I have coronary artery disease


#21

From what I’ve read, I think it’s related to increases in stress hormones and inflammation. I’m not sure science knows the exact cause; it’s more of a correlation, like high A1c and diabetes complications. If you google “sleep and heart disease” a ton of articles come up.


#22

Adam Brown wrote a long article on blood glucose control and sleep in an April 1, 2013 article on diaTribe.

Here’s one section of this extended article. I recommend the entire piece if you haven’t read it before.

I needed 24% more insulin on days following less than seven hours of sleep – in other words, the less sleep I got, the more insulin resistant I was. On nights with less than seven hours of sleep, I used an average of 31 units of insulin the following day, compared to an average of 25 units of insulin on days when I get more than seven hours of sleep. Based on all the research I read on sleep and diabetes, this was the result I was most expecting to see.

My highest blood glucose of the day was even higher on days following little sleep. My maximum blood glucose averaged 180 mg/dl on days following less than seven hours of sleep, compared to 163 mg/dl when I got more than seven hours of sleep. Since I always control pretty tightly to a target blood glucose of 100 mg/dl, I did not expect to see dramatic differences in overall average blood sugar – indeed, my glucose averaged 112 mg/dl on days following less than seven hours of sleep versus 107 mg/dl following seven or more hours of sleep.

He goes on to cite various studies done on this subject. It’s worth the time to read the entire column.


#23

@Terry4 This is interesting - after I read it, then I’ll have to track my sleep and bg!

Thank you so much for posting your journey with coronary artery disease. I’m in your corner watching, learning, supporting.

Best of luck to you!

At some point, I’ll be able to share my similar journey. As I’m still digesting the cac score and other results I recently received. It’s not easy.

((hugs)) all around


#24

Thank you for sharing with us Terry, and sorry to hear about the serious complications. It’s hard to judge how these things turn out, especially when trying to do the calculus on how statistical measures of population effects can affect individuals. It seems far less serious than C.A.D., but my recent run-in with an official diagnosis of serious mixed neuropathy has affected me massively. It’s just hard not to think about it (and what it might mean) a lot…every time I think I’ve gotten to a place where I’ve achieved some level of comfort with my diabetes and its implications, everything changes.

As sorry as I am to hear this, I’m so glad we have this community where we can share fears, lessons learned, and wisdom gained.


#25

I think we need to take our full selves into consideration when we get bad health news. Adjusting to a new diagnosis, it’s only rational that we treat the whole person, including the emotional/psychological part of us.

I’m taking no facet of this unexamined. I will soon see a talk therapist so that I can just exhale and slow down.


#26

Absolutely! My initial diagnosis as diabetic in 2016 and my re-diagnosis as Type 1 a few months later came with massive emotional impacts for me. The same with the neuropathy (thought my low A1c would protect me from the more frightening complications of these diseases), but by talking through it with family, friends, online, and (yes, even) a professional therapist, I’ve been able to get back to a degree of equanimity.

Any kind of shock (medical, social, or otherwise) and my head always goes immediately to “maximum fear based on worst possible outcomes,” and my emotional state follows. At some point, with processing, I get to “I have to do the best I can with the situation as it is,” and I get a certain amount of relief and serenity back. It’s a process.


#27

I think this sharing is healthy. It helps us to cope and also utilize group wisdom when it happens. I know some people prefer more privacy about their health issues.

People historically used their close confidantes to process these kinds of things. Men often just remained quiet while women are better at using their social network to talk about their health. Maybe that’s one of the reasons women live longer!


#28

Terry,
Just wanted to mention to you - as I am sure you are trying to put this all together - there are a lot of potential options.

You don’t know yet what level of blockage you have, or even if you have blockage. That will still need to be determined.

Depending on the condition of your arteries, there are coronary stents, bypass surgeries, medications, etc. Be open to hearing the options.

I think the ECG is just a preliminary step. A lot of times they need to do that before they can order a heart cath or CTA, just to play along with the insurance rules. The other tests after the ECG will give a much better picture of your heart. Be open to those options.

Do you have a good cardiologist? Depending on where you live, I can recommend someone who has a great reputation and is with a phenomenal medical group. PM me if you want, I can get you hooked up with someone really good.


