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Doctor’s Tip: What to do if you have an abnormal carotid IMT screen for heart disease

February is heart month. Almost all heart attacks are preventable, but in spite of that they remain the number one cause of death in the U.S for both men and women.

Let’s say you are a 50-year-old man and take advantage of the special IMT screen for heart disease offered by Compass Peak Imaging in Glenwood during February, and your report comes back indicating that you have arteries of an average 65-year-old American man based on thickness of the endothelium lining of your arteries. If arterial age is 8 or more years greater than your actual age, you are increased risk for a heart attack or stroke.

Let’s say the report also says you have soft plaque (plaque is “hardening of the arteries”). The presence of plaque also puts you at significant risk (even if your endothelium is not thickened), and soft (uncalcified) plaque is more worrisome than calcified plaque because it is less stable and more apt to rupture and block off an artery.

You and your medical provider need to figure out why you developed atherosclerosis, which is the cause of heart attacks and strokes and is also a huge risk factor for dementia. Atherosclerosis is not inevitable as we age — there are groups of people in the world such as the Blue Zones whose arteries are as healthy at 90 as they are at 19, making these people heart attack proof. What these societies have in common is that they eat primarily plant-based, unrefined foods including daily legumes; and they engage in frequent, low-level physical activity.

Following are measures you can take that can prevent, treat, and even reverse atherosclerosis:

DIET: Adopt a plant-based, whole food diet with no salt, sugar or added oil. Dr. Dean Ornish proved over 30 years ago that atherosclerosis can be reversed with this diet. Dr. Caldwell Esselstyn confirmed this subsequently — read his book, “Prevent and Reverse Heart Disease.”

EXERCISE: The Ornish program — which has been approved by Medicare and many insurance companies — includes regular aerobic exercise. If you’re sedentary, ease into a program of exercise such as walking for at least 30 minutes a day. If you have cardiac risk factors and/or severe atherosclerosis, talk to your provider to see if they recommend a cardiac stress test before starting vigorous exercise.

STRESS REDUCTION is also included in the Ornish program. Consider yoga or meditation. If you suffer from depression, anxiety or sleep problems, seek treatment.

BLOOD PRESSURE should be less than 120/80. For mild hypertension, weight loss, salt avoidance and exercise can help, but do whatever it takes to control it, including medication if necessary.

CHOLESTEROL: The aforementioned populations in the world who are heart attack proof have total cholesterols < 150, LDL (bad cholesterol) in the 30s and 40s, and triglycerides < 70. Plant-based, whole food nutrition lowers cholesterol, but if it doesn’t get your numbers to goal, consider medication. In their 2022 book “Healthy Heart, Healthy Brain,” heart attack prevention experts Bale and Doneen recommend a statin for anyone with plaque, no matter what their cholesterol is.

WEIGHT: Attain and maintain ideal body weight. If you look at your profile in the mirror and have even a small “belly,” lose it because that almost always means you have insulin resistance (pre-diabetes), the driver of 70% of heart disease. High triglycerides and low HDL (good cholesterol) are another indication of insulin resistance. Fasting blood sugar above the low 90s, and/or A1C above 5.6 (a measure of average blood sugar levels the previous 3 months) are also indicators of IR, but the gold standard is a 1 and two-hour glucose tolerance test (1-hour sugar of > 125 and/or 2-hour sugar of < 120 indicate insulin resistance).

SLEEP APNEA: Anyone who has atherosclerosis should have an overnight oximetry to screen for sleep apnea. This inexpensive test involves wearing a monitor on your finger all night that records oxygen level and pulse rate.

TOBACCO should be avoided in any form, including second-hand smoke.

INFLAMMATION from conditions such as rheumatoid arthritis, ulcerative colitis, and dental problems plays a large role in development of plaque, and in plaque rupture. Practice good dental hygiene, and if you have tooth or gum problems, see a dentist well-versed in the mouth-vascular connection.

REPEAT THE IMT TEST IN A YEAR: With appropriate treatment, endothelial thickening should improve; soft plaque often disappears or at least calcifies thereby becoming more stable; and the amount of calcified plaque doesn’t increase and often decreases.

Next week’s column will be about cholesterol.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market, and cooking classes. Call 970-379-5718 for appointment, or email gfeinsinger@comcast.net.

Writers on the Range: The housing crisis is harming my town

In Girdwood, Alaska, we’ll long remember the snowstorm of Dec. 6, just two months ago. But it won’t be for the school cancellations. We’ll remember it as the night dozens of residents traveled a snow-packed highway to testify at a public meeting — about housing.

