I’m troubled this week and I’d like to talk about it. Please comment below if you wish. I’d be interested in your thoughts.
It comes as no surprise that one day in the future there will be absolute proof of my mortality. That’s not a great worry, frankly. It’s an inevitability. And I’ve had a good life. Very good. There’s no point in fretting over it ending one day.
But there is a good reason to make an effort to remain healthy, active, vibrant, and functional for as long as I can. Especially so if I wish to continue flying into my golden years, which I do.
A bit of personal information. I’m on the cusp of 60 years old. I’m in reasonable health and don’t take any medications, but I’m overweight and have been for a couple decades. I quit smoking nearly a quarter century ago, and rarely drank alcohol for about that same period of time.
Concessions have to be made during the years of child-rearing. Or at least I believe that to be the case. Today I’m prone to an evening cigar and a whiskey on the porch. I enjoy both tremendously.
For most of those past couple decades I’ve had a great relationship with my primary care physician, visiting more than once a year. In recent years I’ve seen him every four months. My goal was to remain healthy by making lifestyle changes. Specifically, exercising often and learning to eat better. We were doing okay, too.
Then my primary physician died. That was a bit of a shock since he was significantly younger than I am. He was a good guy. I miss him.
After a lot of thought and some casual vetting I chose a new primary care physician. He’s a good guy too. During our first appointment he expressed concern over my cholesterol numbers. They’re not outrageous, but they’re inching above 200, which is the point when doctors seem to feel the need to do something.
He suggested medication, and I countered with a desire to stay away from prescriptions in favor of lifestyle changes. He relented, suggesting that if I lost eight pounds in the coming three months, we’d be good.
I took that suggestion seriously. It was time. I’ve been fat for long enough. So I changed the way I eat. Mostly in terms of what I eat and smaller portion sizes. I also snacked less. It worked too. By the time my next appointment rolled around I’d lost 10 pounds.
My doctor congratulated me on losing weight. I’d beat the goal we set out. Then he recommended I begin taking cholesterol lowering medicine. The exact thing I was trying to avoid by losing weight.
By his estimation my risk of a heart event in the coming decade is slightly less than 10%. To me that sounds pretty reasonable. As I age that percentage of likelihood will rise. Eventually, it will be very near 100%. That’s life. Or more accurately, that’s the circle of life. It ends. I get it. I’m okay with that.
What I’m not understanding is the push to take medication. Medical appointments now feel more like a sales pitch than a health screening. The particular product my doctor suggested is likely to lower my cholesterol, which is apparently an important outcome. At least it is to my doctor. The drug does not come risk free, however. The side effects are not insignificant.
My reticence to jump into the pharmaceutical pool is that during testing of the drug there wasn’t a significant reduction in the number of heart related events for those taking it. In fact, the difference was 1%. Out of 100 patients taking the drug for an extended period of time, and 100 patients taking a placebo, the difference in the two groups was one heart attack. One.
My doctor tells me 10% to 15% of patients taking this drug will experience side effects, including the possibility of muscle damage, liver damage, diabetes, and/or neurological issues.
This leaves me in a conundrum. The math suggests the most likely outcome of taking the pill will be a lower cholesterol level, but with no significant reduction in my risk of heart attack. I’d have a 10% to 15% likelihood of experiencing side effects that could be serious. The least likely outcome, at a mere 1%, is that I’d actually be helped by the drug, benefiting from a slightly lowered risk of heart attack.
Time is not on my side in this. If I take the drug, my risk will continue to rise as I age. If I don’t take the drug my risk will continue to rise as I age. One way or another, my body will give out. That’s what happened to my dad, and his dad, and his dad. I can recognize and accept the trend.
This brings us to a series of interesting questions. What is the meaning of life? What is the value of life? Should we change the values of our life in an attempt to extend it? Or not?
I don’t know the answer to any of those questions. Not in a universal, all-encompassing, one-size-fits-all sort of way, anyhow.
But I think I know the answers as they pertain to me. I think I’m comfortable with the idea of aging and degrading at nature’s pace. I’ve spent the bulk of my life doing things that matter to me. Things that scare the crap out of the average man on the street. Or they at least make him uncomfortably nervous.
