The importance of a heart scan for managing heart health

據一位心臟病專家認為（Dr. Arthur Agatston 有30多年的臨床經驗）如果所有心臟病的風險因素都得到好好地處理的話，任何人都不應死於心臟病，，血管成形術angioplasty和冠狀動脈搭橋coronary bypass手術只應作為沒有選擇時的急救手段，因為他們不能根治動脈堵塞這問題。他的專業意見是根據臨床經驗和80年代和90年的研究發現而定的。 （Agtston, Arthur. The South Beach Heart Health Revolution. St. Martin’s Griffin. 2008. p.28-9.）約 50％死於突發性心臟病的人沒有如心絞痛等預警病徵。最近，60歲的運動員，周錫輝先生就是一個很好的例子。 (前校長周錫輝踼波猝死 (http://news.sina.com.hk/news/32/1/1/2329660/1.html)周先生只六十歲,是運動健將, http://www.singpao.com/NewsArticle.aspx?NewsID=169928&Lang=tc

• 楊式太極拳高手(名咀,洪清田亦是他學生),
• http://pac.org.ru/fruit2/art_main.phpiss_id=20110515&sec_id=4104&art_id=15255005

不胖, 但不注意飲食。)

另一例子是 Jim Fixx. (美國的詹姆斯富勒 James Fixx（1932-1984）是1977年最暢銷的書The Complete Book of Running的作者，他經常慢跑,成功地幫助美國開始普及體育的健身革命。可惜他在1984年7月20日去世，享年52歲​​, 在慢跑時心臟病發作後猝死。驗屍報告指出，他的第一條冠狀動脈有95％阻塞，第二條冠狀動脈有85％阻塞，第三條冠狀動脈有70％阻塞。)

這些突然去世者的剖屍檢驗顯示有些人的冠脈動脈閉塞達 90％以上。吉姆Jim Fixx是一例，他的一條冠狀動脈阻塞95％。然而，他們沒有任何心絞痛的病徵。通常心臟病患者有70-75％的冠狀動脈閉塞時會出現心絞痛之類的症狀。但並不是每個70-75％的冠狀動脈閉塞者都有心絞痛。在80年代和90年代進行的研究發現了答案。我們的身體有一定的自然癒合能力疏通阻塞了的血管，人體自身的分泌物會通血管阻塞, 生長因子的激素會激發堵塞周圍的側支血液微循環來提供血液給堵塞冠狀動脈下游的組織。這就是為什麼有超過 90％的堵塞都可以沒有心絞痛的原因。只要我們給予身體時間和適當的刺激(如生活方式的改變)來發展這個內置側支血液微循環的旁路循環系統，即可解決堵塞的問題促進心臟健康,。任何人僅僅因為血管造影顯示高比例的阻塞而被建議進行手術者應徵求另一醫生的第二意見，才接受這些手術。心臟病突發作是由軟堵塞塊破裂而不是由動脈狹窄硬化做成的。大多數普通人錯誤地認為，如果用手術打通血管堵塞他或她的心臟病即被 『根治』。但是臨床經驗證明，這些手術只應在命危要急救情況時才使用，非緊急的通血管手術並不能延長病人的生命。如果患者繼續過手術前的生活方式的話心臟的搭橋和支架會再出現阻塞。然而，因微循環幔激發的天然心臟的搭橋旁路不會出現堵塞，因為它們直徑太小，瘀斑塊不能積聚。

Dr. Arthur Agatston 建議，每個人都應接受一個心臟掃描heart scan來評估軟瘀斑塊破裂的風險。心臟掃描的鈣分數Calcium Score越高（0 – 1000或以上）曾經發生過但沒有致命的軟斑破裂次數越多， 只不過破裂沒有大到足以造成有病徵的心臟病發作而已。隨著年齡的增加鈣得分亦增長，只要速度正常時，這是正常的，因為正常的傷疤硬化時會有更多的鈣​​沉積在傷口上, (筆者按: 這是為何血壓會隨年齡而增加的原因之一, 因血管壁鈣化而慢慢硬化失去彈性, 血管的鈣化相信不是因為血中太多鈣而引起的, 所以不應減少攝取鈣質。尤其是因骨質疏松而補充鈣的長者。)

