Originally Posted by ATL_Gator
Glad she is fine.
A couple of thoughts....
Does she have a family history of cardiovascular disease? That is also a semi-rhetorical question. Just because she can answer that question as a "NO" to the best of her knowledge doesn't me that the absolute answer is NO. The history could have been there without people realizing it. If the answer is "yes"... genetics are funny like that, and they can't be beat.
Had she always maintained a "healthy weight" and not gotten very heavy, with Type 2 Diabetes in the first place.. would she have had the first heart attack to begin with? (i.e. did she do the first heart attack to herself)
After the first heart attack, had she maintained the obesity, with all "current" associated problems, and possibly new ones on top of that... then BAM, second heart attack... Is she dead? Could the body in the "compromised" state recover from the stress of a second attack? Or did her "improved capability" aid her surviving attack 2.
In regards to the second attack happening anyway.... Can cardiovascular disease be "undone", or is it like bending metal. Once metal is bent so far as to permanently deform it, it can not be undone. So, once you experience the first heart attack, you are ALWAYS at risk for a second?
Funny you should ask as she had a family history of both heart disease and diabetes, so you could have predicted both.
She was always overweight as an adult, but she perceived that her pronounced obesity happened fairly precipitously. And evidence is emerging that diabetes and obesity go hand-in-hand, as if they shared a common genetic marker.
In fact, she told me her doctor had her frustrated and hopelessly confused by simultaneously ordering her to lose weight and also warning her that, owing to her diabetes, it would be nearly impossible to lose weight. Maybe he was half-right ?
The badgering to lose weight seems increasingly odd in light of studies that show that obese diabetics seem to survive their diabetes and heart attacks more readily than thin diabetics and heart attack victims do. This is precisely the reason researchers coined the term 'Obesity Paradox' awhile back. In my mind, how much longer should obesity be characterized as a risk when, more and more it seems like obesity (save the upper ranges) appears to be a benefit ?
Where should my client go from here ? In a sense, she's not unlike me with my hypertension. Eating normally, being active, managing stress, etc., can hardly hurt. But in her case, since her mother died in her 50's and father in his 60's, I somehow doubt that she's going to wind up a female Methuselah.