Diagnostic Uncertainty vs. Unwarranted Certainty: which is worse for patients?

by Carolyn Thomas     ♥    @HeartSisters 

The Emergency physician who misdiagnosed my heart attack displayed not even a whiff of uncertainty while delivering that misdiagnosis.  “YOU” – he declared confidently – “are in the right demographic for acid reflux!”  (without any gastrointestinal diagnostic tests). He sent me home that day with instructions to ask my family doctor to prescribe antacid drugs for my symptoms (central chest pain, nausea, sweating and pain down my left arm).  I now suspect that, if only that confident doc would have bothered to Google my symptoms, both he and Dr. Google would have landed on the same search result:  myocardial infarction (heart attack).

But in fact, he seemed remarkably certain despite being remarkably wrong.   . Continue reading “Diagnostic Uncertainty vs. Unwarranted Certainty: which is worse for patients?”

Why heart patients generally don’t say: “Doc, tell me what to do and I’ll do it!”

by Carolyn Thomas     ♥    @HeartSisters 

When you need medical help, how does your family doctor decide which diagnostic tests to order for you, and which treatments to recommend based on those test results?  Physicians are trained to rely on a type of professional playbook called clinical guidelines to help them make those decisions. But as Dr. Michael Vallis, a professor of family medicine at Dalhousie University in Halifax, described the problem family docs face with clinical guidelines:

“There’s just no way they can follow every single guideline. One of the biggest impediments to physicians following new guideline recommendations is that they’re overwhelmed.”       .
Continue reading “Why heart patients generally don’t say: “Doc, tell me what to do and I’ll do it!””

Family history of unusually early heart attack? You may carry this gene

by Carolyn Thomas     ♥    @HeartSisters 

.            Katherine Wilemon*

“After the shock of having a heart attack at age 39, I was a new mom at home with an infant, trying to make sense of being both a new parent and a heart disease patient”.    Katherine Wilemon had known since age 15 that she had high LDL (“bad”) cholesterol, but years later was diagnosed with a cholesterol disorder called familial hypercholesterolemia (FH), and then with elevated levels of another fatty particle in the blood called lipoprotein(a) – Said out loud, this is called “LP-little-(a).

One in five people worldwide have the same cardiac risk factor that Katherine had.  Dr. Henry Ginsberg at Columbia University, a leading expert on lipoprotein(a), explained in the New York Times: (“A Heart Risk Factor Even Doctors Don’t Know About”):

“People don’t know about it, physicians don’t know about it.”    
Continue reading “Family history of unusually early heart attack? You may carry this gene”

I’m still alive, post-influenza. I think. . .

by Carolyn Thomas     ♥    @HeartSisters 

        Where I’ve spent the past 19 days…

I’ve missed a bunch of really good stuff during the past few weeks: walking our Everly Rose home from Grade 2, watching Baby Zack take his first steps, long phone chats with my sister up-island, or writing last Sunday’s blog post here on Heart Sisters. Also:  Getting dressed. Brushing my teeth. Washing my hair. Feeling like a human being. In fact, I’ve been at death’s door (sort of) with a brutal case of influenza – commonly known as “the flu”.  And let me assure you, the flu is NOT “just like a cold”.         .    Continue reading “I’m still alive, post-influenza. I think. . .”

Chronic heart failure: the true heartache of living with “FAILURE”

by Carolyn Thomas     ♥    @HeartSisters 

 A small Australian study published this month explores two elements that seem pretty darned important to patients and their families following a diagnosis of chronic heart failure (CHF) – yet may often appear to be minimized or even dismissed by healthcare professionals.  In this study, participants were asked to report their lived experience through two key themes:  1. Heartache and 2. Living with Failure.             .
Continue reading “Chronic heart failure: the true heartache of living with “FAILURE””