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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“Everybody has plans ‘til they get punched in the mouth.”

11 Jan

by Carolyn Thomas    @HeartSisters

When Edward Davies of the British Medical Journal attended the recent Lown Institute conference in Boston, he was reminded of some unlikely wisdom from boxer Mike Tyson. In the run up to a big fight, Iron Mike was being bombarded with media questions about how he intended to deal with his latest challenger. Did he have a strategy in place to cope with their plans? The boxer’s response was simple:

“Everybody has plans ‘til they get punched in the mouth.”

In boxing terms, as Davies wrote in the BMJ, this is completely literal sound advice, but as a figurative metaphor for life, it’s not bad, either:

“Listening to a patient panel here at the Lown Institute conference, I was reminded that this is a worldview that doctors might do well to remember.”

Most patients diagnosed with a life-altering diagnosis can readily identify with what that metaphorical punch in the mouth feels like.  Continue reading

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

A year in review: Top 10 Heart Sisters posts from 2013

31 Dec

by Carolyn Thomas    @HeartSisters

It’s that time again, when navel-gazing pundits everywhere compile their Best Of or Top 10 lists of movies, political stories, books or bloopers for the year that’s just about to slip away. Same here at Heart Sisters!  So let’s take a nostalgic look backwards today at what I like to describe as this “cardiac rehab for my brain” – and why over 1 million visitors from 190 countries have viewed this site since I launched it in 2009!  Continue reading

When chest pain is “just” costochondritis

26 Dec

Costochondritis-7by Carolyn Thomas

Many female heart patients become familiar with the word “costochondritis” only while being misdiagnosed with the condition during an actual cardiac event, as in:

  • “My MD said it was just costochondritis and a  pinched nerve, because my ribs were sore.” (LH, age 51, New York: heart attack)
  • “At first, we looked at musculoskeletal causes. It had to be costochondritis; my chest wall seemed tender to touch, so I even had steroid injections in my chest wall.” (ZM, age 59, Arizona: heart attack, 12 stents, triple bypass surgery)
  • “Pains in chest radiating down arm and up to my chin. My GP reluctantly sent me to a cardiologist who was dismissive, said that my age was a big factor and that it was 99% likely to be just costochondritis as I also have fibromyalgia” (BT, age 42, U.K: heart attack, 90% blocked LAD coronary artery, two stents)  

Continue reading

The Christmas truce – 1914

24 Dec

by Carolyn Thomas     @HeartSisters

Christmas Truce 1914As World War I raged on in the trenches of Europe in 1914, Christmas Eve arrived cold and bleak. But German soldiers put up Christmas trees decorated with candles, on the parapets of their trenches. Although their enemies, the British soldiers, could see the lights, it took them a few minutes to figure out where they were from. Could this be a trick?

British soldiers were ordered not to fire, but to watch closely. Instead of trickery, however, the British soldiers heard the Germans singing carols and celebrating. One young soldier wrote home about this remarkable event:    Continue reading

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