Sunday, July 19, 2015

My Sunday Feeling

When you get to be a certain age, especially if you have played sports or otherwise been physically active, stuff starts to hurt.  I ran and played competitive tennis until my late forties.  

Due to degenerative arthritis in my lumbar spine, I no longer do distance running.  Due to a slight tear in my right rotator cuff I am banned from tennis and pretty much doing anything over my head.

But even before my most recent physical maladies, I have practically lived on Non-Steroidal Anti-Inflammatory Drugs or NSAIDS for the past 20 years.  First it was Celebrex, the ads for which showed older folks dancing on the beach, which I guess was designed to show its miraculous healing properties.  I took it back then to ease my hamstrings and Achilles tendons from the rigors of playing tennis 3-4 times a week. And it worked great. 

Then Celebrex and Vioxx started killing people and it got took off the market. Indeed, Celebrex might have caused the heart attack that took my Aunt Jean in her sleep. So, my doctor switched me to a prescription dose of Naproxen which is sold as Aleve over the counter. I took 500mg of that twice a day until I hurt my shoulder in the gym.  That's when they switched me to meloxicam which I have been taking for close to three years now.  

It works great.  It gives me as much relief as the Celebrex or Vioxx did.  And I only have to take it once a day.  Indeed, I can't imagine playing golf, working out or raising my right arm above my shoulder without meloxicam.  

So imagine my amusement when last week the FDA issued new warnings about the risks of taking all NSAIDS, including meloxicam were greater than once believed.  According to an article on the subject in the New York Times, the evidence of increased risk of heart attack, heart failure and stroke "is now extremely solid."  The risk is higher in people with heart disease and people over 65 with with heart disease are urged to be "extremely careful" with this class of drugs. 


Of course, I have coronary artery disease (CAD) which is the genetic bequest of my father.  However, I am asymptomatic despite having a pretty high calcium score which is indicative of gunk in my system.  And I have a completely lousy (perversely referred to as "strongly positive" by the medical profession) family history.  My paternal grandfather died from a coronary at 56.  My own father checked out for the same reason at 52.  

But I got a few things going for me.   I don't smoke.  My BP is well controlled. I'm not obese.  I don't have diabetes.  And I am extremely active physically.  The cardiologist didn't do a stress test on me last November because there was "no need" for it given what I do in the gym on any given week.  And none of the docs I got on the payroll right now have called, texted or left me Facebook messages to quit taking the stuff.  Indeed, my PCP refilled my prescription last week.  

So what to do?  It's a risk-benefit thing I suppose.  Do I quit taking a good and useful medicine that helps me maintain my vigorous exercise habits, which in turn, helps my health because of an increased risk of what they refer to as a "cardiac event" and to which I refer as "buying the farm?" They give cancer patients exceedingly toxic medications in order to kill the cancerous lesions or cells.  

That's not a completely lurid comparison and I certainly don't equate myself with a cancer patient.  But there is a cost-benefit aspect to virtually everything. And I guess this is no different.  In any event, my physical is next month.  I guess we will take it up then.  I think I will live that long.

Indeed, if I play my cards right, in October I will be the first male infected with my grandfather's genes to hit 60 in two generations.  

I like my chances.  NSAIDS or no NSAIDS. 

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