Truths about Cholesterol.

The news media, your doctor and your mother are always talking about your cholesterol. How high it it? How high is too high? While you’re at it, what is cholesterol?

What is commonly called “cholesterol” is really a fatty, waxy-like substance that is found in all cells of the body. Without cholesterol, you cannot live. It is needed to make your skin; to make the hormones like testosterone, estrogen and Vitamin D that circulate in your blood; for the protective coating of your nerves; and to help you digest your food.

Where does cholesterol come from? Your liver makes the vast majority of the cholesterol in your body. About 80% of the cholesterol in your body is made this way. The other 20% comes from the food you eat.

When your doctor measures your cholesterol level, what is actually being measured are proteins that carry cholesterol around in your blood. These proteins are necessary because cholesterol, like cooking oil, doesn’t mix with water. So these proteins allow the cholesterol to be carried in your blood. There are several different types of these proteins, but the main ones are HDL and LDL.

HDL is commonly called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Once at the liver, the cholesterol is either recycled back out to the body, or it is lost in your intestines. People with higher levels of HDL seem to be protected from diseases like heart attacks and strokes. About 20-25% of the cholesterol in your blood is carried by HDL.

LDL is commonly called “bad” cholesterol. That is because it carries cholesterol from your liver out to the rest of your body, where it could possible build up in your arteries and cause a heart attack. LDL makes up about 70-75% of the cholesterol in your blood.

What is high cholesterol? High cholesterol is a condition in which the amount of cholesterol circulating through your blood is higher than average. High cholesterol by itself usually has no signs or symptoms; that’s why your doctor recommends having your cholesterol tested from time to time.

Why should you worry about high cholesterol? Well, people that have high cholesterol seem to be at increased risk of developing Coronary Heart Disease (commonly called a heart attack), strokes and peripheral arterial disease (a condition in which the blood vessels in your legs get blocked).

What can you do if you have high cholesterol? The most effective way to control high cholesterol is through lifestyle changes centered on proper diet, maintaining your ideal weight, exercise, and stopping smoking if you do smoke. Another way to control your cholesterol is by the use of nutritional supplements and medication. There are several different types of medication and supplements your doctor may prescribe. Some may be more effective than others. By working with your doctor and other professionals like dieticians and nutritionists, you can help keep your cholesterol at safe levels. Have you had your cholesterol checked lately?

Changing jobs

Doctor: from the Latin word "docere", meaning teacher. After working in the specialty of Urgent Care medicine for a lucky number 13 years, a new opportunity dropped into my lap.

Four months ago, I just happened to notice that my former residency program, where I trained to be a Family Medicine specialist, was looking to add new faculty. So I sent the program director an email inquiry. I didn't hear back from him for 2 months, so I just assumed that they already filled the position.

Then, 2 months ago, I got a reply from the program director, Dr Gregg Mitchell, telling me that they were indeed looking for new attending physicians to teach the doctors. We met for lunch a couple of times and had a great time catching up with each other. Dr Mitchell was a resident at the University of Tennessee College of Medicine, Family Medicine department, when I did a 3 month rotation with them. He became faculty in the program during my last 6 months of training

After much thought, prayer and discussion with my wife, I decided to make a more formal inquiry. So I met with Dr Mitchell again, but this time he was accompanied by Dr David Maness, chairman of the Medical school Department of Family Medicine. After talking with Drs Mitchell and Maness, I told them I was very interested in the position.

Three weeks ago, I was offered the job. After a couple more weeks of thought and prayer, I accepted their offer. I will be an official Assistant Professor in the Department of Family Medicine for The University of Tennessee Health Science Center Department of Family Medicine, Jackson, Tennessee.

I will still have a few days of my own clinic every week, but my primary responsibility will be teaching newly graduated physicians how to become Family Docs. I'll give lectures; see, examine, and discuss treatment plans for patients with the residents. I'll also occasionally round at the hospital with the residents, teaching them how to manage everything from newborn baby exams, to managing acute myocardial infarctions (heart attacks, to administering comfort measures to patients dying in the Intensive Care Unit.

I always thought I would enjoy teaching at the college or post-graduate level. This will be exciting, intellectually stimulating and scary at the same time! A lot has changed in the 13 years since I admitted hospital patients.

I will deeply miss my current partners. They are the best group of physicians I've ever met, and are more like family than colleagues. Hopefully, before too long, my new colleagues will seem the same!