A 20 year old patient comes in to the ER complaining that he was playing soccer, and the ball hit him in his chest. He feels like "I got the wind knocked out of me" and is doing well otherwise. He has no medical history, vitals are stable. One of the brightest ER interns decides to get an EKG, and you see the following:

What is this?

I just turned 34 this year and thought I needed to establish care with a physician. Plus I really wanted to know my numbers. Everyone should know their credit score, their lipid panel, their fasting glucose, their blood pressure, their TSH, and their Vitamin D level. These figures will tell you all you need about your health and what you need to do.

I recommend to all my 30-something friends, go see your doctors and get your numbers! Don't wait for one of these silent killers to strike!

I just got my results back and here they are: (in parenthesis are the goals or normal values)

Total Cholesterol: 184 (<200)
HDL: 44 (males >40, females>50)
LDL: 129 (<160, optional <130)
Triglycerides: 51 (<150)
Chol/HDL Ratio: 4.2 (<5)

BP: 130/70 (<120/80)

BMI: 26.3 (18.5-24.9)

Fasting Glucose: 80 (60-99)

Vitamin D level: 23 (>30)

TSH: 1.74 (1-5)

My impression and plan:

Lipids:

As far as my lipid panel goes. I don't like it. Yes, it falls within guidelines and looks pretty decent. But I like to be more aggressive about cholesterol control. 

If a patient walked in with this lipid panel I would be all over them about lifestyle modification, diet modification, exercise, and I'd give them 3 months to try and make some improvement. If they can't they'd be on a statin. 

In my case, I don't have much wiggle room in terms of lifestyle modification. I weigh at or very close to my ideal body weight, I eat very healthy, I don't eat saturated fat, I exercise like a mad man at least 2-3 times per week, sometimes way more, and I don't smoke or drink. Hence, this is my lipid panel. This is my genetics. In my case, I will probably start a low dose statin and see what happens. Probably a Crestor 5 or a Lipitor 10.

My total cholesterol is 184. I don't like this number. If I were a patient of mine, I would double whatever statin dose I was on, or start one. The guidelines state that a total cholesterol under 200 is ok.... but do you really want to be the guy with the 196? No. Guidelines are good basic information, but we need to strive for better. The guidelines from the NCEP ATP III are slightly outdated and need to be updated anyways. I am not going to be the guy with the cholesterol of 180 and settle for "mediocre".

My HDL (Healthy Cholesterol)  is 44. Sure it's over 40. But,  we like it to be over 45. Crestor and Lipitor can raise your good cholesterol. There are only a few things that raise HDL; exercise, Niacin, and a few statins (Crestor and Lipitor). Otherwise, you're stuck. Since I already exercise, this is another reason to start a statin.

My (Lethal Cholesterol) LDL is 129. The guidelines technically say under 160 if you have minimal risk factors, and under 130 if you have a few risk factors. I don't have any risk factors (obesity, hypertension, smoking, diabetes, family history, age, male sex, etc). If anything, I am a male.... so that is a risk factor. LDL is the primary target of therapy. When treating patients, I like to see it under 100 or under 70 in very high risk patients (diabetics, or already have CAD). So, statins are great at lowering LDL. That's their job.

My Triglycerides were only 51. This is a number I am especially proud of. I have never seen TGs this low before. This usually represents excess sugar that you have floating around in your blood stream. Triglycerides are chains of 3 sugars bound together. People who eat excess carbohydrates will have high TGs. Since, I don't eat carbs (unless they come from fruits and vegetables), this number is very low. Normally, we tell people with high TGs to start taking fish oil or flaxseed oil (Omega 3s) to help bring this down. I have some flaxseed oil pills at home and pop some every once in a while, but not consistently. So maybe that helped a little. Salmon and tuna have the most omega 3 of most fish we can eat.

My Cholesterol to HDL ratio is 4.2. Pretty high. We like it to be under 5.... but 4.2 is too close for me. I like to see numbers like 2.0 or 2.5. Not 4.2!

