Dr. McChord you want to go ahead and introduce yourself to us
hey good morning Dr. Brewer and good morning to all the PrevMed tribe thank you for having me join the
program today it's been an honor to make your acquaintance and to collaborate on uh not only
rehabilitating my own health but working in this world of educating people on cardiovascular risk
and prevention just about two years ago last week marks the two-year anniversary since I survived
a heart attack and that came as quite a surprise because at the time I did not exhibit any of
the typical characteristics of someone you would expect to have an MI my weight was appropriate I
had already made some positive changes in my life recovering from some years of extraordinary stress
the red flags that would have alerted us to the danger of an impending heart attack
only appeared in hindsight I suppose that's always the way hindsight 20/20 we're doing some
Monday morning quarterbacking but I had quite an experience was hospitalized multiple times
underwent several cardiac procedures underwent two rounds of cardiac rehab and so now in the
two years since that has changed my professional focus in the direction of my practice and now to
begin to deconstruct the story that takes us back about six or seven years earlier for a completely
unrelated reason unrelated to my liver I underwent a CT scan of the abdomen and fatty liver was
one of the incidental findings well upon follow-up for the other issue the fatty liver was brought up
only because I brought it up with a physician who uh ordered the scan and in our discussion
well Kevin this is a common condition lots of people have it watch your fat intake and try to
reduce your weight take some vitamin E but there was no other specific guidance provided to me and
I'm an MD you know and I was talking to a colleague who I know and trust in his area of expertise you
know it was explained as though it's a common finding we see it frequently just pay attention
to it if it gets worse we'll make a referral well I had to learn I had to educate myself on this
but in the meantime there were a number of other stresses in life that's a broader story dealing
more with some of the roots of what influences our health and well-being my own diet nutrition
my own stress level the presence of toxic and stressful relationships and employment situations
nutrient deficiencies irregular sleep patterns all of those things were present as I progressed
through those years prior to a heart attack I actually experienced an episode of a DVT we never
could figure out where that was coming from let me interrupt with a couple of definitions we'll
get to DVT in a second but a minute ago you said you had an MI yes for those who don't know that
stands for myocardial infarction and that stands for heart attack explain for the non-physicians in
the group what we mean by DVT so I experienced a blood clot in my leg now that was after
you think of of things that may provoke a blood clot in the leg I hadn't done any long-distance
travel I hadn't undergone any major medical procedures I hadn't been hospitalized you weren't
a smoker were you I'm a lifelong non-smoker so at the time my BMI was somewhere between
25 and 30 so I qualified as overweight but on a day when I was out hiking I had a hiking boot
tied on perhaps a little too snug around my calf and after that it lit up an episode of
inflammation in my leg eventually resulted in a blood clot that resolved this is another one
of the clues as we look back there was something really wrong there was something driving massive
inflammation in my system until finally that day when I experienced chest pain and I had already
undergone a stress test I'd passed the stress test it's not that it was a bad test it was just the
wrong test for my situation so I'd already been through a battery of tests I had finally turned
the corner was making changes healthy lifestyle changes was dropping way and according to the
good old Framingham risk calculator I got a pat on the back from my primary physician and he said
Kevin whatever you're doing must be working keep up the good work the Framingham risk calculator
says you've got less than a three percent risk over ten years four months later I was lying in
a hospital bed with a collection of stents I just survived a widowmaker heart attack event
so that sounds like you're not such a big fan of Framingham at this point
we all know there are better ways of doing this this audience in particular is well aware
could I just put that in perspective you know I mentioned that book that we're working on in
the headaches associated with it but that book is about this issue you know the typical thing
when you go in to see your doc is he'll do a Framingham that's a risk estimator based on
mostly on information coming out of the Framingham research program in Framingham Massachusetts about
an hour outside of Boston there are problems with it one of the biggest problems is that it for
most people it doubles your risk of having a heart attack inappropriately and the question is can you
fix that no not really because the previous ones are even worse they're based on epidemiological
studies and as Kevin has just pointed out you know it can go the other way as well and so then the
next thing that happens is your doc will say well why don't we get a stress test stress tests about
a third to a quarter of them are false positive or false negative false negative is a problem you
had a false negative Framingham false positives on stress tests end up taking most people into
the cath lab once you get into the cath lab most cardiologists will go ahead and get you
to sign off on doing the stent before they even put you under so that's that just evil triangle
stress test cath lab and stent the reality is what you need to know is your metabolic risk you need
to know whether you have plaque it's a totally different story so thanks for letting me put that
plug in for a different orientation on medicine back with your story well after that event
as I recall lying in a hospital bed I uh came across a series of videos from a Dr.
