Here's the thing about preexisting immunity. Does it magically just avoid prisons? ~2100 inmates were infected at San Quentin (~ 2/3 the population). I guess they just let the people with prior immunity to COVID go early?
A story for a Friday afternoon. Spoiler, I really don't know what to do with it.
So I have this patient. He is mid-50's & healthy aside from an ACS event a few years ago for which he was stented & is on all the right 2ndry prevention things. He is also very active
He wears an Apple Watch, & a couple of years ago the watch was telling him he had Afib. Given his CAD, this was important as it would mean adding a DOAC to his regimen which of course does not come without risk.
The watch continued to trigger frequent AF alerts and we did a Zio
He kept very careful notes and the Zio was on for a week. There was no AF at all. And the events the watch was calling fib were clearly not fib
I don’t understand why people are so bothered by the fact that metabolic disease can be treated by medicines. It’s not that lifestyle solutions can’t work; they can! It’s that they don’t work for a very large number of people…
We should celebrate that more people have solutions that can work for them. Not doing so is the height of arrogance
It also seems relatively uncontroversial to acknowledge that medicines are a life-saving solution for those with hypertension who cannot control their blood pressure with lifestyle alone
Here’s a question for @nicknorwitz & @realDaveFeldman: if I understand, your model hypothesizes that increased ApoB in lean/athletic people on low carbohydrate or ketogenic diets does not result from either 1) saturated fat or 2) genetic variation, but rather from CHO restriction
So in the spirit of n=1 case studies, I have one for you. 52 year old male cardiologist BMI 21, exercises 6 days a week, on low SFA ketogenic diet for 4+ years with ApoB ~80 mg/dl
So how do you explain this? Is it genetics? Is it environment? If so, what else besides carbs is it? Fiber?