Saturday, December 01, 2012

Statins Begone! Cholesterol Fall! Can I Lower My Cholesterol On My Own?

A little bottle of statin tablets arrived in my mailbox early this past June. It had been ordered by my new VA primary care doctor. I was annoyed.

Don't get me wrong. The doctor is good, very good, and I'm glad to have her. But I thought my taking a statin for my moderately high cholesterol was just under discussion.

I don't like the idea of taking a statin. I have a problem with taking any drug unless it is absolutely necessary -- to save my life, for example.

I'm a young man -- only 74. Cholesterol aside, I'm in robust good health. Doesn't my going-strong body have disease-fighting resources better than any statin?

But at the urging of my doctors, I have been taking a statin, simvastatin, off and on for a few years. I take the tablets and my total cholesterol plummets. I go off them and my cholesterol elevates.

In other words, when it comes to taking my statins, it's been good boy-bad boy. When I get scared, I do what the doctors say and take my medicine. When I haven't had a blood test in a while -- and no cholesterol report to scare me -- I just enjoy life and forget about cholesterol and daily statin tablets.

And now when this new bottle arrives, my first impulse is to be a good boy. Oh well, I thought, doctor's orders. Here I go again, swallowing pills against all my own natural instincts because the doctor says so. I took the bottle out of its little box and put it on the kitchen counter. I would start the pills in the morning.

The next morning, I reached for the bottle, took out the prescribed two tablets, and filled a glass with water. But I couldn't swallow the tablets. That's when the annoyance set in. The inside of  a bad boy's head snapped and crackled with rebellious sparks:

I did not agree to this. This was just under discussion. The doctor can't decide something as important as this on her own. That's for ME to decide.

I decided then and there to reduce my cholesterol on my own. This was something I had never attempted to do. The thought had never even entered my mind.

My next appointment with my doctor was five months away, on November 8. I made up my mind to show up with a big surprise: lower cholesterol, reduced on my own -- and maybe deliver a little lesson from patient to doctor.

Or was I delusional, way too into myself?

But my research into statins gave me encouragement, especially the findings of John A. McDougall, M.D. He is a physician and nutrition expert who has practiced medicine for 40 years. He says that
there is no more conventional wisdom than the fact that high cholesterol is best treated with statins. He says that so many physicians believe this that "we may as well put statins in the water."

He says that the typical well-treated patient in our "advanced society" is "fat, sick, and overmedicated." He contends that cholesterol-lowering drugs are over-promoted and that medical and pharmaceutical businesses "brag all the way to the bank about improvements of their customers' risk factors (incidental numbers forced to lower values by drugs)."

Dr. McDougall is not against statins across the board. He prescribes statins for very high-risk patients, such as those with a history of heart disease or stroke. His problem is that today's drug approach to disease is to treat the signs of disease, or risk factors, instead of the underlying cause. He says that high cholesterol is a risk factor, not a disease, and it is caused primarily by the high-fat Western diet.

Dr. McDougall says that the cholesterol molecules in the bloodstream are in themselves relatively non-toxic. He says that he has never seen anyone die of high cholesterol and suggests that neither has any other doctor.

According to Dr. McDougall:

"If cholesterol, itself, were the problem, then their predictive value for heart attacks and strokes would be close to 100% -- high cholesterol would always mean sick arteries. However, I know many people with cholesterol levels over 300 mg/dl, with perfectly clean arteries --and just the opposite, people with levels below 170 mg/dl who have suffered a major heart attack. Furthermore, when the arteries of patients taking statins are studied over time, regression of the underlying disease, atherosclerosis, occurs in only a minority of patients, even if cholesterol drops profoundly under the influence of powerful medications.

"The underlying truth is: there is a strong correlation between the richness of a person's diet (reflected by cholesterol and saturated fat content of the food choices) and the level of cholesterol found in that person's blood. The richer the diet, the higher the blood cholesterol. The association continues: the higher the cholesterol in the blood, the more likely the disease will happen -- such as heart attacks, strokes, and a variety of cancers. The real culprit is the rich diet -- the elevated cholesterol is, more or less, a secondary finding."

Dr. David G. Williams, a specialist in natural healing, declares flatly that lowering your cholesterol will not help you avoid heart disease. Instead of trying to lower cholesterol, he uses and builds upon the body's innate healing capabilities.

Dr. Williams supports this approach by citing three statistical facts: 1) More than 60% of all heart attacks occur in people with normal cholesterol levels; 2) The majority of people with high cholesterol never suffer heart attacks; 3) Half of all heart attack victims have none of the standard risk factors (ie. smoking, obesity, genetics, high cholesterol.

I don't smoke and I never have. I'm not obese. Since I have made it to 74 and am the oldest of five siblings (all of whom will be in their 70's in 18 months), I must have pretty good genes. From my research, it seems to me that even if I don't lower my cholesterol, it's not going to kill me. 

So why take a statin? 

But if I could lower my cholesterol by changing my diet, why not?  I would be covering all bases and could be on my way to making it to age 120. (Wouldn't it be funny if I really did?)

