Before the big D started in November I had blood tests done as part of a yearly checkup. My PCP increased my aspirin to a full one instead of low dose due to a high platelet count. Also statin due to high cholesterol.
I saw her several times before being sent to the GI. She stopped my statin, diuretic, and fish oil due to D.
The first visit to the GI stopped my aspirin. After dx MC he stopped it permanently.
My question is should I be taking something else for platelet and cholesterol? Should I see PCP again for my other issues?
How do you juggle the two drs if they disagree?
PCP and GI
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
PCP and GI
Theresa
MC and UC 2014
in remission since June 1, 2014
We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
MC and UC 2014
in remission since June 1, 2014
We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
I am new here, but I would think you should probably contact your PCP with your questions...and the GI.
You could request her to contact your GI and discuss a treatment plan.
Sounds like a great idea, huh--in theory.
In practice--I hope they work together. Not always the case. You can request the GI doc to send updates and recommendations to your PCP. That person should have all the info about you....It is so hard to get these doctors to talk to each other. I had to deal with this when my dad was alive....
Once you have 2 docs, with one being a specialist, it is so hard to get them to communicate!
But I was told by my dad's PCP, he was the one to co-ordinate things....
You could request her to contact your GI and discuss a treatment plan.
Sounds like a great idea, huh--in theory.
In practice--I hope they work together. Not always the case. You can request the GI doc to send updates and recommendations to your PCP. That person should have all the info about you....It is so hard to get these doctors to talk to each other. I had to deal with this when my dad was alive....
Once you have 2 docs, with one being a specialist, it is so hard to get them to communicate!
But I was told by my dad's PCP, he was the one to co-ordinate things....
Hi,
Well, your GI specialist is correct, aspirin is definitely out (because of your MC). An elevated platelet count can be caused by a number of things, including trauma. Following major abdominal surgery, 4 years ago, my platelet count began heading for the moon. We checked my count every week, and just before we were about to have to give some serious thought to drug intervention, it turned around and slowly returned to normal. My doctor was clueless as to why any of that happened, but as he said, it just happens sometimes.
I trust that your PCP has done appropriate testing to rule out causes such as cancer, and she has considered the medications that you are taking. In cases where there is no apparent cause, the condition is known as essential thrombocythaemia (ET), or primary thrombocytosis (PT). Here's some information on it, if you want to read more:
Essential thrombocythaemia
You might for example, want to ask your PCP to do a blood test to see if you have the JAK2 V617F gene mutation, or a change in the MPL protein (though the MPL protein change is a long shot with a very low correlation percentage {only 2–5 %}).
There are many alternatives to aspirin these days. I take Plavix, myself (well, actually I take the generic form, clopidogrel), since I'm thought to be a stroke risk (because of one-sided paresthesia events where the ER doc could not rule out the possibility that they might be TIAs. The bad news is that most of the better alternatives to aspirin are considerably more expensive (naturally
).
It's standard operating procedure for specialists to disregard (or disallow) treatments prescribed by other specialists and PCPs. It's generally assumed (by specialists) that it's the PCP's job to coordinate all drug treatments, and make sure that all drug treatments prescribed don't carry an adverse risk of interactions.
However, in the real world, most of us find that our pharmacist is generally much more knowledgeable about drug side effect and interaction risks than most doctors, so it always pays to run your entire drug regimen past your pharmacist, just to be on the safe side. Doctors almost always downplay drug interactions and side effect risks, whereas pharmacists won't hesitate to point out the risks, because understanding medications is their turf. In many situations, we don't even have to bring it up, because our pharmacist will notice the risk and bring it to our attention when we fill or refill our prescriptions. When starting a new medication though, it's always a good idea to ask the pharmacist if she or he foresees any problems that it might cause if we add it to our existing treatment regimen.
Concerning cholesterol, when we are at middle-age or younger, high cholesterol levels appear to be tightly linked to increased risk of adverse cardiovascular events. But as we outgrow the middle-age category, the game plan changes drastically, and research shows that elevated cholesterol levels are no longer the risk they once were. My concern is that my cholesterol level is too low, because once we get past middle age, we reach a phase in life where the higher our cholesterol level, the lower our risk of all-cause mortality. In fact, research shows that in general, once we get about 6 and a half decades behind us, the higher our cholesterol level, the longer we are likely to live, because believe it or not, cholesterol is protective of cancer and infections. Don't expect your doctor to tell you that, but if you want to see some medical research references, I'll be happy to look them up and post some links.
Tex
Well, your GI specialist is correct, aspirin is definitely out (because of your MC). An elevated platelet count can be caused by a number of things, including trauma. Following major abdominal surgery, 4 years ago, my platelet count began heading for the moon. We checked my count every week, and just before we were about to have to give some serious thought to drug intervention, it turned around and slowly returned to normal. My doctor was clueless as to why any of that happened, but as he said, it just happens sometimes.
I trust that your PCP has done appropriate testing to rule out causes such as cancer, and she has considered the medications that you are taking. In cases where there is no apparent cause, the condition is known as essential thrombocythaemia (ET), or primary thrombocytosis (PT). Here's some information on it, if you want to read more:
Essential thrombocythaemia
You might for example, want to ask your PCP to do a blood test to see if you have the JAK2 V617F gene mutation, or a change in the MPL protein (though the MPL protein change is a long shot with a very low correlation percentage {only 2–5 %}).
