Staying as young as possible comes down to one word: prevention. So many times a physician prescribes a medicine to treat a patient for a problem but does not adequately emphasize what the patient should personally do to fight against the cause of the problem. The prevention aspect for good health gets overlooked or minimized. A patient is placed on a certain medication and thinks that is all he or she has to do to keep the arteries clean. This is especially true when someone is placed on a cholesterol-lowering medication. Patients think everything is okay if they take the medicine and their cholesterol numbers are in normal range the next time they have their blood drawn.
According to the National Center for Health Statistics, about one in four Americans over the age of forty-five takes a cholesterol-lowering drug. And the use of statins among people older than forty-five has increased tenfold in the past two decades. Doctors currently write 255 million prescriptions for cholesterol-lowering drugs each year. Although your doctor should be the one to decide whether you should take such a drug, many without heart disease are taking statins or similar drugs for preventive purposes. Some reports have shown, however, a nearly 50 percent increase in diabetes among longtime statin users. There are ways to cut the risks of a heart attack other than medication. Weight loss and exercise are by far safer than taking a pill for the rest of your life.
It is disheartening to hear about patients who have a problem with their cholesterol, or have had surgery on their heart arteries, or have had a stent placed, who think the solution to their problem is a prescribed drug. Prevention may be discussed by the doctor, but somehow the patient doesn’t realize prevention is the one thing he or she has control over. Nine out of ten don’t even begin changing their lifestyle to prevent the problem from worsening. Most simply take the medicine and continue on with life as they have always lived it.
Not too many months ago a gentleman told me an unbelievable story about a massive heart attack he had two years earlier, when he was in his midfifties. He felt chest pain and was rushed to the hospital in a small town before being air lifted to a city hospital a hundred miles away. He had two blockages in his heart arteries, and doctors immediately attempted to place a stent into each of the blockages. There was some type of complication after the initial stent had been inserted, however, and the remainder of the procedure had to be aborted. The remaining artery was left with a 70 percent blockage. He was already on medication for his blood pressure and was told after the stent was placed that his blood sugar was borderline high and his cholesterol was elevated. He was given medication for his cholesterol and blood pressure.
I asked him what instructions he received about changing his lifestyle after the procedure was completed and he was stable. “I knew I was overweight, and they may have said something about my weight,” he told me. He had a sense of excitement in giving me the details he remembered. “But their main focus was on avoiding sodium in my diet. So for the past two years, the main thing my wife and I have constantly focused on has been the amount of salt I eat.”
I explained the basis of the Prescription for Life plan to him. (I think it scared him some to hear the truth about where he was heading unless he did something about it.) Then in about a half hour, he committed to a completely new lifestyle. “I want to be around for my children and my future grandchildren,” he said. He had a solemn look on his face. Then he began a half smile. “I like the idea that at fifty-five years of age I can completely assure myself that I am not going to end my life with a heart attack.”
He finally understood that an alarm had gone off so loudly that he had to do something about his own fate.
He was onboard.
His mind was set.
In follow-up, he had lost most of his excess weight, had developed a completely different style of eating, and was exercising. He now takes a lower dose of his cholesterol medicine, and his blood pressure is in normal range. He is another example of someone who simply did not know what he should be doing. Now that he is informed, he is committed and making a difference he will appreciate the rest of his life.
So whether you are talking about taking extra medication or avoiding sodium, keep in mind the importance of a lifestyle change in addition to your treatment. Lifestyle change is the key to prevention.
A pill alone is far from the answer. I remember seeing a scale used to weigh medication to the exact milligram. Two trays were suspended, one on each side of the middle support. The pharmacist would place an exact metal weight on one tray and pour the powdered medication onto the opposite tray until the needle moved exactly to the middle of the scale and both sides were equal.
Some of the things people do thinking they are promoting good health is similar to placing one ounce of truth on one side of the scale and a hundred-pound bag of medical reality on the other. They equate the ounce of prevention they are doing with the hundred pounds of medical significance, things they are not doing. They think their action is in equal proportion to the total overall care of the body. Their ounces consist of eating “lean” beef, “low-fat” cheese, and grass-fed meat, taking daily multivitamins, and the list goes on and on. All of these choices may be “good,” but they weigh ounces on one side of the scale in comparison to the pounds of lifestyle change benefits that are so much more significant to their overall health.
The worst trick you can play on yourself is to believe you are doing something significant to protect your health when at the same time you are doing tenfold harm to your body without realizing it. The basic problem with so many of your “be good to myself” implementations is that you are giving yourself a false sense of security. You think you are hunting elephants, but in reality you are only killing gnats.
Numerous people, by their own decision, take an aspirin a day, thinking they are doing something exceedingly important in preventing a heart attack. An aspirin indeed does thin the blood. And if you had those LDL Cholesterol splinters floating around and some got into the wall of your artery and caused your body to respond by declaring battle—and that battle resulted in some bleeding and the wall of that artery burst open and a clot started forming within the lumen of your artery in your heart—aspirin could indeed interfere with the clotting mechanism and prevent that clot from completely plugging off the blood flow in the artery.