然而，如果鈣得分速度進展異常地高的話，那麼心臟的保健管理計劃要加強才能確保鈣得分速度保持正常，以避免有機會造成致命的心臟病發作。 （Agtston, Arthur. The South Beach Heart Health Revolution. St. Martin’s Griffin. 2008. p.84.）

以Dr. Agtston的意見, 那批醫生在2001年為51歲的美國總統克林頓進行常規體檢時沒有為他作心臟掃描是使他錯過了預早診斷出心臟病潛在高風險的關鍵因數。那沒有進行的心臟掃描很可能顯示一個相對地高於正常的鈣分數。三年後，他差點心臟病突發, 隨後的檢查顯示他有多處的血管堵塞，並立即接受了心臟搭橋手術。(Agtston, Arthur. The South Beach Heart Health Revolution. St. Martin’s Griffin. 2008. p.91.)

Mayfairdiagnostics是加拿大卡爾加里唯一提供有心臟掃描服務的診所：
我們有兩個心臟掃描服務。我們的冠狀動脈鈣化數據是$ 495.00，附有一個在動脈的的硬斑百分比。另一種是$1,350.00的 冠狀動脈電腦 CT血管造影。這種掃描確定冠狀動脈狹窄的位置和嚴重程度, 以及評估血管壁和動脈粥樣硬化斑的性質（軟斑硬斑分別評估）。它還提供心臟解剖資料。評估心腔，閥門，心肌及心外膜的異常, 提供各鈣得分。冠狀動脈 CT血管造影的異常, 還包括放射科醫師有關您的掃描的諮詢 。

在溫哥華的 False Creek Healthcare Centre 同様的服務約 $1800.00

http://www.falsecreekdiagnostics.com/services/ct-cat-scans/ccta-cardiac-scans/

http://www.mayfairdiagnostics.com/香港的明德國際醫院亦有64 slice CT Heart Scan

http://www.matilda.org/eng/service/EHA/EBCTscan.php

21Compression of the patella (positive if painful) 髕骨壓迫痛：在膝後墊一小枕，使關節微屈於十五度，股四頭 肌放鬆，檢查員用手掌上下左右錯動地按髕骨，如髕下疼痛為陽性。

Palpation of the edges of the patella (positive if painful) 髕骨邊緣指壓痛，患膝伸直，股四頭肌放鬆，檢查員用一手將髕骨推起如圖，另一手用指摸 壓髕骨邊緣，疼痛為陽性。

Resist patient’s leg extension (positive when painful) 伸膝抗阻試驗：患者先屈膝，檢查員用一手在膝後固定患膝，另一手握足踝阻患膝伸直，當患膝伸至度出現疼 痛為陽性。

髕骨軟骨磨擦試驗，醫生兩手前後地力按髕骨，前手將髕骨上下左右地移動，令患者屈伸膝關節，有痛或摩擦感者為陽性。Compression of the patella when the knee is bent (positive when painful)

Joint space narrowing of the patella-femoral joint髕股關節間隙變窄

壓在髕骨軟骨的壓力點本來應該是平均A balanced Patella

Tennis elbow treatment

降低血中膽固醇沒有好處; 頸靜脈擴張手術可治多發性硬化症

親 愛的諸君，
願聞閣下的意見：
“*據ALAN CASSELS先生在2010年7月26日，P.A7溫哥華太陽報報導，因接納醫生的意見，服用他汀類藥物（Crestor, Lipitor立普妥,
Pravachol 普拉固or Zocor舒降之），降低血中膽固醇。加拿大人1年中浪費了200萬美元的社會資源。
http://digital.vancouversun.com/epaper/viewer.aspx
大 藥廠和各西醫師公會，根據臨床記錄和研究，得悉他汀類藥物可以降低有心臟病史者的心臟病再發風險，他們推論，膽固醇過高的健康人仕亦可服他汀類藥物，降低 膽固醇,
因而降低患心臟病機會，事實上據全球超過65,000男子和婦女的11個研究追蹤調查，結果顯示這些藥物並不如大藥廠和各西醫師公會推 論，不但沒有為服用者帶來好處，反而對某些人可引發副作用，因為這類藥物會消耗一些肌肉中的酶使肌肉較弱。肌肉無力可引發很多表面看來和這類藥物無關的副 作用，醫生於是開出更多的藥物治療這些副作用。如因直腸肌肉無力的便秘，醫生名正言順地開通便藥。當陰莖環狀肌肉無力而出現陽痿時，醫生開偉哥 Viagera。餘此類推的連鎖反應，浪費了不可計算的社會資源。

