New 2013 cholesterol guidelines

Sometimes it may be the binge eating you had before your medical exam. Other times it may be the dietary recommendations that eating chicken and fish are healthier than red meat. Any animal-source food has cholesterol. According to the Center of Disease Control, 71 million Americans or 1 in 3 have high LDL or bad cholesterol levels. LDL cholesterol is associated with lining arteries with plaque that may lead to organ damage, particularly leading to heart attacks and strokes. For some people, it is dietary, and is easily controlled. For others, these may be familial, chronic conditions. There’s no wonder why cholesterol management is a big topic and essential indicator examined on general blood tests. When the American Heart Association announces new guidelines for cholesterol management, doctors listen. The new report promotes high statin dosage to control high LDL levels.

A group of researchers from the American College of Cardiology and the American Heart Association put their weight on new cholesterol management guidelines. Their emphasis is to increase statin treatments to more people who might be at risk of having a heart attack. The origin of these reports were designed to effectively care for those who already had some level of a cardiovascular episode.

As with all cases, the panel took a traditional approach. As with all patients, they emphasized lifestyle guidelines (i.e., adhering to a heart healthy diet, regular exercise
habits, avoidance of tobacco products, and maintenance of a healthy weight). They cited that use of one of the 4 statin groups would help those who can’t manage to keep their LDL at a normal range. They did not discuss HDL/LDL ratios.

Establishing a target range under real circumstances still remains vague but they deemed that an LDL-C of 190 is considered threatening.

The new guideline recommends moderate- or high-intensity statin therapy for these four groups:

1) Patients who have cardiovascular disease;
2) Patients with an LDL, or “bad” cholesterol level of 190 mg/dL or higher;
3) Patients with Type 2 diabetes who are between 40 and 75 years of age
4)Patients with an estimated 10-year risk of cardiovascular disease of 7.5 percent or higher who are between 40 and 75 years of age (the report provides formulas for calculating 10-year risk).

Chronic use of statins may have negative effects on neuromuscular systems, particularly peripheral myopathies. While Cleveland University research cites that 72.5% of statin-intolerant patients may be treated with statins. There are those that have diseases like muscular dystrophy or multiple sclerosis for which statin use may be almost fatal. Recommendations of high stain dosages may be more dangerous holistically than cardiology specialists realize.

For example, many people suffer from rheumatism and fibromyalgia. These involve muscle pains, affecting over 10 million people, that have no succinct etiology to infer causality and results. There is little data to support that high-dose statins may induce more extreme pain or inflammation. While cholesterol management is vital, average cardiologists may not take these other common diseases into consideration when prescribing statin drugs.

Specialists that read these guidelines may take easier approaches at high-dosing statins to force cholesterol management to those that may not need it. The November 2013 guidelines of the American College of Cardiologists and the American Heart Association seems to sanction this. Most cardiologists adhere to the average and this report definitely targets the average. Patients are then forced to seek out cardiologists that see patients as individuals instead of group numbers. Groupings are attractive at writing presentations. Patients as clients require more specific attention.

Yet statins are touted well beyond cholesterol management with research demonstrating efficacy in treating cancer and other diseases. It’s as if all the leading drug companies that produce cholesterol are behind all the experiments. In some respects, companies like Merck and Pfizer are using cardiologists as drug pushers, especially when two major heart organizations sanction high dosages of statin medications to help lower LDL cholesterol.

I have genetic cholesterol and management requires an almost vegan diet along with exercise. Because of a form of muscular dystrophy, all statins have been proven toxic. I use Source Natural Cholesterol Complex on a daily basis, along with non-statin prescription Zetia and Lopid. Policosanol is a key ingredient in my supplement mix and policosanol research shows that 20mg can help reduce LDL cholesterol by nearly 30%. For people that suffer from statin intolerance, statins are not the conclusive treatment.

Cholesterol is only one of many indicators that may lead to heart disease. Relying on statins to lower LDL cholesterol levels may be great for many people. For those that exhibit statin intolerance, there are other routes and physicians should understand and study these.

Sifting through this 80 page document from November, it’s a rather unimpressive work and further extends that the two leading organizations continue to fail at examining holistic approaches to cholesterol management. Cholesterol levels correlate differently with age and this report didn’t cover that well. As people rise over 70, 190 to 200 LDL is more tolerable than that of a 25 year old.