When it comes to being conventional, I’m not much interested in that. And I don’t think I’m going to join in on the modern convention of taking a pill to ward off the one thing that can’t be avoided.
Maybe I’m wrong. What do you think?
jamie,
greetings from an 87yr old, still flying.
i do take a blood pressure med but nothing else yet.
yes, i am one of your dad’s acquainteances, from USAF Reserve (C119) times
i agree with you. on staying away from meds unless you have mo choice.
i would drop my meds if my FAA doc would go along but he is guided by FAA Rules i imagine.
good piece by the way
John H.
Very nice article, Jamie!
My cholesterol has always been in the 190-210 range. I also have a great doctor who wants to avoid “meds”. In 1984 (I am 83 now) I asked him a simple question: “I know what high cholesterol implies, but what is the actual condition of my arterial system?” He arranged for a nuclear injection stress EKG, which showed excellent arterial blood flow! I took that exam again in “94 with the same results. I am over weight now and fighting the bad habits, although BP is still good and still getting Class III medicals, and still take no “meds”. I guess that my good health is due to continued aggressive physical activities way beyond college.
Cholesterol is not a problem for almost anyone. “High” levels are chosen arbitrarily without the science to support that any level is a problem for anyone except a few known extreme cases. Please research the points below.
1. Your body makes almost all of it. What you eat is practically negligible, as it does not directly enter the blood. Your body knows what it needs, and makes it.
2. Cholesterol is a protector that is often seen where it is most needed, including arteries that are splitting from inflammation caused by carbohydrates.
3. Statins also prevent production of many needed things, including CoQ10. Statins cause muscle pain that sometimes can never be reversed, and other side effects. Studies do not support statin use in almost every case. It does reduce cholesterol, but there is no benefit to that, contrary to the false idea that it somehow helps.
4. Weight gain or loss is primarily a function of what your insulin is doing. Insulin, brought forth by eating carbohydrates, is a fat storing device. Stop eating sugars and starches (carbs), go back to eating fats for energy, and your body will find its own way to health, including weight gain or loss as befits what your body knows it needs. One good source for more information is dietdoctor (dot com).
5. There are nefarious reasons why doctors and organizations promote the failing low calorie diet, why doctors push pills, why the public is kept confused with false studies, and why all our disease epidemics began in the 1980s when fat was wrongly vilified. More books are coming out about this.
6. I read and researched these topics intensely the last 5 years. Since knowing all these things, I do not eat more than maybe 10 or 20 grams of carbs in a day (called keto). I lost 100 lbs, my doctor took me off all my diabetes and heart meds since I no longer needed them. My arthritis and other problems almost disappeared.
7. I found my doctor’s main source of information was what pharmaceutical sales reps said. I have provided what I consider accurate, substantiated books to my doctor, who only quotes outdated ideas without researching them.
There are many good sources of information out there, and there are lots of smokescreen sources meant to confuse. Instead of listing books and studies, just stay very skeptical of everything you read. Again, I suggest the website above, which I found to be very clean of any false information. The books, videos and other suggestions on that site seem to be the better validated materials. (I have no interest in the website other than vouching for it.)
When I wrote my story of losing 100 lbs as a student pilot, I decided to offer it to that website to publish. They did. You can probably google search for it in the Success Story section on that website under my name, Judy Saint. Good luck.
PS. Get off statins right away, unless you are in the infinitely small percentage who have a special condition. Sounds like you are not. Research statins, at least.
Jamie, first things first. Take care of your salvation. This assures your eternity. If you don’t, you will not like the smoking section. Next look into taking vitamin K2. This will take cholestrol (sp) out of your arteries and put it in your bones. I would drop the cigar and the whiskey. If you have to have these all the time to have peace, this is why you need the Lord. Look at walking three times a day for at least ten min. each if not one or two for 15 min. It is terrible, but as we age you will notice that we lose muscle strength. THIS will help keep you fit and have stamina.
Hi Jamie,
I’m an ER doctor, and in my 50’s, and want to keep flying as long as I remain above -6 AGL…
You’re primary care doc is following evidence-based medicine…lowering your cholesterol.
However, you are still PIC of your healthcare. Remember he should provide advice and recommendations, but he does work for you and should help construct a treatment plan that you both agree on.
