Is this doctor playing with a full deck? - High Cholesterol Message Board

ARIZONA73 · 01-05-2005, 06:40 PM

My father is 76 years old. He has been a type 2 diabetic for close to 40 years. He had also been a smoker for over 40 years before finally quitting 13 years ago. He has been able to control his blood sugar quite well throughout the years. He has never had a heart attack, or experienced any chest pains. Nevertheless, he did undergo triple bypass surgery 10 years ago after a routine stress test showed blockages. He had been taking 40mg Zocor for a number of years, but quit taking it about three years ago because of side-effects, which included neuropathy. Of course, his cardiologist never felt that Zocor was the cause of all the pain and discomfort, but he accepted his decision to discontinue the drug. Of course his cholesterol went up after that, but I hardly think his numbers are terrible.

In the meantime, my father has been seeing another doctor for chelation therapy treatments. He visited this doctor today, and brought along with him the results of his recent blood test. His total cholesterol was 233, with an HDL of 75, LDL of 146, and the triglycerides were 62. I think that overall these numbers are pretty good. He is not taking any cholesterol medication. He does take Glipizide for blood sugar, Enalapril for blood pressure, and also something called Coreg and Sular. He also takes quite a few supplements, such as vitamin E, vitamin C, coenzyme Q10, fish oil, selenium, inositol hexanicotinate (flush-free niacin), magnesium, lysine, marine beta-carotene, B-complex, etc.

Anyway, after seeing my father's recent blood test results, he suggested that he start taking statins again! I couldn't believe it when my father told me that. Not only that, but he wants him to take 80mg Lipitor! I think this doctor is caught up in this latest LDL craze, since he said his LDL should be under 70! I just don't buy this nonsense, especially when you're dealing with a 76 year old person who already had problems with 40mg Zocor. Of course, I doubt that my father would even consider doing this. But the mere suggestion of something so absurd is enough to make be question the judgement of many doctors. So what's going on here? Am I nuts, or are some of these doctors literally going out of their minds?

Lenin · 01-06-2005, 08:28 AM

My goodness, a TRIPLE BYPASS without having had any chest pain...gee, that seems like massive overkill! Wasn't he a good candidate for angioplasty?

How is he leaning vis-a-vie the statin dosing?

Has he had an angiogram in the last 5 years? I'm always fond of diagnosing BEFORE treatment...I know this strains medical brains and actually takes some effort.
I'd base my estimate of his need for statins on whether or not the condition of his arteries has deteriorated much in the last 10 years. If so, I'd say go agressive with statins; if not, NOT!

In the same vein, shouldn't some sort of the same check be done before and after chelation be done to assess whether anyone but the doctor gets any benefit. (What is the going rate for intravenous chelation these days?)

Good Luck the old guy!

ARIZONA73 · 01-06-2005, 06:47 PM

Well, at the time he had the bypass surgery he was told that he was not a candidate for angioplasty. As far as I know, the only angiogram he had was prior to the surgery. He did have surgery on his right carotid artery a year after the bypass. He does see his regular cardiologist every three months. He also gets EKGs and echocardiograms done every year. He also visits a vascular surgeon who checks his carotid arteries every year or so.

As for chelation, he is currently on a maintenance program and receives one treatment per month. I believe it costs $100 per treatment, but he must pay the full cost. Unfortunately Medicare won't cover that. The doctor who administers the treatments said that although chelation may not always remove plaque, it does tend to stabilize it. That's what they think, anyway. Is it doing him any good? I really can't say. I have no way of knowing.

As far as statins are concerned, I don't think he has any intention of taking them again after what he went through on Zocor. And I tend to agree, especially for a person his age. He already has his share of aches and pains without statins. But what really floored me was when that doctor recommended an 80mg dose of Lipitor! Eighty milligrams for a 76 year old man? That's insane. That wouldn't help him. If anything, it would probably kill him. I think it's best that he just sticks with the supplements he is currently taking.

cheer up · 01-06-2005, 07:07 PM

Arizona, your dad's current numbers sound fine! In fact, his numbers aren't that much different than mine, though I'm a 55 year old female.

In another thread I discussed statin (Lipitor) usage and mentioned the eventual outcome of my dilemma, since my cardiologist was at odds with my internist. Internist said "take Lipitor now!" and cardiologist said "your ratios are fine -- but if you REALLY want to know if there's any build-up -- go get the heart scan to look for calcium in heart arteries."

So... I went to Cedars-Sinai's state of the art facility in L.A., took the 10 minute, non-invasive test, paid my $400 (yes, it's expensive and not covered by insurance), and found out I have ZERO calcium in those arteries despite elevated LDL and total cholesterol levels. My recent numbers were something like: 240 total, 153 LDL, 65 Trigs, and 93 HDL. The trigs and HDL were clearly excellent and the total and LDL not so good.

If your dad really doesn't want to take a statin, and can afford this scan, I'd say he should do THAT and save himself the aggravation of the pills unless it's found to be absolutely necessary to take them.

At Cedars they had me fill out a questionnaire, then they drew blood (I had fasted overnight per their request), then I had the scan, and then their "Director, Nuclear Cardiology/Cardiac Imaging, Professor of Medicine, UCLA" looked over the results and went over the "score" with me. Within an hour I knew everything I needed to know and was happy as a clam after being told by the doctor, who was LAUGHING, "No, you DON'T need to take Lipitor!"

Even I HAD had calcium build-up, I would've been satisifed with the test and would probably be on Lipitor now, but taking it just because a couple of chol. numbers aren't perfect without knowing the whole situation seems like overkill to me.

Good luck to your dad!!!!!

ARIZONA73 · 01-06-2005, 08:58 PM

Thank you for the reply, cheer up! I really appreciate it. You know, all things considered, I think my father has done pretty well over the years, considering the fact that he had smoked for over 40 years, and has been diabetic since 1965. I also agree that his numbers are pretty good, and that many people half his age would be happy to have numbers like that. That's why I could not understand why that doctor would recommend that a person his age should start taking 80mg Lipitor! It just doesn't make any sense. There are so many other people with much worse lipid profiles who are only taking a fraction of that amount. I just want my father to enjoy his remaining years without enduring more problems than he already has. And I don't want any doctor overdosing him with dangerous drugs. At his age, something like that may put him in a wheelchair, or worse, and I certainly don't want that to happen. I know what the potential dangers of these drugs are, especially among older people, and I certainly would not want to subject my father to such a risk.