And joining me today on the show is my special guest, Farmis is Sean Douglas with a Kroger in Mountsville, the pharmacy there, Sean, how are you today? Don't wanna welcome, thanks for having me. Hey, well thanks for getting a hold of me, wanting to come in and talk some health topics, and we're going to be hearing a lot from you over the coming months, hopefully, we wanna set this up monthly and do different topics, and diabetes is something we both know very well, correct? Unfortunately, yeah, it's very close to both of our hearts.
Yes it is, and today, this is a topic we're going to be discussing, and I was surprised when you sent me information about diabetics, and I know heart health is very important when we talk about diabetes. So no matter what age we are, it's a prompt, but statins. This is something I'm going through real life, everyone listens to the show, I tell all here. So my health's on, you know, open book here.
I'm probably, I'm thinking going to have to go on statins, and I've heard a lot of horror stories about it, and you're going to, actually the information you sent me is gonna clear a lot of that up today. It should, yeah, I'm gonna say the horror stories are mostly myths, not to say that people haven't had issues, but a lot of it can be explained out, a lot of times there can be another option for people, instead of just trying one statin and saying, hey, I had this bad experience. One thing most people don't learn or haven't adopted really here in the valley is that if you're a diabetic, you're between the ages of 40 and 75, you should be on a statin. Doesn't matter what your lab levels are.
Okay. What about those of us that are 37, does that still qualify 40? I'm trying to get out of it. It, in a way, in a way.
The numbers 40 to 75 on the ages are set up basically because that's where the studies have looked. If you're under 40, if you're over 75, the numbers, there's not enough numbers in the studies to prove you're gonna see the benefit here. These guidelines were developed in 2012, late 2012, and it was all based on looking at studies, looking at evidence that was out there, so they're not random things, it's all stuff that's been published. Okay.
Let me back up a little bit, and when we talk about statins, what are they and why would we need that? Why are statins important? Statins, common statins that people would be familiar with would be Crestor, Zocor, Lipitor, Pravicol. Heard of all of those.
They are medications that prevent our body from creating its own cholesterol. Okay. Cholesterol, well, let me step back. When you're diabetic, the sugar that's in our blood will damage the vessels.
Okay. When the vessels are damaged, any cholesterol that's in the blood flowing can hit those little nicks and those damages and start building plaques in our vessels. Okay. So the cholesterol, Medicaid, the statins will reduce the amount of cholesterol we are producing, decreases cholesterol in our blood, decreases the plaques, decreased plaques, allows our vessels to remain free flowing and allows them to remain pliable, kind of like a rubber tube still hydrates, still very flexible.
So those things prevent heart attacks, they prevent strokes. So people with high sugar have more of a problem with that because we know I had a problem there and under new healthcare, my healthcare, she takes good care of it. I got to say Tina Tiberio, she's great with me. But then she's happy now that she switched my medicine on Metforminol, a previous physician had me on something that really was a starter medicine, I think, and I was on that too long.
My sugar had been too high, so when you talk about sugar going through the bloodstream, my body's had plenty of that going through its bloodstream. So I just had some blood work done, so next time I see you all know whether it be on statins, but you're saying probably be a good idea for all diabetics really should be, according to guidelines today. According to guidelines, yeah, they've seen, when we were diabetic, the studies they have looked at, really all the studies have been published, they did a meta-analysis which just means they've analyzed all the studies that are out there, have indicated the diabetics are twice as likely to have heart attacks and strokes, more likely to have early death than non-diabetics. So when they look at people, and it turned out to be ages 40 to 75 or the largest number of people are on a statin, their likelihood for heart attacks and strokes and early death are normalized.
So if I'm taking a statin and I'm diabetic, I'm gonna have the same likelihood of a heart attack as somebody who's non-diabetic. Okay. So really, when you look at those numbers and you look at the health issues, the pain, the costs, the stress on the family that goes with having a heart attack, going through the rehab, potentially being a massive heart attack and you die from it, I can't understand why somebody wouldn't be on a statin. Well, you're helping alleviate some of my fears, because as I said, there's probably a lot of people out there listening, you know, when I'm on those, others may know someone or somebody may be in my situation, they may be faced with going on one, because I've actually, and I told you this, there's a lot of myths out there surrounding statins and it's funny because some of the information that you provided me, some of these I've heard, one of them, that statins can cause memory loss.
