My First Ever Health Checkup - Do I need to add any extra Tests ?

[Sheryl]

What did the heart tests done 3 years ago consist of?

[backstreet]

18 minutes ago, Sheryl said:

What did the heart tests done 3 years ago consist of?

Ive attached 3 sheets , there are many  graph sheets , so i'm not sure which ones to post .

[Sheryl]

You had a negative exercise stress test and normal echocardiogram. 

 

Stress test should be repeated every 3-5 years so no problem to wait a while on it if this was three years ago (I can't see date on what uou posted). 

 

Atorvastatin is same action as the Simvastatin other doctor suggested and same issues/discussion applies to it.

 

I would question the aspirin.  Can cause gastritis and other problems 8ncluding internal bleeding edpecially in peopld over 70.  Benefits exceed risks for people with known cardiovascular lesions but that is not the case with you.

 

See https://www.aspirin-foundation.com/scientific-information/guidelines/usa-guidelines-aspirin/

 

Bear in mind Thai doctors assume all patients want medication and would feel ill treated if not prescribed several on each visit. 

 

 

[backstreet]

11 minutes ago, Sheryl said:

You had a negative exercise stress test and normal echocardiogram. 

 

Stress test should be repeated every 3-5 years so no problem to wait a while on it if this was three years ago (I can't see date on what uou posted). 

 

Atorvastatin is same action as the Simvastatin other doctor suggested and same issues/discussion applies to it.

 

I would question the aspirin.  Can cause gastritis and other problems 8ncluding internal bleeding edpecially in peopld over 70.  Benefits exceed risks for people with known cardiovascular lesions but that is not the case with you.

 

See https://www.aspirin-foundation.com/scientific-information/guidelines/usa-guidelines-aspirin/

 

Bear in mind Thai doctors assume all patients want medication and would feel ill treated if not prescribed several on each visit. 

 

 

 

Thanks Sheryl

 

I forgot to tell the Cardiologist of another symptom that I’m experiencing ,

 

Ive been having an annoying itching sensation around both of my ankles , Ive done a bit of internet research as to the possible cause of the itching and there seems to be several avenues of thought including A & B .

 

A . skin conditions like eczema and psoriasis.

 

B . poor circulation in the lower legs

 

Ive applied some skin cream ( Diphenhydramine ) to the itching area , but the itching continues .

 

The poor circulation ( B ) has me now thinking more about any heart issues I may have  .( Stasis Dermatitis )

 

.

 

 

 

 

[Sheryl]

From your initial check up you do nto have any circulatory problem in your leg. They checked the ankle:brachial index and it was normal.

[backstreet]

Well Like the The Terminator use to say ,  I'll be back .

 

So here I am and I’m hoping that some one may be kind enough to help me again with my current health issue related to my original post . So after seeing the cardiologist at the Bangkok Hospital in Korat and taking the recommended drug atorvastatin ( 40mg ) . I have been taking that drug for over two months now and at the same time I have been on a strict diet ( cutting out sugars / saturated fats / red meat / dairy / milk / fried foods Etc. ) . 

 

 Recently I have been experiencing a strange problem. 

 

When I got up out of bed in the morning and stood upright I felt a bit unsteady on my feet , not a drastic feeling but a gentle feeling that my balance was not quite correct . Over the rest of the day the feeling that my balance felt not quite right , sort of disappeared and then came back in cycles . I never felt any dizziness , but on the odd occasion I do feel a bit queasy and light headed . So I decided to go back to the  Suranaree University of Technology Hospital in Korat and seek a doctors opinion .

 

I outlined to a doctor my current problem about feeling a bit unsteady on my feet when getting out of bed in the morning along with feeling a bit queasy and light headed  and telling the doctor that I was currently taking the drug atorvastatin ( 40mg ) just before I go to sleep at night time. 

 

The doctor then arranged a full blood test and my blood pressure was taken which was 129 / 57 / 75  When those new full blood test results arrived back and the doctor showed me I was amazed at the change in my Cholesterol numbers . 

 

Then I asked the doctor about my feeling a bit unsteady on my feet when getting out of bed in the morning and on some occasions feeling a bit light headed and queasy . Here’s where things became some what unsettling .  

 

The doctor made the comment that my feeling a bit unsteady on my feet when getting out of bed in the morning along with feeling a bit queasy and light headed, may just be a reaction or side effect of taking the drug atorvastatin .  