The fallacy is that all the while you are taking the aspirin, you are doing nothing for the real basic problem of allowing LDL to enter your arteries. Aspirin is the hypocrite heart attack preventer. There should be loudspeakers shouting this reality every time someone takes an aspirin in an effort to prevent a heart attack. The bullhorn should be directed right into the ears of the individual, reminding him or her to prevent the problem in the first place, to not eat the foods that cause LDL to increase, to get to an ideal weight, and to exercise every day.
Nearly a third of middle-aged Americans regularly take a baby aspirin in hopes of preventing a heart attack or stroke. But some doctors report that they are stopping a lot more patients from taking aspirin than they are starting. A recent article in the medical journal Archives of Internal Medicine reports on a study of more than one hundred thousand people who had never had a heart attack or stroke. They were given either aspirin or a nonaspirin placebo. Researchers found that the overall risk of dying prematurely is the same with both groups. The aspirin takers are 10 percent less likely to have any type of heart event but were 30 percent more likely to have a serious gastrointestinal bleeding event, a side effect of frequent aspirin use.
In other words, the study concluded that in people without a previous heart attack or stroke, the regular use of aspirin may be more harmful than beneficial. If you haven’t had a heart attack or don’t have any of the precursors of heart disease, ask your doctor whether or not you should be taking aspirin.
But here’s the point in all this. It is my belief that any doctor who instructs you to take aspirin to prevent a clot from forming in the battlefield should also tell you how to prevent the battle. If you need to take aspirin, you should definitely establish strategies for preventing a heart attack. If you are not living the proper lifestyle, and only taking the aspirin, you are going bear hunting with a switch. You are giving yourself a false sense of security. If you develop the lifestyle of eating properly to keep your LDL down, exercising to get your HDL up, and eliminating any excess fat from your body that also causes your LDL to be elevated, you are preventing the problem that leads to the clotting to begin with. Focus on preventing the source of the problem.
If your doctor recommends you take an aspirin, by all means take it. But now you also know the importance of developing the proper lifestyle in addition to taking the aspirin.
Don’t ever fool yourself into a false sense of security. Even if you are placed on a medicine to lower your cholesterol, or treat your diabetes, or lower your blood pressure, that pill alone is not the complete answer.
I was eating lunch when I received a phone call asking if I could come to a friend’s office right then and check his assistant, Mary. She was fifty-eight years old. Three days earlier, her physician had told her she had high cholesterol and gave her a prescription for medication to help bring it down. Twenty-five minutes before I was called, she had taken the first dose of the medicine. Her face quickly flushed with little white splotches, she started breathing rapidly, she became afraid she was going to pass out, and her hands turned red except the tips of her fingers, which blanched as white as snow. Mary was scared. I got in my car and drove the three minutes to her office and examined her. Her pulse was normal, her blood pressure was okay, and everything checked out within normal limits except for the flushing. She had calmed down and was now only upset with her doctor for giving her medicine that scared her to death. I explained that the medication she had just taken occasionally had such side effects. “I will never take it again,” was her reply. That opened up an opportunity for me to ask her some practical medical questions.
“Mary, what did your physician instruct you to do in addition to taking the medication to gain control of your cholesterol?” She responded by pulling out the instruction sheet her doctor had given her. It read: “Go on a low-fat diet and take the following medication.” That led to my next question: “Do you have the drug company information paper that came with the medicine?”
“I remember a folded paper came with it,” she said, “but I didn’t read it because it looked too medical for me to understand.” She looked at me with a blank stare, her face still flushed.
I explained that the instruction sheet for cholesterol-lowering medicines begins with a statement that such medicine is indicated if—if—eating properly, obtaining the proper weight, and exercising have not been successful in getting the cholesterol to a normal range.
Mary’s doctor only handed her a piece of paper with two sentences written on it. He didn’t stress the need to get her twenty-five excess pounds off. He didn’t tell her she needed to join the health club and exercise five days a week. If he had told her to join a club, she would have told him what she told me: she had joined a club almost a year ago. Her definition of exercise consisted of walking their indoor track for twenty minutes at a time. But after the first month, she had not exercised at all—not even the walking.
I told Mary she could get her cholesterol level to normal by controlling what she ate, exercising, and getting her body weight to ideal. I explained what foods she needed to avoid, discussed losing her excess weight, and made her promise to start back at the exercise club beginning that day. Then I asked her to let her doctor know what her plan was and make sure he agreed, which I was certain he would.
I finished by asking Mary a simple question: “Will you commit to begin this new lifestyle to control your health?” I asked her that straight out because I knew she was the type who would honor a commitment to herself. Mary assured me she would.
But prevention won’t happen if there is no commitment.