Blood Pressure:

Mine was 130/70. Pretty good. I had just walked in and barely had a chance to sit down when she took it. I am sure it'd be lower if she waited a few minutes. Not worried about that number. The lower your blood pressure, the longer you live, regardless of anything else. And for every 20/10 that your blood pressure is above 115/75, your chance of having a stroke doubles.

Body Mass Index:

This tells us how much you should weigh in relationship to your height. I'm five foot eight inches and weigh 173 pounds. It is used for males and females. Normal is between 18-24.9. Women should be to the lower end of the scale around 19-22 while men can be a little higher around 23-24. Yes, according to my BMI, I am overweight. Overweight is 25-29.9. Over 30 is obese. And over 40 is extremely obese.

While my BMI is in the "overweight" category, I don't mind. BMI doesn't work for that well for more muscular individuals. If you played high school sports, or carry around a lot of muscle mass, you will be at the higher end of normal. I've been involved in sports and weight lifting my entire life, and I know I carry around a lot more muscle than the average joe. In order for me to get under 25, I would have to lose about 10 pounds and get to a weight of 163. That's not impossible. And I could probably do it. I will work on this and see what happens. But I don't have much wiggle room here. Losing a few pounds isn't going to change my lipid panel either. 

Glucose:

My fasting glucose is way under 100. I'm very happy. No one's fasting glucose should even be close to 100. If your fasting glucose is creeping up and getting into the 90s, you and your doctor need to have a talk about insulin resistance (type 2 diabetes). I hate when physicians ignore fasting glucose numbers that are "high normal" and aren't aggressive about this issue. If this was you, would you want to wait until you are a full fledged diabetic and can't see, can't feel, and are peeing out protein? Get aggressive about this! Especially, if type 2 diabetes runs in their family! The only way you can get type 2 diabetes is if you inherit it! Please start taking Metformin right away!

Vitamin D:

Vitamin D plays a crucial role in nearly every metabolic reaction in our body. It's actually a hormone, not a vitamin. We are finding out more an more about Vitamin D every day. If you want your number, ask your doctor for a 25OH Vitamin D (25 Hydroxy Vitamin D). Not the other two. None of the others matter or are even useful. Vitamin D is important for our bone health, cardiovascular health, helps suppress inflammation, prevents myalgias, joint pain, stiffness, and nearly everything else.

My number was 23. This is low. Normal is considered 30 and up. But you start seeing problems in humans with vitamin D levels less than 40. So we ideally aim for a level of 50-70. So mine is pretty low. Under 10 is considered Vitamin D deficiency, and 10-30 is considered insufficiency. 

If you live north of Atlanta, cover all your skin with clothes (most Muslim women), wear sunblock or have darker skin.... you are deficient. Get it checked and get treated. Our body uses sunlight to convert Vitamin D to it's active form. So yes, I started taking Vitamin D supplements.

TSH:

This tells us about your thyroid function. Mine is 1.74. Perfect! When we treat people with thyroid issues, we like to see their TSH be between 1 and 2. So this is perfect!

Any thoughts?

I would like to hear all of your thoughts and analysis. Would you be as aggressive? In a 34 year old, otherwise healthy, compliant male? Would you start a statin?  Try anything else?

No, you do not need to exercise to lose weight. It's true. You can lose almost all the weight you want just by changing your eating habits. The vast majority of people can get to with 10-15% of their desired weight with diet alone.

Too often physicians tell patients, "Diet AND exercise." We hear this all the time. Diet AND exercise. The fact of the matter is, that diet alone is usually enough to achieve very significant weight loss.

Most Americans find excuses to not have time to exercise. Work, kids, time, money, motivation, running late, etc. Exercise is usually our last priority. This is unfortunate, but true.

When doctors tell patients that weight loss requires diet AND exercise. We have already built excuses into the system. They can't find time to exercise, hence, they will not be able to lose weight. We are giving people a reason to not lose weight.

We should rephrase our recommendations. You need to DIET ONLY. Forget exercise! If you have time, please exercise, it's great for your heart. But it is not necessary for weight loss. But weight loss is necessary! Please lose weight.

