Participants: Tim Kochis (Host), Dr. James Marcum
Series Code: BRX
Program Code: BRX00019A
00:01 Are you being confused by the conflicting health reports
00:04 in the news today?
00:05 In this well marketed world is hard to know who or
00:07 even what to believe, but there are answers
00:10 you can depend on.
00:12 Hi I'm Dr. James Markham, join me for Bible RX, a program
00:16 exploring the health care world, looking at all aspects
00:20 of healing, using the Bible and Biblical prescriptions
00:25 as the ultimate source of truth.
00:52 Welcome to Bible RX, I'm Tim Kochis.
00:55 We have had many questions about cardiovascular disease.
00:58 Who better to answer these questions then
01:01 Dr. James Markham, welcome to Bible RX.
01:10 Cardiovascular disease is the number one killer in
01:13 America, who better to answer these questions then
01:15 Dr. James Markham, Jim welcome to Bible RX.
01:19 You know it's a lot easier sitting in the seat then
01:22 sitting in that seat.
01:23 As you can see look at all the cameras and to figure
01:27 out when to come on is not so easy a task so
01:29 I actually get a chance to relax and answer some
01:31 very much-needed questions.
01:33 You know I have been asked a lot lately as we want to
01:36 hear what you say about cardiovascular disease and not
01:39 about the guest so this is very much treat for me.
01:42 So thank you for guesting today.
01:44 You're welcome, this is going to be a lot of fun.
01:46 I hope so, I hope we get some questions answered as well.
01:50 I have a number of questions here, and a lot of them are
01:55 open ended which is very interesting.
01:57 Let's start with number one here.
01:58 Ken from Indiana writes, my sister in law had a heart
02:02 attack two weeks ago.
02:03 I've never seen a doctor and don't know much about this
02:06 thing, so obviously Ken has never had a heart attack.
02:08 This is his first experience even with a family member.
02:11 What caused the heart attack?
02:12 Will I have one? Well we don't know very much about
02:18 his sister-in-law, not really family.
02:19 Okay the sister-in-law had a heart attack and Ken is
02:22 worried about having a heart attack.
02:23 First let's talk about what a heart attack is.
02:26 A heart attack is when the heart doesn't get enough
02:28 blood and it dies.
02:30 When it dies many bad things happen, arrhythmias happen and
02:34 you can get a weak heart and go into heart failure.
02:37 I always get asked what are the causes of heart attack?
02:40 How can I prevent it?
02:42 I look at heart attacks Tim as something stressing the
02:45 system and we have to find out what's stressing the
02:49 system that triggers this.
02:51 That stress might be cigarettes, lot of people smoking
02:55 today, that stress might be high cholesterol, that stress
02:58 might be not enough sleep, are not drinking enough water,
03:01 high blood pressure is a stressor on the system.
03:04 Some people have genetic stress, and genetic stress you
03:08 can't change, that stress on the body you are stuck with that.
03:11 The first thing is that all of a sudden stress comes on
03:14 a body and we make a bunch of chemicals like adrenaline.
03:17 When these start surging through our bodies these plaques get
03:20 unstable and actually half of all heart attacks come with
03:24 these little plaques that blow open.
03:26 When it blows open it's just like you cut.
03:28 Now what would happen if I cut your hand Tim?
03:30 What would happen? I would bleed and eventually it will
03:33 clot, - well that same thing happens inside of our
03:36 blood vessels when damage occurs.
03:38 Inflammation, adrenaline, all this stress can cause these
03:41 little plaques to rupture.
03:43 When they rupture guess what?
03:44 All these platelets clog up and pretty soon that artery
03:47 is clogged up and then there's no blood to the heart,
03:50 heart attack, funny heart rhythms, hearts don't work,
03:52 lots of bad things happen.
03:54 That cardiovascular disease as you mentioned is
03:56 the number one killer in America,
03:58 42% of people have cardiovascular disease.
04:01 So the first thing for Ken, is Ken there is not one thing
04:04 that causes cardiovascular disease, it's a conglomeration.
04:08 Cigarettes, high cholesterol, high blood pressure, genetic
04:12 history, all these things can put stress on the system.
04:15 The condition called diabetes puts stress on the system.
04:19 So when the stress adds up we have a plaque that
04:22 ruptures, or arteries that get completely clogged up and
04:24 then have a heart attack.
04:25 Now what was the second part of his question there?
04:27 Is would he have a heart attack?
04:29 Now obviously we don't know much about Ken, that is the
04:32 issue and unfortunately it is open ended.
04:34 He is referring to his sister- in-law, but how is he going
04:37 to handle it for himself?
04:39 We all want to lower our risk of having a heart attack.
04:43 No one wants to go through the damage control,
04:45 unfortunately what I see too much damage control were
04:48 we have to put the stance or bypass round these blockages
04:50 and that doesn't really remove the problem.
