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SECOND OPINION | Reversing Heart Disease Episode | BCBS

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This WEEK, Special guest, Dick Dubois.

He was diagnosed with heart disease and got something that he believes saved his life Dick.

I was concerned about the complications of surgery, but that was never really discussed.

I was told that, by going through with the surgery, it would probably but not necessarily increase my life expectancy, Dr Salgo, Thanks again Dick for being here with us.

It’s nice of you for joining us. Dick.

Thank you for inviting me, Dr Salgo.

I must say you have a fascinating story, and this is your second opinion panel.

They’re here to hear it too.

So let’s introduce them to you.

We have primary care physician, Dr Lisa Harris and Dr Pacos, both from the from the Rochester University of Rochester Medical Center.

We have Dr Colin Campbell from Cornell University.

Thank you for joining us.

You’re sitting here.

You look great And I believe you recently did a triathlon Is that right, Dick Yeah, Dr Salgo, Alright! Well that doesn’t parson out the other term to describe you when I spoke to you And that’s heart disease, You have heart disease triathlon! Let’s step back in time. A little bit Tell me about your past history, Dick.

I grew up an overweight child and was overweight most of my adult life, but I was an exerciser.

I ran many marathons and a couple ultra marathons, Dr Salgo, When you say overweight, you,’re, 5 foot.


How much did you weigh Dick When I graduated from high school, I weighed about 210, Dr Salgo, 210? Okay, you weren’t massively over weight, but you were large.

What were you eating at the time? Dick? I was eating a lot of pasta, eggs, ice cream, the good things Hamburger.

Yes, Not a lot of vegetables, Dr Salgo, Then something happened to change everything.

What happened Dick In 2004, I started to get exercise induced angina, Dr Salgo.

What does that mean Describe it? Dick? When I was running, I would get chest pain, some pain down my arms, and I would have to stop running.

It would go away, but as soon as I started, it would come back. Dr Salgo And you saw a doctor Dick Yeah, Dr Salgo, And what did the doctor do? Dick? I had a stress test and it showed that I had some blockage in the right coronary and I decided to try to control it with diet and exerciser.

Dr Salgo Did that work Dick No, Dr Salgo, So they put you on medicine.

If I recall they put you on metoprolol and nitroglycerin Dick Yes, but I never used the nitroglycerin Dr Salgo, You’re the doctor’s worst nightmare.

They give you the medicine and you don’t take it anyways.

At any event, your angina got worse, or did it get better Dick? It got worse To the point where I could not run hardly at all, Dr Salgo, You had been so active that must have disturbed you, Dick Yeah, very mush.

So, Dr Salgo, So here we have another typical story: Your wife pushed you to do more And what happened Dick.

She basically required that I go see a cardiologist and get and angiogram in September of 2005.

This showed that I had an 80 blockage on the left side and nothing on the right, Dr Salgo.

As I recall, it was actually at the left, anterior descending artery 80, which in medical terms is known as the widow maker, A bad artery to have an obstruction in.

So you have a family history of heart disease, Dick Yes, Dr Salgo, Mom and dad, and with this obstruction documented, what did your doctor sugest? You do, Dick. They suggested that I have bypass surgery, Dr Salgo, That sounded rational.

It was reasonable at the time right, Dick Yup, Dr Salgo, But in the meantime, your wife had a book Dick.

My wife had read Dr Campbell’s book The China Study and she suggested that I should read it.


The timing was amazing.

I read the chapter on broken hearts just about the time I had the angiogram and realized that there were options that I had not ever been offered.

Dr Salgo Tell us a little bit about The China Study, The book that he was reading that changed his plans.

Dr Campbell, Well, it was back to my work starting more than half a century ago, And I was largely focused on a question to cure cancer and eventually concerning the effects of food on cancer During that process, mostly through the years at Cornell University, we learned how Diet can relate to these kind of diseases in a remarkable way: heart disease being one Dr Salgo, So change your diet and you can actually reverse heart disease and effect the incidence of cancer, All these good things, but you have to make radical changes in the way You ate Dr Campbell.

Yes, as far as the heart disease research is concerned, that was my good friend in Cleveland Clinic Dr Esteson.

