The “ultimatum” appointment happened last week. Let me explain - I have referred to it briefly before, but just a refresher: my new cardiologist is looking for ways to get my cholesterol even more down than it is – as all the doctors attempt, of course. So, since my new drug therapy (I ditched the Welchol because it made me miserable and the lowering it was adding was not huge, so I am just on Lipitor +Zetia) does not manage to take my levels down to “normal”, he is looking for “other ways”.
One of his other ways was LDL aphaeresis. As I have mentioned before, I was suggested this therapy before, but I have always refused to attempt it, for various (personal as well as scientific, in my opinion) reasons. So, this time, he told me he wants me to research this and then give him an educated answer. The answer was still NO on my part. I told him my decision was mostly personal and “philosophical, if you will” and he understood – or at least he said he did.
He also revealed my new numbers – a result of a blood test done in late April was never communicated to me, and I got the new results now.
I am now at:
Total Cholesterol: 285 mg/dl (down from 314)
Triglycerides: 98 mg/dl (up from 90 – oops!)
HDL cholesterol: 36 mg/dl (down from 40 – not good!)
LDL cholesterol: 230 mg/dl (down from 255)
Cholesterol/ HDL ratio: 7.9 (normal between 0-3.1 - yikes!!)
So, there is good news and bad news there – lots of bad things are down (lowest I have ever seen them), but the “happy cholesterol” (HDL) is also down – this is one of the downsides of statins, it seems – it brings everything down, good or bad! But then I never quite understood how we can have “good” and “bad” cholesterol … and we want one high and the other low … Just a mystery of science, I suppose …
My blood pressure was also high at the time of the appointment (158 over 98) and he now would like me to keep a blood pressure journal (daily or more often than that, when I have time and remember) and come back in a month, with all my readings. He will determine then, based on my readings, whether I need to be on medicine for this or not. We shall see.
Since I said no to the LDL aphaeresis, he came up with a backup plan. There is a new drug, now, still in research phase, referred to as “Apo 1 Milano”, among other things. The story of it is long (and somewhat boring), but if it works, it will be beneficial for the folks who have this mechanism broken at the moment – read more about what it does and does not do, here.
I will not go into the details if why I personally don’t think it will be beneficial for me (I have a normal level of Apo A1 in my blood, as discovered in the Berkley Lab test) , but we will see what the future brings – it’s still too soon to talk about it, I think.
The good news is that, from what they know now, the side effects of this drug will not be significant. But how will the benefits compare? I guess only time, and lots of clinical studies, will tell.
"In the end, when we look at our life, the questions will be simple: Did I live fully? Did I love well?"
(Jack Kornfield)
"The proper function of a man is to live, not to exist." (Jack London)
Are you on atorvastatin (Lipitor?). Atorvastatin sometimes lowers HDL. Rosuvastatin is better at raising HDL. I'm not sure how important that is, though.
ReplyDeleteWith those numbers I'm surprised your doctor is pushing LDL apheresis. I think you're doing well.
Hi, Marilyn,
ReplyDeleteYes, indeed, it is Atorvastatin, and yes indeed, this one lowers all of the fractions. I was on Rosuvastatin (Crestor), as well - and that did not make a dent in my numbers! As a matter of fact, I think I have been on all the statins, including Vytorin and Zoocor - nothing else other than Lipitor worked, though. So, I have been sticking with that. They needed to add zetia to it, as it stopped working as well on its own, though.
Thanks for thinking I am doing well. That is exactly what I keep telling them: look at the progress and at the whole picture, but just at today's numbers ... But alas, I am not a doctor! :-)
Thank you for your comment and for reading!!