 

I then asked this question , well Doctor if the feeling I now have of feeling a bit unsteady on my feet along with the feeling of being light headed is due to a side effect of the drug atorvastatin ,  surely then I would have felt that same side effect when I first started taking the drug atorvastatin , but on first using the drug atorvastatin I had no side effects what so ever. 

 

The doctor then commented that my current symptoms of feeling a bit unsteady or queasy and light headed when getting out of bed in the morning , may be due to the restricted diet I’m currently following , may be a sugar deficiency issue. 

 

I also asked the doctor if my current symptoms of feeling a bit unsteady on my feet when getting out of bed in the morning and on some occasions feeling a bit light headed and queasy throughout the day  , may have any connection to a possible un discovered heart issue .  

 

The Doctors answer to that question was, if I did have a heart problem that was causing the symptoms of feeling a bit light headed and queasy throughout the day , I wold also be experiencing physical pain in my heart area. 

 

The doctor then prescribed me the drug … Flunarizine .

 

Flunarizine has been used in medical practice for over 25 years. It was initially introduced as a medicine to improve blood flow and is a medicine known as a calcium channel blocker. It has been mainly used in the treatment of dizziness, vertigo and prevention of migraine.

 

The doctor did tell me to reduce the atorvastatin to 20mg a night .

 

I left the doctors office some what disheartened , but I do fully appreciate the doctors input and advice . So I’m not sure what is really causing my current ongoing symptoms of feeling a bit unsteady on my feet when getting out of bed in the morning and on some occasions feeling a bit light headed and queasy throughout the day. 

 

My next Doctors appointment at the Suranaree University of Technology Hospital in Korat is on the  5th of April .

 

I have my fingers crossed that reducing my atorvastatin dosage to 20mg a night may have some positive effect on my current symptoms. . I wish I could track down what is currently making me feel a bit unsteady on my feet when getting out of bed in the morning and on some occasions feeling a bit light headed and queasy throughout the day. 

 

Just a thought that has popped into my head as I write this , now my LDL cholesterol number has gone down , could I stop taking the drug atorvastatin and revert back to my normal diet , just to see if doing those two things will have any effect on my current symptoms of of feeling a bit unsteady on my feet when getting out of bed in the morning and on some occasions feeling a bit light headed and queasy throughout the day. 

 

Any thoughts or suggestions please. 

 

Many Thanks .

 

[Sheryl]

Do not stop the atorvastatin and do not revert to your old diet!!!! You will have rebound and the bad levels will nto only return but skyrocket.

 

Given how good your numbers now are, you could if you want,  try the  doctor's suggestion of a reduced dosage, and retest a few months later.

 

However I am doubtful the atorvastatin is the cause of your lightheadedness. It is not a known side effect of the drug. I think the doctor simply had no idea what was causing it so was grasping at straws.

 

What you describe in the morning sounds like either orthostatic hypotension or benign postural vertigo. Are you taking any blood pressure medication? And are the episodes later in the day occcurring after any change in posture or head movement?

 

Feeling queasy/lightheaded  could also be due to hypoglycemia, possibly your dietary restrictions now are excessive but I really can't say without knowing more about what you eat and when.

[backstreet]

15 hours ago, Sheryl said:

Do not stop the atorvastatin and do not revert to your old diet!!!! You will have rebound and the bad levels will nto only return but skyrocket.

 

Given how good your numbers now are, you could if you want,  try the  doctor's suggestion of a reduced dosage, and retest a few months later.

 

However I am doubtful the atorvastatin is the cause of your lightheadedness. It is not a known side effect of the drug. I think the doctor simply had no idea what was causing it so was grasping at straws.

 

What you describe in the morning sounds like either orthostatic hypotension or benign postural vertigo. Are you taking any blood pressure medication? And are the episodes later in the day occcurring after any change in posture or head movement?

 

Feeling queasy/lightheaded  could also be due to hypoglycemia, possibly your dietary restrictions now are excessive but I really can't say without knowing more about what you eat and when.

Thanks Sheryl.

For my diet , Ive been following the OMAD ( One meal a day ) option. 

 
Basically during the day I eat nothing and drink the occasional cup of black coffee or water. Then I have one normal meal around 6pm each day.