#29

Terry - my thoughts are with you as you struggle to deal with the hand you’ve just been dealt.

I don’t believe any of us are prepared to be told that we have a chronic condition, let alone a severe CVD.

When I was told 6 months ago I have pulmonary hypertension, and that there is no getting better, things looked pretty bleak. But I know you will get over the grief, anger and denial, and choose to make your remaining time here positive and happy.

I’m only a message a way if you want to talk.
Jim


#30

NORM! we want more Norm!

sending more hugs :blue_heart::blue_heart::blue_heart:


#31

sorry to hear the test results.

did I read correctly that you won’t take statins?


#32

Terry,
I told my diabetic Dr. in July during a regular quarterly visit that I was short of breath after one jitterbug dance and I found myself following my wife while hunting whereas a couple years ago she followed me. Since I have had type 1 diabetes for 27 years and it had been 8 years since my last stress test he referred me to a heart doc for a stress test with all the bells and whistles. The 3 hour test went well (good valves) after which the heart doc wanted to do a heart cath which also went well (good open vessels), however after all was said and done I now am on a beta blocker (carvedilol) to make my heart more efficient in its pumping or ??? (still do not have a clear idea but will get a better understanding at the next visit in a couple weeks). My sister in law who is a nurse of 30 years said the good news about being a diabetic is we are less likely to feel heart attack symptons, of course the bad news is we still have the heart attack. I am currently trying to find time in my busy life to do more exercise. I am 63 years young and have been on Statins and Ezetinibe for years and have good cholesterol levels, so I guess there is no guarantee that good cholesterol levels prevents heart disease.

Terry, I do read all your posts religiously and find them very helpful and inspiring in my walk with diabetes
. I pray all goes well for you as you learn more of what diabetes has in store for you in your future. Mel


#33

Wishing you the best @Terry4, thanks for the courage to share and I know you’ll figure out the best course of action!


#34

I am open to options that will return tangible knowledge about my coronary artery status. I’m am concerned with a cardiac catheter procedure as my father had a stroke during that test. I know, I’m not him and that was then and this is now. I still live with that.

I know that stents are often placed during a cardiac catheterization and I don’t want the stent decision to be precipitated or made inevitable mostly due to expediency. Stents are a decision I am not ready to make. How long do they last? Does the plaque usually grow back? Do patients actually live longer due to stent placement?

Right now, I’m hoping that my coronary arteries are currently open enough. I would like to give myself one year to effect lifestyle changes and monitor this lifestyle progress with quarterly advanced NMR lipoprotein profiles and then followed by another coronary artery calcium scan at one year.

Here are the lifestyle changes that I think could change the trajectory of disease progression. As I understand it now, coronary artery disease (plaque increases) will often progress at a rate of 25%-30% per year. I’ve also read that actually stopping the progression may be good enough to stabilize the situation and considered a success.

Here are the lifestyle changes I am considering, some of which are already in place:

  • Eliminate all grain and sugar consumption.

  • Optimize thyroid health, not merely treat to target.

  • Supplement omega 3 fatty acids, vitamin D, vitamin K2, and magnesium.

  • Lose five pounds or more. I am under a 25 body mass index now.

  • Implement a daily meditation program to help improve blood pressure.

  • Continue my daily walking exercise. I’ve averaged 100 miles/month for last 4 years.

Of course, if I discover that my blockages are too far beyond lifestyle mitigation, I’ll need to look at other options.

I think I am dealing fairly well with this situation but I intend to seek out counseling to help process the emotional and psychological effects.

Thanks for your comments, Jim.

@MarieB – I’ve always said that Norm is the rock star and I’m just the roadie! He always gets lots of recognition here. Thanks for your support.

@Dave44 – My problem with statins is that I don’t think they’re effective. I have spent literally hundreds of hours reviewing the literature. I do know that they can reduce cholesterol because I took them for about 10 years and saw that they depressed the numbers.

I just don’t buy the cause/effect connection between cholesterol and atherosclerosis. The outsized influence of big money corrupts. Big pharma, doctors, and hospitals all economically benefit from statins and treating coronary artery disease.

