I'm reporting here what I did in response to a high cholesterol test, about 280 total.
I talked it over with my doctor, who ended up recommending the South Beach diet. I also got a cardiac CAT scan and a stress test. The CAT scan cost $400 and was not covered by insurance; but my insurance doesn't pay for anything anyway unless it's over $10,000, which saves my family about $1000 per month over "better" insurance. So I decided I could afford it. And it is one of the only tests that actually measures cardiac artery disease, that can be used to monitor its progression.
The stress test was normal. The cardiac CAT scan came up with an Agatston score of 25, which means that I have less plaque than 75% of asymptomatic men my age (60). I can afford to take some time to deal with the problem, if indeed there is any problem at all.
I started out on South Beach. But I also started doing research. And I discovered that Atkins really had better science behind it, as far as I could tell. And the recipes were delicious! So I went on Atkins.
I lost about fifteen pounds, I feel better, I don't think that I'm at my ideal weight, yet, particularly considering my sedentary habits, but I am not obese. However, my cholesterol shot up. Total cholesterol was just measured at 320. It's not terribly surprising; I'm drinking heavy cream in my coffee, using butter liberally, generally taking serioiusly the idea that saturated fat is an important part of the diet. My doctor saw the latest numbers and wrote me a note "Terrible! Please see me!"
So I did. We had a great conversation. He acknowledged that my risk was actually low; the only apparent risk factor was the cholesterol level, and we had not yet done a lipoprotein-A test to find out if it was *truly* worrisome. The only heart disease in my family was my father, who was also a smoker and who actually died from lung cancer. (And his favorite food was steak and potatoes.) My mother is doing quite well at 94. So if I do have any problem, it is certainly not advanced, in spite of high cholesterol numbers.
I find myself naturally backing off on the butter and cream.... My wife was originally panicked by the latest test, but she has calmed down.
I suggested to my doctor that I should see a cardiologist to monitor the situation, to play it safe. He said that it was going to be difficult to find a cardiologist who was not going to immediately write a prescription for Lipitor. But he thought of one, an academic actually, who'd really be the expert and who would have an open mind. Especially considering that I was willing to pay for a cardiac CAT scan in another year or two. And then my doctor mentioned the possibility of getting into a study.... which would certainly be interesting and which might allow free CAT scans. Anyway, I got an appointment, but the earliest available was in September.
This all got me to thinking about my mother. So I called her and asked her about her cholesterol. "I have a cholesterol problem," she said. 94 years old, no heart attacks, no shortness of breath. I can see exactly what is happening: she has high cholesterol, so the doctors have told her she has a problem. I haven't yet found out if she has been treated for the high cholesterol, but if she has, it would be a shame. Cholesterol, it seems, might be protective against some kinds of strokes, and guess what? She has had TIAs, mini-strokes.
I'm beginning to get a little ... outraged....
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