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Tuesday. 1.35 p.m. I mentioned the fact that my washing got stuck inside the tumble drier on Friday before I was due to drive to Worcester. Well, the good news is that it has all been removed from the machine, although the drier isn't repaired. 

It's bright and sunny out. Thankfully, no wind or pouring rain. Let's just hope it stays that way, at least for a couple of weeks or so.

Thursday. 8.15 a.m. A wind and rain-free morning. I just hope it remains that way for at least the weekend.

I wasn't going to mention this, but I think I ought to. Two Tuesdays ago, which was Hallowe'en, I wasn't going to go to Camphill. But then I decided that I would go and drive there after 9 o'clock. As I walked into the Chrysalis Theatre, people were unloading pumpkins from a car parked outside. It was obvious that Halloween was going to be the centre of things and no work on drama was going to take place. So, I said to Terrie, the lady who leads the performing arts workshop, that, as a Christian, I 'didn't do Halloween.' She replied that it would be all Halloween stuff and that, if that was the case, I had better go home, which is what I did.

I didn't think any more about this situation until I got to Worcester on Friday evening and was looking at emails on my phone when I came across an email from the lady in charge of volunteers. It said that being a 'diverse' community, all 'religions' were included, and that my reaction was 'inappropriate.' The email was something of a shock and made me really upset. I don't remember that Halloween was a religion, but that doesn't seem to make a difference. I have given five years of my time (excluding lockdowns) for nothing, as a volunteer. I have no end of experience which the theatre group has benefitted from, and many relationships made and built on since I started there. The email said that maybe 'Camphill isn't the place for you.' Not true. I have set up an interview with Julia, the lady in charge of volunteers on 27th November, and I will apologize, even though I can't see that I've done anything wrong by stating my feelings towards Halloween. I can't be a true Christian and be dabbling in Halloween and all it stands for.

I have since contacted Bridge Builders, which is based in Milton Keynes and have an interview this Tuesday, to discuss being a volunteer for them. I will wait and see what this interview produces, which will mean I won't be going back to Camphill.

1.45 p.m. We prayed about the above situation at Camphill. The prayer group knows the situation. I have to walk away from Camphill without any sort of ill feeling, which is necessary if I am to expect a reference from them.

I have been to find Bridge Builder's office in Bletchley, just opposite IKEA. Very easy to find, and it makes it easier to know exactly where it is when I go for my interview there on Tuesday afternoon.

Friday. 1.00 p.m. I have been to Central Milton Keynes Medical Centre to have blood taken, so it can be tested for cholesterol. As I may have mentioned in an earlier post here, I have a problem with this procedure, because the nurse usually has a problem finding a vein. It went well, and I should get the result in about a week.

Doctor's Surgery Visit

As mentioned in an earlier blog post on here, I have transferred doctor's surgeries from Ashfield Medical Centre to Central Milton Keynes Medical Centre. My first doctor's appointment lead to me having to have blood taken for a blood test, to check my various functions and in particular my cholesterol levels. So the appointment for the blood to be taken was today, at 9.50. I was concerned that I would be late and, knowing the level of traffic in Milton Keynes and the aggression of some drivers, I left at 8.40, giving me plenty of time to gently drive along Witan Gate and directly into Bradwell Common, location of the surgery. There are several sets of traffic lights along Witan Gate and each set seems to take a long time to change. Why is this? There isn't a need for them to take so long, the flow of traffic is relatively light, so why does it take this length of time? When I eventually got inside the surgery, I thought to myself 'I'm far too early! I'll have to sit and wait for over half an hour! How boring!' But to me, in some ways, these opportunities aren't in the least bit boring, because they're an ideal opportunity to observe people, which can lead to story and character ideas.

So, I signed in on the computer screen (it seems most surgeries have these self-service screens) and then sat and waited. It was at this point that I needed a toilet. I was dying for a pee (I'll be honest. Well, we all have to, so there!) I scanned around the reception area and the waiting area and the old toilet I could see was thorugh a door which required a Radar key, which are usually held by those with some sort of disability. We got some for Carol's use, and one used to be on my key-ring, but I took it off because it was too large and got caught in things, and the chance of me needing one was unlikely- until now. I then saw a door a little further into the building and headed for it, only to find a notice attached to the door saying, 'Out of order. If you need a toilet, ask for the Radar key and use the disabled toilet.' (Incidentally, I have no idea why it's called a Radar key, although it is probably going to have some sort of meaning based on disability.) So, I didn't feel inclined to go to the receptionist and ask for he aforementioned key. Who wants to be seen or heard to do so and then be seen opening the door to the disabled toilet? Well, it's not exactly discreet and private.

I was surprised when my name came up on the digital display. It was 8.55 and I wasn't scheduled to have my appointment until 9.20, but I wasn't complaining. It seems getting to the surgery early was worthwhile. I had to explain to the nurse that I would need to lie down to give blood, which wasn't unreasonable. Which is what I did and she managed to extract the required amount without too much trouble. I was told it was to be a fasting blood test, meaning I wasn't supposed to eat for 12 hours before hand which was exactly what I had done. I still don't know why you mustn't eat for this particular blood test. I was told that the results of the test would be ready by Monday afternoon and if I went on-line I could see the results and if necessary, I would have to have another doctor's appointment. I am most concerned about my cholesterol levels, which have been low (around 5, whatever that number indicates, I have no idea.) As I have been eating plenty of fruit and veg recently there should be no problem, or at least I hope not. Measured in Mol or something, but not entirely sure what that means, per Mg or something.

