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

Living with both fibromyalgia and heart disease

5 Nov
by Carolyn Thomas     @HeartSisters

     Dr. Barbara Keddy

In her latest blog post, Dr. Barbara Keddy quotes my new book in this statement: Coping with a chronic illness is work” – an understatement coming from somebody like her.  She is a Professor Emerita at Dalhousie University in Halifax, a retired teacher of nurses, a respected author and blogger – but more importantly to this discussion, she has spent five decades living with fibromyalgia, and more recently, almost five years as a heart attack survivor. With her kind permission, I’m sharing her blog post here: part very personal essay, and part book review:

Continue reading

A Woman’s Guide to Living With Heart Disease: my blog-turned-book project!

29 Oct

by Carolyn Thomas     @HeartSisters

The Pitch. . .

“Have you considered writing a book based on your excellent Heart Sisters blog? I would love to explore the possibility with you.”

The date was September 9, 2015, and that’s how the message began that was about to change the next two years of my life. It came from Jacqueline Wehmueller, then Executive Editor at the prestigious Johns Hopkins University Press (JHUP), the oldest academic publisher in North America.

These thrilling words led to many e-mail and phone conversations with Jackie, followed by submitting a project backgrounder, a draft 10-chapter table of contents, and a sample chapter to JHUP before we could sign the book contract. Continue reading

Is coronary microvascular disease serious? Is the Pope Catholic?

22 Oct

by Carolyn Thomas    @HeartSisters

It’s time for physicians to stop telling patients that a diagnosis of coronary microvascular disease (MVD) is no big deal. Or alternatively, to accept that the diagnosis is real in the first place. As one of my blog readers learned to her horror, this awareness is not yet universal. When she asked her own physician, for example, if her debilitating cardiac symptoms might be due to coronary microvascular disease, he replied: “I don’t believe in microvascular disease!” – as if they’d been discussing the damned Tooth Fairy.

But here’s how Dr. Stacey Rosen, a cardiologist and spokeswoman for the American Heart Association’s Go Red For Women campaign, answered a question about microvascular disease in the New York Times recently:

Q: “I have been diagnosed with microvascular heart disease, which I was told mostly affects women and is not considered serious in and of itself. How long can it exist before it turns into serious heart disease?”

A:  “MVD can lead to heart attacks, heart failure and death. It’s serious.” Continue reading