Coronary Artery Disease? From Where?

Last Wednesday I had a stress echocardiogram, and the results were “abnormal.” I don’t have the technical knowledge to understand the medical gibberish in the report, but the bottom line is that my doctor suspects “severe coronary artery disease.” So on Wednesday I have an appointment to see a cardiac nurse practitioner.

Heart disease runs deep in my family history. After getting furious with his doctor, who had missed a key indicator for diabetes on a routine blood test (Daddy noticed it and pointed it out), my father went home and had a heart attack at 62. For the next 13 years he had many long periods of decent health, but also many angiograms and angioplasties, not just in his coronary arteries but in femoral and carotid arteries as well. He was up on the roof one day in 1996, happy as could be cleaning tree and leaf debris off, and died in his sleep that night.

One of my younger brothers had a quintuple bypass while still in his 40s. Mom had atrial fibrillation and congestive heart failure. She developed Alzheimer’s after requiring six surgeries in 9 months. She died in hospice at the end of 2007, at 84, when her heart gave out.

Now, I grew up skinny. In college, at 5’10”, I weighed 120, and when I turned 30 just 125. My boyfriend’s good, healthy cooking raised my weight to a perfect 132. My blood pressure and cholesterol levels were always perfect.

Then I was prescribed Elavil (amitriptyline) for a sleep disorder and gained 30 pound very quickly, till people were asking if I was pregnant (how rude!). Miserably uncomfortable, I quit taking it and lost 40 pounds thanks in part to my boyfriend’s sudden death. I was back to 125.

Full-blown depression put me on Prozac (fluoxetine), and in three years I’d gained 20 pounds. Then, after my diagnosis of bipolar disorder, came the killer – Seroquel (quetiapine). I gained weight up to a staggering 205 pounds. Blood pressure and cholesterol roared up and required medication. I developed adult onset diabetes (borderline).

Seroquel Belly

And I was SKINNY at age 40!

Almost all the extra weight went to my belly and thighs. The lowest I’ve managed to get to is 170 since then, and I wasn’t able to keep the weight down when I got there. I look 9 months pregnant with quintuplets and feel horrible. The fact that I’m also 2 1/2 to 3 inches shorter makes the weight gain proportionately even more significant.

So yes, I have a genetic predisposition to coronary artery disease. What I don’t know is whether I would have severe trouble with arteries if I had not gained all this weight. My brother was not overweight when he suddenly needed bypass surgery, and he exercised regularly to boot. But I also know that I only needed medication for blood pressure, cholesterol and diabetes after psychiatric medications caused massive weight gain.

Bottom line: I feel fine – but I’m scared anyway.

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