Holy Cholesterol

[on-ramp]

if drug companies invented drugs that cured diseases, they would all go out of business..

their only obligations are to the investors and traders down on Wall St.

Think about that for a moment before you pop your next pill.

[Rick Lee]

Originally posted by on-ramp
if drug companies invented drugs that cured diseases, they would all go out of business..

their only obligations are to the investors and traders down on Wall St.

Think about that for a moment before you pop your next pill.

What a great reason to not take any medicine. God forbid, someone makes a profit for inventing something that helps people stay alive or helps their quality of life.

[artplumber]

(LONG)
OK, time for the (long) reply. So long, I got logged off.

Dennis,
Let’s shave the barber…
1. I don't know what you are referring to when you state a comment I made was personal and not adult. My best guess is "Nobody knows as much as Dennis about anything?" If that's not it then you can ignore the rest of #1.

What was the sequence leading up to that? I suggested that people hire professionals for their expertise in their profession. For instance, they hire electricians to do electrical work in their house. Your response about an electrician you hired was “….I felt very free to update his understanding and work with him to change it, with a much better result.”. This reads containing a fair bit of condescension IMO. The logical progression of which is that the professionals never quite know what they are doing and need to be “updated” by you. Hence my reply, which does contain a certain element of sarcasm.

Is this slippery slope argument and sarcasm absent from your own posts? During your reply to Rick about the statistics of risk and population cholesterol distribution you make the observation “ Yeah Rick, I guess a background in physics leaves me woefully prepared for statistics.” Never mind that you are focusing on a single “tail” in the Bayesian distribution which Rick points out.


2. As to the example you cite, about number of individuals who have different opinions than you on IT issues at your work, it is quite incomparable to the patient/physician interaction. First, you are discussing issues where you have a common ground by both having prior educational and/or work experiences, yours perhaps being deeper than one of these other individuals. In fact, the relationship between patient and physician would be much closer to your IT guys trying to instruct a lawyer in how to try a lawsuit. Yes, it’s polite to listen, but you’d think the atty has a little better inkling of how to reach a successful conclusion.

Furthermore, this is not a brainstorming problem solving kind of issue. No new ground is being covered in these discussions, it’s a rehash of the same issues.

3. Physicians are not gods. No one is suggesting they are. However, they are professionals and the premise that they are incompetent, not up on the current literature, and that by doing a few searches anyone will know as much as or more than them is somewhat demeaning. At least you ended your anecdote with a small note indicating you realize its scientific fallacy. More importantly, the likelihood of negative outcomes is quite elevated when people travel to some special clinic in Mexico or Sweden etc. These people often end up back here in more dire straits than when they left. I could make some dig about the Canadian healthcare and cost containment in the case of your friend, and it might even be true (I’ve seen it in HMO’s south of the border too), but will refrain.

4. From your posts, it is obvious that you, along some others prefer to minimize the potential downside of a high cholesterol. No one has disputed the fact that high cholesterol is but one risk factor for the development of cardiovascular disease. More importantly your (and others) opinion(s) have suggested that it is of negligible benefit to intervene. There has also been a suggestion that high cholesterol is still being debated as a risk. It is true that at one time this was the case. However, there is a huge body of evidence indicating its risk, and more importantly, to date, no floor for the benefit of treatment has been found (ie lower chols = lower risk).

5. As to the state of medicine, it is a science when practiced in the allopathic manner, albeit an evolving one. This is no different than physics and mathematics which also continue to evolve. Leeches still are used successfully in medicine (FWIW). Large advances have been made over the last 50 yrs. Not only is there an extensive understanding of pathophysiology, but the science has actually focused on the success of therapies (whether they make pathophysiologic sense or not). This is the difference between allopathic medicine and so-called alternative medicine which actually hearkens back to the days of witchdoctoring and the tradition of generational (handed down recipes) medicine. Some of those techniques have been found to be of value eg/acupuncture for pain, while others not – reflexology or acupuncture for kidney failure.

And finally, I am not offended, merely frustrated. I see this as a forum where folks generally are above average in intelligence with some penchant for logic. To see the same discussions rehashed in the same manner....

Phew

PS Onramp, do you know Schramps entire set of risks or lipid profile?