We have to be clear and truthful. Diet modification is more than enough to cause major weight loss. Let's not tie it to exercise and destin both to noncompliance. They won't do either.

How useful is exercise?

Assuming you weigh 200 pounds, if you walk or jog for 3 miles you will burn about 300 calories. That's not much! That's one plain bagel from Panera. 

Exercise should not be used as a way to burn calories. It should be used to increase your heart rate and improve your cardiovascular health. But's it's not a good way to burn calories.

A 200 pound person doing squats for 2 minutes straight burns 320 calories. That's only 2 minutes of resistance training! Even if you aren't putting up any weight, just your body weight. Two minutes, 320 calories. Better to do two minutes of squats than run for 3 miles if you just want to burn calories.

Back to our problem, diet does not have to be tied to exercise. You can get to within 10-15% of your target weight with diet alone. If your ideal body weight is supposed to be 150 pounds, you can easily get to 165 with just diet. If you want to weigh 170, you can easily get to 187 with JUST DIET!

Start dieting and lose weight! NO EXCUSES! I don't want to hear about not being able to get to the gym, no time to run, had to pick up the kids, can't afford a gym membership.... etc, etc.

Dieting is free! (and may cost you less than what you are paying now) You will be paying a lot less for food, since you will be eating a lot less food. You don't have time to exercise, but you definitely have time to diet. You eat every day, right? Just eat way less. It's not rocket science.

There are all kinds of diets available to use. What it comes down to is picking one and sticking to it. They all work! Just pick a diet and do it.

Diets should not be temporary. You breathe every day for the rest of your life. You should diet every day for the rest of your life! All "diet" means is what we eat and consume. Start eating way less, and way healthier. We all know what that means. It's not complicated. Eat less, eat better. We don't need a PhD to understand that.

Here are some places to start:

http://www.mypyramid.gov

http://www.nutrition.gov

The Health Care Reform bill finally passed congress. It is awaiting a few edits from Senate, and will likely be signed into law.

There is a lot of opposition by "Republicans" or people who claim to be Republican. There is a lot of opposition from physicians who don't understand this bill. Unfortunately, a lot of this is unfounded, based on towing the party line, and misconstrued information.

I am a Republican and I am a physician!

I have voted for every Republican president since I could vote. I worked for every Republican presidential candidate in the last 20 years on various levels. Everything from making phone calls on their behalf, to debating on their behalf, to writing their speeches!

First of all, Republicans are the ones who first wanted health care reform. The current bill that was passed was a Republican idea. Sure, a bipartisan committee eventually finished it. But it's finally done now. Isn't this what we all wanted?

The Republicans and conservative talking heads on TV hating on the bill now are merely trying to rally public support and scare people. Demagoguery is a fun political tool. It's just a political game of oneupmanship. Don't worry about it. Just ignore that. They have to do it and they have to pretend they don't want it. They all wanted it! They are playing the game and positioning for reelection.

This reminds me when for 10 years Republicans were talking about Wellfare reform, then Clinton came and finally passed it in 1996, and suddenly all the Republicans hated it. Then Bush came along and almost reversed it because he wanted the vote of some constituents. Democrats and Clinton were talking about social security reform for many years, but couldn't go near it, due to his impeachment dilemma. Bush came along and got it done.

I have been involved in politics since Reagen got re-elected by a landslide in 1986. I always thought national politics were fascinating. Granted, I couldn't vote, but I was addicted to politics.

This is just another round of political scheming. For the last 20 years Republican and Democratic candidates have been talking about health care reform. It finally got pushed through. Is it perfect? It may not be. We can keep amending it and fixing it as time goes on. Americans are good at tweaking things and making them better.

"There is nothing wrong with America, that what's right with America, can't fix."  

That's my quote from 1999. I modified Bill Clinton's "There is nothing wrong in America that can't be fixed with what is right in America." If I was his speech writer, I would have had him say it the way I wrote it above.

Parts of this will not work, but we can fix it as time goes on. Parts of it will be great.

