I’ve just come back from the doctor after a 7 minute consultation regarding my annual blood test.
I’m so mad I feel like punching the living crap out of my son’s comfort cushion, Kevin (yes he has a name for it!).
Why am I mad? Because I feel ripped off, short changed and generally taken for a ride.
Here’s the doctor/me conversation:
D: David your LDL level of ‘bad cholesterol’ is higher than the accepted limits.
D: This is a function of your diet and exercise.
D: We need to bring this level down, as it’s a major predictor of heart disease.
D: Yes indeed, it can also be treated by drugs which are a safe alternative.
Me thinking: Safer than diet and exercise?
D: Have you thought about this as a treatment before?
D: Well perhaps you should.
It was right about this time when I was suddenly morphed back to a conversation I had last week with one of those animated curbside charity workers enticing me to sponsor a starving kid in Africa. I was sympathetic to the cause but at the end of the day I just wanted to run the hell away.
Me: Can I just back up and ask, is my LDL level, which concerns you, a measure of LDL-C or LDL-P?
The doctor now pulls a face akin to me farting in her consulting room.
D: What do you mean?
Me: Well, as you know LDL can be further analysed into ‘C’ (the amount of cholesterol attached to the LDL molecule) and ‘P’ (the number and size of LDL particles found in the blood) and it’s my understanding that the ‘P’, in particular, the prevalence of small dense particles in the blood is a better predictor of a cardiac event.
More fart-response type expression from the doctor.
It’s pertinent at this point to understand that I was trying really hard not to be a smart arse – but I concede that she probably saw me as one.
D: No, I’m just taking about your cholesterol level.
Me: OK. But what about my HDL level? (my ‘good cholesterol’).
D: It’s high (which is a good thing).
Me: Is that not also a better predictor of heart attacks?
D: Yes, but one doesn’t cancel the other…..
Me: If high cholesterol is ‘bad’ why is it that most who suffer a cardiac event have low to medium levels? Or why is it that vegans still get heart disease?
At this point in the conversation I started to think of an exit strategy (no doubt the doctor was also) so I kindly thanked her for her insight and paid the receptionist $65.
Driving back home I reflected on my consultation experience and concluded that 90% of the conversation was based on ‘conventional medical wisdom’. Wisdom which is now being seriously questioned by epidemiologists, medical researchers and cardiologists world-wide. Wisdom which is running out of steam because it just doesn’t add up anymore. Wisdom based on flawed logic postulated almost 50 years ago.
Consider the fact that it took almost 50 years before Governments imposed regulatory restrictions on the sale of tobacco after it was first proven to cause lung cancer. But I digress.
Here’s the current cholesterol mantra:
Cholesterol is ‘bad’ for us.
High cholesterol causes heart attacks.
Our arteries ‘clog’ by eating foods containing cholesterol (animal meat, milk, cheese, eggs etc).
Taking statin drugs are safe and they will decrease your heart attack risk.
LDL (low density lipoprotein) is an accurate measure of heart attack risk.
Now, I’m not about to begin a long dissertation against conventional wisdom. But you can see it HERE as a start.
Here’s the thing: Why do I know that the supposedly ‘strong link’ between cholesterol and heart disease is now under fire and indeed crumbling?
Why do I know that LDL is proven to be a weak measure of heart attack risk?
And why do I know that statin drugs are by no means a ‘get out of jail’ for heart attack mortality?
Or is it that the good doctor is not allowed to discuss these alternative theories on heart attack risk and how to treat it.
Perhaps they are frightened by being dis-barred from their respective medical association for ‘speaking out’.
The American Heart Association first postulated in 1961 that a diet high in saturated fat (and by default cholesterol, mainly from animal meat and dairy sources) is linked to a higher risk of heart attacks. As a consequence the push towards a diet high in grains (carbohydrates) was seen as a prevention strategy. The AMA still, to this day, vehemently opposes the high-fat diet – and has been very successful in preaching its dangers to a compliant population. This is despite the fact that heart attacks, diabetes and obesity is rising in America (and around the world for that matter) to unprecedented levels.
And this still seems to be the accepted view taught in med school, if the amount of MD’s speaking out about their lack of proper nutritional intern training is anything to go by.
When I walk into my doctor’s office I want them to be ‘up’ on the subject of heart disease – for God sake, it’s the number one killer of Australian adults with 1 person dying every 10 minutes!
I want medical practitioners on the front line to know the latest research. I want to have the conversation which is CHALLENGING conventional wisdom.
I don’t want the party line.
But many people believe it, and I often think about those who are susceptible to a heart attack being given bad advice by people they trust. Bad advice which is accelerating their heart attack risk rather than preventing it.
I call it white coat syndrome. Believing rather than questioning.
My advice: Read up yourself. Challenge conventional wisdom with your clinician. Make a list and have them answer your questions.
God forbid your life may depend on it.