I had a calcium score scan on a 64-slice machine at the Morristown Hospital in New Jersey. No contrast was injected. The technician did three separate scans that included the lung, even thought I didn't for a lung scan. I wonder why three scans were taken. Does it mean that I had three times the radiation?

Hi,
Of course I can't comment specifically on what was done, but it is common practice to perform 1) a "scout" film for the technologist to identify the location of important "landmarks" like the sternum and the top and bottom of the heart to minimize the window of exposure, and 2) lung imaging as a routine part of  heart imaging, not necessarily an additional scan.

If an additional and unrequested lung scan was performed, you may want to call and ask why this policy is in operation.

What do you feel about yearly nuclear stress tests for people with CAD?  The radiation exposure seems high and the ability of a stress test to pick subtle changes in flow is low.  In the absence of symptoms it would appear that the common practice of nuclear stress tests for people with CAD is a questionable practice.

I agree. The radiation is excessive. I tend to follow that route only when nothing else is possible. An alternative for stress testing is stress echocardiogram in its various forms, none of which involve radiation. They still suffer the other pitfalls of stress testing, of course, but do not involve radiation.

I just launched a webiste that may answer some of your questions.  www.xrayrisk.com. It allows you to calculate your cancer risk based on studies you have had and answers some faq on radiation exposure and cancer.

There are several ways to estimate your cancer risk - the best site for background information is probably the Image Gently campaign.

The American College of Radiology has similar information pages for patients and the general public.

To track your exposure, as Mike said there's the xrayrisk website.
There's also a program for the iphone called Radiation Passport that tracks all of your radiation exposure and gives you the associated risk of developing cancer from your radiation exposure.

CT coronary angiography presents a different story. This is where radiation really escalates and puts the radiation exposure issue in the spotlight. As Dr. Cynthia McCullough's chart shows above, the radiation exposure with CT coronary angiograms is 5-12 mSv, the equivalent of 100 chest x-rays or 20 mammograms. Now that's a problem.

The CT scanner was originally designed to take pictures of the brain. Now it is much more advanced and is used for taking pictures of virtually any part of the body.

The scanner is particularly good at testing for bleeding in the brain, for aneurysms (when the wall of an artery swells up), brain tumours and brain damage. It can also find tumours and abscesses throughout the body and is used to assess types of lung disease.

Dear Dr. Davis,

I am glad you posted this. If I may share my wheat elimination story...

On New Years Day this year, I gave up wheat, sugar, cornstarch. (I began taking 5000 IU of Vitamin D, K2, and 1800 mg of EPA/DHA fish oil a few months earlier.)  At the same time, I have *dramatically* increased my green vegetable consumption to replace the wheat products.  For what it's worth, I have long eaten Salmon or sardines often, but not land-based animal meat.

18 months ago, when I had my last physical, I was nearly 6 feet tall and weighted 172 pounds.  My numbers were:

LDL:  103
HDL:  45
TG:  102
Glucose:  98
Vitamin D:  26

I had my blood drawn again last week -- six and a half weeks after eliminating wheat.  I had lost almost 10 pounds at this point, returning to the weight (and 31 inch pants!) at which I have always felt best. The blood results were astounding:

LDL:  60
HDL:  65
TG:  34
Glucose: 95
Vitamin D:  52

So -- you were right that LDL and triglycerides would drop like a stone, and that HDL would really rise.  Wow!  And thanks.

I'm a little distressed that the glucose didn't come down much, but I'm wondering if I just haven't given it enough time yet.  One thing is definitely strange, though:  my blood pressure shot up higher than it's ever been.  It used to be about 115/75, but last week it was 135/85, which really surprised me.  

I'm wondering if I should take anti-hypertensive drugs, which my doctor is going to discuss with me shortly.  And I'm also wondering whether I should have an NMR or VAP analysis, which my doctor thinks is entirely unnecessary given my numbers. (And since I live in NY, I can't get one on my own).

I have tried too!  But with the rest of the family eating many wheat products I always break down.
I've successfully given up sweets but just can't be the wheat.

