Thursday, August 28, 2014

Reading Between the Lines

     Earlier this week I had my monthly appointment with my oncologist, Dr. O.  Since things are going well for me, the appointments over the past several months haven't been very news worthy.  At this appointment, however, I told Dr. O. about my mom's recent stroke.  All of her testing results are telling my mom's doctors that her elevated cholesterol level is likely the greatest contributor to her event.  I have the same lipid profile as my mom and up until I was diagnosed with cancer, had been taking a cholesterol lowering medication, a "statin," for over 20 years.   

     Cholesterol is a fat, a lipid, manufactured in our bodies.  It's necessary for normal body functioning, such as cell membrane growth and maintenance, and it plays an important role in the manufacturing of hormones.  Most of the non-dietary cholesterol in our body is made in our liver.  Most cholesterol lowering medications work on our livers to make them produce less cholesterol.  Sometimes, however, the medications can cause liver problems.

     Back in December of 2012 and January of 2013, when I was first diagnosed, all of my liver labs were really abnormal.  I looked back at my initial lab results while writing this blog.  My heart fell to my stomach as I noted how abnormal the values were.  My poor liver.

       In the early days of my cancer diagnosis, I was told to stop taking my statin because I needed to do my best to preserve my liver.  Reading between the lines, I got the message that...
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#1...high cholesterol was the least of my problems, and 
#2...it was unlikely that I'd live long enough to ever have to worry about any cardiovascular problems due to elevated cholesterol.
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     Earlier this year I had a fasting lipid profile, which included cholesterol testing.  As expected, my cholesterol was pretty high.  In discussions with my internist and oncologist, I decided to stay off of a statin, fearing it would still be too much for my liver.

     Fast forward to August of 2014.  My liver labs are normal and have been for over a year, (What a come back!  Thank you, Xalkori!,) and my mom has had a stroke.  I feel like I need to re-think a few things.  What if I really live longer than anyone expected?  I'd sure hate to look back and wish I'd taken a cholesterol lowering medication.  
     
     So, I brought this up with Dr. O.  He thought for a minute and decided I can start back on a low dose statin.  I'll continue to monitor my liver enzymes and lipid profile and adjustments can be made, if necessary.  

     This time, reading between the lines, I'm getting a different message:
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Writing a prescription for a statin for me is a greatly appreciated show of confidence from my doctor. 
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      It made me feel like I may live long enough to have to worry about a stroke from elevated cholesterol.  My mom's almost 86 years old and living that long still feels unlikely, but no longer like a total impossibility.

3 comments:

Tori Tomalia said...

That's great "between the lines" news! When I was on chemo I came due for my Pap smear etc, but my doctor said not to worry about it (reading between the lines, that's the least of your worries). But at my last appointment she brought it up and said I should start back with those check ups. It's great when the doctors start thinking about our futures!

Luna O. said...

Right! Who knew we'd have futures?! See you in Boston soon :)

Anonymous said...

It is unbelievably exciting to look forward to the future!!! It is so wonderful, Luna. We all really only have one day at a time to look forward to.