Tuesday, June 12, 2007

Yet Another Idiot Doctor with a BUTCHER SHOP Mentality

A recent headline at WebMD's Medscape site proclaimed "It Should Be the Right of All Americans to Have Primary Percutaneous-Based Intervention for Acute Coronary Syndrome" (http://www.medscape.com/viewarticle/557124?src=mp).

In the accompanying editorial, Dr. Melissa Walton-Shirley calls for the "greatest push in the history of American cardiac medicine" in order to "improve accessibility to primary percutaneous-based intervention" (angioplasty, stents, etc.). She suggests that "All invasive cardiac laboratories with access to interventionalists should be urgently brought into programs that will allow for appropriate support staff training ..." given the "Improved pharmacologic therapy, better stent platforms, and the advancement of wire technology."

Now, let me get this straight. According to "Doctor" Walton-Shirley "It Should Be the Right of All Americans" and we should have the "greatest push in the history of American cardiac medicine" to cut people open and snake wires up their chests after she, and other "doctors" of her ilk, let their patients become so diseased that they have a heart attack simply because we have great "technology" to fix it.


I believe "It Should Be the Right of All Americans" and there should be the "greatest push in the history of American cardiac medicine" to provide access to even more remarkable "technology" that provides early-detection and treatment for heart disease BEFORE they have no other alternative than to go under your BUTCHER SHOP care! That IS what doctors are SUPPOSED to do, isn't it?

Now, don't get me wrong. Percutaneous intervention is a wonderful technology that can save the lives of acutely diseased patients. But the priorities, if not position, of Walton-Shirley is so grisly and perverse I don't know what else to say. For her, the solution to heart disease is to demand the opening of more butcher shops rather than demand the institution of pervasive early-detection and prevention programs. What next, expand the distribution of leeches in hospitals? Wake-up and join the 21st century, would ya?



Thursday, June 7, 2007

Co-Q10: Are these docs out of their minds?

A recent report in the Journal of the American College of Cardiology (http://content.onlinejacc.org/cgi/content/short/49/23/2231) authored by Drs. Leo Marcoff and Paul Thompson proclaims, "The routine use of CoQ10 cannot be recommended in statin-treated patients." Let's take a moment and review key findings from their abstract and see if we come to the same INANE conclusion. Italicized items are quotes. Items in parenthesis are my admittedly sarcastic comments.

1. Statins block production of farnesyl pyrophosphate, an intermediate in the synthesis of ubiquinone or coenzyme Q10 ... (So, we agree that statins reduce production of Co-Q10.)

2. This fact, plus the role of CoQ10 in mitochondrial energy production, has prompted the hypothesis that statin-induced CoQ10 deficiency is involved in the pathogenesis of statin myopathy. (Hmmm, that seems to make sense too!)

3. We identified English language articles relating statin treatment and CoQ10 (Translation: We did no original research of our own.)

4. Statin treatment reduces circulating levels of CoQ10. (So, we agree on that too.)

5. ... data on intramuscular CoQ10 levels in symptomatic patients with statin-associated myopathy are scarce. (So, the bottom-line is you really do not have much data to base ANY sort of recommendation.)

6. Mitochondrial function may be impaired by statin therapy, and this effect may be exacerbated by exercise (OK, I'm still with you.)

7. Supplementation can raise the circulating levels of CoQ10, ... (What am I missing? It seems you agree that Co-Q10 supplementation will raise bioavailability.)

8. ... but data on the effect of CoQ10 supplementation on myopathic symptoms are scarce and contradictory (Yeah, you already said you don't really know ANYTHING for certain in item 3.)

9. We conclude that there is insufficient evidence to prove the etiologic role of CoQ10 deficiency in statin-associated myopathy (You keep telling us you don't really know - we BELIEVE you!)

10. ... well-designed clinical trials are required to address this issue (Well DUH!)

11. Nevertheless, there are no known risks to this supplement and there is some anecdotal and preliminary trial evidence of its effectiveness. (So, then why would you NOT recommend supplemental Co-Q10 in an attempt to save your patients the pain and debilitation associated with statin-related myalgia?)

12. Consequently, CoQ10 can be tested in patients requiring statin treatment, who develop statin myalgia, and who cannot be satisfactorily treated with other agents. (WTF?! OK, now I am really confused! Holy contradiction, Batman!)

Gee whiz, what was their idiotic conclusion again? Oh,Yeah.

"The routine use of CoQ10 cannot be recommended in statin-treated patients."

Excuse me, but do I look stupid? What kind of crap are these guys peddling? Did they miss the lecture on deductive reasoning? Did their mothers drop them on their heads when they were infants? Somebody please tell me how simpletons like these two manage to pass their medical boards?

To make matters worse, this ridiculous, off-the-hook statement is the headline in one my favorite online cardiological news sources (http://www.theheart.org/viewArticle.do?primaryKey=794465&nl_id=tho05jun07).

This type of sloppy and insane research and reporting should be EXHIBIT 1 in my constant rant that you have to get your information from multiple sources and use your own reasoning. Just because someone lists "doctor" or "reporter" as their title does not guarantee they have an even an ounce of common sense. Trust your own mind and body. I will keep taking my Co-Q10 for one simple reason - it hurts when I don't!

Give me a break,


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