I was still in need of a toilet. I thought that I could wait until I got home. It wasn't far. I had wanted to shop in Aldi, which was directly opposite the doctor's surgery, but I knew there was no toilet inside the store. So I aimed to go to Sainsbury's and avail myself of the conveniences there. I could also do a small shop, for something for lunch and Alfie's mixer was running low. Which is exactly what I did, but the traffic lights along Witan Gate were being particularly aggravating and preventing me from reaching the necessary facilities within Sainsbury's, around three sets of lights away. As I've already mentioned, why DO these particular traffic lights take so long to change?

I parked in the underground carpark beneath Sainsbury's. It's relatively easy to park at that hour of the day, fortunately. I grabbed a 'bag-for-life' out of the boot of the car and rushed into the store, availing myself of the plumbing arrangements (don't be to detailed on this aspect of my visit!) and then wandered around the store in search of, first, a bag of mixer for Alfie and then something for lunch, a loaf of bread (entitled 'artisan,' which really means handmade and looks somewhat rustic with a crunchy crust.) and then some paté to spread on it. With few items to pay for, there was no point queuing to use a human-operated checkout, so I plumped for the self-service tills. But some items in my basket would not scan, so assistance was required. I think the thing wouldn't scan because the barcode was printed on shiny paper. I am put off these self-service tills because they rarely work as you would expect, some just refusing to scan correctly and then  you get a stroppy voice telling the whole world that you've made some sort of mistake. I wish they'd just turn the voice off.

Changes To Medication

What I haven't mentioned, since describing in fairly accurate detail, my couple of days in the John Radcliffe in Oxford, were the changes  made to my medication. Some were added, whilst some were removed and some had their dosage changed.

I had taken Isoborbide Mononitrate 20mg, Bisoprolol 5mg, Candesarten 4mg, as well as Lansoprazole 20mg. and soluble Asprin 75mg.

The Candesarten has now been removed and the dosage of the Bisoprolol reduced to 2.5mg. I now have Ramipril 2.5mg and a statin called Atorvastatin 80mg as well as a drug to help protect the stent called Ticagrelor 90mg which I have to take twice-daily and they've told me that I have to take this for a year as it's to prevent any clotting around the stent which could lead to further complications.

I was reluctant to continue with any type of statins because I have had side-effects. At the time of my first heart attack in 2006 I was put on one called, I believe, Clopodrogel and a statin called Pravastatin (I may be wrong as to brand name or which is or isn't a statin.) At that time, during the week I was in the C.C.U. unit at Bedford Hospital, I began to develop what seemed like flu-like symptoms, so the nursing staff moved me off the main ward and into a side-ward, as they thought I might be infectious. As it turned out it wasn't actually flu but the side-effect of the possible use of the statins I was on. I have been tested over the last few years to keep my cholesterol levels as low as possible, but I had side-effects from taking which ever type or brand of statins it was (at the moment I have forgotten the brand name, but possibly called Plavix.) Because I managed to have my cholesterol levels at a well-controlled level, done mostly by eating healthily, taking a fair amount of exercise (we used to be members of a gym, and used the swimming pool regularly until Carol's cancer diagnosis.) I got the cholesterol levels in my blood to around the target of under 5mmol. So my doctor took me off the statin drug because I had muscle pain and some digestive problems. I got a certain amount of discomfort in my stomach, for example. The lansoprazole capsules are to protect my stomach as a result of taking most of the other medications.

As I have only been taking the new medications for a few days, I haven't experienced any side effects. I do get a dry cough which comes from nowhere. I'm not sure which medication causes this. But yesterday evening, after I'd taken the medications for my 6 o'clock administration, I had very violent diarrhoea. Sorry, but there's no other way to describe it. I'm fairly certain it was caused as a result of one of the medications I was on, possibly the Atarvastatin or a combination of that and another medication. I had to take Immodium to control this. As I write this post at 6.35 a.m. on Saturday I feel queasy and just hope I don't get the 'runs' again. 

Rough winds do shake the darling buds of May . . . etc etc

You 've probably noticed how often the weather makes an appearance in these posts. It's no wonder, really. The weather does seem to play a central role in life in this country. But today is somewhat overcast and dull. The past few days have been quite warm and pleasant, but the weather has to begin miserable as we head into the weekend. As I look out of the window into what is our garden the trees along the Redway that runs along behind this house are swaying in quite a strong wind. Well, as Shakespeare says in one of his sonnets, 'Rough winds do shake the darling buds of May' and how right he was.  Then he goes on to say 'And summer's lease hath all to short a date.' Yes, when you think that we're only likely to have a few warm days to even call 'summer.' This all comes from Sonnet number 18.  Well, it just shows, in this, the 400th anniversary of his death, that his words can have as much relevance today as they did when they were originally written.  I expect the weather had just as central a part to play in his day as it does today. Probably even more so, particularly in Stratford-Upon-Avon, which was an agricultural centre and weather would be important as far as making sure that the crops were growing well to feed the population of the town. I think 'May' refers to the bushy plant called hawthorn and has white flowers. I've just Googled it and I've discovered that it can be used to help reduce cholesterol in your blood as well as being used in medication to lower blood pressure and prevent heart failure. Amazing how you come across facts such as this when you're on the internet. I think it's called serendipity. The quote was used by H.E. Bates for his book 'The Darling Buds of May.' I have a link, as this television series starred Pam Ferris, alongside David Jason, and I worked with her in 'rep' when she was in the company at Ipswich Theatre in the mid 1970's and I was a D.S.M. there.