Typical recommendations are diet modification and weight loss (which you’ve done…congrats!) along with exercise, and recheck your numbers in 3 months.
Medication may be needed, but there are things you can do to lower your numbers without it that are certainly worth trying first….
I’m 56 and and I have heart disease. I have been flying since in my 20s. I want to fly as long as possible. I have excellent doctors. After my second round of stents I put together my current set of doctors and made the low fat plant based decision suggested by one of them 8 years ago. My cholesterol numbers are excellent now as they should be for someone with heart disease. My philosophy and routine is based on 4 things.
1.) Diet – low fat plant based
2.) Exercise – 5 times a week
3.) Medication – statin and niacin
4.) Testing – check cholesterol every 90 days
I have aches and pains like most people my age and I am prone at times to workout injury.
My philosophy on using meds is to treat them as back up. Lifestyle first then meds on top for extra protection. As far as meds hurting more than they help – I’m sure there is an article on the internet to help everyone support their point of view or sales pitch. Regular testing helps one know if changes are working.
To me it is not about dying – it is about being as disease free as possible while living. I wish you all well in figuring out your path on this one. While I don’t think one size fits all I do know that change comes in sharp focus once the effects of disease are real. Great comments thus far.
Thank you for the article. Like you, I am nearing sixty, made life choice that led me to gain weight and will have an occasional whiskey.
I had a total cholesterol of about 186 and my BMI was to high.
Then I made a change and became mostly Vegan. I eat fish three meals a week (love sushi). The rest of the time, I eat a plant based diet.
Result; cholesterol hovering around 145-155.
Still weigh more than I should but not taking meds to mask the issue.
Hope this helps.
I have a very slight case of Type 2 diabetes and stats show that heart attacks are much more likely so a normal 190 to 200 total cholesterol reading needs to be brought down to 150 or less as a preventative. I personally have had no issues with taking statins, so for me its worth it. Btw, just lowering my weight 20 lbs has also brought all important numbers to better levels.
Jamie,
Your excellent article parallels my experience with the tendency of physicians to treat cholesterol levels with statin drugs.
You’re right about side effects- for me it was eczema, which persisted regardless of the type of statin. My doctor agreed to my stoppping taking the drug and then he retired which put me in the Medicare pool.
My new doctor was a resident in a clinic and his training was to “prescribe the drug,” which I successfully resisted by lowering my numbers (and raising HDLs) with increased aerobic exercise and less sugar and carbs in the diet. He has been satisfied with my downward trend and I am eczema free and have more energy because another thing they don’t tell you about statins is that they lower your testosterone levels!
I’m 72, and hike and kayak and although not currently flying, hope to get back to it in the near future.
Keep asking questions, do the research,
and remember the Lord got our days numbered, so continue to take care of yourself so you can be useful.
Thanks again for your article –
Regards,
Robert
The Word of God declares that “the soul that sins will surely die.” I took care of this problem 38 years ago, when I asked Jesus to save me! We are all going to die, but we will spend eternity in only one of two places. The question is: Where will you spend eternity?
You nailed it sir ,God bless you and continue to trust God in all things we were put here to serve Him! Many are not aware.
Indeed, all is vanity…
I grew up on the airport and have been flying before I was legal. I have a good friend that just turned 92 that I have been flying with most of my life and he told me to not stop flying because it will keep you young! He has 3 airplanes (2 that are flyable) and flies usually once a week or so depending on weather. He still works his cattle everyday and looks great! I am 73 and take a BP pill and a prostate pill and they both do the trick. I watch my diet and how much I eat. Exercise 3 to 4 times a week. I weigh 180 and feel great! Cholesterol is around 105. I believe I will take his advice and keep flying and hope you do too! I really enjoy your column and look forward to it always. Thank you for being honest and all you do to inspire the younger and older generation to fly! Blue skies!
Hi Jamie: You are right on target in your analysis. I say this from an 89 years of living viewpoint. But some things have to be faced – like I quit flying solo at 85. My reflexes and inability to concentrate as necessary
dictated that action, even though passing a 3rd class medical was no problem. I take NO meds except for a once in a while Ibuprofen. Have been a follower of a plant based diet for the past 3 years, and feel better than ever.