There are many alternatives to aspirin these days. I take Plavix, myself (well, actually I take the generic form, clopidogrel), since I'm thought to be a stroke risk (because of one-sided paresthesia events where the ER doc could not rule out the possibility that they might be TIAs. The bad news is that most of the better alternatives to aspirin are considerably more expensive (naturally
).It's standard operating procedure for specialists to disregard (or disallow) treatments prescribed by other specialists and PCPs. It's generally assumed (by specialists) that it's the PCP's job to coordinate all drug treatments, and make sure that all drug treatments prescribed don't carry an adverse risk of interactions.
However, in the real world, most of us find that our pharmacist is generally much more knowledgeable about drug side effect and interaction risks than most doctors, so it always pays to run your entire drug regimen past your pharmacist, just to be on the safe side. Doctors almost always downplay drug interactions and side effect risks, whereas pharmacists won't hesitate to point out the risks, because understanding medications is their turf. In many situations, we don't even have to bring it up, because our pharmacist will notice the risk and bring it to our attention when we fill or refill our prescriptions. When starting a new medication though, it's always a good idea to ask the pharmacist if she or he foresees any problems that it might cause if we add it to our existing treatment regimen.
Concerning cholesterol, when we are at middle-age or younger, high cholesterol levels appear to be tightly linked to increased risk of adverse cardiovascular events. But as we outgrow the middle-age category, the game plan changes drastically, and research shows that elevated cholesterol levels are no longer the risk they once were. My concern is that my cholesterol level is too low, because once we get past middle age, we reach a phase in life where the higher our cholesterol level, the lower our risk of all-cause mortality. In fact, research shows that in general, once we get about 6 and a half decades behind us, the higher our cholesterol level, the longer we are likely to live, because believe it or not, cholesterol is protective of cancer and infections. Don't expect your doctor to tell you that, but if you want to see some medical research references, I'll be happy to look them up and post some links.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex, I read the article about ET and noticed high platelet count can be caused by "inflammatory disorders". Since the blood test showing the high platelets was taken just a couple of weeks before this major flare that makes sense. My platelet count may be a lot different now.
I am VERY interested in learning more about cholesterol in senior citizens. DH is 71 and has been on statins for many years. Mine was just a little high anyway. Also now that I have lost 20 lbs that number has probably changed too.
I am VERY interested in learning more about cholesterol in senior citizens. DH is 71 and has been on statins for many years. Mine was just a little high anyway. Also now that I have lost 20 lbs that number has probably changed too.
Theresa
MC and UC 2014
in remission since June 1, 2014
We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
MC and UC 2014
in remission since June 1, 2014
We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
My first post in the thread at the first link below addresses this topic, and it contains links to a couple of research studies.
Very High Cholestral
Note that there is some evidence/speculation that low cholesterol/statins may increase the risk of developing Alzheimer's disease also, or may cause the disease to progress more rapidly if it is already in development.
Here's Something That Will Knock Your Hat In The Creek
Tex
Very High Cholestral
Note that there is some evidence/speculation that low cholesterol/statins may increase the risk of developing Alzheimer's disease also, or may cause the disease to progress more rapidly if it is already in development.
Here's Something That Will Knock Your Hat In The Creek
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Every time I have taken statins I have developed muscle pain and stopped. My PCP advised me to only stop for a few days and then start again if that happens.
I will absolutely not take it again, my mother had Alzheimer's.
My cholesterol was 235 with 80 being good cholesterol. Both my maternal grandparents lived into the 90s, and had good quality of life until the last year or two. My mom died at 77 after several years of Alzheimer's and diminished quality of life. She had been on statins for many years.
I will absolutely not take it again, my mother had Alzheimer's.
My cholesterol was 235 with 80 being good cholesterol. Both my maternal grandparents lived into the 90s, and had good quality of life until the last year or two. My mom died at 77 after several years of Alzheimer's and diminished quality of life. She had been on statins for many years.
Theresa
MC and UC 2014
in remission since June 1, 2014
We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
MC and UC 2014
in remission since June 1, 2014
We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
.jpg){kind=avatar}
I took Lipitor more than a decade ago. It caused severe joint pain. When I stopped the Lipitor the pain went away. I will never take a statin again. Since then I have read enough about cholesterol to decide I am simply not going to worry about it. I don't even get it tested any more since whatever the results I will not take any drug to change things. My general attitude is that the fewer drugs a person has to take the better off they are. I am not totally opposed to all medication. I just need to have a very good reason to take one.
Jean
Jean
With that HDL level, you should have it made.nerdhume wrote:My cholesterol was 235 with 80 being good cholesterol.
Here's a link to the original research article that Dr. Briffa mentioned:
Nutrition and Alzheimer's disease: The detrimental role of a high carbohydrate diet
It seems to me that the most troubling aspect of the almost fanatic campaign by the mainstream medical profession to convince everyone to take a statin, is the observation that they seem to totally overlook the fact that the brain uses almost a quarter of the total cholesterol utilized by the body, and the brain uses LDL cholesterol.
That said, it's true that for some individuals who fall into a high-risk (of a cardiovascular event) category, the use of statins can definitely lower cardiovascular risk. However, for most of us, lowering our cholesterol level not only does not lower our cardiovascular risk, but it increases our overall mortality risk, and possibly increases our risk of developing Alzheimer's disease. And most doctors appear to be oblivious of the risk.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.