So your doctor won't agree that you have heart disease but you need to be on a statin but statins are by prescription only... So if you're not going to hire an expensive doctor what can a normal person actually do?
Ticker: Don't die of heart disease
291–300 of 501 posts
Re: Ticker: Don't die of heart disease
#292[dead]
Re: Ticker: Don't die of heart disease
#293> I experienced this repeatedly. We were admitted to the hospital for over a week when my daughter contracted viral meningitis (the scariest experience of my life). Even while working with incredible infectious disease doctors, I still had to fight and constantly remind people what the next steps were during our admission. Nobody is watching over you - it’s your job to organize things and ensure they’re on track. I h…
I think you really pretty fundamentally missed the point of what he's saying. Perhaps you've never had to confront the full brunt of the bureaucracy of a large-scale medical provider. If you've got a serious condition, you really do need to have a patient advocate, whether that's yourself or a family member or someone you're paying to fulfill the role or some combination thereof. The medical systems I've encountered…
I don't know, maybe it's just me seeing things differently.
I always thought that you got to choose wisely people that you need their expertise, especially in healthcare, but once you picked one hospital you got to commit and let them do their job.
I understand it's not easy when you are in charge of a 9 month old but you got to suffer through that.
If someone was to go so wrong that even an untrained eye could see, it's different.
Maybe I didn't have my fair share of bureaucracy. Maybe my standard are too low.
I sure did have my fair share of mistake when I went to emergencies, undiagnosed broken bones for instance. I never thought a second about requiring 'better' doctors, more competent nurses or more attention. I just accepted that it's thing that happens and nothing is perfect. Went back to the hospital 2 more times and eventually got everything back in order.
Re: Ticker: Don't die of heart disease
#294I’m sensing a potentially significant misallocation of resources. My mental model is that there’s a hypothetical quantification of not just your time and money, but your anxiety, attention bandwidth, mental energy, etc. I think, in some ways, the trick is being able to short circuit the entire journey represented by this website in favour of some form of, “I’m 40. I should be more mindful of heart disease. I should a…
Seriously there is too much shit to worry about to micro manage each facet, unless your like a Bryan Johnson billionaire with a staff. Beyond just heart disease & cancer taking you out entirely its: my eyesight is going, my hearing, every joint in my body could fail, my brain is slowing, etc. There is just way too much shit to do anything other than be like: sleep, exercise, eat better and don't drink too much.
And even him doesn’t know what’s working and what’s making things worse. He claims to have really good biomarkers but that’s when cherry-picking numbers from studies made in a range of more than two years (!!).
You’ll never see a published set of tests from him. What you’ll see is ads to buy his supplements.
Re: Ticker: Don't die of heart disease
#295[deleted]
Re: Ticker: Don't die of heart disease
#296Earlier quoted context omitted.
I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…
> Sure, it is absolutely true that better lifestyle and diet has a huge effect. not for me. My cholesterol was hovering in the high 200's, then finally hit 300 and I completely freaked out, radically changed my diet, and lost 22 pounds (from 180 to 158). What did my high cholesterol do ? It did absolutely nothing. ticked down to like, 280. So I'm on the statins. my total cholesterol went from high 200's to about 150…
> My cardiologist tells me that the conventional wisdom of "diet and exercise" is almost entirely disproven to have any meaningful effect on lipids these days (though i havent researched deeply).
I would be immensely skeptical of this unless he was talking about something much more narrow, like how there's a fraction of people who have really unfortunate genetics and can only improve their blood lipids with medication.
We have mountains of data showing that diet can massively improve lipids, and the combination of diet and exercise are our largest levers for reducing the risk of heart disease for most people. (There are always some fraction of people who can do everything right but have outlier genetics that require medication anyway, just as some people have outlier genetics and can smoke a pack a day their whole lives and reach their 90s.)
I'd check out the Barbell Medicine podcast for anything related to the intersection of lifestyle and health. They're extremely evidence based with a preference for measurable improvements in outcomes over hypothetical mechanisms.
Relevant to this thread are their episodes on testing and screening, hypertension / high blood pressure, cholesterol, fiber, and the new PREVENT heart disease risk calculator.
I'd also check out the episodes on diabetes, Alzheimer's, fatty liver disease, and health priorities.
Re: Ticker: Don't die of heart disease
#297I am not a statin skeptic--or rather, I don't want to be a statin skeptic. I've done the research and it makes sense to me, but I still feel some social and psychological pressures to reject statins. When I see that it is widely accepted that ApoB is better to measure than LDL-C, but the industry continues to measure LDL-C, but not ApoB, I wonder why. It makes me skeptical. When I see that the purpose of statins is t…
5mg daily Crestor (a very small dose) cut my ApoB in half from ~130 mg/dL to 61. I’ve had no negative side effects.
Re: Ticker: Don't die of heart disease
#298Earlier quoted context omitted.
I think people should be mindful of it since they were 18 - it's something that progresses over decades. You can have a lot bigger impact making changes when you're young rather than at 40 But yeah I agree with your message. Focus on the big impact macro level things. Hyper-optimizing it is a waste of energy
If I'm not wrong, it takes 20 years to revert the damage of smoking. I don't think you need to care at 18, but the effects will be seen over the course of 20 years
Lots of the damage done can't be undone when it comes to heart diseaese.
Notably risk goes up with the time spent with bad numbers, so the most leverage you have on affecting your lifetime risk is caring as early as possible.
It's an area under the curve situation. Waiting until you start experiencing symptoms is putting a band-aid on an open wound compared to avoiding injury at all by focusing on high impact habits related to diet and exercise.
Focus on adopting the following habits as early as possible: https://www.barbellmedicine.com/blog/where-should-my-priorit...
Re: Ticker: Don't die of heart disease
#299Earlier quoted context omitted.
I think the article makes a valid point: stop worrying about 90% of the other stuff and focus on the thing that will almost certainly kill you - heart disease - for which there are easy diagnostic and preventative measures. I think they're arguing for a better allocation of resources, if anything.
Isn't the global population like 50% obese? What is your actual risk of dying from it if you are relatively in shape and in your 40s?
The most current and up-to-date risk calculator for heart disease risk is the PREVENT score.
https://professional.heart.org/en/guidelines-and-statements/...
Re: Ticker: Don't die of heart disease
#300Earlier quoted context omitted.
I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…
Your health is ultimately your own responsibility - it's your body. You have free will, and your appetite for risk is yours alone. You can choose to ignore expert advice and refuse to wear a seatbelt, skip your rehabilitation exercises, invest all-in on crypto, or smoke cigarettes. None of this responsibility should fall on the expert if they communicated the risks clearly.
What you're communicating here, perhaps unintentionally, is that what matters is not results, but blame. If the doctor said what to do but the patient didn't do it, all that matters is the patient is to blame.
You've communicated that by ignoring or dismissing the question of whether better outcomes are possible through other means than demanding that everyone follow doctors' orders and blaming them if they don't.
"Who cares if better outcomes are possible, so long as blame is in the right place"? Is that how we want to approach this?