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FROM THE DOC
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I was shocked to hear about the unexpected death of James Gladofini, the well-know star of the SOPRANOS HBO SERIES.
I know that this will get some 50 year-old guys wondering whether they are at risk for sudden death due to coronary artery disease. It does raise awareness.
Of course, the particulars in his case, are hard to know. From appearances he was a barrel-chested overweight fellow who 'huffed and puffed' often during his acting, and ate a lot of steaks (if you can believe his characters actions.....perhaps not true). That said, how does a 51 year-old man die suddenly of a massive heart attack?
Certainly, sudden and unexpected death is possible for any of us (sorry to say). We can all kid....but yes....that truck really could run us off the sidewalk!! (I'm hoping not....but...hey...let's be real!)
Beyond these issues, the real question is preventing this from happening to you....how do you do that?
1. Exercise regularly. This is the best method to prevent a heart attack or to survive it .....it's not just about 'not getting' your heart attack...it's living through it, and people who are in better shape....survive such stresses better and more often. (Read THE KEYS , my simple book on suggestions for living longer and healthier, for some direction here and what your minimum exercise requirement is.)
2. Know your cholesterol and blood pressure. These two items have the greatest impact on your risk, independent of any actions you may or may not take. Come on in to check on these and see if they need attention.
3. Lose some weight...if you are significantly overweight. Now....James Gladofini was probably obese as defined by a BMI (body mass index) of over 30. Being overweight is not a concern....being obese is! Again....figure our your BMI by looking at THE KEYS and the BMI chart in the back
4. Take a baby aspirin daily. This is a very simple method for preventing heart disease and is particularly a consideration for men (less so for women as they have much lower risk...age-for-age...as men.)
5. Come in and get a heart check up. A simple treadmill test is very diagnostic in this regard and very reassuring, or we can do a CT scan of the heart to check for Calcium deposition in the coronary arteries.
Of course....we don't know Mr. Gladofini's heart history...it may have been substantial, he may have had many heart stents in the past and a long history of heart disease..... but you can do a lot to prevent this from happening to you and to give yourself peace of mind!
Yours in good health,
Dr. Lakin
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Meet Our Featured Healthy Lifestyle
Patients:
Janet & Jeri Celebrating their '90th" Birthday!
|  'Best friends since 1st grade in Cleveland, Ohio!'
Looking Great! | |
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| VOL 9 / Issue: #3 | Summer/ 2013 |
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The Fourth of July 2013 FYIs . . . .
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On this day in 1776, the Declaration of Independence was approved by the Continental Congress, setting the 13 colonies on the road to freedom as a sovereign nation. As always, this most American of holidays will be marked by parades, fireworks and backyard barbecues across the country.
2.5 million
In July 1776, the estimated number of people living in the newly independent nation.
316.2 million
The nation's estimated population on this July Fourth
The Signers
56
Number of signers to the Declaration of Independence.
Benjamin Franklin, John Adams, Thomas Jefferson, Roger Sherman and Robert R. Livingston comprised the Committee of Five that drafted the Declaration. Jefferson, regarded as the strongest and most eloquent writer, wrote most of the document.
It's also worth noting that:
- John Hancock, President of the Second Continental Congress, was the first signer. This merchant by trade did so in an entirely blank space making it the largest and most famous signature - hence the term John Hancock, which is still used today as a synonym for signature. There are 7,354,043 businesses with paid employees in the U.S., according to the 2011 County Business Patterns.
- Benjamin Franklin (age 70), who represented Pennsylvania, was the oldest of the signers. Franklin County, Pa., had an estimated population of 151,275 as of July 1, 2012. Edward Rutledge (age 26), of South Carolina, was the youngest.
- Two future presidents signed, John Adams (second President) and Thomas Jefferson (third President). Both died on the 50th anniversary of signing the Declaration (July 4, 1826). There are 12 counties nationwide named Adams and 26 named Jefferson.
- Robert Livingston, who represented New York, was on the Committee of Five that drafted the Declaration of Independence but was recalled by his state before he could sign it. Livingston County, N.Y., was home to an estimated 64,810 people as of July 1, 2012.