當然還有其他的方法來降低膽固醇,如燕麥片，燕麥麩，核桃，亞麻子，洋 蔥，和魚油等，但大藥商不能從中獲利，許多醫生亦不想降格用食品作為處方。減肥雖然可降低膽固醇，但很多本身是肥胖的醫生很難說服病人減肥。減肥的風險亦 不少，很多名人如Karen
Carpenter因減肥而死亡。
2010年8月4的“時事直擊”(週一至週五，上午8時至10時0，在溫 哥華，AM1470) 廣播節目中主持人，溫建功牙醫生報導，在總統小喬治的管治時期,
美國政府對美國老年人的藥物的開支,
較花於打 擊恐怖主義的戰爭費用還要多。如果將上述兩則報導結合起來地思考的話，任何人都可以推論到一旦政府的醫療政策由西醫協會和大製藥公司聯手通過說客“支配” 各政府的話，對社會資源的浪費，是沒有任何面對人口日漸老化的政府可以負擔得起的。大藥商不會為這些社會問題擔心，只會擔心利潤減少,
股票價下挫 而已。有部份西醫想改革，但西醫公會，盛名所累，積重難返，逃不過大藥商的控制，不能不用他們發展的藥物。最近加拿大BC省政府不肯支付未經証實的頸靜脈 擴張手術,為多發性硬化症病人治病，病人要去波蘭印度等地求診，相信很多西醫亦敢怒不敢言。將降膽固醇西藥用於膽固醇過高的無病之人,
亦 未經雙盲試驗証實其藥效，為何西醫公會和省政府同意廣泛地使用這些大藥商出售的產品？他們敢說這類西藥十分安全，不會有副事故嗎？要証實頸靜脈擴張手術是 否有效，只要調查和比較現存的手術前後病人的病情已有結果，為何硬要用化很長時間的臨床試驗証明？是思想僵硬或是有關團體保護既得利益？讀者諸君，求人不 如求己，信矣！”Mr. ALAN CASSELS reported in the Vancouver Sun on July 26th 2010, P.A7 the
gross waste of social resources ($2 million/yr) when Canadians listened to their
doctors’ advice to take statins (Crestor, Lipitor, Pravachol or Zocor) to lower
their blood cholesterol. http://digital.vancouversun.com/epaper/viewer.aspx
Based on clinical records and studies that statins can lower the risk of people
who have had a heart attack to have a second one the drug companies and the
various medical associations claim that healthy people with elevated blood
cholesterol can benefit from a lower cholesterol reading by taking statins. “One
of the studies, a major metaanalysis, or overview of 11 major trials of the
effects of these drugs such as Crestor, Lipitor, Pravachol or Zocor, examined
the effects of statins in more than 65,000 men and women.” The findings of these
studies do not support the claimed benefits at all and statins can have some
side effects for certain people because they deplete some muscle enzymes making
them weak. Muscle weakness can trigger many side effects, which are then treated
with more drugs. When people are constipated because of weakness of the rectal
muscles they have to take another medication. When the ring muscles of the penis
are weakened by statins, causing impotence Viagera is prescribed. The list can
go on and on, wasting more social resources with their ripple effects.