 

In the approximate two months Ive been on this diet my body weight has reduced by just over 2 kg 
and at the start of that diet I felt fine but now after I now get up in the morning I start to have a strange feeling that my balance is what I would call a bit off, I can walk around without too many problems but some times I feel like like my next step is becoming what I can only describe as a bit wobbly. That wobbly feeling seems to come and go throughout the day  

 

The light headed feeling seems to remind me of past times long ago when I was employed working full time and some times I had to skip several meals during the working day to get a job finished on time.

 

The only drugs I’m currently taking are - Atorvastatin and Flunarizine. 

 

The episodes of feeling that my balance is what I would call a bit off and the light headed feeling 
don’t seem to be effected any change in posture or head movement . 
 

Another random thought Ive just had about my current ‘’ strange feeling that my balance is what I would call a bit off / light headed feeling ‘’  is that around the same time I attended Suranaree University of Technology Hospital in Korat I also went to an opticians to pick up a new pair of bifocal glasses which I have been wearing ever since . I’m wondering if starting to wear those new pair of glasses has any thing to do with my current ‘’ strange feeling that my balance is what I would call a bit off / light headed feeling ‘’ situation .

 

I’m now wondering if my  ‘’ strange feeling that my balance is what I would call a bit off / light headed feeling ‘’  situation could be being caused by a combination of all of the above ( Diet , Drugs , Wearing new glasses ) .

 

Thankfully this current feeling I am experiencing is not too debilitating , more annoying that any thing, but who knows if my current symptoms are some sort of advance warning of a more serious health situation just around the corner.

 

 

Thanks .

 

 

 

[Sheryl]

OMAD is extreme and will certainly lead to periods of hypoglycemia especially in an older person. So can too much coffee. Plus in this hot weather you may be getting a bit dehydrated or have sn ekectrolyt imbalance.

 

You should start eating either 3 meals a day or 2 with a snack in between. Continue to avoid processed carbs (and processed foods in general) and keep red meats to a minimum (with fat trimmed off) but otherwise eat a good variety of foods. Make this a permanent change from your original  diet.  If you feel you stilll need to lose more weight do so by keeping the portions small not by going many hours with no food.

 

Also drink plenty of water, reduce the coffee (which dehydrates) and while it is this hot I'd suggest an electrolyte drink once a day -- can use the sachets available in any 7-11 or green coconut water for that. If gor any reason yoy sweat a lot (for example have been out in the sun and/or exercising) take another electrolyte drink.

[KhunLA]

1 hour ago, backstreet said:

Thanks Sheryl.

For my diet , Ive been following the OMAD ( One meal a day ) option. 

 
Basically during the day I eat nothing and drink the occasional cup of black coffee or water. Then I have one normal meal around 6pm each day.

 

In the approximate two months Ive been on this diet my body weight has reduced by just over 2 kg 

No wonder your lightheaded when waking, body starved for nutrients or energy.   And only lass 2 kg ... that pretty sad, and obviously not working for you.   

 

Try intermittent fasting, not eating from 9pm to noon, overnight.  Then eat whatever you want, common sense & moderation, from noon to 6pm, maybe a snack before bed if like me, can't sleep on empty stomach.

 

That works for me, and way too easy, since sleeping half the time fasting.

 

Definitely don't stop the statin, as obviously working very good, since triglycs & LDL dropped considerably.

[backstreet]

50 minutes ago, Sheryl said:

OMAD is extreme and will certainly lead to periods of hypoglycemia especially in an older person. So can too much coffee. Plus in this hot weather you may be getting a bit dehydrated or have sn ekectrolyt imbalance.

 

You should start eating either 3 meals a day or 2 with a snack in between. Continue to avoid processed carbs (and processed foods in general) and keep red meats to a minimum (with fat trimmed off) but otherwise eat a good variety of foods. Make this a permanent change from your original  diet.  If you feel you stilll need to lose more weight do so by keeping the portions small not by going many hours with no food.

 

Also drink plenty of water, reduce the coffee (which dehydrates) and while it is this hot I'd suggest an electrolyte drink once a day -- can use the sachets available in any 7-11 or green coconut water for that. If gor any reason yoy sweat a lot (for example have been out in the sun and/or exercising) take another electrolyte drink.

Thanks Sheryl 

 

The  electrolyte drink is some thing I had not though of .

 

Any thoughts on …......

