If you have a heart condition, you probably know that medications can play an important role in your health.
But if you’re reading this blog, chances are you’re also interested in helping yourself heal and have a preference for avoiding medication when they’re not necessary.
As I outlined in last week’s blog, we know that poor diet is an independent risk factor for developing heart disease. We also know that unhealthy diets in people with heart disease can lead to increased rates of death and heart events. It therefore makes complete sense to pay attention to nutrition and optimize it as best you can – especially if that allows you the opportunity to avoid drugs.
So when your doctor glances at your cholesterol levels -- or even just your age -- and starts writing a prescription for Lipitor®, what can you say about preferring to try diet first without becoming a “difficult patient”?
Plenty. In my own practice as a cardiologist, I try to talk through different options and guide my patient to a choice they are comfortable with. Every doctor has their own style, of course, but all providers should be interested in your ideas and concerns. It’s your body, after all, and it’s ultimately your decision as to what treatments are utilized.
In some cases, you may need to initiate the conversation. If that’s the case, follow these tips:
- Acknowledge the statin recommendation, express your interest in attaining the proposed cholesterol goal and verbalize your concerns about medications. For example, many of my patients have had previous negative experiences with drugs, or have family members or co-workers that have had issues. Your doctor needs to know where you’re coming from to be best able to help you.
- Ask your doctor if they’ve heard of Step One Foods. Unfortunately, not everyone has, so bring a copy of our clinical trial or forward them a copy via your health portal before the appointment. A clinical trial speaks to doctors in their language, and sharing our results is a simple way to reassure them that our foods aren’t gimmicks.
- Ask your doctor’s opinion on making lifestyle changes through diet and exercise before starting statins. If you don’t have a history of heart attack, stent, bypass surgery, stroke, peripheral vascular disease, or other indicators of atherosclerosis, there’s no reason not to try these proven and side-effect free options first. Suggest a plan of incorporating Step One Foods twice a day for at least 30 days and then rechecking your cholesterol profile on the foods to document their effect.
- Discuss the option of checking a coronary calcium scan to determine if you really need statins to lower your heart disease risk. If you don’t have a history of heart attack, stent, bypass surgery, stroke, peripheral vascular disease, or other indicators of atherosclerosis, this may be a very useful test to help individualize your prevention efforts. And it’s a recognized and recommended step in the Cholesterol Management Guidelines when the need to start statins is not certain.
- In the unlikely scenario that your doctor refuses to listen at all, consider getting a new provider. Medical care is a partnership between doctor and patient. It’s important to have a partner you can work with.
Don’t be surprised if you catch your doctor off-guard. Our profession has created an overprescribed society: 60% of American adults -- and 90% of senior citizens -- take some form of prescription medication. How many of those medications actually treat the root cause of disease? How many unwanted side effects do they cause? When you tactfully point these things out, your doctor will most likely understand why you’re making the smart choice to try diet first.
Finally, it’s really important to point out that medications do have a place in care and may even be necessary. I prescribe drugs all the time. Some patients should be on statins even if their cholesterol is perfect. But we all have to acknowledge that drugs are an incomplete solution. Nutrition is vital to health and healthy longevity, can help reduce the need for medications, and could even be the complete solution for many patients. A good physician is one that recognizes this truth.