Of course there are alternative ways to lower cholesterol but the drug companies
cannot profit from them like, oatmeal, oat bran, walnut, flaxseed, onions, and
fish oil etc. Many doctors hesitate to write these food items as prescriptions
anyway. Losing weight is a good way to lower cholesterol but there are so many
fat doctors it is hard for them to advise patients to lose weight. On top of
that there are many horror stories of people who died from losing too much
weight too rqpidly like, Karen Carpenter for one.
On August 4th 2010 a radio talk show host, Dr. K.K Wan (a dentist co-hosting a
radio talk show, called「時事直擊」AM1470, broadcasted Monday-Friday, 8am-10am) said
that during the terms of President George Bush the junior the government’s
spending on American seniors’ medications was larger than that spent on the war
against terrorism. If the above two stories are put together we can see the
danger ahead of all of us when the medical associations and the drug companies
are allowed to “dictate” their health care policy to our governments. There are
medical doctors who want to break away from this kind of control by the various
governing and funding bodies. However the medical association has already
painted themselves into a corner and it is hard for them to allow their members
to use other so-called “unproven” alternative methods not developed by giant
drug companies, which can afford to spend a lot of money to lobby the various
funding and governjing organisations of medical dortors. The funding refusal for
using angioplasty, called Liberation Treatment on CCSVI (chronic cerebrospinal
venous insufficiency) for treatment for multiple sclerosis patients by the B.C.
Provincial Government is an excellent example. Have they thought of this when
thy paid for the use of cholesterol lowering drugs on healthy patients with
elevated choleserol? Don’t tell the public that these drugs are so safe that no
patents will have adverse effects because of their usage. Therefore these drugs
according to the experts’ opinions can be prescribed without any double blind
studies. A survey to compare the symptoms of the MS patients who have undergone
the controversial operation can give everyone a fairly objective idea of its
effectiveness. Why do involved organisations insist on performing a lengthy
clinical trial? Are they protecting their vested interests of the public? If we,
the people do not help ourselves do you think our government, the drug companies
or the medical association can help us? (For CCSVIplease watch
頸靜脈擴張手術可治多發性硬化症
http://www.youtube.com/watch?v=C_RXs5dPh6E&feature=player_embedded)”

Bikram’s hot yoga

另一個令人費解的例子：

Bigram先生說，“當你的力量相等你的關節軟度時，你不必試圖平衡自己…一旦你有一個完全健康的身體，那麼你必須平衡它與你心靈。”

實際的醫療事實是，自律神經系統中許多內置的受體，如眼，耳和肌腱中高爾基體肌腱複合感應器官等會自動不自覺地平衡人體的。

Bigram先生說所說的“力量相等你的關節柔軟度。”有何意義？

•力量發自肌肉的質量，一般來說，肌肉愈大，力量愈大。

•關節柔軟度決定於韌帶和肌肉的長度，愈長愈柔軟。肌肉的長度和大小是相對的，不能又長又大。他說的相等是否指洽到好處的意思？

•他是否意味著通過他的瑜伽伸展運動可以改善平衡？

•許多運動都可以達到這一目的，例如武術。如果是這樣的話，為什麼他的26式這麼重要？

另一個似是而非的偽醫學解釋：擠壓胰腺“沖掉”脂肪細胞。

Bikram先生說：“…此式

擠壓胰腺使血液受阻不能進入胰臟，像洪水遇到胡佛水壩激發強大驅動力，胰腺以外的血液水平不斷上升！ 停留在此姿勢20秒後，血流量和壓力已達到最大容量…當您走出的姿勢時，一如打開大門，轟！血液如水災地擠壓入胰腺。這式子助您快速地清理胰腺，使精力再現。”  解剖學上胰腺周圍沒有任何空間，血液是局限於動脈和靜脈中。胰腺受周圍的軟棉棉的大型器官如肝臟和胃擠壓，這就是為何胰腺癌是如此致命，因為在腹腔深處，只佔一個狹小的空間，外科醫師無法很容易地操作。許多病況如糖尿病是由於太多脂肪細胞塞滿腹腔，使身體對胰島素不敏感，是糖尿病的成因。無論這式子做多少次，都不能“沖掉”任何脂肪細胞。

然而，許多人受益於高溫熱瑜伽。 •他的學生，朱利安寫了一本書（糖尿病雖未治好但不再需要胰島素了）描述了他的高溫熱瑜伽練習如何控制他的糖尿病症狀和助他擺脫長期的慢性腰痛。在第一次練習時他辛苦到以為他會死去，但堅持6個月後，他減去 50磅，“治愈”糖尿病和腰痛的問題。

