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Cardiac Stress Test Echocardiogram up to Max Heart Rate, with a Surgical Mask

re: A Breakthrough Training Day, Followed by an ER Visit for Chest Pain
re: atherosclerosis

I was required to have a COVID test 3 days prior (negative).

With my overly-large lungs working at max capacity, sucking a fucking surgical mask into my mouth on each inhalation on a treadmill is no picnic. No one said a mask would be required during the test, which offends me.

It was only out of respect for the nurses, not wishing to offend them personally, that I wore the mask during the test. After all, they don't make the rules, the cardiologist was out of the office.

How does it make any sense to stress test someone while impairing their breathing?! Or that a fucking surgical mask will do anything, with that large volume of air blasting out top and sides? The medical community has gone fucking stupid.

If the cardiologist insists on us wearing masks during my visit to discuss the results, I might just walk out the door—this COVID theatre has gone too far. I can’t stand communicating face-to-face with masks on—it’s a horrible experience and so it might as well be a Zoom call. And a doctor who is that tied to anti-science orthodoxy has nothing worthwhile to say to me (mask-up is a credibility disqualifier), excepting some obvious heart impairment from the test—that part I would want to know, but I can learn that in an email.

But if it’s “mask up” and let’s talk about statins and the debunked diet cholesterol hypothesis, then I’ll be out of there. Because the only thing I need to know is whether some part of my heart muscle is getting shorted on oxygen at max HR.

Results

Looks like I am clear. In spite of my crummy CT heart calcium scan score and high cholesterol*.

Interpretation Summary
1. There is no evidence of exercise induced myocardial ischemia.
2. Normal resting regional and global left ventricular size and systolic function (LVEF >70%)
3. Excellent exercise tolerance (12:58 minutes, 17.00 MET's).
5. There is a hypertensive response from hypertensive baseline.
6. Mild left ventricular hypertrophy
7. No significant valvular abnormalities
8. PAP 8 mmHg + CVP
9. There is no previous stress echocardiogram study for comparison.

* The diet cholesterol theory is totally unsupported by the evidence, and I reject it as a proxy for heart health. Ditto for statins in the context of 99% of the people who use them.

Experience with the cardiologist, Jan 4 2022.

Worst doctor experience in my life. A paint-by-numbers doctor who did not examine me, did not inquire about familial history, did not inquire about recent health issues, did not ask about diet or lifestyle. Not one question about my concerns, my past, my condition, my history, the timeline for blood pressure changes (or any consideration of its history). He dismissed every idea and question I had, either with evasion (refusal to answer) or dismissal of the idea entirely, claiming in essence that the science was settled. And ignoring my years of hard data relating my own cholesterol levels to body fat with near perfect correlation (dismissively: “no relationship”). He showed ignorance of multiple questions I posed, dimissed other questions out of hand, and refused to provide any explanation for his recommendations, not bothering to make a single factual statement about risk/benefit (I had at least expected the trope about relative risk reduction). A blank stare and no answer when I asked about applying epidemiological data to an individual, followed by “you have atherosclerosis” and showing me (again and again) the model of a heart and emphasizing the meds I needed. He evinced no knowledge of nutrition, nor any knowledge of the role of magnesium in heart health or the BMJ article I referenced, had never heard of studies on cardiac issues for extreme endurance athletes, and as far as I could discern, had never heard of any non-mainstream views on his own specialty. OMG. At best he persuaded me that he had blinders on.

Thus I was reduced to a non-person, my questions and concerns unworthy of any attention. I became a data point of 3 numbers with the take-it-or-leave-it “here are the pills to take”. Fuck me, but I can't think of a much worse experience. Or a more offensive doctor.

His bio is completely misleading as to expertise. Notwithstanding the claims in it, it was obvious he had little to no knowledge of exercise physiology (or at least no inclination to discuss it), and zero credibility in extreme endurance exercise. What a blowhard. This guy is an intellectual dead end, or perhaps he just has contempt for his patients, feeling it beneath him to do anything but hand down from high which meds should be taken for the data point sitting in the chair.

I had not wanted to spend my money coming in, and I explicitly asked what it was about, but his staff misled me when I had questioned the need, by making vague claims about “multiple serious cardiac issues”. Nor could they tell me if it would be $250 or $700. This doctor is a dishonest and disinterested automaton with no respect for patients and no interest in anything but clinical guidelines paint-by-numbers rote practice. The patient and his/her concerns/ideas/history/etc need not exist, as far it I perceived his take. Why would he even see patients in person is baffling (I could have gotten the story in 5 minutes on a zoom call), since he had made zero inquiries and no examination. This doctor did not even have the courtesy to end the conversion formally, but literally walked way. I don’t even know what he looked like, because he was adamant that masks were to be used. I submitted, but I should have known by his dismissive tone that I was headed down a dead-end.

I would not trust my cat with this guy, let alone my own health. I left there learning absolutely nothing, and my blood pressure was surely up 30 points by the end of it. This was modern assembly line medicine. And it’s fucking awful.

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