Pricey DR. ROACH: My physician is insisting I consider cholesterol medication right after I’ve refused to choose it for several years. I am 66 decades previous, and my overall cholesterol is 301 (triglycerides 76, HDL 83 and LDL 206). He has prescribed rosuvastatin, 20 mg a working day. I come to feel with my triglycerides and my HDL becoming very good amounts that probably the dose may be a minor extreme. I know that I am not a doctor, but I would like a second belief on my doctor’s prescription. — W.P.T.
Respond to: You are appropriate that your superior HDL cholesterol lowers the possibility, but most suggestions do advise statin procedure dependent on your quite higher LDL cholesterol. In studies between individuals with an LDL as large as yours, individuals analyzed were being a lot less most likely to have a coronary heart assault or stroke when taking the drugs. By making some assumptions and with the use of a hazard calculator, I can estimate your risk of a coronary heart assault or stroke in the up coming 10 a long time to be in the array of 6% to 7%. Nevertheless, your blood stress, cigarette smoking history and other health-related details would be vital for a additional comprehensive estimate, and several calculators look at family record and other nontraditional risk variables.
Having a statin drug like rosuvastatin (20 mg is a significant dose — not the best, but it would even now be regarded higher-intensity) would be expected to cut down your relative chance by potentially 20%, meaning an absolute hazard fall of about 1.5%. I am not a health practitioner who “insists” my individuals consider a specified prescription. I’d alternatively check out to present ample information and facts to let my patient make an knowledgeable conclusion, although when I believe they make an unwise preference, I test to influence them.
Occasionally, a compromise is warranted. If 20 mg would make you uncomfortable, why not consider 10 mg? It will however supply a major benefit in safeguarding your heart and mind. My working experience is that when a affected individual is comfortable with a cure system, they are additional probable to adhere to it, and may well even be a lot less most likely to have a facet influence of the medicine.
Pricey DR. ROACH: Really should I get the COVID-19 vaccine? I’m an 82-calendar year-previous feminine who had Bell’s palsy in 1989 and afterwards fibromyalgia for numerous yrs. I stopped acquiring flu photographs, as I believe which is why I got Bell’s palsy. Is it a good idea for me to get vaccine? — P.A.A.
Remedy: Bell’s palsy is a paralysis of the facial nerve on a person aspect. The majority of these are thought to come from a viral an infection, specially herpes simplex virus 1, the sort that results in cold sores. I do not recommend you cease flu pictures.
I certainly advise a COVID-19 vaccine for a human being like you, as I do not feel there is an amplified hazard of Bell’s palsy, fibromyalgia or other complication centered on the tens of millions of persons who have now gotten the vaccine. Most vaccine side consequences, if they come about, will arise promptly or really soon right after vaccination, and just about none right after 6 months or so. Balanced against a achievable but unquestionably tiny chance is an huge reward of protection against COVID-19, which has killed hundreds of thousands of people around the world. In addition to the fantastic amount who have died, there are lots of, numerous a lot more who have long-time period problems. The benefits radically outweigh the pitfalls.
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Dr. Roach regrets that he is not able to response personal letters, but will integrate them in the column when possible. Audience may well email inquiries to [email protected] or deliver mail to 628 Virginia Dr., Orlando, FL 32803.
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