How gender bias threatens women’s health

26 Oct

by Carolyn Thomas  @HeartSisters

Three years ago, I attended the 64th annual Canadian Cardiovascular Congress – not as a participant, but with media accreditation in order to report on the proceedings for my blog readers.  I arrived at the gorgeous Vancouver Convention Centre feeling excited to interview as many of the cardiac researchers attending this conference as I could squeeze into my 2-day schedule – particularly all the ones studying women’s heart disease.  I was gobsmacked, however, when conference organizers in the Media Centre told me that, out of hundreds of cardiology papers being presented that year, I’d be able to “count on one hand” the number of those studies that had anything even remotely to do with the subject of women and heart disease. Essentially, that appalling gender gap then became the Big Story of the conference for me. And every one of those four lonely little studies shared a conclusion that I already knew: when it comes to heart disease, women fare worse than men do.*  See also: The Sad Reality of Women’s Heart Disease Hits Home:

But already, I can tell that this weekend’s annual Congress (once again back in Vancouver) should do better.  This year, the 192-page conference programme lists over a dozen studies reporting specifically on women’s experience of heart disease.(1)  Sounds good – unless you remember that it’s a puny drop in the bucket for an international conference where over 500 original new scientific papers are being presented about a diagnosis that has killed more women than men every year since 1984.
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Little social support: a big gap for younger heart patients

19 Oct

by Carolyn Thomas  ♥ @HeartSisters

I used to offer to sell to my non-Ukrainian friends the guest list from our big Ukrainian wedding. Imagine 450 names, all of whom were raised in a wonderful Slavic culture that knows what to do when hard times strike. No sooner do they hear of a friend or neighbour’s problems (like a family tragedy or a serious health crisis) – and they start pitching in to help. Such support often starts with baking, cooking and getting the casserole dishes lined up on the kitchen counter for imminent delivery to the freshly-diagnosed patient’s fridge. Researchers know that having social support like this from others following a heart attack (or any serious health crisis) helps not only with physical recuperation, but also with emotional and psychological recovery, too. Yet virtually all published health research on the important quality-of-life issue of social support so far has been done on men.

White men.

White men, almost all of them seniors.

So lots of old white men studied, but very few women – and very few patients of either gender who were younger than 55 years of age.  But a new study published in the Journal of the American Heart Association finally attempts to address this gap.(1)  . . .
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First we had peer review – and now patient review!

17 Oct

by Carolyn Thomas    @HeartSisters

You already know that research papers submitted for publication in medical journals are first subject to peer review before a final decision to accept the paper is made. Peer review is a time-honoured way to evaluate scientific or academic papers by others working in the same field.  But The British Medical Journal, the world’s oldest, has launched a unique initiative to include patient review of submitted studies as well. Here’s how BMJ editors explain this project:

“The BMJ has committed to improve the patient centredness of its research, education, and analysis articles by asking patients to comment on them. Patient peer review is a new initiative for The BMJ. We are taking the lead here, and hope other publishers will follow.

My own BMJ debut as a brand new patient reviewer for heart-related studies happened last month!  I described that experience to BMJ readers like this:    Continue reading

“You’ve done the right thing by coming here today”

12 Oct

by Carolyn Thomas  ♥  @HeartSisters

One of the most upsetting things about being misdiagnosed with acid reflux in mid-heart attack was the sense of pervasive humiliation I felt as I was sent home from the Emergency Department that morning. I had just wasted the very valuable time of very busy doctors and nurses working in emergency medicine. I left the hospital feeling apologetic and embarrassed because I had made a big fuss over NOTHING.

And such embarrassment also made me second-guess my own ability to assess when it’s even worth seeking medical help. Worse, feeling embarrassed kept me from returning to Emergency when I was again stricken two days later with identical symptoms: central chest pain, nausea, sweating and pain down my left arm. But hey! At least I knew it wasn’t my heart, right?

I now ask those in my women’s heart health presentation audiences to imagine what I would have done had my textbook cardiac symptoms been happening to my daughter Larissa instead of to me. General audience opinion is that I, like most Mums, would have likely been screaming blue murder, insisting on appropriate and timely care for my child. But as U.K. physician Dr. Jonathon Tomlinson pointed out recently, even parents can feel insecure about their own ability to know what is a real medical emergency – and what is not – when it comes to their children. For example:     Continue reading

Feisty advice to patients: “Get down off your cross!”

5 Oct

by Carolyn Thomas  @HeartSisters

I’ve never met Debra Jarvis, but we’re practically neighbours, separated only by a few measly miles of Pacific Ocean coastline and an international border. She’s a writer, breast cancer survivor, hospital chaplain, and ordained United Church minister from Seattle – a city I can see from the shore here in Victoria. Oh, wait. That’s the city of Port Angeles, Washington. Still, I can see Seattle in the Sarah Palin sense of the word “see” . . .

I first encountered the “Irreverent Reverend” Jarvis watching her poignantly funny presentation at TEDMED 2014.  And like so much in life, when smart people tell good stories, their messages can be meaningful no matter what they’re talking about.     Continue reading

How intense grief increases your cardiac risk

28 Sep

by Carolyn Thomas    @HeartSisters

Emelyn_Story_Tomba_(Cimitero_Acattolico_Roma)My Dad died young in 1983, at just 62 years of age. His was the first significantly meaningful death I’d ever been exposed to, and my personal introduction to the concept of grief and bereavement in our family. My father died of metastatic cancer, lying in a general med-surg hospital ward bed, misdiagnosed with pneumonia until five days before his death, cared for (and I use those two words charitably) by a physician who was so profoundly ignorant about end-of-life care that he actually said these words to my distraught mother, with a straight face:

“We are reluctant to give him opioids for pain because they are addictive.”

This pronouncement was made on the morning of the same day my father died. But hey! – at least Dad wasn’t an addict when he took his last breath nine hours later.    Continue reading

Chest pain while running uphill

21 Sep

Of Shoes & Legs

by Carolyn Thomas  ♥  @HeartSisters

 Part 3 of a 3-part series about pain

My initial heart attack symptoms struck me right out of the blue.  I was out for a brisk walk early one beautiful Monday morning around 6 a.m. when suddenly, I experienced a pain smack in the centre of my chest. It felt like a cross between crushing heaviness and a severe burning sensation that gradually extended right up my chest into my lower throat. My left arm began to hurt. I also felt like I was going to vomit, and I started sweating far more profusely than my walking pace warranted.

But a strange realization about my heart attack symptoms hit me much later, long after I was hospitalized for what doctors still call the “widowmaker” heart attack 

This was not the first time in my life I’d felt the chest pain symptoms I experienced on that spring morning.
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