Like you, I have enjoyed every day of life and look forward to many many more. One thing you failed to mention is a spiritual life. I can’t give an absolute answer to why we are here, but I firmly believe that we are here for a reason, and the search for that reason gives additional meaning to the days, weeks, or years that we are granted. Thanks and keep up the great thoughts.
Hi Jamie, To me your age 60 is still a spring chicken (I am 75). But I too pretty much agree with you. I have never taken an antibiotic in my life. My doctor tells me that I am in a tiny percentile, but am better for it. My wife and I work out every morning at our local YMCA. Many of our friends can hardly get around and we have no problem doing 3-5 mile fast walks every day. I believe that exercise I the key – not meds. Having said that I take one med – a cholesterol lowering med even though I believe it to be more a scam than an aid.
There is one caveat for you to consider however. Consider a serous disease (such as cancer, kidney failure or heart disease). It sounds like you and your family have probably been quite healthy and have not had to consider such. My daughter is stage 4 lung cancer for the second time (never smoked a day in her life). My wife is a breast cancer survivor and is on meds for the rest of her life. I do not want to lose either of them and if meds will prolong their life, that is what I want. It is easy to say that I might not go through chemo or meds if I developed cancer. As is often said “I am not afraid of dying, but of living”. But you must think of your loved ones too. They may not want or be ready to give you up. It is a much more complex issue than saying I don’t want cholesterol medication.
I just heard yesterday on the a the radio, so it has to be true that a new study out of England that demonstrates high cholesterol has insignificant changes in heart attacks.
Modern doctors treat symptoms with chemicals, all of which are poison. Sometimes the potential side effects outweigh the benefits but unless your condition is predicably terminal most likely not. I’m 70 and tried the cholestoral meds for about a year when I was 65 but it got to where I could barely turn my head far enough to back the car out of the driveway. I said the h——- with it and quit. Now I watch what I eat, not completely plant based yet, and the numbers are about the same as they were on the meds. That’s good enough for me.
Jamie, you understand death comes to all of us. The question you have to ask is how much risk are you willing to take for yourself and those around you? Once you are comfortable with your answer, you can move on comfortably. What is the right answer for me, isn’t necessarily the right one for you. Like you I’m retired and because of a serious brush with death a couple of years ago I have no option than to take a few meds to keep breathing. I have the option to take a few others, but decided not to. I know I still have a few more things to finish and work each day on those, but medication isn’t nearly as important as being engaged with those around me.
I know when it’s time, my Lord will be ready for me. I’m ready anytime. Make your peace and live like it. James Swindol has a great line. “You were wonderfully made, so live wonderfully!” I try to remember that each morning.
Enjoy!
Doctors are trained to use medication fully supported by BIG Pharma through University grants etc… System is corrupt.
Took the stupid pills for years, all muscles hurt for no reason except the pills…
New Doctor doesn’t even look at my cholesterol readings.
We have been scammed.
Stay off the damn pills.
Exercise and a decent lifestyle will do you a helluva lot more good.
My 2 cents
My old time doctor retired, so I started with one of the new “whiz kids” they are turning out of college. He was going to prescribe pills for cholesterol…….my bad is 115, because he said the limit on bad used to be 130, but its just been lowered to 100. Then he was going to prescribe something for blood pressure, mine runs between 120/65 to 140/75 when I’ve been a little active, Then he had pills to slow my pulse down. I told him my pulse had been the same since I took my first flight physical at age 17(I’m now 83). He acted kind of nasty so I told him to shove his pills whjere the sun doesn’t shine and changed docs. Now, this one has started the pill routine too. I told him if he enjoys writing, go ahead and write the prescriptions but I was not going to have them filled. He still wrote them and I placed them in my file 13. Sometimes I wonder if these guys are only doing this to cover their butts from law suit happy attorneys. Let them write the prescriptions, Jamie, and then throw them away when you get home. The other thing the pill pushers are causing with these prescriptions is for medical expenses to go up.
It’s silly to go to a doctor and not take their advice. Find another doc who will work with you the way you want to approach things, whose advice you feel you can take. It’s like flight instructors: find the right one for you. They are out there.