Prescribing high intensity statins as a rule instead of an exception, may actually harm some patients in those groups due to side-effects. The fervent faith in statins for cholesterol management that seems to be shared by traditional cardiologists may be taking cardiovascular care in wrong directions. There must be more exploration into alternative approaches that place responsibilities on both doctor and patient.

Finding a reasonable target that I can maintain without statins is my goal. In the overall wellness mix, I prefer to be in control. Control requires an active goal-oriented approach. That control persists between routine visits to my practitioner.

Patients, as drug consumers, will accept statins and will likely not report intolerances. While statins for lowering cholesterol may be beneficial, the overall goal is to help patients (as clients) pursue healthy lifestyles and feel well. On the patient’s side, you must be willing to take necessary drug-free steps to improve your heart and cardiovascular health. Ultimately your health is your responsibility!

As to the new stricter standards proposed by the ACC and AHA regarding cholesterol borderlines and statin medications, everything and anything is subject to change. Each year new studies and interventions lead to new perspectives of how to approach cardiovascular conditions. The ACC and AHA are traditionalists and are likely to follow Statins as a holy sword. Statins are not exclusive. Seek out other options and, if possible, find integrative health centers that offer more holistic and educational approaches to help resolve what may be a chronic condition. There are lifestyle choices that can help you manage your LDL cholesterol levels.

WHIPS or Walk Helping Instruments and Power Scooters

Whips often bring negative and uncommon associations to mind. WHIPS as in Walk Helping Instruments and Power Scooters are necessary devices for those with impaired walking and mobility. Use of WHIPS such as canes, walkers, crutches, braces, wheelchairs and powered scooters are becoming more prevalent and help the mobile-handicapped preserve some degree of independence. For those with ambulatory challenges, the use of WHIPS may be perceived as a negative milestone. Whether temporary or permanent, WHIPS help mobilize the otherwise immobile.

In 2011, according to Cornell University statistics, 5.8% of males and 8% of females, not institutionalized, in the United States have some form of ambulatory disability. Some States have over 10% ambulatory disability statistics. The percentage of non-institutionalized, females and males, with a ambulatory disability, ages 16-64, all races, regardless of ethnicity, with all education levels in the United States who were employed in 2011 is about 24%.

At a recent Myotonic Dystrophy support group meeting I attended, many complained of balance issues when standing or walking, slow mobility, and fear of tripping or falling. Myotonic Dystrophy is a form of Muscular Dystrophy, a genetic transmitted disease, that involves the destruction and wasting of muscles throughout the body. The disease, made popular in the USA be decades of Jerry Lewis televise telethons, currently has no treatment or cure.

I have Myotonic Dystrophy. While I might have had it since birth, most symptoms became evident in the past 5 years, though I was officially diagnosed in 2011, by genetic testing. I really appreciate and mourn the inability to walk distances, skate, bike, and a whole group of things that are now past tense. Even at my less than 1 mile per hour walk, I feel potential tip-overs to left, right, and rear. My steps are very deliberate with a constant fear of falling. As such, I added more supportive shoes and use of a cane. They offered little help. Adding prescribe therapeutic braces helped restore some walking ability. I haven’t been able to use subways for over two years. I definitely rely on WHIPS and, even with those, basic movements are often challenging. Without those WHIPS, home confinement is more likely.

Yet, at that Myotonic Dystrophy support group, many people did not use canes, wore regular sneakers, and didn’t wear supportive socks. Those that did have canes or walkers had the wrong sizes. When it comes to WHIPS, few people have access to proper information regarding proper support specifications. As a cane user with a background in research, I’m now more aware of other cane and walker users. I see the inadequacies of selected WHIPS among some and the denial of using WHIPS by others. While there are different degrees of Myotonic Muscular Dystrophy, proper WHIPS are very important.

Choosing a proper, supportive cane was an educational experience. The HurryCane is a popular cane advertised on TV. It allows one to stand the cane temporarily for certain conveniences, such as swiping a credit card at the counter or near a bench. Canes can be cumbersome when shopping or sitting in public places. I ordered one and found the cane too short for support and its adjustability was too flimsy to rely on. If you’re up to 5’9″ tall and weigh under 170 pounds, the HurryCane might be adequate. I saw too many taller and bigger people bending down to use that cane and say the cane bending with their weight. A probable accident seemed evident with continued use, especially if this is to be your personal partner for support.

