Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, July 08, 2008

Statins for Kids? No F-ing Way!

The nation’s pediatricians are recommending wider cholesterol screening for children and more aggressive use of cholesterol-lowering drugs starting as early as the age of 8 in hopes of preventing adult heart problems.

The new guidelines were to be issued by the American Academy of Pediatrics on Monday.
Puh-leez!

When I'm presented with a patient whose med list is as long as my arm, one of my favorite things to do is go through it and take people OFF meds. Duplicative therapy; unnecessary poly-pharmacy; relieving medication side effects by stopping the drug -- and perhaps one or two more begun to combat those side effects. I love it!

Before I start any 8-year-old on a statin drug for his cholesterol, I'm going to first suggest stopping all video games and discontinuing all TV. Then I would prescribe 3-4 hours/day of running around outside in the sunshine (with sunscreen, of course) possibly supplemented by 1-2 hours in a swimming pool or ocean. Other things I'd like to see on that kid's med list -- before statins! -- would include:
  • biking (with helmet, please)
  • stickball
  • hide & seek
  • daydreaming in a hammock
  • catching frogs
  • etc.

Statins for kids. Sheesh!!

19 Comments:

At Tue Jul 08, 06:49:00 AM, Anonymous JadedDoc said...

Yup -- we want a pill for everything. But wow, Nelly...when we find that given statins to the younger set causes some sort of unanticipated side effect, there will be a huge class action against all of the drug companies.

Personal responsibility for good diet, exercise? The things that TRULY drive HEALTH? Nah. There is no money to be made in that by either Big Pharma or the trial lawyers.

Sorry. I'm really jaded this morning.

 
At Tue Jul 08, 07:33:00 AM, Anonymous Anonymous said...

The guidelines recommend 1 yr of behavior/diet modification before looking at prescribing statins.

 
At Tue Jul 08, 09:02:00 AM, Blogger mark's tails said...

statins for an 8 y/o sounds pretty scary, but then again so does a heart attack at 20. common sense is still important in medicine and there is no doubt you have a lot of it.

 
At Tue Jul 08, 10:53:00 AM, Anonymous RJS said...

What the hell is stickball?

:P

 
At Tue Jul 08, 10:57:00 AM, Blogger Matt said...

So, let me get this straight, having not wanted to really dig for the article and going on my knowledge of statins from biochem/physiology-

Why would you want to give a drug inhibiting the creation of new cholesterol right before a kid is going to go through
1) puberty, requiring a slew of cholesterol derived sex hormones
2) growth spurts, requiring cholesterol for making new cells

is there even any evidence for this long-term? and by long term, I do not mean 2 years but more like 30 or 50. I was able to find an article in JAMA that discussed a 2 year trial but I always have reservations about applying the results of a highly controlled trial to the real-life, especially since statins are touted as beneficial and risk free and prescribed as such.

 
At Tue Jul 08, 11:21:00 AM, Anonymous Anonymous said...

Well Dino, while it is refreshing that you are concerned with the side effects of statins in kids, why aren't you concerned about these side effects in adults?

There's one good thing that may come out of this extreme bit of over-reaching: maybe the medical community will start to question it's obsession with chlolesterol (which is essential for life) and start looking elsewhere for the cause of heart disease. I'm not holding my breath.....

 
At Tue Jul 08, 11:58:00 AM, Anonymous Celeste said...

This is a marketing decision, pure and simple. The tobacco companies instinctively knew that their older customers died off, and to really make the money, they needed to recruit customers younger.

I think it's pretty sad when you have to question if your doctor's recommendation is a health decision or a business decision. I am certain some doctors would prescribe this just to ward off liability for not doing enough.

My child has only ever taken anti-biotics on a short term basis. If she was prescribed something on a long-term basis, there would have to be some highly compelling reason for me to accept the burden on her liver of taking the medicine. In this case, there doesn't seem to be any science.

I like our pediatrician a lot and think his advice has always been very sensible. He's a lot like you, Dino, and that's a big compliment. We just saw him a few weeks ago for a well child visit, before this article came out. I assume he thinks it's ridiculous, too, but of course I want to know for sure.

 
At Tue Jul 08, 12:15:00 PM, Blogger Pink said...

Which begs the question, what's in it for American Academy of Pediatrics to make this recommendation when it flies in the face of sensibility and reason?

 
At Tue Jul 08, 12:23:00 PM, Anonymous Anonymous said...