Now, most people think I'm gonna start having memory issues if I take statins, is that true or? The studies do not prove that to be the case. Okay. If you look at diabetic patients versus non-diabetic patients, if you look at people on statins, people not on statins, the memory loss, the Alzheimer's that dementia, those sorts of things seem to be comparable in both groups.
A lot of it tends to be coincidental. A person is 50, 60, 70 years old, they start a statin, they're also at the point where they have probably started some sort of cognitive decline. Gotcha. And some, but either they or some loved one near them has realized this and kind of put two and two together where yes, it occurred at the same time, but it's not a cause of a fact.
Great. That makes perfect sense. Now, when it comes to blood tests for liver kidney functions, will we need regular, you know, have to get blood tests all the time? They now say you do not.
Okay. There would be generally a baseline test to see where your cholesterol is. In some of the larger, in some of the university areas, I know at Ohio State, I think at WVU, they will do a CK or creatinine kinase level. Okay.
CK is something that will be elevated if the statins are actually, you're breaking down muscle fibers, so you can compare a baseline CK with, okay, I've been on the statin three months, my CK is up, that can explain my muscle aches. Okay. So ideally they would just do a baseline cholesterol and they would do a baseline CK. Other than that, just tracking for your own knowledge, it wouldn't really be a marker to be on or be off of the statin.
Okay. And this guy's sitting across from Sean Douglas, he's the pharmacist with the Mountsville Kroger, and the pharmacy there, and Sean, you've been here before, you should give me my flu shot and I will say you're the best guy with a needle, you hardly feel it, and I just, people recognize your voice, you've been here before, and I appreciate you coming in today to talk about statins and different health topics. And another one that comes to statins, I just had this conversation the other day about muscle loss, muscle damage, that somebody, she had told me that she was on it, and it caused muscle problems in her arms, and so she won't go near them again. There is a definite possibility that a statin will cause a muscle aches, a muscle fatigue.
There's always that possibility with things, right? It's not a high likelihood. Okay. There are, of all the statins that are on the market, there are really four different pathways, our body will break the medication down.
Okay. Zocor for instance, tends to be a more common one to cause the muscle aches. If you went to Crestor, which is broken down a different way, it is less likely to cause the muscle aches. The private call is broken down yet another way.
It is less likely to cause the muscle aches. So just because one causes the problem, doesn't mean you can't take any statin. That would be like saying, gee, I take, I'd be proven for a headache. It doesn't work on me, therefore I'm not going to take a leave for my headache.
Okay, gotcha. Trying one doesn't mean none of them are gonna work. Trying one that causes a side effect doesn't mean they're all gonna cause a side effect. Right, and I always tell people, like me, this is great information, Sean, and help the guidelines, and everybody has questions, talk to their pharmacist, obviously talk to their physicians, because everybody's different, but I love getting kind of an overview of the whim into this and what these studies say about statins, when you send our topic today, I thought, how did Sean know this?
It was like you were right on a target there, and another one too old to benefit from a statin, but I have a feeling that's a myth too, right? It seems like it is. Really, the average age of people now is continues to creep up. I know back when I started school, it was in the low 70s and now it's the upper 70s.
If you have a grandparent that's in the mid 70s, is it worth them not taking a statin to protect themselves? I mean, it's not like, well, a life isn't, is worth something no matter what age you are. I mean, if it's gonna protect somebody and keep them with me another year, another month, another day, it is well worth it. Exactly.
There aren't as many numbers because they haven't looked at the older people as much. As the age continues to grow, I'm sure we will see the numbers in the test groups increase, therefore we'll have higher ages in our guidelines. And another one, Sean, and I don't know that we talked about it before going on the air, that once you start a statin, you can't go off of it because it likely will kill you or it could kill you. I've never seen any indication of that in the studies that I've read, and I personally, I'm a diabetic also.
In fact, I just started a new statin beginning of summer. My LDL was less than 100. Most people would say, if they're looking at the numbers, all your cholesterol is good, you don't need to be on a statin. I'm diabetic, I should be on 44, I need to be on a statin.
So I started a low dose, I should say a moderate dose statin, just because I'm diabetic. And I have had no issues. I've been on a different statin previously, had gotten off of that because my sugar was so low, I was off all my medications, I saw no ramifications from being off the statin. So I've been on one and stopped it, did not die from it, did not suffer any ill consequences.
