Thursday, December 18, 2008

Heart-y Matters

After fighting an uphill battle for nearly 14 years, my primary care doctor and I have given up. We've been trying unsuccessfully to increase my low HDL number. She called in the reinforcements after my September reading yielded an all-time low of 23. (Normal for women is 40 and above.) I'm on a statin now and have been on several different medications in the past...all to no avail. So yesterday I went to a cardiologist for the first time, to see what else can be done. We in the OC are a special tribe when it comes to the ol' ticker, of course. But my mom died of a heart attack at age 55, so I'm in the real 'red flag' category.

The good news? My heart is healthy and happy, despite the HDL issue, and my blood pressure is in normal range. (My LDL and other numbers have always been fine.) To my surprise, though, the doctor patted me on the shoulder and complimented me on being in such good control of my diabetes. I felt weirdly proud and oddly emotional. Sometimes you just need to hear that, I guess, especially from the medical profession. The only thing he suggested I consider in the near term is more exercise (of course) and losing what weight I can (of course, although I'm not too far off). I will also have a more sensitive cholesterol test done soon to see if my statin should be switched.

The eh? news...the ACE inhibitor issue came up. Again. I have never had proteinuria, touch wood, but twice in the last year my PCP has mentioned starting me on one. Apparently it protects the kidneys of PWDs so they'd rather we start sooner than later. Hmmm. We'll see, the cardio doc backed off a little and said he'd be willing to wait on that one.

While waiting, I was thinking about Lee Ann's recent post. The heart is the center of the body, of course, but isn't it (not) funny how it becomes the center of a PWD's thoughts? When I was a kid I simply never worried about my heart. I'd been a fit, healthy, active child, more tomboy than girly-girl. As a teen, and for several years after diagnosis, I rode my trusty 10-speed everywhere, never thinking about the great workout I was was simply my way to explore and get around. But then the stress began with adulthood...and I noticed every twinge and pain in my chest, and even had an EKG or two. But always as a precaution. No one ever mentioned autonomic neuropathy, although it must have been something in the back of their minds. (For years when I lived alone, Mom expected a call from me first thing every morning--did she know about 'dead in bed' syndrome, or was it just normal parent-of-a-type-1 worry?)
When my mom passed away, doctors were quick to point out all her risk factors to me and stress how different I was from her. They reassured me I would likely not share her fate. But do they worry? The cardiologist said yes, of course, and that's why you're on a statin with aggressive management. That's why my doctor was so quick to refer me to a specialist.
Do I worry?
Long ago I started to try turning negatives into positive energy in my life. So, instead of worrying about what could happen, I decided to enjoy every moment. To express love instead of waiting for "some other time". And, hardest of all, to try forgiveness and patience when I might be quick to anger. It all sounds like greeting card schmaltz, I know, but if you really try it works. It's the constant trial that wears on you.
So I will, as always, do as the doctor says. (He noted that diabetics are his most compliant patients.) Hopefully my HDL number will improve. And hopefully, I will defy the odds.


meanderings said...

Sounds like a great doctor. You're right, it's not worth the stress to continually worry about what might happen. So keep enjoying since you know you're doing everything you can to stay healthy.

Scott K. Johnson said...

Great post Kathy. I too struggle with my HDL and getting it up there.

I play full court basketball 3-4 days a week. Doc says "more exercise", I says "impossible", he says "must be genetic". Who knows.

I'll stay tuned!