From 191 to 13 (no, not my IQ)
If my IQ was 191, that would be really cool. really *really* cool. But no, that 191 was my LDL cholesterol. And 191 is bad. REALLY REALLY BAD. It wasn't just the LDL - all the numbers in my lipid panel were in the wrong place. It was so bad my primary care physician made a joke about checking I was still breathing, right before she started making noises about starting lipid meds. And that's where the story gets complicated.
I chose my PCP based on a couple of factors, most notably that she is a member of a practice recognized for practicing patient-centered medicine. Basically, that means they are supposed to do a better job of communicating and listening and practice medicine in which the physician and patient form a partnership based on shared understanding of clinical and lay goals. In some recognized practices, that and a sawbuck will buy you a latte. In this case she totally came through. I did not want to go on statins. I'm really young to go on a long-term medication like that, they can affect liver function and cause damage, and it's not like I thought eating a pound of cheese a week was good for me. (I have a slight addiction to cheese. It's a thing.) There would be physicians who would see that 191 and say it was irresponsible not to push the statins. My PCP was willing to listen when I said I wanted to try something else. It helps that this is my job and I can use words like "hyperlipidemia" and "patient-centered medicine" with a straight face. It also helps that this is my job and I'm not above using my social engineering skills in my own self-interest.
So, we agreed: 3 months of working with a nutritionist and a lifestyle coach to see if I couldn't lower my cholesterol with diet and exercise. The diet part was pretty easy. Eating is something I do anyway, and once I stopped buying cheese (temptation... sweet, milky temptation) and put a little energy into planning meals, it wasn't that big a deal. But exercise, well, that was a much harder deal. I hate going to the gym, I can't jog anymore due to knee problems, and yoga has only modest effects on hyperlipidemia in the units I had time for it. So, I started to think about how easy the diet part was because I was eating anyway, and decided to think "what's something I would do anyway that could be converted into exercise?"
And then I bought a bike.
I've spent the last two months getting back into shape. One doesn't go from a highly sedentary lifestyle where your longest walk was to the end of the driveway to bicycle commuting overnight. Questions of cardiopulmonary sufficiency aside, there were certain other physical dimensions to get used to, about which I will only say a well-made chamois is a bicyclist's best friend. (I'm partial to Shebeest.) It helps that I had forgotten how much I *love* cycling, even with the crazy cars and sweaty helmet. I mapped the route I intended to take and set a series of increasing mile markers to get used to it while increasing distance and I went out after work whenever I had time and the weather cooperated. Today the planets came into alignment - the weather was absolutely ideal for biking, I got out of work on time, and I had enough leftovers that I didn't have to leave time to make dinner. I just kept going until I got to my office, spun around the parking lot a few times, and then came back. 13 miles round trip.
Let us ignore the fact that this means that for fun after work tonight I biked to work.
My PCP was floored when the last round of labs came back. My LDL is still high, although it's come down precipitously from 191 to 125, and that's before I really started biking in earnest. (Exercise more directly raises HDL than lowers LDL, but increasing HDL, along with lowering LDL and triglycerides is part of the process by which hyperlipidemia is controlled.) More importantly, my resting heart rate is down, I'm losing a ton of weight and fitting into clothes I haven't worn in years, I'm sleeping better, and I feel great. Because tonight I biked 13 miles, and kicked 191's ass. I love being in control.
I chose my PCP based on a couple of factors, most notably that she is a member of a practice recognized for practicing patient-centered medicine. Basically, that means they are supposed to do a better job of communicating and listening and practice medicine in which the physician and patient form a partnership based on shared understanding of clinical and lay goals. In some recognized practices, that and a sawbuck will buy you a latte. In this case she totally came through. I did not want to go on statins. I'm really young to go on a long-term medication like that, they can affect liver function and cause damage, and it's not like I thought eating a pound of cheese a week was good for me. (I have a slight addiction to cheese. It's a thing.) There would be physicians who would see that 191 and say it was irresponsible not to push the statins. My PCP was willing to listen when I said I wanted to try something else. It helps that this is my job and I can use words like "hyperlipidemia" and "patient-centered medicine" with a straight face. It also helps that this is my job and I'm not above using my social engineering skills in my own self-interest.
So, we agreed: 3 months of working with a nutritionist and a lifestyle coach to see if I couldn't lower my cholesterol with diet and exercise. The diet part was pretty easy. Eating is something I do anyway, and once I stopped buying cheese (temptation... sweet, milky temptation) and put a little energy into planning meals, it wasn't that big a deal. But exercise, well, that was a much harder deal. I hate going to the gym, I can't jog anymore due to knee problems, and yoga has only modest effects on hyperlipidemia in the units I had time for it. So, I started to think about how easy the diet part was because I was eating anyway, and decided to think "what's something I would do anyway that could be converted into exercise?"
And then I bought a bike.
I've spent the last two months getting back into shape. One doesn't go from a highly sedentary lifestyle where your longest walk was to the end of the driveway to bicycle commuting overnight. Questions of cardiopulmonary sufficiency aside, there were certain other physical dimensions to get used to, about which I will only say a well-made chamois is a bicyclist's best friend. (I'm partial to Shebeest.) It helps that I had forgotten how much I *love* cycling, even with the crazy cars and sweaty helmet. I mapped the route I intended to take and set a series of increasing mile markers to get used to it while increasing distance and I went out after work whenever I had time and the weather cooperated. Today the planets came into alignment - the weather was absolutely ideal for biking, I got out of work on time, and I had enough leftovers that I didn't have to leave time to make dinner. I just kept going until I got to my office, spun around the parking lot a few times, and then came back. 13 miles round trip.
Let us ignore the fact that this means that for fun after work tonight I biked to work.
My PCP was floored when the last round of labs came back. My LDL is still high, although it's come down precipitously from 191 to 125, and that's before I really started biking in earnest. (Exercise more directly raises HDL than lowers LDL, but increasing HDL, along with lowering LDL and triglycerides is part of the process by which hyperlipidemia is controlled.) More importantly, my resting heart rate is down, I'm losing a ton of weight and fitting into clothes I haven't worn in years, I'm sleeping better, and I feel great. Because tonight I biked 13 miles, and kicked 191's ass. I love being in control.