Aggressive Medicine

Nothing is more disturbing than seeing a patient whose cholesterol is elevated, and hearing that their doctor said to them, “It’s ok.”

Or seeing a hypertensive patient whose doctor said, “We’ll keep an eye on it.”

Or a diabetic with sugars running in the 160s and hearing them say, “My doctor said I’m doing well.”

Or seeing patients in the hospital with some obvious medical problems that are not being treated aggressively enough by their physicians.

Not being aggressive about treating patients is simply irresponsible on the part of the medical community. You can’t tell you patient that a cholesterol level of 243 is ok. It’s not ok!

Sure, you can try lifestyle modifications for a few months, but how often does that work?

Ok, so they diet, excercise, lose weight… and their cholesterol is now 217. Is that ok? You have to then aggressively manage their cholesterol.

Cholesterol is not a” lifestyle choices” problem. It’s a genetic problem. You were born with these genetics. You can slightly improve them by changing your habits, but not by much.

People don’t seem to understand that it’s not the amount of cholesterol that you eat that matters, it’s the saturated fat in the food you eat that tells your liver to make cholesterol. 85% of our cholesterol is made in our liver, not from intake. Saturated fat is fat that is solid at room temperature (butter, cream, fat on steaks, chicken skin, etc).

What about the uncontrolled diabetic. A doctor sends some routine blood work on a patient and their fasting blood sugar comes back at 106. That’s not normal! After an 8 hour fast, no one’s blood sugar should be over 100. The doctor’s just ignore this number and say, “It’s ok, we’ll keep an eye on it.” Instead of treating diabetes early and preserving their pancreas. That’s not right.

How about the hypertensive with a blood pressure of 137/89. Is that ok? For every 20/10 that your blood pressure is over 115/75 your risk of having a cardiovascular event (stroke or heart attack) doubles. So is 135 ok? No!

When talking to friends, family, insurance sales people, or others, they always start asking you questions when they find out your a doctor. “Is my cholesterol good?” “Is my blood pressure ok.”

You find out that their doctors told them that a cholesterol of 230 is ok, that their fasting glucose of 111 is ok, and that a blood pressure of 140 is ok. It’s not ok!

We owe it to our patients to treat them aggressively and get their numbers down. We don’t want to see them in the hospital with half their brain not working or half their heart not pumping.

We are highly educated, highly trained. We have to put this to good use and give our patients good advice. We can’t let them be with high cholesterol, high sugars,s and high blood pressures. It’s not right. We are better than that.