Having been the recipient of a fortuitous heart
stent placement in my left anterior descending
coronary artery which was 95% blocked along with
being a licensed physician as well as having a
primary care physician for a father to consult,
coupled with a close relationship with my
cardiologist, I feel more qualified than Dr.
Bjiak to speak on the subject of CAD and
obesity. I practice in a rural area of far
Northern California where obesity is rampant.
Diet and exercise are both acceptable means to
reduce morbidity and mortality with respect to
CAD. Of course, one would get an
electrocardiogram and perform a complete
physical exam on anyone at risk for a cardiac
event before suggesting to them they undertake
an exercise program for weight reduction.
Ironically, there is a text authored by a Dr.
Caldwell Esselstyn describing in great detail
how diet modification alone can reverse CAD and
he has the arteriograms to prove it. To think
that we as podiatrists are not qualified to
apply guidance with respect to obesity
counseling is both short sighted and regressive
indicating an insecurity in the purporter's
mind. We all have limits that we recognize and
allow for, in both our personal beliefs,
educational backgrounds and training.
As physicians, we continually build new
education into our lives to both expand our
knowledge of medicine and to stay up with and be
able to speak to our patients intelligently
about the latest medical information transmitted
to them by both their MDs and the news media.
The medical degree and even the residency
training we all undertook, these were simply
jumping-off points for our lifetime of training
in the medical field. Denying this indicates you
are yourself tumbling toward incurious
irrelevancy in the profession.
If you don't feel secure in your basic
knowledge regarding physiology and cardiology,
then don't venture in too deep. Since the stent,
I have altered my diet to be mostly plant based
and had long ago eliminated caffeine. The recent
change in my body have been dramatic and I feel
like a new person. My cardiologist simply
instructed me to change my diet and walk briskly
for 30 minutes a day 6 days a week and it has
worked well. Triglycerides have gone from 350 to
199 and total cholesterol is 162 and both should
continue to drop as I stay the course with diet
and exercise and a few basic medications. And of
course, my feet are in orthotics and I have no
limitations with regards to walking as an
exercise, which is my point. Obesity reduction
through exercise is viable only if the kinetic
chain is in good functioning shape and that
obviously begins and ends with the feet, and the
podiatrist.
John F. Swaim, DPM, Red Bluff, CA,
podtexdoc@aol.com