PPS Thanks Rick. Add 3 years of fellowship, 1 year of subsubspecialty and few years of practice and do this a few hundred times a week. Yah, no idea of what I'm writing about

[Dennis Kalma]

First of all, thanks for taking the time to reply. I appreciate it and you have definitely gone up in my esteem (not that it was low, just I respect the effort). I don't want to hijack this thread, but just a couple of comments.

Second, when it comes to debate, I hate email. We just don't get the context and breadth of discussion that one gets face to face. It leads to misunderstandings, much of which can be found in threads such as this.

"My best guess is "Nobody knows as much as Dennis about anything?"

If that's not it then you can ignore the rest of #1.

We don't know each other, it most definitely is not it.....but no amount of text can prove this. We probably just have to let it lie.

What was the sequence leading up to that? I suggested that people hire professionals for their expertise in their profession. For instance, they hire electricians to do electrical work in their house. Your response about an electrician you hired was “….I felt very free to update his understanding and work with him to change it, with a much better result.”. This reads containing a fair bit of condescension IMO.

Specific case was the electrician was going to wire the garage, which I use as a workshop, with the minimum standard wiring, namely one plug per parking space. The updated understanding was that I told him what I did for a hobby, the tools I needed, we discussed where I would be placing the work bench, welder, air compressor and so forth and also how they were going to be used, so we could figure out how to get minimum breaker tripping without having to run 27 miles of wire and 100 breakers. No condescension....just making sure that we both understood the balance and came to the "right answer".

Is this slippery slope argument and sarcasm absent from your own posts?

Amen, I am a sarcastic SOB. Point taken. Also note that my sense of humour is...shall we say....obscure at times.


2. As to the example you cite, about number of individuals who have different opinions than you on IT issues at your work, it is quite incomparable to the patient/physician interaction.

Too long a reply is needed to properly disagree....a small example....one executive came to me and told me that it took him 30 minutes to install Microsoft office at home, why on earth would it take 6 months and 10 manyears of effort to install it on the 2200 PC's in the continent wide network. Needless to say, he didn't understand how large networks work....I could have blown him off but basically took the time to help him understand the challenges the IT department faced...and worked to understand what was frustrating him about it (business effort, cost etc)

Furthermore, this is not a brainstorming problem solving kind of issue. No new ground is being covered in these discussions, it’s a rehash of the same issues.

Amen

3. Physicians are not gods. No one is suggesting they are. However, they are professionals and the premise that they are incompetent, not up on the current literature, and that by doing a few searches anyone will know as much as or more than them is somewhat demeaning.

Fair, but don't assume it was a casual search. In the case of the woman I described, the treatment she pushed through has now become the preferred practice for those suffering from the same disease....it was several years of effort and study on her part. My reaction was frustration with the seeming inability of the medical profession to at least consider there are alternatives (as it was, from the professional medical doctors in Sweden...not alternative practioners)

I could make some dig about the Canadian healthcare and cost containment in the case of your friend, and it might even be true (I’ve seen it in HMO’s south of the border too), but will refrain.

Please do....it has a lot of problems, but so do most systems. Can I chime in?

4. More importantly your (and others) opinion(s) have suggested that it is of negligible benefit to intervene. There has also been a suggestion that high cholesterol is still being debated as a risk.

If that is the conclusion that you and others have drawn from my posts, then I have failed to be clear. My bad.

My repeated attempts to find a drug that works for me are indication that the problem and risk is worth attempting to deal with, but not at any cost. I struggle with some of the doctors who have told me that for me to even consider not taking Lipitor, regardless of the pain, is essentially committing suicide. Or how about the life insurance underwriters who, once their doctors found I had a high cholesterol level wanted to charge me $17,000 per year to continue my life insurance when I left the company I was working at, when challenged, they came back with "essentially you are committing suicide and we really don't want to insure you, even though you are 40 and in other wise good health"

And finally, I am not offended, merely frustrated. I see this as a forum where folks generally are above average in intelligence with some penchant for logic. To see the same discussions rehashed in the same manner....

I understand...