I think physicians are griping about this bill because they think it hurts their pocketbook and they will somehow make less money. That may not be the case at all. No one knows for sure right now. Also physicians really wanted tort reform. Obama and the lawyer filled congress could not do it. But individual states may due it when they see physicians leaving. It has happened in the past. Indiana, Ohio, Texas, and many states have passed some type of reform. We will see. This part can be fixed.

The Good:

Doctors who have to take ER call at hospitals to stay on staff, will now get paid for nearly every patient. Doctors hated taking ER call, and getting consulted on ER admitted patients, because half the time you would never get paid. But you had to see and treat the patient. About half don't have insurance. Now that almost everyone has some sort of insurance, you will get paid for every patient you see. It may not be the big bucks, but even if you get $20 bucks, that's better than zero. This is a bigger advantage than most people realize. This alone will make a huge difference. Now you get paid for every patient you see! Not just half.

Every American has to carry health insurance. This is huge! If they just passed this one law, we'd be a happier country! Everyone has to have car insurance and home owners insurance, why not make everyone have health insurance.

No matter what condition you have, you will be covered. Although this was part of the HIPPA law that Clinton passed in 1995, it has more teeth now.

The premiums you pay in health care insurance are now tax credits. Tax credits! Not deductions. That's even better. Tax credits are worth more than deductions! Huge! A tax credit lowers your tax bill dollar for dollar. A deduction shaves money off your taxable income, so the value depends on your tax bracket. If you're in the 25% bracket, a $1,000 deduction lowers your tax bill by $250. But a $1,000 credit lowers the bill by the full $1,000, no matter in which bracket you are. Tell me this isn't awesome? I'm sure a Republican wrote this part.

Small businesses get a tax credit for the health care plans they provide. Huge!

No lifetime limits on coverage. You are covered for as long as you live, and as much as it costs. Companies can't cut you off when you've "used up" your coverage!

Pharmaceutical companies and insurance companies have to pay more of the costs. Not bad. We prescribe their drugs, they should chip in.

Kids can stay on family plan till the age of 26. Not bad! So I can still be on my parents plan! Hahahahaa!! 

Less paperwork. Doctors can focus treating people, not charts. Electronic everything! May slow us down initially, but once it gets going, should be more efficient.

With some rationing, maybe someone won't get 300 CT scans every time they walk into an ER. We need some sanity. ER docs shouldn't have to cover their asses every time someone says, "I have chest pain and only dilaudid helps." Just kick them to the curb! 

The Bad:

Government controls more of health care and how it's rationed out.

Government has a lot of control over private insurance plans.

Government can coerce physicians into following "standards of care" and dinging doctors for "poor compliance" almost forcing them to comply or do what the government wants them to do.

A lot of government oversight and control over what physicians can and can't do. A big brother approach. Can be good to reel in some crazy physicians, but this isn't a good idea ultimately.

This may actually cut back on a lot of the unnecessary tests.

I am sure there are more, but this is all I can think of for now.

What I'd like to see added:

Cap all medical malpractice lawsuit payouts at a figure like $100,000 or $200,000.

Cap attorney takes and fees for medical malpractice lawsuits.

Create medical courts to handle med mal lawsuits. The judge and jury should be a panel of physicians.

Medical school cost reform. It should not cost $250,000 to go to medical school. Yes, we all signed up for it, and it will be worth it in the end. But that's why no one wants to go in to primary care. There has to be a limit on how much schools can charge to teach and train doctors. It's kinda crazy. What happened to the $6k per year tuitions?

Medical school loan forgivement. They began talking about this, they need to implement it somehow. I am sure we will have some form of this.

Bring back clinical judgement. Physicians need to be protected from frivolous lawsuits. People die! It's not your doctor's fault. People just die. An ER doctor should be able to use his clinical experience, judgement, evidence, and intelligence to send home the 20 year old patient, who just had a clean cath last month, who has chest pain relieved by only diluadid. Healthcare costs go up because this 20 year old doesn't have insurance, and is getting tons of free tests at the taxpayers expense. A cath, a stress test, and an ER workup every week is not free. It costs money!

A trial attorney that loses a medmal lawsuit should also be suspended and lose his license, or pay a huge fine. Like the torts they keep filing. Disbarred too!

