I sometimes wonder why I bother blogging. It takes a lot of time, and I guess it’s not always that rewarding. Of course, one of my main goals is to share knowledge. There is so much unreliable information on the internet. Therefore I believe it is my obligation, as a trained doctor, to share information with my readers.
I’ll be the first to admit that sometimes my blog articles are quite dull. I may address a particular subject and discuss it in theoretical and practical terms. These articles don’t get many Facebook likes and they are not Tweeted a lot. However, if somebody is looking for information on the subject he might find my blog post by doing a simple Google search. Thus, I may actually succeed in providing what I believe is reliable information on a particular subject to a complete stranger, maybe residing on the other site of the planet.
I also try to write articles that are more creative and opinionated, and they usually get more reading, at least initially. If I’m lucky they may get a few tweets and likes.
However, what makes all the difference for me as a blogger are my readers and their response. They are what makes blogging worthwhile. Although often argumentative and sometimes arrogant, my readers comments may indeed be caring and compassionate. A touch of humanity can make the dullest of subjects come alive. Let me tell you a little story.
A while ago I wrote a blog article on Lipoprotein(a) (Lp(a)). Well, I guess it’s one of my duller posts. But it may be practical and interesting for some people. Lp(a) is a substance that can be measured in our blood. High levels are associated with increased risk of heart disease. What is unique about this substance is that it is very resistant to lifestyle changes and drugs. Furthermore, it has not been proved that lowering it is beneficial. So why should you know your Lp(a) level if you can’t do anything about it?
Recently a reader by the name of Shannon wrote the following comment on my blog:
“Hi my dad passed away suddenly a few years ago which they believe was heart related. I recently got tests done and found out that my lipoprotein a was 111 (not sure units) they put me on a strict diet and now monitor me every six months they said that if it rises ill have to be put on medication for life. While attempting to explain to me (now 15 years old) what lipoprotein a was, in a bunch of doctor jargon, they mentioned that it can never be lowered , is that true? And are my lipoprotein a levels dangerous and if so are they life threatening? I would for someone to explain it to me in simple English that I can understand. Thank you in advance”.
I was quite touched by this 15 years old girl’s comment. I felt sorry for her loss. I also felt sad because she had to worry about a laboratory measurement which might or might not play a role for her in the future. Shouldn’t she be embracing life and enjoying her youth without worrying about the future. How should I respond? How could I explain these complex issues in simple terms?
A few hours after I read Shannon’s comment another reader responded. Then I knew I didn’t have to do anything. There’s no way I could have given Shannon a better or a more caring and compassionate response.
I am so sorry for your loss.
I’m not a doctor. I’m a dad who has lost his wife (and the mother of my children) to cancer. I was very involved in my wife’s medical battle, and I have helped other family members (parents and children) deal with several serious medical issues. So I know a little about dealing with these things from a patient’s perspective.
I was touched by your note, and if you don’t mind, I’d like to offer the following points and suggestions:
(1) I applaud your taking responsibility for your own health. You’re getting tests and advice from doctors, as you should. You’re also being curious and wanting to learn more. That is EXACTLY what you should do.
(2) Your health and medical care are primarily YOUR responsibility. Accepting that responsibility, and managing your own care, will be the most important thing you can do. (It’s fine if others also feel responsible for your care, but you should never let go of that responsibility completely.)
(3) Medicine and all sciences are ever-evolving. Whatever you hear from doctors now (about tests, diagnoses, prognoses, conclusions, treatments, etc.) will be based on what doctors know and believe now. You can count on that changing over time, even when doctors seem to have definitive answers.
(4) Sometimes, most doctors will agree about a medical issue and the best course of action. Sometimes they don’t. There are controversies raging now about diets (for example, whether to eat low-fat/high-carb, or low-carb/high-fat). Many doctors are also in raging disagreement about how to test for and treat cholesterol, lipids, and cardiovascular risk.
(5) Lp(a) seems to be one of the more important and least-understood factors. So in this case, you might find some doctors who claim to know, others who are guessing, and others who simply say they don’t know what the risk from high Lp(a) is, or what you should do about it.
(6) (I’ve had Lp(a) readings from 33-66. My doctor used to think I should treat it with niacin. But now, after some recent studies, he’s not so sure. I’m 58, and they may or may not figure this out in time to help me.)
(7) The good news, for you, is that you’re so young. Time is on your side. Before your risk becomes significant, doctors and researchers should know a whole lot more about Lp(a) and how to treat it.
(8) It’s understandable why you have asked for clear explanations and definitive answers. There’s nothing wrong with asking those questions. However, I don’t think doctors will have all the answers for you right now. Be patient. They will, probably within the next 5-10 years.
(9) From what I’ve read, the issue about whether you are at risk from Lp(a), and what should be done about that risk, will depend on your specific genetic make-up. (That’s the future of medicine. They used to treat everyone based on what worked best for most people. In the future, they will treat individuals based on their DNA, and what they expect to work for each individual.) Keep and eye out for those genetic findings, relative to Lp(a) tests and treatments.
Sorry to go on so long. That’s what I would want to tell you, if you were my daughter. Again, time is on your side. Be patient. Embrace the responsibility for your own long-term health. Keep learning – throughout your life – and you should be fine. And again, I am so sorry for your loss.”
Thanks Shannon and Richard for sharing your experience and for making blogging worthwhile.