Husband and wife seek answers

Q: My wife and I both have problems that we hope you can help us with.

First, my doctor wanted me to take a statin to lower my cholesterol, but I declined because of the side effects. I tried using your recommendation of niacin instead. I am an 84-year-old male in fairly good health, and, after three months of therapy, my figures are as follows: triglycerides went from 115 to 63, HDL went from 70 to 95, LDL went from 137 to 126, and my total went from 230 to 234. I would appreciate your opinion on how effective the niacin has been.

Second, my 82-year-old wife had a mild stroke four years ago and now sees several small spots in both eyes. The stroke did not seem to do her any other damage, so her doctor concluded that they were on her brain rather than in her eyes. Lately, she has become tired all the time and has no energy. Her blood work is normal, and she doesn't have a thyroid problem. Any ideas?

A: I'll start with your situation first. At age 84 and with a total cholesterol of 230, I would not worry. In my opinion, you did not need a statin drug, and were correct in refusing it. Your numbers were all within normal limits, given that you had a high HDL level (good cholesterol) to begin with. On the niacin, your total went up because of the astounding increase to your HDL. You can stick with the niacin, but I don't believe it is necessary.

Now, to your wife. I am confused by her physician's conclusion that she is seeing spots that are on her brain. To the best of my knowledge, this is not possible. Perhaps you misunderstood?

Stroke can cause several different types of visual problems, such as blurred or double vision. Seeing several spots is not typical. This sounds like floaters, which are the shadows of undissolved particles of the gel-like vitreous fluid that fills the eyeball.

I urge your wife to be seen by an ophthalmologist for testing and diagnosis. If your wife ever complains of flashes of light, she needs to be seen by an eye specialist immediately, as this is a warning sign that the optic nerve and retina are being stretched or pulled. Ask Dr. Gott