Get_Swole
MuscleChemistry Registered Member
ANABOLIC DOC GIVES THANKS
I just arrived home from the Arnold! Damn, I didn't know I was a muscle celebrity! At least a Medical Muscle Guru to all of you! Let me start this month's article by thanking all of you who reached out to me and made my trip an absolute blast!! EVERYONE KNEW ME!! It started in the airport in Chicago, where some guy yelled across the check-in line, "Hey Anabolic Doc, you rock— and your column is great, keep it up!" I was like, "Wow, thanks man." The rest of the trip was a progressive freak show, where everywhere I went, there you were, yelling at me and one guy even attacked me— I loved it!! You see, I'm not Dorian or Shawn Ray, but it's cool to be known as the 'Doc to the Lifters' and that the readers of MD love me. And for that, I give thanks! I will never let you down, as I mediate the modern, arcane world of medicine for lifters. The Arnold Classic is a damn 'Muscle Mecca'! Tens of thousands of brothers and sisters of iron! Thank you for accepting me as the doctor who understands you, and allowing me to keep you strong and healthy!
Thanks to all of you and MD and Steve Blechman! My unique medical practice is growing out of control! And in this regard, let me make a few announcements regarding current developments: First of all, I have hired Fern Assard, (Master's Figure Competitor and professional fitness model) as my personal assistant and liaison to the 'Anabolic Doc,' to assist me in the controlled growth of our medical practice. She will be there for you, as she focuses on answering all of your questions regarding how my practice works and details on becoming a patient. She will, with her expertise in the Figure world, assist me in PR, as we start to appear at bodybuilding shows and powerlifting/strongman events.
Fern will also be in charge of pumping up the Anabolic Doc website. Our plan is to make the Anabolic Doc site the number one web, worldwide, where you can go for accurate medical information for the 'enhanced' and natural lifter— because we understand the under-culture! And the time has come when lifters have their own doc, who understands the culture in which they live and provides evidence-based medical care to protect them in their quest for being big and strong.
OK, let's talk medicine. You all told me that you want more 'REAL' medicine from me, in the form of clinical examples that you can relate to. So I have decided that every month I will present what I call the "Anabolic Doc's Clinical Vignette Series." I will present a case study to you, exactly as we do at any medical school in the U.S. This is how we teach medical students and medical residents real clinical medicine. I have hundreds of patient case studies, and I will present the 'classic cases' that pertain to you, the real lifter. We will discuss diagnostic issues, management plans and clinical outcomes. You will love this, and I hope it will provide you with life-saving information! Here we go!!
CASE #1: June, 2007
CHIEF COMPLAINT:
Mr. W., a 37-year-old caucasian male, presents with 10 years of Anabolic Steroid (AS) use and progressive malaise and fatigue.
HISTORY OF PRESENT ILLNESS:
Over the past year, Mr W. has found himself getting more tired, with a noted decline in his ability to perform in the gym and in daily activities. He notes daily headaches, occasional dizziness, increased shortness of breath and general weakness. He denies chest pain, nausea, abdominal pain, but does complain of pain in his back, knees and left shoulder.
PAST MEDICAL HISTORY:
One episode of acute renal failure
General arthritis in his cervical spine, with neck pain and low back pain
Hypertension
Elevated cholesterol
Obstructive sleep apnea
Ruptured distal biceps tendon. Right side status post-repair, Boyd-Anderson technique, 1997.
Denies any hospitalizations/blood transfusions and has a spleen.
PSYCO-SOCIAL HISTORY:
Mr. W. is divorced with two children. Works as a sales associate. Denies any environmental exposure and does not smoke or abuse alcohol/drugs, although he tells me that he has used cocaine in the remote past. He has been using AS for about 10 years, with almost no time off. His AS of choice are testosterone, mixed blends and Cypionate, about 300 mg q 6 days intramuscular injection (IM). He also enjoys the addition of Deca-Durabolin, about 300-400 mg IM q week. He has used various oral AS, HGH and PCT with HCG and Clomid over the years. His training is intense and strong, with max bench press of 485 raw, squat 585 x 3 in power brief, deadlift max around 600, sumo. And he does dumbbell presses with 110-pound dumbbells for 16 reps!! Sick!! He does not do any cardiovascular training at all! I noted that Mr. W is a "very type A" male and in my clinic he was hyper-alert and not relaxed.
