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Something diabetics might like to bear in mind...

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desidiabulum

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Something diabetics might like to bear in mind...
Just back from my second angioplasty in ten months, and I thought I would pass on something that the surgeon said to me before the latest op which I didn’t know, and which fellow-diabetics might want to bear in mind if they don’t know it already.
Quick background: I am 50, reasonably slim and fit, good BMI, BGs reasonably under control, no diabetes-related neuropathy. I have been diagnosed with blocked coronary arteries, but I had not had angina or any other chest pains to indicate this – the only symptoms were occasional breathlessness and dizziness. It is pure luck that I got the necessary tests done. I know that there are a certain number of people who don’t get angina with blocked arteries, but the surgeon told me that this can be especially the case with diabetics, where the diabetes can cause loss of internal nerve sensitivity (i.e. autonomic neuropathy). I had not heard of internal neuropathy before, but so-called ‘silent ischaemia’ (unfelt chest pain, as it were) is evidently widely prevalent among diabetics. Given that coronary artery disease is a major complication for us diabetics, I would urge you all not just to monitor yourselves for chest pains, but to keep an eye out for other symptoms such as breathlessness, dizziness, extreme fatigue after exertion, unexpected sharp pain in abdomen, back or arm.
Take care, everyone. As with all health problems, early diagnosis is the key. I have been lucky – I hope that you are too.
 
A good post, and a problem not usually noticed. It is one of the things that I am checked for at my annual diving medical, so it could be done, but again it's down to the money.
 
This is exactly what happened to me.

No chest pains or any other symptoms apart from getting a bit out of breath sometimes. They decided to do a stress test which indicated that an angiogram would be worth doing. During the angiogram they stopped and said I could have 5 stents or a bypass and that the bypass was the best long term option for me. Apparently my coronary arteries were 70, 80 and 90% occluded (with no real symptoms).

I had no idea things were so bad. :eek: Anyway, I had a quadruple bypass last year and made a good recovery.
 
There was a write-up in the Balance magazine about heart health and they did say that Autonomic Neuropathy can mask the symptoms of a heart attack and angina pain, it's scary stuff and makes you wonder if screening, especially for those who have been diagnosed a long time should become routine.

I had chest pains around 3 years ago and was finally admitted to hospital with suspected angina, had ECG's done, Echogram and finally an Angiogram to see if there was any blockages, thankfully mine turned out fine and there's was no concerns and my problem was found to be musculorskeletal ( a condition called Costochondritis) which settled down after taking anti-inflammatory meds, it was a worrying time nonetheless as I did think it could be heart related being diagnosed with diabetes for 30 years and having some CVD in my family.

Anyway a good post Desi and hope people take note of what you've said, here's to a speedy recovery!!!!!
 
So glad to hear about your recovery, robert72, and that your chest pains were Ok in the end, noblehead. I do think you're right about screening. The trouble is that arteries can narrow so quickly, just in a few months. regardless of lifestyle. I'm lucky that I had a sympathetic GP, but with constant NHS delays with the referral in the end I gave up and went for a single private consultation (didn't cost much, and was the best money I ever spent) with a surgeon who thought that although a stress test was fine it was worth my having a CT scan 'just to be absolutely sure'. That test found blockages in major arteries just when I was starting to feel embarrassed that I was making a fuss about nothing. So please everyone, do persevere in asking for treatment if you're feeling unwell -- as robert72 says, you don't need to be having severe chest pains to be in a serious coronary condition.
 
Another warning sign that you might be developing arterial disease is pain in you calves or legs when walking (intermittent claudication). I had that for several years - but you don't really associate leg pain with what might be happening in your heart.
 
desidiabulum said:
Something diabetics might like to bear in mind...
Just back from my second angioplasty in ten months, and I thought I would pass on something that the surgeon said to me before the latest op which I didn’t know, and which fellow-diabetics might want to bear in mind if they don’t know it already.
Quick background: I am 50, reasonably slim and fit, good BMI, BGs reasonably under control, no diabetes-related neuropathy. I have been diagnosed with blocked coronary arteries, but I had not had angina or any other chest pains to indicate this – the only symptoms were occasional breathlessness and dizziness. It is pure luck that I got the necessary tests done. I know that there are a certain number of people who don’t get angina with blocked arteries, but the surgeon told me that this can be especially the case with diabetics, where the diabetes can cause loss of internal nerve sensitivity (i.e. autonomic neuropathy). I had not heard of internal neuropathy before, but so-called ‘silent ischaemia’ (unfelt chest pain, as it were) is evidently widely prevalent among diabetics. Given that coronary artery disease is a major complication for us diabetics, I would urge you all not just to monitor yourselves for chest pains, but to keep an eye out for other symptoms such as breathlessness, dizziness, extreme fatigue after exertion, unexpected sharp pain in abdomen, back or arm.
Take care, everyone. As with all health problems, early diagnosis is the key. I have been lucky – I hope that you are too.
Click to expand...
My grandfather (t2) who is going to have a quadruple bypass with valve replacement this Friday never had chest pains too, slim, BGs under control. Found by chance since he needed cardiac clearance for a total knee replacement.What are your markers and how did they find out about your case? Before they did the angio? And your stress test was normal? How was your 2decho results?What were the tests done? .sorru if I ask a lot of questions just wanted to compare :)
 
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The thing is with angiograms (unless elective), they normally have this test if you have a (+) result on stress test, ckmb/troponins or if they find specific changes on the ECG/echo and don't do this as a routine test for everyone...and by that time, your blockage would reach 70 :( :banghead: and for the layman, worse if you don't have chest pains how would you explain that to your doctor....
 