I’m not in the mood to rehash the statin debate. If someone can’t resist continuing this debate, please branch off of this thread or just start a new one.

@Mel22 and @Jason22, thank-you both for your good wishes!


#35

Terry, I’ve learned a great deal from your thoughtful, empathetic posts and I wish I had good knowledge to share back with you. But l do send you positive energy and good thoughts as you work through this new information. Stay strong!


#36

HUGS to u!!! As a cardiac RN BSN, it is common place to asses coronary artery disease status to develop an effective plan going forward & u don’t have to have the stents if needed placed in a hurry. U can have a discussion w ur doc after the catheterization. And stents do prolong life and greatly prevent heart attack, not to mention open heart surgery. Plus, i don’t know when ur dad had his cath, but the procedure has gotten progressively safer over the years! The cath is very accurate in assessing more than just ur coronary artery health! Lots of cardiac health Info is obtained. I’m sure u know, u need more than the standard ekg/ecg and calcium deposit testing to really asses cardiac health. But I’m sure u already know that!!

As many have already mentioned , ur very courageous in discussing ur cardiac health at this point & I know u r helping many others afraid to go forward for testing to asses her/his status, so thank u for sharing!!!

Good luck and I hope the best for u and good health and a healthy future whatever u decide!! Also, I’m a cardiac ICU nurse at Brigham & Women’s in Boston so I’m very well educated in all things cardiac disease!! I’m here for u if u have questions &/ or want to talk!! HUGS! Btw, I have type one too so I can totally understand ur concerns regarding developing cardiac issues!! I wish u the best!


#37

@Terry4, sorry you are facing this info and having to plan your path forward. At the same time, the knowledge is good and better to not be in the dark.

Knowing that you are a great researcher, you’ve probably read tons of stuff on cardiovascular diseases and Type 1. This blogpost I wrote a couple of years ago has some relevant links at the bottom and might be worth checking out to see if there are some articles you haven’t read.

The article that concerned me the most was the one from Diabetes Forecast about why people with Type 1 do worse after heart attacks than the general population and even Type 2. it talks about the idea that a heart attack can cause a massive autoimmune attack on the heart muscle in PWT1. For that reason I think that our biggest job is to prevent that first heart attack.

Knowing what a great lifestyle you lead right now, I hope that you are able to work with your doctors to rationally decide if more lifestyle changes can make a difference. Thinking of you and sending hugs as you work through all of the decisions that you need to make. And you are very brave to share this info and I know that all of us who know you will benefit greatly from what you learn.


#38

Me neither. And I didn’t know I was “rehashing a statin debate”. I was just curious about your OP comment re: statins. I don’t want to argue for or against. it’s all good, Terry.


#39

Ok, I understand. It’s ironic, given my current skeptical view of statin therapy, that back in the early 1990’s I had to convince my endocrinologist to prescribe statins for me. His reluctance stemmed from watching one of his patients who took statins develop a debilitating and permanent known side-effect of statins called rhabdomyolysis. This patient, a man in his 40’s, was confined to a wheelchair.

My doc complied with my request and started me on statin therapy and continued it for about ten years. After much reading and research into statin use, I decided to stop taking my Lipitor. I again thoroughly reviewed this topic in 2012 when I went through a complete reset of my diabetes therapy. I decided to continue with my personal no-statin position.

The reason I discouraged your opening of this topic here is that I’m well aware of the scale of the on-going controversy and knew it had the potential to sidetrack my current main concerns.

I still think that statin use is a viable and pertinent topic on this forum related to diabetes and cardio-vascular disease. I just didn’t want this thread to explode in that direction. I should have expanded on that when I replied to you. No harm, no foul!


#40

Thank you for your support and link to your informative posts back in 2016. It’s funny that I had not read those before. As you know, I spend a good deal of time reading within the diabetes online community and I consider what you write some of the best.

In April of 2016, when you posted this series, I was busy moving off of my sailboat home of 15 years and moving from the San Francisco area to Portland, Oregon. I plead distraction!

I’ve now read your three posts and followed a few of the links. I will return and follow the rest of them soon. Thank-you so much for reminding me of your great review of this topic! I’m also an active reader of yours over on the Facebook groups. I hope you are well!