Experimenting With Drugs

I’ve been experimenting with drugs for a few years now having been prescribed statins to control my cholesterol level since 2012. I’ve also had to stop or take breaks for several weeks because I experienced muscle pains when I take the medications. There are more and more reports of this happening to other people too.

 The first statin prescribed to me was Atorvastatin (Lipitor) 40 mg. daily. It worked very well because my total cholesterol level went from 229 to 139 in a couple of months.  I took it for a few more months then started to get thigh injuries when I went running. I thought it was because my thigh muscles were compensating for my ankle tendon injuries, but apparently I was mistaken. I reported this to my doctor who stopped the medications, but in a few months, my cholesterol level started to climb back up. Without notifying my doctor, I started splitting the pill in half (20 mg.) and took them every other day. This was enough to keep my cholesterol level in check but the muscle pain resumed. I further reduced the dose to 10 mg. three times a week which still controlled my cholesterol at about 179 and at the same time kept the muscle pains to a minimum as long as I didn’t push the pace when I was running. By this time, I already told my doctor what I was doing.

After changing jobs and medical insurance companies, I told my new doctor about the muscle pains, so she switched me to Pravastatin (Pravachol) 20 mg. daily. The pain intensified again so the doctor discontinued it. She prescribed fish oil instead: Omega 3-6-9 complex, 1 capsule twice a day. I took it for a year and when my cholesterol level was checked, it had risen to its highest level ever to 255. So the fish oil didn’t work and in addition, I was eating a lot of cheese and German sausages at that time.

The doctor then prescribed Rosuvastatin (Crestor) 20 mg. daily and my cholesterol level did a correction and went down to 179 after only 3 months. However, the muscle pains started again so the doctor discontinued the Crestor and said I can never take statins again because of the side effects.

I took a six week break from the Crestor and without notifying my doctor, I started splitting the 20 mg. pill and took 10 mg. three times a week. This seemed to keep the muscle pain under control so I kept on taking them. I still have a bunch of pills that are going to last me at least a year.

After my recent job loss, I had to buy my own insurance through Obamacare and found a new doctor. I told him what I did and he hasn’t changed anything so far. After having blood tests done, my cholesterol level has gone down to 156. Of course, not eating German sausages and drastic cut down on cheese helped. As long as the muscle pain stays at a minimum or non-existent, I think I shall continue with my self-prescribed treatment plan. I’ve also switched to brisk walking instead of running.

I know I’m only mentioning total cholesterol, but my HDL/LDL ratio has always been good regardless of what my total cholesterol is and my triglycerides has never been an issue.

Statin Myopathy, Cholesterol Level, Diet, AREC, and Running

          

Photo courtesy of David K. - AREC President

          Normally, I'm overly excited about rejoining AREC's Long Beach Marathon training, but due to my most recent muscle problems, this time, I'm just elated at making it there at all.

          Backtracking a little bit to give you some history: I had to start taking Lipitor again three months ago because my cholesterol level went up when I stopped taking the medication due to muscle pains as a side effect. How bad have the pains been? Well, if I do the same type of workout two days in a row, let's say for example- using the recumbent bike, my leg muscles are more likely to hurt. Giving myself a few months break while taking Coenzyme Q-10 supplements relieved the pain and enabled my muscles recover somewhat. Even though I only took half the dose of the Lipitor (20 mg.) and only 3-4 times a week this time around, I began experiencing the muscle pains again after just 3 months, mainly on both thighs. So I requested a cholesterol level test from my doctor before visiting him and later found out that even the lower dose of medication taken roughly every other day decreased my cholesterol level from 220 to 178. More importantly, my LDL also dropped and my LDL/HDL ration remained good. So the good doctor recommended that I further reduce the dose of the Lipitor to 10 mg. three times a week in hopes that my muscle pains would disappear. By the way, I walked from home to the lab and back for my blood draw and that made for a six mile workout :-) We shall see if the doctor's recommendation is effective in a few weeks.

