The first time I saw David Ashmore he was in for an extensive physical exam.
Really he was in pretty good health for a man who almost died from a heart attack 7 years ago.
"It was like an elephant was sitting on my chest," said Ashmore.
He never wants to go through that again, so he's back for a follow up visit with his wife Lila.
Unfortunately, David's risk of a second heart attack is significant.
Besides the stress of running a local restaurant, the 52 year-old also has genetically high cholesterol.
"You take your bad cholesterol and divide it by your good cholesterol, your ratio is 5, which means your risk of a heart attack is huge."
But here's what makes the risk unacceptable: David stopped medications his doctor prescribed, including a beta blocker to reduce his risk of a second heart attack and a statin to significantly lower his cholesterol.
"You spontaneously, without talking to your physician, stopped your drugs."
In David's defense the medication he was taking made him feel lousy.
"I had no energy, I didn't feel like myself," he said.
But there was absolutely no reason for him to stop the statin and when we measured his cholesterol it was off the charts.
Sometimes patients just aren't diligent about taking their drugs, sometimes it's the cost. Other times, as in David's case, it's a conscious decision.
"I'd go through periods of trying to be compliant and then having to make a decision about whether the quality of my life on the beta blocker is worth the little potential risk of having another heart event."
That's not a choice he should have to make.
There are a wide array of drugs available that may lower his risk without lessening his quality of life.
"If we take good care of you we can dramatically reduce the risk of another heart attack."
Choosing to stop taking your prescribed medication can be a dangerous, perhaps deadly mistake.
To be frank, it's stupid.
If your medications aren't working the way you'd like, don't stop them by yourself.
Consult your doctor promptly and try something else.