About two years ago I had to beg my cardiologist to order a "CIMT." Before I proceeded with the "CIMT," I specifically asked this "heart expert" if the "CIMT" he was ordering would show SOFT and hard plaque. He responded. "oh yes, you can trust me." So I had his "CIMT" test done and what do you know, this "CIMT" reported that I had plaque but there was no hemodynamically significant blockage. There was NO MENTION whatsoever of the dangerous, SOFT plaque versus hard plaque. All I can say is that most American cardiologists are completely CLUELESS on many of the tests they order!!!!!!!!!
The doctor I was seeing is very knowledgeable about CIMTs, and person who did the actually test was a patient of the same doctor. Unfortunately, the doctor no longer takes my insurance, so I'm not sure what I'll do, but have to see someone who knows about it.
@@mystatinfreelife Are you familiar with Dr. Ford Brewer who runs the "PrevMed" Company? He has multiple, very informative, RUclips videos on the CIMT test and its interpretation.
How to decide what qualifies as pertinent data, and how to determine the weight of each entry is an ongoing (hopefully) endeavor. Just because lay people are not schooled in the data should not discourage them (us) from beginning a search. And just because Physicians are schooled to one extent or another does not make them infallible.
You left us with a cliffhanger, Russ! You did not tell us what your interaction with your PCP was after this test and the experience of an 8 hour period of transient amnesia!! Perhaps that will be your next video! If so, I am looking forward to hearing the results!!
@patrickdeady410 i haven't been to my PCP with this, and probably won't. I have no confidence they'll know what to do with the info. I'm waiting to see a doctor who deals with this. Unfortunately, the doctor who ordered the test no longer takes Medicare patients. As to TGA, I have a video on that. ruclips.net/video/QSghaiB7E-g/видео.htmlsi=2TiNKmf-f3btkcpq
I've had a CIMT when I asked my cardiologist for it. Never got any pics. I just remember Dr. Brewer saying it has to be a highly qualified technician who does the test in the right way to get meaningful results. Can't remember the organization he recommends for CIMT.
Dr. Brewer recommended in a recent video CardioRisk (which is the lab that did my analysis), Carotid Care (which is who actually administered my test before sending it out), and Vasolabs, if I'm remembering right. Carotid Care provides the service physically on Martha's Vineyard in Massachusetts, and Windsor, CT. CardioRisk seems to have a rotating set of cities. I don't know much about VasoLabs.
Russ, Curious if there is a online calculator that will take the many heart studies online, which tend to quote relative risk, to an online calculator to convert these studies to an absolute risk as well as numbers needed to treat?
Well, the on-line calculators generally give absolute 10 year or lifetime risk, based on the data from the studies. Then to determine the absolute risk reduction, you have to guess at what the relative risk reduction is provided by the therapy. For statins, I was using 36% based on the famous Lipitor Ad, but now that I've looked at more data, the actual relative risk reduction is more like 17-20%, so I go with that now. As an example, if a risk calculator told you that you have a 7.5% 10-year risk (the threshold for many guidelines), then the absolute risk reduction is about 1.5% (20% of 7.5%) and an NNT of about 67. The two risk calculators I reference the most are the PREVENT calculator and the 2018 (NOT 2013) Pooled Cohort Equations calculator. But I don't know of a calculator that will go ahead and compute NNT for us. Perhaps they are afraid that the numbers will be too low and unimpressive that they'd lose statin victim and the pharmaceutical companies would do their best to shut them downs.
@@mystatinfreelife thanks Russ for taking the time to respond to my question. I got a good laugh from the last line of your response. So true. I would think a college math/computer science major would be able to design a simple online calculator, since all the data or numbers is provided from the various studies. 😀
Thank you so much for this real-life dive into the CIMT test. I am wondering if the CIMT test providers always provide the images or if you have to special request them.
I suppose it depends on the lab. In this case, the technician told me that they give random shots, rather hose that are necessarily useful. I don't know why that would be their MO.
@@mystatinfreelife Thank you for the reply - it's good to have even that piece of info (random shots) from the technician, even if it isn't especially helpful. (Typically I cannot get a radiology tech to give my ANY information (other than "you can leave now" LOL).
So what do you do if you gain enough understanding to ask the right questions, but it becomes clear during the discussion that the doctor is probably not giving you any answers that are accurate or relevant?
@worldcitizenra I guess you have to bring it to a different doctor. This is a common problem, not just with the CIMT; I experienced a similar scenario with my Kraft Insulin Survey results. In that case, I didn't know the right questions and was told I was doing great based on the final reading, while the rest were ignored. In this case, I didn't know the right questions and my diagnosis of "doing great" was corrected by a more knowledgeable doctor. So that's a point I missed: having the knowledge to ask the right questions also helps you know if you're getting relevant answers.
