Metabolic Syndrome and My Buddy JB

My buddy JB was raised country and has always been active and fun loving. He probably has never even heard the term "Metabolic Syndrome". He ran wild with his buddies from the time he was a youngster. They learned to fish, hunt, hike, camp and drink together. JB could tell stories that had people as diverse as the mechanic at the truck shop, the receptionist at the bank, and the Episcopal priest doubled over with laughter. He could pick up a metal dock plate and put it back up on the dock when it fell off. He could hunt all day, drink all night and work for twenty hours a day for a week and do it again starting next Friday night. JB and his boyhood friends matured; they remained bonded and still see each other but life has taken its toll. The high blood pressure was first, then diabetes and finally a massive heart attack. These are the big three disease entities of metabolic syndrome.

JB was a good natured good old boy with a round face and big muscular arms when I met him. He also had a big belly that signaled a dangerous amount of abdominal fat. (Abdominal fat is another marker of metabolic syndrome.) He was diagnosed with high blood pressure which mostly just irritated him and no amount of talking would convince him that taking his meds religiously was a matter of life and death. Actually he made rude jokes about it.

Then he was diagnosed with diabetes. At first he got on a special diet and lost weight; the result of that was that his blood pressure came down and his blood sugar came down also. He did not have everything under control though, and any stressor in his life was an excuse to jettison the diet, stop taking the medications and eat truck stop grease and gravy fare. Then came crunch time with extra stress related to moving and job changes and all the other stresses of life and he just quit taking his medications all together and dropped any pretense of dieting. His weight went back up and his blood sugar hit a high of 465mg/dl. Why he wasn't in a coma is more than I can figure out.

The heart attack happened while he was driving truck....It was huge....the cardiologist called it "global". His echocardiogram showed an ejection fraction of 10 to 15 percent. They placed two stents to open up the cardiac arteries and put a balloon pump in to help out the heart for several days. But his heart is so damaged that the term "global" was then linked to hypokinesia. I had to study on that a bit because it had been so long since I had heard that term. It means the entire heart is under performing. It may not ever heal enough to allow JB to achieve an active lifestyle again.

I checked out the American Heart Association website metabolic syndrome page and learned that if a person has three out of a list of five symptoms they can be diagnosed with metabolic syndrome. I thought back on what I know of JB's health components as I read the list.

For Men

1.) A waist circumference of equal to or greater than 40 inches

2.) High triglyceride levels-that would be 150mg/dl or higher

3.) Low HDL (good cholesterol) 40mg/dl or lower

4.) High Blood Pressure 130/85 or above

5.) High blood sugar.....a fasting blood sugar of 100mg/dl is considered high

JB wore size 42 pants but his belly bulged out over the top of his jeans in the nine months pregnant style.... (Sorry JB but it's true). I do not know about his triglycerides or cholesterol but my guess is it was nearly off the scale. I know he had high blood pressure and a high blood sugar so that put him squarely in the diagnostic profile for metabolic syndrome.

The American Heart Association states unequivocally that people with JB's collection of symptoms are at a hugely increased risk of heart attack, stroke and peripheral vascular disease.

It has been two months since JB's heart attack.

I saw JB today....He is pale and his eyes have that look that can be called two burned holes in a blanket.....his cheeks are sunken so his cheekbones stand out against his pale skin, his lips were a bit bluish and he was struggling to get enough air to talk. His lower legs were swollen with pitting edema and he said he couldn't feel parts of his feet any more. There was a purple blemish that was the remnants of a partially healed wound on the shin of one leg and unhealed marks on the other....it is clear that peripheral vascular disease and diabetic neuropathy are taking their toll.

This could have been prevented. Four things done consistently and proactively would have kept him vibrant for years instead of struggling to stay alive from one day to the next.

1.) Monitoring his blood pressure and blood glucose several times a day

2.) Taking his medications faithfully and consistently

3.) Losing that apple shaped abdomen and keeping it off

4.) Making heart healthy and diabetic wise diet choices

All the time JB was feeling just fine and joking about his blood pressure and ignoring his diabetes those two things were coupling with invisible atherogenic dyslipidemia to destroy nerves and capillaries in his eyes, kidneys, feet and legs and in his heart.

The only consolation I have as I mourn the loss of my good friend's health and vitality is that his story may help someone else.