- Representing Georgia in 1776 were Button Gwinnett, Lyman Hall and George Walton. Gwinnett County, Ga. (842,046), Hall County, Ga. (185,416) and Walton County, Ga. (84,575) were named for these signers.
- Charles Carroll, who represented Maryland, was the last surviving member of the signers of the Declaration. He died in 1832 at the age of 95. Carroll County, Md., named for him, had an estimated population of 167,217 as of July 1, 2012.
- Roger Sherman, who worked as a land surveyor and lawyer, represented Connecticut. Today, there are an estimated 30,445 surveyors, cartographers and photogrammetrists employed full time, year-round, and 840,813 lawyers employed full time, year-round nationwide, according to the 2011 American Community Survey.
- Nelson County, Va. (14,827) and Wythe County, Va. (29,251) were named for two of the six signers who represented the state of Virginia - Thomas Nelson Jr. and George Wythe.
Fireworks
$218.2 million
The value of fireworks imported from China in 2012, representing the bulk of all U.S. fireworks imported ($227.3 million). U.S. exports of fireworks, by comparison, came to just $11.7 million in 2012, with Israel purchasing more than any other country ($2.5 million).
$231.8 million
The value of U.S. manufacturers' shipments of fireworks and pyrotechnics (including flares, igniters, etc.) in 2007.
Flags
$3.8 million
In 2012, the dollar value of U.S. imports of American flags. The vast majority of this amount ($3.6 million) was for U.S. flags made in China.
$614,115
Dollar value of U.S. flags exported in 2012. Mexico was the leading customer, purchasing $188,824 worth.
$302.7 million
Dollar value of shipments of fabricated flags, banners and similar emblems by the nation's manufacturers in 2007, according to the latest published economic census statistics.
Patriotic-Sounding Place Names
Fifty-nine places contain the word "liberty" in the name. Pennsylvania, with 11, has more of these places than any other state. Of the 59 places nationwide containing "liberty" in the name, four are counties: Liberty County, Ga. (65,471), Liberty County, Fla. (8,276), Liberty County, Mont. (2,392) and Liberty County, Texas (76,571).
One place has "patriot" in its name. Patriot, Ind., has an estimated population of 209.
The most common patriotic-sounding word used within place names is "union" with 136. Pennsylvania, with 33, has more of these places than any other state. Other words most commonly used in place names are Washington (127), Franklin (118), Jackson (96) and Lincoln (95).
The British are Coming!
$109.8 billion
Dollar value of trade last year between the United States and the United Kingdom, making the British, our adversary in 1776, our sixth-leading trading partner today.
Fourth of July Cookouts
65.9 million
Number of all hogs and pigs on March 1, 2013. Chances are that the pork hot dogs and sausages consumed on the Fourth of July originated in Iowa. The Hawkeye State was home to 20.3 million hogs and pigs. North Carolina (8.9 million) and Minnesota (7.8 million) were also homes to large numbers of pigs.
6.3 billion pounds
Total estimated production of cattle and calves in Texas in 2012. Chances are good that the beef hot dogs, steaks and burgers on your backyard grill came from the Lone Star State, which accounted for nearly one-sixth of the nation's total production. And if the beef did not come from Texas, it very well may have come from Nebraska (estimated at 5.1 billion pounds) or Kansas (estimated at 3.8 billion pounds).
6
Number of states in which the value of broiler chicken production was estimated at $1 billion or greater between December 2011 and November 2012. There is a good chance that one of these states - Georgia, Arkansas, North Carolina, Alabama, Mississippi or Texas - is the source of your barbecued chicken.
345 million
Acreage planted of potatoes in Idaho in 2012, the most in the nation. Washington followed with 165 million acres. The total 2012 potato crop is forecast to exceed 467 million hundredweight (cwt), the highest level since 2000 when 523 million cwt was produced. Potato salad is a popular food item at Fourth of July barbecues.
Enjoy and have a safe and happy 4th of July!
