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NP doesn't think this is sucess, wants statins

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  • NP doesn't think this is sucess, wants statins

    Which we will refuse, even if it means getting the boot from the practice.

    This DH's cholesterol over the past year

    10/21/11 4/24/12 10/29/12

    Tot 234 217 227

    Trigs 122 129 112

    HDL 38 46 48

    VLDL 24 26 22

    LDL 172 145 151

    HDL/LDL 4.5 3.2 3.1

    Trigs/HDL 6.5 4.7 4.7

    Total/HDL 6 4 4.7

    I calculated the Trigs/HDL and Total/HDL based on what I have read here and elsewhere. If you find an error, please correct me. I am trying really hard to understand this as the only things we were taught to look at in nursing school was Total and LDL. I think this panel looks GREAT! There is room for improvement, but this to me looks like a positive trend. He takes two drugs that are taxing on his liver already. There is no way we are adding a statin into the mix.

    I am preparing a letter to send to her. I would like to be diplomatic and preserve our relationship. I don't think much of her skills, BUT she generally does what we ask without much fuss. We are managing multiple issues and I don't want to start over with someone new.

    What would you say to her?

    I was unsure where to put this to get the most help, but it really is a success story. Oy, if you'd seen his eating habits before! He lived on Pepsi and crackers and the one good meal a day at home.

  • #2
    I don't think they can refuse you service for disagreeing... If they can, that's pretty awful! I would just say, "I feel like it shows an overall positive trend of improvement and we've decided not to use statins."
    Depression Lies


    • #3
      Originally posted by namelesswonder View Post
      I don't think they can refuse you service for disagreeing... If they can, that's pretty awful! I would just say, "I feel like it shows an overall positive trend of improvement and we've decided not to use statins."
      Thanks for the response!

      I haven't know of it personally, only secondhand. I don't think doctors are required to treat anyone in a non-emergent situation. It's the right to refuse service.

      I'm wondering if I should keep it short and sweet, or include the chart above for her?


      • #4
        You can alway smile and nod, take the prescription, and never fill it.


        • #5
          So, new Doctor. But first toy around with this one. Ask why cholesterol numbers, a reliable predictor of NOTHING, warrant the consumption of a known nerve-degenerating substance. Ask what the point of destroying the body is, even if if it DID help the heart - which it doesn't, except in men over 50 who have already had one heart attack.
          Crohn's, doing SCD


          • #6
            Not that I am all that politically correct, but I think there are 2 ways you could handle this.

            One is to do just exactly what Primal Mama suggests, and thank the kind NP for the script and never fill it.

            The other which I would be more likely to do, is print a crap load of medical studies that show the ill-effects of statins and give that to the NP and say that the risks of the liver damage is not a risk you are willing to take.

            Another thing to keep in mind is that MDs are businesses, just like Wal-Mart or any Mom-and-Pop shop. They have to have customers to keep the doors open. Feel free to find another doc. Unless you live in Smallville, there are others to be found....


            • #7
              That's what we did the first time, Primal Mama! And he got scared into action. The second panel is a result of the huge changes he made to his diet. It's funny, the nurse practitioner called the second panel "excellent" and told us to keep doing what we were doing. Now the third panel doesn't look that different and she's insisting on statins?

              We won't voluntarily leave the practice. I don't know how I would find anyone better. He has a complicated history that I have fought to manage effectively for a long time. We've come so far with this WOE! I need to address this with her and let her know that he will not be taking statins ever and deal with the fallout, if there is any.

              I came here for some reassurance that it does look like a positive trend. I think I will go into some detail with her. We've been at this practice for years, and honestly, she could really use some help herself. I imagine she is on statins.

              Thanks for the support!


              • #8
                In the Autism community, I have certainly seen MDs ask patients to go elsewhere for care (vaccine controversy). I doubt an NP or MD would do the same for refusal of a statin, however.

                I think you are on the right track and are doing absolutely the right thing by avoiding yet another medication that requires proper liver function. You can have your husband decline the meds at this point because the dietary changes seem to be working.

                Try tons of coconut oil. Tons of it. My LDLs went down and my HDLs went up in the past year. Trigs down, too. I had a great cholesterol panel before that (wanted to raise my total chol which I kind of did on PB) but I was impressed by the changes. A statin drug will only affect the ratio between HDL/LDL in a negative way from what I've seen with my DH. His LDLs have gone down but so have his HDLs. Not good, since those protective HDLs were already on the low end. My DH is an MD so I have no luck talking to him. I've witnessed his father cognitively decline over the past 20 years on statins/very low fat diet and it is painful. I talk to my DH about his dad a ton to hopefully keep my DH on a higher fat diet. Doctors are a pain in the ass to marry!