 The grass needs cutting again and I'm putting this job off until next week. It does take quite a lot of motivation for me to drag the mower out of the shed and then unreel the cable so I can plug the contraption in and then actually cut the grass. But it can wait. It looks like rain again.

Surgery Appointment

I had a letter from Ashfield Medical Centre a few weeks ago. Apparently they'd been trying to contact me by telephone but could get no answer. No doubt because they had been ringing the old number and we haven't got round to giving them the new one. I am supposed to have an annual check-up so I rang and got an appointment with the nurse for today at 12.10 p.m. I arrived in good time and was actually called into the nurses room well before the time booked. I sat down by the desk and my eye was immediately drawn to a dish containing a rather nasty sharp needle. I have mentioned in previous blog posts my almost total antipathy towards needles, syringes and anything sharp, particularly when they are intended for the purpose of sticking in my anatomy for the purposes of taking blood. The nurse told me it was just to prick one of my fingers for a cholesterol test. It was relatively painless and I she took the sample of blood, tiny as it was, into another room further along the corridor and around five minutes there was a result. My cholesterol level is 4.7 mmol/L which is excellent.  It's certainly a good deal easier than having a needle stuck in your arm, your behind, your leg or any other fleshy part of your anatomy and the results come back a good deal faster than the old method when the blood was sent off to be tested in a laboratory somewhere or other. It is therefore well below the 5  mmol/L which is supposed to be the best level for cholesterol. She took  my blood pressure which is 154/80. Not brilliant, as it's supposed to be 140/90. But it's getting there. 

My B.M.I. (Body Mass Index) is 29. This as far as I can see is measured by taking your height (mine is 6ft 2ins. Don't ask me what that is in metric.) and my waist is 107 c.m. (don't know what that is in inches.) I know it needs to be lower but as we do swimming and I'm about to buy a bicycle then I can safely say I do some form of physical exercise. 

Statin Controversy Rumbles On

More about the statins-controversy on B.B.C. Breakfast this morning. I'm not sure putting perfectly healthy people on statins is such a good idea. I know I was put on them after I had my heart attack in 2006, which I take to prevent a further heart attack. But I'm not sure the health benefits are worth the risk. What with muscle pain, cramps in my legs and so on which are the side-effects of taking them are such a trade-off for those who have no family history of heart problems. Why not put people on more natural products such as food with stanols in, such as Benecol and non-branded health drinks and yoghurts and get people to eat more healthily, such as being on a low-fat diet, eat more fruit, vegetables, less red meat and foods which have high levels of fats and cholesterol in such as butter, cheese, eggs and so on. Of course the drug manufacturers would want us to take more tablets of all kinds, including statins, as it undoubtedly increases their profits. If any of the research is done independently of the manufacturers, all well and good, but I don't tend to agree with just handing out more and more medication.

This was posted on the BBC Breakfast Facebook page this morning.

'Plans to extend the use of statins should be scrapped, according to a group of leading doctors and academics. The National Institute for Health and Care Excellence (NICE) says the use of cholesterol-lowering drugs should be extended to save more lives.

But in a letter to NICE, the experts said the benefits of statins don't justify putting up to 5 million more people in England and Wales on the medication.'

Ordering Medication

Following on from the earlier post I wrote this morning, I actually decided it was going to be easier to phone Sainsbury's pharmacy and order my medication that way. I don't think a couple of days without the pravastatin is going to harm me. I am also drinking Benecol, the yoghurt drink which contains plant sterols and is apparently proven to help reduce cholesterol. (I might add that there are other similar products on the marker and some considerably cheaper.) I cannot collect the made-up order until probably Tuesday next week because apparently the surgery is closed today according to the lady I spoke to at Sainsbury's when I rang at around 9 a.m. I do have enough of the rest of my medications so there is really no problem with all this.

Heart Disease and Fatty Foods A Myth?

The following is taken from a website called Healthy3.co.uk  and may be of interest to those people who have had a heart attack or have been prescribed the use of statins in order to lower their cholestrol levels. I take statins, having had a heart attack and as a result my cholestrol level has been maintained at a reasonable level. I’m not sure whether I would want to risk having another heart attack, as a result of having a blood clot, but the information below is very interesting

Fats- The Cholestrol Myth?

‘A cardiology specialist has written about the “myth” of saturated fat in a leading medical journal. Dr Aseem Malhotra suggests that full fat butter and cheese are not as bad for the heart as previously been suggested. This view goes against that of the majority of the medical establishment.’

