Saturday, November 15, 2014

Falling Forward 2014, #3 fasting blood draw and awaiting my VAP, small ion mobility lab results- Karen's Perfect World

Coffee post blood draw and cat watching
Falling Forward 2014, #3 

My best attempt at a post that does not take forever to write fast post about: fasting blood draw for cholesterol testing.

A. I had a fasting blood draw for a VAP test (small ion mobility panel). I'm not getting 100% of my annual health benefits due to my cholesterol level. To be fair, it's only a street value of $5, but I should not be under penalty for having super high HDL.  Really. I've busted my proverbial butt to get my health and wellness spot on for me. It's a matter of principal.

B. My thoughts on best cholesterol. In Karen's Perfect World (KPW) the algorithm for the wellness product that doles out my health insurance discounts would automatically reflex to an awesome cholesterol test called a VAP or Small Ion Mobility Panel.    Just look at what geeky graphs I can pour over next.

C. The real world deal 
 KPW reflex lab testing hasn't become a reality yet, but instead of brewing a big pot of Karen Stew, I can use the tools that I have:

C1. My vast cholesterol knowledge both in real life ( my day job = a Medical Technologist , MT (ASCP), CLS), and

C2. Learning via great Paleo/Primal Resources (think the science citations in the book Cholesterol Clarity for one example.) and

C3. Resolve to put myself as the key responsible person in charge of my health and well being, and

C4. I can meet up with my doctor and make the best choices or changes that I can possibly make. My molecular genetics, responses to food, weight maintenance tools will NOT be yours.

BONUS Round: Being fat adapted makes for EZ fasting blood draws. Being caffeine deprived is my only drawback to later morning blood draw appointments.

What's working now: KPW
1. Meeting my work place parameters for health discounts as best I can.
2. Asking for additional blood work to confirm wellness algorithms that might be outdated.
3. Patience while sound science gathers data, looking at multiple parameters, keeping hs-CRP =1 or less.
4. The clarity to learn, try full fat foods (avocados, coconut oil, grass-fed beef, olive oil), and resulting good health.
5. Use current blood work to fine tune my diet, in coordination with my doc and n=1.

What did not work in the past: anti-KPW
1. I would be having to pay even more for my health insurance and use it more. No discounts.
2. I ignored my blood work and bio-markers until I was very close to getting sick.
3. I would tow the low fat, high carb, "healthy whole grains" line spewed by many, ignoring being morbidly obese but trying to count my WW points better. 
4.  I was not thinking with a clear brain. I wished I could follow the "rules" but failed to take action when that was not the case.
5. Hey, my cholesterol was "normal" but my hs-CRP was 6.8. Whuuuut!!?? So much NOT healthy about that. Fitting my n=1 into a plan that did not work was not great.

Is there anyone else out there who has to get additional testing based on out of date wellness and blood marker algorithms? Which parameters and what worked?

This post was in no way short. Oh well.. ;)


  1. My favorite phrase -
    ". . . Ignoring being morbidly obese but trying to count my WW points better."

    Really loved it, because that describes it to a T. And explains why so many struggle.

    I 100% understand there are a few who can just count calories without paying close attention to percentages (fat, carbs, protein).

    I 100% understand not everyone has as many food sensativities as you and I do.

    But I think there are a lot of people who do not understand the complexity of their situation. They have secondary conditions. They have complexities. Maybe not as many as you and I, but SOME.

    At the high end of the scale, for you, for me, we just had to start to reign in our quantities. All this fine tuning came later in our process. The fine tuning came to get rid of pain and problems as well as to maintain.

    We did not figure out all this stuff on day one. Our eyes were open to reality and our bodies and our minds. PROGRESSION. I think that is important to understand. Someone with 100 lbs or even 20 lbs, left to lose, is not in the same place in their journey as they will be at goal and in a progressive maintenance, and needs to understand how much more they need to be open to knowledge about their bodies.

    I struggle with my cholesterol numbers. Would be high if I did not watch it. Eggs do have an impact on me. I do egg whites. I do chicken, fish, turkey. The chicken and the turkey are extra lean breast only without the skin. I do tree nuts. I do avocados. I eat a good percentage of healthy fats. I avoid higher fat types of meats. I really have to watch it.

    1. Yeah, Vickie, WW harder didn't really help me. When I weigh in monthly (seeing the Doctors office number vs the home scale is very, very helpful to me) I get the heck out of there quick. I used to stay for meetings, too much talk of processed food and the side eye for even mentioning abstaining of known binge/trigger foods. Sigh.

      Fine tuning: Must happen in weight maintenance. Must. Failure = regain. Food, emotional stuff, hormone regulation due to changing diet changes.

