A small but growing number of doctors are using the science of sound to take a peek inside a patient’s arteries so they’ll know whether they’re at risk of a heart attack or stroke.
High-frequency sound waves produced by handheld ultrasound devices allow doctors to see inside the carotid arteries that are responsible for delivering blood to the brain. The technology offers a painless real-time view of blood flow and plaque build-up, giving a rapid assessment of disease risk.
Backs uses gaming analogies in his practice, describing himself as a coach who offers motivation, measurement, teaching, and feedback to help his patients—the players—gain healthier arteries. He established a proprietary program with interactive software called CureCoach, offering collaborative care to give patients the ability to see and improve their unique root causes.
The BaleDoneen Method
The BaleDoneen Method is holistic and root-cause driven. It leans on a thorough individual assessment of lifestyle and genetic root cause factors and offers non-invasive, inexpensive atherosclerosis screenings currently available by less than 10 percent of doctors.Ideally, a relationship is established between physicians, dentists, and other providers with regular assessments. Another component is that patients aim to maintain wellness while continuously striving for improvements notwithstanding age.
While atherosclerosis is often associated with the heart, it can occur in arteries anywhere in the body. It can cause or worsen a plethora of diseases such as dementia, Type 2 diabetes, kidney disease, and erectile dysfunction.
“Your average doc in the box or even your average cardiologist is probably not very interested in prevention,” said Dr. Ellie Campbell, an integrative primary care specialist who screens her patients for signs of atherosclerosis. “There’s so much disease that needs treating, they don’t have time for prevention.”
It’s been a decade since Backs first learned about BaleDoneen, named for the two doctors who developed it and personally guarantee their cash membership model with full refunds for anyone who has a heart attack or stroke while in their program.
“That convinced me it was for real. I set about learning how to do this for myself and my patients,” said Backs, who has a family history of arterial disease and Type 2 diabetes, and set the example by losing weight and changing many habits.
In his office, patients who have signs of atherosclerosis get further testing. They’re assigned an “arterial age” to gauge the risk of stroke, heart attack, and dementia. This also helps them monitor progress as they adopt changes in what Backs calls their “CurePlan.”
This customized strategy is based on a number of factors such as diet, movement, emotional health, dental care, sleep, and evidence-based supplements and medication. Arterial age and inflammation are monitored by ultrasound at regular intervals. Unlike some doctors who follow the BaleDoneen plan, Backs accepts insurance and Medicare.
While showing ordinary patients the inside of their arteries is an unorthodox technique, observing the level of plaque decrease based on lifestyle changes can be a strong motivator for behavior change—at least for those willing to get that first sonogram.
“People talk about prevention, but they only act when they feel a problem,” Backs said. “A lot of it comes down to the addiction model of hitting rock bottom. People can become motivated to change. The real question is, is the person coachable?”
Reversing Arterial Age
Keith Buescher, Ph.D., already thought he was doing all he could for prevention’s sake but decided to do screenings at the Cure Center after casually chatting with Backs about his risks. He had slightly elevated blood pressure, and a bothersome family history with his mom having a carotid endarterectomy, removal of the inner lining of the artery, in her 40s. His dad had a quintuple bypass at 75.Still, Buescher is a self-described health fanatic who was “dialed in”—eating clean with a healthy weight and a low resting heart rate, plus exercising 15 hours a week. He was a bit shocked to find out his arterial age was 85 two years ago at age 60.
“I wasn’t happy, but at the same time it was validating my concerns,” he said.
With most patients, Backs starts by asking patients to avoid the four S’s: sweets, starches, snacking, and sitting. Beyond that, they might work on stress, sleep, salt consumption, and smoking.
Since behavioral factors were ruled out for Buescher, Backs went to work on medication and supplements with a graduated, conservative approach. Buescher treasures the sonogram images he gets at each visit showing reduced levels of plaque.
“It’s a good psychological boost to see that visual,” he said. “You can actually see something and not just get numbers.”
Buescher is taking vitamin D and anti-inflammatory supplements, as well as cholesterol-lowering and antihypertensive medications. His arterial age is now 63, a number he’d like to lower while avoiding surgery—realistic goals considering his parents are still living independently at 93 and 96.
