Heart Complications: One Story (Mine!)

Type 1 and LADA
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Diagnosed at 30, right off the bat I was warned about Type 1 Diabetes (T1D) complications. Being a soldier, I quickly created an acronym to describe those I feared most: BAD (blindness, amputation and dialysis). At 28 years into the T1D journey, I’ve avoided those. One I glossed over was Heart Disease. Many of us do.

In 2007, I was hospitalized for Diabetic Ketoacidosis. I had a stomach bug and dehydration and was found unconscious after a couple of days. Somehow getting disconnected from my pump didn’t help. The local volunteer rescue squad couldn’t get a BG, so they gave me IV Dextrose. Result: BG of 1,440. After a few days I woke up and on the day I was to be discharged I had chest pains.

Immediately I. was hooked up to a heart monitor and had a blood test for cardiac enzymes. The EKG was negative but troponin levels indicated a heart attack. Next was a visit to the Cardiac Catheterization Lab. A catheter was inserted through my groin and up to my heart that showed some occlusion (deposits of plaque inside the arteries of my heart) of around 40-50%, but not warranting treatment with a stent. I was given some medication and discharged a couple of days later. Not having a family history of heart disease (or diabetes, for that matter) my Cardiologist blamed T1D since that is a common complication. I didn’t have any more heart problems–End of story, or so I thought.

Flash forward to 2017. I was having some chest pain, particularly after exercise. I called my doctor and was told to go to the Emergency Room RIGHT NOW! As I was driving along, I was about 5 miles away when I started getting new pain in my left arm–a classic symptom of a heart attack. I had a choice: either keep driving or pull over, call 911 and hope the Rescue Squad could find me. I drove faster.

When I walked into the ER, I went to the desk and said, “I think I’m having a heart attack.” A nurse checked my EKG and her eyes got big. I was put in a bed and a troponin check was off the charts high: heart attack in progress. Within seconds I was surrounded by doctors and nurses. The doctor said, “You’re having a heart attack from a blockage and were going to take you to the Cath lab to fix it.”

Just like the last time, they ran a catheter into my heart (through the wrist this time) and found one artery was 90% blocked. This time a drug coated metal tube was placed in the artery to expand it and hold it open. The medication was intended to keep it from re-closing. Within an hour I was having dinner.

After I was discharged I was enrolled into a Cardiac Rehabilitation class. Three times a week I’d have an hour session of supervised exercise and heart healthy classes. After a couple of months I graduated and went on with life. Subsequent testing showed I had some permanent damage, but noting that would impact my quality of life.

Flash forward to 2017 and a work-up for a pancreas and kidney transplant. CT scans and MRIs revealed that I was not a candidate due to plaque deposits in my abdominal arteries. Other than continuing with statins, there really isn’t anything that can feasibly be done to fix that once it has happened.

Over time the chest pains came back. Along the way my kidney function had declined 20-22%. One drawback of doing another cardiac catheterization is that the dye tends to hurt the kidneys. My doctors and I decided to put off another Cath as long as possible since it’d likely put me on dialysis. This past March we decided it was time.

The results of Cath number 3 showed that the previously blocked artery was re-blocked and 2 more were at 80-90% occluded. This time stenting wouldn’t solve the problem. I was sent back to my room and had to wait for the next step until some of my medications were stopped and out of my system. Next up: cabbage.

Pronounced ‘cabbage’ CABG is current medical shorthand for Coronary Artery Bypass Graft. Some tests were done including one to find an appropriate vein in my leg that would be removed.

On the day of surgery I was put to sleep (unlike the cardiac Cath procedures). About 24 inches of vein were taken out of my left leg. Hint: do NOT watch any YouTube videos of the procedure ahead of time. Then the doctor split my breastbone in two, attached a machine and stopped my heart for 84 minutes. Then he attached a piece of my leg vein from my aorta to just below the heart artery blockage. Then he did that again 3 more times.