Residents across the West will recognize why so many came out that snowy night. A proposed development, called Holtan Hills, would expand our town’s footprint but include almost nothing affordable for teachers, firefighters, wait staff or others who comprise the soul of our community and drive its economy.

With no guardrails to support local homeownership, second-home real estate investors would likely gobble up the project’s predominantly high-end units. It’s happening already, with most shunning the long-term rental needs of a few thousand people in this south-central Alaskan community. New owners often offer nightly rentals or just leave their houses unoccupied.

That would mean more empty houses in a town with a severe housing shortage. The dozens who testified that night, and the hundreds who wrote letters, described the impacts.

They included Emma, who runs a fishing boat with her husband, and whose young-adult daughter can’t find a place to rent in the town where she grew up and now works. And Amanda, the pizza shop owner, who is overwhelmed trying to help her employees find housing, including the 65-year-old man whose landlord recently booted him out on short notice.

Erin described bailing on her long-held dream of raising a family here after 11 years of pouring her talents into nonprofit youth education programs. She reminded me of Autumn, my daughter’s former piano teacher, who recently moved away after years of teaching music to local kids. She had been unable to find steady housing.

Such stories swirled into that winter night from the heroes every mountain community knows — the ones who clean rentals, provide health care, build houses and teach our kids to speak, spell, ski and say “thank you.” Business owners were there, too, detailing how the lack of attainable housing causes employee shortages that curtail operating hours, leaving fewer visitor services.

Some who didn’t speak that night included the local workers who sleep in their cars or in drafty cabins on the edge of town. We also didn’t hear from the Filipino parents of my daughter’s close playmate, who are trying hard to remain in the town where their accounting jobs are located, and where their daughter is thriving.

Dozens of us highlighted how communities across the West have fought similar battles for an entire generation now. We talked about Whitefish, Tahoe, Breckenridge, Boise and other towns. We explained their use of sensible deed restrictions, limits on nightly rentals, incentives that promote local home ownership, and concessions from developers. All helped local workers attain housing.

I know the benefits. Living in Colorado in the 1990s, I accepted a financial incentive to put a deed restriction on my modest condo. After my wife and I sold the condo, the payment became seed money for our first house. Meanwhile, the condo still holds a deed restriction that helps locals enter the market. Under such reasonable measures, developers could still make buckets of money while workers gained access to housing.

Someone else who didn’t show that night was the developer, who instead dropped a guest column in the state’s largest newspaper maligning her project’s critics.

Some of our elected officials were equally indifferent. One blithely suggested that someone just needs to build a hardware store in town so that building costs could come down. Another asked why our town hadn’t solved the housing issue earlier. Others grilled residents on how many more houses it would take to solve the problem.

Of course, as with many Western communities, the issue is not an actual shortage of houses. It’s the blizzard of cash that second-home speculators and others can throw at any property that enters the market.

The meeting ran almost to midnight, as snow blanketed the cars outside. I imagined this must have been the scene two decades ago, as housing proponents in the West’s mountain towns spent nights eking out seemingly small wins. But those wins are now the proven programs that can help communities today.

We just need elected officials to understand that people can’t work here if they have nowhere to live.

Tim Lydon is a contributor to Writers on the Range, writersontherange.org, an independent nonprofit dedicated to spurring conversation about the West. He writes in Alaska.

Whiting column: Freedom of speech can be complex

Freedom of speech isn’t easy.

Everyone desires it. No one’s happy without it unless it’s negatively affecting us, making us feel uncomfortable or requiring responsibility.

It requires we not only allow and tolerate another’s words but be willing to fight for their right to safely espouse words with which we vehemently disagree, deem inappropriate or find disgusting. Freedom of speech doesn’t require our acknowledgement of validity, just the right to say it.

We must acknowledge the personal responsibility to utilize manners and role model appropriate behavior when exercising our right. Sensitivity and freedom of speech are not oxymorons. If our words don’t meet that criterion, they will stop listening and with it any chance to change their minds.

Demonstrating empathy is effective. When our first word is “no,” others don’t feel they’ve been heard and resulting acrimony assures nothing constructive occurs. The “yes, but” technique is useful: acknowledging their thoughts first, then presenting ours.

Our daughter asks to ride with friends to an out-of-town Taylor Swift concert necessitating her returning after midnight. Instead of immediately responding “not a chance,” if we respond “That would be a lot of fun; she’s a great singer. However, your curfew is 11 p.m. and the roads are too slick to drive that far at night.” She may not like the answer, but she may accept it better knowing we heard her. The technique can be useful when an employee asks for a work schedule change or any instance when a positive response isn’t possible.

