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Pharmaceutical manufacturers, if they had an opinion, would consider me a bit of a waste of space. Other than the very rare occasions when I pop a few generic paracetamol in the throes of man flu, I’ve had the good fortune of never taking any regular medication. I’m not enhancing the pharma industry’s bottom line in any meaningful way…”must try harder” would be on the report card.
That might be about to change. Recently, when I visited my doctor to whine about my inability to play tennis at a level high enough to compete against players twenty years younger than myself, he suggested it would be a splendid idea if I started taking a daily low-dose statin. This caused me a bit of a pause before I thought to ask, “what’s wrong with me?”
Apparently, the answer is “nothing.” My blood pressure is great, my cholesterol is low, cardio function is impressive, and my BMI is bang on the recommended level. Then he threw in a “but”—my father had heart disease in his early 50s, eventually leading to a triple bypass before sixty. Super cautious prevention seems to be the name of the game.
My doctor explained there are differing views within the medical profession around prescribing low-dose statins for possible hereditary heart conditions, but he plumps for the proactive side of the argument. Before we discuss the possibility any further, he’s carting me off for something called a CAC scan to better understand the need. Since it’s not deemed urgent, it might be six months before I’m scanned. I’m happy with that.
Six months gives me time to get my head around the concept of maybe, possibly, taking pills every day for the rest of my life. It would certainly be a novel experience for me. I’m only recently retired, and it seems big pharma has me in their crosshairs. I’ve always been pretty chuffed, considering lots of my peers already take a cornucopia of tablets, that I’m a medication-free zone.
I guess I’m grappling with another reminder of mortality; it sits quite comfortably beside the reflection in the mirror and my graying hair—what’s left of it, that is. The memory of youth is fading, even the memory of my wedding is receding at indecent speed. I suspect statins would just be another chink in the conceit that I’m still in the summer of life. But you never know.
Hopefully the CAC scan says “no” to medication. I understand it’s definitely in my future, but before sixty seems a bit of a poor show. After all, it only seems like yesterday I was dealing with teenage acne. Joining the adults-only prescription club might be one rite of passage I’d be happy to put off for another few years. Surely big pharma can do without my two cents for a while yet? Happy retirement indeed.
It is unknowable whether or when any of us may suffer a stroke, heart attack or some other malady. The probability of such events based on your personal data and family history can be estimated. The purpose of health guidelines, and certain procedures and medications when indicated, is to reduce that probability, or at least delay it. Your doctor can give you this information, which will include the risks of the proposed treatment, so that you can make an informed choice.
Anecdotes about someone who lived a very long and satisfying life, despite avoiding medical care and or ignoring health guidelines should come as no surprise, indeed they should be expected if you understand we are dealing with probabilities.
For decades, when given forms asking about medications, diagnoses and previous surgeries I enjoyed writing “None”. But in recent years since retiring from practicing medicine, it now takes me a while to fit all my answers into the small spaces allotted. It was not easy, but I have adjusted and I feel grateful that I have access to excellent care. My advice: Choose a doctor you trust, and carefully consider what they recommend. Sounds trite maybe, but I think its the wise thing to do.
My wife and I each had the coronary artery calcium test done a few years ago. We paid about $200 US out of pocket each. Unclear why insurance doesn’t typically cover it. But it was worth it. Wife was completely fine, but I had a small amount of accumulated plaque. I started seeing a cardiologist for proactive treatment. What a great move. I’m now in much better control of my exercise, diet, blood pressure, and cholesterol (yea, statins!).
I completely agree with the other HD comments that getting hard data and professional advice on these health matters is imperative as we grow older. Go for it.
The good news is statins are relatively inexpensive. Be aware there are 2 types of stains and how they work. One is water based and the other is fat based in how it acts. If one statin does not work or causes side effects your doc will suggest another until you find the right one for your body and genetics. I was on low dose atorvastatin for 15-20 years without issue. I had tried prevastatin first and had unpleasant side effects. But then we needed to increase the atorvastatin dose and some concerning side effects ensued. Had to switch to a lipid statin and so far OK. Be patient and work with your doc to find the right one and dose.
