Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I am sorry for the many issues that you are facing.

If you would upload your tests I would gladly look at them as well. Also apart from weight it would be useful to know your height as well in order to judge the degree of overweight if any (normal weight varies with height). If you have had any imaging evaluation of those carotid plaques it would be useful to have as well to judge how much they narrow the artery.

Regarding some of the sensations you describe like carotid plaques tickling or brain moving are misperceptions. Carotid plaques do not have such manifestations, they do not tickle or cause pain, they are not felt at all, when they cause symptoms it is when they involve the brain vessels by releasing blood clots and blocking them, or when they narrow the vessel so much the brain does not receive enough blood. Otherwise you do not feel plaques. The brain does not move either.

That LDL-P value you mention is high, but other chlolesterol particles types must be considered as well, and treatment with a statin be initiated, you do not mention to have received treatment for that. Also a blood thinner like aspirin is necessary as well.

In my opinion the main culprit for your symptoms, your seemingly slowed cognitive functions affecting your everyday abilities, is to be seen in sleep apnea. Sleep apnea manifestations correspond to your description, the apnea episodes with lower oxygenation, frequent sleep disruptions do affect daily functioning causing fatigue, sleepiness, slowed thinking etc. So management should be concentrated on that. Weight loss is the most important measures. After that apart from cpap machines it should be looked for airway issues favoring sleep apnea, abnormalities in your airways leading to narrowed airways. In that case surgery may be considered as well.

I remain at your disposal for further questions.

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Brief Answer:
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Detailed Answer:
Thank you for the feedback. Sorry for misunderstanding you about the "brain moving", I took you too literally I guess.

Regarding uploading pictures, my site interface as a doctor is different from yours as a patient, but I believe there should be an option somewhere which says Upload reports/files or something similar. There you can upload reports, click and select the file which can be a .jpg one, meaning a photo of the report taken say with your smartphone for example. Can also be a pdf file as well, whatever fits you best.

What I was asking specifically (but any test you want me to see is fine) was the lipid profile which typically includes Total cholesterol, LDL-C cholesterol, HDL-C cholesterol and triglycerides. LDL-P is not always measured, it is thought to be linked to vascular disease, but needs further studies.

Judging from those values you have inserted (you write LDL-P: 140, could that be LDL-C perhaps?) your total and LDL cholesterol are raised. That increases the risk for vascular disease, meaning development of atherosclerotic plaques. The HDL rise is not a bad thing, HDL is called the good cholesterol, higher values mean less risk.
Apart from dietary measures statins are the main drugs used to lower cholesterol, that is why I suggested them. Apart from that effect they have a beneficial effect on stability of atherosclerotic plaques and vessel wall, so their benefit goes beyond simply the cholesterol reduction. Whether that would influence cognition, no that is not the aim, but if you have important plaques of the carotids it is a risk factor for stroke, so you have to think about prevention. That applies to aspirin as well. That is why I mentioned uploading carotid imaging report as well (I imagine you have had an ultrasound or neck CT/MRI since you were told about plaques), in order to judge the severity of these plaques and how necessary preventive treatment with statins is needed.

For the cognition, slowed processing, my opinion remains the same, sleep apnea is the most important contributor. For your height and weight, your body mas index is 32.9, which means you are obese and that is a very important contributor to sleep apnea, so weight loss is vital. It is good that you are being checked by a pulmonologist as pulmonary problems may add to sleep apnea. Furthermore obesity and sleep apnea are risk factors for stroke as well so it is one more reason to address them to prevent stroke, apart from the symptoms you already have.

I hope to have been of help.

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Brief Answer:
You're welcome.

Detailed Answer:
Thank you for the kind words, I hope you to be healthy as well.

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