Some things, at first glance, just “look wrong.”

And every time I see a Little Debbie “Nutty Buddy,” I immediately feel an unpleasant catecholaminergic wave of emotional dissonance.

Some might think I’m merely reacting to the metabolical evil of processed, sugary snack cakes. But it’s actually the Double T of “Nutty” followed by the “Double D” of “Buddy” that throws me off. I possess an unapologetic natural yearning for semantic symmetry, so I desire uniformity among the repeated letters sandwiched in the rhyming couplet.

But these wafers mock me. Although they remain diabetogenic abominations, they remain acceptable in regards to grammar and spelling. Still, these “Buddies” are no friends of mine. 

But on a less cardiovascularly catastrophic note, clinicians often think a Cholesterol Panel “looks wrong” the first few times they see patients with single-digit LDL-C levels. And it can initially be a little unsettling.

But then you remember that every nucleated cell in the body synthesizes its own cholesterol.

And you remember that the cholesterol carried in lipoproteins represents a small fraction of total body cholesterol.

And then you see on the medication list that the reason for these low levels is that you recently prescribed her a well-established agent that safely and potently enhances clearance of lipoproteins.

And given her high-risk profile and checkered cardiac history, you’re now feeling pretty good about the safety of her Lipid Neighborhood.

Little Debbie with Low LDL-C is going to be just fine. And since you’re helping her reduce her risk of having a heart attack, you might just end up being Buddies after all😊