The generally accepted rule for proper cane size is half your height in inches. If you are 5 feet, you are 60 inches. If you are 6 feet, you are 72 inches. I’m 74 inches and most of the sold canes were up to 36 inches. There are many online cane retailers. After lots of research, I found Fashionable Canes as a great source and resource. They offer a wide variety of styles, sizes, accessories, and tips for proper sizing. I was able to get a 37-inch wood cane that fit my height comfortably so I can walk straighter.

Weight capacity is also an issue. If you weigh 180 to 200 pounds, your cane needs to have a 250 pound capacity. You often lean down on the cane for additional support. This level of inertia adds weight on the cane, sometimes as much as 50 pounds. To assure adequate support with integrity, seek a cane that supports at least more than 40 pounds of your body weight.

While Amazon offers many cane styles and sizes, I found their specifications somewhat inaccurate. If you’re a Prime member, delivery and return privileges are rapid and liberal. But the Fashionable Cane online store, physically located in Florida, is extremely accurate and the customer service is very helpful.

One of the unexpected cane features I found at Fashionable Cane is the cane tip. The tip of the cane is very important since it meets the walking path of varied surfaces. Most canes have soft, smooth tips. Fashionable Cane tips use steel supported rubber with circular treads, providing better traction than most tips. Among accessory tips that they offer, you’ll find among the selection that deliver support like the HurryCane (quad-tip) and for walking on snowy surfaces.

Vista offers a wide variety of canes found in shoe and shoe repair stores. They are also premium WHIPS but generally are around 36 inches in height for most canes. Seek them out if you are 68 to 72 inches tall and prefer to buy one at a local provider.

Another popular instrument in the WHIPS category is the medical walker and these are very popular among women. For the most part, these are used by people around 60 to 65 inches tall, though some models adjust to 72 to 75 inches high. These permit broader walking support, especially for those suffering from osteoporosis, a crippling bone disease. These often have seats and storage available. Height is a problem here too as chronic users may develop a bent-over posture due to recalibration of the spinal vertebrae. I’ve seen some people with muscular dystrophy using these and some have already developed a hunchback appearance. Proper height and weight support are key issues here and often overlooked by providers and consumers, when considering chronic use.

Another extension of the WHIPS category are powered scooters and wheelchairs. These battery powered mobile assistive vehicles have been growing in popularity. They can greatly extend mobility range and can offer independence for advanced cases of immobility.

Most powered scooters are designed to fit on public transportation devices to help save battery power (usually up to 10 miles while carrying a 170 pound load).

I had considered this option in my earlier stages of ambulatory challenge but observed some restrictions in door entry of various stores without automated doors. I was thinking of using this as a vehicle to be able to enjoy use of nearby parks, though I haven’t seen too many in parks. The reason is these battery power devices offer minimal torque for uphill and downhill use. The convenient 3-wheel scooters may tip on the uneven leveling of paved park paths.

The EMS-48 Adult Scooter would have been perfect for use in the park but is too large for use in public transportation. At speeds up to 20 miles per hour and a huge up to 45 mile range on a battery charge, this would seem perfect. It’s like a supportive electric moped. Unfortunately, that distinction makes it illegal for use in city parks.

Mobile challenges aren’t just targeted at older people, though it seems that way. I do see people older and younger than me making use of WHIPS. Being mobility challenged is disabling in many ways, shapes and forms. Using WHIPS may help make existence more palatable. There are, as in life, benefits and consequences. The biggest consequence is the challenge and often the challenge seems insurmountable.

Elizabeth Kubler-Ross is a prominent psychologist that studied patients who were dying. She came up with the DABDA process that all patients went through. The DADA process involves Denial, Anger, Bargaining, Depression, and Acceptance. I observed in my neurocognitive research that this also applies to those that find challenges in overcoming other diseases, though most remain stuck in Denial.

Muscular Dystrophy, Multiple Sclerosis, Arthritis, Osteoporosis, Cerebral Palsy are diseases that can severely immobilize and affect perceptions and choices of “I can” and “I can’t”. It feels like an invisible whip striking deep to the core of being. Fortunately, with medical guidance, family support, and the responsible use of the right WHIPS, people can accept their plights and make life appear less challenging in contrast to definitions of normality. Proper WHIPS help bring redefinition and acceptance to feel better against the odds you encounter each day.