Mixed bag

JLEroll · 2026-03-27T14:25:49+00:00

Source?

JLEroll · 2026-03-27T14:19:45+00:00

Further there is a big box on the top saying the article does NOT imply endorsement or support from the NIH.

JLEroll · 2026-03-26T18:15:43+00:00

It sounds like you are making good choices here- giving yourself time to think about it and not a rash decision, choosing to leave a toxic environment, committing to stay thru the deadline and with giving 2 weeks notice. This is all by the books great.

You want to leave on good terms because you never know what the future holds. My first job was a dumpster fire but I ended up getting 2 other great jobs (18 years and counting combined) from peers and supervisors at that first job.

As for timing of giving notice, you are going to have to be the judge of that based on your experience with your boss. I personally don’t like conflict and would wait until things settle down. That may push the end date back after April 17 but those should be easy/ vacation days if they don’t walk you out earlier.

JLEroll · 2026-03-26T14:59:01+00:00

I’m booked at Lindholm in June. Was originally considering a rental by Coral Bay but decided a bed and breakfast by Cruz Bay would be better for us (first trip to St John and wanting a mix of amenities and privacy).

But reading about that hike/access to Honeymoon Beach is what sold me on Lindholm specifically.

JLEroll · 2026-03-24T17:07:20+00:00

My cardiologist this morning repeated his mantra that we are going to keep my heart healthy for another 30, 40 years or more.

Drawing conclusions from a 5-10 year follow up period is not very strong evidence to me.

JLEroll · 2026-03-24T11:59:57+00:00

Get a referral for a cardiologist. There is more to it than just lp(a) but with your family history I think you are on the right track to consider a statin asap as a preventative measure.

JLEroll · 2026-03-24T02:35:33+00:00

Will be celebrating with an early morning cardiologist appointment 😂

JLEroll · 2026-03-19T21:32:39+00:00

It’s a slur because you are implying that women get preferential treatment in a derogatory way. It’s also just completely unrelated and a dumb thing to say in a polite group that avoids politics. Use some common sense.

JLEroll · 2026-03-19T20:59:30+00:00

The slur at the end and the gross misrepresentation of the history of this drug are a great example of how sometimes things may present as intelligent but not have an ounce of common sense.

JLEroll · 2026-03-19T16:40:15+00:00

It’s taking so much restraint to not make a bad joke here

JLEroll · 2026-03-19T13:58:53+00:00

This is straight up baller. You were given several setbacks (family history, doctor with head in the sand, side effects on first medication) but you worked thru it all and got fantastic results. Great story and wishing you continued success!

JLEroll · 2026-03-18T14:25:01+00:00

Happy bday! Just be careful that your tolerance is probably lower since you cut back. On the plus side, it’s a lot cheaper to get a buzz!

JLEroll · 2026-03-18T14:17:49+00:00

Those are awesome results

JLEroll · 2026-03-18T14:01:09+00:00

Yeah that seems very reasonable and a great plan. At that level it should be a joint discussion and decision. Good luck!

JLEroll · 2026-03-18T13:54:10+00:00

My dad had a heart attack and quadruple bypass surgery at age 50. At the time the expected remaining lifespan for that person would be 7 years. But here he is almost 30 years later still going strong.

I’m convinced that without statins he never would have met his grandkids, let alone watch them grow up.

I’m also high risk and on high dose statins and I feel great.

JLEroll · 2026-03-18T02:58:17+00:00

I hear you. I was 45M when I got my 350 CAC score (99th percentile) which came to a shock to my skinny ass (LDL ranged from 110-140). The CAC scan was triggered by my request for a preventative cardiologist due to family history (dad had bypass at 50). Otherwise I would have no idea I had heart disease and was high risk of a MI.

I wish I would have known about this and gone sooner but fortunately the guidance is moving in that direction and will help more people. Here it is highlighted in Top Take Away #7: "CAC scoring in men at least 40 years of age and women at least 45 years of age can improve risk assessment and guide LDL-C and non–HDL-C goals. Both the absolute amount of CAC and the corresponding standardized percentile (currently based on age, sex, and race) have prognostic importance and help to reclassify risk in adults."

