[quote]gojira wrote:
Typical medical community bullshit. Fix it with drugs. They are sooooo owned by the pharmaceutical companies.
I have very little faith in doctors. Remember, they are trying to sell you their product.
Oh, and by the way all my tests were fine. I could rant on as there is much more to say but, I’m gonna go eat some eggs now.
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Good to hear all your tests are normal.
But my question was rethorical, just to make people understand that they have no idea if they belong to a really prone group or not. My cholesterol is pretty low and my HDL is pretty high, but I could be atherosclerosing pretty intensly.
Just like a dead guy I saw recently on the autopsy table, lean as hell, muscular, chronic jogger, 45 years old, said to be in tip top shape. The doc showed me some of his major arteries, look at that, couldn’t even get a fish wire in there. His thoracic and abdominal aorta was so calcified I could of used it as a replacement barbell.
If we had a better test of endothelial dysfonction, it would be nice, but we only have indirect methods. Maybe one day, we’ll be able to tell Mr. X that he has basically no chances of developping atherosclerosis or that another guy should be really careful but we are not there yet.
But to the fact that medical doctors are sooo owned by pharmaceutical companies, I’ll have to disagree somewhat.
I don’t know about the US, but North of the border, basically no doctor is getting enough gifts to warrant any undeserved change in prescribing habits. What influences docs towards statins for example is seeing journal article after journal article showing new evidence of statin efficacy. As well as the guidelines that come out.
So if a doc thinks you should lower your cholesterol levels he will choose the single most effective method of doing so, which are statins. Whether reducing cholesterol is trully an effective mean to achieve significant CHD mortality/morbidity reduction in all risk brackets is another discussion altogther.
But such discussion does not interest me at the time, since I don’t plan on doing a litterature review on it anytime soon. (Interestingly, I a currently taking a class on the Lipoprotein Metabolism, and I could have gotten to write a paper on Statins, but I drew another topic from the hat. And the bastard who drew it didn’t want to switch, my topic sucks ass. You guys (an me of course) could have benefited.
Now, if you do not want to take statins solely because they are from pharmaceutical companies, why don’t you use alternatives that work through the same pathway. Of course, these alternatives are significantly less effective at reducing cholesterol but at least it will be a start. And they have other benefits.
Eat Red Yeast Rice. A cardiologist at a conference at the Montreal Heart Institute was arguing that it might nutritional advice from which people at large might benefit since it contains the equivalent from low doses of Zocor (since it is Zocor in it). (
To me thats akin to liking a Penecillium fungus when you could take the pill, but that way everybody can have some of the benefits)
Drink grean tea, it as some cholesterol blocking properties, a bit like the new Ezitimbide.
Cinammon research is hinting that there is some HMG-CoA Reductase Inhibition after consumming it in the gram range 1-6. And helps control glucose levels through insulin receptor phosphorylation.
As for the whole fix it with drugs bullshit…well, I agree with you, thats what they do. But I agree with them, that is largely the only way.
Not the only way that works in studies, but the only way that works in life.
If people ate well and exercice, we probably would not need Type 2 diabetes medication or anti-obesity meds or surgery (that seems to be gaining momentum).
An to be honest with you, there used to be recommendations to use dietary change and exercice for 6 months before trying drugs to see if the problems would be reduced but newer guidelines indicate that you should start medication right away.
You could argue that this is due the pharma companies putting pressure, but I find that kinda tough to justify for changing the guidelines. However, we know that people are lazy, weak and not ready to change.
Doctors soon realize that basically nobody does what they are supposed to do. (Then again basically everybody has been so brainwashed by the notion of balaced diet that has become synonymous with a little of everything in moderation…well, a little Big Mac here, a little potato chips bag here, a Mars bar at the coffee break,a little slice of cake there, another one can’t hurt right and so on an so forth.)
I speak to people about nutrition and pretty much everyone is convinced they eat correctly…
Even if they don’t eat healthy, they don’t want to change. A pretty recent marketing study showed that people are going back to taste over health, in the well if you are going to eat ice cream, better eat the real thing mentality…true, if you have a BMI of 22, when its 32, you might consider choosing the healthier approach calorie-wise.
A while back I was taking a patient history for an exam on a CVT surgery floor. She had been there almost a week and her wound would not heal. The patient is a 220 lb women with severe diabetes and advance CHD (she had just gotten out of CVT surgery for 3 bypass). She reports eating healthy, non-fat mayo, low-carb X and other calorie reduced things. How about sweets? I ask. Well, once in a while, you know for celebrations.
When I got out, the treating surgeon that was evaluating me asked me what I thought. The first thing that came to mind was that you don’t get to be 220 lbs at 5’3 by eating celery stalks and lettuce.
Another guy, around 300lbs, 6’3, with significant abdominal adiposity, 50 some odd years, impotent for 4 years because of diabetes related neuropathy, hospitalized for cellulitis from infected diabetic foot ulcer. So you check your blood glucose regularly or not? Nah, not really.
How often did you get foot ulcers like this? Hum, this is the third time, but last time I wasn’t hospitalized. How about food, do you follow a diet or go with what you want? Well, I know I should eat less and better but I’m not doing too well on that.
I don’t know about you guys, but if I was loosing my dick to diabetes/CHD, I would be doing something about it.
A toe I can understand…up to the point where it necroses and amputates or infects.
To me these kind of situations were eye openers. Here I was, fresh out of patient contact and professionalism courses, beleiving to some extent that the patient is and wants to be a major decision maker in his healthcare process. What a bunch of utopian bullshit.
For every one person that we find like that here on T-Nation, self-determining, health oriented and driven, you find thousands of apathetics, lazy and aimless people that don’t even care that we are going to amputate their necrosing and gangrenous leg at the knee and that they could have prevented it with a good diet, regular exercice and compliant medication taking.
So you may think that doctors are pushing for medication. I think its people pulling for it.
I mean, I don’t believe you guys are so shelterd from the world not to see this. People in general are not like you. They don’t watch what they eat, they don’t train with weights, they don’t do any cardio and they couldn’t stand changing their behavior for the life of them.
I am not necessarily pro drugs but I understand that people in general would rather lose their toes to diabetes than to change their lifestyle and diet. People want easy, simple and quick solutions to hard, complex and chronic problems.
Most of the times, doctors can do no better than to delay the inevitable, not because pills don’t work but if you are diabetic on medication and you keep eating strawberry shortcake every day, D’UH, no wonder the diabetes/obesity/CHD is still progressing.
A doctor I know has taken a habit of asking a question like this: Ok, your lab results and physical exam place you here in the risk brackets for CHD. We can do 2 things, either you stop smoking, start getting some regular exercice, eat less and greener, lose weight and then go from there or I can pump you of all these medications (listing statins, fibrates, ezitimbide, methformin, sulfonylureas, ASA, diuretic, ACE inhibitors and so on). When I asked him what most patients choose, he asked another question:
-‘‘Ever seen a fat guy jog?’’,
-‘‘No’’,
-‘‘Well there you go.’’
You guys can think doctors are morons and such and such, but I would look elsewhere.
AlexH
Take care.