          A couple of days after the doctor's visit, I showed up at AREC marathon training not necessarily to train with them but mainly to pick up the beach towel which is what we get for being a member this year (last year it was a windbreaker). How often do I go to AREC runs? Well I saw a woman with her husband carrying a baby last Saturday. I never even saw that woman pregnant last year! Anyway, the workout for the day was either 4 or 6 miles and I opted for the longer distance, thinking it would take me about an hour and a half to cover it. Of course a few people after seeing me walking asked if I was recovering from an injury and all I can say is that it's just SNAFU (situation normal, all fu.... up). Nevertheless, my pace felt pretty brisk but since I was the only walker who was doing 6 miles, I was in last place. So much so that when I reached the turnaround point where the water station was, I suggested to Tina and Rosie that they could probably start packing up the supplies because I was the last one . About a mile down the road, good old Dave, the club president was still taking pictures and waiting for the last person. Thank you Dave, for being such a caring president :) I wended my way through the streets of Naples (Long Beach) in the last two miles until I reached the finish area at Joe's Crab Shack. When I clicked off my stopwatch, it registered 1:18:32. Hmm, that seemed quite fast for 6 miles but I couldn't calculate pace per mile out of the top of my head. See, I haven't been using my GPS watch lately. I had to wait to get home to plug in the numbers in a pace calculator before finding out that I had walked at an average pace of 13 minutes and 5 seconds per mile for 6 miles! My goodness, I've never walked that fast before, with or without muscle pain! That was pleasantly surprising since if I'm not mistaken, my previous fastest pace was about 13:40 per mile. I haven't exactly done any roadwork lately other than my futile attempts to jog a few weeks ago before my thigh muscles began being affected by the statins again. I guess those treadmill hill walks must be helping. And I should probably also thank AREC and it's members for the motivation they provided. And to think that I even forgot to bring coughdrops which I suck on during workouts to keep my mouth moist. Maybe not carrying 2 to 3 pieces of candy lessened my load which enabled me to walk faster :) Now if I can only learn proper racewalking technique...

Always appreciating Dave's photos :)

          Going back to my battle with cholesterol - taking psyllium and fiber gummies weren't working by themselves. In addition to the lower dose of Lipitor, I also had to do other things like cutting the cheese from my diet, bringing my own turkey sandwiches to work instead of eating the ham and cheese they give out for snacks, substituting fat free sherbet for ice cream, and using imitation crab meat or tofu instead of meat for my barley and vegetables concoction. Other things I've cut out are hamburgers, hotdogs, fried chicken, and peanut butter and jelly sandwiches except for an occasional jelly sandwich. One thing I can't let go completely though are the sweets, which is my guilty pleasure, and some of you may have already seen my dessert photos on Facebook.

          So two things to be happy about: being able to walk faster and lowering my cholesterol to healthy levels. To end this post, I decided to just focus on the things that I can do (like walking at a good pace) and be thankful for them rather than lament what I cannot do (like running).

Always try to look good when you see a photographer :)

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SYTYCR - So You Think You Can Run

