Greetings!
Good morning! How are you this morning? We wish you could be having coffee with us at WWAD HQ this a.m. Whenever you want, you know you are always welcome. We know you have a busy Friday, so let's share what we are focusing on this week This week's newsletter touches on Monday's National Holiday, statins, then we touch on when and where we will be walking this weekend (in Columbus). For all sites national, please check ( www.walkwithadoc.org). Don't be shy - it's actually kind of interesting. Finally, we discuss your 'bonus check'. We hope you agree that it was worth all of the important time you invested in yourself this year. Thank you for your time and if you have any additional questions after reading today's correspondence you can reach us at 614-714-0407. |
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Martin Luther King Jr. Holiday
The Martin Luther King, Jr. Holiday celebrates the life and legacy of a man who brought hope and healing to America. We commemorate as well the timeless values he taught us through his example -- the values of courage, truth, justice, compassion, dignity, humility and service that so radiantly defined Dr. King's character and empowered his leadership. On this holiday, we commemorate the universal, unconditional love, forgiveness and nonviolence that empowered his revolutionary spirit.
- Coretta Scott King
Walk with a Doc draws its inspiration from our friends (read - walkers), our site leaders, and the great figures that have come before us. We thank you Dr. King for the path you have set.
*For the full text of Mrs. King's beautiful explanation on the meaning of Monday's holiday please see (www.thekingcenter.org/KingHoliday/)
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Statins
 There are so many important things to talk about with statins (popular cholesterol medications) The ones we see/prescribe the most are simvastatin (only generic statin currently available), Lipitor (atorvastatin), Crestor (rosuvastain), and Pravachol (pravastatin). Statins are an important class of medicines because they are proven to reduce the risk of heart attack and stroke.
Today, we'll briefly touch on the most frequently asked questions - myopathy (associated muscle aches/disease), grapefruit juice, CoQ10, and what's generic
My two cents on statin associated myopathy. It's real, but not terribly common (2-11% of patients). The big issue is that there are a lot of people with aches and pains and at times it can be challenging to discern whether or not it's related to your medicine. How can we tell? Your physician should check a CK (creatinine kinase is a muscle enzyme) before starting you on the medicine and then we check it again if there is a problem. The most common offenders of the group are simvastatin, atorvastatin, and lovastatin. If you run into problems with one of those, it is very reasonable to try either pravastatin or fluvastatin. They are metabolized by a different pathway.
Grapefruit juice. While you have to go over the individual labels of your particular statin daily use of eight ounces or less of grapefruit juice (that's a lot), or one half of a grapefruit or less, is unlikely to increase the risk of muscle injury. But as always, check with your own physician. Personally, I share with my patients that it is all right to drink/eat this amount.
Currently, there is not enough evidence to recommend CoQ10 supplementation for prevention of statin-induced muscle toxicity (the main reason people use this with statins). Although there is only a small amount evidence benefit, if a patient requires a statin and experiences muscle pain while on pravastatin or fluvastatin (the two statins felt to have the lowest risk of myopathy), some physicians suggest a trial of supplementation with CoQ10 at a dose of 150 mg to 200 mg daily prior to rechallenge and during the course of statin therapy (Source: UpToDate). Personally, I do not use it for my patients. But guess what, check with your doctor - she or he may be seeing better results than I have.
Right now the generic statins are lovastatin, pravastatin, and simvastatin. Simvastatin (Zocor) is the most common that I see in the office. It is able to lower your LDL by around 50%. This is the biggest drop that you will see with the three drugs mentioned. This can be a very good choice. Pravastatin, for the reasons we discussed, also has a time and a place. Of note, Lipitor (atorvastatin), will be generic around the end of this year.
If we did not answer your statin questions within this column, please feel free to get our opinions at this weekend's walks.
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This Saturday in Columbus
 3 great opportunities going on in Columbus this Saturday
a) Outdoors - Dr. Scott Kurzer, a sharp family practicioner, would love to have you join him and others at Sharon Woods Metro Park. This would be a wonderful opportunity to get some crisp air, make some new friends/share time with old ones, and get the thoughts of a very bright and caring physician.
b) Indoors - Eastland Mall's campaign will be led by our long time leader Dr. Wendy Anderson, an expert in adolescent medicine. Wendy is also brilliant and has a magnetic personality that lights up the room (I sound like I'm hosting The Dating Game)
c) Indoors - Dr. Patricia Stafford enjoys moonlit walks on the beach, polar bears, and a nice Chianti. Dr. Stafford, is a wonderful, personable radiologist and our newest star. She has a passion for friends, running, all things medicine - including integrative. She will be discussing resolutions and how to be effective in keeping them.
We are honored to have these well-respected, community minded physicians leading this weekend.
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Happy New Year - Time for Your Bonus Check!
 Happy New Year? It's already January 14th!
Many of you are aware of the 'rule of thumb' that we live 2 extra hours for every hour we exercise (in due time studies will prove that it is significantly more). But for now, for those of you who averaged walking 150 minutes/week last year? That's an extra 5 hours/week and 260 hrs/year. it's almost 11 days. 11 days of upbeat, disease-free, hedonistic bliss. Kind of like a tour of WWAD HQ. Those of you who raised the bar to 300 minutes/week? We'll be wishing you a Happy New Year on January 23rd. This stuff adds up. Big time.
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Tucson
 It is safe to say that all of our hearts have been with the people of Tucson. We have been moved by their strength and resilience in this most difficult time. Over the past 4-6 months, we've personally been fortunate to work with a woman set on bringing positive change to Tucson. Her name is Tyna Callahan. In concert with the Pima Medical Society (www.pimamedicalsociety.com) and other local groups, she is making multiple Walk with a Docs happen for the people of Tucson. Our love, our thoughts, and our full support remain with you in this time of recovery.
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We are honored to be alongside you as we tackle and defeat these challenging issues facing us today. Thank you for your faith and trust in our collective belief that exercise can bring us together, and together we can, and we will, make the difference that is needed.
Our best,
David
Walk with a Doc
614-714-0407
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