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Shifting medical goal-posts

Discussion in 'The Pub' started by hornet, Feb 6, 2010.

  1. Ok, this is a bit of a whinge, and might end up as a rant, but what is it with the constantly shifting goal-posts in medical matters these days? Let me explain..

    I have a family history of heart disease. My father and all his brothers died from it, one, albeit in his 70s. So, I need to be careful because one thing that IS agreed upon is the role of genetics and family history in this area.

    So, I'm 60 years old, a tee-totaller and a life-long non-smoker. I'm around 178 cms or five foot eight in the old scale, and weigh around 90kgs.

    Some years ago I visited the doctor who ordered some blood tests and tut-tutted when my cholesterol was nearly 8. Drugs and exercise got it down to around 6 in less than three months.

    NOW my current doctor says 6 is "way too high" and he's surprised that I haven't "dropped dead" already. As well, I am supposed to be a diabetic, the medical craze of the noughties, it appears. I asked him what were the dangers of this disease. He told me I could lose the use of my hands and legs, and could end up having my feet amputated.

    He then asked when the last time was that I had visited a GP. I told him I don't get sick, and I go to the doctor when I am sick. His reaction was on the same level as that he would have given if I had blasphemed his prophet! "You should visit you GP once a month!", he blustered. "What for?", I asked. He didn't have any sort of answer.

    Now I'm always the first to debunk or ridicule conspiracy theories, but in the medical realm at least, I'm beginning to believe.

    If a level of cholesterol was considered to be under control and manageable 5 years ago, how come it's now the equivalent of an imminent death sentence?

    If diabeties is an epidemic, how come I'm not seeing people all aroung in wheelchairs?

    If the figures for deaths from heart failure, excluding the thousands of people who die each year in hospital, at advanced age, of unrelated diseases, were reported properly, how serious is the 'epidemic'? Why are otherwise healthy men and women not dropping like flies in Pitt Street, on the basis of this relentless media campaign, driven along by the medical profession?

    And if the attitude of this doctor regarding unnecessary GP visits is reflected across the whole profession, is it any wonder the Medicare system is collapsing under the weight of this avalanche of people sitting in waiting rooms, waiting to see the doctor because he has told them they should?

    Is it just me?
  2. Firstly, Paul, what we know about medicine changes over time. If it didn't, we'd still be fumigating women over pots to draw down their wombs from their brain to stop its migration up there from giving them hysterics.

    There are very few absolutes, especially when it comes to disease. Studies and research is always being conducted, journals publish new findings all the time. Doctors are expected to keep current. What may have been considered an acceptable blood pressure for you five years ago in your mid fifties may now be considered dangerous in your sixties. Things change the more the medical profession learns. Different doctors may have differing views on what is acceptable - it's not an exact science by any stretch. Some may err more on the side of caution than others, some may be entirely too lax in their diagnosis. It's why you should always get a second opinion if you aren't confident. And sadly, as I know too well, a poor and lazy diagnosis can result in tragedy.

    Yes I think monthly visits are over the top, except if you've been diagnosed with a serious condition that they believe needs frequent monitoring until it has stabilised.

    Diabetes is a very serious condition Paul and if you've been diagnosed you should not be casually dismissive of it. There is a whole host of problems associated with it if it is unmanaged, up to and including death. The statistics for mortality attributed to diabetes are real, and diabetics are over represented in statistics for high blood pressure, angina and stroke.
  3. I wouldn't be worrying too much at your age pops, 60 is a pretty good innings. :D
  4. Apparently 6 is considered a little high these days.

    I would say that a once a month visit is a bit over the top... but it's recommended for "older" folk. My dad's 67 and goes monthly - but he does have a bunch of other issues that are being monitored.
  5. And so you should believe. Firstly nobody can tell you what your blood cholesterol level should be.

    Secondly, your body regulates your cholesterol levels and if you seriously want to live the longest your body can give, youd do well to stop taking statins if those are the drugs you are referring to.

