0:00

Mailbag Norman, we love it when

0:02

people write in, and we've had

0:04

Richard who has contacted us after

0:06

the interview last week on calcium

0:08

scores and assessing cardiovascular risk. Richard

0:10

has written in and said that

0:12

he had a coronary calcium score

0:15

done. It came back as zero,

0:17

but he actually ended up having

0:19

a really blocked coronary artery. So

0:21

it hadn't been picked up on

0:23

the calcium scan. and has

0:25

said that soft plaque does not show on

0:27

a calcium score and it can be very unstable.

0:30

He had no family history of

0:32

heart disease and then has

0:34

said he has an alpha -gal

0:36

allergy, which you know something about. Yeah,

0:38

and this is something that a

0:40

lot of doctors think is just

0:42

an imaginary syndrome and it's certainly

0:44

not an imaginary syndrome. So the

0:46

issue about soft plaque here by

0:48

the way is that when you

0:50

get a heart attack, particularly in your

0:52

40s and 50s, because atherosclerotic plaque that hasn't

0:55

calcified yet and is not stable and

0:57

can easily burst open. So that's why you

0:59

do get an instance of sudden cardiac

1:01

death in 40 and 50 year olds, because

1:03

it's still soft plaque. And what Richard

1:05

is saying is that it's soft plaque because

1:07

of his alpha -gal allergy. So briefly, what

1:09

an alpha -gal allergy is, often associated with

1:11

a tick bite, and you

1:13

get this allergic response

1:16

to a protein

1:18

in non -primate mammalian

1:20

tissue. So, beef, etc.

1:22

Oh, so consuming it? Consuming

1:25

it. And alpha -gal

1:27

stands for the substance, which

1:29

is galactose alpha -13 galactose,

1:31

which is shortened to

1:33

alpha -gal. Okay, thank goodness.

1:35

And you can get an

1:37

immediate serious allergic response,

1:40

particularly to a monoclonal antibody

1:42

used to treat lymphoma

1:44

called satuximab. But also

1:46

you can get delayed allergic responses

1:48

several hours after eating beef

1:50

or pork. And this can be

1:52

from a tummy upset to much

1:54

more serious side effects. And

1:57

it's taken a long time for people

1:59

with alpha -gal syndrome to be

2:01

recognized as having it, and therefore,

2:03

they do have to avoid beef

2:05

and pork in their diet. Now,

2:08

what Richard is saying is

2:10

absolutely right, which is there is

2:12

growing evidence, and it's actually

2:14

Australian research that's found it, is

2:16

that for some reason, it's

2:18

not entirely clear why, people

2:20

with alpha -gal syndrome are

2:22

at risk of soft plaque. And

2:25

in other words, they've got obstruction

2:27

in their coronary arteries, and

2:30

it's not calcified. In other words, if

2:32

a calcium score is not going to pick

2:34

this up, whereas another test

2:36

called a coronary CT angiogram

2:39

will pick this up. but

2:41

you are at more risk of this. And

2:43

this is important for people to know is

2:45

that it's another thing to be checked up

2:47

on. If you've got an alpha -gal syndrome

2:49

or an alpha -gal reaction is that you need

2:51

to have, you know, need to discuss with

2:54

your GPA about a referral to a cardiologist

2:56

about checking up whether you might have non

2:58

-calcified plaque. So this is a potentially

3:00

serious allergic disease, as well as being

3:02

very inconvenient for people. We might cover

3:04

AlphaGal in a bit more detail in

3:07

a future show. Yeah, I was going

3:09

to say we probably should. This is not something that

3:11

I've seen ever in my literature when it comes to

3:13

heart disease. No, and maybe people

3:15

don't talk about it. Maybe. So yeah,

3:17

maybe we should do a little segment on it. So

3:20

some people are also in the inbox

3:22

flagging the fact that we haven't talked about

3:24

LP, little A, or lipoprotein A, that

3:26

particular type of cholesterol in the context of

3:28

cardiovascular disease. The reason is it's

3:30

been covered in the health report previously and so

3:32

in the show notes there'll be a link to

3:34

that episode but it has been covered in detail

3:36

previously so that's why we haven't deep dived in.

3:39

And some feedback on our story on

3:41

vocal cord dysfunction. Yes so

3:43

Amanda has written in saying that she

3:45

was very interested in the program on

3:47

vocal cord dysfunction because a dear friend

3:49

of hers was diagnosed with it last

3:52

year after seeing an ear nose and

3:54

throat surgeon. So she then

3:56

underwent speech therapy which didn't really help her symptoms

3:58

went back to the GP and was subsequently

4:00

diagnosed with lung cancer. Yeah

4:02

and she says her husband who's a doctor often

4:04

quotes beware of the unilateral red eye. And

4:06

so I should say the suspended

4:09

lateral red eye is that this is

4:11

a catch for trainee doctors in

4:13

a lot of different fields, certainly for

4:15

us in pediatrics, is that if

4:17

somebody comes in with one red eye,

4:19

it's not necessarily just conscientivitis. You've

4:21

got to take it seriously because there's

4:23

a lot of different causes of

4:25

one single red eye. And what Amanda

4:27

is saying is maybe vocal cord

4:29

dysfunction, you should be looking beyond it

4:31

just in case there are other causes going on. Yes,

4:33

it may not be vocal cord dysfunction, it could be

4:35

something. think else. And Amanda goes on

4:37

to say, maybe thanks for your excellent program, listen

4:39

to either at the gym or gardening. I

4:41

love that. I love that we're reading

4:43

the positive bits out too now. That's

4:46

good. That's right. We do love it.

4:48

So please write into healthreport at abc

4:50

.net .au with what you think you'd like

4:52

to hear on the program or any

4:54

feedback or stories. We love it. And

4:56

if you haven't already subscribed to The

4:58

Health Support, please do so. And on

5:00

our sister podcast, What's That Rash, we

5:02

ask the really deep question, can

5:04

you train yourself to pee less? The

5:07

big questions I like it, I'll be listening. See

5:09

you next week. See you next week. week. You've

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