‘Dr Malhotra, a cardiology specialist registrar at Croydon University Hospital in London says that four decades of medical wisdom of cutting down on saturated fat to reduce the risk of heart disease may be wrong. He argues that the saturated fats have been given a bad reputation since a major study in 1970 linked high levels of heart disease with high cholesterol and high saturated intake. Dr Malhotra even suggests that eating foods that have not been processed such as cheese, butter, eggs and yoghurt may even be good for the heart.’

‘Saturated fat should not be confused with “trans fats”, which are found in margarines, cakes, chocolates and biscuits. Trans fats are universally recognised as being bad for our health, and unlike saturated fats from dairy food, do not contain any vitamins or minerals. Dairy foods are rich in vitamin A and D, calcium and phosphorus, which can help to support cardiac function.’

‘Cutting down on saturated fat has been the mantra from the health authorities, but these fats are being replaced with refined carbohydrates or sugars which are thought be more dangerous for cardiac health.’

‘The current NHS guidelines recommend that the average man should eat no more than 30g of saturated fat a day and the average woman should eat no more than 20g of saturated fat a day. Cutting down on sugar should be more of a priority according to Dr Malhotra.’

‘Dr Malhotra said, “From the analysis of the independent evidence that I have done, saturated fat from non-processed food is not harmful and probably beneficial. Butter, cheese, yoghurt and eggs are generally healthy and not detrimental. The food industry has profited from the low-fat mantra for decades because foods that are marketed as low-fat are often loaded with sugar. We are now learning that added sugar in food is driving the obesity epidemic and the rise in diabetes and cardiovascular disease.”’

‘Dr Malhotra also questions the mass prescribing of statin medications, as he believes that doctors are not assessing the risk of heart disease correctly. Decades of warnings that high cholesterol levels cause heart disease have led to over medication of statins in health patients, he claimed.’

‘“The fact that no other cholesterol lowering drug has shown a benefit in terms of mortality supports the hypothesis that the benefits of statins are independent of their effects on cholesterol,” he wrote in the British Medical Journal.’

‘He goes on to suggest that a Mediterranean diet is more effective than taking a statin to promote a healthy heart and cholesterol levels.’

‘Dr Malhotra also pointed out an interesting fact that although the amount of fat consumed in the US has gone down in the past 30 years, obesity rates have rocketed. This is linked to the amount of carbohydrates and sugars that are in “low fat” versions of processed foods.’

Article written by Rahul Shah and published on October 23^rd 2013

Could statins be adding to the epidemic of ‘heart failure’?'

 Doctor  John Briffa writes:

'Statins are drugs that reduce cholesterol by inhibiting an enzyme in the liver known as ‘HMG-CoA reductase’ which ‘drives’ cholesterol production (most of the cholesterol in the bloodstream is made in the liver and does not come directly from the diet). But HMG-CoA reductase also facilitates the production of a substance known as ‘coenzyme Q10’ which itself participates in the production of what is known as ‘adenosine triphosphate’ (ATP) – the most basic unit of energy ‘fuel’ in the body. The major biochemical process which involves CoQ10 that drives ATP and energy production in the body is known as ‘oxidative phosphorylation’.'

'Now that we have the potted biochemistry lesson over, we can see that statins have the potential, by lowering CoQ10 levels, to put a break on oxidative phosphorylation and ATP production in the muscles. The end result may be fatigue? Muscle pain is another potential consequence.

In a study published this week in the Journal of the American College of Cardiology (JACC), Danish researchers measured CoQ10 levels in individuals taking simvastatin (a commonly-prescribed statin), and compared them with those not taking statins [1]. The levels in those taking the statin were significantly lower.'

'Now, studies such as this one are what is termed ‘epidemiological’ in nature, which means it looks at associations between things, but cannot prove that one thing is causing another. However, of relevance here is other evidence which finds that giving statins to people does indeed have the capacity to lower levels of CoQ10 in the body [2]. '

'What was also interesting about the JACC study is that it found that those treated with statins had lower levels of oxidative phosphorylation than those not taking them. They also had reduced ‘insulin sensitivity’. This is relevant for a number of reasons, including the fact that insulin facilitates the uptake of nutrients such as glucose into the cells. Lowered insulin sensitivity can therefore ‘starve’ the cells of essential nutrients. Reduced insulin sensitivity is also the underlying fault in type 2 diabetes. It is perhaps worth bearing in mind that statin use has been proven to increase the risk of type 2 diabetes.'

'Another thing worth bearing in mind here, I think, is the fact that the heart is a muscle, and depleting it of CoQ10 may be hazardous for cardiac health. Specifically, it may weaken the heart and lead to what is known as ‘heart failure’ (also known as ‘congestive cardiac failure’). I think the ‘benefits’ of statins are vastly overstated, generally speaking. However, if someone is to take statins, I think it’s a reasonable safeguard to take CoQ10 on a daily basis. 100 mg a day is a decent dose, I think, though higher doses are likely to better when symptoms of statin toxicity are present.

In researching this article, I came across an interesting review of the evidence for statin-inducted CoQ10 depletion in both humans and animals [3]. Here’s what the authors of this review have to say in their concluding remarks:

Statin-induced CoQ10 deficiency is completely preventable with supplemental CoQ10 with no adverse impact on the cholesterol lowering or anti-inflammatory properties of the statin drugs. We are currently in the midst of a congestive heart failure epidemic in the United States, the cause or causes of which are unclear. As physicians, it is our duty to be absolutely certain that we are not inadvertently doing harm to our patients by creating a wide-spread deficiency of a nutrient critically important for normal heart function.'