You are so correct no matter what we do regarding our health the result is the same for all. Now we might can delay the result we all face through good practices pertaining to our health. For example more exercise and watching what we eat will certainly help improve our health. The other answers to your other questions and no mention to your Maker is interesting. As we travel on this very short stage of our journey on this planet onward to eternity we are so focused on this short phased of our earthly life we neglect to prepare for what we call afterlife. We have a deep human need to figure out what happens to us after death.The Book of Life, our operating manual has all the answers of life, open it. God Bless.
Jamie: I’m on pills for blood pressure, cholesterol, and a couple to counter the effects of radiation for prostate cancer. I’ll be eighty in a few months and I still fly the Van’s RV that I started building when I was in my mid-sixties. They’re working and I’m still flying.
There may be doctors who “push pills” for the sake of doing so, but I haven’t met any. The pills I take do their job admirably and I expect to keep flying formation until I’m in my nineties. (I may need somebody to help me find my aircraft by then, but that’s the plan!) (;>0)
My wife had numbers in the mid-200’s and decided to attack the problem via food and exercise vs pills She wasn’t overweight but her genes are the issue. If you saw what she eats … it’d nauseate you. Her numbers have improved and she’s happy with them but the Doc still tries to prescribe the pills … she refuses. Mostly for side effects reasons AND because — like you — she doesn’t want to be on the meds. She’s 77.
I’m a carbon copy of Sam H below and eat what I want although in moderation. MY weight has hovered just over 200 since I retired from the USAF 30 years ago and my cholesterol is below 200. My doc has been after me to lose weight but even when I seriously worked on it, I can’t seem to lose even 5#. So, I say that my body is talking to me … it’s where it wants to be … one way or another. MY biggest vice is zimne piwa (beers for you non-Polish types). I can look at a beer and it disappears. Usually, I have two, sometimes three although once in a while more. My doc looks askance at that honest admission but I ask him if he can guarantee that I’ll live to 90 if I stop … you know his answer. He’s the same doc who signed my BasicMed form last year, BTW.
With respect to flying, that TOO is something that will end and likely before you depart the planet. I turn 71 next month and would love to buy more airplane OR build OR even buy a new RV12iS but cannot justify it at my age. SO … I’ve decided to soldier on with my venerable C172. I’ve put it into my conscious thoughts that within 5 to 7 years I may voluntarily or involuntarily have to give it up. That’s similar to your mortality question. Just yesterday, I did my flight review and see no age related degeneration in my physical abilities but I know internal issues could become the problem. MY next aviation goal is to accede to the Master Pilot award in just over two years. At THAT point … everything I get is “gravy.”
SOME doctors are quick to put patients on every pill that they can. I don’t know if they get kickbacks or just use that as their modus operandi. Watch TV at nite and see just how many big pharma commercials (along with their obligatory side effects spiel) there are. TOO many. Or, sit outside his office and watch how many drug sales people come in pulling their case of “samples.” Skip all of it. BTW … I heard just yesterday that a major UK study revealed cholesterol meds are a waste of time!!
ME … I’m now on my 13th year of full retirement as a snowbird and enjoying life to the fullest. I DEFY the undertaker to wipe the smile off of my puss! 🙂 I never had to carry a planner when I worked but NOW … I do.
Here’s my input to you … watch your weight as best you can, eat in moderation, get exercise often, skip the pills (it ain’t worth it by YOUR description) and — above all else — enjoy that whiskey and stogie every night after you’ve enjoyed a flight around the block. Stop worrying … it’ll kill you.
Hello Jamie,
I wish you the best. You may want to investigate the opinions of “The People’s Chemist” who advertises on AOPA. He has strong opinions about big pharma meds.
DON’T TAKE THE MEDICATION, JAMIE. Why do your appointments feel like a sales pitch? Because doctors are trained not in health and healing but in medications and “disease management.” Huge difference. They’re rewarded not in healthy people but in prescriptions written. One of my best friends was on Lipitor for 20 years to get his cholesterol down and just found out that Lipitor burned out his kidneys. He has “necrosis” and now at just your age and my age he’s finished because he believed in arbitrary numbers about cholesterol that are manipulated to get you on medication. Just like they lowered the optimal BP numbers to get millions more people on drugs drugs and more drugs. Just say no.
