Recently, I attended a conference on hyperlipidemia. Again, another choice to make. Do I or don’t I take cholesterol-lowering drugs. Five years ago I discontinued hormone replacement therapy (fondly referred to as HRT). I had been taking the estrogen /progesterone combination for two years.  Lo and behold, one day of unexplained bleeding and subsequently a D&C. After the procedure, my gynecologist smiled and said, “Resume the estrogen therapy.  Everything was normal.”

I returned his smile and said, “Thank God I don’t have cancer, but I am not taking estrogens again. I am too nervous about them.”           

“I’m not worried,” says he. “Worse scenario is if it happens again we do another D&C.” Of course he’s not worried, I thought: I’m the one with the ovaries, he’s not. I then made another of my many life and death bargains with God.      

“God, I’ll take my risks with a heart attack. I would appreciate it if you would make it quick and fatal. I would rather have a heart attack than an increased risk of endometrial cancer and breast cancer.”      

One day, after two years of resisting HRT, and as I was rubbing my aching back, I renegotiated in my head.. My gynecologist had reminded me for the umpteenth time that I had no history of cancer but did have a history of heart disease, and, he stressed, “ Your shoulders and back are rounding a little. You know, osteoporosis can put you in a wheelchair. Calcium, Vitamin D, and estrogen therapy probably can lower your risk. Estrogens might even lower the LDL and your cholesterol, but I can’t make the decision. I can only write the prescription.  It’s your call.” 

If experts are making all these medical statements, albeit couched in perhaps and maybes, why do I have to make the decision? I long for the good old days when the doctor treated the patient instead of the lawyer and the kindly family doctor wrote the prescription and then said, “Don’t worry. Just take this pill. It’ll make you feel better.” 

I had no sooner made my decision about the HRT when I was faced with another decision.  My internist said, “Estrogen may or may not lower the cholesterol but the statins and watching your diet probably will. Your cholesterol is 250.”

“You know, doctor, you’re much younger than I am, but when I went to pharmacy school I was taught that after forty a normal cholesterol was 200 plus your age.”

He didn’t even crack a smile as he said, “That was then and this is now, and you know it. I can only write the prescription, but it’s your decision.”

Again, my call! Why couldn’t I be in the twenty first century of the Woody Allen movie “Sleeper.”  They had discovered that everything we in the twentieth century knew about medicine was inaccurate, and in fact fat was good for us. What happened to the bacon and egg breakfasts of my childhood? Those were the wonderful days of balanced meals with their daily portions of bread, eggs, butter, milk, and meat in addition to the vegetables, fruits, cereal and fiber recommendations of today  Are the comfort foods of today granola, oats, bean sprouts, alfalfa sprouts and bran. It makes me wonder. Are we raising children or cattle? 

Do I take the cholesterol-lowering drugs with their encyclopedic possibilities of side effects that include diarrhea, constipation, pancreatitis, gastritis, hepatitis, abnormal liver and endocrine function tests, eye abnormalities and let’s not forget alopecia, gynecomastia, as well as muscle pain and flu-like symptoms that might be indicators of rhabdomyolysis and serious kidney or nerve damage? A recent study noted that patients dying of colon cancer had low cholesterol levels. Could these experts possibly be implying that there was a link between low cholesterol and increased risk of colon cancer? Much as I would like to believe that, I am sure they meant that the low cholesterol was due to cachexia and malnutrition. 

I may still be wrangling with my medical problems, but I have solved a somewhat parallel problem, that of the expensive funeral. Last week, my insurance agent called me. “Mrs. Reskakis, have you thought about life insurance?”

“Yes, and I am not taking any odds on my dying. I don’t need another piece of paper in my “D for Dead” file. Besides, I need the money now a lot more than my kids will need the money then.”

“Well, what about burial insurance?”

“I’ve made arrangements.”

“May I ask what they are?”

“I’ve told my kids to put me in a baggie and then whatever.”

Super-pregnant pause on his end, so I continued, “Well, I did tell them to be sure the baggie is big enough so they don’t have to fold me.”

The next morning my daughter, who has the same insurance agent as I do, called, “Mom, are you okay? Pete, the insurance agent, called me this morning and said you didn’t sound like yourself. In fact, he suggested you see a doctor. What did you say to him?”

I told her what I had said and giggled, as I thought, “Now, if only I could solve my drug regimen problems as easily.”

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