I was a researcher, But we could do remarkable things with food. If we did it, the right way Actually treat disease, not just prevent it Same strategy, Dr Salgo, But before we go any further, let’s be clear.

What we are talking about.

We are talking about an extraordinary change in diet.

For most Americans, We are getting rid of meat proteins.

You going onto a mostly vegetable based diet and cooking.

These things has to be done in a very special way, Dr Campbell Right, Dr Salgo.

If I recall, I remember, you mentioned the 80 legion, But you had a 60 blockage, Dick Yeah, a 60 blockage and a 5 years after that time we did find that reduction Dr Salgo Well, we are not going to go there yet, But that first study showed 2, big ones Dick That’s right A 60 kind of big and an 80.

Everybody agrees that’s big And here is Dr Campbell and his associates.


Not only can you stabilize your heart by eating right, but you can reverse heart disease if you eat right, Jason Lisa. What do you think Jason? I think that there is certainly a lot of research, and definitely Dr Campbell has done a great job demonstrating this and that certainly prevention of this is dietary.

Dr Salgo Ahhh don’t weasel here.

Prevention is not the same as reverse Or treatment Jason.

You are absolutely right.

As a cardiologist, I can say that I have never treated anyone with diet for their coronary disease alone.

Lisa And again, I think that you can mitigate disease with dietary changes.

Dr Salgo, Let me call you You used the word mitigate.

What does that mean? Lisa? It means that you can improve some of the symptomatology.

I don’t know that we can permanently reverse disease.

I say that not that I don’t believe that diet can do that. The problem is our western society, and the way that we live does not allow for patients to continue on that type of diet And many patients, folks that live in urban areas, don’t have access to some of the foods we are talking about.

Dr Salgo, Dr Campbell, you’ve, heard skepticism.

You have lived with that your whole life.

How do you answer that Dr Campbell Well, first off, if 26 years, isn’t reasonable time When people stay on this diet, it goes away and it stays away.

You know for as long as you like, We have records now for 27 years, actually Now with 100 and all the people can, who can do that it just disappears.

The remarkable thing about this from my perspective is that the reduction of angina pain goes away so fast With Dr Estonsin.

I was telling her that I relying on his experience, particularly Now within a week or two angina, is gone.

Cholesterol, drops by 50 100 to 150 points, Dr Salgo, That being said, you’re reading this book You get excited and you e mail, Dr Campbell, Then what happened Dick.

I actually got a call the next day by Dr Estelson in Cleveland and within 3 or 4 days.

My wife and I were at his home in Cleveland, Dr Salgo, Okay, and what happened Dick. We spent most of the day with Dr Estelson and his wife Ann.

He reviewed the possibilities by going on the diet and I think a big part of it was his wife Ann taught us how to prepare food, so we can go on the diet and stay on the diet.

Dr Salgo, You got a second opinion Dick.

We did get a second opinion that’s right, Dr Salgo.

What did you do with the proposed surgery? Dick? I made the discussion at that time to at least postpone the surgery and try the diet.

Dr Salgo, I can tell you that right now, hearing that I don’t know about you: two there are doctors in our audience that are cringing Dr Harris Just a few palpitations, Dr Salgo.

What do you think of that decision? Dr Pacos? There have to be a few things that we are clear about: The The chest, pain and the angina that you were having at very high levels of excursion.

You were running marathons, So we would classify that as rather stable, angina at a very, very high work load.

So you could do your daily activities and have your normal life without having any symptoms That’s a vastly different situation from people we see or people that I see come to the office and hospital with chest pain.

So I think, certainly in that situation, we know that you have an 80 blockage which is significant, meaning more than 75 blocked, but it is certainly not in that critical range where you have to do something about it. In that moment, You have time and that’s really what was to your advantage And if you use that time to start medications, diet changes whatever you use in that time.

I think that that is important and we need to clarify it.

39, s, not that you came in with a heart attack or having chest pain at rest.

Dr Salgo Lisa Dr Harris, And I have a question that pops into my mind is: is it truly food that’s exerting the effect or is it the reduction of the adiplus tissues, which, in and of itself, is a hormone and can exert inflammatory effects? Dr Salgo, So you’re going to say that the weight loss contributes to it.

