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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Notes On My Recent Hospital Stay - Part 1

If I didn't survive my recent hospital stay, my headstone might have said "Here Lies Noel. He died of boredom while in the hospital". Fortunately I was able to find things to occupy me. Finding out that wi-fi was available in the emergency room and throughout the hospital certainly helped, and to my surprise, Facebook wasn't blocked and the wi-fi didn't cut you off after a certain amount of time. At my job, a lot of websites are blocked including Facebook and the wi-fi cuts you off after half an hour. Posting on FB and getting responses certainly kept me occupied and entertained. Although being hospitalized is not an ideal bloggable moment, writing about it helped pass the time.
One of the blood tests that was done was the lipid panel. Although my triglycerides were low, my HDL cholesterol had gone down while the LDL had gone up. Total cholesterol had gone down 9 points from 229 to 220 since last February. Still, an LDL of 138 was worrisome so I asked the doctor if it was time for me to start taking a statin medication. Even modifying my diet since last February hasn't helped with the LDL. I’ve tried Niacin and Red Yeast Rice to lower my cholesterol in addition to not eating fried chicken, hamburgers and ice cream anymore, but they didn't seem to have much of an effect. Beans, barley, brown rice, and an increase in fiber intake hasn't helped either. I don't know if the decrease in my running and the subsequent increase in abdominal fat is related to the cholesterol problem. Well my cardiologist did prescribe generic Lipitor. I did some checking online about how much they cost. Generic Lipitor in the U.S. is about $130 for a month’s supply if you don’t have insurance. In the Philippines it’s about $11.25 (according to mom). Whoa! I thought that since the generic form became available late last year, the price would have dropped significantly compared to the real Lipitor. With insurance I would only have to pay $15 but that is still more than triple of what I pay for my blood pressure medications. A thought occurred to me: can an Atorvastatin pill be split? Well, it’s not scored (a line that sometimes is placed in the middle of a pill), but with a good tablet splitter, it can be done properly. I’ve been prescribed 40 mg. so next time I’m going to ask the doctor for 80 mg. pills.
When I was transferred from the  ER to the telemetry unit I noticed something that might have been a change in nursing policy. They used to automatically at least give you a pitcher of water and a glass so you can hydrate unless it’s contraindicated. I guess they don’t give those out anymore unless you ask for them. But then again I was NPO (no food or drink until after all tests are done) so that’s probably the reason. I did have to ask for a toothbrush and toothpaste. I was hooked up to a Holter monitor for the duration of my stay. I noticed that the monitor is now about 2/3rds of its previous size. From my experience of being hospitalized for a night more than 10 years ago, I vowed that next time that happens I’m going to bring earplugs. Well, I forgot to do so, thus I didn't get much sleep with all the beeping of machines and alarms on the unit.
There was a delay on my cardiac ultrasound (echocardiogram) and treadmill stress test. They were not done until mid afternoon. If they were done in the morning, I would have been discharged by noontime.
Part 2 to follow

Electrolyte Imbalance - Me With Hyponatremia? No way!!

 I mentioned in a previous post that I have been having abdominal pain at the end of the December. It hadn’t subsided and not only that but my dizzy spells have come back. So I finally made an appointment with my doctor last Tuesday. The first thing I noticed upon entering the examination room was that the doctor was now using a laptop to access and document my medical records. Gone was my paper chart. I printed out my symptoms and medications I was taking prior to the visit so I just gave it to him to read. He palpated my abdomen and said he didn’t feel anything unusual, then did the semi-dreaded prostate exam. Afterwards he ordered some lab tests. Before leaving the office, I was given a couple of printouts. The first was about the visit, what the doctor ordered, and a list of my meds. The second had the lab test orders which I took to the lab across the street. Fortunately when I got there the crowd had thinned out. From previous experience, when you don’t have an appointment, you would have to wait awhile before you blood can be drawn. Since it was almost noon, most of the other patients were gone and I was seen in about 15 minutes.

The results were supposed to be out the next day and I had another doctor’s appointment for Thursday. On Wednesday, I was notified by the medical assistant by phone that my sodium level was low, my cholesterol and blood sugar levels were high. The surprising thing was not the cholesterol and blood sugar, it was the low sodium level because I’m such a high salt eater. When I went back to the clinic the next day, I was told to control my cholesterol, eat a little bit more salt, and have another blood test done the following week to check my sodium, a long term blood sugar test called Hgba1c (glycohemoglobin - it tracks sugar level over a length of time), and a stool test for occult blood. By the way, my chloride level was also low so that made both Na and Cl abnormal. More salt in my diet was the answer. The only possible explanations for these abnormalities would be because I take a diuretic for my high blood pressure, or that I’ve been drinking too much fluids. I believe it’s a combination of both because I do drink a lot of fluids during the day so I have to cut down on that plus eat more salt. We shall soon find out after my next blood test. As far as the high cholesterol, I could probably blame all the fatty holiday eating for that. All other tests – CBC, liver function, kidney function, and prostate specific antigen (PSA), were normal.

 I couldn’t believe that I had hyponatremia with all the salty food I eat! No wonder I was feeling sluggish and fatigued the past few weeks. As I write this, I feel slightly better. I still don’t know the source of the abdominal pain and I’m supposed to see the doctor in a month’s time. If the pain isn’t gone by then, he said was would order an ultrasound. In the meantime, I have to watch what I eat so I can get back to normal. I’m talking about the body here because the brain is a lost cause: still crazy after all these years. Frankly, with all my symptoms, I was expecting worse.

A few days ago I had my follow up tests and the doctor’s medical assistant notified me that my sodium level was back to normal, my glycohemoglobin likewise, and there was no blood detected in my poop. That was very reassuring. Now I have to work on getting my cholesterol level back down. There is no cure for my dizziness problems, they just come and go. Here is a link to my dizziness problems from last year: http://aboutlifeandrunning.blogspot.com/2010/04/dizziness-diagnosis.html and http://aboutlifeandrunning.blogspot.com/2010/10/my-first-mri-experience.html.

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