Hi, when are the live skool get togethers? I listened to last weeks but don't see how to actually join. I am a member. The live instagram isn't that great because it only lets me type so much so it's a very disjointed way to communicate my questions. Thank you, Loraine

Ask Me Anything - November 2, 2026 - 5pm CST If you are not able to attend LIVE and want to ask a question then please leave it in the comments below and will be discussed during the event

If you are not able to attend LIVE and want to ask a question then please leave it in the comments below and will be discussed during the event

> Date Time: 2026-10-05 17:03:11 Dr Twyman clarifies differences between carotid imaging modalities, strategies to monitor aortic stenosis risk, individualized considerations for blood donation, cost/access realities for lipid-lowering therapies, reliability of wearable HRV tracking, safe heart-rate training zones, and practical grounding guidance. Audience members Scott, Terry (Speaker 1), and another participant (Speaker 4) ask questions spanning medical monitoring to lifestyle practices. ## Introduction 1. Dr Twyman: Cardiologist guiding patients through vascular imaging interpretation (carotid duplex vs CIMT), lipid and inflammation biomarkers (apoB, Lp-PLA2, oxidized phospholipids), monitoring for aortic stenosis, therapy access (PCSK9 inhibitors), exercise prescription using HRV and heart-rate zones, and evidence-informed advice on grounding and sauna use. 2. Speaker 1 (Terry): Participant asking about carotid tests, leather-soled grounding footwear, and distinguishing exercise intolerance from deconditioning; shares personal grounding and hiking experiences. 3. Speaker 3 (Scott): Participant asking about blood donation post-op, PCSK9 inhibitor timelines/costs, and practical year-round grounding strategies and measurement. 4. Speaker 4 (Unknown Speaker): Participant with brief interjections and a question about exercise intolerance. ## Key Points 1. Carotid duplex measures blood-flow velocity and grades stenosis; CIMT visually estimates plaque burden and intima thickness, indicating ongoing vascular injury. 2. CIMT plaque detection often uses a threshold >1.0 mm; lower cutpoints can identify earlier disease but may reflect inflammation rather than mature plaque. 3. For Lp(a)-associated aortic stenosis risk, echocardiograms about every three years are reasonable; lab markers (oxidized phospholipids, IL-6, Lp-PLA2 activity) help gauge inflammatory progression. 4. Blood donation should be individualized; ensure adequate hemoglobin and iron stores to avoid fatigue and reduced exercise tolerance, particularly post-surgery or with testosterone-induced erythrocytosis.

Let me know in the comments any feedback Thank you