a healthy diet, healthy and moderate exercise and a stress free life to avoid heart problems.

 

Again, the team of doctors and nurses I had working on me were professional and efficient.  Although the process went very smooth, there were some tense moments when the IVL was being used and the subsequent expansion of the fractured calcium obstruction was expanded to insert the stent.  Again, because of the radioactive dye that was injected, the whole section of the heart and the arteries being worked on was displayed on several large scaled monitors that I could watch.

 

I hope not to go through that experience again.