Weekly Wellness

Stents: Quite disturbing news from a coworker. Stents, which are usually of two types, plain metal or drug eluting are used to keep vessels, arteries, passageways if you will, open. We are most familiar with stents used to keep arteries open after angioplasty of clogged or thickened arteries. This allows oxygenated blood flow to reach all the tissues and organs of the body. The main reason that stents are needed is heart disease and the main risk factor for heart disease is lifestyle, mostly what you eat and what you do or do not do with your body. Believe me, it is a lot safer to eat well then to get a stent placed. Stents were in the news a lot last year with several complications noted, including, re stenosis, blood clots and excess bleeding. There was a scandal-like damning of the drug eluting stents which increased heart attacks in the population that received them. This all played out quite interestingly in the stock market for companies like J&J, Boston Scientific and Guidant. It is a very confusing topic actually. Stents are meant to prevent narrowing or stensosis. As stated above, the devices themselves can cause clots and excessive bleeding. Some argue that the problems are not the stents but the vascular surgeons who place them and on it goes. Obviously, your best bet is to avoid coronary heart disease. The disturbing news brought to me by my partner in crime in the tobacco field, is direct marketing to consumers. Can you imagine? “Hey doc, do you think invasive heart surgery is right for me?” To which the doctor might reply, “Why yes Mr. Smith, it’s a whole lot easier than that diet I recommended at your last visit!”

Denial and Premature Death: Weight is not a measure of wealth, attractiveness, status or intelligence. Weight is an indicator of wellness. A study out of UMichigan indicates that parents of children with BMI confirmed obesity more often than not, declared their children to be just right or only slightly over weight. As the pediatrician who led the study, Matthew Davis states, obesity is “something that can have health effects.” He notes that the health effects occur in childhood and include diabetes, hypertension and increased LDL. This is not okay and can lead to the above.

Free Samples: I caught a brief blurb on the local NPR station regarding the controversy of free drug samples in health care. The news story noted the concern that the drugs which proponents say will assist the poor, really do not go to them. A research study was completed to test this theory and found that in fact, the poor and or uninsured do not usually get the samples. It was also suggested that the doctors would be more likely to prescribe the drugs that they had on hand. (The drugs provided by drug companies when they visit doctor offices or treat doctors to catered dinners.) That did turn out to be true. It has happened to me in fact and this was when only the docs were being wooed by glamorous drug reps. (Zyrtec, Vioxx, Fosomax in my case, two of which have now been said to have serious risks and none of which do I take now.) The point of the study however was whether or not the underserved were getting the samples. Some reasons that they do not include that the clinics in which they are seen do not have the samples, secondly, intuitively, I would think the drug companies aren’t wining and dining those docs. But here is something that the report doesn’t say. It may in fact be better NOT to give the underinsured or Medicaid/Medicare patient those samples as they are brand new very expensive meds that may not be on the formulary. When I was in hospital work we began considering this in discharge planning. We then chose the best medicine (often it really was the better medicine) that was generic and could be obtained by the patient as long as they needed it. So, the whole free sample argument well it’s the wrong argument. The fact that drug companies are pushing meds IS the problem and free samples are a way of pushing them. (I still shudder when I think of the white paper bag full of 50 mg Vioxx samples that I took while also working out – oh, it scares me bad.)

UK V. USA The BBC news recently ran a story about the amount of fast food eaten in the UK and how that was leading to a staggering rise in obesity. The reporter seemed to say that they had a higher rate than the US, but when he offered figures it was not so. Either way, it was called “Globesity”. Guess we can add that to the Diabesity coined in this country. Interesting then the reporter noted the overweight and obesity rates in OUR country and said that one in three adults in America were obese. OMG. The reporter than began to talk about America’s fattest city at which time I changed the channel.

OILS: Well, I am going to replace my olive oil. Yes the one I brag about somewhere along the parameter of this newsletter. It is still very good for you of course and better raw than fried in, oh man did I say fried, I meant sautéed or simmer fried. Here is what I learned this week when reading about the good fats, mono and poly unsaturated and Omega 3s. My olive oil, which I pour on my dinner after I cook it and before I eat it :), in very modest amounts is still packed with good fat but apparently only .5 grams of Omega 3. At least we are talking grams though, not MGs. Well, I learned that Flaxseed Oil which many people already use has 7 grams of Omega 3s. It has less mono unsaturated fat, but for my muscles and such I want the Omega 3s. Omega 3s are also said to have healing or anti inflammatory properties. So, it’s on this week’s grocery list. [remember though there are still a lot of calories in these good oils so don’t be too generous with the pour]

Drug Ads V Be Well Ads: Because I am always pissed off about direct to consumer drug ads, I tend to pay attention to them. Here is what I noticed this week. If these ads, if these companies truly wanted to raise awareness and educate on health issues, they would say “ask you doctor about diabetes”, not “ask your doctor about Chantix, Lipitor, Cymbalta, Ambien, Zocor, STENTS….”. How about the commercial for Chantix end instead with, “Ask you doctor about quitting smoking?” Or the commercial for Avandia could say, “Ask you doctor about your blood sugar.” Hey and then there is this one, so we can role model for the UK, “Ask you doctor if your weight may be putting you at risk for disease.” Let the doctor decide if any one of those conditions warrants medication use.

Watch List: A study has linked restless leg syndrome or RLS as the commercials say, to heart disease. I must admit that I have been less than reasonable about this condition and have poo pooed it without doing any research. I see that the NHLBI and others give this condition a good deal of respect and so shall I. However, I will say that not everyone has it and it is not mere fidgeting. It is quite serious and painful. The research that noted a link with heart disease did use statistical analysis that allowed for other risk factors to be excluded and this condition independently was linked to heart disease. One hypothesis is that the person’s blood pressure and heart rate will spike repeatedly during the night with these episodes. Based on what we have been talking about for weeks now, I would expect oxidative damage and inflammation as a result and those factors are also related to the development of disease.

Wishing you a peaceful sleep and the wellness it promotes

deirdre