Examining The Link Between Diabetes, Autoimmunity and Heart Disease for American Heart Month

February is National Heart Month. This article was written by Dr. Chad Larson, NMD, DC, CCN, CSCS. His aim is to help anyone who either has diabetes (or another autoimmune issue), or heart health issues understand the important connections between diabetes, autoimmunity and heart disease as a thorough understanding is vitally important for anyone with heart health issues. If you have Diabetes or heart disease, this post is for you! 

As medical science advances, we are learning more about the links between different individual diseases. In recognition of American Heart Month in February, I’d like to draw attention to some largely unknown facts about heart disease and its indirect link to autoimmune disease. In spite of pharmaceutical and technological medical advances, heart disease has continued to rank as the leading cause of death in the United States for several decades. Although we associate high cholesterol, obesity, high blood pressure and smoking as some of the most common factors leading to cardiovascular complications, there are actually hundreds of varying risk factors that can lead to heart disease, including an entirely different disease: diabetes.

Let’s first look at a brief but noteworthy chronological history of diabetes and its classification as an immune-mediated disease:

  • The term diabete was first recorded in an English medical text written around 1425.
  • It wasn’t until over 300 years later, in 1776, that it was confirmed diabetes was an issue of an excess amount of a certain kind of sugar (in the urine).
  • Just over 100 years later, in 1889, the role of the pancreas in diabetes was discovered.
  • Shortly after, in 1910, it was found that diabetes resulted from a lack of insulin.
  • In 1922, the first person received an insulin injection for the treatment of diabetes.
  • Types 1 and 2 diabetes were differentiated in 1936.
  • Autoimmunity was discovered in the 1950s.
  • Not until the mid 1970s was it recognized that diabetes can have an autoimmune basis.

Medical research has linked several diseases as being immune-mediated years after the original discovery of such diseases. Although this discovery was made almost 40 years ago, many people are still unaware that all types of diabetes can have an autoimmune component.

Now let’s look at how diabetes is linked to heart disease. Caused by a hardening of the arteries or a blocking of the blood vessels that go to your heart, people with diabetes are more than twice as likely to suffer a heart attack than those without (American Diabetes Association). In fact, two out of three people with diabetes die from heart disease or stroke, also classified as cardiovascular disease. Perhaps even more alarming is the threat that diabetes can cause nerve damage, sometimes making heart attacks painless or silent.

Autoimmune diabetes is caused when the body’s immune system begins attacking the beta cells that produce insulin in the pancreas. When insulin levels are down, the amount of glucose in the blood increases over time. High blood glucose levels can damage nerves and lead to increased deposits of fatty materials on the insides of the blood vessels. Complications such as poor blood flow, decreased oxygen in the blood stream, and the clogging and hardening of blood vessels can ultimately lead to two types of cardiovascular disease: coronary artery disease, responsible for heart attacks or failure, and cerebral vascular disease, leading to strokes.

And there you have it – a three-way link between Diabetes, Autoimmune Disease and Heart Disease. So, are there preventative measures that diabetics can take to prevent heart attacks and control autoimmune reactivity? Prevention of heart attacks for diabetics is parallel to that of non-diabetics, but with one very important additional measure – monitoring and regulating your blood sugar and insulin levels. Cyrex Laboratories, a clinical lab that specializes in functional immunology and autoimmunity, offers the “Array 6” – Diabetes Autoimmune Reactivity Screen. Array 6 assists in the early detection of autoimmune processes of Type 1 Diabetes, impaired blood sugar metabolism and Metabolic Syndrome, and also monitors the effectiveness of related treatment protocols.

A is always the case, it is recommended to schedule regular visits with your medical practitioner and specialists. Proper administration of medications can be vital to prevention of heart disease. In addition to insulin injections for diabetics, there are medications to aid in regulating blood glucose, blood pressure and cholesterol, which could all be vital to prevention of heart disease.

Dr. Chad Larson, NMD, DC, CCN, CSCS, Advisor and Consultant on Clinical Consulting Team for Cyrex Laboratories. Dr. Larson holds a Doctor of Naturopathic Medicine degree from Southwest College of Naturopathic Medicine and a Doctor of Chiropractic degree from Southern California University of Health Sciences. He is a Certified Clinical Nutritionist and a Certified Strength and Conditioning Specialist. He particularly pursues advanced developments in the fields of endocrinology, orthopedics, sports medicine, and environmentally-induced chronic disease.