I woke up the next morning with 53 staples and some wire holding my chest together. I also had a couple of tubes inserted under my ribcage and hooked up to suction to drain things. And although I wasn’t in huge amounts of pain, it was definitely uncomfortable. The doctors said I’d feel much better once the drains were out, and they were right.

The moral of this story: although we with T1D fear lows the most, and in the abstract fear blindness, etc., Heart Disease is our number one killer. It is sneaky, often hidden, but forces us to pay attention to health besides just Diabetes. So eat right, exercise, do your best to keep your blood glucose where you know it should be, and listen to your body. Blood pressure and lipids should be followed closely and controlled as well.

Trust me, you don’t want to be in an ICU thinking, “I wish I had…” Or worse.

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Welcome to the forum.

At least many people here will understand what you’re saying, even if we have it (so far) on a smaller scale.

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Tom is so very right when he says that lipids need to be watched. When I received stents I was ignoring my high LDL, because there was a very popular book out which said that cholesterol numbers didn’t need to be watched. I was on The Bernstein diet which is fine as long as your lipids are normal. I had an HDL score of 100, Trigs 37 but LDL was almost 200. My A1c was 4.7.

Sorry that you have been through so much Tom!

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Welcome to the forum - Diabetes, left uncontrolled will lead to complications including those you mentioned, but let’s not forget that diabetes is like a 3-legged stool where all three legs need to be kept evenly in check to live a long, fairly healthy life. Diabetes - Cholesterol - Atherosclerosis all work together in tandem, which is why when any one of the 3 is ignored, life-threatening condition(s) will ensue.

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The dextrose thing worries me.
This is one of my big fears.
I had a car accident and the ambulance took me to the hospital and immediately started a dextrose iv.
I told him no. I’m diabetic and my pump came off during the accident so I had no insulin.
He checked my sugar and it was 260. So he allowed me to get saline instead after checking with a doctor on the phone.

I got myself a tattoo on my wrist to let medical professionals that I am type1, but I’m not so sure they would change their procedure because of that.

Lucky for me my cholesterol and triglycerides are pretty low naturally. I currently eat low fat and my cholesterol has dropped even more. I think it’s very important to watch these numbers. Ldl especially. That’s the stuff that causes blockages.

My mother had super low lipids until she reached her 60 s so I’m not depending on my lipids staying low on their own.

I know a guy who had a heart attack at38 and he wasn’t even diabetic, although he was overweight.

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It really is a two front battle. I have near perfect lipids. Unfortunately, I also have RA and in 2015 I received two stents. I asked my cardiologist. She said look it is both lipids and inflammation. Low lipids are terrific, but high blood sugar can cause issues because it causes inflammation.

While my A1C was great and my blood sugar under control it had not always been that way. In fact it is the accumulation of that which likely caused placement of the stents.

Because if it isn’t something, it is something else.

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Thank you for this remonder and recommendation that we all pay attention to these important ways of life, including exercise and heart condition, plus eye condition. I hope that you are now fit and heart and cardiovascular system is healthy.

For me, i know exercise is key to my health just as important as the food i put into my mouth. Neither of these can be ignored. Of course, i sway from the iptimal path now and then and disappointment in myself follows, as i see and feel the damage it does to my body. Amazing how fast the body can react!!

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I am a type 2 of 28 years . On low doses of insulin and on a low carb diet for the last one year or so . My last A1C was 6.9.The other day while on a walk I had some mild angina .Took an ecg the next day which was normal but said I had brachycardia or low heartbeat . Is this anything to worry about ? Has anyone had this experience ?
Grateful for any response
Thanks

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From the beginning, I was more aware of the risk of heart disease. I’ve long assumed that that is how I will die since I have T1D but also a family history of almost nothing else but heart disease in the male members of the family. Since the beginning I was focused on avoiding cardiovascular problems and have long done aerobic work. That includes strength-related activities, although not lifting, but more rowing and cross-country skiing simulators. Also, I quickly adopted an ovo-lacto diet, but now Mediterranean-like.

