My good friend Cynthia presented me with a supply of Lipitor that is going to last me a long long time, sixteen months to be exact. She even gave me a tablet cutter to split the 40mg tablets into quarters since I am only taking 10mg daily.

Lipitor 40mg and a tablet cutter from Cynthia. Thanks!
Photo taken with the Samsung Galaxy S II.

Lipitor comes in dosages of 10mg, 20mg, 40mg and 80mg. The price difference between each succeeding dosage is minimal. This medicine has to be taken long-term. Buying a higher dosage and splitting it into the smaller recommended dosage makes economic sense.

Some medicine, like the Detrusitol capsules that I am taking cannot be split. Likewise other tablets that have a coating that releases the medicine slowly. However, Cynthia the pharmacist assured me that Lipitor tablets can be safely split without it losing its efficacy.

The difference in shape and size between Lipitor 40mg and 20mg.
Photo taken with the Samsung Galaxy S II.

There is a difference between the 40mg tablets that Cynthia gave me and the 20mg tablets that I recently bought from the University of Malaya Medical Centre (UMMC) Community Pharmacy. The former are round which makes splitting them into quarters easier. The latter are elongated and I had to get only the 20mg tablets to be able to split them evenly. Both tablets are manufactured for different regions.

Thank you Cynthia! My cardiovascular system thank you too!

Until two days ago, my only medicine was Detrusitol SR 4mg for a neurogenic bladder. Yesterday, on the first day of 2012, I had to add one more to my daily medication for another health problem that has cropped up. My HDL and LDL cholesterol are not at their ideal levels. There is also the family history of heart disease. My father died of congestive heart failure.

The lipid profile done on November 18, 2011 was not too positive. My HDL cholesterol was 0.97 mmol/L and LDL cholesterol was 3.09 mmol/L. The ideal ranges should be above 1.10 mmol/L and below 2.59 mmol/L for the HDL and LDL respectively. In short, I have high cholesterol!

Lipitor 10mg (atorvastatin) daily to treat my high cholesterol.

Taking into consideration the family history, the undesirable levels of both HDL and LDL cholesterol and the fact that I lead a very sedentary lifestyle, I was advised by Dr. Kumaran of the UMMC Spinal Rehab Clinic to go on atorvastatin therapy. This is to keep my cholesterol levels in check and lower the risk of heart attack and stroke later on.

I took my first dose of 10mg Lipitor (crystalline atorvastatin calcium) last night just before bed. The serious side effects of taking Lipitor include muscle problems that could lead to kidney failure, and liver problems. A blood test to check on my liver and renal functions is scheduled in February. Hopefully, Lipitor will not exacerbate my existing kidney problem. I am keeping my fingers crossed.

I went for my schedule medical checkup at the University Malaya Medical Centre Spinal Rehabilitation Clinic on Wednesday. The good news is that the renal and liver profiles did not show significant changes. Serum creatinine has gone down to 272 umol/L from 291 umol/L in July 2011.

Renal profile for November 18, 2011

Sodium 139 mmol/L
Potassium 4.8 mmol/L
Chloride 105 mmol/L
Total CO2 26.0 mmol/L
Anion Gap 13 mmol/L
Urea 7.8 mmol/L
Creatinine 272 umol/L

Liver profile for November 18, 2011

Total Protein 76 g/L
Albumin 38 g/L
Globulin 37 g/L
Total Bilirubin 8 umol/L
Conjugated Bilirubin 2 umol/L
Alk Phosphatase 86 IU/L
ALT (GPT) 17 IU/L
AST (GOT) 15 IU/L
Gamma GT 12 IU/L

The cholesterol levels are not too encouraging though, especially when there is a history of heart problem in the family. My father passed away from congestive heart failure. I was advised to go on the lowest dosage of Lipitor (atorvastatin calcium) which is 10mg to keep the cholesterol levels in check.

Lipid profile for November 18, 2011

Triglyceride 1.4 mmol/L
Total cholesterol 4.7 mmol/L
HDL 0.97 mmol/L
LDL 3.09 mmol/L

The ultrasound of the kidneys, ureters and bladder report is somewhat similar although the length of the left kidney size was measured at 8.9cm this time as compared to 9.1cm in December 2010 and 6.89cm in February 2004. There is an inconsistence in the three reports, with the 2010 report being the odd one regarding size of both kidneys and the position of the cyst.

KUB Ultrasound Report for November 18, 2011

Findings

Comparisons made previous ultrasound dated 27.12.10
Both kidneys are normal in size but with increased echogenicity
The right kidney measures 9.5cm in BPL and 0.6cm in cortical thickness
The left kidney measures 8.9cm in BPL and 0.5cm in cortical thickness
There is a small cyst seen in the upper pole of the left kidney measuring 1.0cm
The bladder wall is trabeculated
Prostate is normal in size with smooth outline

Impressions
Renal parenchymal disease
Left renal cyst
Trabeculated bladder secondary to neurogenic bladder

Electrocardiograph (ECG) for November 30, 2011.
Photo by Wuan with Samsung Galaxy S II.

I also had an electrocardiogram (ECG) done on the same day as the checkup. According to the doctors, the results did not show any problem which is a relief.

ECG figures for November 20, 2011

Rate 88

PR 152
QRSD 94
QT 380
QTC 460

AXIS
P 62
QRS 90
T 67

Overall, I am happy with the blood test results except for my cholesterol levels. Renal and liver profile tests will be done two months after I have started on Lipitor to check whether these organs are effected by it. A urodynamics study is also scheduled in the first quarter of next year to determine the pressure in my bladder. It was last done in 2008 at Subang Jaya Medical Centre.