It Runs in the Family

I have bad cholesterol. I have had it probably my whole life but known about it since I was 19 and got my very first cholesterol test at my very first grown up physical which followed directly after I finally got a job with health insurance. (Which, unfortunately, was after I had already had the worst kidney infection ever, because I didn’t go to the doctor, because I didn’t have health insurance)

Gram also had bad cholesterol and because of that, I never really minded it. It was a family trait, something I had in common with Gram. And Mom. And her brother Conrad. We have a specific kind of bad cholesterol in my family. The Bad Triglycerides kind. You can have a normal overall cholesterol and still have Bad Triglycerides, how lucky is that?

A quick lesson on triglycerides andwhat qualifies as “Bad” for my family: Normal triglycerides levels are 0 to 149. This year my triglycerides were cut in half from last year, because I was taking fish oil pills all year- and they were 396. 396 is better than its been in six years (I usually hover just under 500, last year’s top score is only because I cheated and had cream in my coffee before the test) but my personal best is 384, achieved in my early thirties, after an entire year of Weight Watchers.

Gram is a family legend for getting kicked off a cholesterol study at the University of Minnesota that she and her friend Delores volunteered to participate in, because her triglycerides were too high. I have a true story about how the healthy living app that we use at work to earn health insurance discounts will not allow me to enter my actual triglycerides. I get a hard stop red error that says, “PLEASE ENTER A VALID NUMBER” because it does not believe my number can be accurate.

One time, years ago at Gram’s, I was telling her about my latest cholesterol test and how my doctor was threatening to stop prescribing my birth control pill if my triglycerides were above 500 because she had attended a seminar where she learned the two things (Birth control and Bad Triglycerides) may be connected, when my Uncle Conrad interjected;

“Why do you even worry about it?” he asked, “we all have it, we’re fine. Who cares?”

I cared quite a lot about my birth control pills, actually, way more than I cared about my cholesterol because like Uncle C said, “We all have it, it’s fine.”

My triglycerides came in at 496 that year and I felt rather smug (and might have muttered “suck it!”) when I read the letter. (Back then we did not go online for test results and they took like 7-10 days and then your doctor actually CALLED you if something was amiss). Did I feel bad that my score was 496? Yes, a little. On the inside. But you see, it was a family tradition.

My current doctor has been very patient with me. (The threatening one retired but never did take my pills away) New Dr. refers me every year, via a nice note on the website, to a family practice doctor regarding my cholesterol and she really never gets up in my grill about it.

“That will only last so long,” Mom told me, “my doctor eventually said, ‘You WILL begin taking medication or you will find another doctor’.”

The moment of reckoning arrived for me yesterday. My doctor, ever resourceful, had her student come into the room and ask me if I could attend an appointment with the internist next door who just happened to be available in twenty minutes and our appointment would be done by then. I felt trapped. I said, “Uhhh, sure, I guess.”

This Dr. was on my case in a matter of seconds after he pulled up my cholesterol results for the past six years. I remained calm, I am an expert at Bad Triglycerides conversation avoidance.

“I’m excited to see what it comes back this year because I’ve been taking fish oil all year,” I said.

“This level,” he began, his voice unbelieving at what he was seeing on the screen, “cannot be solved with fish oil and diet. This is probably familial. 796 last year?”

“I had cream in my coffee last year.”

“Even before that it was 500!” he was getting excited, or maybe irritated, it was hard to tell.

“That’s more normal for m-“

“THAT IS NOT NORMAL!” He raised his voice this time and I closed my mouth.

He went on to tell me about my heart, and my liver, and all the potential horrendous things that could be happening right now. About how the Bad Triglycerides kind of cholesterol needs to be treated two ways with two medications, one for the triglycerides and one to improve the “good cholesterol”. He ordered me a bunch of tests which required follow up appointments.

In my head, I was remembering how when Gram was 72, she had her day of reckoning with the doctor.

“I told him I’ve had it my whole life, and made it this far just fine, and was not about to start taking medication at age 72!”

After that she might have found a new doctor, it seems like something she would do.

“We’ll wait and see what the test results come back with,” Dr. Passionate-About-Cholesterol said, in a much calmer fashion, “and then we’ll talk.”

And he looked me in the eyes and waited for confirmation and so I slowly nodded once to get him to go away.

“Do you know what things you should not eat for a low cholesterol diet?” he asked.
In the front of my WW books, which are now twenty plus years old, I have a folded in half piece of paper, printed front and back, listing what you should and should not eat as part of a low cholesterol diet. It’s the original piece of paper that they gave me at my original appointment when they told me I had high cholesterol at age 19. In other words, now he was insulting me.

I channeled Gram and displayed a slightly indignant air, “Yes.”

“Tell me then, tell me what you should or should not eat.”

He really was so bossy.

“Oh, you know- high fiber, whole grains- nothing I love like butter, cheese, baked goods, fried foods, egg yolks.”

I stopped and Dr. Passionate-About-Cholesterol added, “Creamy sauces,” just to one up me.

My test results came in later that afternoon. Dr. Passionate-About-Cholesterol did not send me any notes congratulating me on my significant reduction in Bad Triglycerides. (Lowest in six years!)

My liver and heart results are not in yet.

“We’ll be talking,” he said as I left, a stack of print outs in my hand.

There’s a country song that used to make me and Mom chuckle. It was a song about a family through the years called “Time Marches On” (Tracy Lawrence). In the first verse “brother runs in with feathers on his head”, in the second “brother’s wearing beads and he smokes a lot of dope” and then the last, “brother’s on diet, for high cholesterol”. Mom could relate.

We all could.

It runs in the family.

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