This time, it’s personal:
How could any doctor in his/her right mind write such a prescription for an 86 year old, totally paralyzed man who has normal cholesterol? Even one who has elevated cholesterol? After about age 50, the higher the cholesterol, the greater the longevity. So, again, why would anyone write a prescription for a non-benign drug to an elderly patient? Plus, the chance for rhabdomyolysis is greater in the elderly who take statins as well as those who are taking a ton of other drugs, as is my dad. It’s a set up for disaster with no potential upside to balance the risk. It is blind stupidity to prescribe a statin under these circumstances.
And not just any old statin. The script was for a large dose of Lipitor, a fat-soluble statin. Fat soluble statins are much more likely to be involved in drug interactions, and they can induce insulin resistance and possibly cause diabetes. If you’re going to give an unnecessary drug, why wouldn’t you at least give one with the fewest side effects?
As I’ve noted in the past, I think that nutritional witch-doctory killed my own father a third of a century ago.
[Update a few minutes later]
A debate on the science of statins.
I’ve had a lot of experience with Statins and their side effects via my family.
My mother, two of her siblings, and my Great Uncle, experienced severe side effects; episodes of severe mental foggyness, memory issues, and muscle wasting. The mental effects were so bad in my Uncle that his doctor thought it was Alzheimers. The onset timing coincided with the start of taking statins, though it varied a bit from person to person.
Once they stopped taking the Statins, the effects (except for my great uncle) ceased entirely within two weeks (except for the muscle loss). For my great uncle (who ceased Statins about a decade ago), the symptoms drastically diminished, but it took several years before they were largely gone – and he still has a slight occasional impairment.
As for doctors… I suspect that this mania of “Statins for everyone” might not be entirely their fault. Here’s why; I had an appointment with my doctor a few weeks ago. He pronounced my blood work as “mostly excellent”. The one exception was my cholesterol; I have an LDL of 115 (The lab reference range states under 120 as normal) and an HDL 0f 68 (considered an excellent ratio). However, he said that the new guidelines said I needed to be under 100 LDL. I raised the issue of side effects and my family history, but he was adamant that that didn’t matter (Family history isn’t proven to be a factor) and that due to my “above the recommended range” of LDL, he had “No choice but to put me on statins”. (I’m 38)
However, what’s important here is the words he used. “I have no choice but to put you on statins”. Even though I was saying “No”, he was writing out the prescription form.
He looked up, our eyes met, and I’m guessing he could see that I was I was furious, and about to blast him out at full volume. He blinked, and said, “But I could give you six months to get it down by diet changes and exercise” and before he’d finished that sentence, he’d wadded up the script and tossed it in the trash. He then mumbled, “But if your next test is high, I’ll have to start you on statins”. My reply was a quiet but firm, “I won’t be.” His response was, again, a very quiet, almost mumbled, “Sorry, but I don’t have a choice.” meaning he was the one with no choice (though also implying that I had no choice either!).
There are many things I should have said. I should have bought up the issue of informed consent: Nobody has to follow a doctor’s orders if they disagree, and that very much applies to taking medications. He can write all the scripts he likes; I don’t have to use them.
The point here is; what are the reasons why doctors are pushing statins so hard? Are they under strict rules of some sort, or is this perhaps due to liability issues? I’d like to know.
I have no personal or family history of heart trouble (well, no family history under age 80, anyway) and am fit and very active. So, I see no reason for me to go on Statins, and loads of reasons not to.
Side note; the bad mental side effects of statins have been controversial for years, but weren’t in the prescribing info as possible side effects until this year. Most doctors still don’t know that they are in there.
I’m quite sure they are under strict rules. If they don’t sell enough statins to suit the drug company, they don’t get their kickback.
A follow up to my above post and Rand’s update;
Here’s a post from the comments that touches on an issue I raised; are doctors under pressure to prescribe statins, and if so, by whom and why.
“I work in cardiothoracic surgery in a teaching institution. i want to d/c many orders i see for statins but am told that we put ourselves and the hospital at risk of malpractice suits if we send a pt home without an order for a statin. Where do these protocols come from!!?”
I’m only speculating, but it could be they’re practicing defensive medicine on the orders of their malpractice insurance company. Just as often as you see those “1-800-BAD-DRUG” commercials by law firms trolling for class action lawsuit patients against drug companies, you’ll likely find them looking for cases of people who suffered heart attacks and weren’t prescribed those drugs, thereby proving the doctor was guilty of malpractice.