Posts Tagged ‘Dr. John M.’

Walking shoes, Liquid Plum’r, and Cholesterol

November 22, 2010

There was a pretty big announcement at the American Heart Association’s Scientific Sessions 2010 meetings last week: the new drug Anacetrapib is very good at raising “Good” cholesterol (HDL) while at the same time lowering “Bad” cholesterol (LDL) with very little side effects!

Why is this important? (Part 1): Here’s a good way to remember the difference: HDL is Happy Cholesterol and LDL is Lousy Cholesterol. Lousy Cholesterol gunks up your blood vessels and causes blockages. Blocked arteries are official, certified BAD THINGS. Happy Cholesterol, on the other hand, eats Lousy Cholesterol and then drops it off in the liver, where it is processed out of the body.

Why is this important? (Part 2): Drugs don’t always work like you think they will. A few years ago there was a big clinical trial for a new drug that would also raise your HDL while lowering your LDL. Suddenly the trial was cancelled… a significant percentage of the trial participants suffered from high blood pressure and/or heart attacks. Some of them actually died.

Ouch.

So there was a lot of excitement when anacetrapib came through the clinical trial with acceptable results. Dr. John M. has a good post on the new drug, including how it is more like Liquid Plum’r. Or maybe Pac-Man.

We’re still a long way from this drug going to market, the next step is another clinical trial involving 30,000 people. But in a few years it will be available – and someone will promote it as “an alternative to exercise.”

In the words of the great philosopher, Mr. Bruce Hornsby, “…don’t you believe them.” A pill can not replace exercise, no matter how much LDL it gets rid of. Your heart and lungs are muscles – If you push them just a little past their optimal range of use on a regular basis, they’ll get stronger. If you don’t – if you sit on the couch and take your pill – they’ll slowly wear out. It’s a rule of life; you can’t stop it. We all age, but some of us do what we can to slow it down.

The new drug won’t be cheap. New drugs never are, there is too much Research and Development funding sunk into it. No one knows what the price will be yet, so let’s make a guess. The new anticoagulation drug Dabigatran will probably cost about $240 per month. That’s not taking into account any insurance plan you may use, but if you walked up to the pharmacy counter with your prescription and paid cash.

Using this as our estimate, a one year supply of Dabigatran would cost $2,800 per year. You can figure that Anacetrapib’s price will probably be somewhere in that range.

But one pair of good walking shoes will cost you $85. Shoot, let’s splurge a bit and get one of the more expensive brands. That will cost us $130. If we just use them for our high intensity walks, they’ll last a while. If we use them as our everyday shoes, we may need a new pair in a year. Cost of drug: $2,800 per year. Cost of shoes: possibly $260 per year, more likely to be less.

Exercise is cheaper than drugs – and a lot more fun!

Nine Point Plan for Weak Hearts

May 4, 2010

Dr. John M. is a blogger I have recently found, and I like his writing. He’s currently an Electrophysiologist (Heart Rhythm Specialist) living and working in Louisville, Kentucky and his blog entries are very informative.

In this post, Dr. John gives a nine-point plan that usually keeps a weak heart going:

The sonogram may show a weak heart, and weak hearts are supposed to limit longevity, but those that live the plan seem to just keep showing up every year for their routine checks.

Of course, this nine-point plan may not be your nine-point plan! The person given in the example is specifically an older gentleman with an Implantable Cardioverter Defibrillator (ICD). So you will have to discuss this with your doctor and revise the plan to fit your situation (if you chose to use it at all). But let’s look at Dr. John’s nine points:

  1. ACE/ARB inhibitor (cost: 4.00/month)
  2. Beta-Blocker (cost: 4.00/month)
  3. Aspirin (cost: 1.00/month)
  4. Statin (cost: starting at 4.00/month)
  5. Exercise: (cost: sneakers and jacket)
  6. Nutritional restraint: (cost: 0.00)
  7. Goodwill to others: (cost: 0.00)
  8. Lifelong companionship (costs: variable)
  9. Sleep hygiene (costs: variable, but not too much)

Obviously, your drugs are probably going to be different, but Number 5 through 9 apply to anyone fighting a heart problem. As I have said before, check with your own doctor first.

But in general, following these nine points should extend your life. And as I often write, “Every heart deserves to live a lifetime!”