18663 Ventura Blvd, Suite 202, Tarzana CA 91356

Wednesday, January 30, 2008

The Suit Experiment

I'm a young woman and I don't look like the stereotypical cardiologist. So, I've become accustomed to the confused stares that I get when I introduce myself as a cardiologist. Often I suspect that my young looks give me less credibility than if I was a man and had some grey hair.

Normally, I wear pants and a shirt or sweater or a dress under my lab coat. I've never been one to wear a suit to work. But today, I put on my black pant suit and blue button down shirt, without the lab coat, to see if there's a difference.

One of my colleagues who noticed said, "I'll vote for you!" suggesting that I look like a candidate for office. Others complimented me on how nice I looked today. And I had a few questions of what the special occasion is.

There definitely is a difference in how patients react. Today, I felt like I got fewer of those looks of astonishment from new patients. And, patients seemed to take what I had to say more at face value.

Maybe I should wear a suit more often.
Image from

Monday, January 28, 2008

The Zetia Scandal

Schering-Plough, the company that makes Zetia and Vytorin (simvastatin combined with Zetia), released the results of the ENHANCE trial. The trial looked at simvastatin 80 mg versus simvastatin 80 mg plus Zetia 10 mg and the effects on carotid intima medial thickening, in other words, the lining of the carotid artery. The addition of Zetia had no beneficial effect.

I think that the intent of Schering-Plough was to demonstrate that not only is Zetia good at lowering LDL cholesterol, but that it also has a beneficial effect on the lining of the arteries, and therefore can protect against cardiovascular events. Clearly, the study fell short.

I've gotten phone calls and e-mails from patients on Zetia asking, should I stop taking Zetia? Does it matter if my cholesterol is lowered?

The bottom line is this: There is great data for statins, particularly simvastatin (Zocor) and atorvastatin (Lipitor) for lowering cholesterol and reducing event rates. With these medications, we know that lower cholesterol is better, with an optimal LDL goal of 60-70. And, I think that this new study lends credibility to the theory that it does matter what class of drugs are used to lower cholesterol, that it's not just the cholesterol lowering effect of the statins that make them so effective, it's also the effect on the arteries' lining.

However, some people cannot tolerate statin medications due to muscle aches or liver function problems. For these patients, Zetia might be an appropriate alternative.

If you're taking Zetia or Vytorin, please do not stop your medicine. Talk to your doctor. If you are on Zetia alone, you may ask if you should be on a statin instead. There may be good reason why you are on Zetia.

The Training

My week's schedule for training looks like this:

Monday -- 1 hour weight training and 30 minutes running
Tuesday -- 1 hour spinning (indoor cycling)
Wednesday -- 1 hour weight training and 40 minutes speed work
Thursday -- 50 minutes running
Friday -- 1 hour spinning
Saturday -- Long run. 20 miles.
Sunday -- 1 hour spinning and 30 minutes running.

Thursday, January 24, 2008

Spirit of the Marathon

I went with several members of my running club to a screening of the movie Spirit of the Marathon. It detailed the training and obstacles faced by a few first time marathoners and two world-class runners, and the reason why they choose to run a marathon. It was really well done.
The timing of the movie was great. For me, I'm running my first marathon in almost seven years. It got me thinking about why I train to race in endurance events.

I run to prove that I am strong, that I am capable of finishing a marathon, and hopefully by the end of the year, a half and full ironman. I run to destress from life. And, I run to set an example for my patients.

If you can, see this movie. It is absolutely inspiring.

Monday, January 14, 2008

Lentil Pilaf with Bulgur

This recipe is from one of my practice's office managers. She is an amazing cook, brings in home-cooked food for us all the time, and when she brought this in, it was so amazing I *had* to have the recipe. And finally I got around to making it.

Put lentils in pot, cover with water, and boil. Then add bulgur and a cup of water, and simmer until water evaporates. Meanwhile, saute some chopped onion in olive oil. Then mix it all together.

With a salad and some sweet potato soup from Trader Joe's, this was a filling dinner.

Sunday, January 13, 2008

Ironman Heather???

I think I've lost my marbles.

Ellen, a sorority sister from college, called me today. She's signed up for an ironman in November in North Carolina and since she knows I "do this crazy stuff" wanted to know if I wanted to join her. There was only one spot available, and I pondered it..... and now........

I am signed up for the Beach 2 Battleship Ironman on November 1!!!

Wednesday, January 09, 2008

Running Smarter

I have vowed to be a smarter runner. That means I take better care of myself so that I don't get injured. It also means being prepared in the case of an emergency.
The metal tag on my shoe is a Road ID. It is engraved with my name, date of birth, and emergency contact numbers. A good idea to have just in case something bad happens.

Saturday, January 05, 2008

Athlete Physicians

Saoirse pointed out this New York Times article that describes how athletes often seek out physicians who are athletic.

Knowing this, how can I put it to work for me? Hmmm....
Photo from New York Times, Jan 3, 2008.

Why am I awake this early?

Lately I'm awake by 5 am, sometimes a little earlier, sometimes a little later. The morning is the only time I can reliably get my workouts in, and that way I don't have anything hanging over my head that I *have* to do later in the day.

It hasn't been a good running week for me. My iliotibial band (that's the band of connective tissue that runs along the outside of the thigh) has been very inflamed. I've felt tired. My running has been slower. My worst run was on Thursday, when I got on a treadmill in our hospital's cardiac rehab center in the afternoon, and even at 5.3 miles per hour, I felt completely wiped. Maybe it's because it was so warm in the room, but I've just felt so discouraged this week.

With the LA Marathon only 8 weeks away, I'm worried that I'm not getting in the miles that I need. And I'm afraid of any injuries that could sabotage my running the marathon.

So, this morning when my alarm went off at 5:15 am, I was not thrilled at all to roll out of bed and run an hour and a half on my apartment's treadmill. I'd rather run outside with the LA Leggers, but since I'm on call, I can't be that far away from the hospital.

Today ended up being my best run in the past two weeks. I did a walk/run workout, run for 9 minutes, walk for 1 minute. It averaged out to a 10:33/mile pace, which felt good, and I finished eight and a half miles in an hour and a half. My iliotibial band (ITB) only hurt a little bit.

This is a foam roller. It has been the savior for my ITB woes. By rolling on it with body weight, it helps dissipate scar tissue, and makes running much easier.

I'm very grateful for today's run. Had it not been so good, I really would have been discouraged.