 

Another random thought Ive just had about my current ‘’ strange feeling that my balance is what I would call a bit off / light headed feeling ‘’  is that around the same time I attended Suranaree University of Technology Hospital in Korat I also went to an opticians to pick up a new pair of bifocal glasses which I have been wearing ever since . I’m wondering if starting to wear those new pair of glasses has any thing to do with my current ‘’ strange feeling that my balance is what I would call a bit off / light headed feeling ‘’ situation .

I was thinking that tomorrow when I get out of bed , I will not wear those new glasses through out the remainder of the day , just to see if any of my symptoms change .

 

 

Thanks.
 

[backstreet]

38 minutes ago, KhunLA said:

No wonder your lightheaded when waking, body starved for nutrients or energy.   And only lass 2 kg ... that pretty sad, and obviously not working for you.   

 

Try intermittent fasting, not eating from 9pm to noon, overnight.  Then eat whatever you want, common sense & moderation, from noon to 6pm, maybe a snack before bed if like me, can't sleep on empty stomach.

 

That works for me, and way too easy, since sleeping half the time fasting.

 

Definitely don't stop the statin, as obviously working very good, since triglycs & LDL dropped considerably.

Hi , thanks for your comment 

 

I was wondering if there was a correlation between my symptoms  ( strange feeling that my balance is what I would call a bit off plus a light headed feeling ) and my current OMAD diet . 

 

The intermittent fasting is some thing I’m going to check out , 

 

Now the  doctor has reduced the Atorvastatin dosage to 20mg I’m hoping that reduction from the original 40mg to 20mg , will hopefully some how help me with my current ongoing symptoms .

 

Thanks .
 

[Sheryl]

1 hour ago, backstreet said:

Hi , thanks for your comment 

 

I was wondering if there was a correlation between my symptoms  ( strange feeling that my balance is what I would call a bit off plus a light headed feeling ) and my current OMAD diet . 

 

The intermittent fasting is some thing I’m going to check out , 

 

Now the  doctor has reduced the Atorvastatin dosage to 20mg I’m hoping that reduction from the original 40mg to 20mg , will hopefully some how help me with my current ongoing symptoms .

 

Thanks .
 

Again, there is no question but that your OMAD diet is extreme and unhealthy for someone your age and bound to cause periods of low blood sugar, which is likely what you are experiencing. It is also not the best way for someone your age to lose weight as your body will compensate for the prolonged periods of no food by reducing its metabolic rate.

 

Without much increase in total quantity that you  eat now (or at least without much increase in total caloric intake - you can safely add in increased quantities of salad, fresh vegetables etc) , try to space out consumption into at least 3 times in the day (the one in the middle can be a light snack) so that your blood sugar does not keep yo-yoing like this, which is definitely unhealthy and places stress on the body.  Younger people can get away with this, older people often cannot.

 

I would also suggest that you take a small snack just before bed time to help stabilize blood sugar through the night so that it is not too low when you first get up. To achieve this, what you take needs to be high in protein and also contain some fat (healthy fat) as this slows absorption. Suggestions: small quantity of nuts, a half a peanut bitter or tuna fish sandwich (might use the other half for mid day snack. Make sure the bread is whole wheat).... but anything high in protein and containing healthy fats will work.

 

Note that it is neither necessary nor desirable to be on a low fat diet. Fats are essential nutrients necessary to absorb certain vitamins, and also help slow digestion so that blood sugar levels don't bounce up and down too much. But they need to be healthy fats. Examples being oils from fish and vegetable oils: sunflower oil, canola etc.  Do not eat anything made or cooked with palm oil, and minimize animal fats (minimize not 100% eliminate).

[BigStar]

Good advice above. Changing to the 8-hour eating window intermittent fasting should help. Healthy snack before bed, sounds good. Add back in some red meat, no need to avoid full fat milk, Greek yogurt.  Seed oils, I dunno. I avoid; can't go wrong w/ olive oil.

 

I hope the Flunarizine isn't going to be another ongoing drug. It may mask symptoms of the real issue, whatever it is. I'm not a big believer in statins, so I like the doc's advice about a reduction.

 

We're not hearing about exercise. Dizziness can be associated with weakness and poor circulation; exercise certainly helps your heart. Work up to adding intensity. It'd be nice if your diet & exercise could get your TG/HDL/LDL into good ranges naturally. Your TG/HDL ratio wasn't so bad before.