I didn't expect my deep dive into Bernie's doctor letters to get so much attention. Thank you all for the kind words! Due to popular demand, I'll go over the remaining 2 letters. Well, really only one of them since the other doesn't say much. Let's get to it #Bernie2020 1/?
The first letter written by Dr. Monahan that I previously discussed was a general health summary. The next letter written by Dr. Ades and Patrick Savage MS from the Uni of Vermont Medical Center is strictly dealing with the results of his post-heart attack stress testing 2/?
The second letter helps us understand his long-term prognosis with more being said in this short paragraph than you might suspect. On the surface, it's easy to understand that the doctors are saying his stress test went well and Bernie is healthy for his age/risk factors 3/? 
Some people, most notably @JoyAnnReid, mocked the statement that Bernie "was able to exercise to a level that is approx 50% higher than other men his age with a similar diagnosis" without realizing THE DOCTORS PROVIDED CITATIONS THAT ARE VITAL TO UNDERSTANDING THIS CLAIM 4/?
If these pundits had even a modicum of training when it comes to reporting on science topics, they would have known to check the citations. The first peer reviewed study listed is even written in part by Dr. Ades himself! So you'd think he knows what he was talking about, no? 5/?
The first study can be read in full here: ahajournals.org/doi/full/10.11…
In it, Dr. Ades compared aerobic capacity in patients entering cardiac rehab. Cardiac rehab is a very important therapy given to patients who have just undergone a cardiac event such as a heart attack 6/?
In it, Dr. Ades compared aerobic capacity in patients entering cardiac rehab. Cardiac rehab is a very important therapy given to patients who have just undergone a cardiac event such as a heart attack 6/?
Cardiac rehab has shown to significantly improve long term outcomes. If your doctor recommends it, don't pass it up! It may seem like a waste of time but it is tremendously beneficial, especially during the recovery period when you're at high risk of a repeat cardiac event 7/?
Going back to the study, it measured aerobic capacity by measuring VO2 (oxygen consumption) during a stress test. All patients studied had recently been hospitalized with a similar diagnosis as Bernie, so it's a very good comparison when trying to determine his relative risk 8/?
As you can see from the data in this graph, VO2 drops precipitously with age (dashed line is men, solid is women). THIS is what Dr. Ades is referring to when he compares Bernie with other men with a similar diagnosis. To understand further, let's look at the second citation 9/?
The second study can be read in full here: ncbi.nlm.nih.gov/pmc/articles/P…
It's pertinent because unlike the study Dr. Ades conducted, this one looked only at people WITHOUT known heart disease. As I said in the previous thread, everything in these letters is written deliberately 10/?
It's pertinent because unlike the study Dr. Ades conducted, this one looked only at people WITHOUT known heart disease. As I said in the previous thread, everything in these letters is written deliberately 10/?
Regarding the second study, the letter states "compared to otherwise healthy men...[Bernie's] exercise capacity is average for [age]." Going by the data below, the median VO2 max in his age cohort is about 25 mL/kg/min with a range of about +/- 5. 11/?
Remember when the letter stated that Bernie performed about 50% better than his peers with a similar diagnosis? Well let's go back to that first graph. The mean VO2max for 70-79 men was ~16. Increase that by 50% and you get 24. Bernie performed close to someone in their 40s! 12/?
That VO2max of 24 is right within the range expected of someone Bernie's age w/o known heart disease. Don't get me wrong, I'm not saying we should act like Bernie didn't have a heart attack. He absolutely did. But when the docs say it was a mild one, they're not BSing 13/?
When they say his level of fitness is suggestive of favorable outcomes, believe them. The 3rd and final letter by Dr. LeWinter reaffirms this. The big things cardiologists look out for in patients with a recent heart attack are signs of heart failure and recurrent chest pain 14/?
"Preserved" heart function is a medical term. It means Bernie has no heart failure and his heart is pumping blood without issue. Saying he's asymptomatic means he's not reporting any chest pain with or without exercise (which is always a bad sign FYI) 15/?
And given what was said in the 2nd letter, stating that Bernie's exercise tolerance is well above average looks well rooted in fact. All in all, he looks good! Great even, all things considered. He's still 78 & still just had an MI but he looks about as good one could hope 16/?
I hope this was another illuminating thread for y'all. And if any journalists or pundits have been following, I implore you, PLEASE SEEK EXPERT GUIDANCE ON TOPICS OF HEALTH AND SCIENCE. It's only a slight against you if you act like you don't need it. Trust me, you do. 17/?
That's all for now. I appreciate all the new follows but please know these kinds of threads are rare for me. I prefer to use Twitter to make dumb memes and vent about the world. Have a great 2020 and don't forget to check your voter registration! 18/18
#Bernie2020 #NotMeUs
#Bernie2020 #NotMeUs