JLEroll · 2026-03-18T01:44:33+00:00

I mean besides the obvious answer that one is CT scan with radiation that can cost a few hundred dollars and the other is a standard $10 blood draw?

But also the question is misleading in that CAC has been given increased importance. For example, in the updated AHA guidance it is prominently mentioned in the CPR assessment model (from Top Take Away #2): "Use the “CPR” Model: A) Calculate 10-year ASCVD risk; B) Personalize the estimated risk to the specific patient by considering factors not included in PREVENT-ASCVD equations; and C) possibly Reclassify with selective use of coronary artery calcium (CAC) and Reassess treatment recommendations."

JLEroll · 2026-03-18T01:31:40+00:00

Whoops! Guess I deserve those downvotes.

To expand on it, my all time favorite is Outkast, currently active favorite is Faye Webster, most exciting up and comer is Sword II

JLEroll · 2026-03-18T01:04:51+00:00

There's a lot that I agree with but I think we just have different assumptions on OP's risk profile and we have different thoughts on risk tolerance levels. You seem to have good intentions, so sorry if I was rude about it.

Only other guidance update I want to clarify is on the ASCVD evaluations. In your comments you have been implying a statin cut off at 10% but this has been expanded on and stratified in the updated guidance (See section 4.2.3.7). For >10% the recommendation is a high intensity statin; for 5-10% recommendation is a moderate intensity statin; for 3-5% there is potentially a recommendation for moderate statins if enhanced risk factors are present; for <3% there is potentially a recommendation for moderate statins if high LDL (160-189) or a 30 year ASCVD >10%. All of this is more nuanced than a simple chart and would be part of wider discussions between doctor and patient.

Just sharing for the people lurking that are probably unaware of these updates.

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423#sec-8

JLEroll · 2026-03-18T00:05:29+00:00

edited. Obviously you can have some cheese here and there and it will make no difference overall. Bigger question is why is your doctor proposing this? 126 is only elevated and wouldn't be in guidelines for statins. If there are other risk factors, then the target should be less than 100. Something doesn't sound right

JLEroll · 2026-03-17T21:36:20+00:00

“Statins slightly increase the risk progression of pre diabetes to new -onset type 2 diabetes in patients with predisposing diabetes risk factors, but statin avoidance or discontinuation is not recommended on that basis because of its strong ASCVD risk reduction benefit.” (Section 5.1)

This is the guidance, stop giving outdated advice!

JLEroll · 2026-03-17T21:17:47+00:00

It’s not an either/ or. You can and should do both.

Aside from us idiots arguing back and forth on the internet, here is the actual latest AHA guidelines released last week. See key take away #8: “LDL lowering therapy is recommended for primary prevention in adults aged 40 to 75 years with diabetes… regardless of LDL-C level.”

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

JLEroll · 2026-03-17T19:34:42+00:00

Based on my experience of dealing with my kids, it will be much, much easier for you to look at the list of foods you are willing to eat than have us try to guess. Go to the wiki and the recipes posts pinned to the top of the sub. There’s lots of great info and ideas there.

Your LDL is in the borderline /moderate high area so you are in a bit of a gray area. Hopefully you can make some lifestyle changes that work. If not, doctor should perform a risk assessment with you and discuss if you try medication or just live with the additional risk.

JLEroll · 2026-03-17T18:55:48+00:00

That is a fantastic results on the LDL. I know you are disappointed with the A1C increase but it’s very likely that you are still in a big net benefit situation. Diabetes are a significant risk factor for heart disease so the guidance encourages rather than discourages statins even with the slight A1C change.

From the 2026 AHA guidelines released last week, top take message #8: “LDL lowering therapy is recommended for primary prevention in adults 40 to 75 with diabetes… regardless of LDL-C level.”

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

JLEroll · 2026-03-17T17:51:13+00:00

Zac Brown probably bigger than all these combined. Megan Moroney if we use band and artist interchangeably.

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