A New Routine And A New Doctor For 2017

Over the last almost five years now, I have spent so much of my time going to doctors. First it was to the follow up appointments after my surgery. (If you are new to the blog, then look at the posts for June, of 2012 to get up to date on what happened) Then it was to gastroenterologists both in Arizona and here in Georgia, trying to get answers to why I was in so much pain, and trying to get my colostomy reversed. I was denied the surgery to reverse the colostomy and repair my abdominal wall. That was devastating to me but with the help of the mental health clinic I was able to cope and get myself ok with it. I also did not ever get an answer to why I was in so much pain months and years after my surgery. I still don’t have an answer to that. But starting last week, I have changed the game plan, and have moved forward to a new phase in the taking care of Fabgrandma.

The first thing that happened was on Monday. Fabgrandpa and I went to the health supply store in Carrollton, Georgia to pick up our BiPAP machines. Our sleep studies back in October and then again in December indicated that we both have sleep apnea. The sleep apnea, along with the opioid pain meds I had been taking, was making me sleep all day. Almost every day. If we had a doctor appoinment to go to, I would almost fall asleep driving home. I really had no idea that I had sleep apnea. I was referred to the sleep study by the cardiologist I went to after my feet and legs swelled up. 

I have now been sleeping with the BiPAP machine for a week. Even though I am only sleeping about five hours a night, I feel more refreshed and more like I really slept. Getting used to having the mask on my face is not easy. It dries out my mouth so much that my lips stick to my teeth inside my mouth. But I am doing it, and it is helping me feel better. I bought a bottle of Biotene Spray and that is helping with the dry mouth.

The second thing that happened is that I went to a pain management doctor. I had asked my primary care doctor for a referral over a year ago, but she could not find a pain management doctor who would accept me as a patient. On my last visit to her, I told her that the Percocet she was prescribing for me was no longer working as it used to. I asked if she could write me a prescription for something different. She told me that what she was prescribing for me already was the strongest she was allowed to write a prescription for, and that she knew the day would come when I would sit there asking her this very question. She tried again to refer me to pain management, and the next day, Dr. L’s front office called to schedule an appointment.

Dr. L examined me and went over my records. She started out saying that she normally does not treat people who have abdominal pain, they usually treat people whose pain originates in their back. But after her examination, she did detect some arthritis in my back. I also did a check off sheet for symptoms of Fibromyalgia, and had so many of the symptoms it was insane. So, Dr. L decided to accept me as a patient. 

The first thing I had to do was stop taking the opioid pain medication that my primary care doctor prescribed, and to sign an agreement that says I would not ask for opioid pain medications from any other doctor. I also had to sign an agreement that I would submit to random drug testing to insure that I was not taking any opioid, or narcotic, pain medications. I have not taken any of those pain meds since last Tuesday. Instead, I am now taking Gabapentin, which attacks pain in a different way. She also prescribed Meloxicam, a anti-inflammatory medication; and Flexeril, a muscle relaxer. She told me to take the Gabapentin only for four days, to make sure I had no reaction to it. Then, take the Meloxicam for four days, again to check for reaction. And last, add in the Flexeril, at night when I go to bed. So far, so good. 

I want to say here that even though I have been in pain, true debilitating pain, for almost 5 years, when I quit taking the Percocet, I seemed to have quit having the pain I was taking it for. That sounds weird, but it is how I feel. I still have pain, but it feels different now. I can tolerate it. I can live with it. I am not sleeping all the time either. So, while I may be a bit grouchy, and somewhat weepy since I stopped taking the Percocet. I will get over that I am sure. 

So. We are treating ME. NOT my PAIN. I am getting the sleep I need. I will update as we go, and hope that things continue in a positive manner. What are you doing to improve your health this year?

This #BloggersTalkingAbout series features amazing bloggers writing from the heart. Continue reading more by following these links.

Loving Yourself by Joanne

 Loving Yourself This Valentine’s Day by Traci

 Care For Yourself By Reducing Anxiety & Worry by Karen

 Permission To Cry by Brandy

 Caring For Myself In My First Trimester by Jenny.

If you’re a mom/female blogger, join us in our group, Bodacious Bloggers.

