Re: NYT article on diabetes T2

Jackie Patti <jpatti@xxxxxxxx> wrote:
Chris Malcolm wrote:

Not to me! If someone wants to persuade me to take a drug for the rest
of my life they have to come up with a much bigger risk reduction than
13% in five years! That kind of risk reduction might persuade me to
cross the shady side of the road to reduce skin cancer risk by 13% in
five years, or change my brand of butter, but to take a new drug for
the rest of my life?

I'd want at least 30% before I'd start considering doing that!

13% in five years is roughly the amount of uncertainty about as yet
unknown injurious side effects :-)

Well, I'm presumably in a different place than you. I'm an actual heart
patient already, having had a heart attack a while back which was
treated via angioplasty, a week of IV heparin, then a CABG.

Horrid! Yours sounds a lot more serious than mine. I was told that I
was lucky to have started out with a pretty good heart, so that the
heart capability I lost as a result of the attack reduced it to the
capability of the average heart of a person of my age. Plus I have to
avoid anything resembling a competitive athletic activity, or I risk
getting carried away in more than one sense :-)

At this juncture, I'm expected to be on a beta-blocker, ACE-inhibitor,
statin and aspirin daily for life.

Me too. But something about my other health conditions contr-indicated
the beta-blocker, and when I was walking away from the doc's surgery
he came running out and snatched away the ACE-inhib prescription
because he'd just remembered my asthma, and I later discovered the
statin was causing mild confusion and forgetfulness, so I stopped
it. However, I still sometimes take the aspirin when I remember :-)

The reason I'm not too worried about my heart is that at the time of
the attacks, and for a few years after, I was also prone to angina and
long mildly uncomfortable episodes of skipped beats (actually small
premature beats). My heart also quite often simply felt a bit
distressed, and seemed to be asking me to stop and take a rest. But
when I discovered I was diabetic and started bringing my BGs down all
these symptomatic indications of a unhealthy heart started to decline
slowly but surely, and over several months pretty much disappeared
completely.

Now, years later, I still have a fairly low ceiling of maximum
cardiovascular effort, but I can now walk or cycle at a pottering pace
for most of day, when 45 minutes used to be my limit, and the next day
I had to rest. My heart *feels* a lot better, and I've got quite a lot
more strength and endurance, and for me that carries more weight than
hypothetical statistical risks.

I'd prefer not to be on any of them,
and find it very disconcerting that I am on all these meds, plus a
basal/bolus insulin routine, when a few months back I was on nada. My
cardiac surgeon thinks I am not on very many meds, but most of her
patients are 40 eyars older than I am.

My cardiologist and doc are a little distressed that I'm not at
least taking a statin, but on the other hand despite being older I'm
sure I could easily leave both of them behind in a walk up a steep
hill :-)

But, I think the decreased risk of death on a statin is much more
important than the side effects I've heard complained about. Even if
the odds are equivalent, death is simply something I prefer avoiding
much more strongly than most side effects.

About the only side effect I'd prefer avoiding nearly as much as death
would be having another damned heart attack - those suckers hurt way the
hell more than I can express in a Usenet post.

You're lucky! The time I tried to hang my weight on a broken arm was
so painful it was hard not to vomit and faint with the pain. Fainting
would have been a really bad idea because I was on a cliff face at the
time. I had a few similarly painful injuries before the lesson that
I wasn't actually immortal and indestructible got properly hammered
home :-)

--
Chris Malcolm cam@xxxxxxxxxxxxxxxxxxxx DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

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