•減體重50英鎊可以“治療”（控制是一個更好的名詞）許多病，包括腰背疼痛和2型糖尿病。

在他書中的所謂的科學解釋，其實是根據自己的練功經驗。 •在2009年第七屆溫哥華加拿大西部的高溫瑜珈Chanmpionships比賽時他向溫哥華太陽報記者承認，回顧早年在印度很熱故鄉時，他會閉門來加 熱練功，[從 13歲起他已經在加爾各答的高希體育學院練瑜伽每天至少4小時。在此期間，他第一次開始注意到高溫對他的身體的影響。 “當房間愈熱，我出汗愈多，我身體可以伸展更多，我可以更深入我的身體裡，而且永遠不會受傷，”他說， “因此，我的多年實踐開發了我自己的高溫瑜珈功法。”]（週六，11月2009分之28，最新消息： Vancouversun.com，藝術與生活體育第7頁）。

Another example of something that does not make sense

•      Mr. Bigram said, “When your strength and flexibility are at the same level, you don’t have to try to balance — the body will balance itself…Once you have a perfectly healthy body, then you have to balance it with your mind ”

•      The medical fact is that the autonomous nervous system unconsciously balances the human body with many built-in receptors, like the eyes, the ears and the muscle-spindle-golgi-tendon-complex etc.

What does Mr. Bikram mean by “strength and flexibility at the same level?”

•Strength is associated with muscle mass.

•Flexibility is defined by ligament laxity and muscle length not strength.

•Does he mean that balance can be improved by lifting body weight while stretching in his yoga poses?

•Many exercises do this, like martial arts. If so why his 26 poses are so essential?

Another example of spurious medicine: squeezing the pancreas by the Standing Separate Leg Head to Knee Pose to flush out fat cells.

Mr. Bikram said,  “…the blood driven by the excited heart is approaching the pancreas like a flood. But it can’t get in; the blood is blocked (by the Standing Separate Leg Head to Knee Pose).

So outside the pancreas the blood level is rising and rising. It is like the Hoover Dam! Then after 20 seconds in the posture, the blood volume and pressure have reached maximum capacity…you come out of the pose, open the gates, blood rushes it and flood the pancreas. Boom! In this way you reenergize, revitalize and clean it in a brief period of time through this one asana.”

Anatomically there is no space for any blood volume build-up outside the pancreas. Blood is confined in the arteries and veins. The pancreas is squeezed in by the surrounding large and soft organs like the liver and the stomach etc. This is why pancreatic cancers are so lethal because this organ is so deep inside and is occupying such a tight space that surgeons cannot operate on it easily. Many pathological conditions like diabetes is caused by too much adipose cells (fat) making the body insensitive to the hormone insulin. No matter how many times the pancreas is flushed by the Standing Separate Leg Head to Knee Pose the blood cannot “blow off” any fat cells.

Yet many people have benefited from the hot yoga practice. •His student, Julian wrote a book (Diabetic Always- Insulin No More) describing how yoga practice controlled his diabetic symptoms got rid of his chronic low back pain. He thought he would have died in the first class but persisted and in 6 months he lost 50 lbs and “cured” his diabetic problem.

•Losing 50 lb can “cure” (control is a better term) many cases of low back pain and Type 2 diabetes.

His so-called scientific claims in his books base only on his own experiences.

•In 2009at the 7th Annual Western Canadian Hatha Yoga Chanmpionships he admitted to the reporter of the Vancouver Sun Newspaper, [from age 13 he had been practicing yoga at least 4 hours a day at Ghosh’ College of Physical Education in Calcutta. During that time he first began to notice the impact of heat on his body. “When room is more hot then I can sweat more, I can stretch more, I can push more, I can go more deeper and inside my body, it hurts less and you never get injury, “ he said, recalling early days in India when he’d shut door to keep in the heat. “So I developed this with my own practice,” he said. “Years and years and years and years and years.” ] (Sat., November 28/2009, Breaking News: Vancouversun.com, Art and Life P. D7).