Older, No Wiser

why would you need statins for a 141 cholesterol reading? Perhaps I'm
completely off on this but isn't 141 well within the normal range? (I could
only wish for a reading that low)

George
<[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Me: male, 63, 5 /11, 182 lbs, college prof, still teaching, 30 yrs of
swimming, x-country skiing, no smoking or drinking.

May 2003: PCP suggests I lose weight re: METs. Weighing fat grams
carefully, I drop 25 lbs to my present weight of 182.

Since the early 90s, have taken 50 mg Tenormin and .25 mg Lanoxin for
SVT which was effectively controlled.

Dec 2002: PCP adds 10 mg Lipitor with cholesterol at 141. Within two
weeks, after intense abdominal pain, I'm hospitalized with a bleeding
ulcer that heals within 60 days. Lipitor's involvement? "Anomalous."

Aug 2003: adenosine stress test by interventionist cardiologist:
results normal.

Oct 2003: concomitant with weight loss, PVCs increase. PCP switches
me to 100 mg Toprol XL and 2.5 mg Altace and 5 mg Crestor, cholesterol
at 150.

Within a week, abdominal pain returns and I quit the Crestor; it
remits.

Now, on a daily basis: bigeminy such that I need .5 mg lorazepam to
sleep; my daytime activities have been similarly disrupted.

PCP remains "concerned but baffled."

Anyone?

and thanks,
Phil

George - There are several indications for statins, the most common of
which is, simply, hyperlipidemia. You are correct that a total
cholesterol of 141 is well within the desired range, although it may
be that the original poster was talking about LDL rather than total
cholesterol. In addition, there have been several randomized control
trials that show both decreased mortality and reduced incidence of
cardiovascular events in patients on statins INCLUDING those with
mildly elevated or even normal cholesterol levels. These include the
REGRESS study and the CARE trial. In the original poster's case, he
does not report a history of coronary disease, however, and had a
negative stress study. If his TOTAL serum cholesterol is 141, then he
probably would not have significant benefit from statin therapy.

As for the original poster... Lipitor (atorvastatin) does have peptic
ulcers listed as a potential adverse effect, although the incidence
was less than 2% of patients in Phase I-III studies. Crestor
(rosuvastatin) is relatively new, so I don't know the specific
relation between that and peptic ulcers. It sounds like the thing
that is bothering you (the original poster) most is the palpitations.
It isn't clear to me what the cause of that is, although it would help
to see an EKG or a holter and get more history. Electrolyte
imbalances are probably the most common cause. Another possibility is
that if you are on both Toprol and Lanoxin and your heart rate is too
low from excessive AV nodal blocking you may be having lots of
ventricular escape beats. One other thing to note is that statins can
increase serum digoxin levels which can lead to arrythmias. Since it
sounds like you were off the Crestor long before the bigeminy
continued to be a problem, though, I think it would be worthwhile to
see an electrophysiologist. If all or the majority of the PVC's
originate from the same locus, it should be easily ablatable. It is
nearly impossible to make a diagnosis without a more complete history,
a physical, and some basic lab studies including an EKG, but if your
PCP is "baffled," then a referral to a cardiologist is appropriate.
There is no reason for you to have to take daily Ativan (lorazepam) to
help you sleep because of palpitations! Hope that helps.

FMW

"George Prager" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

why would you need statins for a 141 cholesterol reading? Perhaps I'm
completely off on this but isn't 141 well within the normal range? (I could
only wish for a reading that low)

George
<[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Me: male, 63, 5 /11, 182 lbs, college prof, still teaching, 30 yrs of
swimming, x-country skiing, no smoking or drinking.

May 2003: PCP suggests I lose weight re: METs. Weighing fat grams
carefully, I drop 25 lbs to my present weight of 182.

Since the early 90s, have taken 50 mg Tenormin and .25 mg Lanoxin for
SVT which was effectively controlled.

Dec 2002: PCP adds 10 mg Lipitor with cholesterol at 141. Within two
weeks, after intense abdominal pain, I'm hospitalized with a bleeding
ulcer that heals within 60 days. Lipitor's involvement? "Anomalous."

Aug 2003: adenosine stress test by interventionist cardiologist:
results normal.

Oct 2003: concomitant with weight loss, PVCs increase. PCP switches
me to 100 mg Toprol XL and 2.5 mg Altace and 5 mg Crestor, cholesterol
at 150.

Within a week, abdominal pain returns and I quit the Crestor; it
remits.

Now, on a daily basis: bigeminy such that I need .5 mg lorazepam to
sleep; my daytime activities have been similarly disrupted.

PCP remains "concerned but baffled."

Anyone?

and thanks,
Phil

It seems to me I heard somewhere that George Prager wrote in article
<[email hidden]>:

Quoted message said:

why would you need statins for a 141 cholesterol reading? Perhaps I'm
completely off on this but isn't 141 well within the normal range? (I could
only wish for a reading that low)

My cardiologist's answer: with my history of a mild heart attack five
years ago and familial high cholesterol and heart problems, he wanted to
reduce my LDL below the new (?)target of 100. He therefore moved me
from Lipitor 40mg to Lipitor 80mg.