Freedom of speech includes the written word, but not freedom of action. It doesn’t include infringing on others’ rights, such as spray-painting store windows or rec center walls. It doesn’t include physically demonstrating a contrary opinion by throwing rocks through a window or burning a police car. Doing such magnifies their admission that their words won’t stand on their own merits.

Freedom of speech does require us to toughen up our toleration level. No matter how passionately we disagree or how distasteful or disgusting we may feel their words are, they have the right to say them, and we must allow them to do so. We can’t nit-pick freedom. It’s an all or nothing concept.

It bears repeating that it’s helpful to remember most people who hurt or disparage us, don’t care about us. Consequently, let it go. Why allow someone who doesn’t care about us to control us?

We’re better off spending our energy advocating the validity of our words. Attempting to prohibit theirs, arguing or getting mad feeds their motivation; their energy. However, we don’t have an obligation to listen or read what they say. We can turn around, walk away, or disregard their paid ad, sign or column.

There are exceptions. After justifying youthful disagreement with my father with “freedom of speech” he responded. “You may have freedom of speech, but so do I and I win.” His response could have been worse.

We don’t have an obligation to facilitate their words. It’s up to them to acquire the means. They shouldn’t expect free space in a newspaper, radio or TV time any more than we should.

Freedom of speech doesn’t include violating our right to privacy. Technology can facilitate tracking our movement in our cars as well as private and commercial airplanes. Those doing so argue “it’s freedom of speech.” Sorry, that’s a stretch.

Freedom of appearance isn’t included when it’s essential. I reminded students to dress appropriately for an interview and an employer may require certain appearance on the job. They occasionally said, “That’s not fair. My appearance expresses my freedom of speech.” The world’s response is, “Fine, dress as you wish, but the employer may not to hire you. He hires those who fit in with his company culture and meets the needs of the position.”

Can employers control our freedom of speech? Depends. Views contrary to his expressed outside of work? Probably not. During work? Yes. Courts have reinforced the employer’s right to develop and maintain the company atmosphere he deems essential.

Contrary to what media may feel, courts have supported “confidentiality” related to running a business or the White House.

Freedom of speech in social media? Yes, but remember opening the app is voluntary. It’s hard, especially for our youth, but we can role play the will power to resist.

On a Sunday interview show, the guest made a unique argument that may have validity. The nature of social media emphasizes physical attractiveness, accomplishments and social acceptance. Consequently, it’s created a group of very lonely young men who don’t possess any of those characteristics. They aren’t getting attention, so they look to create it. A significant percentage of those committing mass shootings tend to occupy this group. At the least, it requires conversation with our children about social media and provide them with strategies to maximize its positives and minimize its negatives.

A tougher question is, “does our freedom of speech trump a person’s right to not be offended?” The short answer is, yes. It can be considered the price we pay for the freedom. We must realize if we want to think, improve or change we must be willing to risk being offensive to someone, especially those involved in the status quo. We must be willing to hear and consider uncomfortable words or questions if there is to be the possibility of progress.

The ramifications of freedom of speech can be difficult, but it exemplifies the extensive freedom we enjoy. It requires we demonstrate the personal responsibility to exercise that right with empathy, manners, good taste and an open mind.

Bryan Whiting feels most of our issues are best solved by personal responsibility and an understanding of non-partisan economics rather than government intervention. Comments and column suggestions to: bwpersonalresponsibility@gmail.com.

Vidakovich column: Maravich memories

A few weeks back, in the sports briefs section of the Denver Post, I read that a young man from Detroit Mercy University had moved into second place on the NCAA college basketball all-time scoring list. His name is Antoine Davis and he had just scored 42 points in a game the previous day to pass Freeman Williams, who played at Portland State in the mid-1970s.

Davis, a fifth-year graduate player, has amassed 3,274 points in his collegiate career, which puts him behind only Pistol Pete Maravich who starred at Louisiana State University in the late 1960s. Maravich, who was coached by his father, Press Maravich, scored 3,667, a total which is well within the reach of Davis.

Growing up in Glenwood Springs in the 1960s, this hotshot from LSU who they called “The Pistol” was my boyhood basketball idol. Back then there was no cable TV, so college basketball games on television were usually relegated to the single game on Saturday afternoon’s CBS broadcast. Since these games almost always featured the powerhouses of that time such as UCLA, Indiana and North Carolina, I never got to see Pete play in college.