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Be Sure You Have Our Correct Address!
| Paradise Valley Medical Clinic
Ninety Mountain View 9977 N. 90th Street, Suite 180
Scottsdale, AZ 85258
480.614.5800 (Phone)
480.614.6322 (Fax)
**Additional Top Floor Ramp Parking:
The 2nd floor ramp parking is very close to our door, but the entrance is at the VERY NORTH END of the parking area of the two buildings. You drive all the way North...enter at the NORTH END, then drive down to the SOUTH END of the 2nd FLoor Parking to get a space very near the entrance.
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Why Do Belly Flops Hurt So Much? Ask 'Professor Splash'
| Let's talk smack. As pool season perks up, you may witness or suffer one of the summer's most stinging moments: the dreaded belly flop. To learn why they smart so back-flippin' much, we asked - of course - a professor.
Professor Splash. "They hurt a great deal, but the pain lasts a minute. The glory lasts a lifetime," said Darren Taylor, who's built an international career executing lofty belly flops under the stage name "Professor Splash." Sunday night, in Istanbul, Turkey, broke his height record by leaping from a 37-foot-4-inch-tall platform and landing gut-first in a small, shallow pool.
"I hate it but I love it. It brings me joy but keeps me awake for two days before I perform - and scared to death," Taylor said via email from Turkey. "Yeah I said it: It scares me like nothing EVER has!!!!! I can't eat 'til after a big dive and that is a huge strain on the mind and body. This is a train wreck - a FrankenDive!"
At age 52, the ex-professional high diver turned belly-flop phenom - (he appeared on NBC's "America's Got Talent") - has never broken a bone but says he has sustained eight concussions, what he described as internal swelling near his pancreas, and "repeated blows to the chest."
Amateurs and klutzes alike, however, a pancake collision between an abdomen and a pool surface is generally a harmless event, said Dr. Sonu Ahluwalia, clinical chief of orthopedic surgery at Cedars-Sinai Medical Center in Los Angeles.
"Most of the time, other than ego and the skin, nothing will happen," Ahluwalia said. But at lakes with high ledges or cliffs that beckon brazen jumpers, if a plunge ends in a belly flop or a back landing, that type of impact can cause bruises, skin breaks, hematomas (collections of blood internally) - or worse, Ahluwalia said.
"Once in a while, because of the jarring, you can injure your liver and your bowels and all the things that sit inside your belly," he said. A doctor should be seen by a belly-flopper if blood subsequently appears in their urine or stool, or if it hurts to walk or cough.
Even the shortest, most innocent belly flops cause a loud crack and an instant wince, however. For that brief pain, blame simple physics: the larger the surface area of the object slapping the water - like your stomach and chest - the greater the force of resistance from the liquid, Ahluwalia said.
"Although water seems pretty soft when we're in it, when you enter the water at a certain speed, the surface is actually pretty hard. When you dive from a 10-meter platform, you're probably entering the water at over 40 miles per hour," the doctor said.
"When you hit the water, you have to break the water to enter. When you dive, you part the water with your hands, and it's not an issue. If you fall on your belly, the same surface area has to break the water to enter it, and all that force goes into the body. It's not quite like falling on concrete, but it's a similar sensation," Ahluwalia said.
To survive a belly flop from 37-plus feet - into a small, 275-gallon pool - Taylor plans to repeat his usual pattern: jumping up and out from the platform, creating forward energy. He hopes to strike the surface with his hands in front of his face to disturb the water tension. He also aims to keep his chin "way" up to protect his eyes and throat. "I must land flat, and keep in the layout position. A 'leapfrog' hit on the knees and hands will dislocate the hips and shoulders," Taylor said.
For some stunts - typically for televised falls before crowds - he has earned paydays in the "mid five figures," he said. A resident of Denver, Colo., he never practices. He typically performs every three weeks, often abroad.
His Sunday night leap was made under under dark skies and in the blazing glow of TV and show-production lights.
"it was the best dive of my life. I was so scared my hands were shaking badly. I was dizzy with fear," Taylor said via email. "But I did my job. I am very glad to finally get something to eat and get some sleep."