FAMILY MEDICAL HISTORY:
Mr. W. tells me that both of his parents have issues with elevated cholesterol and blood pressure and his father had a stent placed in his heart when he was in his mid-50s, indicating coronary artery disease. He has one brother with hypertension. His children are healthy.
MEDICATIONS:
Mr. W. is not currently on any meds, although he was prescribed something for his blood pressure several years ago. He takes a multivitamin, creatine and protein powder before and at times after workouts. He uses AS, as above. He denies any known drug allergies.
REVIEW OF SYSTEMS:
On detailed review of body systems, Mr. W. mentions that he has very poor sleep over the past year or so, with periods of what appears to be apnea. He is very tired during the day and has almost crashed his car several times driving to work in the morning! He is short of breath on easy activity, complains of heartburn at night, occasional swelling of his lower limbs, dizzy spells in the gym after heavy sets, and urinates several times per night. He also complains of erectile issues.
PHYSICAL EXAM:
Vitals signs showed a heart rate of 90 beats per minute and blood pressure of 150/110.
A very muscular man in no apparent distress, Mr. W. is 5'10" and weighs 250 pounds.
His neck size is 19" and abdomen is 46".
Cardiovascular exam revealed no murmurs, lungs were clear on auscultation, gynecomastia and nipple tenderness were noted. No abnormalities of the abdomen, including palpation of liver and spleen. His testes were atrophied on exam and his prostate was slightly enlarged on digital rectal exam. He had trace edema of his bilateral ankles. His neurologic exam was within normal limits.
LAB & DIAGNOSTIC STUDIES:
Cholesterol panel shows a total of 287, HDL of 9!!, triglycerides of 198 and an LDL of 238!!, cho/hdl ratio of 31.9!!
On CBC, hematocrit was 52%, comprehensive metabolic panel shows an elevated creatinine of 1.5, AST of 65, urinalysis shows trace protein. Vitamin D, low at 13 ng/ml.
ECG shows a normal tracing, with possible signs of LVH (enlarged heart).
Echocardiogram shows enlargement of LV with mildly reduced systolic function.
Stress test myocardial perfusion with wall motion, left ventricular ejection fraction shows a mild dilation of the LV, findings suggestive of nonischemic cardiomyopathy.
Sleep study shows moderate Obstructive Sleep Apnea.
ANALYSIS AND PLAN:
Mr. W. has what I call "Lifter's Endothelial-Cardiomyopathy," heart disease, secondary to a combination of long-term uncontrolled hypertension, abnormalities in lipids, obstructive sleep apnea and AS have played a role in the pathophysiology. This case represents the classic multi-factorial nature in which lifters who use AS (and some who don't) get into trouble with their health. It's been almost three years since Mr. W. walked into my office and he is doing well!!!
In the next edition of MD, I will elucidate in detail how I helped this man restore his heart health. He is still lifting and doing well. Although, his life with AS is quite different and he is on stable doses of HRT, managed by me. He is still strong, but most importantly, he feels better. And on a recent echocardiogram, the cardiologist called me and said his heart was now normal!! I love this case! This is why the Lord put me on the planet. The amount of work that went into caring for Mr. W. has been enormous, including direct coordination of other physicians by me and my dedicated staff.
PLEASE DON'T BE SCARED OF THIS PRESENTATION! IT IS REAL AND THESE MEDICAL ISSUES ARE COMMON. DEALING WITH THEM EARLY WILL SAVE YOUR LIFE AND ALLOW YOU TO STAY STRONG AND HEALTHY FOR AS LONG AS POSSIBLE.