The above quoted from drbriffa.com

What are flavonoids, and how can they help heart-health?

Some foods, such as grapes, tea and chocolate, contain special components called phytochemicals that may be beneficial to your heart health. Enjoying them in moderation may be doing something healthy for your heart.

Flavonoids are one group of phytochemicals found naturally in red wine, tea, cocoa, soy, citrus fruits, berries, apples, onions and pulses (dried beans, peas and lentils). There are thousands of different flavonoids found in many different foods. For example, there are catechins in tea, flavanols in cocoa and isoflavones in soy. Research shows a variety of flavonoids may be beneficial for your heart health.

Flavonoids act as a shield in plants to protect against toxins and to help repair damage. It is thought that when we eat flavonoids, they act similarly within the body. As antioxidants, they help prevent damage from free radicals that can build up during normal body processes, such as breathing. When flavonoids prevent free radicals from building up, oxidation of "bad" lipoprotein (LDL) cholesterol decreases, which prevents atherosclerosis, or plaque formation within the walls of the arteries. Flavonoids also appear to help prevent blood clotting, lower blood pressure, lower cholesterol, decrease inflammation and help with insulin sensitivity. Thus, although more research is needed, eating a variety of foods rich in flavonoids may lower your risk of heart disease.

From secondscount.org.

High cholesterol diet helps mice with Pelizaeus-Merzbacher disease

A diet high in cholestrol may help people with a fatal genetic disease which damages the brain, according to early studies in mice.
 

Patients with Pelizaeus-Merzbacher disease struggle to produce a fatty sheath around their nerves, which is essential for function.

A study, published in Nature Medicine, showed that a high-cholesterol diet could increase production.

The authors said the mice "improved dramatically".

Pelizaeus-Merzbacher disease (PMD) is one of many leukodystrophies in which patients struggle to produce the myelin sheath. It protects nerve fibres and helps messages pass along the nerves.

Without the sheath, messages do not travel down the nerve - resulting in a range of problems including movement and cognition.

Researchers at the Max Planck Institute of Experimental Medicine, in Germany, performed a trial on mice with the disease and fed them a high cholesterol diet.

'Striking potential' The first tests were on mice when they were six weeks old, after signs of PMD had already emerged. Those fed a normal diet continued to get worse, while those fed a cholesterol-enriched diet stabilised.

"This six-week-long cholesterol treatment delayed the decline in motor co-ordination," the scientists said.

Further tests showed that starting the diet early was more beneficial, leading the researchers to conclude that in mice "treatment should begin early in life and continue into adulthood".

This study was only in mice, meaning it is not known if there would be a similar effect in people - or if there would, how early treatment would have to start.

The authors of the report said: "Dietary cholesterol does not cure PMD, but has a striking potential to relieve defects."

It is thought the cholesterol frees up a "traffic jam" inside cells in the brain. The disease is caused by producing too much of a protein needed in myelin, which then becomes stuck inside the cells. It is thought the extra cholesterol helps to free up the protein.

Taken from BBC website, news section.

Over-50's should take statins, report recommends

The following article is posted on the Daily Telegraph website this morning, and the  report was mentioned on BBC Breakfast this morning.

 

 ' Everyone over the age of 50 should be given statins because they reduce the risk of a heart attack even in healthy people, a study has found.

Statins can reduce the chances of a heart attack or stroke even in people who are already at a low risk, Oxford University researchers find. '

 

'The risk of a heart attack or stroke is cut by a fifth in those who have no sign of heart disease, shows research by scientists at Oxford University'

'Treatment guidelines should be reviewed in light of the findings, the experts said, and the NHS should impose a blanket policy of prescribing up to 20  million people statins at a potential cost of £240 million a year.'

'Currently, the only people considered at high risk, those with a one-in-five chance of having a heart attack in the next 10 years, are given the cholesterol-lowering drugs.'

'Half of men aged 50 or over and almost a third of women qualify for statin treatment. About five million people are thought to take them.'

'National guidelines should be amended to lower the threshold for treatment to those with a one-in-10 risk over a decade, the experts said.'

'As the majority of people in their fifties would qualify for statins under this criteria, it would be cheaper and easier to implement a blanket policy to save money on screening tests — which cost up to £700 per patient — to identify them, it was argued.'

'The cost of statins, £1 for a month’s course, would also be offset by the savings they would bring to the NHS in preventing costly operations, medical procedures, rehabilitation and by freeing ward space and places in care homes. A total of £1.3 billion is spent annually on cardiovascular drugs alone.'

'The proposed statins programme would be controversial, as many believe it is unnecessary to medicate otherwise healthy people, and it is not clear how many would take the tablets if they were not experiencing symptoms.'