Apologies to the TV show So You Think You Can Dance (SYTYCD).
          I have been taking CoEnzyme Q-10 supplements for several months to counteract the myopathy caused by taking Atorvastatin for high cholesterol and thought that my thigh muscles had recovered enough to try running again. After a few weeks of dabbling on this running or plodding workout, I have come to either an assumption or conclusion. It's not a new one because I've been arriving at the same result for at least the past two years. I've already been content with my exercise routine in recent months without running, but for some reason I keep getting drawn back to give it one more try, not in the hopes of returning to previous capabilities, but just as another workout option. It worked for about three weeks, then not surprisingly, my muscle imbalances and statin related myopathy came back to spank my butt. As if it wasn't hard enough trying to run again.
          How did it happen this time? Was the cause due to restarting the Lipitor three months ago and the effect the return of myopathy even with the coenzyme Q-10 supplements? Or was the cause due to restarting running and doing 2 minute pickups too soon with the effect as being too much too soon? More likely, it is the combination of both. My muscles were already achy from just three weeks of running 2 to 3 times a week and the pickups just took it over the top. It didn't take very much - just 3 pickups in the last 10 minutes of a 40 minute run, but that's all it took to trigger the pain on both hips. I have already chopped my stride to lessen the impact but with the pickups I unintentionally extended the stride which I think started the pain. My hips don't lie when they say they're hurting. How do I know if it's really a bad injury? When I descend down stairs, it hurts like the dickens (I really don't know what that means). I have to hold on to the rails to keep my balance and so I don't fall. It's not the kind of pain that can be relieved by analgesics either. Believe me, that's based on experience and research. Would you believe the feeling of utter depression actually overcame me the day after and it lasted for several hours? Being debilitated made me feel that way. Fortunately I got over that funk the next day.
          So it's back to no running (or plodding). Is it safe to assume that I should stop making these comeback attempts? When something that give you most pleasure also gives you the most pain, then is it definitely time to stop forever? The problem with running is that it's like heroin which from what I hear, the detox and cravings are intense. Nevertheless, getting high on running even just for three weeks was worth it. SYTYCR? I cannot, or rather , should not. Until the pain dissipates and/or the cravings start again...
          How I wish someone had developed a training plan for people with myopathy, perhaps something similar to a beginner's guide to running. As far as Do I Think I Can Dance? HA! Let's just say that Elaine on Seinfeld dances much better!

Weight, Cholesterol, and Processed Foods

          When I went back to Zamboanga in late August last year, I expected myself to gain weight because I was sure I was going to indulge in a lot of foods that I haven't had in decades, plus I didn't have a weighing scale available to monitor my weight. I did indulge (especially satti) but apparently much less so than I anticipated. Instead, when I got back to Long Beach two weeks later, I had lost close to three pounds. Together with taking 40 milligrams of generic Lipitor daily, my cholesterol level also dropped dramatically. However within a month of returning to the U.S. my cholesterol level jumped about 35 points. Is that coincidental or does that have anything to say about eating fresh foods as opposed to mostly processed foods in the U.S. despite the reduction of trans fats from a lot of them? Then two months ago, I had to stop taking the Lipitor due to lingering muscle pain in all my limbs. When I had my cholesterol level checked, it was back to what it was before I started taking the statin. So I resumed taking a lower dose in hopes that the pain won't be as intense as before and that my body would adjust to it. It has been three weeks and although the pain came back within a week of restarting Atorvastatin, so far it's not as bad as it was before and it seems like I am able to maintain the intensity of my workouts.
          In the meantime, I'm trying my best to improve my diet. I've begun to refuse foods that my co-workers have been offering, especially a couple of them who usually give me fried fast foods. I also started bringing my own sandwiches to work - turkey sandwich with mustard and sriracha sauce, which I eat instead of the leftover patient snacks of ham and cheese sandwiches. But if the leftovers are turkey sandwiches, then I still eat them. Usually, when I get home from work in the morning, I have a slice of cheese and a small glass of wine to unwind. I put the kibosh on the cheese and started having a banana instead. Another change I made is instead of having ice cream, I am now opting for sherbet, which although high in sugar, it's at least dairy and fat free.

          How will these minor changes affect my cholesterol level? I won't know until the doctor orders another test. In the meantime, I have to schedule my next colonoscopy because it has been 5 years since the last one. But that's another topic for another day.

Note: half of this post was typed on a tiny Bluetooth keyboard using index fingers. Too small to touch type.

My Experience With Lipitor and the Resultant Myopathy

I went to see the doctor two weeks ago for a follow up on my body’s response to Atorvastatin (generic Lipitor). A few days before that I had my blood drawn for a cholesterol level. At the doctor’s office, I was told that my cholesterol  level went up from 133 to 164 and LDL from 44 to 70, which is understandable because the doctor halved my dose from 40 mg. daily to 20 mg. To add to that, I had been eating almost indiscriminately on Thanksgiving and the days that followed. But that was not what I was concerned about. In the last few weeks, I noticed that whenever I worked out, my muscles seemed to recover more slowly than usual, meaning that the soreness lasted longer, and the left thigh injury I had suffered from running several weeks ago wasn’t healing well. I’ve read about the side effects of Lipitor and myopathy was one of them but I minimized it, thinking that because I try my best to keep physically fit, such a thing could not happen to me. Well, it turns out exercise cannot overcome this side effect because as time went on, my muscles have become more sore. I even feel soreness when I do my usual aerobic workouts nowadays consisting mainly of treadmill hill walks and stationary cycling. Since there are no other factors that could possibly contribute to the soreness, I can only assume that it’s the Lipitor that’s causing it.