Tomorrow We Get Our BiPap Machines

Back in November, I wrote about Fabgrandpa and I going for sleep studies.  That started a round of about a hundred doctor visits for us that included me going to a cardiologist. The cardiologist did a gazillion tests, and found nothing wrong with my heart. That is a relief, but it didn’t tell me why my feet and legs swelled up and were so painful. She referred me for a sleep study to check for sleep apnea

sleep study

All wired up for a sleep study for sleep apnea

After I went for the sleep study, I had an appointment with a lung doctor, Dr. Reid. He said my sleep study showed that I stopped breathing 29 times in an hour. That is enough to be labeled as “Severe Sleep Apnea”. The next step was to go back to the sleep center for another sleep study. This time, they put one less wire on me. This test was to determine the settings for my BIPAP machine. I still didn’t feel like I slept at all, but they were able to get the settings and send them to my doctor. Dr. Reid then sent a prescription order to a home health supply place in Carrollton. We finally got the call from them last week that our machines were ready to pick up. We go in the morning to get them. 

BIPAP

BIPAP Machine

In between times of the sleep studies, I also went to my endocrinologist, D. Vavrik. I showed him pictures of my legs and feet, and he said “I don’t do feet and legs, if it happens again, go to your primary care doctor.” Well, then. My A1C was too high, at 8.9. This is not a good trend for me. We talked about my blood sugar numbers when fasting, and how much insulin I was taking. He raised my insulin dosage to 35 units at meals for the short acting Novalin R, and 3o twice a day for the long acting Novalin N. So far, those increased dosages have been keeping my fasting blood sugar under 125, which I can live with for the moment. 

Fabgrandpa has also done the sleep studies, on the same nights as I went. His test results showed that he stopped breathing 66 times in an hour, which is more than once a minute. It made me wonder when he DID breathe. So Dr. Reid has also ordered him a BIPAP machine. I am really hoping that these machine make a difference in our sleeping, and therefore, in the way we feel during the day. Because, I am sleeping all day most days in my chair. I have no energy, no get up and go. If I do something like to to the grocery store, I wind up not being able to do anything for two or three days after. I still have to go and do it, though. 

On Tuesday, I am going to a pain management clinic. I went to my primary care doctor over a year ago, and asked to be referred to a pain management doctor, but none of the ones in our area would accept me as a patient because my pain does not originate in my back. They know how to treat back pain. They don’t, however, know how to treat chronic pain caused by a 12 inch surgical scar and lack of core muscle. My primary care doctor finally found a pain group that would accept me and I am hoping that they can at least prescribe a new pain reliever that will help me feel better. We’ll see. 

So, that is where we stand as far as health issues go. I have no heart disease, no congestive heart failure, no vascular disease. I DO have sleep apnea, chronic pain, and high blood sugar with type 2 diabetes. I hope that the coming year doesn’t bring any more issues for me. I also hope that whatever happens in Washington, D.C. doesn’t effect my health insurance. I have Medicare and a MAPD plan through Humana. It isn’t the best ever, but it is insurance. Have you been for your yearly checkups yet? What do you think is going to happen with the state of healthcare in the United States? Let’s get the discussion going. 

How to Recognize and Avoid Chronic Lung Conditions

All I want to do in the winter is snuggle under some warm blankets with a good book and cup of cocoa, as I’m sure many of you can agree with. I would also take a guess that you tend to get sick around this time of the year. Hello runny nose, sore throat and exhaustion! So I thought there would be no better time to share a quick guide on how to maintain a healthy lifestyle to help prevent a serious chronic lung disease, one issue that hits close to home for me.

What are some chronic lung conditions?

COPD is a chronic lung disease that obstructs airflow from the lungs and generally develops later in life. Adults over 40 may begin to have symptoms like a dry cough, shortness of breath, fatigue, or a tight chest. Emphysema and chronic bronchitis are the most common conditions of COPD. Fabgrandpa has COPD. When we worked at the Grand Canyon, at an altitude of almost 9,000 feet, he had a really difficult time acclimating to the climate there. Every spring, he wound up in the emergency room, getting breathing treatments. He also gets bronchitis frequently when seasons change.

Mesothelioma is a rare cancer that is caused by exposure to asbestos. The most common type of mesothelioma, comprising about 80% of cases, is pleural mesothelioma, which affects the thin tissue surrounding the lungs. Some symptoms include difficulty breathing, hoarseness, difficulty swallowing, and fluid build up.