I got back on my diabetic medication as age, my diabetes has kind of resurfaced again, started back up on the statin, I keep taking a long. Yeah, I have no hope of my diabetes going away. There's no way, I told you my U1C at my last test, and anybody out there that's familiar with it, is going to be like, oh, 8.5, that's bad, isn't it? That's pretty high, that is pretty high.
Oops, yeah, Paul's been doing some eating, so when we say they're sugar going through my blood, I'm surprised when they try to draw blood, it's just not sugar that comes out all sugar. Well, yeah, fortunately mine hasn't been that high, but I know how that goes, definitely. It's a tug of war, I don't think people think that I just sat and constantly wish that wasn't, you know, am I as active as I should be? No, my doctor and I talked about that, it's all about motivation and exercise, I mean diet's a big part of it, but you've got to move, I mean, you, whether it's walking, you know, 30 minutes a day, whatever you can do, you've got to be able to move, and that will take a big part in helping bring those sugar numbers down.
It helps a lot, and the more active you can be, if you can tone your muscles a little bit, they'll be burning sugar while you're sitting here at work, I know. That's what I need to do. Right. Yeah, that helps a lot.
Because one good thing, and you don't, I know you don't have this going, either, but neither of us have the weight issue, so they're happy with my weight, and so that's one less thing I have to worry about. Yeah, that, in fact, when I was diagnosed diabetic, I was 30, some odd pounds heavier, so, wasn't fat, but I was definitely a little cushy at that point, so it does, I do feel a lot better having lost the weight, and it really helps me, I feel like I control it better, just makes me feel like I'm eating more healthy. Yeah, and honestly, I know people are gonna think I'm ridiculous with the statement, but having someone sitting here, obviously professional, and personally, you know, you being a diabetic, and I, you know, two diabetics here, when I was first told five, six years ago, I was a diabetic, it felt like a death sentence to me, because I've lost family members, of course it was, you know, they had childhood, my sister had had had childhood diabetes from when she was five, six, and I watched what happened, the kidney failure, the eyesight going, the body's not healing like it, so I watched all of that, which was very scary, so she was insulin dependent, I'm just, you know, I had take shots, I'm just a type two, so, but when I heard that, I was like, that's it, it's over. And in a sense, it's good to feel that way, because you feel the urgency to change things, but it also shows how much science has changed, you know, everything that doctors, pharmacists, nurses, learn in school with science-based, science is evidence-based, you gotta prove it to me, and it's kinda like I'm saying with these guidelines, now saying you should be on a statin, evidence shows you should be on there, we don't quite see nearly as many of those drastic cases with people are older, you know, getting much, much older before they start seeing the eye issues, the kidney issues, the wound healing issues, so.
Just what you're saying there is a very good example of how much this evidence will benefit us if we pay attention to it. Absolutely, and Sean, while I'm talking to you, you know, anybody has any questions or comments, talk to us a little bit about, you know, the Mountsville-Kruger's pharmacy, your pharmacist there, you guys offer a lot of services, and when you brought me some information here, I didn't realize how much, you know, what you do. The pharmacy has changed quite a bit in the last, really the last 10 years, it started when I was in school, the last 10 years has been quite a bit. You know, from us, given the flu shots and we do immunizations, most of our Kroger pharmacies also do health screenings where we can check your cholesterol, we can check your blood sugar, we will check your blood pressure for you, we can do A1C checks, a lot of these are more, the equipment we use is more of a little snapshot, it's good, it's not as good as having the blood drawn, but it's also much less expensive than having the blood drawn.
We can also, I mean, I do diabetes coaching with diabetic patients, I've got a partner that does smoking cessation coaching. So we get into quite a, I guess a healthcare, they call us care centers now, a lot of times within Kroger, so. You got us covered from head to toe, it sounds like. Pretty much, and most of our stores will do that.
All of our stores immunize, most of our stores do the health screenings, all of our stores have a smoking cessation coach. So yeah, we kind of cover the whole gamut of healthcare. If anybody has any questions, Sean, is there a way they can get ahold of you? They can reach me just by calling the Kroger in Mounsel, which is 304-845-8298, or you can feel free if you live in St.
Clair's or Lele Wheeling or Steubenville, just call your local pharmacy and Kroger pharmacy and they'll be able to let you know what services they offer and what each of our pharmacies has a clinical director, that clinical director will do under point and right direction. You know, Sean, I think the toughest part about being a diabetic is like I said, I watch it with other family members. You want to still try to live that normal, like you watch other people sit down and man, they can just pile the food down. And I remember what those days were like, and you didn't feel guilty about it.
