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Doc just prescribed a statin!

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Doc just prescribed a statin! Empty Doc just prescribed a statin!

Post by OnTheBayou Fri Mar 30, 2018 4:43 pm

I went in yesterday because my Metformin had run out and he wants to see me every six months just fro med renewals it appears. My old doc in FL did no such thing. I suspect it's an excuse to bill Medicare for a visit and to appear to practice good medicine. From my perspective, it's a pain the ass, nothing pops up.

Almost as an afterthought, he said something about going on statins. I don't recall his exact words, but I didn't say OK, nor did I argue the point. So I went to pick up my two (no oversight needed) prescriptions and what do I find? Rosuvastatin! I told the pharmacist I will not take a statin. He asked why, I told him what I know in regards effective and uneffective populations; I am in the latter category.

What's really bizarre is that my last big panel 14 months ago and by EVERY measure, EVERYthing was EXCELLENT, including ratios. I am having another panel on Monday, so we'll see where that goes. Frankly, I don't expect as good as a year ago, but I doubt if I've a foot in the grave.

A1C 6/17 4.9
Total Cholesterol 174
HDL 72
LDL 76

Zero history of cardiac problems in my family. No events for me. And I need statins?

Time for a new doc, I think. And I've grown increasing frustrated with the horrible communications with this major regional player, Austin Regional Clinic. Many specifics, won't rant. It seems like I am always the one having to make sure things are happening, too. Sometimes I've been so frustrated I thought I will just go to Mexico, four hours away, stock up on meds, and only see the locals as needed. I know not practical, just how frustrated I am.

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Post by Rig D Fri Mar 30, 2018 6:10 pm

OTB, I'm pretty happy with my GP, but he's wanted me on statins for a long time. I've respectfully declined, told him my reasons and he's grudgingly accepted that I'm not going to take them. If you are otherwise OK with your doc, you might try exploring the "why" a little more, he/she may be receptive to your rationale.

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Post by Narrowminded Fri Mar 30, 2018 6:52 pm

OTB, the other side of Medicare is that if you need something that needs ordered at any point (I know your healthy), but they do have to have had a face to face within 6 month. I go through that with getting things for DH. That could be the rational on seeing you every 6 mo. It’s a medicare policy. Now, since you don’t need any medical equipment, that should not be an issue.

Yeah, why the statins when your Total Chol is well within very good range is beyond me.
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Post by tomi1000 Fri Apr 20, 2018 2:03 pm

I'm a little to late to the main subject time line - but I think I can shed a bit of light on this also. I worked in admin in a diabetes clinic for 17 years. Medicare has basic guidelines that they want the doctors to meet with their patients - they are considered "health maintenance" items to try to avoid medical issues later on. As an "incentive" as they call it - if your doctor is meeting these guidelines - as tracked by medical record markers (thank you electronic charting) the doctor receives monetary kickbacks at the end of the year. The monitoring is all done anonymously by tracking certainly markers within the chart. For example: if a patient has a diagnosis of diabetes then they also look for A1c levels, medications and things like foot care and dietary counsel.

The payback for the clinic can be quite profitable. The clinic I worked at was a single provider with a PA - and the "incentive" paycheck would often exceed $50,000 a year.

So - this could be a reason for your doctor insisting on statins. It is a common medical practice for diabetics to be on statins as a precautionary treatment for cardiac issues.
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Post by OnTheBayou Fri Apr 20, 2018 4:50 pm

@tomi: In a word, "Wow." Sort of like the public finding out years about car dealer incentives by the manufacturers. How they could make a profit with zero mark up.

I've been with a large regional clinic system since I moved here fall, 2015. Increasingly, I've been suspicious of marginally necessary procedures and perhaps even mis-billing for more income. The NYT had a story not long ago how there are not only seminars on how to increase income by billing changes, but you can actually get a degree in, well, flim flammery.

Does this happen in any advanced country? I doubt it. Another story I read some years ago examined two hospitals with the same number of beds, admissions, and typical procedures. One had 100 billing clerks, the other, five. The difference? Geography. The first was in Seattle, the second, in Vancouver.

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Post by Rig D Sat Apr 21, 2018 8:29 am

Tomi thanks for your post. You expose a lot of what I consider to be issues in the medical/insurance/gov mess we are all dealing with. I think that the only potential avenue open to any of us is to be as informed as possible on health related issues and to develop a good "stiff-arm" when dealing with the medical complex.

And here in the USA, I think it is important to closely evaluate your current legislators, particularly Sen Beaux Zeaux and Rep Les Clue. Those who advocate more of what doesn't work well now should get the boot at the next opportunity.

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Post by OnTheBayou Sat Apr 21, 2018 9:04 am

Rig D wrote:Tomi thanks for your post. You expose a lot of what I consider to be issues in the medical/insurance/gov mess we are all dealing with. I think that the only potential avenue open to any of us is to be as informed as possible on health related issues and to develop a good "stiff-arm" when dealing with the medical complex.

And here in the USA, I think it is important to closely evaluate your current legislators, particularly Sen Beaux Zeaux and Rep Les Clue. Those who advocate more of what doesn't work well now should get the boot at the next opportunity.


Hey! I voted for them! I will always vote against my best interests. It's the Amurikin way!

