Next week I’m heading for bypass surgery so I may be back or not. I may wind up dead or I may wind up stroked drooling in my lap going weedle weedle weedle. It’s a matter of odds. , so what are my odds?
My genetics are CAD. The genetics in my case is based on metabolic syndrome which is a constellation of disease process including obesity HTN, T2DM. lipid abnormalities and possibly neuro degenerative disease. Each of these “sub diseases” in my opinion is a phenotypic expression of the main disease, metabolic syndrome. The sine qua non of metabolic syndrome is insulin resistance and insulin resistance is pretty much strictly diet based. The culprit is carbohydrate, all of it. Insulin is a master anabolic hormone and it will take precedence in hormone competition. Excess blood glucose causes insulin to be secreted and the goal of insulin is to store this excess energy and the end organ is to store the excess glucose as fat in the fat cell. Constantly bombarding the tissue with glucose, constantly bombards the tissue with insulin, which constantly bombards the tissue with an anabolic stimulation. The normal is to cycle. The cyclic hormone is glucagon which is catabolic. In the absence of hyperinsulinemia, glucagon undoes what insulin does. Glucagon promotes turning stored fat into free fatty acids available for energy and it promotes the conversion of glycerol into glucose through neogenesis in the liver. You can eat only protein, some fat and no carbs and you will have a normal blood glucose and adequate stores of glycogen based on the liver’s ability to make glucose from glucerol and amino acids. The body knows what to do. It does not involve a lot of hocus pocus or vegan schmegan or vitamin schmitiman it involves turning off the constant anabolic insult of tissue by hyperinsulinemia which is directly caused by carbohydrate consumption. The most extreme form of this diet is Zero Carb in which you live on meat some fat and water and let the enzyme system of the body normalize and heal.
I’ve had CAD for decades based on this poorly understood metabolic syndrome scenario and I’ve treated the sub diseases accordingly under supervision. I have managed to avoid actual muscle damage through a cardiac stent and exercise. but my genetics for the vascular inflammatory response to hyperinulinemia and my coronary anatomy is my problem. The heart has 2 main arteries right and left. My heart has a vestigial right artery. not diseased just barely there. My left is patent and the only artery feeding my heart. The left immediately subdivides to 2 arteries the circumflex and the LAD and those are diseased. The circ has a stent and the LAD was too small to stent. That is my anatomy PERIOD. You have no control over your anatomy, that is the hand you are dealt. My course after the stent was to slow the progression but stenting doesn’t change your genetics nor your anatomy. I exercise 4 hours per week and can raise my heart rate to 180 for a sustained period (bordering on anaerobic metabolism) and can recover to a normal heart rate in less than 2 minutes and my blood pressure response to extreme exercise is non hypertensive which means my vasculature responds to correctly to the metabolic load of exercise. It wasn’t always so. In previous years, though I exercised, the exercise was suboptimal and my heart responded in a decompensated fashion as opposed to it’s present proper response. I got to proper response through proper training. Since I retired I didn’t have a 60 hour a week job to get in the way. By changing my diet to zero carb, I lost weight and I lost inflammation and I lost hypertension and diabetes which are the killer combo of the CAD HTN DM Obesity quartet of metabolic syndrome. My arterial disease and anatomy remain.
During my cath I had them shoot my carotids and my c’arotids are clean. No disease. I also had the leg arteries doplared and no PVD. I don’t smoke which means my cilia work correctly and my lungs are not scarred. I do not have pulmonary HTN based on cath data and my CVP normally runs zero to +1 which means no component of failure. I got to this state through effective training not half assed suggestions from the Mayo clinic. I didn’t know if I would be able to be bypassed, my cardiologist felt I was not a surgical candidate and would be doomed to stents, a substandard solution given my anatomy. Given my rate of decline I figured I had 2-3 years left before the disease moved from salvageable to failure. I consulted with a surgeon had he said he could do a LIMA to the LAD and a vein graft to the circ, a 10-15 prognosis improvement. Because I spent a year preparing for surgery, getting all my ducks in a row even though not a surgical candidate according to my cardiologist. My acute prognosis post op is
This would have been my scores a year ago before I went into effective training
The point of this article is you have the power to author your life, but only if you do so effectively. Doing something is not enough, doing what is necessary is what is required.
If I had followed conventional treatment, I would still be living the slide 2 risk profile. I was fortunate to hit upon a combination of protocols that changed the odds, and it’s all about changing the odds. Hitting that combination was not random. It took all the experience of my 67 years. There is a properly productive way to play and an ineffective way that is actually pseudo random. If you are doing ineffective stuff you are basically doing random stuff. The process is Bayesian in that an action then effects the probability of all subsequent probabilities. This idea is best described by a Galton Board.
The video describes a normal distribution of events, and is based on the random 50/50 odds of a ball tracking it’s way to its final bin. Bayesian statistics suggests that although the populations behavior is normative the fate of any individual ball is not random. If you wantto end up on the “right” side of the board you have to bounce as much as possible rightward, and your rightness therefore can be affected by making choices with rightward probabilities and risks.
Bayes theorem is described in this video on the Kahn site. By going into training I affected my odds moving them considerably rightward, and by a combination of correct weighting of choices the odds improved even more. Conceptually this in my opinion is the best way to approach retirement as well as life. It’s about growing and pruning trees and affecting the probabilities which can be calculated. The above calculator is a medical example. Monte Carlo in the financial realm is another example.
In the past couple months I’ve become somewhat disillusioned with FIRE. It’s all taken on the sheen of bullshit. I see all kinds of cute schemes which are likely ineffective and random in the main. For example people invest in low cost index funds. Investing in low cost index funds guarantees you won’t do better than market return and in fact that is the point of this way of investing, yet people persist in trying to guild the lily and outsmart the market with this scheme or tat scheme, this hustle or that hustle and no way of determining the effectiveness of the hustle. A t some point it becomes about marketing and not knowledge. A t some point it becomes Amway aka multievel marketing, and I think the point has been reached. The FIRE Blogoland is not any less susceptible to Galton board statistics than anything else since its human endeavor raised to the level of religion. I see much in the middle and no one trying to Bayesian their way to the right, rather opting for clicks over ideas. Too bad really, all those wasted words selling soap instead of ideas.
Next three months are gonna be a bitch for me, and not sure what my FIRE apatite will be post op. Depends on whether my squash will still work at speed or I get pump brain, time will tell. In the mean time keep effectively biasing your decisions rightward so you wind up on the right side of the mean. That is how to author your life, by creating truly effective rightward narratives and avoid the click bait.