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Five years ago, between heart attacks #1 and #2, I was plagued by mouth sores. A series of incidents, each worse than the other or, worse still, at the same time. I wasn’t sure if it was just bit lip, bit tongue, or bit cheeks. It was more than those: cankers, periodontitis, and lichen planus. The last, pure misery: I felt like someone had taken a soldering iron to one side of my tongue. I chewed my food on the opposite side, wincing. People who watched me eat thought I was ingesting poison.
Applesauce, topical ointments, mouthwash: nothing helped. Then, coincidentally, I had my wisdom teeth (they were disappearing under the gums) pulled out. Crowded teeth caused gum infections. On the mend, I read the dentist’s brochure about gums and heart disease. If your mouth is infected, it’s likely your coronaries are inflamed, too. More to worry about, what with my freshly diagnosed heart disease.
Inflammation. What is that? We know it as the body’s natural response to ward off a foreign invader or an injury. The redness and swelling accompanying a cut, for example, is the white blood cells fighting off the bacterial or viral infection, or a toxin, whether it’s circulating within the body or is hit from outside. That’s the acute kind, from whose self-healing the body benefits.
The chronic kind is different—and is not good. It occurs when the body over-treats a long-term injury with its own resources. The inflammatory response sets in: the white-blood-cell-rush to repair the hurt produces telltale redness and heat and, as long as the injury continues, pushes more of these resources to the site.
In my case, my gum infections and impacted teeth collected and circulated bacteria to organs already (internally) inflamed from lousy food and cholesterol buildup. I started realizing there was a lifetime of such inflammation, accumulating in the cells of my coronary arteries.
How? Pull back a moment. It’s not just bacteria that infects the cell walls; it’s also sugar from processed foods. Insulin, as we know, pushes sugar into our cells for energy-storage. But when the sugar molecules are too many, they mass together and pass through the larger blood vessels, like a car fender against a guardrail, they scrape the cell lining.
This, along with excess fat in overloaded fat cells, also bombards the arterial walls. More injury. Then, LDL cholesterol enters. These molecules accompany the white blood cells when they come to the aid of their party. The sticky LDL infuses itself into the cell (for repair!) and, at the same time, collects as plaque. As one doctor put it, the body then perceives there’s something wrong with the artery—there’s too much cholesterol, too much sugar, too much fat (sounds like dinner at McDonalds). So the inflammatory response sends more white blood cells and more LDL, slowly building a calcium-domed barrier or covering to isolate/protect the injury. A little Ebola-like tent.
But if nothing changes in the diet or in the body’s stress levels, the plaque site can be constantly inflamed. The site accumulates more lesions and oxidizes. Eventually, the plaque may break and block the artery. Mine did—in the end, a total of three times.
HDL cholesterol is supposed to take LDL away, after it has arrived at the injury and before it enters into too many cell walls. But LDL overpowers HDL if the inflamed spot does not heal. The body, trying to fix the problem, can’t quit trying. The body wears itself out trying to heal itself.
The mystery is, some cardiologists believe that inflammation attracts an overabundance of LDL to the coronary arteries where the cells are occupied by the invader who, in turn, overtakes them. It’s called the inflammation hypothesis. Other docs believe the lipid hypothesis, where too much cholesterol circulating helter-skelter in the body, whether produced naturally or via food, is the culprit. For heart patients, the answer in both cases is lowering one’s LDL number, eating less fat and less sugar, ridding the diet of processed foods, and de-stressing. This is why statin drugs may be the cardiac sufferer’s wonder drug: they reduce the total amount of cholesterol and they may reduce arterial inflammation.
I wonder whether my gum infections and beleaguered coronary arteries weren’t co-productive, like Vladimir and Estragon in Waiting for Godot, a pair of tragic comedians who keep infecting each other. And they don’t just do it for a two-hour play: it was constant over my lifetime while I, heedlessly, consumed all the wrong foods (not to mention my family’s predisposition for heart ailment)—all that crap, the pizza, the ice cream, the hot dogs, the donuts. Please note the linking verb in the preceding sentence, I’m happy to say, is was.