If you do take the meds for cholesterol, be prepared for muscle aches and pains when your connective tissue is destroyed because it’s made by the same cholesterol that this doctor is trying to get rid of. And dementia because oh by the way your brain IS MADE OF CHOLESTEROL. And yes your kidneys rely on cholesterol; just ask my friend Mike. All the vital good cholesterol is hunted down and destroyed with the bad. Happy golden years to you, Jamie. If health is important, do the work first by learning about those pills, then change your diet, lose the weight, and outlive this doctor too. We can take turns dancing on his grave because he’s not looking out for you. (I know you know these things or you wouldn’t have written your column the way you did.)
Dear Jamie,
As far as your health goes, I will differ to your doctor and the body of evidence for lifestyle changes over meds.
As far as your questions about life and the afterlife, I recommend a full read-through of the most banned book in the world. I’ll give you a copy.
I love you more than anything, Joni. You’re a good friend and a great co-conspirator of the written word. Let’s meet up again soon – even if we have no specific reason to do so.
There’s actually another option that you don’t discuss – changing your diet. High cholesterol is most often caused by consuming dietary cholesterol; stop consuming it and your cholesterol will come down (and your health will improve as well). It worked for me. A year and a half ago I was 50 years old and on the brink of high cholesterol. I switched to a plant-based diet and within a few months my cholesterol was way down, into the ideal range.
There is a lot of research to show that my case is not the exception, but rather the rule. NutritionFacts.org is a great resource for learning about the latest nutrition research (on the site do a search for “cholesterol” and “heart disease”).
It seems that many people find it hard to change their diet and would rather take medication, but medication rarely fixes the problem completely and usually has side effects. In the case of cholesterol one really can fix the problem completely, and gain many other health benefits as well. It’s not the conventional choice, but it should be.
Best wishes,
Matt
Jamie, I’m with Matt. Seven years ago I quit the cholesterol meds I had been on for five years and went whole foods-plant based. Total cholesterol went from 185 on the meds to 150 after a few months off meds and off animal proteins. BP is 100/60 at 63.
See you at Gulf Shores,
Mark
OK here’s my 0.02. I have just turned 70. I’ve been retired since I was about 63. I have a reasonable lifestyle, in reasonably good health, and I have been flying since about 1972 and still enjoying it. My take on all of this is more philosophical. I’ve lost a good many friends in the past few years, so I know we all have to go. I have a couple of regrets in life, but I am about to be resigned that there is nothing I can do about those now. I’m going to look at death as just another phase of … something. It’s just another step. When it does come, if suddenly, then fine. If it takes a while then I will likely be looking forward to it.
‘No evidence’ high cholesterol causes heart disease, say doctors
https://www.irishtimes.com/news/health/no-evidence-high-cholesterol-causes-heart-disease-say-doctors-1.3627093
Stay off the meds. They don’t work and you will feel terrible!
I took your request for comments seriously, so here goes.
I have a-fib and using a pacemaker.
I had shortness of breath 6 weeks ago, however we moved from Southern California to Albuquerque Sea Level to 5800’ agl four months ago.
My weight was 275 pounds for the past 20 years. Nothing I did helped in the weight loss efforts. VA doctors were handy at dishing out drugs.
Hi Blood Pressure, cholesterol, Vitamin D, Prostate meds, etc.
I presently am partners in a Piper P-38 Tomahawk.
Why did I want to loose weight? Simple, so I could fly the Mooney Mite (M-18) , and the Long Easy. Max weight 230 Lbs.
I went to the VA hospital and they put me on a gurney, BP 175/99.
The ER Doctor checked for swelling of the ankles and gave me water med via IV. 8 hours later I weighted 230 lbs. and still weight between 222/234 lbs.
If I notice swelling I take a water pill In the AM and It holds the weight for 4-5 days. Other then IB Profane for Hip pain, and Prostate meds, I take nothing else.
Jamie, If you feel like calling me on the phone. My number is 1-949-254-4557 and live-in North-West Albuquerque.
PS: I will be 81 in December, still fly, and drive UBER 40 house a week. 1 made 2 beers a night.