Ok, Dr. Davis.  I'm trying.  So far I have been wheat and sugar free for 8 days.  I have lost 5 pounds.  Unfortunately, I am finding myself extremely hungry at bedtime.  I am not snacking--just going to bed hungry in hopes of a lower number on the scale the next morning (this has been working).  

I have not noticed a change in other areas, but will keep you posted.

Everytime I get a bit distressed (and HUNGRY for something yummy like those Girl Scout cookies that are calling my name), I re-read your posts.  

After all, I am doing this for my heart health.  The weight loss is a plus.

Thanks for such a great blog!

Tonya, try eating more saturated fat at dinner.  It will help keep you from getting hungry.

I eliminated wheat to support my partner who had to for health reasons.

After a few months I ate a wheat-based product and within an hour and a half my sinuses were playing up. I tried this again after a few wheat-free weeks. The same thing happened.

I now wonder whether I have had a wheat intolerance for a long time but my body somehow compensated for it. Well, my body obviously doesn't like it so that's that.

I gave up wheat 11 months ago. Very occasionally I cheat but only small amounts and it does not do anything for me (the idea is always better than the reality). Anyway the real purpose of my comment was to say I had no problem coming off of wheat because I ate raw nuts whenever I wanted wheat. I don't weigh myself but I have a lot less stomach flab even through I must be eating lots of calories with the nuts.

I would appreciate if somebody could let me know whether a coronary artery stenosis between 70% and 80% can be reduced,or bypass surgery is the only alternative.

Many thanks in advance for your comments

There are a lot of addictive stuff in food. I´m grain-free since 10 years. Sugar-free since my youth. Casein-free for 2 years. Last year I throw even fruits out. Glutamate via chips was very difficulty to quit. Now eating means just to satisfy hunger and no mood issue.

I recently took a trip to South America and during the trip ate plenty of the local food, including empanadas, which are meat-filled pastries. The usual breakfast there is coffee and sweet pastries. Definitely addictive. On my return, I found myself craving carbs and sugar. I also felt physically worse on my trip.

The hard part about wheat elimination for me is finding a wheat substitute! I would happily get rid of it if I knew what I could eat instead to fill the calories and the sensation of consumption. Of course, I'm hardly the most creative person so I don't easily come up with ideas on my own.

-- Boris

Trying to substitute wheat is not the idea here. It will take a little time for your body to go through the change from burning glucose to burning fat and during that time you may still crave carbs. But don't fall into the trap of eating low-carb substitutes and buying these products from all those well-meaning companies who are trying to make the low-carber's life easier...Increase the amout of fat in your diet, eat plenty of meat and vegetables and see those cravings disappear along with excessive pounds

I´ve been baking a bread with only 2.9% carbs and no wheat. Regular bread eaters can´t tell the difference. Until I tell them there is no flour in the bread. They don´t believe it.

I started with a low carb high fat diet 1 month and 1 week ago. So far Ive lost 18 lbs and the health benefits are plentiful.

Thanks David for sharing your numbers it is very interesting !

Has your blood pressure risen since adopting your new diet though ?

High blood pressure means atherosclerosis. Like it or not but addition of cholesterol (even as egg yolks) and saturated fats leads to fatty streaks in laboratory animals.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1938976/pdf/canmedaj00868-0002.pdf

Instead of bread (I'm two months off of it after reading the wheat-free 2010 article of January 1, 2010 of Dr Davis http://heartscanblog.blogspot.com/2010/01/wheat-free-2010.html) I now eat soy products and I'm feeling great ! (At the beginning though I felt slight headaches, fever and insomnia). Soy protein is anti-atherogenic and as a result it will lower your blood pressure !

On soy protein and atherosclerosis:
http://linkinghub.elsevier.com/retrieve/pii/S0021915003003265

On soy protein and blood pressure:
http://www.nutraingredients.com/Research/Soybean-protein-may-help-lower-blood-pressure

70% of people (NOT 100%, but the majority) will experience unexpected health benefits by eliminating this corrupt, unphysiologic product called wheat from their diet.