Chronic Total Occlusion

by Mike Stone

In 2001, I surprised my family, friends, co-workers and just about everyone when I had a Myocardial Infarction, also known as MI or more commonly, a heart attack. I was even surprised. After all, I was a non smoker, not overweight, in decent physical shape, rarely sick, couldn't remember the last time I needed to take a pill of any kind, prescription or otherwise.

In fact I was hitting the swimming pool 2-3 times a week in the morning before rushing off to the stressful demands of my livelihood. The only person not surprised by my heart attack was the person closest to me in the whole world, my wife Esty.

An angiogram showed I had 3 blockages. The Second Marginal Artery contained a blockage of 50-70% and the RCA ( Right Coronary Artery ) showed light blockage. The actual heart attack was caused by a blood clot that was not able to pass through my LAD ( Left Anterior Descending Artery ) which contained a blockage in the mid section of over 90%. As I found out later, the LAD artery is also referred to in the cardiology world as the ‘widow maker artery'.

A week after my heart attack, I was released from Hadassah hospital in Jerusalem with a new stent implanted in my mid LAD ( a process known as PCI - Percutaneous Coronary Intervention - or more commonly, angioplasty ) and a long list of prescription medications to take, including a cholesterol lowering statin.

Only a week earlier I was still living under the illusion that good health was something to be taken for granted; ‘statin' and ‘stent' were not yet terms I was at all familiar with. However, as the coming months and years would prove, these two terms would become the dominating influence on my life.

As per industry standards, the statin dosage I was prescribed was not based on the pleiotropic attributes of statins, but rather on an outdated premise - the infamous lipid hypothesis - the lower the cholesterol and LDL in particular, the better. I was prescribed what is not considered to be strong statin - 20mg of pravastatin, locally marketed as Lipidal® (not to be confused with Lipitor®, which is atorvastatin). Over the coming months, I started experiencing cognitive peculiarities.

After 35 years of driving, I had never locked my keys in the car. I found that this was starting to become the habit, not the exception. When I realized this was actually a problem and I started making a deliberate effort to make sure I leave the car with keys in hand, I would invariably forget my cell phone or something else instead in the car, or even lock the car from the outside, however not notice that the window was still open.

I was becoming confused. There were occasions I would forget the name of a co-worker, or at a social event bump into someone I had a recent business meeting with, and not exactly remember from where I knew him from.

I started having trouble making decisions, even regarding trivial matters. All my professional life it was ‘everyone loves Mike', but in addition to the cognitive problems, I found my personality changing for the worse which resulted in very strained work relations with coworkers, subordinates, even senior management. And worse of all, I was becoming totally apathetic to the person closest to me, Esty.

Millions of people suffer from heart disease and heart attacks. Was I the only one suffering side effects from the heart medications? It wasn't until I discovered Prof. Beatrice Golomb's pioneering NIH study regarding statin side effects that I realized what had been causing such an upheaval in my professional and personal life (1). I also learned from her research that receiving apathetic responses to statin complaints from the medical establishment was a common complaint of many of my co-sufferers.

Now what? An anguishing decision had to be made. On the one hand is the professor of cardiology who very likely saved my life two years earlier. He has with dedication been saving people like me over the past few decades.

Statin distribution is what he and his department believes in. It is the international standard that his hospital must conform to. On the other hand, I, a non-medical layman, had become very familiar with the works and publications of the opposite camp; the lipid hypothesis never was, is not, and will never be valid.

Cholesterol is not really that dreaded substance that caused the last two generations to hit the panic button. How do I now climb out of the mental and emotional abyss I had somehow fallen into to? Do I continue with the world consensus, or with the rebel point of view as represented by Dr. Uffe Ravnskov and others?

Over my cardiologist's objections, I discontinued the statin medication in mid 2003. The physical recovery from the heart attack was nothing when compared to dealing with the statin side effects.

In 2004, I released my first book "Surviving a Successful Heart Attack" in order to document what I had gone through. The book ends with me already past the physical recovery from the heart attack and the two statin years, researching and looking for answers. However, what next - to what direction?