      Cholesterol: No struggling here... Saturated fat is most welcome in balanced amounts. 2 eggs daily, grass-fed beef makes me feel quite well, bison, lamb are also sources, but nothing in in this world makes me feel satisfied like some good grass-fed beef or steaks. I WILL cut fat off non-grass fed meat (suspect that it's the nutrient profile). Chicken... I steer clear of the skin and tend to strip visible fat on thighs. I won't buy chicken breasts at all, unless I'm roasting the whole bird and I'm forced into it- I put it on salads and then supplement with a TBS of olive oil or avocado oil. I NEED my cholesterol to haul around my other hormones and for any sort of normal inflammation and my immune system. There's a reason I don't get sick, cold body temps, don't take hormone replacement in menopause, and am less anxious and sleep better. With a low hs-CRP, low triglycerides, good glucose levels, then high HDL, well, I'm going to have cholesterol in the 200-250 range. It's normal. The cholesterol blood normal ranges were changed. I going "retro" normal cholesterol blood ranges for good health. My docs on board with it.

    2. I am not arguing with YOU.

      But adding for posterity - when I read other blogs talking about low carb, high fat, and talking about all the bacon they eat, my personally feeling is - it is still addict brain talking. I substitute the word fat with the word chocolate as I read. Because I think a lot of them are totally fooling themselves. These are people who do not have all their weight off, have not hit maintenance, have not learned. It reminds me of the WW 100 calorie packs of candy. Can wrap it in different paper, but it is still the "fix" addict brain talking.

      It will be interesting to see what comes of your cholestrol work with your doc. My HDL is also high, which puts my total high. But I can get my LDL in a better range if I am super careful. Not arguing, just saying. Will be interesting to see if any parameters, dealing with high HDL's appear in our lifetime. And I wonder if this is only a factor with those who were formerly obese.

    3. RE: bacon, yeah... it gets a little tiring reading the bacon jokes. Especially since I'm pork sensitive. One kind of interesting thing when I addressed my other food addictions (sugar,grains) super flavorful foods became "That tastes delicious, I'll have a slice" from "Holy Smokes, I want a whole plate full" Big difference in the recovered brain and the addiction. Same thing with 85% chocolate. The WW 100 calorie packs and the 3 point bars were my undoing. Legalizing those kept me in the binge cycle for many years. (Medifast food didn't do that, very different product, and probably why people are successful on the weight loss - although due to dairy and soy, no more MF for me)

      I'm only worried about the small dense LDL particles. I can have as many large fluffy as what is "normal" for me. That's the thing about most cholesterol tests is that only the total number is reported. Heart Disease is somewhat silent in many ways, so I need to know now if I need to change my diet, not post event. Plus, the insurance discounts will be more counted in higher discounts $$ wise each year. No sense in changing my very health promoting food template if I'm tweeking the wrong values. Happy to change up, only if it's value added.

      The other silent thing is blood glucose. I still monitor myself from time to time to make sure I'm not over fruiting things ( I stick to berries, doesn't seem to have much effect). Of course, insulin would be the best measure not not as easily tested or screened, but I think glucose and HA1c are good secondary indicators. I was always taught "no sweet potatoes unless you are already lean or fueling a crossfit or other epic work out. Starchy carbs have a pretty big effect on my fasting glucose.

      Can't wait for my results..!

  2. I seem to be one of those people who could eat just lower calorie almost any type of food and have all my health numbers be okay. But...I really don't know for sure, because even though I eat primarily smaller portions of regular food, I also mind my food groups, fatty vs. lean meats, having enough vegetables and fruit, eating low fat dairy, etc. I don't eat regular sweets, candy and junk foods, such as chips, etc. My losing calorie count is about 1200 to 1400. I sometimes count calories, and at other times I just use a small plate and mind my portions. We eat out fairly often, so I probably have a fair amount of fat at those meals. My fasting blood sugar is down to 98-100 from 150 to 180; my A1c is down to 5.9 from 6.5 and continues to fall with each six month test. Total cholesterol is 195, but has never been much higher, even when more overweight and overeating. All is well, even though I just usually mind my portions. I guess we're all different, so it's good to know our numbers and the effect that food has on them.

    1. E. Jane, I found that my calories can vary widely (they do based on my activity, if I'm truly hungry, I'll eat a balanced Protein, Fat, and carb from a veggie) but I will absolutely gain weight on increasing my carbs- even from veggies. Yep! I'm one of those people. The WW crowd would have overheated points calculators on 70-100 grams of fat and protein a day. I think they'd see me coming and lock the doors. ;) Just for the pure fun of it, I may grab an online points tool and run my Paleo-ish style diet through the WW system. Just curious what the points are. I would venture to guess 28- 30 points?? Could be more due to the fat. Leanest body I've ever had in my life. Youngest I've ever felt. It could also have to do with my molecular genetics ( I know I have two copies of my APOE3 genes).

