Here's another real story that has made me very frustrated and even more convinced that we need to aggressively screen and lower cholesterol earlier in life.

60 y/o 👩 with big heart attack (MI), blockages everywhere, needs triple bypass.

This is the kind of person about whom people might say things like "Oh how could she have this heart attack?! She has never had heart problems!"

Because of this MI, her heart pump function is ~30% (normal 55-60%). Badness.

Please read 🧵 Her LDL was 175. Not only was she not on meds, she had NEVER been started on cholesterol meds. Decades of plaque build up, unchecked.

Great.

If you are a lay-person, my goal with my threads here and videos on TikTok is to educate and empower you to take charge of your own health. You only get one heart.

It’s easy for physicians to tell their patients to just do “diet and exercise and lose weight” to bring down their LDL, A1c etc.

We think we do some big thing dishing out this advice. We’re not. Patients are not stupid. Everyone knows that.

Y’all think people don’t know a healthier diet, more exercise, weight loss, quitting smoking, etc is good for them?

We look stupid. Seriously. People think we are dumb and detached from reality. It’s another thing altogether to actually implement that LONG TERM diet, exercise, and lifestyle modification to make meaningful changes.

Anyone who has tried to actually do it knows it. Physicians who dish out this advice and think it’s easy are either in some utopian bubble or have some sort of superiority complex.

There are also plenty of social media gurus, BioHackers and “optimizers” who sell this. It’s bullshit.

Got a lot of grief for suggesting that we shld be aggressive in screening for and lowering cholesterol in young people in their 20s-30s.

Let me use a patient story to tell you why I believe that.

Long 🧵. Please read the whole thing before commenting. As an interventional cardiologist I treat heart blockages heart attacks for a living with stents.

Too many 40/50 y/o with NO prior medical care/screening coming to my ER with big heart attacks later, I am a true believer in CVD prevention >>> cure (or patch, rather). Here's the story:

I read the three recent NEJM editorials on how "wellness culture" is cheapening and degrading medical education. (Part 1 as this is too long a thread)

There are some valid points. Interestingly, they were majorly focused on trainees being the sole problem. #wellness This is a two-way street. There are rampant issues with academic medical leadership that directly contribute to un-wellness that are not discussed, or get a cursory mention.

If we are truly being genuine and honest, we must discuss it all, and not just one side.

Famous demon sperm doc Stella Immanuel wrote a staggering ~150,000 Rx for ivermectin and hydroxychloroquine in just 2 years (2021-22)!

Like her friends she has also has a website where she sells silly BS like “Vax Injury” vitamin cocktails.

But the most insane thing? A🧵 I wanted to know how much she charged for telehealth visits to prescribe people IVM and HCQ. After all, these meds are so cheap, right? It shouldn’t be expensive!

I went to her website, and what I found was unbelievable.

Earlier this week, this thread by NaturallyFTW went wild. She blocked me (snowflake LOL) but I was able to grab a screenshot before she did that.

As a cardiologist, myocarditis is in my wheelhouse. So let's talk about why this tweet is fear-mongering clickbait garbage. A🧵 The news article linked (seems to be deleted now?) claimed that a recent "cardiac testing" event in Washington found a 53% myocarditis rate.

🚩#1 - you can't diagnose myocarditis at a random screening event set up at a convention center. That is not a thing.

In an amazing display of anti-vaxxers eating their own, Pierre Kory gets destroyed by his own supporters in the comments section of his latest Substack:

pierrekory.substack.com/p/a-contrarian…

A 🧵 In this long-winded essay PK actually debunks (!) some obviously wrong allegations incl:
1. There was no COVID surge in badly hit cities like NYC
2. In early days of the pandemic, doctors intentionally "murdered" patients with high dose sedatives, opioids, use of vents, etc.

A lot of the #UrgencyofNormal folks say "Oh, we need to LIVE again. If you get COVID you can easily get paxlovid and monoclonal antibodies, etc and probably be fine." Thread. 1/6 Only problem with that is with Omicron (including BA.2 et al), most of our current mAbs don't work so well and the ones that do are not readily available. Paxlovid is incredibly hard to find AND a lot of docs and providers STILL don't know that they should prescribe it. 2/6