Every morning for the next five months, I looked at the unopened bottle of simvastatin and went on with my own self-prescribed regimen for reducing my overall cholesterol from the 239 it was on May 25. The acceptable range is 0 to 199.

I dramatically altered my diet. I have a sweet tooth.  I love ice cream, sherbet, chocolate, cakes, apple pie, muffins. I no longer ate them. With my wife Barbara's agreement -- she too was working to lower her cholesterol by changing her diet -- they were banned from the house. Also banned were cheese and red meat.

When I want to relax, I like nothing better than going to Dunkin Donuts and reading The New York Times or The New Yorker while sipping coffee and enjoying a big, delicious blueberry muffin. I stopped that, cold turkey, though I still dropped by Dunkin for a black coffee (no sugar) and a read.

Because I am physically active -- playing tennis three or four times a week, walking briskly up and down our steep hill, and lugging heavy fieldstone rocks to build stone walls -- I had assumed I could eat to my heart's content. Now I cut my portions, often in half. I ate one piece of raisin toast instead of two (no butter), half an orange, and carefully removed all skin from chicken.

At first, I was nonstop hungry and miserable. I don't know how many times I thought of going to Dunkin's for a plump, warmed-up, heavenly sweet blueberry muffin. But I didn't go, not once.  Whenever I got the urge, which was regularly, I called upon my one best weapon against giving in: impulse control.

When Dunkin called, I pressed the impulse control button and got this stern message:

No! If you go there, if you eat the muffin, it will be gone in no time and you will feel awful. But if you resist, the urge will pass and you'll feel great. Awful or great, which do you want in the next hour?

The first few weeks were the hardest. Soon, the more I resisted the impulse to eat those blueberry muffins, the easier it became. I must emphasize easier, not easy. But my new, careful way of eating gradually became a way of life.

Weeks passed, then months. On November 8, I went for my appointment at the VA with my primary care doctor. An assistant giving me the standard weigh-in, was surprised. "Wow," she said. "Is this right? In May you were 188. Now you are 170. You lost 18 pounds!"

The new skinny me is at right.

"It's right," I said. "I changed my diet to lower my cholesterol. I'm going to surprise the doctor."

"She will be," the assistant said, "she will be. Congratulations."

"How are you doing?" the doctor asked when I entered her office.

"Well, I've been a good boy and a bad boy."

"How is that?"

"First the good. I've changed my diet to try to lower my cholesterol. Since my last visit, I've lost 18
pounds." I pulled up my sweater. "See, no more belly."

"Very good." She pulled me up on her computer. "Yes, I see that, from 188 to 170. Well done."

"Now the bad. I haven't been taking the statins that you sent me. We didn't really discuss it and I wanted to see what I could do on my own.  I'd like to take another blood test to see if my cholesterol is down.  If it is, then maybe I don't have to take a statin."

"I'll order it right away. When can you come in?" No talk-down lecture. No hurt feelings. No questions. Actually, she was almost an eager accomplice to a patient's taking charge of his own health care.

"Tomorrow morning," I said.

She tapped on the computer. "Tomorrow morning, November 9, it is," she said.

"Great. Thank you, doctor. What if I succeed in lowering my cholesterol and don't have to take the statin?"

"Well, maybe you could help me. I have high cholesterol."


"Yes, really."

"Well, maybe next time, we'll change places. You sit here and I'll sit there with your white coat and stethoscope and tell you how to lower your cholesterol. Deal?"

She smiled. "Deal."

My total cholesterol dropped from 239 to 199, no longer marked with the big H for high. The LDL (lousy stuff) fell from 180 to 146, though still above the reference range of 120.

I'm going to try to lower that LDL even further, on my own, without a statin. I'm looking into adding  omega 3 supplements to my diet, for example. In taking charge of managing my cholesterol levels, I'm just getting started.

I can't wait for my next appointment. I used to dream about being a doctor -- and here I am with my first patient. I just know I'm going to help my doctor lower her cholesterol.

So long and keep moving.

NOTE: George Pollock's novel, State Kid: Hero of Literacy is now available as an E-book on Amazon (Kindle) and Barnes & Noble ( Nook). Billy Stone was a foster child. He ran away from abuse.  He went to juvenile prison. He went up from there.  And he did it his way. Through the power of the written word.

Amazon E-Books by George Pollock

"State Kid: Hero of Literacy" is fiction based on his real-life experiences growing up in foster homes; "Last Laughs," is the true story of how five foster kids (he and four younger siblings) found their way in life and each other. "Killers: Surprises in a Maximum Security Prison," is the story of his being locked up for 23 hours with killers in a maximum security prison; "I, Cadaver" is about his postmortem adventures and mischief in the anatomy lab at UMass Medical School. “A Beautiful Story” demonstrates the art and process of creative writing as a 16-year-old boy goes all out to write a story that literally saves his life; "A Long, Happy, Healthy Life," is about how to live the title every day; and "Unlove Story," Writing anonymously as "Elvis," a husband, dumped after 38 years of marriage, lets it all out on love, marriage, life, everything. A guy doing this? It's unheard of.
For the Nook:

A Beautiful Story
A Long, Happy, Healthy Life
I, Cadaver
State Kid
Unlove Story

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