When we should stop worrying too much

[tokyopaul]

In 2002 I had an angiioplasty (CAG). Removed  6-mg plaque via  PCI in proximal LAD  (MLD_1.60mm, dsicrete 60 percent narrowing they said).  Effort angina dissappeared.  Followups in 2004 (catheritization), 2008 and 2009 (64-slice CT scan) showed no restenosis.  Lifestyle changes include walking 3-5 times  fast for at least 30 minutes, more often 1 hour or more. Also 2 red wines 4+ days/week. 4 grams of fish oil.

I am 56.  I went for the 2009 followup because of some breathlessness on starting to walk. But I can always walk fast and long. Cardiologist said likely some muscle skeletal thing (I had a herniated disk and  some spondylosis a long time ago). Said the 4 tests tell me not to worry.

Dr. said my hypercholesterolemia was most likely hereditary as bloodwoork has always been more or less ok.  Take Bayaspirin and 5 mg Lipitor. Weight is at least 8 kilos less than it has been in the last 5 years also. Maybe 3-4 kgs over ideal. Recent blood tests--average sort of like this: Total 185, LDL 100 or less, HDL 55 or so.   What is always slightly high is CK (446 last time) and TG ALWAYS fluctuates.  Even when I fast from the night before, it can be anywhere from a few points above the normal limit of 150 (170) to 89, to 262.   Cardiologist says not to obsess about TG as long as my lifestyle is as described and my cholesterol figures are good.   She would only up the dose of lipitor or moving to a new statin if my LDL got worse. Said the Ck elevation not unusual given statin use, but  could consider a thyroid check, Also said exercise itself can elevate it.

Girlfriend, (nurse) and docs both say obsessing over TG or can be self defeating. Even avoiding eating something "forbidden" occasionally should not  dominate. And that overall am doing well. I suspect a lot of us on these forums obsess about our health, but I guess there is a time to look at what is POSITIVE about our results and not be disappointed that we are not "perfect".

Wonder your take on above? Thanks!

[tokyopaul]

Thank you. Actually this is the first time to hear of the last part (screening the other parts of my vascular system).  No-one has bothered to mention that before.  I assumed that the lipitor would cover everything, but I suppose there is always the possibility that another clot could be found.  Of course, this has got me obsessing again!!  :)

I will ask the cardiologist.

[Lee Kirksey, MD]

That's a great story. The very compelling part of it is that at the age of 50 or so you had your initial PCI. You seem to have made some significant lifestyle changes which you have sustained over time.  There seems to be a fine line between being extremely conscientious and obsessing. I don't know what it is but I know that people like yourself that try there best to change what they can and dont get discouraged about the things that they have little control of seem to do the best.

I think this is underappreciated part of personal health. It is so easy to get discouraged when one gives their best effort to lose weight or improve your labs.

Keep up the good work and make sure that the other parts of your vascular system at risk ie carotids, legs and kidneys are screened appropriately with ultrasound and ankle brachial index respectively.