I have coronary artery disease


#61

I too have zero calcification and therefore zero atherscherosis and zero blockage but have CHF and have had an MI. My arteries are really clean. You can die with really clean arteries.

Point two: I bet your omega 3 (w-3) level is NOT terrible and w-3-index OK too due to the sardines you eat. I could never bring myself to eat a sardine. But they are loaded with w-3.

Ditto on the killer red meat. I compliment you. I’ve eaten in the past enough red meat for two or three lifetimes already. Anyhow, no more for me. . .


#62

Seriously ??


#63

Your case is interesting and I appreciate your response. My challenge now is to find the best rational path through my predicament. I know I need to learn more and I’m being reminded what it feels like for some who’s just been diagnosed with diabetes and is trying to learn everything at once. It is like trying to drink water from a fire hose.

On top of the reality that a ton has been written about cardio vascular disease and diet, a lot of it makes no sense to me. Just look at the how eggs have gone from a trusted source of nutrition to its suspicious alignment with the “heart clogging cholesterol,” only to move back to its former status as a nutritious food.

Congrats on your good heart health. I’m sure your lifestyle and food choices have helped you.

I’ve been considering taking up the sardine habit for many years. Now’s the time to pick up an tin and give it a try.


#64

@Aeonn, thank you for lengthy and thoughtful reply. There’s a lot for me to absorb. I come to this spot in time with extensive personal experience with the glucose metabolism and nutrition. I believe that diabetes is a disease of carbohydrate intolerance. I know when I exceed a certain level of carbohydrates, my glucose becomes unmanageable.

I’ve certainly read about people with diabetes, some T1D, who consume hundreds of grams of carbs per day using a plant-based diet. The nutritional sufficiency debate of diet that includes meat along with some fruits and veggies versus one that excludes meat and amps up the fruit and veggie component is not one I want to spend much time on now.

What I would like to see is the glucose data from someone with diabetes (T1D or T2D) who eats a high carb, low fat diet. I’m interested in continuous glucose monitor data, meal dose size and timing, and total daily dose amounts. I’ve made this challenge elsewhere on this site and have yet to have a plant-based diabetic show what kind of glucose control they live with consuming hundreds of grams of carbohydrates each day.

I am just beginning to learn all the various terms used in heart diagnostics. I will likely refer back to this post as my case progresses.

You used this term “S/S” a few times but did not define it. Can you tell me what S/S means?

I agree with you here, it’s just the supporting details I’m not so sure about.


#65

I believe this is “symptoms.”


#66

Continuing with the low-carb, high-fat (LCHF) versus hIgh-carb, low-fat (HCLF) issue raised by @Aeonn, I came across this story written by T1D Ginger Vieira. I first read this earlier this year when it posted. She’s a delight to read and has taken a more moderate position between these two camps.

Enjoy.


#67

Yes, S/S is Signs/Symptoms


#68

Hi @Terry4
The link above that Laddie had posted for her blog led me to a Heart Sisters group. I’ve thanked Laddie in PM, but you might want to check it out too. There is a page for terminology and abbreviations which may come in handy some day. (I checked and S/S is not on this page.)

Their primary site is:

I’ve read though just a smidgen of their postings and find it very helpful. Even though you’re a fella, I think it will be of benefit to you too, in many ways!


#69

oh so sorry sir. S/S is medical notation used everywhere in notes for signs and symptoms. W/u means work up. F/u means follow up. R/o means rule out. R/i means rule in, E&T means eval and treat, . . . there’s about 100 more like this. One I use often not in common use is AEB for as evidenced by. A bunch of old fashioned ones include S/O subjective/objective. . . well you get the picture. In cardio, SVT means supraventricula tachicardia, VF is venticular fib, VT is ventricular tachy, BB is beta blocker, ACEi is ACE inhibitor, CCB is calcium channel blocker. ASA is allergy to aspirin. My favs are the ones that don’t look obvious like tHcy for homocystein, TCHO for total cholesterol, etc. . . Eventually we could just all speak in abbreviations too.

HAWD (have a wonder day)


#70

I had a similar story. I am 70, with a 37 year history of type 1 diabetes. 3 years ago, during a visit for recurrent sciatica, a lumbar spine X-ray showed a lot more calcification of my lower aorta than was seen 10 years earlier. I asked my Family Doc about what else could be affected by atherosclerosis. He ordered carotid ultrasounds, which showed minimal disease and a cardiac calcium score, where ch was VERY high at 1330. Even though I had no cardiac symptoms, I insisted on seeing a Cardiologist, who I saw 3 days later and he oerformed s cath 3 days after that. The cath showed a flow limiting lesion of my right coronary artery, which was almost 90% closed. A stent was put in, and I was placed on plavix and aspirin. A follow up cath a year later showed no new problems.
Since the initial cath, my wife and I have traveled extensively to Cuba, NZ (3times), Scotland and Ireland, and Japan and SE Asia (Vietnam, Cambodia, and Thailand). I work out in a gym 3 days / week.
Life is good, even though I fully realize that my life span will be lessened because my underlying type 1 diabetes.
I am not particularly worried about dying since at 70, I have had a good life so far and realize that even without diabetes or coronary heart disease, I would be near the end of my life span. I just want to make the most of the months, years, or decade that I might have.
My only advise to you is to not allow the fear of death detract from your joy of living right now. A 65, you have already outlived many type 1 diabetics who had diabetes as long as you have had it. Recently, I read a study that showed that long term type 1 diabetics who have lived to 65 will have a 3 year reduction in life span. If that gets you to your late 70s, that would give you quite a few more years to enjoy family and friends v


#71

yes tim35. Leads and electrodes are two entirely different things and not equated on an exact one to one basis. Generally several electrodes including one that’s completing the circuit as a ground electrode to your leg contribute to any one lead.