My first time seeing Maravich play, other than on the late night sports highlights, was when he was a rookie with the Atlanta Hawks. It was in New York’s famed Madison Square Garden, on national TV against the Knicks. Pistol Pete made a behind-the-back pass on a fast break that not only faked out Knick’s guard Walt Frazier, but had my dad jumping out of his seat and asking me, “Did you see that, Mikey?!” Of course I did, pops. This is my hero dressed in shorts, a tank top and floppy gray work socks which were his trademark.

At that time, I was convinced that Pete Maravich was born in a manger, walked on water, and could feed the multitudes.

If you have taken the time to read this far, you may just be convinced that what I have to say from this point on is a bit biased, but in actuality, I’m just giving you a few facts to ponder in case this Davis guy actually does break Pete’s scoring record.

First of all, as I mentioned above, Davis is a fifth-year senior, that means he had four full season to accumulate the point total he is at now, and that is with a 3-point line and more games being played each season than back in Pete’s time.

When Maravich played, freshmen were not eligible to compete at the varsity level, so he scored all of those points in just three years. Legend has it that when the freshmen played at LSU, the stands were packed to watch this young phenom from the steel city of Aliquippa, Pennsylvania play. The stands would pretty much empty for the varsity game at LSU.

Maravich played far fewer games in his three seasons than what is allowable today and there was no 3-point line back then. Pete averaged 44.2 points per game (that is not a misprint) for his career. When Dale Brown took the coaching job at LSU in the 1990s, he watched all of the games on tape that Maravich played in his career, charting the long bombs that would have counted as 3 instead of just 2 points. Brown came up with the calculation that had there been a 3-point line when Maravich was playing, he would have averaged an astounding 52 points per game.

Just some things to think about folks, if you see down the road near the end of the season that Davis did indeed eclipse Pete’s record. I’m not sure that I will recognize it, and I do hope when it happens that it will be pointed out by the national scribes and broadcasters some of the facts I have mentioned.

Pistol Pete Maravich passed away at the young age of 40 years while playing a pickup basketball game in a church gym in Pasadena, California. It was January 5, 1988 and I will never forget that evening when I walked into my parent’s home and my father told me the news.

It turns out Pete had major problems with his heart, and doctors were amazed that he had lived as long as he did, based on the strenuous physical activities he had engaged in for so many years.

I always joke with my sixth grade friend Hayden Picore that Pete was much better than her idol, Steph Curry. She just gives me a look like, “C’mon old dude,” and she rolls her eyes. You know what? I would have done the same thing at that age to someone who tried to tell me that Pete wasn’t the top dog.

Pistol Pete will always be the greatest basketball player who ever walked the earth in my eyes, and that’s all that matters.

Glenwood Springs native Mike Vidakovich is a freelance sports writer, teacher and youth sports coach. His column appears on occasion in the Post Independent and at PostIndependent.com.

Carsten column: Oral health is essential for quality of life for pets

February has been designated as National Pet Dental Health Month to help draw attention to the importance of dental health care for our pet companions.

It has long been clear that there is a connection between the health of the mouth and the health of the rest of the body. Dental disease starts early in life for pets with the majority of dogs and cats having some degree of dental disease by the time they are three years old. Ongoing dental disease can contribute to mouth discomfort and stress on organs like the heart, liver and kidneys. This means that dental checkups and care are important important all year. Monitoring and preventive care should start early in life.

It is often bad breath and build up of hard calculi material on the teeth that brings attention to the mouth. These changes are often just what is seen on the surface with more serious conditions becoming apparent with a deeper look. Indication that there are more problems include a pet with abnormal chewing, food dropping from the mouth when eating, drooling, reduced or no appetite, swelling in the mouth or face, bleeding from the mouth, or pain in or around the mouth.

One goal of preventive dental care is to avoid more serious problems by addressing issues early. Regular dental exams along with regular dental cleanings are an important part of any preventive program. Ideally, daily teeth brushing with a pet appropriate toothpaste occurs as a way to reduce the plaque on the teeth. Unfortunately not all pets will allow teeth brushing.

Other options for attempting to reduce plaque accumulation include dental foods, dental treats and chews, oral sprays, and additives in the food or water. Products that have been approved by the Veterinary Oral Health Council (VOHC) can be found on their website. Strategies for reducing plaque and maintaining healthy gums vary by product. Some focus on reducing bacteria levels in the mouth or altering the biofilm on the teeth. Others mechanically “scrape” across the tooth during chewing in a way that helps reduce plaque.