'Prof Colin Baigent, co-author of the study, said: “If we want to prevent heart attacks and strokes that come out of the blue in people with no previous evidence of problems — and about half of such events happen in the absence of any prior history of disease — then we have to identify and treat people who are currently healthy but are known to be at increased risk of developing heart disease. Such treatment should, of course, be in addition to obvious things like encouraging better diet, more exercise and avoidance of cigarette smoking.” '

'A National Institute for Health and Clinical Excellence spokesman said the study findings will be included in the ongoing review of the clinical guidelines on cardiovascular risk assessment and treatment.'

'The study analysed data from 175,000 people in 27 random trials which compared people on statins with those on a dummy pill.'

'Researchers found that for every one-point reduction in levels of bad cholesterol in the blood, there was a 21 per cent reduction in the risk of serious events, including heart attacks, strokes or surgery for blocked arteries among those with no symptoms of heart disease.'

'The risk of dying from a heart attack or stroke among those at lowest risk was cut by 15 per cent.'

'For every 1,000 people in the low-risk group treated with statins for five years there would be 11 fewer major heart attacks or strokes. “A benefit that greatly exceeds any known hazards of statin therapy,” the authors wrote.'

'Side effects of statins can include muscle aches, stomach disturbances, and altered liver function. Patients have also reported sleep and memory problems, depression and headaches.'

'There was no evidence of a rise in deaths from cancer, the authors said, and although there was a small increased risk of a “bleeding stroke” (a burst blood vessel in the brain) and more people were diagnosed with diabetes in the statin group, these were outweighed by the benefits of the treatment.

In an accompanying commentary article, Prof Shah Ebrahim from the London School of Hygiene and Tropical Medicine, said: “The benefits of giving statins to everyone over the age of 50 would probably save the NHS money in the long run, owing to the savings in health care costs from the heart attacks and strokes prevented.”'

The findings were published online in The Lancet.

Prominent cardiologist reveals some of the flaws in conventional cholesterol wisdom

 I found the following item in a link from the Heart UK messageboard of which I am a member:

Harlan Krumholz is a professor of medicine and cardiologist at the at Yale University School of Medicine. He recently co-authored an open letter which appeared in the journal circulation. The letter was written to the Adult Treatment Panel – a group of ‘experts’ charged with setting cholesterol guidelines for the American public. The panel is current considering this issue and is due to report later this year.

One suspects the panel, like a multitude of panels before it, will recommend that we keep strong downward pressure on our cholesterol numbers. But not all individuals in the medical and scientific community agree with this approach. One such dissenter is Professor Krumholz.

In this video below, Professor Krumholz does a good job, I think, of highlighting some of the major issues with current cholesterol policy. I advise you to watch the video but, for good measure, here’s a short summary of the salient points Professor Krumholz makes:

1. While targets are often based on levels of LDL-cholesterol, evidence shows that this is just one potential risk factor for cardiovascular disease. Many others exist, some of which are better predictors of cardiovascular disease than LDL-cholesterol.

2. Although it’s generally accepted that improvement in cardiac risk factors is beneficial, there is plenty of evidence that does not bear this out. He cites, for example, the example of the drug torcetrapib which lowered (supposedly unhealthy) LDL-cholesterol and raised (supposedly healthy) HDL-cholesterol. Torcetrapib, however, significantly increased overall risk of death in those who took it.

Professor Krumholz in his letter cites hormone replacement therapy as another example of a drug therapy that can ‘improve’ cholesterol numbers but that actually increases risk.

Other notable failures in terms of brining broad benefits to health include the drugs ezetimibe and fibrates.

3. Professor Krumholz speculates on why cholesterol ‘improvement’ may not actually improve health. One theory is that drugs which reduce cholesterol and have benefits (such as statins) do so through one or more mechanisms that are distinct from their cholesterol-lowering effects. Another is that even if cholesterol reduction is beneficial, this may be offset by the hazardous effects of a drug.

4. Professor Krumholz goes on to make the point that while doctors are encouraged to treat peoples’ cholesterol down to a target level, not a single study has actually tested this approach.

5. He recommends an approach not based on cholesterol levels, but risk. He quite rightly points out that those at low risk of cardiovascular disease are unlikely to benefit much, but are still at risk of suffering from side-effects from treatment. He also points out the large ‘numbers needed to treat’ for relatively healthy people. Basically, about 50-100 people would need to be treated with a statin for 5 years to prevent on heart attack. This means, by the way, that 98-99 per cent of people treated will not benefit. People at higher risk stand to benefit more. However, it’s still true that the great majority who take statins will not benefit at all.

So there you have it, a neat summing up of the flaws in the conventional thinking regarding cholesterol lowering. And from a professor of medicine and cardiologist to boot. It’s a shame that the Professor Krumholz’s objectivity and ability to break out of the cholesterol ‘group-think’ is so rare in medicine. Many, many doctors would do well to follow his example.

Blood Test Result

I've just been to take a repeat prescription for Carol to the doctor's surgery in Farthing Grove. I asked at the desk if there had been a result back for my blood test last Thursday. My cholesterol level is 4.8, which pleases me, as it is supposed to be below 5.

Spring is in the air!

It was quite frosty first thing this morning, and there was ice on the car when I looked out of the kitchen window early this morning.   This soon disappeared as the sun came out and it's  been sunny and bright all day. There are daffodils and crocuses out all along the verges of the grid roads around Milton Keynes and the leaves are starting to sprout. Spring is definitely here, but it seems incredibly late.