04:53 So in talking to Ken I would ask him what's stressing the
04:56 system, I would specifically want to know about his blood
04:59 pressure, is that optimal?
05:00 Does he have diabetes? Does he smoked cigarettes?
05:03 Does he exercise? Is the stress on the system adequate?
05:07 Does he stay up all night? Is he getting good nutrition?
05:10 So we try to minimize the stress that might be occurring
05:13 on his body, now can we ever eliminate the chance of
05:17 having a heart attack? No!
05:18 But by making lifestyle changes we can lower a heart
05:22 attack 90% - that's considerable!
05:26 Yes that's considerable but just by lifestyle changes.
05:29 They might be taking cholesterol medicine, it might be
05:31 exercising, it might be a diet, we can lower his risk
05:34 of heart attack considerably and I think that is what
05:36 Ken is wanting to know.
05:39 Even if you sister-in-law had artifact that doesn't
05:41 mean that you had to have one if you can lower the
05:43 stressors on your system.
05:45 Very interesting and I think a lot of us can learn a lot
05:48 from that because a lot of people have those issues, but
05:51 it is a lifestyle change.
05:52 Ye it is.
05:54 We also have another question here.
05:55 Tracey from Washington writes:
06:08 His doctor put him on a variety, a very strict diet and
06:11 he is considerably overweight which is a factor.
06:13 He has become very depressed, and that is another factor
06:16 there I'm sure, although seems to be healing perfectly
06:18 well, any suggestions?
06:20 That is a great question Tracey and a lot of suggestions.
06:24 Now we talked about earlier bypass surgery doesn't take
06:27 away the problem, remember the problem is still there.
06:29 Blockages in the arteries, the damage has been done.
06:32 All we do is bypass around these arteries.
06:36 It has already been done and unfortunately he is
06:38 depressed, I don't know whether it is to because of the
06:42 strict diet, or the fact that he is obese, I don't know
06:46 why he is depressed but depression is one of
06:48 the worst enemies we have.
06:50 At the heart of health is love, so what I want to do is
06:54 encourage Tracy to give him some love and happiness.
06:58 Don't try to make everything happen at once, now we want
07:01 to move the stressors but what I want to do with him is
07:04 tell him it is not uncommon to be depressed after heart
07:07 attack. - That's what I've heard.
07:09 This should pass, in addition I would loosen up on the
07:12 diet a little bit and what I would do is say listen let
07:15 me tell you the things you eat and there is nothing
07:17 you have to take away, you can still have the food.
07:20 I'd rather have a person be happy then eat perfectly
07:23 and be unhappy because the chemistry from unhappiness
07:26 is the worst chemistry there is.
07:28 Right and that is a sadness, that is the depression part.
07:31 I want to get rid of that, so what I tell them is there is
07:34 no food that you cannot have but let's be smarter and make
07:37 our evening meal the smallest, maybe just some fresh fruit
07:40 and vegetables and a snack or whatever.
07:43 Make it small, and then you can still have the stuff you
07:46 like but eat it as a treat not as nutrition.
07:49 Fill up with the good stuff and save that, what is your
07:53 comfort food Tim?
07:54 Peanuts, nuts and dried fruit, I love dried fruit.
07:59 You eat very healthy.
08:00 I try to. - but some people eat candy and I have comfort
08:04 food as a donut.
08:06 Let's say what I would do if it was me, I would eat all
08:09 he fresh stuff and enjoy it and take a little nibble of
08:12 a donut and say mmmm, this taste good and enjoy that.
08:15 Then I am still happy and make it a little progress toward
08:18 my goal and as my chemistry improves that I would work on
08:21 another health Tip and would not try to do everything in
08:25 one day because this diet might be too strict for him just
08:28 getting over, and also work in some exercise.
08:32 But the prescription I would fill is Tracey gave him a
08:35 lot of love and encouragement and do things to make him
08:39 happy even if it's not eating quite perfect.
08:41 Small steps at a time, little bites at the time and take
08:44 it slow. - because if you overdo it then you are going
08:47 to lose the benefit.
08:48 Now go by fast surgery has improved his symptoms and now
08:51 he feels like walking and doing things, however if we take
08:54 love away and happiness away what does it really matter?
08:58 Exactly, so you want to have that love, take it slow and
09:02 actually just may get a habit forming lifestyle change.
09:06 Which will actually promote a happier lifestyle and
09:09 a healthier one at that.
09:10 You can be too strict, and take the joy of living if
09:13 it is too strict, so I think you need to take it in
09:16 small increments and that is exactly correct.
09:17 Another question, Benjamin from Mississippi writes:
09:22 they put a drug eluting stents in my artery, you will
09:26 have to explain that to me.
