Avoid large amounts of tropical oils
Dear Dr. Roach: Please write about the increasing use of “fashionable” coconut oil and coconut milk. I am on a plant-based diet, approaching vegan, and
I see more products with high amounts of saturated fat, which seems to be due to increased use of coconut.
G.W.
Answer: The science isn’t entirely settled. Most authorities have recommended avoiding tropical oils, including palm oil and coconut oil, but feel they are not as unhealthy as meat-based saturated fats. I also recommend against large amounts of coconut and palm oil. In my opinion, vegetable oils, olive and canola oils and nut oils are better choices for health.
Dear Dr. Roach: I would very much like to stop using warfarin. I underwent a successful ablation surgery (maze procedure) to correct my atrial fibrillation, and my valve replacement surgeries also were successful (mitral and aortic). At that time, they also did a closure of the left atrial appendage where the blood pools and possibly clots. It’s been a year on the blood thinner, but I would like to stop. Would that be safe?
G.M.
Answer: You have had a lot done. The combination of atrial fibrillation with both mitral and aortic valve repair makes me concerned that you may have had rheumatic fever as the underlying cause.
The electrical abnormalities of atrial fibrillation can be treated with antiarrhythmic drugs or with surgery. The maze procedure is about 60 percent effective in restoring normal heart rhythm. At the time of the maze procedure, the left atrial appendage (where clots are most likely to form) is normally closed. In people who have been successfully treated and have remained in normal heart rhythm for at least three months, with no recurrence of atrial fibrillation, and who have had the left atrial appendage closed, anticoagulation can be stopped, particularly in people who are not good candidates for long-term oral anticoagulants, such as warfarin, due to bleeding risk or some other reason. So, it’s reasonable to ask your cardiologist about it. Your cardiologist knows you better than I do.