There are some products that are a combination of these approaches. For example, products like soft rawhide and vegetable based chews containing enzymes, antimicrobials, and antioxidants combined with special shapes to increase plaque reduction when chewed are available. Keep in mind that not all effective products are listed on this VOHC website. For example, a controlled study evaluating a green tea product added to the daily water showed efficacy in reducing plaque.

Some online sources advocate the use of natural products like deer antlers, rawhide, bones and bully sticks. It is important to recognize that some of these hard products, like bone and antlers, can cause tooth fractures and other trauma to teeth when chewed. Tooth fractures can lead to pain, infections, and often extraction of the tooth. It is important to note that fractured teeth have been reported to occur in nearly 50% of pets at some time in their life. Depending on the extent of damage to the tooth, a root canal and restorative procedures can be done to save the tooth, but not all damaged teeth can be saved. So consider avoiding hard products or at least be aware of the potential problems so that careful monitoring can be regularly done. Concerns with rawhide include how free of contamination the product is and the potential that the pet could swallow pieces of the rawhide leading to digestive distress.

Regular dental cleanings under anesthesia should be anticipated over the life time of all pets. Some pets like small breed dogs typically require more frequent cleanings than large breed dogs because of the structure of their mouths. Dental x-rays can be essential when assessing the overall health of the mouth. In some studies it has been found that almost 28% of dogs and 42% of cats had diseased teeth seen on x-ray of teeth that appeared normal above the gum line. In pets with teeth that appear abnormal above the gum line there was an additional 50% more teeth in dogs and 53% more teeth in cats that were found to be abnormal with x-ray.

In addition to regular dental cleanings, daily or every other day brushing is valuable along with the use of products that reduce plaque accumulation and maintain overall oral health. If you have questions about your pet companion’s oral health, contact your veterinarian.

Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs. Dr. Carsten is the 2022 Colorado Veterinary Medical Association Distinguished Service Award recipient.

On the Fly: Learning to tie your own flies will elevate your game on the water

To the uninitiated, tying flies may seem daunting, but it’s never too early (or late) to start. When your creative juices start to flow, the sky is the limit whether you are tying for freshwater or salt. If you are blessed with attention to detail, tying your own will pay big dividends — especially with the picky fish we encounter here locally.

The benefits are paying closer attention to the size, shape and color of your offerings, plus building an understanding of why the fish key in on a certain insect, or more specifically, the life cycle stage of that insect. One caution — many people who are starting to tie try to bite off more than they can chew, attempting the most difficult flies before learning the basics, which ultimately leads to frustration on the vise.

We recommend starting with simple-yet-effective flies like San Juan Worms, midge larva, brassies and simple streamers. Learning how to throw consistent thread wraps on a hook and how to whip finish without giving it a lot of thought is half the battle. We also steer folks away from buying a “kit,” and suggest that they simply build up their selection with materials they’ll actually use, versus a bunch of stuff that they won’t.

It doesn’t take much to get started — all you need is a quality pair of scissors, a comfortable chair and table, cool and bright light, a rotary vise, and a few other oddball tools and materials to get going. No one ever forgets the first fish that they caught on a fly they tied themselves, I know I never will. It may have just been a simple San Juan Worm, but my heart leapt out of my chest when that fish was in the net.

Don’t forget about the 7th annual Iron Fly Competition at the Tipsy Trout in Basalt on Feb. 11; you’ll see some of the best tyers in the valley spin up some of their creations in a fun-filled evening and perhaps get some inspiration to pick up a new hobby!

This report is provided every week by Taylor Creek Fly Shops in Aspen and Basalt. Taylor Creek can be reached at 970-927-4374 or TaylorCreek.com.

Doctor’s Tip: February is Heart Month — Do you and your loved ones have healthy arteries?

Once again during February (“heart month”), Compass Peak Imaging in Glenwood (970-665-2194) is offering a special price for carotid IMT heart disease screening — a special, FDA-approved ultrasound study that assesses artery health.

Heart attacks are the number one cause of death in the U.S. year after year, in spite of essentially all of them being preventable. Here’s what Christiaan Barnard — the South African heart surgeon who performed the first heart transplant — had to say about heart attack prevention: “I have saved the lives of 150 people by heart transplants. If I had focused on preventive medicine earlier, I might have saved 150 million.”

