How heart patients can untwist that twisted thinking

10 Dec

by Carolyn Thomas    @HeartSisters

The freshly-diagnosed heart patient has plenty of opportunity to start thinking thoughts that are new, bizarre and sometimes even frightening. Any life-altering diagnosis can throw us off-balance emotionally, but with heart disease, even the tiniest twinge of new chest pain can paralyze us. Is this something? Is it nothing? Should I call 911 again? As New Zealand cardiac psychologist (and more importantly, a heart patient himself, Len Gould likes to say: “Before a heart attack, every twinge is just indigestion. After a heart attack, every twinge is another heart attack!”

And our worried thoughts can stick around far longer than they should, as we play them over and over and over like our first Beatles album. Mental health professionals call this kind of twisted thinking cognitive distortion. Continue reading

“Very different from other heart books”: my Q&A with Johns Hopkins University Press

3 Dec

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by Carolyn Thomas    @HeartSisters

At some point during the two-year adventure of writing my new book, A Woman’s Guide to Living with Heart Disease, an author questionnaire arrived from my publisher’s marketing staff at Johns Hopkins University Press, including this request: “Sometimes a conversation is the best way to introduce a book/author. Please answer the following questions:”

Q: What were some of the most surprising things you learned while writing/researching this book?
Continue reading

When are cardiologists going to start talking about depression?

26 Nov

by Carolyn Thomas    ♥   @HeartSisters

I can vividly remember those early days and weeks at home after surviving a heart attack, especially that cold creeping anxiety around how I “should” be feeling. I had just survived what many do not: what doctors still call the “widow maker” heart attack. (By the way, note the gender semantics there, please: doctors are not, after all, calling this the widower maker”).

I was now resting comfortably, both of my darling kidlets had flown back home to be with their Mum, our home was filled with flowers, get-well cards and casseroles delivered by the daily line-up of concerned friends, family, neighbours and co-workers.

So why was I feeling so bleak inside, and even worse, now feeling guilty for all that bleakness?  Continue reading

Do women need different treatment of coronary artery disease?

19 Nov

by Carolyn Thomas    @HeartSisters

Dr. William Bestermann, in reviewing his own 40+ year career as a physician, now concludes that, in all of medicine, “there is no better example of the disconnect between what we know and what we do than in the case of women with coronary artery disease.” I’m a woman who has survived a widowmaker heart attack, and now lives with coronary microvascular disease, and I’ve only been writing about such sentiment for eight years. As Dr. B. explains bluntly:

“Every other week, I see a woman who has had symptoms of coronary artery disease and has been told that the problem is her esophagus – or worse – depression or anxiety.  She is told in effect: ‘Go home, take your anti-anxiety drugs, you will be fine!’  What she has been told is often wrong – too often, dead wrong!” Continue reading

When “nudging” doesn’t work to change patient behaviour

12 Nov

by Carolyn Thomas     @HeartSisters

CAROLYN’S WARNING: this article contains a C-word that drives many chronically ill patients stark raving bonkers. Continue reading only if you can stomach the word “COMPLIANT”

Dr. Aaron E. Carroll wrote a compelling essay in the New York Times recently. (By the way, I’ve often wondered why so many people – mostly men, I’ve observed – insist on formally using a middle initial? Is it to differentiate them from all of the other Dr. Aaron Carrolls out there?)*

Dr. Aaron E. Carroll’s subject has intrigued me ever since 2008 when I was told in the CCU that, from now on, I needed to take this fistful of new cardiac meds – many of them every day for the rest of my natural life. And pesky patients who, for whatever reason, do not follow doctors’ orders represent a perennial frustration in medicine. Sometimes the consequences of not being “compliant” (or “adherent”, the slightly less patronizing term) are brutal, so this decision not to can be deadly serious, accounting for two-thirds of medication-related hospital admissions. And more to the point, it begs the question of how to convince people to do what the doctor says they must (or, as some people – but not me – like to call it: “how to make non-compliant patients compliant”). Continue reading