[snowman]

I am totally surprised that no one has mentioned the following that will reduce your cholesterol by at least 30% or more without any side effects, they are:
1. Flax seed oil, 1000 mg daily
2. Fish oil, 1000 mg daily

Both must be taken to work effectively. NO joint pain.

Also Red Rice yeast may help even more, but look out for same effects as Lipitor.

These reduced my total cholesterol from 230 to 170. Proven by repeated blood tests over 10 year period. I cannot take any statins, period. I just started Red rice yeast and do not know if I can take it long run or if it adds to the result.

This is not a natural foods bs type of thing but a recognized medical fact.

As to LDL there are two types, big fluffy types that are generally harmless and small dense types that can be very harmful. Know which type you have.

[Nathans_Dad]

Fish oil does have some cholesterol lowering effect, but many people cannot stand the belching of...well fishy stuff all day. If you can stomach the pills, by all means take fish oil.

Better yet...eat more fish!

[artplumber]

Dennis
Thanks for the reply. So if I don't know what you took personally I apologize for....

As to the all health systems - no doubt we could have some fun w/all depending on what one believes is the basis for med care.

Snowman,
the debate rages on about all of those (just like vit c, e, garlic) and just what the trials prove. The bulk of the evidence certainly does not suggest 30%.

BTW where do you think they got the first statin (lovastatin) from - you guessed it red rice yeast. Another example of how allopathic medicine looks into folklore, finds and proves the benefit of a therapy, that becomes part of the armamentarium.

PS lovastatin is one of the least potent statins, and has one of the highest rates of muscle inflamation.

[upwardr]

My story goes like this.
Prior to Xmas did the test you do when your 50, blood work, prostate thing, check up. Wait for results, between holidays received note from Doc to make an appointment to speak about results, not urgent.
Okay after holidays I'll make a visit.
Jan 2/07 pain in chest! Hospital right away, heart attack!!!!
1 artery 100% blocked, insert 2 stents and 1 hr later I'm in recovery.
Results of my cholesterol now forwarded by my Doctor, total cholesterol 699!!! TGs 490!! HDL 100!! LDL not done since numbers were so far from normal.

I'm home now feeling better but not encouraged since I am on Lipitor and the future does not appear bright.

I'm 51, my dad was 57 with the first heart attack with a total of 3, my mom was 57 with the first attack also had 3. My granddad was 57 had his first.

Will visit family doctor later this month for a check up.

Thanks all
Larry

[snowman]

Originally posted by Nathans_Dad
Fish oil does have some cholesterol lowering effect, but many people cannot stand the belching of...well fishy stuff all day. If you can stomach the pills, by all means take fish oil.

Better yet...eat more fish!

If you can't take fish oil tabs, you sure the heck will not stomach fish! The combined effects of fish oil and flax seed oil is well nuff established that even my Harvard educated Cardiologist recommends it. And with me it has in fact done more than a 30% reduction. The number I gave is at he lower end of my actual colesterol, it was typically 230 to 280 and now is never above about 170.

[artplumber]

Sno,
You have an MS and something in physics right? You understand a bell curve, right? (We quote mean reductions) You understand the scientific fallacy of anecdotal evidence right?

EDIT: Larry, good luck to you. I'm not sure why the future does not appear bright (because you're on lipitor?). The good news is that we can do lots to reduce you risk of future events. Plus you're lucky that you got to angioplasty immediately, a lot of Canada remains on clot buster drugs first and hope for the best.

[Nathans_Dad]

Actually eating fish tends to give less stomach issues than a fish oil capsule. You get a more potent dose of fish oil in a capsule vs. eating a piece of fish, thus the untoward side effects.

As Art said, I'm glad it worked for you, however making assumptions based on an n of 1 is dangerous.

[snowman]

A great number of people who cannot take statins can take fish oil and flax seed oil. There is a proven benefit, for a broad number of people from this regimen. Just like the drugs, eg Lipitor, not everyone can take them.

In general I do not agree with the health food finatics and their so called "natural" solutions. But this one seems to work for me and a lot of others, for real. A couple of blood tests can prove if it works for you, talk to your physician about it. The only reason I did it was I couldn't take any statins and the doc said try it. I was relunctant, but I tried it because I had no other choice.

