August is Medic Alert Awareness Month. Medical identification (ID) tags such as those available from the Medic Alert Foundation provide emergency responders and health care providers with immediate access to important information about your health. Having this information accessible could save your life.By Judy Blunt, Director of Regulatory Affairs and Quality Assurance at 23andMe
In an emergency, medical personnel have only moments to begin lifesaving care. It is challenging enough to help someone who is hurt, let alone someone who can’t speak or communicate. When a person has potentially life-threatening health conditions — allergies to medications, a disease that could complicate their medical care — it’s especially important that emergency medical staff are aware. In these circumstances, medical identification tags containing emergency information can save lives.I wear a medical ID bracelet. This is why.One day a few years back, I experienced an unusual set of symptoms. I felt unusually thirsty and fatigued, and my vision was blurry. I thought it might be a new medication I was taking, so I contacted my doctor and made an appointment for later in the week. The next morning, my husband could barely wake me. He rushed me to urgent care, where a doctor quickly zeroed in on my distinctive symptoms and ran a glucose test in the exam room. “HI” appeared on the display of the glucose meter.This was not a greeting — my glucose levels were too high for the meter to read accurately. I was admitted to the hospital ICU where the laboratory confirmed my blood glucose to be over 1400 mg/dL, more than 10 times the normal level. I had developed type 1 diabetes.At the hospital they administered IV fluids and insulin to gradually lower my glucose levels. I don’t remember much about that day because I was close to being in a coma. I remember the next morning though, vividly. I woke with a start to find myself in a room full of strange people and equipment. They left quickly, without saying much.
Before I could ask what was going on, I got a frantic phone call from my son, who told me that I had just been resuscitated. My heart had gone into ventricular fibrillation causing sudden cardiac arrest (SCA). SCA is usually fatal; the brain is damaged if deprived of oxygen for more than a few minutes and death soon follows. But if there is a defibrillator nearby, rapid treatment can be lifesaving, as it was for me.Later my cardiologist showed me the EKG tapes from that morning and pointed out that my heart rhythm was restored in less than four minutes, a feat only achievable in an ICU.Cardiac arrhythmia can result from ketoacidosis (a complication of diabetes where your blood accumulates high levels of acidic compounds called ketones), but it is a rare complication so we consulted a cardiologist. He examined my EKGs going back several years and determined that I also have long QT syndrome (LQTS), a rare condition where the electrical activity between two types of waves on an EKG (called the QT interval) is prolonged. Certain drugs, including the one that I had recently been prescribed, can further prolong the QT interval in people with LQTS, to the point that the heart stops beating altogether.
I can’t be sure when or if I would have developed ventricular fibrillation if I hadn’t been suffering complications from type 1 diabetes, but there is a reasonable possibility that it would have developed if I had continued taking that drug. If I hadn’t already been in the hospital at the time it happened, I would easily have died or been brain damaged. If my LQTS had been diagnosed earlier, I could have avoided both the hypothetical and the very real near-death experiences.What I learned from this experience is the value of knowing your health risks and the risks that run in your family. You can’t do anything about them if you don’t know what they are. I learned to seek them out and take them seriously. I had noticed having “heart palpitations” for years, which I reported to my physician. But LQTS is rare, and anxiety (which can also cause my symptoms) is common. My doctor prescribed an anti-anxiety medication and I took up yoga. The symptoms persisted, but I did not. Though I didn’t think I suffered from anxiety, I didn’t want to be a bother or a hypochondriac, so I let it go.
LQTS is caused by mutations in specific genes, and genetic testing later confirmed my diagnosis. Since diabetes also has a strong genetic component, I wanted to know if my children inherited my genetic risks for these serious conditions, especially since my father had diabetes. After I learned about 23andMe, I gave everyone in the family a spit kit for Christmas.My report confirmed my increased risk of developing type 1 diabetes. Everyone in my family learned about their own risks, and all of them appreciated this information. I came to believe so strongly in the 23andMe mission that I now work here.
The beauty of knowing your risks is that once you have identified them, you can do what you can to decrease your risks. I agreed to have an implantable cardioverter defibrillator (ICD) implanted in my chest that will restart my heart automatically if I go into ventricular fibrillation again. I also wear an insulin pump to administer the insulin I now need to survive. And I wear a medical ID bracelet 24/7.Not everyone needs to wear a medical ID bracelet, but many people have information that would be useful for medical responders to know in an emergency (see sidebar).A paramedic could probably figure out my conditions fairly quickly from my other “accessories” but, if there is ever an emergency, every second saved is precious time that could be spent saving my life – or yours.Results not typical. Results vary due to unique differences in each individual’s DNA. On average, users receive at least one or two results that may help with proactively managing health. 23andMe’s services are not a substitute for professional medical or diagnostic advice.
 Type 1 diabetes, formerly called juvenile diabetes because its onset often occurs childhood, can occur at any age and almost half of diabetics are diagnosed as adults. It is not associated with obesity; rather, it is an autoimmune disease.
 SCA is not the same as a heart attack. You can learn more about SCA at the NIH website.
 You can learn more about LQTS at the NIH website.
 23andMe does not currently report on long QT syndrome.