#72

That good advice to all of us including me. I am pretty much finished and 60y/o. The game is to stay alive and put out fires. I agree that a full life is prob what it’s about for me. But some of us never anticipated ending up isolated, alone, broke, and not able to do much. I just couldnt believe I add COPD to my list of HCC. That’s another terrific common abbreviation for heirarchical condition category. LOL. Anyhow, it’s not nice being SOB and SOBE (shortness of breath and the same upon exertion.)

I don’t have AFib but had H/o (history of) DD (diastolic dysfunction) and SVT with AVNRT and prior MI with poor r-wave progression and elevated cQRS with HFpEF that now is not preserved any more. So I had a recent ablation. OMG (oh my god) did that help!

What was disturbing to me was that the boombox in the surg was paroxysmally playing vulgar rap music and I asked to please not make that the last thing I hear before leaving this world if things go poorly. They had more confidence in me than I had in them. So they asked what I wanted to hear? I thought it would be funny to say achy brakey heart. They never heard of it nor got the joke. So I said Wagner, something heroic and noble celebrating man and nature like maybe Tristan. They asked me how to spell Wagner. The guy said spell that after the V. I am not kidding you . . . I just shut up and though to myself oh good lord people don’t let these kids who failed calculus kill me today. Apparently I woke up and am here still, I think.


#73

I do believe you have now proven your superiority.

You can rest easy tonight. Job well done.


#74

I love that dog. So sweet. Here’s my little girl falling asleep sitting on me on the sofa


#75

I humbly propose a moratorium on acronyms for the remainder of…THIS YEAR.


#76

Sorry for your troubles, but that’s the best laugh I’ve had for days.


#77

While I know the appeal of using acronyms as a way to help the keyboard catch with the speed of your thoughts, I try to write with as few as possible. My intent is that anyone visiting here for the first time is able to follow the interchange from comment to comment without have to resort to google.

I’m not always successful at that but I think trying is worthwhile. Use of jargon and shop-talk can be seen as exclusionary. I know that’s not what was intended here but looking through the lens of a new visitor might motivate us to key in a few more characters.

I appreciate the help decoding S/S and many more acronyms, especially the clinical heart related ones.


#78

For you or others who may be interested in medical advice: It is possible for everyone to search the ADA Standards of Care that are updated at least every year an more often when new information is available. Here are some highlights from: Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2018

The short version is that a statin is recommended for anyone over 40 with diabetes and there are new drugs being used by people with T2D that also have heart health benefits that can also be considered by people with T1D.

(The A level advice is the highest rated category.)

* Lifestyle modification focusing on weight loss (if indicated); the reduction of saturated fat, trans fat, and cholesterol intake; increase of dietary n-3 fatty acids, viscous fiber, and plant stanols/sterols intake; and increased physical activity should be recommended to improve the lipid profile in patients with diabetes. A

* For patients of all ages with diabetes and atherosclerotic cardiovascular disease, high-intensity statin therapy should be added to lifestyle therapy. A

Near the bottom of the page there is a report of recent large cardiovascular safety trials of medications currently approved for type 2 diabetes. There is a place for the in patients with type 1 diabetes and empagliflozin or Jardiance may soon be approved for people with type 1 diabetes. If I had T1D and any form of heart disease I would want to see someone who is familiar with these new drug and consider taking one in addition to a statin.

In summary, there are now large randomized controlled trials reporting statistically significant reductions in cardiovascular events for two of the FDA-approved SGLT2 inhibitors (empagliflozin and canagliflozin) and one of the FDA-approved GLP-1 receptor agonists (liraglutide) where the majority, if not all, patients in the trial had ASCVD. The empagliflozin and liraglutide trials further demonstrated significant reductions in cardiovascular death.

My disclaimer: I’m a CDE who attend the ADA Scientific Sessions meetings and medical advice should come from your physician - ideally someone who up-to-date on the recommendations.


#79

Terry,
I have been thinking about you since you first posted about your heart complications and how bad it is.i am having a hard time trying to express my thoughts nd feelings. You are one of my favorite on line friends. You are knowledgeable, caring, understanding and you never judge or preach. I can only hope to live up to your example. I am so, so sorry you have another problem to add to the many one with diabetes must deal with.
I must say, I wouldn’t want to play poker with you! All the chats on line and that retreat we both attended where we spent quality time talking about everything. The seriousness of your condition was never talked about as this bad. And we did talk about this as we both had the same kind of family history and fear of this complication. All those talks in between sessions, or our walks or our coffe or our fish tacos( yes have to have fish tacos when in San Diego).
I know you will approach this with the same gusto you put into your diabetes.
I don’t have a lot of advice for you except to trust yourself. And remember while some have a distrust with doctors, there are very good ones out there and there is nothing wrong with getting a second or third opinion. Especially for something this serious.
You have been in my thoughts since I read your first post. Please know I am thinking about you and sending positive vibes your way. You’ve got this and we are here for you. And if you ever need a shoulder to cry on or an ear to vent with, just let me know!


#80

Perhaps I’m not understanding the results, although I understand that they feel alarming…

80-something percentile risk doesn’t seem all that much worse than average for a 65 year old man with known contributing risk factors does it? I mean, the diabetes, the diet, etc, didn’t even enter that equation. It just means that out of about 100 men your age based on this measure you’re likely at that point on the risk spectrum…

I’d encourage you to not frame these results in the worst possible contexts. That said it’d worry me too. But I wish you the best and suspect you’re still on track to a long healthy life.