Monday, April 15, 2013


The most commonly used medications to treat high cholesterol are statins (Lipitor, Crestor and the generics). Many patients stop taking statins due to side effects but most will be able to take them if the statin is stopped and then restarted.  This is important, since most patients will need to take statins for the rest of their lives.

In a large study in Boston, researchers concluded that while patients often report statin-related events and discontinue statin therapy because of them, most are able to restart statins and remain on them long-term. "This suggests that many of the statin-related events may have other causes, are tolerable, or may be specific to individual statins rather than the entire drug class," they wrote.

Some patients do better if they take their statin medication every other day. However, the dose needs to be twice as high as taking it daily in order to achieve the same lipid lowering. There appears to a genetic factor associated with statin muscle aches. Exercise can makes the muscles aches and can be a good reason to change to a different statin. The onset of muscle aches is usually within weeks to months of initiation of therapy but can occur at any time and resolves with six months of stopping the medication.

Of course, the cornerstone to cholesterol control is diet. It is clear that the Mediterranean diet is a delicious way to improve one’s lipid profile. Even the most careful eater may need to take medication to reduce the risk of heart attack or stroke. The lesson here is not to be discouraged if the initial statin experience is not good – a rechallenge might be more successful.

Sunday, April 7, 2013

The Bank Next Door

There’s a branch office for a national bank right next door to my office. I can peer into the drive-up window from my ‘consultation room’ – the room with my desk that‘s loaded with charts and the bookcase mementoes (that include the medical textbooks that predate paid iPad subscriptions).

On Saturday, crews of movers installed all new furniture. I recognized the name on the boxes as top of the line. I am sure that the bank employees will like the new stuff – but what was wrong with the furniture that was delivered last year? Redecorating the branch seems to be a yearly event and replacing the computers occurs semiannually.  I’m not a customer but have noticed the swap-outs since the extremely large delivery trucks block the common driveway.

Two years ago the tellers started wearing matching light blue shirts and navy cardigans. I suppose that made it easy for the customers to figure out the blue-shirted person behind the counter worked there.

According to the television commercials for this national bank there is no reason to even go to the redecorated branch office. Snap a photo of the check and consider it deposited. No need to get cash since there is an ATM on every block. And there are so many commercials! On the most popular TV shows! 

There must be a substantial budget to pay for these marketing initiatives. Would the average customer be less inclined to bank there is a portion of that budget were diverted to the public good? Keeping down bank fees for low-wage workers would be a good start. Rather than showing lions at the zoo, how about a public service announcement or two?