[Originally posted 9/12/2007]
When I was discharged from the hospital, I was told that I would now have more aggressive targets for blood pressure and for cholesterol levels. Specifically, they wanted me to reduce LDL levels to below 70. I had been so happy to have finally reached my target of 100 a few years ago. They assured me that this really couldn't be achieved by diet but needed a higher dose of statins.
I was advised to double my dosage of statins and the result came last week. My LDL was down to 60! Amazing! I'll never know how much of this was due to diet and how much was due to the statins. I did go on a non-fat diet as well. One thing I've learned, there's no time to do the one-parameter-at-a-time experimental approach.
Yet, the comment that diet alone is not enough cuts both ways. On one hand, it gives the impression that a strict diet isn't all that important. Somehow, I don't think that's the intended message. Perhaps it does give a flicker of hope to those of us who can't adhere to diets 100% of the time. On the other, it does lead to a path of greater dependence on medications. What does it mean that our health is increasinglyh dependent on a steady dose of drugs?
There's a similar story with plavix. This anticoagulant was prescribed for me inconjunction with the stent. I've been told that many times a problem occurs with the stent if the plavix is stopped. Some have told me that I'll be on it the rest of my life--I should never stop. I have had some easy bruising but I think I can live with that. But again, there's the dependence on drugs.
This isn't a new development for those with chronic illnesses that have dependencies on drugs. We are all most grateful for the development of specific drugs that sustain our health. It does, however, raise that ethical dilemma of access. With the high expense of medication, is it ethical to make it available to a privileged subset of the population? How can we ensure that the pharmaceutical companies get a fair return on their development investment but also ensure widespread distribution and affordability?
I certainly don't have the answers but many of the questions are becoming obvious as I think too much about my health!