“I want to be like them so that’s another reason I’m glad I saw Dr. Backs,” Buescher said. “I’m hoping to be as healthy as possible as long as possible, and this is one tool that helps me think about the future. Arterial disease can be reversed. It was a novel thought to me at the time. But I think it’s happening.”
The Role of Oxidative Stress
Of all the root causes of cardiovascular disease, oxidative stress is the underlying common denominator. Understanding how choices increase oxidative stress and raise the risk of atherosclerosis can help lower the chances of health complications that extend beyond the heart.Oxidative stress is a disturbance in the body, a type of physiological stress, caused by reactive oxygen species (ROS) in the cells that accumulate when the body is unable to neutralize them fast enough, due to a heavy toxic burden. Plaque formation is a result of inflammation in the lining of arteries that generates ROS.
“You want a doctor who is well versed in prevention of the No. 1 killer of our country, and that means seeking someone out who has skills and training to screen for oxidative stress and markers of inflammation, atherosclerosis in early stages,” Campbell said.
“People ask me what kind of exercise, and I say ’more',” Backs said. “There’s a lot of evidence that building up muscle mass through strength training is just as important as cardio, maybe more.”
Other factors that contribute to oxidative stress are air pollution, chronic kidney disease, autoimmune disorders, HIV, chronic infections, vitamin D deficiency, obstructive sleep apnea, depression, and anxiety.
Dentists for Heart Disease Prevention
Because of the relationship between periodontal disease and atherosclerosis, a natural collaboration could lead to more screenings and streamlined care. This is the aim of the American Academy for Oral Systemic Health (AAOSH), a non-profit organization of health professionals expanding awareness of the relationship between oral health and whole-body health.“Those same mouth bacteria make plaque. They make plaque on your teeth and they make plaque in your arteries,” said Campbell, who is an AAOSH board member. “If our dentists and hygienists aren’t aware of the role of the mouth in heart attack prevention, they’re missing the boat.”
Her at-risk patients get a saliva test at annual exams that detect periodontal pathogens. If positive, they get referred to a dental specialist in her network.
“As these consumers understand the importance of these connections, they’ll drive these practitioners to become more educated,” she said. “No cardiovascular prevention program is complete without a dentist and hygienist.”
Backs has several dentists on his software platform, which is designed for doctors, life coaches, dentists, and hygienists to communicate with patients. His bigger vision is to get carotid ultrasounds in the hands of dentists and hygienists who can rapidly screen at-risk patients for evidence of atherosclerosis.
There’s No Such Thing as Arteriology–Yet
Despite the volume of knowledge pertaining to arterial disease, care has not exactly evolved rapidly; meanwhile, a life is lost to heart disease every 34 seconds in the United States. Preventative care doesn’t come easily or thoroughly from a majority of doctors, even specialists.The only comparison in allopathic care tends to involve cardiology where a specialist usually intervenes at a problematic stage—possibly when irreversible damage has been done. The field relies heavily on testing for cholesterol, blood pressure, and blood sugar—contributing factors for diseases that don’t reveal what’s actually happening in the arteries.
“There’s no financial motivation to get rid of disease. Prevention is not emphasized in mainstream and modern medicine,” Backs said. “Your arteries can get younger and healthier. This has become my passion. To me, there’s a moral way to take care of people, to improve their results and health.”
There are 30,000 miles of arteries in the body, and while the BaleDoneen Method calls it the specialty of arteriology, there’s no official subspecialty in medicine. Without one, some doctors say patient care is incomplete.
However, the article puts more emphasis on the number of tests, equipment, surgeries, and prescriptions that would need to be managed in this subspeciality, leaving the reader to wonder if prevention measures will ever get top billing in the current medical model. Presently, consumers who want help with arterial health will typically find more resources outside the system with functional and integrative physicians.
“In my opinion, heart attacks are optional, strokes are stoppable and dialysis is not your destiny if you have a practitioner who is willing to look for these root causes and correct them,” Campbell said.