I guess I'll be taking a statin

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floramaria
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Re: I guess I'll be taking a statin

Postby floramaria » Wed Jul 03, 2019 4:48 pm

WhatNext wrote:[quote="j

Yeah, I know, but easier said than done. I plan what I'm going to say in my head and then when the time comes I chicken out.


HI WhatNext, I understand the problem, having had to abandon one physician already. ( That was over HRT. ) Over time, and with a lot of practice I have gotten better at the role of advocating for myself. I am accepting that though I would love to have a progressive doctor who is very well-informed...better informed than me!...and able to give me the latest info and to discuss my options in light of the best current research, that is not what I have. While he has a broader range of medical knowledge, I am certain that I am better informed than him in some areas that are specific concerns for me. When comes to really doing the research and looking out for my absolute best interests, turns out that person is me, not my doctor.
My cholesterol numbers are all higher than yours. My doctor mentioned statins, but has learned that I am following my own course. I asked him to write a lab requisition for LDL particle count, rather than a statin prescription, which he did. I’ll pay for it if it is not covered.
In standing up to my own PCP I have taken to heart advice given to me similar to gilberAZ’s message to you: Your doctor is your employee, not your boss.
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WhatNext
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Re: I guess I'll be taking a statin

Postby WhatNext » Thu Jul 04, 2019 6:12 am

jgilberAZ wrote:
Do what my wife does ... she tells her doctor "I'll take this information and discuss it with my husband before making any decisions."

easy peasy

Can't do it--I'm a widow. Even when I had a husband I wouldn't do this, but this forum isn't the place for that discussion ;) . I do on very rare occasions resort to something similar: I'll say "I'm going to talk to my son about this; he's an attorney." Works wonders. :D

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Re: I guess I'll be taking a statin

Postby WhatNext » Thu Jul 04, 2019 6:42 am

floramaria wrote:
HI WhatNext, I understand the problem, having had to abandon one physician already. ( That was over HRT. ) Over time, and with a lot of practice I have gotten better at the role of advocating for myself. I am accepting that though I would love to have a progressive doctor who is very well-informed...better informed than me!...and able to give me the latest info and to discuss my options in light of the best current research, that is not what I have. While he has a broader range of medical knowledge, I am certain that I am better informed than him in some areas that are specific concerns for me. When comes to really doing the research and looking out for my absolute best interests, turns out that person is me, not my doctor.

Thank you Floramaria for this. When I disagree with something my doctor says he has statistics at the ready. He thought I should take HRT; when I told him I didn't want to he said "More women die after breaking a hip than from breast cancer." Maybe that's true, but what is the median age of death from a broken hip vs death from breast cancer? I didn't think to ask. That issue didn't matter because it wasn't his call: I was still seeing a gyn and she had not suggested I take HRT. When I told him I'd heard bad things about statins he said "I've heard bad things about heart disease and strokes." I need to go in well-prepared to make my case. He knows I'm in good health and that I pay attention to my health, eat healthy, and exercise. I'm more concerned about the quality of my sleep than I am about cholesterol.

I'm wondering if I should tell him I'm apoe3/4 and tell him about this forum and the extensive research done by the contributors here.

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Re: I guess I'll be taking a statin

Postby jgilberAZ » Thu Jul 04, 2019 7:45 am

WhatNext wrote:Can't do it--I'm a widow. Even when I had a husband I wouldn't do this, but this forum isn't the place for that discussion ;) .


The point was twofold:

- an easy way to let your doctor know you view her/him as an advisor not an authority

- an easy way to not have a conflict with him/her then-and-there

Whether you have a husband or not is irrelevant.

Whether one discusses healthcare decisions with their spouse, or anyone else, or not is irrelevant.

In our house, my wife and I discuss our health and what to do about it. But obviously, the decisions we make are our own as it is our own health we are responsible for. But, we do value each other’s input.
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Re: I guess I'll be taking a statin

Postby KatieS » Thu Jul 04, 2019 8:33 am

WhatNext, I am your same age, small body frame, high HDL, 3/4, previous widow...but I am on a very minimal dose of simvastatin. Despite a zero calcium scan at age 64, my lp(a) is double normal and have two other cardiac risk factors (hypertension and sleep apnea). Unexpectedly, I experienced side effects to the water soluble statins (rosuvastatin & pravastatin). Plus, my 101 y/o, 3/4, double normal lp(a) mom has been on simvastatin 10mg for decades and still living at home with assistance. The decision to go on statins incorporates all the risk factors and if possible, other family member's experiences.

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Re: I guess I'll be taking a statin

Postby WhatNext » Thu Jul 04, 2019 9:55 am

KatieS wrote:WhatNext, I am your same age, small body frame, high HDL, 3/4, previous widow...but I am on a very minimal dose of simvastatin. Despite a zero calcium scan at age 64, my lp(a) is double normal and have two other cardiac risk factors (hypertension and sleep apnea). Unexpectedly, I experienced side effects to the water soluble statins (rosuvastatin & pravastatin). Plus, my 101 y/o, 3/4, double normal lp(a) mom has been on simvastatin 10mg for decades and still living at home with assistance. The decision to go on statins incorporates all the risk factors and if possible, other family member's experiences.