Unfortunately, medical training and practice in the U.S. are geared towards managing chronic diseases such as heart disease with pills and procedures instead of preventing them. Heart disease is looked at as a plumbing problem, with blockages that need to be fixed with stents and bypass procedures, rather than a medical disease (atherosclerosis — hardening of the arteries) that can be prevented, treated and reversed through simple lifestyle changes and, when necessary, non-invasive medical therapy.

About 50% of men and 70% of women who die suddenly from heart disease had no prior symptoms, making screening for diseased arteries imperative.

Risk factors for atherosclerosis/heart attacks include: smoking; blood pressure above 120/80; high total cholesterol, low good cholesterol (HDL), high LDL (bad cholesterol), high triglycerides; obesity, particularly around the waistline; pre-diabetes and diabetes; sleep apnea; inflammation including that due to dental disease; sedentary lifestyle; stress including depression; inadequate sleep; the standard American diet; age (men over 40, women over 50); family history of cardiovascular disease; gout; autoimmune disease; erectile dysfunction; migraine headaches; and sleep apnea.

Some doctors use risk calculators based on these risk factors, but as respected heart attack prevention experts Bale and Doneen point out in their 2022 book “Healthy Heart, Healthy Brain,” these risk calculators are dangerously inaccurate.

If arteries are stressed by bad genes; bad habits such as smoking or unhealthy eating; or by other aforementioned risk factors, the endothelium that lines arteries thickens, and eventually plaque (atherosclerosis) develops — 99% of which is in the walls of the arteries, not causing a blockage. If the plaque ruptures — often triggered by inflammation — a blood clot forms in the artery, blocking the blood flow, causing death of part of the heart muscle (or brain in the case of a stroke).

Twenty percent of heart attacks result in sudden death. For the other 80% of heart attack victims who make it to the hospital, an interventional cardiologist can save lives by opening the blockage with a stent. However, stents and bypass procedures don’t treat the underlying disease, and in non-heart attack settings have not been shown to save lives or improve quality of life.

There are two commonly-used methods of determining arterial health. One is coronary calcium scoring, available at most imaging centers. This is a CT scan of your heart, which shows how much calcium (atherosclerosis) you have in your coronary arteries. It involves a small amount of radiation, and can result in false-negatives because it doesn’t pick up non-calcified plaque, which is the most dangerous kind. Repeat coronary calcium scoring is not useful in determining effectiveness of treatment, because calcification of uncalcified plaque — which is a good thing — results in a higher score.

The second method is carotid IMT, which provides a soundwave picture of the carotid arteries, located just beneath the skin on both sides of the windpipe, and therefore easily assessable. It measures the thickness of the endothelial lining, and picks up both calcified and uncalcified plaque. If abnormal, IMT should be repeated a year after starting treatment — appropriate treatment should result in less endothelial thickening, stable or lesser amount of plaque, and calcification (stabilization) of uncalcified plaque. The downside of IMT is that it looks at the carotid rather than the coronary (heart) arteries, but there is a 95% correlation between the two — i.e. if you have atherosclerosis in one area you almost certainly have it in arteries throughout your body.

The Bale-Doneen Method is one of the most successful heart attack prevention methods in the U.S. Dr. Doneen recently served on a Society of Atherosclerosis Imaging and Prevention expert committee, which developed guidelines for IMT screening. They recommend carotid IMT screening on everyone at age 40, and younger if significant risk factors are present. Note that the carotid IMT is much more sensitive than the usual carotid ultrasound done at most imaging centers and by companies such as Lifeline Screening — which just pick up major blockages.

Next week’s column will be about what to do if you are found to have plaque.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market, and cooking classes. Call 970-379-5718 for appointment, or email gfeinsinger@comcast.net.

Merriott column: Yellowstone, then, now and again 40 years later

The field trip for my long-anticipated visit to Yellowstone was finally here! It was 1983 and I was trapsing along with CC Lockwood, a great friend who happened to be an acclaimed photographer and led winter field trips into Yellowstone. It is rumored he and Marty Stouffer of our valley drank a few beers, head sucked a few crawdads in south Louisiana and took a few pictures along the way.

I was so excited I had butterflies. I was fully engaged ready to do this! I wanted to see my favorite critter, “Buffler’s,” up close and personal and see the steam come out of their noses. I marvel now more than ever how humankind could almost cause this magnificent animal to go extinct. There were once more than 60 million spread across North America when we arrived. Now there are less than 20,000 genetically pure American Bison.