Malpractice insurance reform. Insurance companies should not be allowed to charge physician whatever the hell they want for coverage. Doctors should all just go on strike and stop paying. If the government wants everyone to be insured, then they should take steps toward protecting physicians. West Virgina many years ago put $20 million away to protect all the OB/GYNs because they were all leaving the state. We need a huge amount of malpractice insurance reform. It's not going to be easy, and I can't think of a good fix now, but we need it.

Collaborative electronic medical records. We need a huge, robust, and easy to use system. Local physicians office, and hospitals should be able to tap into this huge database of patient information, records, tests, history. I don't care what the software looks like that presents the information, it just all needs to be deposited into one large database. Huge and expensive.... but necessary. I can't tell you how many physicians order a cholesterol panel, eventhough the patient just had it last week, but we don't have it and can't access it. This will reduce waste and cost.

Rules to prevent insanity. If a patient just had a clean cath two weeks ago, and they come in complaining of dilaudid deficiency angina.... you can send them home and can not be sued if they die and you have two negative troponins (or even NONE!). Although we sorta do this, we need more protection against the waste and fear of being sued.

People who make dumb decisions should be penalized. If you have peripheral artery disease and have 15 stents up and down your legs and you STILL SMOKE..... you should not be covered, or you should have to pay more. Waaaay more! That is a huge burden on society. Why should you keep getting healthcare when you don't care about your health? That is irresponsible.

Final thoughts:

"There is nothing wrong with America, that what's right with America, can't fix." -Mohammed Alo, 1999

I whole heartedly believe this. This is the greatest country mankind has ever seen and humanity has ever imagined. We will all get through this and find a way to make it work. That's how Americans do it! We are starting to chip away at this problem, and we will get it fixed. I know that medical malpractice reform will come sooner or later, it has too. I know that we will fix the costs of going to medical school. I know we will make this right so that every one will be happy. It wouldn't be sustainable otherwise.

As the greatest country on earth, we should be ashamed of ourselves for not providing some basic health care to everyone. Other terrible countries (much suckier than us) have been doing this for years. And yes, some of us that are better off should help our poorer, more destitute countrymen. That's what makes a country and a people great. You are judged by how well you take care of your ill, your weak, and your poor. We needed this for a long time. Yes, Republicans thought of it and first proposed it. It's finally done. It isn't exactly perfect. Nothing is. But it will be. Don't let the political ramblings and political sideshow distract you! Those guys have to do that. It's their job.

As Americans, we are the smartest people on earth. We can easily tweak this thing and get it right! Everyone will be satisfied.

Every once in a while you wonder if people actually understand what they are dealing with and whether or not they really understand what's going on. A recent encounter with another physician perplexed me.

A patient is brought to the ER because he or she is found unconscious by a family member. It turns out the EKG looks "scary" and they call cardiology. What the ER thought they saw on the EKG was an entity called "ST Elevations" which typically means someone is having an acute heart attack and needs to go to the cath lab to get the artery opened up.

We arrive. It turns out the patient is in acute renal failure, with a creatinine of 3.5, the potassium is over 8 (which gives you a similarly bizarre EKG pattern), and has a blood sugar of over 1300, and a bicarbonate of 5. The ER also ordered a troponin which was indeterminant and a BNP which was 1300.

The patient on paper looks like he is in Diabetic Ketoacidosis, dehydrated as hell, and has gone into acute renal failure from the severe dehydration. Yes, the elevated potassium is very high and at such high levels you get EKG changes which look very abnormal. A potassium over 7.5 gives you wide QRS complexes, wide T waves (the QRSs and Ts look similar), lack of P waves (or very blunted), bradycardia. 

We rehydrate the patient, his potassium quickly comes down (as is expected, because they are really potassium deficient), treat his DKA, and over the next few days his kidneys resume normal function.

A few days later one of the physicians from the ER saw me in the hallway and asked me, "Hey, how do you explain the CHF in that guy?"

I asked, "CHF? Why do you think he was congested? You think he is volume overloaded?"

"His BNP was like 1300"

"He was in acute renal failure."

