PREACH, PRACTICE, REPEAT
I am trying to practice what I preach…I have always believed that good living will trump most medications. I am not saying you can treat all medical problems with diet and exercise but I am saying that lifestyle is more important than medications.
Look up the treatment recommendations for hypertension, heart disease, diabetes, arthritis, etc and the first line will say either diet and exercise or lifestyle modification which is really the same thing. Your doctor glosses over this because he or she has no control over what you eat or whether you work out…What we in the medical profession can control are the meds and you know we love our pills! We give out pills to help you sleep at night and then another pill to keep you awake during the day. One pill for your blood pressure and another to counteract the side effects..When you add in the supplements and the vitamins and aspirin..many people find they are taking 10 pills a day or more. We can’t control you but we can control the pills we give you.
So, my mantra has been diet and exercise….exercise and diet…I read somewhere that to get the same benefit a person gets from statin drugs (the popular cholesterol lowering drugs like crestor, lipitor, zocor etc ) …the radical alternative that has the same benefit as the statins….eat more veggies ! Now I am talking about primary prevention here….If you have already had a heart attack, blocked arteries, stents, stroke, diabetes etc that’s secondary prevention and the statins are very important for those people.
The debate has raged however as to how important it is for the average Joe to take a statin. Some doctors think they are overprescribed while other doctors think practically everyone should be on a statin. The studies are reviewed all the time with different conclusions depending on who is doing the interpretation. The most recent recommendation regarding statin use involves using a risk calculation like http://cvdrisk.nhlbi.nih.gov/..If your 10 year risk is higher than 7.5% you should consider a statin. This number is calculated by putting in your sex, your age, your cholesterol number, smoking status , and blood pressure information.
So, I try to plug in my numbers and when I punch the calculation button I get an error message. It seems my cholesterol level is so high that the computer assumes that I mistyped the number. My cholesterol is so high that when I tried to get life insurance years ago the agent said…don’t bother to even apply. My response at the time was to show them my recent cardiac cath results which did not show any blockage. So even though my cholesterol was high…it was not sticking to my arteries. They didn’t care that I didn’t have blocked arteries …they only cared about the number on the paper….So I went on meds…got my number to where they wanted it and got my insurance. Of course I stopped the pills afterwards…I am not a pill guy if I can help it.
Fast forward to this month….From time to time I get chest symptoms. Could be anything..probably nothing but that’s not how I treat my patients. If you worry about some symptom and some test can give us information why not get the test? At least twice a year I will push myself past the limits of my endurance physically…usually hiking and skiing with the Clan Haswell. I would rather not keel over in the near future because life is great right now. My wife still seems interested in me and my professional work has never been more satisfying with Signature MD so I would like to stick around long enough to at least see how Iran, Greece and China all play out.
I told you that I took meds to get my cholesterol down…I didn’t stay on the meds…I don’t like meds and what I read says you can accomplish the same thing with the right diet and exercise program so that’s what I concentrate on. But am I being stupid not treating my high cholesterol ? Are my arteries slowly and silently clogging up? In my favor is the fact that I am not a smoker or a diabetic ..that makes whatever cholesterol you have stickier. Also, my family history is good…neither parent having had an mi or stroke. So , do you go with a good family history and lifestyle or go with the population based scientific calculation. Well, you don’t have to be abstract about it…you can just measure the amount of blockage and act accordingly . So, last month, I went to St Joseph’s Hospital and had a heart catheterization. They snake a wire from your wrist or groin to your heart and inject dye to check the arteries. Its an interesting sensation. Not pleasant but tolerable. Dr Simon and his team were very professional …not even giving me grief about my not wanting to take any sedating meds. I don’t like to alarm my wife and I figured if I skipped the sedating meds I could drive myself home. My wife is a working girl after all and no need to keep her from her job. Bottom line is that there were no real blockages . Maybe a little plaque here and there but no blockages that needed stents, balloon angioplasty etc. If that’s all the blockage I have after 57 years of genetically high cholesterol I am doing the right things !! Maybe the tequila has some role in keeping the arteries open but that’s another column altogether. . Until we know for sure I am going to credit the exercise and diet. I feel a little vindicated with my diet and exercise mantra. I also think having a persistently optimistic attitude is also important but that may be more for my head than my heart. There is data to suggest that being happy ..having a positive attitude ..is as important for your heart as it is for your head and I want to believe that as well.
The deal I made with the heart doctor was that if there was any plaque at all …any narrowing…I would go on the statins. I don’t like statins but a deals a deal. If they will only come up with a pill I could take Sundays only…that way I could be possibly compliant with doctors orders.Just because I think I am a good doctor doesn’t make me necessarily a good patient!
So, just like I preach and practice…if you worry about a possible problem and there is a test for it…why not find out for sure. You know I don’t like surprises or guessing. When it comes to your health you shouldn’t either. Never be afraid to be proactive with your health…It’s not wrong to say to your doctor…”This is my symptom…this is what I read about it…this test seems to provide clarity…is there a reason I should not get the test?” Until next month… Get well… Stay well.
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