Clyde took 10 of us into the park in the dead of winter on a Wildlife Photography Workshop. After the obligatory stop at the Chico Hot Springs Lodge in Pray, Montana, some cold beer (no crawfish), we were met at the entrance to Yellowstone by two top-of-the-line snow cats. Don’t get me wrong here, the only way to get into the park really was by snowcats; snowmobiles don’t count. Hell, I was from north Louisiana I did not know there were such things as snowcats. It vaguely resembled an army half track but with no machine gun out the top.

Clyde soon took his place there with his Army WW II army hat with ear covers. He looked just like Donald Sutherland as Dr. Oddball in Kelly’s Heroes. CC gave the animated sign to move out. I have got to find the slides from that trip besides the three hanging on my wall.

We started into the park on what I guess was a road, but not like one I had been on before. The snow was really deep, appearing to climb half way up the trees. When we came around a bend in the “road” there was a huge bull elk. Maybe 20 points I guessed and bigger than any horse I’d ever seen? I was quickly corrected and told you only counted one rack side in the West. How the heck would a flatlander know that? He was like 30 feet away and could have cared less that we were there visiting his winter home.

Our cat driver was an interesting character for sure. He worked as a park ranger in the summers and worked mostly with problem Griz. He curiously asked if any of us knew how to tell a black bear from a grizzly? Several of us pilgrims answered “color!” enthusiastically. He proudly informed us there were actually black bears that were brown. Well, so much for that old wives tale.

The only definitive way to tell, it turns out, is climb a tree while you are being chased: if he follows you up, he’s a black bear, and if he pushes it over it’s a griz. Turns out he described his summers “scared —-less,” sleeping in a canvas tent in the depths of Yellowstone with the critters and baiting grizzly bears. He was armed only with bear spray, which I doubt was very effective 40 years ago.

The next day we took the snow cats over to the Firehole River to observe the small herds of buffalo grazing along the river. Out in a field on the way to the river, CC caught some movement from his lookout portal and the snowcat was animatedly signaled to halt. There were two coyotes hunting field mice. Don’t know if you have ever seen that. I hadn’t. They stand totally still in the deep snow and then on some internal signal honed sharp by millennials of time as a predator, they pounce head first into the snow, their heads totally buried, sometimes to the tail, and then in seconds they are up, more often than not with a wiggling critter in their mouths.

It was just like watching a National Geographic movie. We were spellbound for quite some time seeing another natural wonder in the place we call Yellowstone. All of a sudden the coyotes cocked their heads up simultaneously. What was it that they smelled or heard that caused then to go to high alert. Then we heard it, too — humming noise from way in the distance intruding on the soliloquy of Yellowstone.

And yep, you guessed it, two renegade snowmobiles; the only ones we saw on the whole trip. One of the rangers guessed fewer than a 100 people were in the park. Imagine that today. It would never happen. No way you could recreate the experience now, and that’s a damn shame.

The snowmobilers coasted to a stop to see what we were looking at. They saw nothing. The coyotes had noiselessly faded into the forest. The National Geographic film was over.

But, you know what? You could hear those snowmobiles for 10 minutes and smell exhaust fumes for 30. Is it worth it? You tell me.

Trip two to follow next month.

Frosty Merriott of Carbondale is a longtime local CPA, former member of the Carbondale Board of Trustees and current appointed member of the town Environmental Board.

Superintendent’s Corner: 100+ days in, a look at some accomplishments and next steps

At the time of this publication, I have been the proud superintendent of the Roaring Fork Schools for 134 days. It is hard to believe that next week I will celebrate my seven-month anniversary! As I near this milestone, I want to share with our community some of what I’ve learned during my tenure as superintendent and what I recommend as next steps for our district.

Last spring, during my visit to the Roaring Fork Valley as a candidate, I spoke with stakeholders about context-sensitive design. It is the decision-making process used to construct the highway through Glenwood Canyon that allowed stakeholders to engage in the design process by sharing what natural beauty had to be preserved if a highway was to be constructed through the canyon. Not to mention, building a highway through a canyon was once deemed impossible, so preserving the natural beauty would also require creativity and innovation in engineering.

It seemed appropriate and serendipitous to me that I would adopt a similar approach to my work this year, as superintendent, if selected.

As a candidate, I created a 100-day entry plan. Succinctly, my entry plan was, and remains, to: listen and learn about what we must preserve, where we must innovate, and to create a long-term plan that is community-informed to fulfill our mission. I have had the opportunity to hear from staff, parents, students, and community members in a variety of ways and there have been some emerging themes–both in what we must keep but also, where we must try new things.