"So, why was he volume overloaded?"

"He wasn't. He was about as dry as they come. You coulda given him 10 Liters and he'd be fine."

"And the BNP?"

"You can't really evaluate a BNP with renal failure. Nor troponin for that matter. Just toss those two out the window."

Sometimes you just think to yourself, "Wow!" Sometimes things that you think are common knowledge may not always be. We can't rely on merely tests and numbers. We can't be robots. We have to understand what happens behind the numbers.

Medicine humbles you every day! There isn't a day that goes by that I don't learn something new.

Eating cholesterol does not raise your cholesterol! People need to stop worrying about eating cholesterol! Eat all the eggs and shrimp you want!

What raises your cholesterol is saturated fats! These are fats that are SOLID at room temperature. Butter, margarine, cheese, fat on steak, bacon, chicken skin, pork, goose fat, cream, ice cream, and the fat in milk (even though it looks like liquid, it's actually solid fat particles floating around in liquid).

Eighty-five to ninety percent of your total cholesterol comes from your liver. Our liver makes over 85% of our cholesterol! Only a small percentage comes from food you eat. If you don't eat cholesterol, your liver makes more to make up for the difference. If you eat cholesterol, your liver will make less. So it doesn't matter how much you eat!

What tells your liver to make cholesterol?

SATURATED FAT!

Fats that are solid at room temperature. Avoid those and you will be ok! If you remember that, you will be fine.

We always tell our patients to first try diet and exercise to help improve their cholesterol numbers. So they go around and stop buying foods that say "cholesterol" on the label, or buy "cholesterol free" foods. Bad idea! You liver will just make up the difference.

What we should tell them to do is to avoid foods that have saturated fat in them. Solid at room temperature! Remember that!

Saturated fats are found in high amounts in:

Butter, Coconut, all those butter substitutes, Cheese, Pork, Beef, Chicken skin, Goose fat, veal, sausage, hot dogs, bacon, processed meats, cream, milk and other dairy products, ice cream, etc. You get the picture. SOLID FATS! When you look at that steak and see the marbelling and fat in between the muscle fibers, or the fat on ribs and lamb chops....  IT's SOLID FAT!!!!!

Avoid Solid Fat!

But, there are two liquid fats that contain a lot of saturated fat; coconut oil and palm oil. But my guess is no one really eats those. Especially, not here in the United States. Butter, cheese, cream, bacon, pork, and beef are our main problem.

What about trans fats?

These are liquid fats (like vegetable oil) that are heated in the presence of hydrogen to make them semi-solid. Like all those butter substitutes. These are awful!

Trans fats are even worse for cholesterol levels than saturated fat and cholesterol itself because they raise LDL ("bad") cholesterol AND lower HDL ("good") cholesterol.

February is Women's Heart Disease Awareness Month! In honor of women's heart health, I will dedicate a majority of my posts in February to Women's Cardiovascular Health Issues.

I plan on covering several topics: (possibly more)

1. General Cardiovascular Health
2. Tobacco Cessation
3. Why it's harder for women to lose weight, and how to break through
4. What really raises your cholesterol? (it's not the cholesterol you eat)
5. The Alo Diet (hey, if Atkins can have one, so can I)
6. How to look young for a long time

For starters, did you know:

Cardiovascular disease kills approximately 450,000 women each year, about one every minute.

While 1 in 40 American women die of breast cancer, about 1 in 3 die from cardiovascular disease.

More women die of cardiovascular disease than the next five causes of death combined, including all forms of cancer.

Ninety percent of women have one or more risk factors for developing heart disease.

Only 1 in 5 women believe that heart disease is her greatest health threat.

Heart disease is largely preventable.

In fact, 80 percent of cardiac events in women may be prevented if women make the right choices for their hearts, involving diet, exercise and abstinence from smoking.

Cigarette smoking contributes adversely to the top 5 killers of women.

Lear more at http://www.goredforwomen.org/

Try to wear something BRIGHT RED throughout February to raise awareness of the number one killer of women!

If the ladies can do it....

Then men can too....