Asthma is more common, tends to be diagnosed during childhood, and can be triggered by exercise, allergies, or inhaled particles and gasses. This can cause coughing, wheezing, shortness of breath, and tightened airways. My youngest daughter had asthma when she was growing up. Her attacks could be triggered by excitement, such as a birthday party or Christmas. She was allergic to live Christmas trees, and had an asthma attack every year at Christmas until her doctor told me to take down the tree. We had an artificial tree after that.

Lung cancer is sadly the leading cause of cancer deaths in the U.S with over 200,000 new cases per year. Similar to some of the other conditions, symptoms include a dry, phlegmy cough, weakness and loss of appetite, frequent respiratory infections, shortness of breath, and hoarseness.

Tips to Help Prevent Lung Disease

Though there are treatments for these conditions, many of them can’t be completely cured. But who want’s to deal with the symptoms, tediousness and sometimes pain of treatment? Don’t worry though! Follow a few of these preventative tips instead.

  1. Avoid smoke: Tobacco smoke is related to about 90% of cancer cases and about 80% of COPD deaths. It can also trigger asthma attacks for some people. The American Lung Association has some great resources to help you quit here, because it’s never too late. Did you know your risk for lung cancer drops by half after 10 years of being smoke free? That’s amazing!
  1. Avoid air pollution: Okay I know this one’s hard because air pollution is essentially everywhere, but it is important to know that even the air you breath outside, where you think of fresh pure air, can be hazardous and incite asthma and COPD. Air pollution is not just the smoke from power plants and factories that you might be imagining, but it also comes from fireplaces, vehicles, and even natural wildfires, volcanoes, and dust storms. Though you alone can’t stop air pollution, you can watch your carbon footprint and monitor your own intake of dirty air by checking the daily air quality forecast before you exercise outside.
  2. Avoid hidden toxins: Asbestos is a natural mineral used in many homes for insulation, floor tiles, shingles, and much more. It is still legal to use asbestos in the U.S. even though it is well know that it causes the cancer mesothelioma. Protect yourself by hiring a professional to check your home for asbestos before renovations if your home was built before the 1980s and NEVER try to remove it yourself. Even inhaling the tiniest particle is not safe. You can even use your voice and contact your representatives to get the EPA to ban asbestos once and for all!
  3. Use an artificial Christmas tree. While not everyone is allergic to the trees used as Christmas trees, they can contain pollen, dust, mites, and aphids that can trigger an asthma attack when used indoors. Using an artificial tree can prevent having an attack of a chronic lung disease during the holidays. 
  4. 5. A second harmful indoor toxin is radon, which can cause lung cancer with long-term exposure. Found naturally in the soil and bedrock of certain areas, elevated radon levels occur in about 1 in 15 homes in the U.S. Protect yourself from this colorless, odorless gas by getting your home professionally tested or by using an at home test kit.

Additionally, there are many toxins that you may be unaware of in products that are ironically supposed to be making your house cleaner. Use this guide to know whether your cleaner contains harmful toxins or if it’s a-ok. A good rule of thumb is if you can’t pronounce the chemical ingredient name, it’s probably not healthy for you to be breathing.

What do you do to protect your lungs and stay healthy during the winter months? Comment below with your thoughts!

*Note: I am not a doctor so please consult your doctor if you are having any symptoms or believe that you might have a lung disease.

What Factors Affect How My Body Absorbs Insulin?

For individuals with type 1 diabetes and some individuals with type 2 diabetes, getting the correct amount of insulin your body needs is one of the most important ways to manage blood glucose levels. Monitoring blood glucose levels and administering insulin is a necessary routine.

insulin pen

New technologies, such as smartphone-like touchscreen insulin pumps, are simple to use and can make administering insulin more convenient. There are factors that affect the absorption and performance of your insulin that are important to understand as well.

Insulin Injection Site

The injection site can affect how quickly the body absorbs insulin. Continuously using the same injection site may cause the body to form scar tissue, which can cause slower absorption. Regardless of the method of injection, it is recommended that the injection site is regularly changed as to avoid the development of scar tissue.

Exercise

Exercise increases blood flow, which in turn increases the absorption rate of insulin. If the body absorbs insulin too quickly, it may lead to hypoglycemia. Individuals with diabetes should avoid doing exercise during the peak time of action for their insulin injection, since blood glucose levels may be lowered for up to twenty four hours after physical activity.

Individuals who plan to exercise after injecting insulin should also be sure to inject insulin in a part of the body that will not be affected by the exercise. For example, if you plan to go running after injecting insulin, do not administer insulin into the leg.