In my entry plan, I shared my personal beliefs and core values, which are central to who I am as a person and as a leader. Since becoming superintendent, I’ve had the opportunity to formally share these with our community but also, my hope is that I have been able to demonstrate these through my actions and throughout my interactions with staff, students, parents, and community members at large.

Beliefs and core values

The following are the five goals that I set out to achieve this year:

1. Nourish a trusting, productive, and collaborative relationship with our Board of Directors.

2. Ensure a strong transition in leadership with a focus on accelerating achievement.

3. Implement listening and learning sessions in Glenwood Springs, Carbondale and Basalt.

4. Learn about the values, norms, expectations, and culture of our three municipalities and district at large.

5. Focus on narrowing differences in achievement between student subgroups and increasing the achievement of all students.

I am proud to say that I have mostly succeeded in accomplishing the expectations and goals outlined in my entry plan. Some of the key actions that I have taken toward those goals have been:

  • Conducting small group meetings with staff vía appreciation lunches
  • Reviewing the current strategic plan and general overview of its implementation
  • Conducting 1:1s with identified key stakeholders and organizations
  • Analyzing 2021-22 academic achievement and growth data
  • Visiting every school in each community multiple times
  • Hosting community forums for parents and community members through coffee chats
  • Learning and evaluating how our current organizational structure supports the vision of our district
  • Starting instructional rounds with instructional team and campus leaders

Based on these actions and from listening to, and learning from, our community, I am recommending the following next steps for our district to our Board of Education:

  • Launch strategic planning process this spring by co-constructing a district-wide Portrait of a Graduate & District Core Values, then engaging in a more extensive strategic planning process this fall;
  • Continue our focus on policy updates, such as our graduation requirements, because as superintendent, one of my key responsibilities is to carry out policy through the development and implementation of regulations;
  • Adopt our recommended Learning Acceleration Plan that will strategically support teachers and school leaders in narrowing the difference in achievement between students and elevating the achievement of all;
  • Prioritize housing solutions for current and future staff so that we can attract and retain our talented educators
  • Identify our instructional priorities for 2023-24 to help guide our Unified Improvement Plan process for 2023-24, including informing our strategic priorities and initiatives.

Each of these recommendations come from carefully listening and learning to our community — from our community’s many anecdotes that support these recommendations for next steps.

I will present these recommendations to our Board of Education at our next Wednesday board meeting. Additionally, our Chief Academic Officer will be presenting our Learning Acceleration Plan, which the Board will take action on, at an upcoming board meeting.

Even though the days of my entry plan as superintendent have come to an end, I remain committed to listening and learning to our community and I look forward to implementing these recommended next steps with you in order to fulfill our mission that we will ensure every student develops the enduring knowledge, skills, and character to thrive in a changing world.

Dr. Jesús Rodríguez is Superintendent of the Roaring Fork District schools in Glenwood Springs, Carbondale and Basalt.

On the Fly: We can find our humanity in our fishing journeys

I have always seen my life in terms of landscape and journey. My earliest memories are of water, sky, mountains and streams. I have been inspired by the natural world in ways that, even in my later stage in life, are both fulfilling and mystifying.

For one who was trained as a scientist, I see things in very mystical and weird ways. I look for the meaning when it is elusive. I look for metaphor when my rational brain tells me that a rock is just a rock and a storm is just a storm. I search for and see trout in my sleep. I believe that time spent in nature exploring the wonders of fish and their habitat teaches us more about ourselves and our lives than we would ever learn otherwise. We find our humanity and wrestle with its dark side: fear, desire, failure, and weakness.

Like most of us, I am enchanted with the notion of journey. I have done my share of wonderful road trips — I love to explore wander, dream, and engage creation on its own terms. The human spirit is always best expressed in terms of journey. In my life in medicine, I meet people in all stages of journeying. They are the walking, the broken, the wounded and the glorious.

Fishing captures and symbolizes the completeness of the human spirit and journey. I see each journey to the river as a tiny recapitulation of my own humanity and the things I share in common with my fellow travelers.

Early in my fly fishing career I remember telling a friend that there is so much to learn! Some 40 years later, that is still true. Every trip I learn something new about rivers, fish and the natural world. Most importantly, I learn something new about myself. Every encounter with the waters of our planet draws me deeper into who I am and who I want to become.

(Excerpts, originally published in “Fly Fishing — the Sacred Art,” by Rabbi Eric Eisenkramer and Rev. Michael Attas, MD, Skylight Paths Publishing)

This report is provided every week by Taylor Creek Fly Shops in Aspen and Basalt. Taylor Creek can be reached at 970-927-4374 or TaylorCreek.com.