During my visit to the doctor, I mentioned the soreness so he decreased the dose to 10 mg. daily. However, that hasn’t seemed to have helped because my muscle pain has become worse since then. It’s so hard to believe the breakdown happened so fast since it’s only been over three months that I’ve been taking Atorvastatin. I’m now seriously considering calling the doctor up to tell him that I’m discontinuing the Lipitor and see if my muscles could recover before permanent damage occurs. I’ll have to start eating healthier again and see if I can maintain the decrease in cholesterol levels I’ve achieved since taking the medication. It would be terrible not to be able to workout due to being debilitated by muscle damage. Heck, I need my daily cardio fix after all, even if it’s not from running.

                Here’s the catch though: drug companies advise that once you take Lipitor or any other statin, you have to take it forever. Of course they have a vested interest in this approach since they make money off it. There is of course an opposing view that in the absence of other risk factors, it’s not worth continuing taking the medication if the side effects affect your quality of life adversely. I’m just stating that here briefly since there is already too much information about this issue on the internet. I’m not getting into coenzyme Q10 and vitamin D and how those might help with the myopathy, or neural pathways of the medication. That’s easy enough for anybody to look up if so interested. Here is a good article on statin myopathy and exercise though : http://www.medscape.com/viewarticle/707898 . The title is: Are Physically Active Individuals Taking Statins At Increased Risk For Myopathy?

                So anyway, I’m planning on stopping generic Lipitor and hope that my LDL doesn’t get out of control. It is at a manageable level now at 70 and not the 138 it was in August. As my high school classmate who is a doctor advised: more psyllium J.

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Cholesterol - How Low Is Too Low?

This is not an endorsement of the product, I just like the warnings

How low should your cholesterol level be before it becomes dangerous and unhealthy? That was the question I had for my doctor after I got my cholesterol level results last week. After my chest pain episode last August, a routine blood test showed that my LDL cholesterol (the bad cholesterol) had hit 130, which was at its upper limit of normal. So I was started on Atorvastatin (generic for Lipitor) 40 mg. and had been taking it daily for seven weeks. Well, the recent results showed that my total cholesterol dropped precipitously by 100 points in just 7 short weeks of taking the Lipitor. The LDL went from 130 to 44. My HDL (the good cholesterol), which was already good went up about 10 points.  I didn’t even think the huge LDL drop was possible so quickly. I thought maybe the consumption of fresh unprocessed foods in Zamboanga contributed to the decrease, but I’m sure, not by much.

 Of course I checked on the internet before my doctor’s appointment to find out how very low cholesterol might affect the body. Well there’s the increased risk of some cancers, anxiety, and depression. Hmm, none of those I want to experience. So I did what I thought a rational person would do, and that’s to catch up on my cholesterol intake. For the first time in years, I had chili cheese fries for lunch one day. I stopped eating those when my cholesterol started to rise about 5 years ago. I don’t expect to go overboard and start eating all the junk food available, but at least it’s good to be able to indulge once in awhile. In the meantime, my doctor said my levels were still within normal limits, although he ordered another cholesterol level in a month, and halved my dose from 40 mg. to 20 mg. This means I have to split the pill in half thereby saving me some money. If my cholesterol level goes down any further in a month, the doctor said he will decrease the Lipitor to 10 mg.

 When I first tried to split the 40 mg. pill, I thought I may have to use much force especially that it wasn’t scored in the middle. I was surprised at how easily I was able to cut it in half with the pill cutter. The smaller Lisinopril blood pressure pill is much tougher to split even though it’s scored. Well, I’ll let you know in a month’s time what the new results are. In the meantime, can I start eating fried chicken, eggs, and ice cream again?

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