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  • Writer's pictureRobert Danziger

What Is a Determined Patient?

A determined patient is someone who partners effectively with the health-care professionals treating them and does not give up when obstacles to their wellness appear.

As practicing physicians, Dr. Gellens and I have seen many changes in the way patients and physicians interact. Gone are the days when it was common for doctors to be seen as nearly infallible experts who should never be questioned by patients. That’s good for the physicians and for you as a patient.

Here is an example of a determined patient I worked with.

Tony was referred to a cardiologist (me) by a general internist to get greater insight into his condition. I knew the basics of his case from the referring physician, but Tony filled me in on the rest: He was a general contractor and lately, he had been having memory problems: He would forget appointments, where he had left his tools, and so on. His internist didn’t know what was happening and had ordered a battery of standard tests for dementia and/or “change in mental status” that included CT and MRI scans to look for brain tumors. Tony then started researching the problem himself, using Google and investigating a variety of websites, including that of the Food and Drug Administration (FDA), which keeps a record of all side effects reported for each pharmaceutical drug for sale in the U.S. He found a number of reports of statin medications, which are used to treat high cholesterol levels, causing memory loss. Tony looked up each of the medications that he was taking and found that one, Lipitor, was also called atorvastatin—in other words, it sounded suspiciously like a statin! His internist was familiar with the more common side effects of statins, including muscle aches and possibly diabetes, but didn’t know of Lipitor’s potential to cause memory loss, a side effect that was mostly reported in Europe.

“Do you think the medication is what’s making me such a space cadet?” he asked.

I asked Tony when the memory problems began and fortunately, he could remember! They had started around the time he started the Lipitor for controlling cholesterol. I told Tony that it was the likely culprit—and that he had been right in guessing that an atorvastatin was a statin. While he knew of this side effect of Lipitor because he is a cardiologist, Tony’s internist wasn’t as well informed about statins. That wasn't surprising since the primary side effects of statins are myopathies (muscle pains/cramps) and hepatic (liver) toxicity—not memory loss.

Now, thanks to Tony informing him, his internist knows about this side effect of Lipitor. He agreed with me that Tony should stop taking it and try a different medication that wasn't a statin and wasn’t associated with memory loss. Sure enough, very quickly, Tony’s short-term memory problems vanished and his cholesterol numbers were good.

It didn’t take Sherlock Holmes to figure out what was causing Tony’s memory lapses, but it did take information his internist did not have—and a proactive attitude on Tony’s part. He came to my office with good questions and having done his homework, making my job very easy.

It’s not always this easy to get to the bottom of what is causing a patient's symptoms, but as you can see, Mary and I believe in empowering people to partner in their health care. With so much information available on the internet, and access to that information sitting in your pocket or purse, you can become a determined patient like Tony—even if your case is more complicated than his turned out to be.

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