Until next time, stay strong and healthy! Dr. O.
I just arrived home from the Arnold! Damn, I didn't know I was a muscle celebrity! At least a Medical Muscle Guru to all of you! Let me start this month's article by thanking all of you who reached out to me and made my trip an absolute blast!! EVERYONE KNEW ME!! It started in the airport in Chicago, where some guy yelled across the check-in line, "Hey Anabolic Doc, you rock— and your column is great, keep it up!" I was like, "Wow, thanks man." The rest of the trip was a progressive freak show, where everywhere I went, there you were, yelling at me and one guy even attacked me— I loved it!! You see, I'm not Dorian or Shawn Ray, but it's cool to be known as the 'Doc to the Lifters' and that the readers of MD love me. And for that, I give thanks! I will never let you down, as I mediate the modern, arcane world of medicine for lifters. The Arnold Classic is a damn 'Muscle Mecca'! Tens of thousands of brothers and sisters of iron! Thank you for accepting me as the doctor who understands you, and allowing me to keep you strong and healthy!
Thanks to all of you and MD and Steve Blechman! My unique medical practice is growing out of control! And in this regard, let me make a few announcements regarding current developments: First of all, I have hired Fern Assard, (Master's Figure Competitor and professional fitness model) as my personal assistant and liaison to the 'Anabolic Doc,' to assist me in the controlled growth of our medical practice. She will be there for you, as she focuses on answering all of your questions regarding how my practice works and details on becoming a patient. She will, with her expertise in the Figure world, assist me in PR, as we start to appear at bodybuilding shows and powerlifting/strongman events.
Fern will also be in charge of pumping up the Anabolic Doc website. Our plan is to make the Anabolic Doc site the number one web, worldwide, where you can go for accurate medical information for the 'enhanced' and natural lifter— because we understand the under-culture! And the time has come when lifters have their own doc, who understands the culture in which they live and provides evidence-based medical care to protect them in their quest for being big and strong.
OK, let's talk medicine. You all told me that you want more 'REAL' medicine from me, in the form of clinical examples that you can relate to. So I have decided that every month I will present what I call the "Anabolic Doc's Clinical Vignette Series." I will present a case study to you, exactly as we do at any medical school in the U.S. This is how we teach medical students and medical residents real clinical medicine. I have hundreds of patient case studies, and I will present the 'classic cases' that pertain to you, the real lifter. We will discuss diagnostic issues, management plans and clinical outcomes. You will love this, and I hope it will provide you with life-saving information! Here we go!!
CASE #1: June, 2007
CHIEF COMPLAINT:
Mr. W., a 37-year-old caucasian male, presents with 10 years of Anabolic Steroid (AS) use and progressive malaise and fatigue.
HISTORY OF PRESENT ILLNESS:
Over the past year, Mr W. has found himself getting more tired, with a noted decline in his ability to perform in the gym and in daily activities. He notes daily headaches, occasional dizziness, increased shortness of breath and general weakness. He denies chest pain, nausea, abdominal pain, but does complain of pain in his back, knees and left shoulder.
PAST MEDICAL HISTORY:
One episode of acute renal failure
General arthritis in his cervical spine, with neck pain and low back pain
Hypertension
Elevated cholesterol
Obstructive sleep apnea
Ruptured distal biceps tendon. Right side status post-repair, Boyd-Anderson technique, 1997.
Denies any hospitalizations/blood transfusions and has a spleen.
PSYCO-SOCIAL HISTORY:
Mr. W. is divorced with two children. Works as a sales associate. Denies any environmental exposure and does not smoke or abuse alcohol/drugs, although he tells me that he has used cocaine in the remote past. He has been using AS for about 10 years, with almost no time off. His AS of choice are testosterone, mixed blends and Cypionate, about 300 mg q 6 days intramuscular injection (IM). He also enjoys the addition of Deca-Durabolin, about 300-400 mg IM q week. He has used various oral AS, HGH and PCT with HCG and Clomid over the years. His training is intense and strong, with max bench press of 485 raw, squat 585 x 3 in power brief, deadlift max around 600, sumo. And he does dumbbell presses with 110-pound dumbbells for 16 reps!! Sick!! He does not do any cardiovascular training at all! I noted that Mr. W is a "very type A" male and in my clinic he was hyper-alert and not relaxed.