Brewer in Lexington who at that time was still holding pieces of paper up against the camera to
illustrate to illustrate the point of his teaching and I thought to myself I need to meet this man so
we connected a few months later and it was only at that point that we finally unraveled the mystery
of what had been occurring and that was insulin resistance so it was a core component that helped
explain a lot of these smoking guns that we were finding in my medical history and it was only when
we began to tackle that issue head on understand not only the metabolic markers that were out of
range but what do those markers mean what do they indicate secondly how hot is the fire inside what
can we learn about numbers that measure or assess vascular inflammation and then the third component
is how do we appropriately assess the presence of plaque what is the plaque burden in the body now
in my case I already knew that I had it but bear in mind that even my interventional cardiologist
was very surprised that someone at my age and with my medical profile had such extensive coronary
disease his job is to be an expert plumber so he got me out of trouble when I needed it
so thankfully there was a high-level intervention and actually required several of those procedures
but on the back end of it then prescribing high-dose atorvastatin there wasn't much more
that in a daily aspirin wasn't much more to offer so that was a completely different discipline and
lifestyle change Kevin did you have a stent as a treatment directly for your heart attack I did yes
so that is what stopped the event I continued to experience some unstable angina and I had to
go back in just another point for orientation for folks you hear me time and time again talk about
how a stent won't prevent heart attacks correct stents are very much indicated and life-saving
when you're able to give a stent as a treatment for an active heart attack the major issue is
90% of stents were not done for treatment of a heart attack 90% of stents are done to prevent a
heart attack and they just don't work for that purpose you're bringing up some great teaching
points Kevin thank you you are welcome my life and my career at this point pivoted into redeeming
this whole experience for something far far more beneficial a huge number of people experience a
first-time cardiac event without really any prior warning or other issues have escaped
they've passed beneath the radar until ultimately someone is in deep trouble or they don't survive
or they survive the event with permanent disability afterwards being aware of that now
a lot of cases that I have seen through my career suddenly begin to make sense where I had some
gut level suspicion there were greater issues at stake and merely throwing a statin or medications
after a particular problem all we were trying to do is adjust a particular lab number not
really understanding the importance of that lab number what does that mean what's going on inside
someone what kind of internal chaos is present and how can we correct that chaos and quiet
that fire and that is ultimately what reduces someone's risk we're not really looking to take
somebody's numbers necessarily and correct them to perfect levels but we are looking for progress
we're looking for improvement and I believe that is where significant risk reduction and improved
quality of life occurs so Kevin you've added some new capacities some new services to what you do
a little bit about that yes so my wife and I have a uh we're a husband and wife team in her career
in uh medical management and uh administrative capacity she's had her own health challenges
we have a partnership that we call 2nd Chance Health PLLC there's our effort to redeem our own
experiences for the benefit of others at large everybody deserves a second chance we're thankful
for our own second chances and want to see that spill over to other people so we're taking this
combination what we've known out of the world of conventional health care we don't want to
completely disparage pills and procedures where necessary there is an appropriate place for them
but we want to do more than just merely perpetuate someone's diagnosis or their pathology we want to
get over to the other side of this thing where can we really leverage health and that's getting
into the root issues of how diet and nutrition how exercise or sleep pathology uh poor oral
health exposure to toxins toxic relationships or environment how nutritional deficiencies
affect someone's health we don't have a way to prescribe that those things don't come in a pill
bottle and there certainly isn't a procedure for that so that really requires a partnership with
health care providers who want to see you regain your resilience uh your vitality we're looking
to coach up those opportunities that restore someone's health their capacity for healing their
energy level and that requires a great deal of accountability we're not just merely in the role
as health care providers brokering prescriptions to everyone this is a collaborative situation
people need to be engaged in their own health this is a health care stewardship proposition
we're here to help guide and coach to collaborate and then there is a level of accountability that's
expected as well where can we use labs then not just to monitor how well a particular intervention
is coming along but how well are you managing your health are you aware of these numbers
what they mean how they serve as guideposts and opportunities then for further improvement it's
a story we'd like to see people avoid events like I experienced on the other hand most of us get to
a point in our lives in our careers where we're stuck we really don't realize the danger we're
in there's a great deal of self-denial and we just we're on a hamster wheel we're stuck
we're stuck and sometimes it takes some real honesty from a health care provider to come
alongside you and say with a healthy dose of some truth and identify opportunities for change
continue to get great feedback regarding the webinars and here's why you know on the
internet when you hear a webinar you expect for somebody to try to sell you something we're not
doing that we're trying to tell you something people are coming in with their labs from Quest
inflammation panel OGTT insulin survey response and then they're finding out do
I have inflammation do I have insulin resistance and where does that fit in terms of other folks
we're getting ready to start one for CIMT as well so again people are really
excited about finding out their own status looking forward to seeing you there thanks