People ask me you know we get really confused about this whole issue of calcified plaque
one thing that will happen is I'll get people come in with a calcium score of a hundred
they might be obese they might get started with us we might find significant prediabetes or even
diabetes they get focused they drop their carbs they lose 30 pounds and they expect
to do another calcium score and at least have a hundred or maybe even reverse that
and then they'll turn around and instead of reversing it they'll have an increase up to 400
or 600 or more I had a patient just a few weeks ago who went from 300 when he first saw me
did all of that stuff lost over 40 pounds dropped his blood pressure had to go off of blood pressure
medications all the right stuff but instead of having a decrease on that 300 of calcium he had
an increase and it was like oh my God are you sure we did the right thing and it's you know
he's fine now he understands where he is but it's just something that takes people a little bit of
time to work through because they've heard this if you've heard it once you've heard it a thousand
times and I'm sure both of you have heard it increased calcium score means increased risk
so why Brewer would you want to get people increase their calcium well here's the thing when
you've got acute hot liquid plaque it's full of liquid it's full of immune cells your immune cells
are attacking the plaque and when you stabilize it you pull that liquid out you pull the immune
cells out they're no longer attacking the plaque but it's sort of like a cut on your arm or in your
skin when you heal cuts sometimes they calcify and that's exactly what happens with these if
you don't believe it here's a very clear article that shows the difference this was a person with
very little calcium in their plaque then you take a look obviously you can just see from the right
much more calcium at this point if you want to be objective about it they were objective they
did an optical counter for these obviously much more black in this image and much more
white or calcium in this image and here's what happened in terms of events the calcified people
had another event in their group early on but they stopped meanwhile those people that did not
develop calcium continued to have more and more events so as you see the people with soft plaque
had 29 events total this is out of about 100 and the people that had that calcified their plaque
had four events occasionally you can get some inkling from a CT angiogram you can never
get this from a calcium score the only place that you're reliably going to get it is from a
CIMT and here's where you'll see this so if you look down under comments the following values
are the largest intima-media thickness test measurements in other words discrete plaque areas
1.3 millimeters or higher so as you can see this is mine I have a discrete plaque in my right bulb
a discrete plaque oh that's the only place I have one so you see that H next to that 1.6
what that stands for is heterogeneous and what that means is a moderate amount of calcium
in other words it's no longer soft so in other words you can see soft
or stable calcified plaque on a CIMT you really cannot see soft plaque on any other type of study
so I'd like to talk with you a minute about the webinar people don't understand what the webinar
is it's actually a great way to get some access to healthcare that you're just not going to
get any other way you actually get the lab tests yourself for at a local lab a Quest lab near you
for the inflammation panel and the OGTT and the insulin survey these are things inflammation and
prediabetes that your doctor just does not know about and here's the thing Harvard Health and many
others have said look sudden death is not always so sudden the Hollywood picture that it's a bolt
out of the blue is not realistic it's more like real lightning preceded by clouds wind and rain
stop that metabolic storm before the lightning strikes and here's where that metabolic storm
comes from it's inflammation and it has to do usually with prediabetes so again we actually
get labs we go over them in the webinar and then you can start finding out how you can
prevent that heart attack others said that you couldn't even predict we can show you how thanks