“In life as in nature, what’s good for the bee, is good for the hive”

Statins: Curse or Cure Debate – Towards The Informed Patient Physician Partnership

Sep 24, 2017

Well, it’s fast approaching: the open mic’ public debate on the Isle of (free) Man.  In the red corner, the good Doctor – the highly experienced Dr Alex Allinson.  He’s kind and smart, yet he was ‘foolish’ enough to stand for our Tynwald Parliament last year – and as we’d hoped got in by a landslide.  He got my vote too, plus more votes than any other election candidate.  Poptastic for a tough, ‘hard to please everyone’, political gig. But, now the ballot box is closed and I’m in the blue corner, ready to debate statins with him. Fully buffed up, shorts up to my nipples – and I’m ready to rumble.

Tomorrow night we’re debating in that bear pit, the Manx Museum – the baying hordes snoring at us, as we cut to the chase on: $tatins Curse or Cure.  Likely, our debate will go from Mary Poppins to Machiavelli and back again.  Such are the Mary Poppins issues of positive PR from Pharma Co’s clinical trials, using careful screening to ensure that sponsors get the answers their big dolloping dollars demand.  Cynical, moi, how so?  The near war cry of “show me the evidence and all of it”, will be framed within a consensus of how we now, best move forward.  But, what if cholesterol is merely yet another blood bio-marker? acting as an excitable Firefighter at the scene of a crime – trying to dampen down an inflammatory, dietary triggered and sedentary lifestyle?

Stateside, academic, Dr Beatrice Golomb has focused her research on the balance of statin treatment risks v benefits, a context that gives meaning to those opposing statin views – the yin and yang of real life.  Dr Golomb has studied female physiology as particularly affecting violent mood swings and has studied suicide ideation for both sexes too.  Hardly “cuddly kitten Blofeld” – but there you go.

A statins trial recently featured in a British daily paper.  The trial followed more than 5,000 male patients over a twenty year period.  But whoa or should, that be ‘wo’, as there were no, repeat, no WOmen on the trial, men only.  Maybe WOmen were in short supply in the Rolodex of trial commissioners – but having 50% of the patient group fully excluded strikes one as, well, a bit skewed, since you ask. That’s more of a coin flip with only heads predicted to land, face up, each time.  Good odds – or maybe even, odd goods? Back here our debate will cover Number Needed to Treat (NNT) for effectiveness and cover the ‘drug gateway’ aspect of statins, which, once prescribed, often lead on to the patient needing another drug, then another – those pesky and complex side effects are like that.

The Good Doctor supports increased patient autonomy and careful de-prescribing over time for better whole system health.  But first, we have to break free of mass medication, a driver of so many addictive ‘medical’ substances.  Maybe we are too casually listening to that 1960’s Eagles classic, Hotel California “you can check out any time you like, but you can never leave!” As those med’s sure are complex.  But at the final weigh in, it will be the kindly Doctor who will bravely lead the charge, while we hand him the towel for a good rub down. “Ladies and gentlemen, please start your microphones and: let the Informed Patient Physician Partnership debate begin”.

Too late for the Oscars but: https://www.youtube.com/watch?v=7xgdQ8KzRdo&feature=youtu.be