Oh, but Dinosaur, the AAP says you can't just prescribe playing outside (lifestyle modification) for some of the most at-risk kids--it's right to statins. I agree--no f-ing way. Thank god I don't do primary care anymore--you all are supposed to have everyone on every medication known to man, plus screen for every medical and non-medical condition so far recognized (if only by the companies who make drugs to treat such conditions). No wonder medical costs in this country are out of control. But let's just save Medicare by screwing the doctors (of whom more and more is expected every day) by cutting the amount we pay them by 10% (even though they can't break even seeing Medicare patients as it is). Pre-med students of the world--don't do it, it's going to get even uglier before this whole this is sorted out. Dino, I think your way will be the only way docs are going to take back control of patient care and take it back to the basics--a doctor doing his best to help patients, with any administrative people (who know nothing about actual medical care)doing what the doctor tells them, NOT vice versa.

Sorry for the rant. Thought about erasing it, but what the heck.

 
At Tue Jul 08, 02:17:00 PM, Anonymous Anonymous said...

3x I have said this: No way I will ever accept the validity of their new "norms" for cholesterol based on the Framingham, Mass study. Normals as they were prior to that study made some sense; since then, well, the drug companies love it.

 
At Tue Jul 08, 03:39:00 PM, Blogger Ms.L said...

I saw a blurb about this on the news this morning and thought the same thing!
What has the world come to??

 
At Tue Jul 08, 04:02:00 PM, Anonymous Anonymous said...

Wow! Aren't statins notorious for causing liver problems? I know my dad had statin-induced hepatitis and was very (nearly) deathly ill from it (although, he did wait waayy too long to seek medical attention).

Our poor kids...numerous immunizations, so many on ADHD and psychiatric medications. Why not toss statins into the mix?? (not).

Sigh...:(

 
At Tue Jul 08, 04:20:00 PM, Anonymous Anonymous said...

Response to Anonymous 12:23: How are we patients to know if out doctors are compromised? This is all a very slippery slope.....

 
At Tue Jul 08, 04:35:00 PM, Anonymous Anonymous said...

That should say "our" doctors....

 
At Tue Jul 08, 09:08:00 PM, Anonymous mamadoc said...

As my kids say, WTF?

 
At Wed Jul 09, 10:04:00 PM, Blogger Dragonfly said...

GPs here use "lifescripts" to prescribe lifestyle modifications to patients....of course the adherence is not 100%, but I completely agree with you that kids should be exercising (as should everyone). Otherwise they end up like my father who says "I don't need to exercise, my 2 antihypertensives control my blood pressure!!" Sigh.

 
At Wed Jul 09, 11:43:00 PM, Blogger Picara said...

I want to know how the heck they GET the kids to take the meds? Do they have a syrup statin?

I know when I was a kid, if I had to have baby aspirin (back in the days when you gave kids aspirin), it was crushed in a spoon with strawberry jam so I could swallow it.

It is pretty outrageous how we are medicating the next generation without longitudinal studies.

DoIHearanEcho.blogspot.com

 
At Thu Jul 10, 02:49:00 PM, Anonymous Cynic said...

The AAP should be ashamed of themselves for this. What a bunch of fucking morons!

Whats next? Neurontin for growing pains? Haldol for temper tantrums?

What a bunch of quacks.

 
At Wed Aug 27, 06:38:00 PM, Anonymous Anonymous said...

Hello,

I have taken my first statin pill last night. Ive had a problem with some blood vessles and am lucky they occured in my eye.

My Dr, and he is good proscribed me Statins... and asprin... before I read about the side effects this is what i felt after one yes one strength 40 pill.

In the morning, full of energy slight twinge in my knee walking up hill nothing concerning.

Later in the day looking back was feeling very HAPPY very very happy. Was rude to my friends blunt and unfeeling.

Later a bit strange confustion in my mind, nothing to serious but noticable. I did not think anything of the above untill later on when the symptoms have become more odvious and I can pick out my behaviour.

Later this evening I felt like my cheaks were sucking in. I want to grind my teath. When I spoke to my brother about it. My eye brows whent to the top of my head and wanted to stick their. Ive had the odd shooting pain in my head nothing much but in a strange position diagnoal to the top of my head above my eve just on top of my fourhead. My joints hurt a little when I type.

I wondered if to take another pill earlier. But I have since started to read up on all this Statin stuff. I cant believe the science does not backup the claims. I will not be taking another tablet no way.. I think my life going to consist of fish soup, but I rather live. Its going to be one of those drugs that everyone suffers from later as the effects were not understood. I thought this would be a cure but after todays experience... Someone should study how these systems of goverment and industry are operating as there in no ones interest. Best regards,,,StatinTrip... but never again

 

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