Re: statins after by-pass

Jackie Patti <jpatti@xxxxxxxx> wrote:
nadyad via MedKB.com wrote:
My chol. was 5.8 (down from 6.2) when I was diagnosed with diab. Fasting BG
was 6.5 and was prescribed Metmorfin (500g x 3 a day). Doctor said I did not
need statins yet.
However my husband whose chol. was 5.4 and A1b was 5.8 WAS prescribed
statins as he had had a by-pass 2 years ago. The current trend apparently is
that after a by-pass cholesterol needs to be as low as possible.

I can't find any of my lipid tests that were done in the hospital;
neither my internist nor my cardiologist has them. Last week, I ordered
my entire medical record from the hospital so I'll know something shortly.

I very much like my cardiologist but the one thing he said that I didn't
like was that it didn't matter what my lipid panel was, they'd have put
me on a statin anyway after the bypass. I found that a bit
disconcerting as I'd kind of like to know I have a problem before being
drugged for it.

Meanwhile, I'm on Zetia instead cause I decided not to continue with a
statin. The internist scheduled me for a lipid panel in Nov as he said
I needed to be on the Zetia for ten weeks for them to tell how well it's
working. Given that no one seems to have my pre-drug results, I don't
see how they'll be able to tell if Zetia is working or not! Hopefully,
the hospital will come through with some numbers.

The cardiologist did give me some specific goals: bp needs to be
consistently under 110/70 - so I know when the beta-blocker should start
being reduced. I'm not sure about the ACE inhibitor though; have to do
more reading to tell.

At this point, I kinda suspect it was just standard procedure to put me
on the statin, beta-blocker, ACE inhibitor and aspirin - that this is
what is automatically prescribed for everyone who has a heart attack.

That's what they wanted to prescribe for me. An asthmatic history
scored the ACE-inhib off the list, something else scored the
beta-blocker off, and progressive cognitive problems caused me to dump
the statin, twice. Twice, because after the first time my worried doc
coaxed me into taking it again because of the amazing cardiac problem
risk reduction it offered, and the unlikelihood of the cognitive
problems being due to the statin ("you're getting old" :-). When the
same cognitive problems which had slowly receded after I stopped it
came back after I started it again, and receded again after I stopped
it, I decided that was likely enough for me, especially since what I
experienced was not only a known possible statin side effect, but one
which was known to be only partially reversible if you stopped the
statin.

I also became a little annoyed with my doc when I asked him if I could
achieve the same levels of cardiac event risk reduction by diet and
exercise as by taking the statin he was still trying to talk me into
taking.

"Yes,", he said, "That's true."

"Then why have you spent ages trying to talk me into taking this
statin again, and you haven't spent even a few seconds advising me to
change my diet and exercise habits?"

"Because research shows quite clearly that very few people are able to
keep up the necessary diet and lifestyle changes, whereas most people
find taking a pill no problem. So spending time advising people to do
something they're very unlikely to be able to do is not a good use of
a doctor's time."

"But you know, and if you've forgotten you can find it in my medical
records, that I *am* the sort of person who *can* make long term
adjustments to diet and exercise, because I've successfully done it
before!"

He had the grace to look embarrassed :-)

Figuring out what I really need is a whole other thing.

What you really need are some indicators that you personally can use
to measure which way your general heart health is probably going. You
can measure your own heart's resting pulse rate, rate after a measured
amount of exertion, resting and exerted BP, and BP recovery rate after
exertion. You can also keep a log of how your heart feels. I for
example am prone to episodes of skipped heart beats which make me feel
tired and uncomfortable, so I keep a log in order to see whether
they're getting better or worse.

I'm encouraged that despite my dangerously statinless state :-), I'm
nevertheless slowly improving on most of those measures, and the ones
which aren't improving aren't getting worse.

One thing that does surprise me given the reading I've done since I've
been home is why they don't automatically prescribe fish oil. It seems
a no-brainer and completly noncontroversial to put everyone on several
grams a day. The cardiologist agreed and actually suggested I should be
taking more than I am, he said to up it to 6 grams instead of 4.

Mine too. It interests that there's this category of treatments which
they won't advise, but if you tell them you're doing it, they enourage
you. I suspect it's because they fall into the category of things they
personally believe, but they know other doctors don't.

When I run low on fish oil, I'm going to replace it with cod liver oil.
That way, I can cut out the D supplement and save myself a pill.

Be cautious about the possibility of overdosing on vit D if using cod
liver oil. In the UK some cod liver oil suppliers make it easier to
get enough of the omega oils without too much vit D by producing an
omega-enriched version.

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

.

Relevant Pages

  • Re: statins after by-pass
    ... I very much like my cardiologist but the one thing he said that I didn't like was that it didn't matter what my lipid panel was, they'd have put me on a statin anyway after the bypass. ... The internist scheduled me for a lipid panel in Nov as he said I needed to be on the Zetia for ten weeks for them to tell how well it's working. ... One thing that does surprise me given the reading I've done since I've been home is why they don't automatically prescribe fish oil. ...
    (alt.support.diabetes)
  • Re: statins after by-pass
    ... me on a statin anyway after the bypass. ... That's what they wanted to prescribe for me. ... change my diet and exercise habits?" ... In the UK some cod liver oil suppliers make it easier to ...
    (alt.support.diabetes)
  • Re: For Some, Diabetes Care Worse Than Illness Itself
    ... my LDL &Trigs are too high but not insanely over the top. ... Some doctors prescribe statins to nearly all diabetics, so that you were prescribed them doesn't mean you're doing badly. ... You might consider asking for Zetia or Werchol instead if being on a statin freaks you out. ... very cheap fish oil softgels. ...
    (alt.support.diabetes)
  • Re: "Statin safe in kids with high cholesterol"
    ... >>Jim Chinnis wrote: ... >>effects of the Portfolio diet as the diet has been developed only ... >>cholesterol by statins than by a healthy diet. ... > for statin groups. ...
    (sci.med.cardiology)
  • Re: "Statin safe in kids with high cholesterol"
    ... >effects of the Portfolio diet as the diet has been developed only few years ... A "healthy" diet is, by definition healthy and would improve ... for statin groups. ... Jim Chinnis Warrenton, Virginia, USA ...
    (sci.med.cardiology)
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