When his cousin had a heart attack at 50, it was a wake-up call for Dr. Robert Sigal, a plastic surgeon in Washington, DC. area. His father had died when he was young, so Dr. Sigal didn't know if heart disease ran on his side of the family, but his cousin suggested he go get tested and find out his calcium score. What happened next was life-saving. Here is his story.

A Failed Test, and a Look Back.

"I was always athletic, a college rower at Harvard, and after school, I kept up being active, cycling, and later doing triathlons. I was totally asymptomatic. But when my cousin had his heart attack and suggested I get tested, I went.

"They give you a calcium score, it's just a number, but I had a really high number, like 750. Above 100 or so you should start to be concerned since that's the level when your risks rise of having a heart attack. But mine was off the charts. So while I was asymptomatic, I had a really high probability of having a heart attack - like 100 percent. I had to make some changes.

"During my surgical training many years ago, I did a lab research fellowship in cancer and nutrition. The lab I worked in had, decades before, been the lab in which Dr. Jonathan Rhoads had worked on the development of "Hyperal" or liquid IV nutrition. Before Hyperal, when people's gut didn't work or for some other reason they were too sick to eat, they would die. So Dr. Rhoads and one of his junior doctors, Stanley Dudrick, figured out how to give the exact right mix of nutrition by IV, and with the perfect mix of protein, fats, carbs, vitamins, and minerals, and a healthy number of calories, the patient would survive -- even thrive.  Dr. Dudrick then used that idea to show that Hyperal could reverse heart disease if you pulled out all the fats from the IV nutrition.  He took some patients that were called "cardiac cripples," put them on Hyperal without fat, and got them out of their wheelchairs.  He showed that their heart disease even reversed! Years later, I remembered these studies, when I found out about the work of Dr. Caldwell Esselstyn.

An Ambitious Experiment

"Dr. Esselstyn was a surgeon at the Cleveland Clinic who clearly knew about Dudrick's studies.  He thought that if he could get patients to cut out animal protein, dairy, as well as nuts and all oils, he might be able to mimic the Dudrick studies and reverse heart disease. So he tried it and low and behold, he got so-called "cardiac cripples" out of wheelchairs just as Dudrick had. I believed this way of eating might work to stabilize my coronary disease as well. So I started eating plant-based, with very little nuts or added oils.

"Without taking any medication I dropped my cholesterol from 225 to 150 and that was without any drugs at all. It very much works. I got fitter, felt better and lost weight. Maintaining the diet is a bitch at first, but I ended up losing 12 to 14 pounds and had to get all new clothes. I had already started doing triathlons, but I went from finishing anywhere from 5th to 3rd in my age group before the diet, to after the diet, I actually won my age group.

"If people need to lose weight, they can do it on this diet, but it's really about inflammation.  Anything that ends in "itis" is an inflammation in your body.  Appendicitis is an inflammation of the appendix, for example. Coronary calcification is really just the artery healing it's own inflammation, in this case, called vasculitis. You can't feel this type of inflammation, and you can't feel it when it heals with calcification, but as the plaque and calcium build up in your arteries, you definitely will feel the angina (or lack of blood flow) as the tissue downstream from the blockage screams out for blood!

Fighting Inflammation, to be Heart Healthy for Life

"Well, colitis runs in our family. My dad died of colon cancer from it, and it turns out I had it too. Mine flared every now and then, but I had it, and when I went plant-based it went away completely. Gone! I had thought I was gluten intolerant, but I wasn't. Gluten is a pretty big part of Dr. Essestyn's diet (that he gives to heart patients who get treated at the Cleveland Clinic), but when I got off dairy, all my inflammatory markers when down. So I use my colitis as a "marker" for the other inflammations in my body -- including coronary vasculitis -- or heart disease.

"I feel normal. In fact, I feel great. I remember, back when I was in the lab (as a med student), one time I took my own blood to run as a control for a study I was doing.  I had just eaten a steak sandwich, and what came out of my arm looked like milk! It was full of white fat, or actually cholesterol conjoined with protein. This stuff circulates around our blood vessels and pisses them off. Crazy. You can only imagine what years of a diet like that can do!

"Inflammation can long-term lead to cancer. Anything that diminishes your body's inflammation is good and likely will also diminish your cancer risk. Dr. Esselstyn knew this as he headed up the Cleveland Clinic's breast cancer program. The Mediterranean diet is a good step, but for me, being 90 percent vegan for two and a half years has been the way to go. Any food raised in nature has a healthier ratio of omega-3 to omega-6 fatty acids and will be less inflammatory than its "Frankenfood" cousin. So for me, that means occasionally eating fish from Alaska or, if I know who grew the food at a local farm, well, then I am interested. But stuff raised on antibiotics or hormonally manipulated? Then I don't want it. And sadly that's what we feed people in this country most of the time.

A New Test, and a Wedding

Dr. Sigal recently had an angiogram -- the gold standard to "look at" the coronary arteries.  He has a minimal blockage that didn't even need a stent. In just a few weeks, Dr. Sigal's daughter is getting married, and he is looking forward to dancing at her wedding.

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