You know, maybe you worried about gaining a pound or two at the most is all you had to worry now. It's like, what's this doing to me? Yeah, it's always a matter of give and take. You know, if you're sitting down in the Tallahunian, you want to have their Reese's Cup?
Oh man. Go ahead and have the Reese's Cup. You just got to know somewhere during the course of the day, don't have the potato, don't have the roll, don't have the sugar filled cereal in the morning. You know, just got something else out to it balances out for you.
People be surprised too, Sean, a lot of the cereals, because even my healthcare provider, she talked to me about this just recently. We talked about, you know, my weakness, my bad french fries, breads, because I could just, I could live on bread. I love breads, but she even said cereal and even some of those out there that are common that people say, but that says it's hard healthy for me. Or it says it's this, but it's just loaded and sugar, whether it actually has the show, it can still affect your blood sugar very negatively.
Absolutely. Another one of the services our pharmacies offer are grocery tours. In the grocery tours, we teach label reading on packaging. Okay.
Yeah, it's amazing. You go down the cereal aisle, we teach you the first thing you want to look at is the first ingredient. Okay. If it's a whole grain, you're going to be getting mostly grain.
Okay. And most of them won't mention some of my favorite cereals. First thing you get is corn syrup, is fructose, is processed something, you know, processed corn for instance. Those are all sugar based, carb based things, what you're just going to jack your sugar right through the roof.
Yeah. And I can personally test one of my favorite cereals and I can put honey nut Cheerios. Love me some honey nut Cheerios. I was going through, you know, well over box a week because I sit down in the afternoons, I get home from work, I have two bowls of that.
And take my sugar medicine, still wonder why my sugar was really high and I couldn't get it down under control. But I've learned now, you know, Paul has one bowl in, it's now that I'm on different medicine and I can find out on the right medicine, you can eat more, you don't have, but it's all a fine balance, you walk that fine line. And as you said, if you're a little worse here, later on, don't lay off the baked potato, don't have to pass that up for something healthier or you know, skip that all together. And another thing I would try to do is just basically starve myself to get my sugar to come down.
So I was, you know, miserable, cranking another way because I had to love blood sugar because I was starving myself. I was getting those numbers down, but at a sacrifice that's not healthy either. And at some point for most of us, our body will kick into starvation mode and start dumping sugar out of the liver. So then we think, well, she wise my sugar high, I haven't eaten in so long.
That's a good point. Well, it's because our liver's dumping sugar thinking we're starving to death. Okay, because I wonder that too. I haven't had that much to eat wise my sugar still here.
And it wasn't, didn't have the exact results that I wanted. I just got my answer. Yeah, period. It's like during the day of work, I'll work eight, 10 hours.
We really don't get an opportunity to go out and have a meal. But I have cereal bars, a glass of milk, something just, you know, say every two or three hours. So I'm getting some kind of protein, vitamins, carbohydrates in the body just to kind of keep everything functional normal. And Sean, we talked about the pharmacy at Kroger Star Ratings adherence.
What's that all about? Something else here, some interesting statistics here. I kind of like when I was reading through this. Star Ratings are very interesting, very complicated.
Okay. But if you, yourself, are on a Medicare D plan, those plans are rated by Center for Medicare and Medicaid Services. They can get a five star. If they do everything perfectly down to a one star, if there's a lot of holes in their service.
Okay. Things such as being on, diabetics being on a statin are graded. If you are adhering on your blood pressure medication, adhering on your cholesterol medication, adhering on your blood, oral blood sugar medication, or if you're on high risk medications, medications to make, an elderly person more likely to have a fall. Okay.
All of those things are graded. And the better your health plan is graded, the cheaper their prices are. Okay. And the more services they are allowed to offer you.
Okay. If they rate low enough, Medicare will not let them market their plan, or can in essence cause them to shut down because they won't be able to go out and solicit customers. Okay, that makes sense. They are starting to roll that out now for doctors and for pharmacies.
So our pharmacies are being graded on these things. Thus, we would like to make sure, it encourages us to make sure you are taking your medication like you're supposed to instead of just filling the medication. And it should be encouraging your doctor to make sure you're on proper therapy. The way Medicare is kind of driving that toward the healthcare professionals, we will see better reimbursement if you are more here on your medication or on proper therapy.
