18663 Ventura Blvd, Suite 202, Tarzana CA 91356

Tuesday, May 22, 2018

New Research on Eggs -- Beware the Details

Eggs are in the news again.

A recent study from the American Journal of Clinical Nutrition comes to the conclusion that there is no risk from eating up to twelve eggs a week.  Look closer.  There are some important details --
-- The study was paid for by the Australian Egg Corporation.
-- The "low egg" group ate two eggs per week, BUT ate more meat to make up for eating fewer eggs.

Another recent study has led to headlines like, "An egg a day to keep the doctor away"  The article, "Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 millon Chinese adults," was featured in BMJ Heart.  Issues with this study:
-- This was an observational study. You can't make definitive cause and effect conclusions from observational studies.
-- People in China who consume more eggs tend to be more affluent
-- The study relied solely on dietary recall, a questionnaire asking people what they eat, not observing what they eat.

I'm not about to start recommending eggs to my patients.  Eggs do contain a large amount of cholesterol, and while dietary cholesterol is not the sole cause of high cholesterol in humans, it definitely contributes.  Eggs also have choline which increases the risk of developing and dying from several kinds of cancers.  PCRM's The Exam Room Podcast from last week does a great job of tackling the subject of eggs and health.

Some people may suggest that the egg itself isn't the problem, but rather the foods that often accompany eggs -- ham, bacon, sausage, butter, and cheese, for example.

There are so many healthier foods to enjoy for breakfast.  Oatmeal is my favorite easy go-to breakfast, but if you want something hearty with the consistency of eggs, a tofu scramble is a filling and healthier choice.  One of my first blog posts twelve years ago featured a tofu scramble, or you can check out my book on Amazon for a great tofu scramble recipe, along with many other recipes.

Wednesday, April 18, 2018

Heart U -- Weight Loss, featuring Lori Manby

As part of my mission to educate and empower my patients, I am holding monthly Heart-U educational sessions.  This month's session, coming  up on Monday, April 23 at 6:30 pm in my office will feature the topic of weight loss.
I've had countless discussions with my patients about weight loss.  Losing weight, and then maintaining a healthy weight for the long term, is a goal that eludes many.

Lori Manby has succeeded.  She lost 80 lbs and had maintained that weight loss.  She uses the Weight Watchers program to guide her food choices. She has used her experience to pay it forward by founding the support group Vegans of Weight Watchers.

Her story is compelling.  And if you're struggling with weight loss, she's the perfect person for your to hear from.

Please attend her talk this coming Monday, April 23.  You can RSVP here, or call my office at 818-938-9505.

Read more about Lori here in Weight Watchers' online magazine

Sunday, March 25, 2018

The ones we don't save

One of the most rewarding parts of my job is saving lives.  I can open a blocked coronary artery in the setting of a heart attack.  Or I can help prevent that heart attack by guiding my patients to good lifestyle choices, and when necessary, prescribing medication.

Everyone knows I'm passionate about lifestyle and the power of food and movement.  I will admit, though, as an interventional cardiologist, I enjoy procedures, and I take call at a few local hospitals to care for those in the throes of a major heart attack.

Far more often than not, my team and I work together, open an artery, and save a life.  The gracious patient who no longer has chest pain thanks me and my team, and goes home in a day or two.

It's the patients who don't have that outcome that haunt me, especially when they are young.  I was called emergently for a man in his 30's.  When I arrived, he was sweating profusely, clearly in pain.  His blood pressure was low, so I knew we needed to start working immediately.

I got some brief information from him -- he'd had pain for several days.  He smoked.  He had a strong family history of heart disease.  He hadn't been to a doctor in a long time.

I had one of the best scrub techs at my side, as we worked hard first to get access into his artery and vein.  I worked as quickly as I could, advanced a catheter to his left main, injected it to see that the left anterior descending, the widow-maker artery, was completely blocked at its origin.

His blood pressure was dropping, and we gave medication to support that blood pressure.  I knew I needed to open that artery.  I managed to get a wire into that artery, inflate balloons within the artery, saw blood start to trickle through.  But there was so much clot that had organized in that artery.

Then his heart stopped.  We did cpr, we shocked him, we provided every intervention at our disposal that we could to save his life.

He didn't survive.

I think about this patient often.  I remember telling his wife who sobbed, absolutely shocked and devastated.

I also think, this didn't need to happen.  What if he had come in a few days earlier when his pain started?  What if he hadn't smoked?  What if he had been to a doctor, who may have been able to treat high blood pressure or high cholesterol?  What if someone had gotten through to him to convince him to eat better, to exercise?

I think about what I could have done differently as well.  He was so sick on arrival, I just don't know that I could have done anything differently that would have saved him.

What's my point?  Heart disease can be deadly.  Even if you have no symptoms, but you have risks -- high blood pressure, cholesterol, family history -- manage those risk factors.  Eat right, exercise, if you have high blood pressure get it under control, if you have diabetes, get it under control.  Quit smoking if you're a smoker.  See your doctor and listen to your doctor.

Sunday, January 21, 2018

On Starting a New Practice

I opened my new practice three weeks ago.  After ten and a half years as an employed cardiologist,  I'm now an employer.  A solo physician.  A business owner.

In medical school, residency and fellowship training, I never thought I'd work on my own.  I learned the science of medicine and cardiology.  I paid little attention to the business of medicine, up until a bit less than a year ago, when the gears in in my head started turning.  Before that, I never thought that I would go it on my own.  I brushed off any suggestion of being independent -- the expenses are so high.  It's so hard to fight for patients, and would my established patients even come with me?  And all the work of starting and maintaining a practice -- is it worth it?

Room 4.  Of course that's a greyhound on the wall!

As I thought more, the potential of independence appealed more and more to me.  The ability to practice in my own setting, in the way that I want, during the hours that I want, without approval from management.  The independence to run a cardiology practice in a way that suits my philosophy of health.

Starting a medical practice is tough.  I have an incredible respect for anyone who runs his or her own medical practice, or any business for that matter.  But, I've found that even if the hours are long, it's work for a purpose -- to build something that is mine.  And that is rewarding.

I'm grateful for all the advice and support I've received.  I'm grateful to have two talented staff members, Diane and Sylvia, who make my job easier.  And I'm grateful for the many loyal and terrific patients who've chosen to follow me in my new adventure.

I'm inviting patients, friends, family, friends of patient, and anyone curious to come see my practice.  Come to my open house on Thursday, January 25, 5:30-7:30 pm.  I'm proud of what I've created and I welcome you to take a look yourself.

Thursday, January 04, 2018

Meet my office staff!

The office opened this week, and we are up and running seeing patients!!!

Let me introduce you to my staff members:

Diane Shockcor - Medical Assistant
Diane worked with me at Lakeside for over three years, and I can't be happier to have her join me at my new practice.  She's smart, works hard, and gets along well with patients.  Diane is a dog lover and has a boxer named Harley.  Her major flaw is that she is a Buckeye fan.

Sylvia Tadeo - Front Office 
Sylvia has over ten years of experience in the medical field, including as a medical assistant and a phlebotomist.  I met Sylvia a couple years ago at Tru Fit Bootcamp, where I was impressed by her dedication and the fact that she can do burpees far faster than I can.  Sylvia is also fluent in Spanish.

Call us for an appointment at 818-938-9505.  Or, come to our OPEN HOUSE on January 25, to say hi and see the new office!