    If you eat well and exercise, no matter how "shockingly" high that level may be, its the level your body determines its cholesterol level needs to be at.

    Everyone has different cholesterol needs depending on environment and state of health, and genetics. Apart from important hormonal functions, it also is a part of the body's repair system. There seems to be this funny idea in pop medicine that if we reduce the body's repair responses, our health problems go away.
  6. That is funny. I haven't been to a doctor except for a few tetanus injections, and one examination for an insurance policy since . . . um . . . Well, since before 1977 anyway. The last time would have been for childhood illness. Of course, now that I have hit 50, I am thinking about getting a thorough checkup, since that is the logical thing to do.

    In my experience via family members, doctors can't diagnose anything out of the ordinary anyway, and often cause more problems than they solve. They do know how to keep you alive even when they can't cure you though.

    Paul, your doctor was just drumming up business, using the tried and true Fear, Uncertainty, and Doubt technique.

    BTW, if you actually have diabetes, you should do something about it. Hopefully just diet and exercise. Diagnosis is pretty well defined these days, but I would be seeking a second opinion to confirm.
  7. Gixxer, you speak as though you may have a bit of knowledge on the subject (cholesterol) , Could you please direct me to a bit of reasonably accurate reading, I am sooo bloody confused with what doctors say that I need to work it out myself. Like Hornet I had a reading in the very high eights. Also like Hornet I have a family history of heart problems, Unlike Hornet I smoked for over thirty years (only quit a few months ago)
  8. Ok, let's start at the basics ......

    1. strong family history of heart disease
    2. overweight - unless that 90kg is composed solely of rippling muscle.
    3. high cholesterol level (was 8 now 6)
    4. possible type 2 diabetes - on what basis did your doc say you were diabetic?

    For somebody with a family history, this is a bad combination. Now, I wouldn't go so far as to say you are in imminent danger of dropping dead on the spot, but you're unlikely to make it to four score and ten.

    What's your blood pressure, btw?

    Do you take regular exercise?

    These days, the accepted cholesterol level for people without a family history of heart disease is 5.5 - so your current level of 6 with a strong family history is not good. Unfortunately, the cholesterol goal posts keep moving but for people with a family history, the lower you can get your LDL cholesterol (the bad one) the better.

    Monthly visits to your doctor, unless you have an unstable condition, are overkill. However, if you do have diabetes, then you will need frequent monitoring until your sugars are under control, so in that setting monthly visits are appropriate. Once you are stabilised however, you will still need regular visits, albeit less frequently.

    I would suggest a visit to another medical practitioner, possibly one less inclined to histrionics. This one seems to be a bit of a drama queen.
  9. Yes. As a person with a significant family history of heart disease, overweight, a diagnosed diabetic, an undisclosed blood pressure, and high cholesterol, you'd be best served by taking the advice of some random person from the internet who has no idea of your medical history and abandon any medication doctors have prescribed that will lower your risk of stroke, heart attack, and a myriad of other proven health risks associated with high cholesterol. Perhaps you could also read up various other internet based blogs or forums on medical issues and self diagnose and do without doctors altogether. :roll:
  10. I go to my GP every 6mths, the cat gets a 6mth vet check, the car gets a 6mth mechanic service (approx, km vs mths) and so on. Depends on age I guess.

    I asked for a blood test last time because I've never had one. Cholesterol level came back at 4.3 which is within the 'average' healthy range however apparently the trend is try and get it to around 3, which I think is for people that suffer from high blood pressure for which there is a history of such in my family.

    Apparently 50% of Australians over 25 have cholesterol levels over 5.5 which is increased risk, >=6.5 is considered extreme risk.
  11. +1. All those factors make bad reading. Whilst a monthly checkup is over the top, at 60 it doesn't hurt to visit the doctor for full health checks.

    Doctors can be scaremongers and unfortunately a good bedside manner is compulsory to pass your exams.
  12. My grandfather never drank or smoked his whole life.
    Exercised every day, especially in his later years as he has had two knee replacements and walking was a required part of his physio.