FAMILY MEDICAL HISTORY:
Mr. W. tells me that both of his parents have issues with elevated cholesterol and blood pressure and his father had a stent placed in his heart when he was in his mid-50s, indicating coronary artery disease. He has one brother with hypertension. His children are healthy.
MEDICATIONS:
Mr. W. is not currently on any meds, although he was prescribed something for his blood pressure several years ago. He takes a multivitamin, creatine and protein powder before and at times after workouts. He uses AS, as above. He denies any known drug allergies.
REVIEW OF SYSTEMS:
On detailed review of body systems, Mr. W. mentions that he has very poor sleep over the past year or so, with periods of what appears to be apnea. He is very tired during the day and has almost crashed his car several times driving to work in the morning! He is short of breath on easy activity, complains of heartburn at night, occasional swelling of his lower limbs, dizzy spells in the gym after heavy sets, and urinates several times per night. He also complains of erectile issues.
PHYSICAL EXAM:
Vitals signs showed a heart rate of 90 beats per minute and blood pressure of 150/110.
A very muscular man in no apparent distress, Mr. W. is 5'10" and weighs 250 pounds.
His neck size is 19" and abdomen is 46".
Cardiovascular exam revealed no murmurs, lungs were clear on auscultation, gynecomastia and nipple tenderness were noted. No abnormalities of the abdomen, including palpation of liver and spleen. His testes were atrophied on exam and his prostate was slightly enlarged on digital rectal exam. He had trace edema of his bilateral ankles. His neurologic exam was within normal limits.
LAB & DIAGNOSTIC STUDIES:
Cholesterol panel shows a total of 287, HDL of 9!!, triglycerides of 198 and an LDL of 238!!, cho/hdl ratio of 31.9!!
On CBC, hematocrit was 52%, comprehensive metabolic panel shows an elevated creatinine of 1.5, AST of 65, urinalysis shows trace protein. Vitamin D, low at 13 ng/ml.
ECG shows a normal tracing, with possible signs of LVH (enlarged heart).
Echocardiogram shows enlargement of LV with mildly reduced systolic function.
Stress test myocardial perfusion with wall motion, left ventricular ejection fraction shows a mild dilation of the LV, findings suggestive of nonischemic cardiomyopathy.
Sleep study shows moderate Obstructive Sleep Apnea.
ANALYSIS AND PLAN:
Mr. W. has what I call "Lifter's Endothelial-Cardiomyopathy," heart disease, secondary to a combination of long-term uncontrolled hypertension, abnormalities in lipids, obstructive sleep apnea and AS have played a role in the pathophysiology. This case represents the classic multi-factorial nature in which lifters who use AS (and some who don't) get into trouble with their health. It's been almost three years since Mr. W. walked into my office and he is doing well!!!
In the next edition of MD, I will elucidate in detail how I helped this man restore his heart health. He is still lifting and doing well. Although, his life with AS is quite different and he is on stable doses of HRT, managed by me. He is still strong, but most importantly, he feels better. And on a recent echocardiogram, the cardiologist called me and said his heart was now normal!! I love this case! This is why the Lord put me on the planet. The amount of work that went into caring for Mr. W. has been enormous, including direct coordination of other physicians by me and my dedicated staff.
PLEASE DON'T BE SCARED OF THIS PRESENTATION! IT IS REAL AND THESE MEDICAL ISSUES ARE COMMON. DEALING WITH THEM EARLY WILL SAVE YOUR LIFE AND ALLOW YOU TO STAY STRONG AND HEALTHY FOR AS LONG AS POSSIBLE.
Until next time, stay strong and healthy! Dr. O.
