My father's nasty letter and CAD

[Callogician]

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Background: My father and I have not spoken for about four years due to a series of arguments. He recently sent me an eleven page letter. An excerpt is quoted below (the brackets are mine):

[calllogician's] biological father, grand-father (on the father's side), great-grandfather (on father's side) and every male relative of his father has CAD. (This has been verified by recent communications to descendents now living in England). Most male biological relatives on the father's side have died of heart disease before age 58. In each male, the heart disease progressed despite aggressive intervention. In the case of [callogician's father], the disease has progressed nothwithstanding optimal reduction in low density lipoproteins over a five year period. The disease in [callogician's father] has progressed from no lesions at Time 1, to lesions of 50% and 70% occlusion within 4 years after baseline measurement. Attached are results from a 2006 scan and prior angiography that should be saved for future purposes. Accordingly, [callogician], depending on the genetic load from his biological father, is at high risk for early onset CAD which is treatment resistant and rapidly progressive. These facts have certain implications for life style management and prophylactic intervention.

NOTHING IN THIS LETTER IS INTENDED TO BE ADVICE. THIS IS INFORMATIONAL COMMUNICATION SENT ONLY OUT OF MORAL OBLICATION [yet you had to open the letter with two pages about how I'm a horrible son]. DO NOT CONTACT THE SENDER.

Next comes an attached lengthy medical report.

Summary:

56yo male

2 mm ST depression on stress test
codominant heart circulation
20-30% LCA stenosis distally
LAD: moderate diffuse plaque
70% stenosis in small high-rising marginal vessel.
RCA: mild atherosclerosis
overall calcification: 90th percentile

Treatment: Aspirin, Zebeta 5mg, Lipitor 10mg.

---------------------------------

I don't really know what to make of all this. I left a message on my father's machine telling him that I was sorry to hear of his declining health (I never received a response). If he dies, my sister is already planing to ironically donate the will money to a gay charity in his name (he cried when she came out). My dad isn't really an evil guy. He's actually quite noble (one of those rare noble lawyers), and he's done some amazing things. He once had a chance to meet President Clinton at some democratic event and advised him to not let the Lewinski fiasco get in the way of his job. My dad's problem is that he is angry and socially inept. I'm probably not even in the top 10 of his "people I have permanently cut out of my life list."

Another thing: Do I really have anything to worry about in terms of CAD risk? I have only have 1 affected first degree relative (although early onset, rapidly progressive, and without many lifestyle risk factors). There's not much I can do in terms of lifestyle because I'm already a total health nut. Should I go get a lipid panel or something?

 

[Chronic Student]

Yes, get the lipid panel.

Anecdotally, I have several friends who are on the skinny side of normal, eat extremely healthy (one is a strict vegetarian) and who both have cholesterol in the 350 range with a high LDL and are both in their early to mid twenties.

In this case it is a genetic thing and even if its normal you will have a baseline to judge future studies by.

BTW, I'm sorry to hear about the relationship between you and your father. I have a similar sort of relationship with my mother and I can empathize with some of what you're going through.

-Mike

 

[sga814]

my two cents-

1st- you should probably go see a genetic counselor
2nd- you should probably see a genetic disorder specialist for treatment

 

[SoCuteMD]

3rd - you should probably buy your life and disability insurances first.

 

[Hard24Get]

Just be sure to get screened regularly for cholesterol, diabetes, and hypertension, and keep exercising and eating fatty fish. Family history is only one risk factor.

A bigger problem is the "nasty letter" and what you will do about your relationship with him. As heart disease goes, this case doesn't sound bad at all in terms of risk of dying, but in general it is not good to have tension like this with someone you clearly still love/respect. He obviously is reaching out in some way or he would not have attached a long letter, as you alluded to.

Background: My father and I have not spoken for about four years due to a series of arguments. He recently sent me an eleven page letter. An excerpt is quoted below (the brackets are mine):



Next comes an attached lengthy medical report.

Summary:

56yo male

2 mm ST depression on stress test
codominant heart circulation
20-30% LCA stenosis distally
LAD: moderate diffuse plaque
70% stenosis in small high-rising marginal vessel.
RCA: mild atherosclerosis
overall calcification: 90th percentile

Treatment: Aspirin, Zebeta 5mg, Lipitor 10mg.

---------------------------------

I don't really know what to make of all this. I left a message on my father's machine telling him that I was sorry to hear of his declining health (I never received a response). If he dies, my sister is already planing to ironically donate the will money to a gay charity in his name (he cried when she came out). My dad isn't really an evil guy. He's actually quite noble (one of those rare noble lawyers), and he's done some amazing things. He once had a chance to meet President Clinton at some democratic event and advised him to not let the Lewinski fiasco get in the way of his job. My dad's problem is that he is angry and socially inept. I'm probably not even in the top 10 of his "people I have permanently cut out of my life list."

Another thing: Do I really have anything to worry about in terms of CAD risk? I have only have 1 affected first degree relative (although early onset, rapidly progressive, and without many lifestyle risk factors). There's not much I can do in terms of lifestyle because I'm already a total health nut. Should I go get a lipid panel or something?

 

[78222]

At least i'm not the only one who hasn't talked to his father in 4+ years.

 

[Callogician]

Thank you all for the input.

Yes, get the lipid panel

I think this is a good idea. I should also get Hba1c and whatever else the family doc thinks is appropriate. I don't think I need to go to genetic counselor unless I have dyslipidemia. It's not like my dad told me he had familiar hypercholesterolemia or anything.

3rd - you should probably buy your life and disability insurances first.

I would not be willing to lie on application forms about my knowledge of family history.

Just be sure to get screened regularly for cholesterol, diabetes, and hypertension, and keep exercising and eating fatty fish. Family history is only one risk factor.

Will do.

A bigger problem is the "nasty letter" and what you will do about your relationship with him.

Honestly, I don't feel motivated to try to repair our relationship. I'm much better off without him in my life.

He obviously is reaching out in some way or he would not have attached a long letter, as you alluded to.

Maybe. My sister thinks that he has borderline personality disorder and that the letter exemplefies impulsive behavior and black/white thinking (thinking of me as pure evil).

*Note: My sister is a Pscyhology PhD student, and my dad has a doctorate in psychology (he's PhD, J.D.)

At least i'm not the only one who hasn't talked to his father in 4+ years.

high five!

 

[pratik7]

YESSSS!!!!!!!!!

This was my cousins history:

33yo male
Genetic history of CAD
Physically fit...ranked #2 in tennis in NJ
history of high cholesterol and triglyc
had a MI last month !!!!

 

[EvoDevo]

Hey dude. Sorry about the letter and its implications. 👎

OTOH, asking for medical advice is a violation of the SDN TOS, so I'm going to have to close this thread.

Good luck.