Presumably his answer would be different for a patient with a different
risk profile. Since Phil didn't tell us what his HDL and LDL are, his
issues may not be comparable with mine.

Quoted message said:

<[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Me: male, 63, 5 /11, 182 lbs, college prof, still teaching, 30 yrs of
swimming, x-country skiing, no smoking or drinking.

Quoted message said:

Quoted message said:

Since the early 90s, have taken 50 mg Tenormin and .25 mg Lanoxin for
SVT which was effectively controlled.

Quoted message said:

Quoted message said:

Dec 2002: PCP adds 10 mg Lipitor with cholesterol at 141. Within two
weeks, after intense abdominal pain, I'm hospitalized with a bleeding
ulcer that heals within 60 days. Lipitor's involvement? "Anomalous."

Quoted message said:

Quoted message said:

Aug 2003: adenosine stress test by interventionist cardiologist:
results normal.

Quoted message said:

Quoted message said:

Oct 2003: concomitant with weight loss, PVCs increase. PCP switches
me to 100 mg Toprol XL and 2.5 mg Altace and 5 mg Crestor, cholesterol
at 150.

Quoted message said:

Quoted message said:

Within a week, abdominal pain returns and I quit the Crestor; it
remits.

Quoted message said:

Quoted message said:

Now, on a daily basis: bigeminy such that I need .5 mg lorazepam to
sleep; my daytime activities have been similarly disrupted.

Quoted message said:

Quoted message said:

PCP remains "concerned but baffled."

--
Don
[email hidden]

Quoted message said:

It seems to me I heard somewhere that George Prager wrote in article
<[email hidden]>:

Quoted message said:

why would you need statins for a 141 cholesterol reading? Perhaps I'm
completely off on this but isn't 141 well within the normal range? (I could
only wish for a reading that low)

My cardiologist's answer: with my history of a mild heart attack five
years ago and familial high cholesterol and heart problems, he wanted to
reduce my LDL below the new (?)target of 100. He therefore moved me
from Lipitor 40mg to Lipitor 80mg.

Presumably his answer would be different for a patient with a different
risk profile. Since Phil didn't tell us what his HDL and LDL are, his
issues may not be comparable with mine.

At the time of the overall cholesterol of 141, my LDL was 105 and HDL
was 32.

Thanks for the comments,
Phil

Fred,

Quoted message said:

... It sounds like the thing
that is bothering you (the original poster) most is the palpitations.
It isn't clear to me what the cause of that is, although it would help
to see an EKG or a holter and get more history. Electrolyte
imbalances are probably the most common cause.

Can dietary additions or deletions help with this?

Quoted message said:

Another possibility is
that if you are on both Toprol and Lanoxin and your heart rate is too
low from excessive AV nodal blocking you may be having lots of
ventricular escape beats.

The Lanoxin was dropped when the Toprol XL began.

Quoted message said:

... I think it would be worthwhile to
see an electrophysiologist. If all or the majority of the PVC's
originate from the same locus, it should be easily ablatable. It is
nearly impossible to make a diagnosis without a more complete history,
a physical, and some basic lab studies including an EKG, but if your
PCP is "baffled," then a referral to a cardiologist is appropriate.

One of the hospitals near me has an electrophysiologist on staff; I
would consider an ablation only after trying other/additional
medications.

Thank you for the detailed comments,
Phil

Quoted message said:

Me: male, 63, 5 /11, 182 lbs, college prof, still teaching, 30 yrs of
swimming, x-country skiing, no smoking or drinking.

May 2003: PCP suggests I lose weight re: METs. Weighing fat grams
carefully, I drop 25 lbs to my present weight of 182.

Since the early 90s, have taken 50 mg Tenormin and .25 mg Lanoxin for
SVT which was effectively controlled.

Dec 2002: PCP adds 10 mg Lipitor with cholesterol at 141. Within two
weeks, after intense abdominal pain, I'm hospitalized with a bleeding
ulcer that heals within 60 days. Lipitor's involvement? "Anomalous."

Aug 2003: adenosine stress test by interventionist cardiologist:
results normal.

Oct 2003: concomitant with weight loss, PVCs increase. PCP switches
me to 100 mg Toprol XL and 2.5 mg Altace and 5 mg Crestor, cholesterol
at 150.

Within a week, abdominal pain returns and I quit the Crestor; it
remits.

Now, on a daily basis: bigeminy such that I need .5 mg lorazepam to
sleep; my daytime activities have been similarly disrupted.

PCP remains "concerned but baffled."

Anyone?

Suggest you ask to be referred to a cardiologist.

Quoted message said:

and thanks,
Phil

You are welcome.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/