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Question:

From Caledonia, Mississippi, USA:

I recently had my blood work done, and the Nurse Practitioner called me in a panic. I needed to come in ASAP. My triglycerides are 3500, and since I hadn't seen a doctor for about eight months (they were 900 then), they don't know how long it has been like that.The PA that saw me told me they were afraid to increase or change my Zocor saying it might be what puts my heart or pancreas over the edge. He told me to stop exercising (I just started going to the gym a month ago) and to try not to stress myself since my heart or pancreas could go any time. He told me that if I get any sharp pains in my side that goes through to my back or if I have heart attack symptoms I need to call 911. I also have high blood pressure, elevated liver functions, a fatty kidney, irritable bowel, hiatal hernia and asthma. I actually look and feel fine.

Is the doctor trying to scare me? Do I really need to worry? I am scheduled to see an endocrinologist sometime this week. No one believes that I am a 60% disabled veteran. I work a 40 hour a week job and everything. Would this have an impact on my knee replacements? I've had five operations to correct problems that developed on active duty, and they plan on replacing my knees in about seven years.

Answer:

When the triglycerides get over 500, there is concern that this may induce a condition called acute pancreatitis. Pancreatitis can be a life-threatening illness where the enzymes marked for delivery to the gut to help with meal digestion of proteins become activated within the pancreas. This has the effect to actually "eat away the pancreas." The higher the triglycerides, the higher the risk.

Not changing the Zocor is probably directed at not letting get any higher. However, Zocor is not the best agent to use as a single agent in the treatment of elevated triglycerides. Please talk to the doctor about medicines specifically geared toward lowering triglycerides. As long as you don't develop pancreatitis, you are probably okay in the short-term. However, the elevated triglycerides in the face of diabetes have been shown to be a marker for atherosclerosis. Triglycerides can also be made better by better control of blood sugars, adjusting your diet, and losing weight. This disorder is often present in family members.

Your last question, referring to your ability to have a knee replacement, is indirectly appropriate as anyone with a high heart risk should first be cleared to have surgery like that. Managing heart disease is important and requires multiple interventions with control of sugars, blood pressure, weight, the use of daily aspirin, and so on. You need to talk with your physicians about these issues.

JTL

DTQ-20030415135906
Original posting 30 Apr 2003
Posted to Other

  
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Last Updated: Tuesday April 06, 2010 15:09:46
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