CPAPtalk.com

cathyf wrote:...Another example that my boss and I were talking about yesterday. His cardiologist insists that he has to take Crestor for his cholesterol. My boss keeps begging to try a cheap generic statin and see if it works well enough, because the Crestor costs over $100/month. The doc insists that it has to be Crestor, "because Crestor has worked so well for you!" This is just a frighteningly stupid thing to say! The only cholesterol drug he's even taken is the Crestor, and so nobody knows whether Crestor is the best thing, or whether something else would work as well or even better. You don't have to know anything about cholesterol or statins or any other drugs to realize that the doc is claiming something he doesn't know and can't know -- all you have to know is the question "so well" compared to what?!?...

Crestor would be more than a few spots down on my list of "Statins to have patients on" Nearly everyone should be started on Pravastatin. It is one of the most lipophobic, and has a novel mechanism of metabolism. Both of these features lend it to not crossing the BBB, where statins can mess with the brains own internal cholesterol system (which is separate from the one in the liver that services the rest of the body due to the nature of the BBB), having a far lower rate of rhabdomyolysis, and it does not carry the risk of increasing the chance of Type II diabetes as all the lipophilic statins do. The only time I suggest starting somewhere else is if the person has had an MI, CVA, PVD, etc... and needs aggressive cholesterol management. In that case I'd go for Atorvastatin as its the only one proven to decrease the risk of MI and CVA related to dyslipidemia in the context of established cardiovascular disease.

I'm amazed that guy hasn't switched cardiologists. The reasoning he is using to justify Crestor as a drug of choice is just scary.

Paralel, what's the ACTUAL risk reduction (not relative risk reduction) for Atorvastin in primary prevention? What's the NNT?

Since I was talking about Atorvastatin strictly in the context of secondary prevention, I'm not sure the why you are asking about primary prevention. I don't generally like Atorvastatin as primary prevention except in very particular circumstances.

Sorry, I should have said Prevastatin.

I noticed a huge difference in energy when I cut wheat/gluten. I did not lose any weight though.

lilyaqha wrote:I noticed a huge difference in energy when I cut wheat/gluten.

You had less energy.

I can't imagine how they do it.
I have tried vegan dishes, and usually find myself looking around for protein when no one is watching.

chunkyfrog wrote:I can't imagine how they do it.
I have tried vegan dishes, and usually find myself looking around for protein when no one is watching.

I enjoy eating vegan....

I mean, cows are vegan, right?

Hang Fire wrote:

lilyaqha wrote:I noticed a huge difference in energy when I cut wheat/gluten.

You had less energy.

No I had more energy and needed to sleep less.

I don't know if I eat gluten-free, I try to eat free, but IGA keeps making me pay, I only eat free range glutens, that I hit with my car. I eat cows, but only the ones that eat grass and grain, that's my vegan diet, it's me helping to do my part to reduce green house gasses. Jim

My daughters both have small bowel biopsy confirmed Celiac Disease. My older daughter has been treated in the hospital on several occasions due to reactions to gluten. I have the genes but not the small bowel damage. However, after many years, my GI doc suggested I go gluten free. Lo and behold, my 'IBS' disappeared. As another commenter stated, I can be glutened without knowing it and suddenly I'm sick again.

As far as placebo/nocebo, placebo effect only occurs if you know you're taking something (real medicine or sugar pill) and your mind makes you better or worse depending on your expected outcome. Placebo effect cannot occur if you don't know you have been dosed until after you experience symptoms. Now, you can erroneously attribute symptoms to something that doesn't exist, too. That's why it's important to find out if you really have been dosed. In my case it isn't as black and white as it is for my daughters, but it's still there.

However, try being gluten free and vegan. You pretty much can't eat out anywhere. Sucks to be me sometimes. LOL

Somewhat off topic for this thread but...

As far as things being all in your head, I brought bedbugs back from a five star hotel in 2008 (1). My doctor thought I was imagining it and my rash was placebo effect. I had to catch one of the bloodsucking vermin (2) and take it to him for him to see before he believed me (and freaked out that I'd brought a live bedbug to his office).

(1) Incidentally, five star hotels are a great place for bringing home bedbugs because of the higher number of international travel from places where bedbugs are endemic.
(2) There were hundreds of them in the bedframe and surrounding furniture, they were even laying eggs on the wood paneled wall behind the bed by the time we figured out what was going on.

KatyDidAgain wrote:There were hundreds of them in the bedframe and surrounding furniture, they were even laying eggs on the wood paneled wall behind the bed by the time we figured out what was going on.

How did you get rid of them?

Gluten, fructose, bedbugs, oh my.

Just a little fuel for the fire: http://www.mayoclinicproceedings.org/ar ... 3/abstract

The full text article is there if you dig.