Dr Harris, Absolutely, Dr Salgo.

What did your cardiologist say when you told him this Dick? They were not happy about putting off the surgery.

Dr Harris But Jason has a very valid point.

This is very stable, angina and for most patients we would not run into surgery.

We would give you an option to try medical or dietary measures.

Dr Salgo, Dr Campbell, you’ve, heard the M D’s. Responses and you’ve, heard his MD’s response.

What do you say, Dr Campbell? Well, I have to say that this effect of this kind of diet is so remarkable, not only at reversing heart disease for years and years as long as people continue to do it, but it’s not just that it’s what it actually does for A whole variety of diseases and illnesses And the effect is so rapid I mean I came form the other side of the coin, with my research, believing the opposite, But the repeatedly and the breath of the effect, the profoundness of the effect is far greater than any Drug can do, I must say Dr Salgo.

Alright, then you are on a heart, healthy diet.

Then, Can you describe it for me, Dick Umm Yeah, it s strictly plant based Very low fat.

We use no oil, No dairy, no eggs, It’s strictly plants, vegetables, grains, Dr Salgo.

I know there are people out there saying my gosh.

There is no protein in this diet.

Is there protein in this diet, Dr Campbell? Absolutely the ideal level of protein is found in a whole food plant based diet.

I mean that’s ideal, Most people think of protein as being meat, but it’s not.

Protein is found in plants as well as animals, And so, if you have a whole foods plant based diet, the level of protein is ideal and the level of antioxidants and complex carbohydrates and dietary fat. I mean all of that from a research perspective come together, Dr Salgo.

This is a very good place to stop for a moment Stay where you are, and we’ll be right back, because we’re going to pause for this week.’s, Myth or Medicine male voice.

The key to good health is nutrition.

Research has show that making lifestyle changes can reduce the risk of heart disease, but is it possible to actually go beyond reducing the risk to actually reverse heart disease? All together through diet alone? Is that Myth or Medicine Diet alone can reverse heart disease? That is generally a myth, and I’m going to tell you why Hi my name is Ryan and I’m a cardiologist at Highland Hospital and the University of Rochester Medical Center.

We are very unlikely to clean out the narrowings or blockages in the coronary arteries.

We know that we can prevent them from happening or getting worse and prevent future events through the lifestyle, modifications and dietary modifications and medication.

We never completely remove the fact that a patient has coronary artery disease, They are never cured, But it is something that is managed as a chronic illness.

Compared to how you manage high blood pressure for years.

By taking a blood pressure pill, Elizabeth from Seattle WA asks.

I follow a healthy lifestyle and I’m doing great. Can I go off my medication? That is an individual discussion that needs to be undertaken on patient to patient basis, But generally most cardiologist will tell their patients that the answer is usually no to going off of the medications.

We know that it is unlikely that anything that is done, whether it be medication or dietary modifications or vigorous exerciser, is going to completely clear up or remove blockages or narrowing in the arteries.

The focus of our therapies is to holt any progression of coronary disease, prevent future events, heart attacks or heart failure and control blood pressure, And that’s medicie Male voice, Not sure if it’s, myth or medicine Connect with us online.

We will get to work and get you a second opinion, Dr Salgo, And we are here with Dick who was found to have coronary heart disease.

He was scheduled for surgery, read a book and discussed to follow a different path, a diet and see what happens as you go along and your primary care physician was going to follow along with you.

So you didn’t have the surgery, and you went on this diet.

Tell me about what happened there after Dick Dr Richardson told me to follow up with a lipid profile within think about three weeks after I started, and we started to see a pretty signification drop in the LDL Dr Salgo.

The LDL is a so called bad cholesterol And what else Dick? I also started seeing a pretty rapid weightless, I was loosing weight pretty quickly, Dr Salgo, That was Lisa.’s point.

How are you feeling? How is your exercise going Dick? Well, I never really stopped exercising.

I continued to walk, but i started to add a little running and I stated to notice a regression of the angina. I got pretty quickly, Dr Salgo, How quickly Dick, Within a few weeks, Dr Salgo After a year.

