Question

Testing and Screening Ken had just turned 40, and with a little encouragement from his wife, he decided that it was time to have a physical-it would be his first real visit to a doctor since he broke his arm as a kid. Seeing a doctor had not made sense to him before. He was in great shape, felt fine, and did not smoke. Maybe it was his 65-year-old father's sudden death from a heart attack just a few weeks after his retirement that finally convinced Ken to find himself a doctor. He knew that his father had had high cholesterol, but he was told his own cholesterol level and electrocardiogram results were okay when he entered the military at age 18. Besides, Ken was not big on desserts and only ate a Big Mac when he took the kids out after their soccer games. The examination was quite uneventful and Ken was reassured when the doctor could not find anything of concern. A few recommendations on nutrition and better ways to exercise were about all that came out of the visit. Then he got the call from the doctor's office-could he make a follow-up appointment to discuss his cholesterol? His low-density lipoprotein (LDL, or "bad" cholesterol) was 165 and his high-density lipoprotein (HDL, or "good cholesterol) was 40. "We used to think these levels were okay because they are so common," his doctor began. "However, now we consider your LDL cholesterol too high because it increases your chances of developing heart and other blood vessel diseases. There is no evidence of heart disease at this point, but your cholesterol needs attention. "What do you mean by 'attention?" Ken replied. "I exercise, do not smoke, and generally keep my fats down." Ken soon learned a lot more about cholesterol. He first tried his best at changing his diet-it helped a little, but just did not do the trick. Ken's doctor told him: "For some people, there is a strong genetic component to high cholesterol levels, and while diet is still important it just cannot always reduce LDL cholesterol enough by itself. Exercise helps, especially by increasing the good cholesterol, but it does not do much for the bad cholesterol Medication may be needed, and there is now evidence that if taken regularly, it reduces the chances of having a heart attack or at least delays its occurrence."

Answer 1

1. Total cholesterol level upto 200 mg/dl is normal and desirable range for adults. But the LDL level should be less than 100 mg/dl and HDL level is 60 mg/dl. When the HDL level falls below 40mg/dl increases the risk of developing Heart attack. Also th e LDL level raised above 160 mg/dl increases the risk of heart attack.

Positive Illustrations:

• LDL level too high
• HDL 40 mg/dl
• Genetic predisposition

Negative:

• Ken's father blood cholestrol and ECG were normal when he entered millitary service.

2.'Attention'

3. At least the extra cost is worth the extra benefit.

4. The results of medical investigations should be kept confidential. It should be disclosed only for treatment purpose.