IMT. So just one thing I did want to show you. You know we keep talking about you
get a flow study. This is the common carotid. That should be the internal
and external carotid. This is the bulb. So hemodynamically, anytime you have a fork
in the road, you're going to get turbulence quite often. You're going to
get... if you're going to get a discrete plaque, you're going to get it here. Here
is the intima, this white... thin white line. Here's the media, the muscle layer, the
thicker white line. And that's the distance We take a flat space of at
least a centimeter. That's part of what Laura's having to do back there. She has
to know you know how to find your anatomy, how to find a good flat place
in your common carotid, so they can do this. They then have technology which
will go in, take 600 cuts... not physical cuts... cuts in the image, and measure them.
And that is what will show your arterial age. So as you see up here, the external
carotid is going to muscles in your face. Yyour internal carotid is what's going to
your brain. And for most of it, the internal... most of us, the internal carotid is a
bigger artery. For those of us that it isn't, no comment.
A landmark study is called the CAFES CAVE study. Here's what... here's the... to cut
right to the chase, here the people... this makes a big difference about. We
always knew if people didn't have plaque, they weren't at risk. We always knew if
people had risk if you have plaque impacting your flow. You know those for
everyone. CIMT. You can find there's at least three or four hundred regular
ultrasounds which people keep bringing in to me thinking they've got to CIMT.
They're looking at that. And if they have a positive on that area on this one, if
they have a positive on this, their 10-year event rate is 80%. So
this is without treatment. Don't panic. But here's where I fell. And here's where
a whole lot of people fall. You think you're doing great, and you've got no
impact on your flow study. But we do it - CIMT - and sure enough, you have plaque
40% event rate over the next 10 years. Are you feeling lucky? Again, don't panic,
that's untreated. And that's why the CAFES CAVE study obviously never been
repeated. I'll just skip over there. Discrete plaque right there. Again, it's
in the bulb. That's where we're most likely to see it. I've got three or four
hours worth of video, free videos for you or anybody else out there with the one
of the world's experts. He's played a big role in this. He actually graduated... he
got a doctorate in healthcare quality, and that's the big bugaboo with this,
trying to make sure or making sure that you're getting the exact same view, the
same cut. So you've got to make sure that these folks are very, very good. And she
is Laura's... actually Brad's niece. by the way. I met her through Brad. So he's
very good. Todd Eldredge is very good at making sure these people do the right
job every time, and it's comparable to other people doing the same job.
This is a slide I borrowed. I don't know how to do that kind of transition stuff.
But the bottom line again is it's the folks that have... the folks that already
have impact on their flow. They are... they're in serious trouble, and most of
them already know it. The surprises and the real value that you get from this is
when you didn't have an impact on flow. This is mine, I think, so big
surprise. I went in, I got my first CIMT at age 57, expected to do some victory
laps because I've always practiced what I've preached in terms of healthcare.
I've been... I thought I was a poster boy for health for our lifestyle. As I've
mentioned, I've got some epigenetic challenges and some genetic challenges
too and I probably should have been taking what I need. I lost 10 pounds. I added a
statin. The statin haters out there, I know I want to and I still am, but I
added a statin. And if you look in the science, here's the thing. One of them, it
isn't... well now you can see significant drops in plaque when you've got two
things. Somebody that's virgin to statins, they've never had statins before.
And number two, their plaque is less than three years old. So we're having a
conversation about this last night, and Doug was saying, well, how did you know
that your plaque was less than three years old. Well, I actually started
developing hypertension about a year and a half before that. Okay. I do... I am gonna
take five more minutes. I'm sorry, I do want to make this one thing. Yes, the
new calibration of the instrumentation to your new group here did your CIMT
test get worse. I just went, I just blitz through that. So you know you
ever heard about, oh the hospital's got a new MRI, it's got a four Tesla instead of
one or two. I don't know that stuff very well. Some of your tech guys made
you ever heard of that technology marches on things get machines get
better and better and better. Todd made an adjustment in his machines
which made them far better at picking up plaque what about a half a year and a
half ago. And it just rippled right through my population because everybody
said, I got a huge increase. Well, I did too, and I just I got used to talking
them down out of a tree. And that's actually what happened to Jon Lorscheider.
He got a big increase despite the fact that he'd lost 40 pounds. He'd gone
from having a blood sugar routinely up in 2 and 3 hundred area down to a hundred or
less. And his CMT looked like it went up. Yeah, and in fact, that's why I went ahead
and said, well, darn, I'm just going to get another calcium score. So nothing is
that simple, is it? Here's the problem to CIMT, and here's why it's so hard.
Here's what Laura is so good at Everybody, once you see that picture, you realize
perspective matters, doesn't it? And here's what we're wanting to look at.
We're wanting to see make sure. So when I take the ultrasound wand, I
actually trained in this but it never got good enough to do it, don't trust me
if I try to do it for you.
You see the plaque on the backside of the artery. Well, obviously, if
they came in from here, that's a very different number from coming in from
here. And that's the problem with getting a good CIMT.
Did you want to go to the intense experience in Louisville but just didn't
have that kind of money or time? Take a look. We've got another one coming
up in Orlando, February 28th. There's a way to save a lot of money on it as much
as 50% off. take a look.