What was you exercise, tolerance, Dick In a year I was back running At first, I might get a little bit of angina, but I would stop and walk a little and go on without angina, Dr Salgo And after a year, did you get a repeat angiogram? Did you not Dick? It was actually a few years afterwords, Dr Salgo.

What did it show Dick The angiogram showed reduction in the 60 blockage to 30, The main blockage? The 80 showed no reduction, Dr Salgo, So here we have an angiogram which shows objective evidence that at least one of the blockages in your coronary artery shrank, and you have subjective evidence that you are exercising and you don’t have angina anymore.

Are you guys still skeptical Dr Harris? Well, I’m glad that his symptoms have reduced, but I’m still concerned that he has an 80 blockage in the LED, Dr Pacos.

The 60 to 30 is fairly insignificant change.

We know that a blockage of less than 75, probably don’t matter and are best treated with medications and lifestyle changes That 80 legion clearly did not change and was really the cause of all your symptoms.

The culprit that we need to be concerned about Dr Salgo, But wait if it is the cause of all the symptoms, and now he doesn’t have them and in fact you just finished a triathlon.

His symptoms did get better.

Dr Pacos Right.

I think that will angina it’s kind of a demand and supply type phenomenon. You clearly have a lot of weigh reduction and improved cardiovascular, health and efficiency of your heart in that time period and training It’s pretty classic.

We see people that have claudication and pain in their legs, and one of the best thing they can do is walk and get exercise and the more that they do the more they are able to do.

Dr Harris And again, I’m concerned that there is a blockage in one of the main arteries, and the issue is that if he is excising at a high work load, is that blockage going to com to a point where it is critical? And there is no blood flow through that artery.

Dr Salgo, You’ve heard these skeptical doctors.

What do you say, Dr Campbell? Well, every case is individual and we know that, But people respond differently over different periods of time, But it is almost uniformly true that 100 of the people respond in such a way that 5, 10 15 years later they don’t have evidence of the problem.

The data I’m familiar with there is the case of heart disease, but also diabetes and a number of other diseases.

As long as one stays on this, some of that evidence may be there and it may not go away in some cases, but the fact the reality is.

You are doing well, Dr Salgo, But wait.

Let me just put it on the table In your view, based on his symptoms, has his heart disease reversed, Which is the key word reversed heart disease, Dr Campbell, It all depends on how you define the word.

There is a bit of a nuance when using the word, But it’s, symptoms, go away and people recover their normal lifestyle do dishes. What do you call that, Dr Salgo? Do you guys agree with this That he has reversed heart disease that his symptoms have gone away Compared to where he started? He’s better Isn’t that reversed Dr Pacos.

He still has heart disease.

We know he still has blockages.

He still has acrothosis and based on that, his disease is still present.

He is not cured of heart disease.

It is very well controlled at this time, Whether that is from medication, lifestyle or diet.

All those play a role in controlling it, Dr Harris, He still has a blockage.

I think that his symptoms are controlled and that’s important He’s regained the normal lifestyle and that’s really what we want to achieve with anything we do in medicine, whether it’s, diet, medication or otherwise, Dr Salgo.


So let me ask this: What’s the harm? What’s the harm of going on this diet, feeling better having better exerciser tolerance? What’s the harm, Dr Pacos? In this case, there was very little harm to start with, because his symptoms start at very, very high levels of exercise. Again I think I came back to this.

He didn’t come in with a heart attack.

He didn’t chest pain at a very low level of activity.

This was a very high level, so we know that he was in pretty good physical shape to start with and that with the dietary changes he improved.

So I think it would be a reasonable approach, when he first to say, let’s try somethings, and reassess down the road.

Now, if you came back to the office a month later and were having chest pain, I think we would know that things were not working and I think we would have to revisit that.

Dr Campbell, I think we are getting too technical and are parsing words And we have to go back and look at our definitions and assumptions.

Basically, I could say the same thing for cancer.

I mean we all have carcinogenic sort of seeds.

