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Is your doctor paying attention?

11 Feb

by Carolyn Thomas    @HeartSisters

When Mayo Clinic’s Dr. Mary O’Connor published her compelling essay called The Woman Patient: Is Her Voice Heard?“, she raised some frightening questions, particularly for those of us carrying the XX chromosomes.  Examples of what she calls the medical profession’s unconscious bias” against female patients include:

  • women are 22 times less likely to be referred for knee replacement surgery compared to men presenting with the same symptoms and diagnoses
  • girls on pediatric kidney transplant lists are 22% less likely to get a new kidney compared to boys
  • women in their 50s and younger are seven times more likely to be misdiagnosed and sent home from Emergency compared to their male counterparts of the same age presenting with comparable heart attack symptoms(1)

But perhaps the most disturbing lesson was the pervasive sense that somehow docs are just not getting it, and worse, that this “unconscious bias” is affecting medical decision-making – and even doctors’ ability to pay attention. Continue reading

When thyroid problems masquerade as heart disease

27 Jan

by Carolyn Thomas    @HeartSisters

I love a medical mystery that gets solved by a patient, don’t you? In May 2009, one of my regular readers – known to me and other readers here simply as JetGirl - experienced what she calls “classic heart attack symptoms” of very sudden onset, and sought help immediately at the Emergency Department of a Los Angeles hospital.  The 45-year old former airline pilot was released from hospital after a week’s stay in the Coronary Care Unit with a vague cardiac diagnosis of ischemia*.

Six months later, JetGirl once again experienced more cardiac symptoms including “massive chest pain” and shortness of breath.  This time, nothing was found.    Continue reading

Doc chat: in the cath lab with a “radial evangelist”

19 Jan

by Carolyn Thomas    @HeartSisters

Like most heart patients who get their blocked coronary arteries opened up (or revascularized) at Victoria’s Royal Jubilee Hospital, my stent was implanted by inserting a slim catheter into an artery in my wrist and threading it up, up, up into my heart, a procedure known in the cath labs of the world as a Transradial Intervention (TRI).

But if I had been in an American hospital, my cardiologist would have more than likely threaded that catheter through the larger femoral artery in my upper thigh instead of my wrist, despite growing evidence suggesting significantly safer results, less bleeding, fewer complications, superior outcomes, and resounding patient preference for the radial approach.(1) In fact, while cardiologists across Canada, Europe and Asia are moving towards using radial as a default access, American cardiologists lag behind. 

I just don’t get it. Canadian coronary arteries simply cannot be that much different from those of American heart patients. Continue reading

My blog post in the British Medical Journal!

14 Jan

Allow me to share with you this thrilling sight, dear heart sisters!  It’s the Twitter page of the British Medical Journal (BMJ) plus its Tweet about my BMJ blog post called Why Physicians Must Stop Saying: “We Are All Patients that was published today. 

A big “thank you” for this goes to Dave de Bronkart (some of you know him better as ePatient Dave). Dave is a sneaky sort of guy who, unbeknownst to me, sent the BMJ editors a link to my recent Heart Sisters post called “We Are All Patients.” No, You’re Not. The editors then contacted me to ask if I’d also write something for them, and here we are!

Can I just say – - – WOW!!      :-)

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When doctors can’t say: “I don’t know”

3 Jan

Mimi and Euniceby Carolyn Thomas     @HeartSisters

Pity the poor Emergency Department physician who first studied the results of my cardiac diagnostic tests. Despite my textbook heart attack symptoms of central chest pain, nausea, sweating and pain radiating down my left arm, all of my test results that day appeared to be “normal”. So instead of admitting this puzzling discrepancy, the doc seized upon an alternative hypothesis as he pronounced confidently to me:

“You are in the right demographic for acid reflux!”

I was sent home from hospital that morning (feeling very embarrassed about having made a fuss over nothing) with his directions to make a follow-up appointment with my family physician to discuss what turned out to be a misdiagnosis of indigestion.

Part of the problem with this scenario is the reluctance of some physicians to admit that they just do not know. Continue reading

“We are all patients.” No, you’re not.

17 Dec

by Carolyn Thomas  @HeartSisters

patientI read recently about a conference on breast reconstructive surgery following mastectomy, to which not one single Real Live Patient who had actually undergone breast reconstructive surgery following mastectomy was invited to participate. This is, sadly, yet another example of “Patients Excluded” health care conferences – in stark contrast to the growing number of notable conferences that have garnered the “Patients Included” designation.*

The result of attending a “Patients Excluded” conference is just as you might imagine: hundreds of people working in healthcare getting together to talk at each other about caring for people who aren’t even at the table. Or, as one physician arguing for  “Patients Excluded” conferences protested online:

“I already hear patients’ stories all day long in our practice. Why should I have to listen to more stories at my medical conferences?”

Continue reading

Don’t touch those magazines in the waiting room

9 Dec

by Carolyn Thomas  @HeartSisters

Several years ago while sitting in a management team meeting, I was suddenly stricken with symptoms of a particularly hideous strain of an outbreak of  norovirus that had been spreading through the hospital where I worked. Because those infected with a norovirus illness shed billions of the dreaded virus particles in their stool and vomit, the hospital protocol during this outbreak was to immediately call in a specially-trained housekeeping team wearing what looked like Hazmat suits to scrub down the staff washroom I’d just used.  Even the calendar and paper posters pinned up on the washroom’s little bulletin board were removed and destroyed.

Until then, I thought I was the only one who felt creeped out by touching paper in any public waiting room. These rooms – particularly in hospitals and doctors’ offices – are jam-packed with sick people, people!  At the best of times, I don’t like sitting in a patient waiting room, never mind voluntarily picking up any reading material while I’m there. Even people who are not coughing, hacking, snorting, sneezing or wiping dripping mucous from their inflamed noses with unwashed bare fingers can still be transmitting bacteria and viruses onto every page of those waiting room magazines.  Continue reading

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