Friday, August 29, 2008

A wake-up call

I spent all day Wednesday--I mean all day--at a doctor's office. Not just any old doctor, but a doctor who specializes in what he calls "vitality and longevity."

A majority of the day was spent going over a detailed blood analysis, bone scan, and body mass/fat analysis he had done for me.

What I learned shocked me.

First, I should probably give you a sense of exactly how "detailed" these analyses were . . .
  • They tested 70 different . . . I'll call them "features" . . . of my blood.
  • They checked for seven different substances in and two different features of my urine.
  • They scanned my lower back (lumbar region) and my hips for bone density--then provided 10 specific analyses based on detailed analysis of the individual L1 through L4 vertebrae and 28 specific analyses based on detailed analysis of six different areas on each of the left and right hips.
Some of the numbers were distressing, but what really bothered me was how little I've ever heard about some of the tests that the doctor told me are extremely important. For example . . .

While my LDL (bad) cholesterol is high and my HDL (good) cholesterol is low, and both of these create what the medical profession calls a high "coronary risk ratio," my doctor told me that LDL and HDL, on their own, are not good markers or predictors for heart attack. A far more important indicator, he said, is the number of LDL cholesterol particles per unit of blood, and the particle sizes. Indeed, he said, LDL particle number is the #1 risk marker for heart attack.

Have you ever heard that before? I hadn't! And my LDL particle number is very high.

I haven't been able to learn much about this matter of particle numbers and particle sizes, but I have been able to confirm that Dr. Leonardi wasn't just blowing smoke.

There were some more surprises:
  • My fasting glucose level was high.
  • My HgbA1c (Hemoglobin A1c--glycosylated hemoglobin) was high.
  • My testosterone was low.
  • Though my hemoglobin and hematocrit levels were officially in the "normal" range, they are, said Dr. Leonardi, "low for Colorado." (When you live at relatively high altitude, as we do, your blood should have a little more hemoglobin and hematocrit then someone at sea level.)
  • I don't know that I've ever heard of osteoporosis in men, but the bone density analyses were interesting as well. I have no osteoporosis, but I do have what Dr. Leonardi called osteopenia, or moderate bone loss, in portions of my hips.
  • And then there is the matter of body fat. I have a BMI (body mass index) of 24.5 which is within the normal range. Most people when they look at me say they think I am almost on the slender side. But the fat analysis shows that my body is composed of 24.9% fat. The goal, Dr. Leonardi said, should be under 20% body fat, or 80+% of lean mass (bone and muscle). What's even more interesting is where the fat is located--hidden away in the middle of my abdomen. Dr. Leonardi says he wants me to lose 16 pounds of fat and gain 8 pounds of lean mass.
I listened to all of this and wondered why I have heard so little of it before. It's not as if I've been ignoring my health! I've been going to my doctor on a regular basis. But I've never heard most of these things before. Why? (Or, rather, why not?)

I thought Dr. Leonardi's answer to that question was rather interesting . . . and sobering. as his website says concerning medical insurance,
[I]nsurance companies typically don't pay for preventive care. Their job is not to keep you healthy. It is to provide standard care for covered illnesses in return for your monthly premium.
The traditional medical industry is all about treating illness. It is not about, as Dr. Leonardi would say, helping people to decelerate or even block our progress down the highway toward disease.

More on this stuff at a later date!
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