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Adelle0607 said:
My grandfather (t2) who is going to have a quadruple bypass with valve replacement this Friday never had chest pains too, slim, BGs under control. Found by chance since he needed cardiac clearance for a total knee replacement.What are your markers and how did they find out about your case? Before they did the angio? And your stress test was normal? How was your 2decho results?What were the tests done? .sorru if I ask a lot of questions just wanted to compare :)
Click to expand...
Hi Adelle. I hope and trust that your grandfather's surgery goes OK. Initially I told my GP about breathlessness and had various breathing tests before she referred me for a cardio check. My stress test was normal (I managed more than 9 minutes, so it actually counted as good) apart from a very slight anomaly on the ECG, for which the surgeon ordered a CT scan, just to reassure that there was no problem. It was the scan that identified the blockages, and how one artery had forced its way round a blockage and reconnected lower down (clever!). I didn't have an angiogram as such -- they are often classified as angiogram/plasty, as once they have seen the problem it makes sense to deal with it at the same time. It took me 2 months to get CT scan results and 2 months to have the op (they would have done it earlier but I didn't want to interrupt work -- so you can see how stupid I am). Two cardio surgeons in succession have told me that they think the stress test -- devised nearly 100 years ago -- is not at all helpful as a detector of cardio problems, but we seem to be stuck with it.
 
MIne was a doppler test simultaneously on my wrists and ankles. Took minutes.
 
desidiabulum said:
So glad to hear about your recovery, robert72, and that your chest pains were Ok in the end, noblehead. I do think you're right about screening. The trouble is that arteries can narrow so quickly, just in a few months. regardless of lifestyle. I'm lucky that I had a sympathetic GP, but with constant NHS delays with the referral in the end I gave up and went for a single private consultation (didn't cost much, and was the best money I ever spent) with a surgeon who thought that although a stress test was fine it was worth my having a CT scan 'just to be absolutely sure'. That test found blockages in major arteries just when I was starting to feel embarrassed that I was making a fuss about nothing. So please everyone, do persevere in asking for treatment if you're feeling unwell -- as robert72 says, you don't need to be having severe chest pains to be in a serious coronary condition.
Click to expand...

It was money well spent.

Perhaps in time they'll be more wide-spread screening for those who are thought to be at the highest risk, but do take on board what you say that arteries can narrow in a short space of time. I think we should all never become complacent about CVD and never take things for granted, often we are too focused on controlling our bg that we can take our eyes off the other things that matter.
 
desidiabulum said:
Hi Adelle. I hope and trust that your grandfather's surgery goes OK. Initially I told my GP about breathlessness and had various breathing tests before she referred me for a cardio check. My stress test was normal (I managed more than 9 minutes, so it actually counted as good) apart from a very slight anomaly on the ECG, for which the surgeon ordered a CT scan, just to reassure that there was no problem. It was the scan that identified the blockages, and how one artery had forced its way round a blockage and reconnected lower down (clever!). I didn't have an angiogram as such -- they are often classified as angiogram/plasty, as once they have seen the problem it makes sense to deal with it at the same time. It took me 2 months to get CT scan results and 2 months to have the op (they would have done it earlier but I didn't want to interrupt work -- so you can see how stupid I am). Two cardio surgeons in succession have told me that they think the stress test -- devised nearly 100 years ago -- is not at all helpful as a detector of cardio problems, but we seem to be stuck with it.
Click to expand...
Thank you very much for the info @desidiabulum. I'm glad that the doctors have identified the problem for you and are able to do something about it....Yes the diagnostics more often than not are conducted after the damage has been done rather than before it (such as acute coronary syndrome/ischemic heart disease/MI) it's better if we can check up on it and consult with a cardio on a regular basis especially to those who are at high risk of developing it (male, genetics, familial dyslipidemia/dyslipidemia, diabetes,pvd and age) and request for appropriate tests if needed.
 
Adelle0607 said:
My grandfather (t2) who is going to have a quadruple bypass with valve replacement this Friday never had chest pains too, slim, BGs under control. Found by chance since he needed cardiac clearance for a total knee replacement.What are your markers and how did they find out about your case? Before they did the angio? And your stress test was normal? How was your 2decho results?What were the tests done? .sorru if I ask a lot of questions just wanted to compare :)
Click to expand...
Adelle - I hope it goes well for your grandfather on Friday and that he makes a good recovery.

Best advice I had was to hold a cushion tightly to my chest when coughing during the first few weeks... although sadly I was caught out by the occasional sneeze ;)
 
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