                My biggest suggestion is to have your DH deal with the refusal. You act as the back-up.
                Age 48
                Start date: 7-5-12
                GOAL: to live to be a healthy and active 100

                "In health there is freedom. Health is the first of all liberties."
                Henri Frederic Amiel


                • #9
                  Thanks for the response and encouragement, PHaselow. I feel certain we are on the right track, as well. He didn't believe he could ever recover from his health issues, but he cannot deny the progress.

                  I needed the reminder for the coconut oil. We were using lots of it, and just got out of the habit.

                  We've seen the same cognitive issue with his mom. HOWEVER, she recently decided to listen to me and her optometrist and add healthy fats and drop grains. She saw an amazing 45 point drop in her TC. She told me she had a normal cholesterol panel for the first time in years. Next will be convincing her to drop the statin.

                  As far as the last suggestion- I wish. But this is an old marriage. He is who he is; I am who I am. He needs me to do this for him, and I have accepted that. It's a strength/weakness that mostly works for us.


                  • #10
                    me too, I have accepted that. It's a strength/weakness that mostly works for us. thanks for your sharing


                    • #11
                      My dad tried statins and it almost killed him (messed up his blood pressure really bad) so he switched red yeast rice and it worked.

                      Last year I dropped my cholesterol 81 points just by doing daily exercise and diet, but if I hadn't been able to do that I might look at red yeast rice next. Oh, I also spike my tea with cayenne and cinnamon and both are known to reduce cholesterol. So that may have played into it.
                      High Weight: 225
                      Weight at start of Primal: 189
                      Current Weight: 174
                      Goal Weight: 130

                      Primal Start Date: 11/26/2012


                      • #12
                        After struggling with Celiac's for 16 years and being diagnosed with EVERYTHING UNDER THE SUN (including hypochondria) but having Celiac's suggested by a pharmacist (!), I'm tired of trying to educate doctors. I do my own best research, and if they say something stupid that I know to be untrue, I go out the door. To be fair, I think doctors in general do not expect patients to do the right thing. They're all, "here, take this statin since you will never change your diet and maybe you will live slightly longer and I won't have to feel guilty about doing nothing". When you have a patient changing his life... maybe they find this hard to believe or to trust.

                        I vote you find another doctor.


                        • #13
                          Double check your math.
                          I think this is more correct:

                          21-Oct-11 24-Apr-12 29-Oct-12
                          Total 234 217 227
                          Trigs 122 129 112
                          HDL 38 46 48
                          VLDL 24 26 22
                          LDL 172 145 151

                          LDL/HDL (goal < 4.30) 4.53 3.15 3.15
                          Trigs/HDL (goal < 2.0) 3.21 2.80 2.33
                          Total/HDL (goal < 5.0) 6.16 4.72 4.73

                          For reference, I had mine checked last week and my ratios are 3.3, 2.5, and 4.8. Quite comparable to the last column of numbers above.
                          Last edited by PBNewby; 12-19-2012, 07:13 AM.
                          Began Primal Living: 25 Sep 2012
                          Starting Weight: 82kg (180 lbs) - Lost 30 lbs since going Primal!

                          "I do not eat enough carbs to justify eating low-fat."
                          "Have some bread with your bread, pasta, bread, and HFCS." - Unicorn
                          "I also walk my dog twice a day now instead of paying someone else to do it." - IronGirl
                          "Tell me you're not weak minded enough to be outsmarted by a donut?" - not on the rug


                          • #14
                            I wouldn't try to tell a doctor (or other professional) how and why to do their job
                            That's correct. Instead tell them what their job is. As in, what result you want, and what you are willing to do to get there. An architect can't design your dream house if you don't tell her what you dream, and a dream house you cannot afford to build, or wouldn't be willing to live in, isn't much of a dream either. Professionals are people you hire to help you acheive specific results in areas requiring special knowledge and flexible problem solving abilities. You must give them the parameters of your problem or they can't do their job. Often they can guess but their guesses may well be wrong. If one of your parameters is "no statins", that's just like if I was specifying my dream house and said, "no doric columns". I can't blame an architect for designing me a house with doric columns if I haven't told her I think they look wrong on houses.

                            Trust is an overused word, but it comes into play here. Not the authoritarian "trust us, we're professionals", but the prosaic, "provide correct information" sense. It should go both ways, but in the short term you only control one side. Make yourself trustworthy because that gives others a chance to show their true colors. If you can't develop trust in return...if you don't find the professionals you have hired them and hire others.


                            • #15
                              So the numbers seem to be getting better each visit and they want statins....sigh.
                              Eating primal is not a diet, it is a way of life.
                              Don't forget to play!