- Bill Briggs, NBC News contributor
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Hot tips for summer!
| Summer is the season for backyard barbecues, afternoons in the park and weekends at the beach. While fresh air is good for the body and soul, all that fun in the sun does come with its own set of health risks. The sunscreen part you have down pat: Buy broad-spectrum SPF 30, use lots of it and reapply regularly.
Here are three more hot tips:
Spray away bugs and ticks. DEET-based repellants are the strongest; the higher the concentration, the longer it lasts. You can use DEET on your kids if they're older than 2 months and the product is less than 30% DEET. Sprays with picaridin are skin-safe, too. If you prefer plant-based options, consider IR3535 or oil of lemon eucalyptus, which studies show protect as well as low-concentration DEET. Camping and hiking? Spray clothes and shoes (not skin) with a permethrin product to repel and kill the critters.
Take grill temps. Keep a meat thermometer next to your spatula and tongs, and make sure your favorites are fully cooked and bacteria-free. Ground meat should hit an internal temperature of 160 degrees. Steaks, roasts, and chops: 145 degrees plus a 3-minute rest time. Poultry: 165 degrees. Hot dogs: Reheat until steaming. On the other end of the thermometer, insulated coolers should be kept at 40 degrees or below to minimize bacterial growth. A full cooler stays colder than a partly filled one, so pack food straight from the fridge and top with plenty of ice or freezer packs.
Watch for dehydration. If you're urinating less often than usual, or if your urine is a dark yellow or amber, those are signs of dehydration - a serious condition that can occur if you're sweating in the sun. Other signs include dry mouth, thirst, fatigue or lightheadedness; in severe cases, you may have rapid heartbeat, fast breathing or skin tenting (skin won't bounce back when pinched). Prevention is simple: Drink plenty of water and snack on foods with high water content.
-The Doctors, USA Weekend
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Summer Dates: Mix It Up!
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This summer, ditch the typical dinner-and-a-movie date.
Doing something out of the ordinary produces the same chemicals that are released when you first fall in love, says Chiara Atik, HowAboutWe.com dating expert and author of Modern Dating: A Field Guide. Atik shares these three fun and different ideas:
Progressive dinner. Go to one place for drinks and appetizers, another for the main course, and a third for dessert; switch off picking spots with your partner. If there are food trucks in your area, visit various ones for a cheap, unique dining experience.
Minor league baseball game. The stadiums are smaller, but they still have all the trappings of America's pasttime like hot dogs and peanuts. " Even if you know nothing about the team or baseball, it's really easy to get into it and cheer," Atik says. "It's a little bit of what baseball used to be."
Drawing class. Cities are offering "'drink & draws,' where they serve wine as you draw," Atik says. You don't have to be artistic for this date; it'll probably be more fun if you're not!
- Written by Sarah Albert, USA Weekend
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The Mediterranean Diet Presentation Video . . . . .
|  If you missed the presentation in May with Dr Lakin & Debbie Landau-West, RD, you can CLICK HERE to view it!
SAVE THE DATE: Our next presentation will be August 7th, topic TBD. We will send out RSVPs closer to the date.
Hope you can attend!
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Dr. Lakin's Book!
The Guide: A Pocket Guide For Managing Medical Symptoms"
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Be sure to pick up your free copy at our office!
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We Need Your Help!
| Keeping you on your correct medication is as important to us as it is to you. With your help, we can be more efficient and be sure you are getting your refill requests on time and to your correct pharmacy.
Tips: 1. If you need a refill, be sure to call your pharmacy FIRST, not our office. They will know if you have more refills, and if not, they will call/fax/electronically message us with your request. Then we will contact you if there is a question or concern.
2. Remember to call your pharmacy in plenty of time so you do not run out of your medications. Sometimes we need up to 48 hours to complete a request and we do not want this to be a hardship for you.
3. Register and use our SECURE PATIENT PORTAL for refill requests. We monitor this continually and again will contact you if there is a problem.
