Saturday, April 16, 2005

Prevention Zealotry

When J visited her new pediatrician for her recent physical, she told me in her practice they checked cholesterol levels for all their patients. I looked at her in astonishment. J is only three ! Yet, the worst was not over. I almost fell off my chair when I heard the reading.

J would have to go on a diet post-haste. No more whole milk, cream cheese or eggs. J sat beside me smiling coyly at the doctor as she played with beanie babies. I wanted to burst into tears. J is at the twenty-fifth percentile in the weight charts. Now I was going to have to starve her until she fell right off it. What the doctor was prescribing for J sounded like an ultra-lite version of South Beach meets Zone diet. I had decided to seek a second opinion even before I left her office.

Once home, my resolve had already weakened. The HDL and LDL counts were too powerful an adversary and numbers do not lie. I found myself telling the daycare center to stop serving her whole milk. I did not feel at peace with having age-old wisdom on children's diet displaced by two life changing numbers.

I found a way to explain my situation with J in an article on powerful medicines which included an excerpt from Dr Jerry Avron's essay where he says

"...One early attempt to measure the benefits that come from medications and other health care interventions was based on the notion of 'human capital', and flowed directly from industrial cost-benefit analyses. A decision on whether to repair a machine or retool a factory would start by calculating the future productivity expected from the equipment, given its age and condition...We've all confronted this kind of choice with our cars or refrigerators or computers, though usually not with our grandmothers."

I had only to extend the car and grandmother analogy a little further to see where this was coming from. Children like J were being treated like manufactured goods on an effective preventive maintenance schedule.

Why wait forty years to detect and then put them on Lipitor when Mommy can go South Beach on her three year old for the cost of a cholesterol screen. Getting value out of human capital can get no easier than this. For some reason, I don't believe that J and I are winning in this game.


Sumita said...

am not a doc.... but cholesterol counts is a controversial topic in itself...

what'll happen if they discover ten years later that lipitor causes more problems than it prevents and that raised cholesterol levels by themselves are no cause for worry....wihout other factors being involved...

Why cant I shake the view out that lilitor makers pay for all this paranoia to be propogated?

cheti said...

my jaws are down and the tongue rolling out .. my eye balls are popping out too !

Cholestrol for a three year old !!! What are the medical implications here ? Isnt a little fat okay around that age !? We are talking about
flesh and blood .. not an oiled machine ... a little swing of ups and down in "specifications" over the early stages of the life cycle is okay i guess !

but as i said .. this is waaaaaaaaaaay beyond my comprehension !

cheti said...

and heck yeah .. the industry sponsored medical "research" is becoming too biased ! mobile phone causes cancer .. no it doesnt .. it does .. no it doesnt .. it does too ... no it doesnt ! sheeesh !

mariasaus said...

Hi HC,

I do not want to give medical advice without knowing all the specifics. However in general, no need to be alarmed or too concerned (unless the total cholesterol is above 230) and there is any family history-genetic disposition for heart diseases.

Jiva is right..Although it's believed that the problems caused by high cholesterol can start in childhood, it still isn't entirely clear what high cholesterol levels indicate for a child.

It is good that you know about it,
But- don't think you need to impose too many diet restrictions on a child.. a balanced diet *'moderation' as in anything- is perhaps sufficient.

Just monitoring the Cholesterol counts- annually, should be okay and I am sure she is going to be just fine! No need to worry too much!


Heartcrossings said...

Jiva/Maria - The count the 270 and as such supposedly alarming. The family history is bad too. I have always been moderate as far as her diet but am watching it closer now and leaving the rest upto God. Thanks for the insights though.

Cheti - exactly my feelings when I found out. Shock and awe.

Priyamvada_K said...

An extra hug to J.


Heartcrossings said...

Thanks, Priya :-) That's a mom's remedy of choice and often works better than what the doctor prescribes.

Chay said...

A great big hug to J and Crossings!!! Choco join in with Kamala and we can group hug!!! :-))

Shock and awe and some indignation it is!! Ditto Cheti's reaction here!!

Hey, what ever happeend to balanced diets that worked so well for us when we were kids!?? We've all turned out fine!!