"Chronic Total Occlusion - After the Heart Attack, the Statins and Restenosis" (2), is that new direction. It started out to document and to substantiate my lifestyle changes. The emphasis was to duplicate as much as possible, by natural methods, the pleiotropic benefits that statins do provide for heart patients.

Pleiotropic attributes are totally independent of statins' cholesterol lowering abilities. These heart friendly attributes which are documented in many peer-reviewed journals are well known, including stabilizing atherosclerotic plaques and reducing plaque rupture, anti-inflammation and acting as an antioxidant.

If the statin problems weren't enough, then came the stent problem. In the beginning of 2007, an angiogram following routine testing showed that the stent in my LAD artery was totally occluded - a total blockage, a condition known as chronic total occlusion.

At the time, I was not experiencing chest discomfort, any of the other heart attack warning signs, nor did I have another heart attack - well, maybe yes as my medical records do list this as an apparent silent ischemia, but it still remains a fact that I was not aware of anything going on out of the ordinary. I also was not disabled with heart failure and a cardiac ECHO (echocardiogram) showed my heart's pumping capacity was fine and no significant tissue damage was noted.

Despite this total occlusion in my critical LAD (widow maker) artery, a bypass operation to circumvent the blocked artery was not necessary at the time. My new lifestyle changes promoted the expansion of the arterioles in the vicinity of the blocked artery, essentially bypassing the blocked portion.

In August, 2011, the inevitable finally occurred. A triple bypass was performed. This included the two deteriorating partial blockages (existing heart disease) first identified in 2001, and the already known occluded LAD. Despite my present situation, an angiogram done before the bypass operation proved my lifestyle changes had indeed prevented the development of new heart disease.

A month before my bypass operation, at 61 years old, I celebrated my 10 year heart attack anniversary by going on a trail/road bike trek of 120 km. Besides dietary changes, some of which may be considered very unconventional by today's norms, bike riding first thing early in the morning has become a way of life for me.

My lifestyle changes not only postponed the impending bypass procedures for four and a half years since discovering the occluded LAD artery, but brought me to the operation in excellent physical shape, which decreased the chance of complications during the operation, and expedited my recovery.

What does the future hold for me with regards to statins? Medical databases document many occurrences of patients still maintaining their statin regimen and yet having subsequent heart attacks (3).

As I mention several times in "Chronic Total Occlusion", despite the nightmare still engraved in my memory from those two horrible statin induced side effect years, there may be a time when I would reconsider the pleiotropic attributes of statins.

According to research, it has been shown that much smaller dosages than commercially sold statins still offer significant heart friendly advantages without the massive side effects (4).

Now that I am starting afresh with my new bypasses, the time has come. I will continue my current lifestyle regarding food choices and exercise routine and take a very small dosage of a statin while reinforcing my system with supplements such as CoQ10 along with other anti-inflammatory supplements.

In "Chronic Total Occlusion", I explain and substantiate with many references the changes I have incorporated in my daily lifestyle. These changes prevented new heart disease from developing and allowed me to enjoy a full and active life, despite the occluded LAD artery and my deteriorating existing partial blockages.

Mike Stone
Mike Stone grew up in Baltimore, Maryland and graduated from the University of Maryland.
He has lived in Israel since 1975.
Mike Stone's website is:


1. Golomb B, McGraw J.,Lack of Physician Response Toward Perceived Statin Adverse Events" paper presented at the American Heart Association, 45th Annual Conference on Cardiovascular Disease Epidemiology and Prevention in association with the Council on Nutrition, Physical Activity and Metabolism April 29-May 2, 2005, Washington D.C

2. Released in 2010 (previously released as "The Next 20,000" in 2007)

3. Graveline D, The Statin Damage Crisis, Chapter 13, 'Failure of Medwatch',

4. Law MR, Wald NJ, Rudnicka AR, Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis.BMJ. 2003 Jun 28;326(7404):1423, among others.

October 2011

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