4. Remember we do not refill pain medications on Fridays or weekends and all pain medications must be picked up at our office. We cannot mail or any medications outside our office. Please plan ahead and make arrangements!
We are always here to help you and appreciate the opportunity to care for your healthcare needs!
Yours in good health, Dr. Lakin & Staff
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A bright red eye can be dramatic and often causes concern. Certainly it can be a conjunctivitis (eye infection), but very often, particularly as we get older or if we are on blood thinners like aspirin or Coumadin, it is something benign, non-worrisome, and more dramatic appearing.
Looking much like a piece of red coral in a piece of Native American Indian Jewelry, subconjunctival hemorrhage is present. This is caused by a small capillary rupture in the clear tissue that covers and protects the sclera (white of the eye).
Vision is not impaired in any way, and this condition will resolve on it's own and does not require a doctor's visit. If you develop this and are unsure, e-mail me a picture to confirm the diagnosis, but know that this is not something that is a concern.
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Have You Scheduled Your Physical Yet?
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As you all know, Dr Lakin is a strong supporter of annual physicals. This is a time we can visit and explore any unresolved medical problems and any new health issues that need to be addressed. Annual physicals are one of the best ways to safeguard your health.
The American Medical Association recommends that if you are between the ages of 40 - 49 years, physicals should be done every two years. If you are 50 years plus, it is recommend you have yearly exams, especially if you have any chronic medical conditions that need to be monitored.
Call to schedule your well care visit today!
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Did You Know You Can Pay Your Account Online?
|  For your convenience, you can pay on your account through our secure Patient Portal online.
Simply, complete the brief informational form and 'SEND'
 It's as easy as that! Check it out: LOGIN HERE!
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2 Ways To Repair Skin. . . .
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Some sun damage can be reversed. Here's how.
Cancer, of course, is the most serious consequence of excess sunbathing, but it's not the only one: With repeated exposure to the sun and its ultraviolet rays, skin loses its ability to repair itself. Result: more fine lines, wrinkles and sun spots. The good news: You can repair - even reverse - skin damage from the sun. So first slather on sunscreen to prevent more damage, and then take these steps: Exfoliate. The list of reasons is long: It removes dead skin and reduces fine lines; it helps detoxify, brighten and smooth; and it allows moisturizers and anti-aging serums to work better. Loofahs, scrubs or alpha hydroxy acid cleansers do the job at home; you can also ask your dermatologist about microdermabrasion, a procedure to treat age spots and shallow wrinkles. Deeper-penetrating procedures - such as dermabrasion and chemical peels - are options at the doctor's office. Important note: Exfoliating makes your skin even more vulnerable, so take precautions before going outdoors. Use A, C, E. These antioxidant-packed vitamins fight sun damage, particularly when they're in skin products. Vitamin A derivatives (retinoids, especially prescription tretinoin and tazarotene creams) help reduce fine lines, age spots and rough skin. Vitamin C (ascorbic acid) is vital for collagen and elastin, a fiber that supports skin structure; it may improve texture. Vitamin E (tocopherol) protects cell membranes. Get your antioxidants in green leafy vegetables, tomatoes, carrots, blueberries, beans, fatty fish and nuts. - The Doctors, USA Weekend
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Recipe: California-Style Salmon Burgers
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California-style salmon burgers:
- 2 ounces stale bread (about 1 slice bread)
- 1 large egg white
- 1 pound skinless salmon filet, cut into pieces
- Salt and pepper, to taste
- 4 buns
- Sprouts
- 1 red onion, sliced into rings
- 1 avocado, sliced
- 1 lime, cut into wedges
Preheat the broiler with a rack in the top position. Line a baking sheet with foil. In a food processor, combine stale bread, torn into pieces, with egg white and pulse to form fine crumbs. Add skinless salmon filet. Season with salt and pepper and pulse to finely chop the salmon. Form the mixture into four 3-inch patties (about 1 1/2 inches thick).
Arrange the burgers on the baking sheet and broil until lightly browned on top and opaque throughout, about 5 minutes. Sandwich the burgers in buns with fresh sprouts, sliced red onion and sliced avocado. Serve with lime wedges.