      Really, really happy that you are keeping your glucose values in check. I know too, too many folks in real life that don't monitor and don't take action on their known high sugar levels. Breaks my heart. I don't have diabetes or even prediabetes ( I was so, so close), but even I have a glucose meter and test a few times a week. My HA1c runs 5.2-5.4 no matter how low carb I go. Glucose is 70-80's consistently, even 2 hours post eating.

      Glad you are seeing what works for you.

    2. Karen,
      It sounds like what you are doing is working well for you. It's also apparent that you know what your body needs. I find myself very hungry if I just count WW points, so I have my own way, which is less "junk" than many WW folks eat. My numbers are much better since losing weight and I expect them to be even better when I get the last 30 off. I enjoy hearing what others do to lose and maintain.

  3. I need to get my cholesterol checked and my blood sugars checked. I have reigned in eating eggs very day and now do more egg whites because my cholesterol tends to be high--and I need to be careful as I head into menopause (and I think I am definitely perimenopause at 44 because my periods are now all over the place). One thing that losing weight has done for me is lowered my blood pressure. It is genetically high, but at one point untreated (and when I was very stressed), it was 180/90! Scary! I do take bp medication, but now it is 105 or 110 over 65-70. I partly credit the lower blood pressure to lifting heavy weights. I think that has helped a lot.

    1. Ahhhh, Ali. I'd recommend the Cholesterol Clarity Book (Jimmy Moore) and an expanded cholesterol panel (VAP, Small ion mobility, or NMR). I can't tell you how many menopause symptoms that I believe I've kept in check by not looking at total cholesterol, but looking at low triglycerides ( lower carb), high HDL, under 100 glucose readings, in check HA1c readings. I have to guess that my body really likes my cholesterol so it can synthesize all my other hormones in balance. I could be totally wrong (but I think I'm right)

      I so, so need my cholesterol (so called building block of all the hormones) to be there for inflammation, to make all my hormones.. oh, so important for cell integrity. When I was morbidly obese, my cholesterol was "normal", but I didn't feel so great. It's poorly absobed from food- hint my body will make it on it's own..... read more at Wiki.

      I had to totally forgive myself for studying this as a major in college and med tech school then, not forgiving myself for trying to eat super low fat/ low good sources of cholesterol (eggs). I am a medical professional who ran cholesterol tests- both in in the main lab and screens and I KNEW better. 1000 sighs... It's not my fault, but feels good to be living my learning. LOL. ;)

      Anyhoo- good news on your blood pressure. I had borderline high blood pressure until I lost weight, ate more Paleo-ish style. Getting sea salt in and conventional salt out really helps. Kudos to the heavy weight lifting.

  4. Great post. I pay for my own health insurance and so far there aren't any discounts available for being in better health. I have a pretty high deductible and so if I want lab work I am pretty much on the hook for it. Have been thinking about if getting cholesterol tested would even be worth it, especially if they are only looking at total cholesterol, hdl and ldl without looking at VAP. Have you read Grain Brain by the neurologist David Perlmutter? He points out that total cholesterol and risk of dementia/early death in the elderly are actually inversely correlated (I think based on data from the Framingham study), so that having total cholesterol above 200 is actually protective against dementia and having it below 200 (the so-called healthy number) correlates with greater risk of dementia. Interesting stuff. Hopefully the message about cholesterol will become more nuanced as more information gets out there. Cholesterol Clarity is on my to-read list.

  5. Sharon, I suspect that you being in better health will help to keep your premiums (and medications) low. My deductibles are through the roof! I jokingly told my daughter, In 2015, our goal will be not to get sick... at all...ZERO. ;) Well checks are still covered.

    I've heard in the Paleo sphere that certain docs will discount lab work heavily for cash transactions. I have a unique lab test benefit that most don't have, but my doc is very conservative on ordering lab tests ( she's a great diagnostician so piling on lab tests on a healthy person is not required). In 2015, I'll still pay heavily for everything.

    I've skimmed Brain Grain and listened to lots of Perlmutter podcasts. I totally believe that on the cholesterol being inversed for things like dementia. My brain is made of lipoproteins.. it's going to need a varitey of nutrients. I can also see why MS patients see an improvement by going on the Whals protocol. Cholesterol is going to aid in lowering inflammation, the neurology path ways.

    I know that science is studying this closely and I hope that better guidelines come back around to the general public sooner rather than later. So glad you are getting Cholesterol Clarity. For me, with my molecular genetics, my family history, my background in cholesterol synthesis, and just n=1, just glad to get on solid ground. I can't wait for the wakcy canola oil guidelines to change.

    Here's to navigating the health care premiums in 2015. No better time to n=1 than now... :)