Convalescence: the forgotten phase of illness recovery

8 Jun

by Carolyn Thomas     @HeartSisters

I love the work of U.K. philosopher Alain de Botton, an explorer of the  ‘philosophy of everyday life.’  He once wrote:

“People can accept you sick or well. What’s lacking is patience for the convalescent.”  

Convalescence. It’s the gradual return to health while you still need time to recover from illness or medical treatment, usually by resting. For patients, it’s that fuzzy grey area in between feeling acutely ill and feeling 100% healthy again. The term comes from the Latin convalescere: to grow fully strong.”

Most garden-variety convalescence is mercifully short. After spending a few days in bed with a flu bug, for example, you might feel a bit weak or shaky for a while. Not exactly sick anymore, but not yet 100%. Other forms of convalescence, however, may take weeks, months or even years of recuperation. And with some chronic and progressive disease diagnoses, everyday life can start feeling like one long endless period of convalescence – with good health merely a dim memory.  The difference: unlike the historical practice of viewing convalescence as a distinctly separate and important stage of illness recovery, today’s convalescents may simply feel like they’re being forced to very quickly adjust to the “new normal” of life. Continue reading

How having a wife shortens time to heart attack care

1 Jun

by Carolyn Thomas     @HeartSisters

Help-by-LiminalMikeHere’s a news flash from the Department of the Bleedin’ Obvious . . .  Medical researchers tell us that married men suffering heart attack chest pain get to the hospital far quicker than single men do.  In my admittedly non-scientific opinion, this reality is entirely due to the fact that these married men have wives.

As Dr. Ralph Brindis, past president of the American College of Cardiology, once told a Wall Street Journal interviewer: 

“Thank God we have spouses. I can’t tell you how often, if it was left up to the patient, they never would have sought care.” 

According to one study, for example, a Canadian research team out of Toronto’s Institute for Clinical Evaluative Sciences found that the odds of men showing up at the hospital more than six hours after the onset of cardiac chest pain were a relative 65% lower in men who were married or in common-law relationships.

In a spectacularly understated explanation for these findings, researchers reported in the Canadian Medical Association Journal:(1)

“We surmise that, in general, women may be more likely than men to take the role of caregiver and to advise their spouses to seek early medical assessment.”

This early medical assessment during a heart attack is crucially important, because we know that half of the deaths from a heart attack occur in the first 3-4 hours after cardiac symptoms begin. Now here’s the interesting – and utterly maddening – part of this surmising from the Canadian study: a similar association was not seen in married women.   In other words, being married did not mean that women were more likely than their single peers to seek faster help in mid-heart attack. Continue reading

Misdiagnosis: is it what doctors think, or HOW they think?

25 May

As a heart attack survivor who was sent home from the E.R. with a misdiagnosis of indigestion despite presenting with textbook symptoms (central chest pain, nausea, sweating and pain radiating down my left arm), I’m pretty interested in the subject of why women are far more likely to be misdiagnosed in mid-heart attack compared to our male counterparts.

Dr. Pat Croskerry is pretty interested in the subject of misdiagnosis, too. He’s an Emergency Medicine physician, a patient safety expert and director of the critical thinking program at Dalhousie University Medical School in Halifax. In fact, he implemented at Dal the first undergraduate course in Canada about medical error in clinical decision-making, specifically around why and how physicians make diagnostic errors. Every year, he gives a deceptively simple critical thinking quiz to his incoming first-year med students.

So here’s your chance to practice thinking like a doctor. Try answering these yourself, but as Dr. Croskerry advises, don’t think too hard. If you were an Emergency Department physician, paramedic or first responder, he warns, you’d have only seconds to size things up and make a decision. Don’t read ahead to peek at the answers! Now, here are your questions:   Continue reading

When drugs that help turn into drugs that harm

18 May

by Carolyn Thomas    @HeartSisters

nutrient-drug-interactions-2129I’ve been thinking an awful lot about drug safety lately, ever since I’ve been camped out at the hospital bedside of a dear friend.  She’s been hospitalized with a severe drug toxicity reaction to a commonly-prescribed medication she’d been newly taking for the past month. And when I say “severe”, I mean you cannot even imagine the horrific symptoms she has suffered day after day after day, week after week, while the pharmaceutical culprit, excruciatingly slowly, clears her system.
Continue reading

The five questions your doctor is probably not asking you

14 May

five questionsWhen I spoke at the eHITS2014 Vancouver conference on health and technology recently, I was happy to share with the mostly-physician audience my enthusiasm for a new health care initiative called Flip The Clinic.  Have you heard about it yet?

This Robert Woods Johnson Foundation project asks our health care providers to start thinking seriously “beyond the walls” about the way medicine is practiced during a doctor’s visit. Continue reading

A motherless Mother’s Day

11 May

Based on a post originally published here on May 13, 2012

This month marks both the occasion of my mother’s birthday (she would have turned 86 on May 7th) and, of course, Mother’s Day – the third  Mother’s Day in a row that I didn’t send my Mom a card and flowers. That’s because she died two years ago on February 21st. Last month, she missed the birthdays of her first child (me) and her first grandchild (my own son, Ben) – but since the cruel diagnosis of vascular dementia invaded her brain cells some time ago, she’d long been unable to keep track of things like family birthdays anymore.

As Christopher Buckley wrote in his memoir, Losing Mum and Pup, when the last of your parents dies, you are an orphan:

“But you also lose the true keeper of your memories, your triumphs, your losses. Your mother is a scrapbook for all your enthusiasms. She is the one who validates and the one who shames, and when she’s gone, you are alone in a terrible way.” Continue reading

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