When something’s wrong with the body, the innate immune system kicks into high gear, sending inflammatory molecules through the body, which help recruit macrophages – the cellular garbage collectors – to the scene. Recent publications show systemic inflammation goes hand-in-hand with cardiovascular disease (CVD) and atherosclerotic vessels. Researchers have been trying to pinpoint which inflammatory markers could potentially be used as biomarkers for CVD risk or progression. Current efforts have zeroed in on one marker in particular, the C-reactive protein, in the hopes of finding a way to assess a person’s risk for CVD both non-invasively and well before a cardiovascular event occurs. Preliminary evidence has shown that in the normal population, the higher the C-reactive protein level, the higher the risk for CVD. But what exactly is a normal population? These days, a full serving of heart disease often comes with a heaping side of Type II diabetes, rheumatoid arthritis, or chronic kidney disease, creating a so-called “co-morbidity” of chronic diseases. Not surprisingly, these secondary disease states also affect the levels of C-reactive protein in the blood. So when a patient has more than one chronic condition, how useful is measuring the C-reactive protein level in predicting CVD risk?
Read MoreWe've all heard the mantra: keep LDL levels – the “bad” cholesterol – down, and the “good” HDL cholesterol up. But thanks in part to the ubiquity of statins, such as Lipitor, which allow us to simply pop a pill to limit LDL production in the body, we've recently adopted tunnel vision when thinking about managing cholesterol. LDL levels are all we seem to care about now, as we strive for lower and lower numbers at each visit to the doctor's office. However, I think we're missing the bigger picture by focusing solely on LDL. First, it's made us reliant on medication to solve a problem that can many times be addressed with changes in diet and exercise regimes. Once someone starts Lipitor treatment, they'll be taking it for life, and if LDL levels don't quite get as low as they should, it's all too easy to solve the problem by increasing the dose. When patients first begin Lipitor treatment, physicians typically prescribe the lowest possible amount, 10mg. However, dosing can go as high as 80mg, which begs the question: Do higher doses of the drug really improve outcomes?
Read MoreOne morning, a little over a year ago, I woke up with a very sore, and slightly swollen elbow. I remembered that I had cut my arm on a neighborhood bar table while watching a football game with some friends a few days prior, and I wondered if the cut was infected. I made an appointment with my primary care physician, who quickly diagnosed me with bursitis, an inflammation of the fluid-filled sac that pads the elbow. Since I had broken skin, the doctor wisely prescribed clindamycin, an antibiotic, to treat any tissue infection that may have seeped in. As the hours crept by, the pain in my elbow worsened, until I woke up in the middle of the night with extreme arm pain. I immediately checked the elbow that had been swollen the previous day. The swelling had doubled in size, and the skin was an angry-red color. The following morning, I was back in the clinic, and my doctor started to suspect that this was no ordinary infection on my elbow, and may in fact be a drug-resistant staph infection. Gulp. Nonetheless, he felt confident that the clindamycin should clear it up.
Read MoreA smart post by The Sunlight Foundation's Nancy Watzman has me thinking about what it really means to have access to all of our personal health data. In the past, I've myopically viewed personal health data as anything that my body produced, in one way or another, and now sits in my shadowy file at the doctor's office. Things like X-rays, MRIs, and blood test results. No doubt, I should have access to all of this information. What about prescription medication? Sure, I can easily make a list of the meds I'm currently taking, or get my doctor to hand this list over if memory fails me. But how much do I really know about these drugs? Most people, myself included, take our doctor's word when he or she decides to put us on a commonly prescribed medications. For example, let's say a patient has blood-work that shows elevated LDL cholesterol on two consecutive screenings, comes from a family where cardiovascular disease runs rampant, and was previously unable to regulate cholesterol levels with strict diet and exercise regimes. If the doctor prescribed Lipitor to treat the problem, a patient may not even think twice about taking it. After all, we see commercials for such drugs on our TV, and we flip past their ads in our magazines. Direct-to-consumer marketing by pharmaceutical companies makes drugs familiar and, presumably, safe.
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