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A while back we were discharging a patient from the hospital and gave her prescriptions for all of her medications. One of her prescriptions was for Crestor (the most powerful cholesterol lowering medication). The nurse calls me and says that the patient would like to ask me a few questions before she leaves.

"Doctor, I'm allergic to Crestor. Can I take something else."

"Maam, how do you know you are allergic?"

"I break out in hives and get itchy when I take it."

"Well, you've been on Crestor for the past two weeks while here in the hospital."

"Oh really?"

"Yes."

"Well, maybe that's why I haven't been able to sleep. Can I have a different medication?"

"Like what?"

"Vicodin?"

I look at her puzzled and ask, "How will that fix your cholesterol?"

"I don't know. Isn't that for cholesterol?"

"No, it's a pain reliever."

"Well, if I'm not in pain, won't my cholesterol get better?"

"No, maam. I'll give you a prescription for something else."

Any other funny patient stories, post them below!

I don't know that we've ever had a championship weekend where there have been as many amazing story lines as we have this year. No matter who wins these games, the story lines will only grow and increase in legend as we approach the super bowl. Probably the best post season in a long time!

The NFL is all about stories. This is what makes football the greatest sport ever. Football is about scheming, planning, practicing, strategy, gaining ground, losing ground, gaining yards, wearing out the defense, everyone working together to make each play work, coaches, coordinators, and the players executing. It's the greatest sport the world has ever seen. It's not like soccer where you have absolutely nothing going on for 90 minutes (other than utter chaos), then finally someone wins on a penalty kick with 1 minute to go, because a referee didn't like a certain team. Football is the King of Sports!

Stories grow into legends as the years go by. Stories are a crucial and huge part of the football experience.

Older fans never forget the third super bowl when the underdog Jets upset the Colts. It was the first AFL-NFL championship game to be called "Super Bowl". Newer fans will never forget the 2007 championship year, when the Giants came out of their mid-season slump to win three road playoff games, and upset the undefeated Patriots in the Super Bowl with one of the most amazing plays and catches of super bowl history.

Football is about stories. Here are this year's amazing stories:

You have the 40 year old quarterback trying to get to the super bowl. Elway was 39.

You have Manning, who may end up being the best QB ever, playing against a rookie.

You have three future hall of fame quarterbacks playing all at once, and a rookie whose story will unfold over time.

You have the Colts, who let the Jets into the playoffs, now having to play them again. Mistake? Or good planning?

You have Favre, who has thrown away more playoff games than any other QB, trying to redeem himself.

You have Manning who has only played in one super bowl trying to add to his super bowl deficient legacy.

You have Sanchez trying to be the first rookie quarterback ever to take his team to the super bowl.

You have Darrell Revis, the best DB in the NFL, going up against Reggie Wayne, one of the best WRs in the NFL.

You have the Colts amazing offense, going up against the NFL's No 1 defense.

You have Brees and the Katrina ravished New Orleans crowd playing for a chance to go to their first super bowl ever.

You have Jared Allen, Kevin and Pat Williams, and Ray Edwards trying to face Brees and the NFL's no 1 offense. Can they rattle him?

You have Reggie Bush, who finally started emerging, trying to justify his draft status and salary.

You have Percy Harvin, rookie of the year, trying to overcome migraines and play both RB and WR for the Vikes.

You have Percy Harvin, overcoming marijuana issues. (maybe it alleviated his migraines, someone get him a better doctor)

You have Adrian Peterson not running for over 100 yards in the last 8 games trying to redeem himself.

You have the Jets No 1 rush attack going against the speedy (but poor in run defense) Colts defense.

You have rookie Shonn Greene taking over the running duties in the playoffs for Jones.

You have the revitalized, improved Greg Williams led Saints defense trying to show that they can play well.

You have Favre who is 4-0 lifetime against Greg Williams led defenses, playing against a Greg Williams led defense.

You have Favre going back to play in his home state, but the fans aren't cheering for him.

So what will happen? Should be an amazing weekend! Will be awesome to watch all these games and see who will make it! The Colts Jets game is first! Enjoy this awesome weekend!