Hi Katie! Thanks for your input--it's good to hear from someone taking a statin. Your mom is another great example. My own mother, not so much. When she came to live with me she was on 40mg of Crestor. I took her to my GP and to his credit, he lowered it to 20. On 20mg her LDL was similar to mine. I moved her down to Florida with me (I was there for 3 years; it was a job-related move) and her doctor in Florida wasn't satisfied: he doubled the dose and her LDL dropped to 112. That wasn't good enough for him--in spite of her being 92 years old he was determined to get it under 100. He changed her to Lipitor and her stamina and energy tanked. She could barely take two steps without having to stop and rest. I started giving her CoQ10 but it didn't help. She was supposed to go back to the doctor for more blood work after 3 months but she didn't live that long. She didn't die of heart failure: her digestive system shut down secondary to the flu (in spite of having had a flu shot, which I was told "missed the strain").

Lp(a) doesn't seem to be included in any of my test results. When I've ordered and paid for tests myself I've ordered the "extreme heart health" panel but in spite of including a ton of stuff I can't find Lp(a) or HbA1c in the results.

My blood pressure is okay--the last time my doctor took it it was 120/70 and he said it was "perfect for a grandma". I'd told him my first grandchild is due in August. :D (He has 6 grandkids and one great-grandkid.) In spite of my family history--my father's anyway--I don't have genetic risk factors for coronary artery calcification or disease. I didn't inherit my father's worst genes. He had what my brother says was "malignant high blood pressure". It was controlled by medication his whole life. He went off it once for a while and when his optomologist took his bp during a routine eye exam it was 260/180. He was hospitalized immediately and told he was a "dead man walking". His father, all of his father's brothers (4 of them) and his father's father died at the age of 49 or 50.

I've decided to ask my doctor for a prescription for a calcium scan. My father's medical history should be an adequate justification. If it turns out I do have calcium in my arteries I'll take a statin but I'll ask for a minimal dose. Your response makes me feel better about this decision--thank you!!

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Re: I guess I'll be taking a statin

Postby JudyH » Sun Jul 07, 2019 8:30 pm

I am a 58 year old woman and I have taken a statin since I was 40 years old. I had some side effects of muscle pain for a couple weeks but that went away. My reason was very simple, both my mother and grandmother died of heart attacks at 42 years old. This is not normal but it is my story. I only discovered in the last year about my e3/e4 status. I suspect my mother and her mother might have been e4/e4's but I will never know.

I am still gathering information on this e3/e4 journey and am still researching and considering whether or not taking a statin is the best choice for me and also if I am on the best choice of statin. I know I have lived 16 years longer than any woman in my family so that is a positive and this is something I will put a lot of effort into studying as I make my decision!

For me, there were some other factors, after reading the primer, that seemed like higher priority for me. My A1C, fasting glucose and triglycerides were all just reaching the pre-diabetic limits. I made a couple of changes since January (reducing added sugar and increasing the length of my fast) and the results have been pretty dramatic and encouraging. A1C and fasting glucose now in the normal range again and triglycerides dropped from over 300 to 160 range. Plus the bonus of 11 lbs and 3 inches from my waist gone! Still a work in progress but this is where I am going to focus my effort at this time. Improving my diet and getting my insulin resistance in check.

A lot of words but no real answers for you! e4's have a greater risk of heart disease, stroke and AD so I don't think it is as easy of an answer for most people as it is for me. I need to reduce my cardiac risk but now I know I need to balance that with my AD risk too. Nothing I have read makes me jump to eliminate my statin today but instead it is something I need to discuss with my GP and cardiologist.
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No family history of AD, they drop dead of heart attacks in their early 40's!
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Re: I guess I'll be taking a statin

Postby WhatNext » Mon Jul 08, 2019 7:33 am

Hi JudyH,

Thanks for your input. If there's one thing I've learned from this forum it's that each of us is on our own journey. We share one or two copies of APOE4 but it's just one gene and we have to figure out the best strategy to reduce our risk given everything else in our genome. I'm homozygous for a gene that may be worse than being APOE3/4: it's associated with a reduction in activity of the melatonin receptors that tell the brain it's time to sleep. Stavia listed 12 basic risk reduction strategies in her primer and sleep is one of them. If I had to point to one thing I need to focus on it's sleep, and one of the possible side-effects of statins is difficulty sleeping.

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Re: I guess I'll be taking a statin

Postby floramaria » Mon Jul 08, 2019 11:46 am

WhatNext wrote: I'm homozygous for a gene that may be worse than being APOE3/4: it's associated with a reduction in activity of the melatonin receptors that tell the brain it's time to sleep. Stavia listed 12 basic risk reduction strategies in her primer and sleep is one of them. If I had to point to one thing I need to focus on it's sleep, and one of the possible side-effects of statins is difficulty sleeping.
WhatNext


Hi WhatNext, what gene is it that is related to reduced activity of melatonin receptors? Are you taking supplemental melatonin?
I ask because, like you, I am focused on improving my sleep, which seems to be the weak link in my health chain.
Thanks!

And just a reminder: if you are replying directly to someone and want to be sure that person is notified, use the quote function. You can read about that and other helpful tips in How-To Get the Most out of the ApoE4.info website
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Re: I guess I'll be taking a statin

Postby WhatNext » Mon Jul 08, 2019 11:56 am

floramaria wrote:And just a reminder: if you are replying directly to someone and want to be sure that person is notified, use the quote function. You can read about that and other helpful tips in How-To Get the Most out of the ApoE4.info website

Thanks for the tip Floramaria; I hadn't thought to use the quote function just so someone would know I'd replied to their post.

I'll have to get back to you on the gene. I got the result when I uploaded my 23&me data to "Find My Fitness" (or something like that). The result wasn't in my Promethease report and I don't have the information on my computer.


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