About two years ago I had to beg my cardiologist to order a "CIMT." Before I proceeded with the "CIMT," I specifically asked this "heart expert" if the "CIMT" he was ordering would show SOFT and hard plaque. He responded. "oh yes, you can trust me." So I had his "CIMT" test done and what do you know, this "CIMT" reported that I had plaque but there was no hemodynamically significant blockage. There was NO MENTION whatsoever of the dangerous, SOFT plaque versus hard plaque. All I can say is that most American cardiologists are completely CLUELESS on many of the tests they order!!!!!!!!!
The doctor I was seeing is very knowledgeable about CIMTs, and person who did the actually test was a patient of the same doctor. Unfortunately, the doctor no longer takes my insurance, so I'm not sure what I'll do, but have to see someone who knows about it.
@@mystatinfreelife Are you familiar with Dr. Ford Brewer who runs the "PrevMed" Company? He has multiple, very informative, RUclips videos on the CIMT test and its interpretation.
Thank you for another great video. More things for me to think about but information is good.
How to decide what qualifies as pertinent data, and how to determine the weight of each entry is an ongoing (hopefully) endeavor.
Just because lay people are not schooled in the data should not discourage them (us) from beginning a search. And just because Physicians are schooled to one extent or another does not make them infallible.
You left us with a cliffhanger, Russ! You did not tell us what your interaction with your PCP was after this test and the experience of an 8 hour period of transient amnesia!! Perhaps that will be your next video! If so, I am looking forward to hearing the results!!
@patrickdeady410 i haven't been to my PCP with this, and probably won't. I have no confidence they'll know what to do with the info. I'm waiting to see a doctor who deals with this. Unfortunately, the doctor who ordered the test no longer takes Medicare patients. As to TGA, I have a video on that.
ruclips.net/video/QSghaiB7E-g/видео.htmlsi=2TiNKmf-f3btkcpq
whoa - seriously your best one! well done!
Russ, thanks for the video. Amazing the technology that we can see the artery.
I've had a CIMT when I asked my cardiologist for it. Never got any pics. I just remember Dr. Brewer saying it has to be a highly qualified technician who does the test in the right way to get meaningful results. Can't remember the organization he recommends for CIMT.
Dr. Brewer recommended in a recent video CardioRisk (which is the lab that did my analysis), Carotid Care (which is who actually administered my test before sending it out), and Vasolabs, if I'm remembering right. Carotid Care provides the service physically on Martha's Vineyard in Massachusetts, and Windsor, CT. CardioRisk seems to have a rotating set of cities. I don't know much about VasoLabs.
Russ, Curious if there is a online calculator that will take the many heart studies online, which tend to quote relative risk, to an online calculator to convert these studies to an absolute risk as well as numbers needed to treat?
Well, the on-line calculators generally give absolute 10 year or lifetime risk, based on the data from the studies. Then to determine the absolute risk reduction, you have to guess at what the relative risk reduction is provided by the therapy. For statins, I was using 36% based on the famous Lipitor Ad, but now that I've looked at more data, the actual relative risk reduction is more like 17-20%, so I go with that now. As an example, if a risk calculator told you that you have a 7.5% 10-year risk (the threshold for many guidelines), then the absolute risk reduction is about 1.5% (20% of 7.5%) and an NNT of about 67. The two risk calculators I reference the most are the PREVENT calculator and the 2018 (NOT 2013) Pooled Cohort Equations calculator. But I don't know of a calculator that will go ahead and compute NNT for us. Perhaps they are afraid that the numbers will be too low and unimpressive that they'd lose statin victim and the pharmaceutical companies would do their best to shut them downs.
@@mystatinfreelife thanks Russ for taking the time to respond to my question. I got a good laugh from the last line of your response. So true. I would think a college math/computer science major would be able to design a simple online calculator, since all the data or numbers is provided from the various studies. 😀
Thank you so much for this real-life dive into the CIMT test. I am wondering if the CIMT test providers always provide the images or if you have to special request them.
I suppose it depends on the lab. In this case, the technician told me that they give random shots, rather hose that are necessarily useful. I don't know why that would be their MO.
@@mystatinfreelife Thank you for the reply - it's good to have even that piece of info (random shots) from the technician, even if it isn't especially helpful. (Typically I cannot get a radiology tech to give my ANY information (other than "you can leave now" LOL).
So what do you do if you gain enough understanding to ask the right questions, but it becomes clear during the discussion that the doctor is probably not giving you any answers that are accurate or relevant?
@worldcitizenra I guess you have to bring it to a different doctor. This is a common problem, not just with the CIMT; I experienced a similar scenario with my Kraft Insulin Survey results. In that case, I didn't know the right questions and was told I was doing great based on the final reading, while the rest were ignored. In this case, I didn't know the right questions and my diagnosis of "doing great" was corrected by a more knowledgeable doctor. So that's a point I missed: having the knowledge to ask the right questions also helps you know if you're getting relevant answers.
I'm totally censored!
Yikes. I saw your comment today and responded. Is it not showing up?
ruclips.net/user/livelckVKDa88sM?si=lxRawNFRvc_wK5zQ
An answer to a Statin for me!
I'll probably e-mail you.
Thanks Russ for your concern!