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Post by Rig D Sat Apr 21, 2018 9:32 am

Yeah, OTB, you are in good company. Us 'Meruhcans live by the motto "never in doubt, frequently in error."  Here in OH-10 we have one Repoop and one Dummycat for senators. My rep is a Repoop, who votes pretty consistently on the liberal side.  He's deeply entrenched with the big military contingent here (We have Wright Patterson AFB in the district) and has not had a meaningful opponent in my memory. For me, elections are normally a tough choice between Slim and None. I haven't yet seen "None of the Above" on the ballot.

I just don't understand the mindset that says "This hasn't worked at all. Let's double down and do more of it."
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Post by OnTheBayou Sat Apr 21, 2018 9:49 am

Rig D wrote:Yeah, OTB, you are in good company. Us 'Meruhcans live by the motto "never in doubt, frequently in error."  Here in OH-10 we have one Repoop and one Dummycat for senators. My rep is a Repoop, who votes pretty consistently on the liberal side.  He's deeply entrenched with the big military contingent here (We have Wright Patterson AFB in the district) and has not had a meaningful opponent in my memory. For me, elections are normally a tough choice between Slim and None. I haven't yet seen "None of the Above" on the ballot.

Well, that caused a much needed major laugh this AM! My situation is not disimiliar, Rep. John Carter's district includes Ft. Hood. A typical Texas extreme gerrymandered district. He is ineffective and plays on the fears of the iggarint. We have a woman running against him in the fall who is not only an, actual, like, you know, veteran (unlike chicken hawk Carter) but has a Purple Heart for her role in saving crew members of the helicopter she was piloting that was shot down in the Middle East. Her book, "Shoot Like a Girl," has been well received.

https://www.amazon.com/Shoot-Like-Girl-Dramatic-Afghanistan/dp/1101988436

Oh, I guess this is supposed to be about statins. So, there, I used the word.

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Post by Rig D Sun Apr 22, 2018 12:29 pm

Yikes! Interesting article by Malcolm Kendrick, courtesy of MDA's Weekend Link Love.
https://drmalcolmkendrick.org/2018/04/09/statins-and-amyotrophic-lateral-sclerosis/

Association of statins to increased ALS.
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Post by OnTheBayou Sun Apr 22, 2018 1:14 pm

Not surprising that statins, which effect cholesterol, which is important for the nerve's myelin sheath, increases disease of that sheath.

Beyond that, I found this comment supportive of the idea that enough results can reasonably mean causation: "It is often said that association does not mean causation. However, this is only true up to a point. Most statisticians agree that an odds ratio > 6 represents proof of causation. When you find that people taking atorvastatin have a seventeen-fold increase in risk of ALS, this is proof of causation. The effect is too massive to be due to anything else."

It's like the Finnish study that found blood donors, with much lower ferratin serum levels, had 1/17th the CVD rate of non-donors. Well, gee, I think a 17:1 ratio all but screams causation about iron levels.

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Post by Narrowminded Sun Apr 22, 2018 1:17 pm

Rig thanks for linking that article.

As some of you here know if you’ve read my thread, my husband has ALS. He was DX at 44, having had symptoms that started at 42. He had never been prescribed statins and still hasn’t.

It would be interesting if they could find a link, but it should also be noted, that those being DX are also becoming younger. As someone who is intimately linked with the ALS community and has been for nearly 14 years, there is definitely something else going on out there. We are seeing a lot of 30, 40 and 50 somethings being DX. Most of those should not have started down the statin road just yet.

All that said, I’ve never been in favor of the drug, even pre-paleo. It never felt “right” to me. I watched my mother decline in abilities after starting the stuff. And my brother, who has now been on them about 8 or 9 years constantly complains of muscle pain. Both landed there from poor eating/exercise habits, and zero desire to change said habits.

It would definitely be awesome if they could reduce the number of ALS cases by removing statins from the market. However, I don’t see that happening until they finally are willing to admit that cholesterol isn’t the monster they make it out to be, at least when healthy eating is tied to it.
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Post by Narrowminded Sun Apr 22, 2018 1:19 pm

OTB we were posting at the same time. In ALS, it does not affect the myelin sheath the way MS does. That’s something that is looked for when DX ALS. Had there been sheath issues, DH would have had MS, not ALS
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Post by Rig D Sun Apr 22, 2018 1:58 pm

NM, it amazes me that your husband has survived as long as he has with this terrible illness. He must be an amazingly tough guy, and I'm sure the care you provide has helped as much as possible.  I've had a couple of friends, one very close, who developed ALS and they died from it within a couple of years.

I also agree that "something's going on out there" that is causing a lot of health issues, not just with ALS. There are so many relatively new things going on, from chemicals on the crops, aerial spraying, increased injections, radio and cell phone radiation, prescription issues, gmo foods, it goes on and on. Some, one, or a combination of things is likely to be contributing to deteriorating health.

So, the average Joe & Jane Sixpack adopts the wisdom of this guy:
Doc just prescribed a statin! What-m10



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Post by Narrowminded Sun Apr 22, 2018 6:53 pm

Rig - DH is a tough guy, but if he had not vented, we would have lost him in 2010 or at the latest 11. His Respitory status was rapidly declining. I know it’s the vent that has kept him here the past 8 years. If that had happened it would have been 5-6 years from onset of symptoms or 3+ from Dx.

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