[livi]

Wow, many of you guys are much younger than I am and you all seem to be checking your fatty acid and cholesterol profiles. I have never ones had any blood work done. Maybe I live to much in the pediatric world, where those subjects very rarely are any issues.

Perhaps the doc should be more health self-conscious and go check himself..

[Moneyguy1]

livi..

Two of us....ignorant and happy (and not paranoid, I suspect!!!)

[Nathans_Dad]

Livi: I have to get my cholesterol checked yearly because of the US Air Force. They check freaking 18 year old kids every year...ridiculous.

Anyhow, my cholesterol tends to run a touch high, total is usually around 200, LDL of 130 or so, HDL 40. Not terrible, but given my strong family history of CAD I might need to consider a statin in the next 5 years or so.

My first order of business is to get back onto a regular exercise program. Thinking of joining a gym with a pool....I detest running.

[Moneyguy1]

Rick

Less than a year ago my doctor had me undergo an ultrasound(?) for my arteries (whaever it was, I could watch the procedure on a CRT). Both he and the tech were nonplussed to see that I had less than 5% occlusion anywhere. Still don't know what my cholesterol is, but the Doc said there shouldnt' be much to worry about and instructed me to keep doing whatever I was doing.

Anecdotal but I think that not worrying and taking things one day at a time go a long way toward wellness.

[Nathans_Dad]

Yeah, either that or you are just blessed with good genes.

On the other hand, I saw a patient today I had seen a couple weeks ago. He had a wierd coughing spell a few months back and had some strange back pain since then. Long story short, there were enough concerning issues with the pain (despite the fact it wasn't "chest pain) for me to admit him to the hospital. He got cathed the next day and had a 90% LAD occlusion (main artery that feeds the left heart) and was stented.

Presto!! No more back pain.

He's on Lipitor, we increased the dose to drive his LDL below 70.

[artplumber]

Originally posted by Moneyguy1
..

Less than a year ago my doctor had me undergo an ultrasound(?) for my arteries (whaever it was, I could watch the procedure on a CRT). Both he and the tech were nonplussed to see that I had less than 5% occlusion anywhere. ...

If they were really looking at your arteries, then it probably was a CT coronary angio. If not, who knows.

BTW 80% of heart attacks happen in blockages less than 50% of the diameter of the blood vessel.

Rick,
Flax seed and fish oil, Flax seed and fish oil. The drug companies are just fooling you.

[Nathans_Dad]

Moneyguy I'm going to take a stab and say they did an ultrasound of your neck? If that is the case they imaged your carotid arteries and while no plaque in the carotids is certainly a good thing, it does not mean you have no plaque in your coronary arteries.

In fact, autopsy studies on accident victims have shown that Americans have fatty streaks in their coronary arteries in their early 30s...

[snowman]

My LDL is only 109, but the docs are the aggressive treatment types (I like that) and want to see it lower, down to at most 90. My HDL is a very low 25 or so, not good. exercise is no longer an option due to other health problems, but even when I took Judo, for over 35 years, 2 to 3 4 hour sessions of extreme exercise per week, plus 1/2 hour to 45 minutes of warm up and jogging every single day, my stats were exactly the same.

I have read that most fatal heart attacks are caused by occlusions that are relatively small, but unstable. They break free and go somewhere where they do damage, many times fatal.

My LDL is only 109, but the docs are the aggressive treatment types (I like that) and want to see it lower, down to at most 90. My HDL is a very low 25 or so, not good. exercise is no longer an option due to other health problems, but even when I took Judo, for over 35 years, 2 to 3 4 hour sessions of extreme exercise per week, plus 1/2 hour to 45 minutes of warm up and jogging every single day, my stats were exactly the same.

I suspect that genes have more to do with it than anything I can control. The male side of my family has lived to over 90 for the last 600 plus years, except, my grandfather and father. Marriage to a family that had problems clearly caused this problem as my gg grandfather had 2 sons, the other sons family has continued to live into the late 90's in good health, but with t he worlds worst eating habits. All the members related to my ggrandmother had the same problems going back many generations, and several of them are Harvard educated MDs. They knew what to do , but it didn't matter, mother nature won. Dead by mid 50's._