Carol has been off work all week. She has had a really nasty cough and she had a doctor's appointment on Monday and got a prescription for antibiotics. I had a blood test at 9.30, but the nurse couldn't take any  blood as she couldn't find a vein. She attempted from both my arms, but no success. I immediately made another appointment for the following Monday. I just hope it works this time.

As I write this, Carol's cough is really no better. The antibiotics don't seem to be working. She will have to have another doctor's appointment on Monday as she had a sick note and it will need to be up-dated. I just hope this cough clears up soon. 

Last time I went to the doctors for my appointment the doctor insisted that I take a further statin in the morning, but, from past experience, I'm non too keen, as the side-effects are unpleasant.    I have started taking yoghurt drinks with plant sterols. There is a  brand called Benecol which I have used, but that particular product is very expensive. We have managed to buy a similar product from Aldi, which is about half, if not more than half, the price of Benecol.  You can buy 'own-brand' versions of these drinks from supermarkets such as Asda and Sainsburys, but you will need to have a look in the dairy section of your favourite supermarket to find out what they sell. You can also get spreads and cooking oils with sterols in. I'm now not sure of the exact spelling of sterols, so do check that also.  Is it stenols or stanols? Or, indeed, sterols? There is some confusion when I put the word into Google. Anyway, I digress.  As I was saying, these products are proven to reduce cholestrol. I'll try anything that reduces my cholestrol levels without having to take statins. I also eat oats in some form or other for breakfast as that is supposed to help reduce cholestrol. Another brand is Flora Activ, and they have a full range of products including spreads and yoghurts as well as the yoghurt drinks

The dogs are really loving the sunshine. Alfie has been running in and out of the house through the French windows and likes to lie in the sun. Poppy barks at people as they walk past on the Redway.

Heart Disease Genetic link being missed

 The following news item was featured in BBC Breakfast this morning. The following is taken from the BBC News website:

Genetic link to high cholestrol is being missed

'About 100,000 patients have not been tested for a preventable form of heart disease in the UK, according to an audit of the NHS.

Familial hypercholosterolaemia is genetic; when people are diagnosed, their families should be tested.

The audit of nearly 2,500 patients by the Royal College of Physicians found that very few relations were being screened, especially in England.

The British Heart Foundation said it was frustrating and unacceptable.

Around 500 people in the UK have familial hypercholesterolaemia, which causes hight levels of “bad” cholestrol (LDL) in the blood.

If it is not treated then half of men develop heart disease before they are 55 and a third of women by the time they are 60.

Taking cholestrol-lowering drugs, statins, and living a healthier lifestyle do reduce the risk to normal levels.

Because of the genetic nature of the disease, the National Institute for Health and Clinical Excellence recommends DNA and cholestrol tests for family members, but the study says this is not happening everywhere.'


My grandparents had heart disease. I am pretty sure my grandmother (on my mother's side) had heart problems, and I am sure that she died of a heart attack. My mother had a stroke, and had angina in the later years of her life (although she never talked to us about any of her ailments. Well, parents in those days never discussed these sorts of things with their children.) She eventually died of a heart attack. This was almost exactly 30 years ago. So I know that I must have inherited my heart problems. My doctor kept an eye on my health, with regards to my family history of heart disease. So it was really no surprise when I had my heart attack in May 2006. I was told to cut down on fatty foods, which I did. I went over to drinking semi-skimmed milk and using low fat spreads and attempting, wherever possible, to always choose the lower-fat option when eating foods. 

Medications Side Effects

It's one thing having had a heart attack, but it's quite another that you have to contend with the side effects of the medications that you are prescribed. When I originally went into hospital, having had my heart attack, I was put on a range of medication, mostly to relieve pain. I had Warfarin to thin my blood and thus to prevent further blood clots. I recall that when a nurse was taking out the canula which was in my wrist, at around the time I was discharged, there was a quite a spectacular flow of blood as she had not noted that I was on Warfarin (which prevents not only blood clots, put prevents wounds from healing quickly.) I was put on statins, and the first type had the effect of giving me flu-like symptoms, which were rather unpleasant, to say the least. It wasn't until I discussed my state of health with one of the nurses on the C.C.U. ward that I learnt that this flu-like symptom was a side effect of taking this particular statin drug (which is used to control cholestrol levels in the blood.) I don't exactly remember what the name of this drug was, but I was soon put on another statin which didn't at first appear to have such violent side effects. I was also put on Bisoprolol (which I am still on, but at a much lower dosage, 5 mg.) I was also on Clopodogrel and soluble asprin (another drug to keep the blood thin and thus prevent clots.) 

Some of the side effects of the drugs, particularly statins, are that they give you muscle cramps. Without beating around the bush, another is rather unpleasant, bloating, flatulance and diarrhoea. Sometimes this can be very violent and you can spend quite a lot of time running to the toilet, and it can be quite uncomfortable. On the other hand, it can also have the opposite effect, constipation. Sorry if this is rather  too graphic for some people, but I'm writing this on this blog to try and help anyone else who is going through a similar experience. If my experiences can be shared with others then I hope it comes as some sort of comfort to know that there are others who have had a similar experience.

