Risk and consequence

Got the blood test results yesterday. Would you believe it’s four years since the last ones? Time flies when you’re having chronic degradation of your biological functions, doesn’t it? The best news was that I’m still not a diabetic, and that for a male in his late fifties, my PSA is normal, so no finger up the bum – not for medical reasons at least.
Cholesterol 8.3. Yes, that’s up on four years ago. So few scores increase these days, one thinks it’s something of an achievement – would that blood tests included IQ results – but then again, perhaps not.
So, what the hell is 8.3? Yes, Yes, it obviously combines good scores and bad scores – like getting 93% for your three point turn in the driving test, only to fail by running over a small child on a pedestrian crossing. It means that the doctor advises I go on statins.
What their records don’t show is that I was on them some years ago because I knew my cholesterol number was high and rather than get a prescription, which at the time would have cost me €45 per month to buy, I stopped into a pharmacy off the Ramblas in sunny Barcelona while weekending on rich creamy food and lots of drink, and bought a month’s supply for €2.50. Having a slightly older brother-in-law who also self-prescribes helps – like having an older brother who smokes I guess. Anyway, having bought a month’s worth, I decided to buy a couple of years’ worth and started self-medicating. After about two years of noticing precisely nothing from taking them, and failing to have another blood test, I went to India, and in a fit of holistic meaningfulness (something which India engenders), gave them up. A few months later, having blood tests for some other reason, I was told my Cholesterol had risen to about 7 from about 6. Who’s counting?
Back on the statins, and another year later, stopped again – I’m quoted as admitting to feeling under pressure to give them up because one side-effect reported in some medical journal is that they’re supposed to dampen your ardour, not so as to make you soft in your old age, but just to take away the urge. Did I notice this side effect? No, I can’t say I did, in retrospect, and even if there was statistically a shift in activity levels over a four year period, I’d have put it down to the chronic degradation of biological functions (again). But let’s not post-rationalise something so fundamental to one’s well-being as sex. If I was less driven, then I would risk a coronary to keep my mojo.
Two years later and 8.3 raises the question: what are the cons of statins, and do they outweigh the pros? The pro is singular, as far as I’m concerned. It is a reduction from 8.3 to something less – who knows what is appropriate, for an old git with so many other issues in his life, most of them from the neck up. Let’s say we get the number from 8 to 6 with the help of statins. Let’s say we don’t suffer from the myriad of other side-effects which include, incidentally, diabetes caused by raised blood sugar, muscle pain, diarrhoea and stomach problems, loss of memory and not to mention the pain in the bum caused by buying and taking a drug permanently …
Change your diet, I hear the multitudes cry. Get rid of all those cholesterol-inducing foods. Well, yes, I do have to admit to a passion for full fat cheese, bacon and other processed meats, and I will bite that bullet, if I must, but then I also love avocado, spinach, nuts, oats and dark chocolate – yes, chocolate actually reduces cholesterol.
But the issue is numbers. After all, like all probabilities, they’re only possibilities, risks. A score of 8.3 raises the level of risk of coronary. WebMD says:
190 mg/dL and above represents a high risk for heart disease and is a strong indicator that the individual can benefit from intensive treatment, including life style changes, diet, and statin therapy for reducing that risk.
For LDL levels that are equal to or less than 189 mg/dL, the guidelines recommend strategies for lowering LDL by 30% to 50% depending on what other risk factors you have that can affect the health of your heart and blood vessels.
Risk management. That’s the question. How do you look at risk as you move from the thrills and spills benefits of a life driven by the need for risk to the fears which go with risking the precious 8889 days left? Maybe it’s time to stop wondering about these things and accept that a healthy person is one who enjoys life and risks enough to be stimulated and stimulating, that so much else matters more than biological degradation… But interestingly, health is the number one worry for most people once they’re past the mid-point.
Fuck it. Back onto the statins!

Doctor (2015)

I’ve got an early appointment but
there’s already a woman in the waiting room;
Small, solid and pale, tired looking.
She reminds me of the queen,
the world on her shoulders,
looking straight ahead,
absorbing her suffering.
She’s counting under her breath.

I think my heart is going to misbehave, you know:
pain in the chest,
down the left arm,
palpitations.
Classic: cut down when I’ve finally begun to get there.

We’re both looking for our fifty euro reassurance.
She thinks it’s mild for the time of year.
She smiles like a mother.
I’m thinking of Freud standing naked at the easel,
eighty, sinewy, staring intensely, wielding his brush,
ready for the fight.

He tells me it’s probably my back:
tension, too much coffee, wine, cheese.
But we’re not getting any younger.
I stopped taking the statin,
it took away my sex drive.
He’s older than me – he takes it,
but its OK to stop, he says,
half the world is on it,
but you seem healthy, for your age.

As I’m leaving, I see her
climbing into an ambulance.

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