If you will that in our tissues most of our lifetime And for those who are inclined to get diabetes or are inclined to get one of the auto immune diseases, the root causes for that will probably remain in our tissues for their lifetimes. Because all of this is genetically based, Dr Harris, I absolutely agree that diet is of paramount importance and lifestyle changes are of paramount importance and probably if someone had talked to him about your book earlier on, we might have been able to see greater changes.

The concern that I have is that I don’t want patients to think that they are cured and that now there is no risk of any possibility of a heart attack.

He still has an 80 legion and if the plumbing’s blocked the plumbing 39, s blocked Dr Capmbell.

But if you want to argue that the cure is to take you all the way back to baseline, to where you don’t have any president of legions that’s, not what I’m talking about.

I don’t like that particular definition.

Dr Salgo, Let me go right to the source Right now.

How are you feeling Do you think that your heart disease is reversed cured What’s your take on all of this Dick, I’m feeling great, I m probably feeling the best I’ve felt in many many years.

I’m the thinnest.

I’ve been since I was a young child and I do feel like I,’ve reversed the heart disease, Dr Salgo, And you haven,’t abandoned your doctor and your doctor, hasn’t abandoned you.

You’re still being followed Dick. That’s correct Dr Salgo.

So again, if things turn around start going the wrong way, you’ve got backup Dick Correct, Dr Salgo, And last I promised that you would have a chance to ask a quick second opinion.

I know you.’ve got a big second opinion.

Is there anything before you go that you would like to ask any of them Dick Yeah? I guess you know when I was first going through this whole process.

Diet and exercise were never really disused as an option.

It was surgery And I was concerned about the complications of surgery, But that was never really discussed.

I was told that by going through the surgery, I would probably but not necessarily increase my life expectancy.

Well then, I’m saying why go through the surgery if there are other options – And I wasn’t offered those options, Dr Salgo, Should he have been offered some options? Do you think, Dr Pacos? I think it’s a difficult situation, because when you are in the hospital in an acute setting, I think it is very difficult to say: Go home don’t eat animal protein eat plants and you’ll, do fine In your situation with a severer Legion but symptoms that are very well controlled.

I think that would have been an option, Although a very difficult option that I don’t think many people are able to make that change in their diet.

Dr Salgo, I’ll, give you the last ten seconds and then we do have to go. Dr Capmbell, I want to say don’t avoid animal protein.


Just one thing I want to say basically consume whole food plant based diet.

That’s a very positive message, Avoid animal foods and processed foods.

Dr Salgo, I want to thank everybody for being here Thanks to the panel.

What a dramatic discussion I want to.

Thank you all.

Thank you for sharing your story as well, And at this point it’s time for this weeks.

Second opinion: five, Dr Black Hello, I’m Dr Bob Black and I’m here to tell you the five biggest risk factors for heart disease.

The first risk factor is your age. The older you are the more likely you are to develop signs of heart disease.

You can’t turn back the clock, but you can choose a heart, healthy lifestyle that can help your heart.

Keep ticking a steady beat.

The next risk factor is smoking.


The worst thing you can do to your body, but quitting at any age, is good for your body, because your body can repair itself Do what ever it take to quit smoking.

Smoking causes damage to the blood vessels and creates potentially deadly plaque buildup.

The third is hypertension.

Elevated stress puts extra strain on your heart, raising the risk of heart attack and stroke.

You can improve your blood pressure by taking your medications. Your doctor prescribes everyday cutting the salt in your diet.

Losing weight and exercising Another risk factor is high cholesterol, Like hypertension, too much cholesterol can build up in the arteries causing atherosclerosis, which can be life, threatening, Get your cholesterol checked regularly And the last one is family.

History, If someone in your family, such as a parent or sibling, has a history of heart disease, this could be a risk factor for you.

However, if detected early, it could be managed, And that’s, your second opinion five, Dr Salgo.

Thank you so much for watching Second Opinion.

We hope that you continue the conversation at our website where you can comment on this show, send us your show, ideas or share your health story with us, and maybe we’ll invite you to be with us on the set.

The web address is second opinion.

Dash tv dot, O R G, I’m Dr Peter Salgo, and I’ll see you next time for another second opinion: Child THERE ONCE WAS A TIME WHEN WE WERE TRULY FREE, FREE OF WORRY FREE OF FEAR.




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