I wasn’t aware of different types of statins. If I’m honest, I haven’t really looked into the whole thing too deeply, I’m hoping the CAC scan comes back clear…I’m ignoring a possible reality until it knocks on the door.
You are right to be cautious. I had a 94 year old aunt whose doctor wanted to put her on a statin. She said no thanks. Drugs certainly have a valuable role, but can be overdone and unless there is good coordination among providers there can be a risk.
I agree with your aunt. Statins are really to address long term problems. By living to 94 she obviously is doing something right.
Per AI at that age she has already outlived 85-90% of the population.
Please trust your doctor who is trained despite all the human frailties of any profession. But please stay away from YouTube videos on the topic of statins: they use anecdotes as evidence and amplify side effects without any context.
And definitely focus more on data-driven prevention strategies and less on popular media perceptions around big pharma, etc. No different than the noisy nonsense about investing and retirement 🙂
Two decades on statins and low-dose beta blockers. My mom and her family didn’t live to see 70 due to poor cardiovascular health. My doc assures me, it’s 33% genetics and 67% diet/lifestyle 🙂
I have a friend who consults YouTube and Dr. Google every time he’s feeling unwell — he’s continually convinced he’s on the way out. I get great amusement ribbing him about his latest untimely passing, although I suppose eventually he’ll get the last laugh when he’s finally proven right.
I hear you, Mark! Before I went on a statin — I really, really wanted to make it to 75 without needing any prescription medication — I spent a year trying to lower my cholesterol level by adjusting my diet. It went down 40 points, which was not nearly enough, clearly indicating that I have familial high cholesterol (familial hypercholesterolemia, FH; it’s caused not by diet but by a defective gene preventing the liver from removing the “bad” cholesterol LDL, so at least I don’t feel like I brought this upon myself).
Anyway, shortly before turning 75 — sigh, so close! — I began taking the lowest-dose atorvastatin, and immediately the level dropped to normal. You said your cholesterol level is already low, so for you this would be preventive. If you take a daily vitamin as I do, that extra little pill is no big deal. Best wishes to you.
It’s rather disappointing to contemplate starting medication. I was surprised to discover how much my ego was wrapped up in being someone who didn’t need to take anything. I’d love to follow your example and push that start date out to nearly 75 — here’s hoping!
It sounds like you’re approaching this with a healthy mix of humor and caution, which is exactly the right mindset when considering lifelong medication. Getting the CAC scan first is smart it gives you data rather than just assumptions about risk. Whatever the outcome, taking it step by step and staying informed is the best way to balance prevention with enjoying your retirement without feeling prematurely medicated.
Steve, I’ve always been a firm believer that humor is a great medicine for all of life’s challenges. I’m hoping for a very low CAC score, but whatever way the dice roll, I intend to be a very good patient.
Hello Mark. I’d say listen to your doctor. My maternal grandfather died of a sudden heart attack at age 56; my father’s dad dropped dead of a heart attack at 65, and my dad at age 67. I became acutely worried that the same fate awaited me. In my early 40’s, I went to my family doctor and cardiologist, and they recommended blood tests for cholesterol levels, stress tests, etc. The results indicated I should start statins. I’ve been on the daily med for over 31 years now, and all is good for me–approaching age 77! If your tests indicate you should start meds, I would recommend doing it.
Fred, I’m even better at listening to my doctor than I am at listening to my wife — and that’s saying something! You had to start medication at 46? That’s certainly young, but sometimes you just have to do what the doc orders.
Hey Fred,
I’m in the same boat when it comes to genetics. My maternal grandfather, whom I take after physically, had his first heart attack in his 50s, mini strokes in his sixties and didn’t live to see his 70s. This lead me to begin regular aerobic and weight training in my very early 30s. But by my 50s I was on statins and blood pressure medication. I was really bummed, but my doctor told me I could not exercise myself out of my genes. I tried once and dropped 25% of my body weight, but as research has shown, over the past 20 years I have returned to what is apparently my set weight 😢
Hi Fred, great to see your post and happy you are still doing well!
Hello Ken! Greetings to you also.Hope you’re doing OK and enjoying semi-retirement. We’re staying healthy and live each day to the fullest. Can’t believe almost 26 years have gone by since retiring–and so happy that I was able to take advantage of the opportunity.