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Pastimes : Heart Attacks, Cancer and strokes. Preventative approaches -- Ignore unavailable to you. Want to Upgrade?

To: LindyBill who wrote (2411)	12/6/2008 8:41:40 PM
From: mistermj	Read Replies (1) \| Respond to of 39297

Good article from Dr. Richman. He is going right into my Google Reader. I noticed in the comments section of that blog post that he doesn't think much of calcium scoring. I've always thought Dr.Davis explanation made a lot of sense regarding calcium scores and the 30% growth factor ect....have to look into Dr. Richmans's view more thoroughly when I get some time. Michael Richman, MD, FACS said... Thank you for your kind words Joe. In regard to calcium scoring, you are exactly right. It provides me with no information and exposes people to unnecessary radiation. I also think many physicians have bought them and need to use it. CIMT is a good surrogate for generalized Cardiovascular disease but the problem is that insurance and Medicare do not pay for "screening". I use it in patients that have borderline NMRs as a way to assess how aggressive I will be with treatment. blogs.webmd.com

To: LindyBill who wrote (2411)	12/7/2008 12:39:44 PM
From: LindyBill	1 Recommendation Respond to of 39297

A comment from a TYP Poster: Dr. Richman's views re: heart scans are indeed troubling but not an enormous surprise, since his background is as a cardiac/thoracic surgeon. He and I have exchanged our perspectives several times on his WebMD message forum (the "Cholesterol Forum" at WebMD), and he's almost militantly against scanning, has called it useless, worthless, and a procedure without merit. He believes that there is nothing of clinical benefit that can be derived from measuring calcium because, in his words, "it's the soft plaques that are dangerous, not the calcified ones." He believes that his surgical knowledge and experience (based largely on autopsy findings) demonstrates that plaques which rupture are not those that are calcified and he is not sold that there's any real relationship between calcific deposits and soft plaques at all. Dr. Richman runs the "Center for Cholesterol Management" in West LA, where he treats lipid disorders. He also runs another clinic in Beverly Hills called the "Varicose Vein Treatment Clinic" which I think is largely devoted to peripheral vascular disease and, since it's in BH, cosmetic procedures. The guy is very good a self-promotion (not, as they used to say on Seinfeld, that there's anything wrong with that). Several months back, another TYP member (I can't recall his name) was looking for a cardiologist who might be open to TYP concepts and I recommended that he check out Dr. Richman based on an interview he did on ReachMD radio on XM satellite radio. During that interview, Dr. Richman was portrayed as a huge proponent of NMR and particle testing. I actually have no idea how things turned out for the other TYP member who was treated by him, but after several written exchanges with him, I don't think I'd ever use him. If you search "Richman" in the search engine at TYP's forum, you may find the thread. His views on Vitamin D3 are not surprising. Many docs here in Los Angeles are now on the Vitamin D3 bandwagon, and are recommending it heavily and testing for it very aggressively with their patients. Dr. Richman's position in this regard, while encouraging, isn't all that different from what many other gp's and internists are doing in Los Angeles. He's also a HUGE user of Crestor. On the Reach MD interview he bragged that he's probably the largest single prescriber of Crestor in the Southern California area. He probably feels pretty good about the JUPITER study. While the WebMD message forum on Cholesterol Management bears his name and likeness and its supposed to be "his" board to respond to questions, he rarely writes there any longer. I think he got tired of people like me peppering him with questions. LOL. There is some useful information at his Cholesterol Managment website (the one promoting his clinic, not at WebMD) that is worth checking out, notwithstanding his antipathy toward scanning.