Yield: 4 servings Per serving (with bun): 306 CALORIES, 28g CARBOHYDRATES, 30g PROTEIN, 7g FAT (1g saturated), 1g FIBER, 53mg CHOLESTEROL, 380mg SODIUM
- USA Weekend
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AT THE MOVIES WITH BARB A. . . . .
|  A MUST SEE! + + + + +
GREAT + + + +
ENTERTAINING + + +
RENT THE MOVIE + +
FORGET IT! +
**EMAIL ME! ???
+ + + + "42" THIS FILM TELLS A STORY FROM MY GENERATION. RACISM WAS RAMPANT DURING THOSE YEARS. I SAW IT HAPPEN OVER AND OVER - EVEN IN MY HOME. THE FACT THAT JACKIE ROBINSON DIDN'T TAKE BIGOTRY LYING DOWN WAS HISTORICAL. I LOVED THE MOVIE. I FELT THAT CADWICK BOSEMAN WAS PERFECT AS JACKIE ROBINSON, ALTHOUGH THE CRITICS DIDN'T AGREE WITH ME. HARRISON FORD AS BRANCH RICKEY DIDN'T THRILL ME. I SAW MRS ROBINSON ON A TELEVISION PROGRAM AND SHE STATED THAT THE MOVIE FOLLOWED THE FACTS PERFECTLY. I FEEL IT IS A MUST SEE.
+ + + + + BEFORE MIDNIGHT
I TRULY LOVED THIS FILM. I WAS TOTALLY 'THERE' WHILE IT WAS SHOWING. THE FRIEND I GO WITH USUALLY WHISPERS TO ME DURING THE FILM, BUT SHE DIDN'T MOVE. ETHAN HAWKE AND JULIE DELPY ARE SUPERB. I HAVE NOT SEEN THE TWO THEY MADE TOGETHER BEFORE BUT INTEND TO GET THEM FROM NET FLICKS SINCE IT IS KIND OF A TRILOGY. YOU MIGHT WANT TO SEE THEM TOO: BEFORE SUNSET AND BEFORE SUNRISE. THIS COUPLE IS SO VERY REAL - YOU FEEL AS IF YOU KNOW THEM. ALSO, IT TAKES PLACE IN GREECE WHICH MAKES FOR A LOVELY BACKGROUND.
+ LOVE IS ALL YOU NEED.
THIS HAD GREAT REVIEWS ABUT I FOUND IT DRAGGY AND A CHICK FLICK, PIERCE BROSNAN WAS SO DISAPPOINTING.
Only 3 this time..... Baseball Season!
See you at the movies! Barb A. Back To Top |
Question To Dr Lakin: INSIDIOUS SIDE EFFECTS OF STATINS?
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Hi Dr. Lakin,
I'm forwarding this message because it speaks to an issue that has concerned me for some time. I have been working out consistently, lifting weights and stretching twice a week, walking or bicycling twice a week and doing yoga twice per week, for several years now, and have felt that I was not making much progress in terms of aerobic capacity and developing muscle mass. The research reported in the attached email suggests some reasons why that may be. When I meet with you in June, I would like to discuss how we might manage this situation, or whether we should even try.
From The New York Times:PHYS ED: Can Statins Cut the Benefits of Exercise?
An important new study suggests that statins, the cholesterol-lowering medications that are the most prescribed drugs in the world, may block some of the fitness benefits of exercise, one of the surest ways to improve health.Statins and Exercise: NY Times
Signed;
T
Dear T:
Interesting...and this is something I've wondered a bit, as I take a statin (very low dose) and that is does impair my physical capacity slightly. That said, my dad had bypass at 54...so I feel the need for some help (imperfect diet, and all). Certainly, the potential for insidious side effects of medications are something to consider, and this may be one of those cases.
As always, the balance of benefits and risks need to be considered on a case-by-case basis and individualized to the particular person.
We can revisit when we get together....thanks for sending.
Dr. Lakin
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Happy Summer Time . . . . .
Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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