09:31 He is already taking aspirin, but he's wondering,
09:34 is that enough?
09:36 Stents are very good for heart attacks, now remember
09:38 we have already talked about what a heart attack is.
09:40 Part of the heart is not getting enough blood and it's
09:43 dying, bad things are going to happen.
09:45 When you start having a pain of a heart attack, symptoms
09:48 that will not go away, chest pressure, you can't breathe
09:51 going up to the neck and the arms, the thing
09:54 you don't want to do is to sit at home.
09:55 When a person goes into the emergency room we will
09:58 hook you up to EKGs and we will see if you're having
10:01 a heart attack, if you are having a heart attack its
10:04 damage control at that point.
10:05 This is not the time for lifestyle modification,
10:08 in fact they don't even usually bring up the cigarettes,
10:10 I don't usually bring up these things.
10:12 First we have take care of the acute problem because there is
10:15 a chance that you could die from this heart attack.
10:17 One in three people die from heart attacks before
10:20 they even make it in.
10:21 If they make it in time there is still another 10% that dies.
10:24 So out of every heart attack that happens at least 40%
10:28 die within the first year, so time is of the essence.
10:31 If you have a heart attack you want to get in and let's
10:34 see the arteries occluded.
10:36 We have a certain amount of time to open the artery up to
10:38 restore blood flow so the muscle doesn't die permanently.
10:41 Part of that is with the stent.
10:44 We go through the groin and we put a catheter, a catheter
10:47 that takes pictures of the artery and then we actually
10:50 run a small wire up through the artery.
10:53 When we get to the blockage each week push that wire
10:57 through the blockage and then we blow up a balloon.
11:00 When the balloon blows up the blood can flow
11:03 back through the artery.
11:05 The stent itself? That's the balloon.
11:06 We shall have a stent we put on top to tack it up.
11:09 Okay that's the wire attached to that? - That's right!
11:12 That's a stainless steel mess that props that artery up.
11:15 Walla the artery gets blood and you start feeling good.
11:19 Now a lot of people think does that fix everything?
11:22 No! The things we talked about does not fix, it does not
11:26 fix the stressors on the life.
11:28 Now as far as the stent goes, remember the stent is
11:31 a foreign object and blood sees the foreign object and
11:34 what's it do? - it wants to attack it.
11:35 It wants to clot and we have to take Plavix as well as
11:38 aspirin to keep the clotting mechanisms down.
11:40 We don't want to put that stent in and all of a sudden
11:43 the body says, this is a foreign object and I'm going to
11:45 attack it, clot and guess what boom!
11:47 - another clot. A re-stenosis, we have another heart
11:49 attack, so the Plavix and aspirin prevent the platelets
11:52 from sticking together and prevent the clotting mechanism.
11:55 Over a period of time, it depends on person-to-person,
11:59 we actually grow a lining around that stent so the stent
12:03 gets what we call vascularized.
12:05 And when that endothelium no longer sees the stent then
12:08 it might be safe to stop the Plavix.
12:11 Amazing, so you do that through the Plavix
12:13 and the aspirin?
12:14 And yes it depends on what type of stents, we have two
12:16 types of stents, one is called a bare metal stent.
12:19 A bare mental stent is just bare metal and for that they
12:22 recommend Plavix and aspirin for at least one month.
12:25 This would be a typist and we put on a person whom
12:27 we didn't think was compliance, that need another surgery
12:31 soon because you only have to double up twice.
12:33 Remember when you are on this Plavix and aspirin you are
12:36 a bleeder, so you couldn't have another elective
12:38 surgery for at least that month.
12:39 A person might have to have a gall bladder surgery needs to be
12:42 done or something else we might put a bare metal stent in.
12:45 Now the other type of stents is called a drug eluding
12:48 stent, it makes medicine that helps the stent from
12:53 Those are shown to do well too.
12:54 In fact those stents we have to keep Plavix and aspirin,
12:57 at least Plavix on for a year.
12:59 Then after that year, depending on the circumstances we
13:02 would only keep aspirin as the anticoagulant.
13:05 You can go in and check that actual vein and stent itself?
13:09 Well we can but we usually do it indirectly by a stress
13:12 testing, asking the patient if they have enough pain and
13:15 those kind of things.
13:16 So I think these questions are very good and explains the
13:20 difference between acute care where you need a stent or
13:23 something to break up the clot and chronic care where we
13:26 need to back off of some of the stressors Tim.
13:29 I think that's a good place to start in answering a few
13:32 questions and cardiovascular disease.
13:34 So far we have covered lifestyle changes, get rid of the
13:38 stress, and let's have more love in our hearts.
13:40 That is exactly right.
13:41 All right when we come back on Bible Rx, we'll discuss
13:44 a couple questions about New Year's resolutions.
13:46 We will be right back.