If I’d had my heart attack decades ago . . .

24 Jan

by Carolyn Thomas

“When I first became a GP in England well over 30 years ago, the early diagnosis of myocardial infarction (heart attack) was a matter of slight importance, since there was no intervention which made any difference to survival.

“You tried to reach patients in their homes quickly to relieve their pain with heroin, but only sent them to hospital if their pain was not controlled, or they were going into shock.  Studies at the time indicated that patients with heart attacks survived better at home, where they were less likely to be killed with injections of lidocaine.”

Quite a difference, according to Dr. Richard Lehman, writing this in the British Medical Journal last month, compared to modern cardiac care options like clot-busting thrombolytic drugs or invasive coronary angioplasty procedures that are now routinely available to patients presenting with heart attack symptoms these days. (Unless, of course, you happen to be a woman under the age of 55 presenting to the E.R in mid-heart attack, in which case, as reported in the New England Journal of Medicine, you are seven times more likely to be misdiagnosed and sent home compared to your male counterparts with the same symptoms).  But I digress . . .      Continue reading 

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Homicide in the E.R. – the tragic case of Beatrice Vance

20 Jan

by Carolyn Thomas

This story has been told for over five years, and it deserves to be told again. It’s the tale of 49-year old Beatrice Vance, who in July of 2006, arrived in the Vista Medical Center Emergency Room in Lake County, Illinois complaining of chest pain, nausea and shortness of breath.

Despite these textbook heart attack symptoms, Beatrice was not seen immediately by E.R. physicians, but was instead told to sit down in the waiting room.  So she waited.  And she waited.  And by the time the E.R. nurse finally called her name two hours later, Beatrice Vance was slumped in her chair, already dead.

The coroner’s report determined that this heart attack was caused by a blocked coronary artery, and contributing factors were delayed and inadequate treatment.

Much later, in a truly startling decision, a coroner’s jury investigating the Beatrice Vance case didn’t just cite the hospital, but it declared this death a homicide in its ruling against the E.R. physicians and nurses working that night.  Continue reading 

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Could heart disease have its roots in your mother’s womb?

16 Jan

by Carolyn Thomas

When my mother was pregnant with me in 1950, mothers-to-be were very afraid of weight gain.  Back then, doctors had spent at least two decades warning pregnant women against gaining too much weight,  believing that excess pounds would lead to dangerous conditions like pre-eclampsia or toxemia. And lower weight gain would also ensure “preservation of one’s figure”.

In fact, I recall Mum’s stories about actually starving herself during the 2-3 days before each monthly prenatal appointment weigh-in so as not to incur the disapproval of her obstetrician. She was not alone. The average total pregnancy weight gain of North American women in 1950 was less than 20 pounds.

Less than 20 pounds?   Continue reading 

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My heart attack story in Ladies Home Journal

13 Jan

by Carolyn Thomas

A few months ago, I was interviewed on the subject of surviving a heart attack by magazine writer Amelia Harnish for Ladies Home Journal’s special Heart Month online edition.  Her article called Heartburn or Heart Attack? is now out – see what you think! But first, an embarrassed warning: remember when your parents wagged their fingers at you and said: “Do like I say, not like I do!”  Keep that counsel in mind when you read my heart attack story. Example: do not, under any circumstances, get into your car and drive yourself anywhere while you are experiencing heart attack symptoms.   Continue reading 

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Take your pick: carrots, eggs or coffee beans?

12 Jan

A young woman went to her grandmother to talk about life and how things were so hard for her. It seemed that as one problem was solved, a new one that was even worse cropped up. She didn’t know how she was going to make it, and wanted to give up. She was tired of struggling.

Her grandmother took her to the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to boil.

In the first she placed some carrots, in the second she placed two eggs, and in the last she placed ground coffee beans. She let them all come to a boil, without saying a word.  Continue reading 

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Misdiagnosis: the perils of “unwarranted certainty”

8 Jan

by Carolyn Thomas

Until being misdiagnosed with indigestion in mid-heart attack, I generally trusted that all people with the letters M.D. after their names knew what they were talking about when diagnosing serious medical problems. That was long before I learned from a study reported in the New England Journal of Medicine that women under the age of 55 who are experiencing a heart attack are seven times more likely to be misdiagnosed and sent home from the E.R. compared to their male counterparts presenting with identical symptoms.

And that’s why I now find Dr. Jerome Groopman’s landmark book, How Doctors Think, so illuminating.  It should be required reading for all med school students.  Continue reading 

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