Skin Temperature

Heat causes blood vessels to dilate, or expand in size, and will increase blood flow. If the skin of the injection site is warm, insulin will be absorbed more quickly than if the injection site is cold. It is recommended that individuals with diabetes avoid extreme temperatures after administering insulin.

Extremely hot environments after insulin injection, such as may occur from taking a hot shower, may cause a reaction such as hypoglycemia. Alternatively, extremely cold environments, such as spending time outside in the winter without proper clothing, may lead to less absorption of insulin, and potentially high blood sugar levels, which can be very dangerous.

The State of the Insulin

The stability and state of the insulin can have an effect on how the body absorbs it. Insulin that has been open for too long or that has been exposed to extreme temperatures may perform very poorly.

For this reason, it is imperative to follow all storage instructions for insulin according to the package insert. Always inspect vials that are in use to ensure that they have not changed in color, translucency, or consistency.

 Communicate With Your Healthcare Provider

Always speak with your physician and your diabetes management team before making changes to your insulin administration routine. Healthcare professionals can help you better understand the factors that affect insulin absorption, and the methods that are best for you and your specific diagnosis.

 

 

 

Another Day, Another Doctor

sleep study

All wired up for my sleep study

Around the first of October, I was experiencing a lot of swelling and pain in my legs and feet. It was so painful that it hurt to have a sheet on my legs when I went to bed at night. Even putting a washcloth on them when I was in the shower hurt so bad! So, of course, the first thing I did was consult Dr. Google. You know, that whole search the symptoms thing in google, where you find out you are dying soon of congestive heart failure or leprosy. After a couple of days of being in this hot, burning pain, I called and made an appointment with a cardiologist, because I really did think I had a problem with my heart. 

swollen legs and feet.

My poor swollen legs and feet.

As you can see in the photo above, my legs were swollen from the knees down, as well as my feet. My shins were red, and felt hot to the touch. My toes were also red, and were hurting a lot. I felt like chopping them off with an ax. I had been taking my regular pain reliever, percocet, as directed by my doctor, but even when I was fully dosed with it, my legs and feet still hurt. So, I had been taking one Aleve twice a day for the break through pain. None of the pain meds touched the pain I was in with my legs and feet. 

You can see where my sandles were on my feet.

You can see where my sandals were on my feet.

The cardiologist, Dr McFarland, was very thorough. She asked me tons of questions about my health and the symptoms I had been having. She also ask Fabgrandpa a lot of questions about me, my sleeping habits, and his observations of me. When she was through asking the questions, she told me that she was going to schedule me for a few tests, then I would come back in to discuss the results and go from there. 

The first test I had done was a sleep study at the Sleep Center at the hospital. They attached about a million wires to me, on my head, chest, back and legs. Then, I was supposed to sleep for the night, and all those wires would record whether or not I experienced REM stage; if I snored; or if I tossed and turned in bed. The room where the did the study didn’t look like a hospital room at all. It was more like a hotel room with nice furniture, cable TV and a Sleep Number bed, so that you could get as comfortable as possible. Even with all that, I felt like I didn’t sleep a wink while I was there. When it was over, I went home and slept most of the day in my recliner. 

Next, I had an EKG and was given a shot of radioactive dye so they could take a bunch of x-ray pictures of my heart. After that, I had a Nuclear Stress Test. They put another bunch of wire all over me in the doctor’s office, and then gave me a shot that made me feel like I had been running for miles. As soon as they gave me the shot, it felt like my head was going to explode, and I had pain shooting down my left arm, and my fingers on my left hand felt numb. I had to walk slowly on a tread mill for a few minutes, then they let me sit in a chair until the effects of the shot wore off. 

After the stress test, I got into a hospital gown, and laid down on an exam table for them to do an ultra sound of my heart. That part wasn’t so bad, except for the goo they use for the ultrasound wand. I thought that was all, but I still had to go back to the x-ray table and get some more shots of my heart. Finally, I was done.

All of this happened in the last week. I am so glad all of that is over with. I have a follow up appointment with Dr. McFarland next week to hear all the results of the tests, and to decide what to do next. Yesterday, the nurse called from the doctor’s office to tell me that all of tests were normal, showed no abnormal heart problems, except for a leaky valve in the left ventrical, but that was nothing to worry about. I’ll let y’all know what the doctor says next week. 

In the meantime, has anyone experienced swollen, painful, red legs and feet? What was your diagnosis? Have you found a treatment that worked for it?