According to the leaflet which comes with a packet of Pravastatin it gives a list of possible side-effects. It reads as follows:
Dizziness
Headache
Sleeping problems
Sleeping disturbances
Vision disturbance such as blurred or double vision
Stomach upsets (such as feeling or being sick, constipation, diarrhoea, flatulance, indigestion and stomach pains.)
Hair loss
Rash
Itchiness
Tiredness
Feeling of weakness
Changes in the way your liver works
Heartburn
Bladder problems (painful or frequent urination

Very rare side effects:
Numbness or loss of sensation in the arms and legs
Tingling or pins and needles (paresthesia)
Inflammation of the liver or pancreas
Severe allergic reactions including localised swelling of the face/lips and/or throat
Yellowing of the skin and whites of the eyes (jaundice)
Muscle and joint pain

When I was first put on statins (although it might have been caused by other drugs I was on.) I used to get tingling in my feet and sometimes my fingers, and a sort of numb sensation in the soles of my feet, but that gradually went off after a couple of weeks. 

Immediately after I had the heart attack (which was back in May 2006.) I felt really depressed. I was told that this was a normal reaction to what had happened to me. I discussed this with a nurse on the C.C.U. Most men don't like to talk about their health, and particularly not depression. I have had a few periods of clinical depression, a couple of years before my heart attack, but I haven't experienced anything that severe since my heart attack. 

I was put on isosorbide mononitrate fairly recently, as an alternative to using glycerol trinitrate spray, which I used whenever I got an attack of angina. It was prescribed the last time I was in hospital back in October. It does seem to work, and I haven't had any severe angina attacks since then. But I get quite severe headaches and I'm sure it's that medication which causes insomnia. I go to bed as normal, but after a few hours I wake up, generally to go to the toilet, but then I cannot get back to sleep. I was told by my consultant at Milton Keynes Hospital that this drug would cause headaches for the first month or two, but that it would gradually ease off, which it did, but the headaches seem to have come back, but not quite as severely as when I first took this drug. The drug makes the blood vessels widen so as to increase blood flow, and this is very prominent in the brain, hence headaches (if you use the red spray,glyceryl trinitrate, you do find that you get headaches, as well as feeling light-headed, which is another effect of the iosborbide mononitrate, although I admit that it's not unpleasant, rather similar to the feeling you get when you've had one too many alcoholic drinks, but without the other unpleasant side-effects you get with alcohol.)

I can feel extremely tired. This particularly was a side effect of not only taking some of the drugs, but the effect of actually having a heart attack. A heart attack is a very traumatic experience in itself, and tiredness is the body's way of repairing itself. If I over-exert myself, like going on long walks, I find that my leg muscles can get quite painful, but if I rest for a short while, stop and sit down, this soon eases off. 

Doctor's Appointment

On Friday I put in a repeat prescription at the doctor's surgery, as my medication is beginning to run out. I like to get this sorted out fairly rapidly, as I don't want to find that I am down to one or two tablets before I put in the repeat prescription. Then, at midday, I got a call from the surgery to say that I would have to make an appointment with one of the doctors before they'd give me a prescription. I think it's the statins that they are concerned about. As I've mentioned in this blog elsewhere, I have had problems with statins from the first time I was prescribed, and have been taking Pravastatin for quite a while without too many side effects. One of them has been muscle pain. So I attempted to make an appointment by telephone this morning. I started ringing at 8.15, and the automated system told me 'the surgery isn't open at the moment . . .' and a few minutes later I got through and the message was 'the surgery is experiencing a hight demand' etc. I then decided, as the surgery wasn't too far away, I'd drive there. The traffic was quite heavy, but I got there fairly quickly, parked the car and then walked into the surgery. There was quite a long queue at the reception desk, but I got to the receptionist and managed to get an appointment at 9.50, so I returned home as there was no point waiting at the surgery for an hour and a half.

On returning I didn't have to wait long. I was hoping that the surgery would have had the letter from the hospital regarding my consulatant's appointment last Thursday, and the doctor had it on his computer screen. I mentioned that I was getting headaches and imagined it was a result of taking Isoborbide Mononitrate. The doctor now tells me that it would be as a result of taking Bisoprolol, the headaches are the cumalative effect of taking this particular drug, and that I should take only 5 mg rather than 10 mg each morning. I am to continue taking the Isorbide Mononitrate. I am to have a blood test and he wants to check my cholestrol, so on the way out of the surgery I made an appointment at reception and have to come back at 9 tomorrow morning. The doctor printed out a prescription and I took this to the pharmacy in Netherfield, a short walk from the surgery, to get it made up. One of the advantages of reaching the age of 60 is that I don't have to pay for my prescriptions, which is quite a considerable saving. The prescription was made up, except of part of the Pravastatin order, which was incomplete, so I will have to return tomorrow sometime to get the remainder of the prescription.

I got home to discover the Post had been delivered. There was a bank statement and a buff, official-looking envelope, which I never like the look of as they invariably mean trouble, but, on opening it, I discover it contains good news. A cheque from H.M. Inland Revenue, a rebate of Tax for nearly £500. I was expecting it, so I immediately drove into the centre of Milton Keynes to deposit it in my Nationwide account. It should be cleared through the account by Friday.