The others, BlindnessAmputationDialysis, I see as being the lesser risks. Not that they can’t happen, but B and D are often the results of uncontrolled HBP, but I’ve had well-controlled BP for 35 years and have never had protein excretion issues. As for A, I’ve long been told I had excellent pulse flow and have been working out regularly for even longer. Circulation seems not a problem, but I do have some issues with varicose veins, the result of family genetics and my height, 6’4". Regardless, all of these issues are cardiovascular in nature, and death comes to us all, one way or another. A failure to maintain fitness or a complication could cascade into multiple morbidities.

The issues concerning me right now are more quality-of-life (QoL) related, diabetic hand (Dupuytren’s Contracture) and neuropathy. For the first, I’ve had surgery on one hand, but my other hand has non-specific adhesions that can’t be operated on, and there don’t seem to be a lot of existing treatments. For the second, I don’t have any major issues, some minor tingles from time to time, but I recently read how height increases the likelihood of neuropathy, so I am on watch to deal with it if it becomes significant.

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Hey jaybee,
I also have Bradycardia.
I’m also hypotensive.
Since I was diagnosed doctors have pushed ace inhibitors and such as a preventive kidney protection. I was never able to tolerate it because I would get light headed when I stood up.
Also I was hospitalized at 18 , years before I was diabetic and the nurse was worried my heart rate was 40 at rest.
I was at that time a competitive swimmer and I was training for a marathon so the doctor thought it was not a problem.

Jump to the present I bought an Apple Watch and I noticed my resting heart rate is running in the high 40s.

I have not been running any marathons in 20 years and I’ve gained some weight since then. So it no longer makes sense.
I did a 2 week heart monitor and it showed nothing.

My doctor suggested it’s likely been a lifelong baseline and my activity level had nothing to do with it. And it should be considered my normal.
I suggest you get a monitor so you can put your mind at ease

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I suggest that at 28 years it makes sense to see a cardiologist. I am T1 had chest pain was referred to a cardiologist and she found my heart was behaving much as it was meant to do.

The issue was I had a birth defect that was robing my heart o oxygen. It required open heart surgery and believe it or not at age 45 my birth defect was corrected.

Since then I have had three stents placed (age 55) and i see my cardiologist every year. She calls my EKG abnormally normal.

She is a big part of my care team. I suggest that at at certain point it makes sense to get a referral so you can add a cardiologist to your care team. Just my 2 cents when me giving you 2 cents is likely more appropriate.

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Thanks Timothy for your reply . My basal heart rate is 54. So far no hypotension , though I am on BP meds. Planning to meet a cardiologist soon and show him the ecg reading . Will also ask about the holter.To set my mind at rest as suggested by you . Thanks again

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Thanks for your 2 cents Rphil2 ! Sometimes this becomes worth 100 cents ! Planning to see a cardiologist soon . Thanks again

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One funny thing about some heart/BP meds are how they impact heart rate. For example, while doing closely monitored cardiac rehabilitation I’d ride an exercise bike for 40 minutes. Despite pedaling my ■■■ off (180 rpm+) my pulse never exceeded 70. In my marathon days 180 was my standard training heart rate.

The body is an incredible and baffling machine (as people with diabetes know all too well).

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@jaybee (if you’re still around here),

Have you spoken to a doctor about this? I think that there are doctors who hold that a story like this should have a real medical follow-up.

Good luck.
M.

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It could be gas or a chest muscle strain. I went to er with chest muscle strain and they did a Cath exam. My Pcp thought that it was fine. I thought it was alot. But what do i know. But with a heart you may want to see a cadiologist because so many things are not easily seen

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I also have bradycardia. I went on a heart monitor for 10 days and it showed nothing. I was pretty athletic. When I was young and that would explain it for back then, but I’m not running any marathons now, but I have a slow heart rate and low blood pressure. There isn’t much to do aside from a pace maker. I’m hoping it won’t progress.
I have never had any indication of a root cause.