    A couple of years ago: BAM! "You need a quadruple heart bypass."

    So I'm in the 'live it up while you can' camp.

    It's gotta be a bit comforting for a doctor to be passionately discussing with a motorcyclist how they plan to most comfortably die of old age, though, right?
  13. Good input folks, and thank you.

    I don't want you to think I'm looking for an excuse not to listen to the doctor's advice, by the way. My dad had a coronary in 1959 at the age of 48 and died ten years later at the age of 58. I've already passed that and attirbute that to knowing a lot more about health than he did 50 years ago and doing something about it. I think if I don't make it to my three-score-years-and-ten it's most likely to be my own fault.

    I have re-started a 20 minute a day vigorous walk programme, and am on anti-cholesterol medication, so I'm hopeful that this may work to my favour without the need for swallowing a fistful of pills every morning with breakfast for the rest of my life.

    Nonetheless it is sometimes hard not to believe that the doctors and the drug companies between them have a very strong interest in keeping us terrified about our health and spending large amounts of money to maintain it :p.
  14. Yes, I am currently reading through "essentials of human anatomy and physiology" 9th edition by elaine marieb, also try to find someone with a subscription to The Lancet or New England Journal of Medicine. Also check out some of the work of Dr Ron Rosedale, Dr Emil Levin, and Dr Paul Rosch. Particularly Dr Rosch.

    When you stick to strictly academic sources of info like textbooks, they do not speak of cholesterol as some giant bogeyman, and do not discuss cholesterol as a cause of heart disease. Interestingly the journals like Lancet and NE journal of medicine had to start demanding the researchers disclose where they received funding, since it looks a little suspicious when your one and only source of funding is Pfizer.

    The bottom line is, cholesterol is an extremely important steroid base which your body regulates. Interferring with this system through artificial means, ie statins, can lead to muscle, organ, and brain complications. I cant stress enough how important cholesterol is in the body. And yes, you will have people claiming its going to give you a heart attack, to which I say, show me how.

    Its an interesting topic, which Im no doubt going to be flamed for.
  15. Hornet, don't know who your doc is or how long you've been going to him and how loyal you are, but if your after a second opinion from a gp, check out Nicholas Brittain at Caringbah Medical Centre. Completely no nonsense, tells it how it is and actually looks after you unlike most of the idiots at that place. I've spoken to people who will travel half way across sydney and then be willing to wait an hour or two to see him.

  16. Are you a medical professional?
  17. My dad used to be a huge smoker and drinker until almost 40, when my parents heard of mum being pregnant with me, dad stopped smoking, drinks 'light' for the past 37 years, mum stopped smoking when I was about 5-8 from memory heh.

    Anyway, dad has always had 'super high' blood pressure, eats what he wants, he is 80 now. Still has all his cognitive and motor functions plus he still has a GREAT time in life. If he had paid attention to doctors with his blood pressure and what not, he was supposed to have been dead 20 years ago :nopity:

    Here's still all and well + LOVING being a grandparent for the first time :D http://s82.photobucket.com/albums/j250/undii/?action=view&current=cassy008.jpg
  18. also, what is more important than cholesterol count is your HD:LD triglyceride ratio, so make an effort to find out about that. Ideal ratio is 5:1, apparently most Australian's are at 1:20 :shock:
  19. Yes, I also read about that and it makes sense. Although I didn't have a chance to see what my ratio was or if it was actually tested for.
  20. Unless you have any 'conditions' that need managing, any GP worth their salt will tell you that all you need to do to stay healthy is eat your fruits and veggies, get some light exercise, sleep more than 6 hours a night, avoid smoking and drink in moderation.

    If your doctor says different and recommends a vast array of branded supplements - piss 'em off quick smart.

    Drug companies certainly are concerned with their bottom line.
    Our complete dietary requirements (except for Vitamin C) can be met by eggs and sunlight.