Mr. D.T.'s Story - There Is Hope

Medical Author: Dennis Lee, M.D.

I am sure many of you have been reminded by doctors, nurses, and public health officials to lose excess weight, quit smoking cigarettes, exercise regularly, and eat less saturated fat and sweets. Here is a real life example of how effective these measures can be.

Mr. DT is a healthy and active 50-year-old man. He exercises six days a week. He does not smoke cigarettes. He tries to hold down fat and cholesterol intake; he only cheats on weekends and holidays. He is slightly overweight (only 12 pounds heavier than ideal body weight). His mild high blood pressure has been well controlled with an oral medication called an ACE inhibitor. There is no family history of any heart disease.

Last week, he asked his doctor for a complete blood panel that includes cholesterol and triglyceride levels, since he has not had one for more than a year. The nurse who drew his blood first noticed there was something wrong; Mr. DT's serum was abnormally discolored. Before performing blood chemistry measurements, she had to spin the blood sample in a centrifuge to separate the red and white blood cells from the serum. Normal serum is clear yellow in color. But Mr. DT's serum was pink and milky. Milky serum indicates excess chylomicrons (protein complexes that contain high amounts of triglycerides and cholesterol).

The laboratory reported the following morning that Mr. DT's cholesterol is elevated at 260mg/dl, but more importantly his triglyceride level was 2,500 mg/dl! Normal triglyceride levels should be less than 150mg/dl. His good cholesterol (HDL) is abnormally depressed at 20 mg/dl. These cholesterol and triglyceride levels not only increased his risk of developing arteriosclerosis of the arteries, the sky high triglycerides put him at risk of developing acute pancreatitis - a painful, serious inflammation of the pancreas.

His doctor wasted no time in placing him on a strict low saturated fat and low sweets diet, along with a medication that lowers triglycerides and increases HDL. Over the weekend Mr. DT adhered faithfully to the prescribed diet and the medication without cheating. Yes, he walked away from tiramisu, chocolate cheesecake, mud pie, and fried calamari.

The doctor called Mr. DT into his office Monday morning for a repeat blood test, only three days into treatment. This time, his cholesterol had dropped down to 211 mg/dl, his HDL had risen to 44 mg/dl, and most impressively his triglyceride level had dropped from 2,500 to 35 mg/dl.

Granted, such rapid response to treatment is unusual. Most of the time we do not enjoy such dramatic and satisfying treatment results. But this case did teach me three lessons:

  1. Periodic blood lipid tests should be performed even when you feel fine.
  2. Faithfully adhering to the diets prescribed by your doctor can make a big difference. (Also don't forget that regular exercise, quit smoking cigarettes, and losing and maintaining excess weight are also important).
  3. Do not despair if you have unfavorable cholesterol and triglyceride numbers. Work diligently with you doctor to get them right!

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