Andy Palacio’s Death:

Another Look

By Charles C. Lino, Pharm.D.

t has been nearly two years since the death of legendary Garifuna musician and cultural ambassador Andy Palacio (Andy P). In 2007, Andy P successfully completed his musical tour which gave him international recognition and fame. His CD “Watina” is now being played in many countries around the world. I watched Andy perform in August of 2007 in San Francisco as part of his world tour. He appeared strong, vital and moved with great energy and tenacity on stage. Nearly three months later we were stunned upon the announcement of his tragic and untimely death. Indeed, there were numerous questions raised regarding his death since no one expected him to die at such a young age.

It was my hope that Andy’s death and celebrity status would be used as a catalyst to spark a campaign on health awareness among young males (and females alike) in the country of Belize. But as we remember Andy’s death and celebrate his life and legacy it is important to note that the debate on health care and health awareness is still largely missing in our communities at large.

Sadly, healthy living is not a key focus in the everyday lives of most Belizeans. So as we remember Andy P, we remember him mostly for his musical contributions and his crusade in preserving the Garifuna culture.

So let us rewind and revisit how Andy died. It was reported that Andy was experiencing symptoms of stroke (slurred speech) for one to two weeks before seeking medical attention. So why did it take him so long to see a doctor for a perfectly treatable condition? It is obvious that we don’t know the full story or have all the answers of his underlying medical condition. However, it is a known phenomenon that many young males are afraid of seeing a doctor and many have not had a physical or check-up in years. This is one reason why the life expectancy in women is far greater than in men. Women are usually not afraid to seek medical attention and get help when needed. Most diseases are still curable and early intervention remains a key indicator in outcome and long term survival.

Andy Palacio died from a stroke, heart attack and complications of respiratory failure. He reportedly had a cholesterol level of 500 mg/dl. This level is 2.5x the normal recommended level for cholesterol. Although high blood cholesterol is a treatable condition, many individuals remain untreated because they have not been to their doctors to get checked. As such, they could be walking around with potentially fatal high blood cholesterol levels and be at risk for heart disease, heart attacks and stroke.

So what is high blood cholesterol and why is it important to treat high blood cholesterol promptly? Cholesterol comes mainly from two sources: your body produces it or you get it from your diet. A diet high in saturated fats is the major source of cholesterol. Reducing fats (triglycerides) in your diet and exercising (at least 45 minutes per day 4-5 times/week) regularly will lower your cholesterol.

High blood cholesterol (above 200 mg/dl) is a major risk factor for heart disease. Cholesterol forms plaques in your blood vessels and these plaques can later form clots that break away and cause a heart attack or stroke. Lowering your blood cholesterol in itself might not be enough particularly if you have other risk factors for heart disease, these are age (>55 men, >65 women), diabetes, family history of heart disease, overweight/obesity, high blood pressure, cigarette smoking, male sex, and physical inactivity. Many of these risk factors are controllable. One can exercise daily, eat a diet low in fat, lose weight and quit smoking. If you have diabetes or high blood pressure, that can also be controlled with diet, weight loss and medications.

For people with high blood cholesterol the first treatment option should be to lose weight if they are overweight and to consume a diet low in saturated fats.

If total lifestyle changes are unsuccessful then drug therapy should be tried. At no time should lifestyle changes be stopped after drug therapy is initiated. The combined approach of lifestyle changes and drug therapy will be more effective than either method alone in ultimately lowering your blood cholesterol and reducing your risk of heart disease.

There are different kinds of medications used to treat high blood cholesterol; most of which are very safe with minimal side effects. These drugs are commonly called statins (i.e. lovastatin or mevacor, simvastatin or zocor, atorvastatin or lipitor). Statins have been shown to lower cholesterol, heart attacks and stroke. Most statins are generally given once daily in the evening when cholesterol production is highest. Prior to being started on a statin your doctor should first obtain a lipid (fat) panel. A lipid panel is obtained from a blood draw after a 12-hour fasting state. There are four main components measured in a lipid panel. These are High Density Lipoprotien (HDL) cholesterol, Low Density Lipoprotein (LDL) Cholesterol, Total Cholesterol and Triglycerides. Each component carries a normal range. HDL cholesterol is the “good” cholesterol and should be greater than 40 mg/dl. A normal LDL cholesterol is <130 mg/dl. A normal triglyceride is less than 150 mg/dl. The primary target of treatment in clinical lipid management is to lower LDL cholesterol. Individuals who have multiple risk factors may benefit from a lowering of LDL to <100 mg/dl. Lowering LDL cholesterol will result in a lowering of your total cholesterol to the desirable less than 200 mg/dl. After starting your drug therapy your doctor should obtain another lipid panel in six weeks to assess how the medication is working. The dose of medication might be increased until your LDL cholesterol is at goal (<130 mg/dl, or <100 mg/dl if multiple risk factors).

The key to getting the best medical care is to be informed about your medical condition and to ask as many questions as possible. Please check with your doctor and don’t be afraid to ask questions.

Dimurei.com

Where the Past Intersects the Present

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