And we will have better contracts with the third parties. So if you come to a Kroger pharmacy and Kroger pharmacy has a four or five star rating, you're going to be more likely to have your health plan accepted with this. You're going to be more likely to have a preferred copay at our pharmacy. Okay.
So it's kind of their progress. It's something that's been in a progressive stage. And it's kind of unusual to me in that they are grading us today on something that will go into effect actually two years from now. So what we're doing in 2016, well actually as far as a cost standpoint and availability standpoint will take effect in 2018.
So it's all trailing. So you could be doing great work today and not realizing it two years down the road is where you will either reap the rewards or pay the, pay the piper so to speak for what you didn't do right today. I know you did a good job breaking that down because I wonder what that was all about. But I know all of the services and things people have questions.
I would have to say you guys do great. So I mean, I've heard nothing but good things. And I enjoy personally, I enjoy working with students and seeing the stuff that they're teaching in pharmacy schools now is amazing. They really teach a team based approach from the doctor, the nurse and the pharmacist to work together as a team.
They're really giving the pharmacist all this new information. So they come out ready to go with the health care screenings and immunizations and the coaching and understanding the stars programs. If your pharmacy is paying attention to all these things, you should get tremendous care. We work very closely with the prescribers.
Some pharmacies, it feels like, or just as I talked to other farmers are so busy, their pharmacist will tell me I can hardly get the prescriptions filled, let alone do this other stuff. But the industry is changing. They're slowly but surely we're getting into a point where we have to focus on these clinical things in order to take care of a patient and an expensive side a lot better. Sure.
And Sean, now we just have a couple minutes left here. Again, we're talking with Sean Douglas on weekend focus pharmacists with Moundsville Kroger. Somehow I was usually getting those mixed up in order. But I think I was pretty good with that time.
Sean, when it comes to things, you guys even watch maybe if something's prescribed to somebody and you see a couple medications that raise a red flag and talk to somebody's like, wait a minute, maybe you shouldn't be taking this. And I'm sure that happens. It's not on purpose, obviously. I'm sure there are instances that happens that raises a red flag to you guys.
So it's nice to have that extra set of eyes looking out for us. Absolutely. And that's pretty much the crux of how we started getting into these other clinical aspects. There is so much that doctors need to learn or prescribers, I should say now that you have nurse practitioners and PAs writing.
So much they have to learn and focus on in a diagnostic standpoint, understanding a disease state standpoint, that they don't get as much education on the prescriptions as the medications as we do. Pharmacists get three years, classwork, learning nothing but the chemistry of how the medications work, how the body breaks down the medications. And then we do one full year out in the field doing 11 or 12 rotations, different sites to get a good feel of how the medication works in practice. So it might be in a wound care center.
It might be in a nursing home. It might be in a mail order center. It might be in a specialty pharmacy, a coominate clinic, something of that sort. So we get, and it's on a daily basis, I work in retail, of course.
It's on a daily basis. I'll see something, either that I recognize or the computer system throws out at me and says, hey, this is a problem. Maybe you see a specialist for one thing in your family doctor prescribed something else and they clash. They didn't realize you're on it.
Maybe something that has the evidence has shown as a new interaction that hasn't been thought of in the past. All of a sudden we're seeing it saying there seems to be an association between these two things. Now I understand even more when they at when I go to somewhere that list all medications are on, even if it's over the counter, that's why it's important that our health care providers know exactly what we're taking. Even if it's just once in a while that we tell them everything.
Yes. So that makes better sense. And the over the counter natural products that people don't think of and we're learning a lot more about those, but they're not studied like medications are. We don't know the ins and outs of them as well.
So whatever you can provide on that front, at least we can try to research and make sure that it does fit as well. All right. Well, Sean, again, give us a we have reminding down here of people have any questions for you how they can get in touch with you. They want to reach me personally.
The mouseville Kroger pharmacy at 304-845-8298, or you can call your local Kroger. As to speak with one of the pharmacists, each pharmacy has a clinical services director. Any of the pharmacists can answer the question, the clinical services director works on this on a daily basis. So they might be a little more in tune if you want one of the specialty services.
And Sean, I appreciate you. It's a pleasure to talk to you about half hour flu by fast, isn't it? It sure did. I feel like about five minutes.
It does. And Sean, I look forward. I can't wait to see our upcoming topics and discussions we'll have here in the future. So I look forward to the addition of you here on the show.
I thank you for having me. It's a lot of fun. Thank you.