Manic, depressed, anxious, traumatized, or addicted people don’t forget their education, their knowledge, or their common sense when they make unwise choices or make poor decisions. They make unwise choices, poor decisions, and take unhelpful actions because the drive to avoid immediate pain, to obtain a near-term reward, or to experience a fleeting pleasure is so very overwhelmingly strong.

Charles Tadros, M.D.

March 28, 2023

Saint Louis, Missouri

About learning…

I seem to need several things:

To understand the big picture (often to name and understand what I see and what I hear) and then drill down to the, “what, where, when, and why” (ie the minutiae), then step back to the big picture, then drill down to other minutiae.

I need to hear about common mistakes and mistaken assumptions (i.e. I have to understand why I need to remove my previous, incorrect perceptions/thinking before I understand and remember the correct / better insights and thinking).

I need to practice, specifically, many different scenarios, in order to feel comfortable and secure in my knowledge (and to be able to securely build upon this knowledge).

As long as the information and lessons are accurate, specific, and digestible, I’m happy to learn from any source.

Charles Tadros, M.D.

March 22, 2023

Saint Louis, Missouri

Silicon Valley Bank is insolvent

Even if you don’t like to listen to, or read about finance, economics, banking, or start-up technology companies, please listen to a good chunk of the All-in Podcast regarding this sudden bank collapse. This affects us all, even if you can’t see the reasons.

https://youtu.be/CEee7dAk25c

Charles Tadros, M.D.

March 13, 2023

Saint Louis, Missouri

Bempedoic acid (Nexletol and a combination pill called Nexlizit)…a new cholesterol lowering drug for people who don’t tolerate statins…

Cardiovascular and lipid experts don’t talk about this enough… for many years we’ve had several drugs that lower cholesterol or triglycerides but don’t improve morbidity or mortality (heart attacks, coronary artery stents, coronary artery bypass, strokes, and deaths).

Statins lower LDL cholesterol and raise HDL cholesterol and show improvements in cardiovascular morbidity and mortality.

This is a statement from the product insert for bempedoic acid:

INDICATION AND IMPORTANT SAFETY INFORMATION
INDICATION

NEXLETOL and NEXLIZET are indicated as adjuncts to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C.

Limitations of Use:
The effect of NEXLETOL and NEXLIZET on cardiovascular morbidity and mortality has not been determined

So if a drug manufacturer added a new cholesterol lowering compound to some small level of tolerable statin, then if researchers ever see any positive effects on morbidity or mortality, some of it may be from the statin.

You can see that they have another drug , Zetia/ ezetimibe, which is combined with the new bempedoic acid (Nexlizit).
Well, it turns out that the Zetia is also an add-on drug to statins. Zetia was introduced 20 years ago, also for people who don’t tolerate statins.
Zetia, by itself, does not reduce cardiovascular morbidity or mortality.

Zetia has been cheap for years because it’s a generic… generic drug plus a new, name brand drug, equals a very expensive, combination, pill.

I am very eager to see improvements in morbidity and mortality numbers for this new bempedoic acid.

https://www.nexlizethcp.com/?utm_source=google&utm_medium=cpc&utm_campaign=branded&gclid=CjwKCAiAu5agBhBzEiwAdiR5tMauT3tZlA-fYXGQQgl7pKV92BcgS-hqVspry-sY495JVqs4LfsmPxoCuAcQAvD_BwE

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516816/#:~:text=Authors’%20conclusions,effect%20on%20clinical%20fatal%20endpoints.

Charles Tadros, MD

March 6, 2023

Saint Louis, Missouri

I love the planned soft landing pillows, the honest encouragement, and the positive energy. Looks like this Great Escape has been done before…

https://www.instagram.com/reel/CmJ9Ea_JrpP/?igshid=MDJmNzVkMjY=

Charles Tadros, M.D.

February 25, 2023

Saint Louis, Missouri

Kids

I grew up with my parents and my brothers around me all the time. There was love. At times that love revolved around right words and right actions, occasionally with a parent making harsh corrections.

The older I get, and the more adolescents and adults that I see for their mental health concerns, the more I recognize that kids need loving, predictable, and stable boundaries. Kids need to learn by frequent, excellent examples…by witnessing how things are said, what things are discussed, how things are done, how people behave, and how good people treat each other.

Kids are exceptionally good imitators. They want to do good work. They want to show-off their good work and accomplishments. They want to become independent, competent, and confident. They want to be, at the very least, noticed for who they are, and for their competencies and accomplishments. Compliments from people who matter in kids’ lives, are not just superfluous bonuses. Compliments augment these kids’ internal drives to persist and to achieve more.

Kids want and need your attention, and your encouragement.

In contrast, corrections, reprimands, demerits, tongue lashings, public or private shaming, corporal punishment, and corrective action plans are demoralizing, and at their worst, work temporarily, create traumatic, defensive behaviors, and are dehumanizing.

Charles Tadros, M.D.

February 24, 2023

Saint Louis, Missouri

So many times, our logic, thoughts, beliefs, and behaviors don’t make sense…

we won’t or don’t question some of our own basic assumptions. We, willingly, continue down decision paths or pursue actions, many of which are absolutely ridiculous, even if we recognize our foolishness. In the face of all these contradictions, we still do not, or will not, stop, change course, or ask for help.

Charles Tadros, M.D.

February 11, 2023

Saint Louis, Missouri

EQUANIMITY

Evenness of mind especially under stress (merriam-webster.com)

If you think “equanimity” looks like it has something to do with “equal,” you’ve guessed correctly. Both “equanimity” and “equal” are derived from “aequus,” a Latin adjective meaning “level” or “equal.” “Equanimity” comes from the combination of “aequus” and “animus” (“soul” or “mind”) in the Latin phrase aequo animo, which means “with even mind.” English speakers began using “equanimity” early in the 17th century with the now obsolete sense “fairness or justness of judgment,” which was in keeping with the meaning of the Latin phrase. Equanimity quickly came to suggest keeping a cool head under any sort of pressure, not merely when presented with a problem, and eventually, it developed an extended sense for general balance and harmony.(merriam-webster.com)

Charles Tadros M.D.

February 8, 2023

Saint Louis, Missouri

Not having $1 vs having $1 while being in debt to someone for that $1 may look the same when we look at our balance sheets and net worth. However, they certainly don’t feel the same.

The vast majority of us have credit card debt, home loan debt, automobile loan debt, school loan debt, medical bill-related debt, gambling debt, investment margin debt, business-related debt, liens against our property, or owe money to a friend or relative. Too often, these debts last long after the joy and usefulness of the purchased product or service have left us.

Charles Tadros, M.D.

February 7, 2023

Saint Louis, Missouri

Illness and suffering, our own, as well as that of others, remind us of the miracle of life, the elevation of life through love and empathy, the wonder of nature and the universe, the superficiality of physical death, and the infinite possibilities yet to be discovered.

Charles Tadros, M.D.

February 7, 2023

Saint Louis, Missouri

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