Premenopausal women and cardiac symptoms

23 Jul
by Carolyn Thomas      @HeartSisters

Most of you throughout your adolescent and adult lives have no doubt observed that hormone fluctuations during a menstrual cycle can affect certain body parts on certain days of that cycle. These fluctuations cause symptoms ranging from bloating to cramps, vivid dreams, fatigue, acne breakouts, food cravings, or irritability. (That word ‘irritability’ is doctor-speak to describe the act of threatening spouses with homicide if they leave that freakin’ toilet seat up one more time…)

For decades, scientists have also observed that women’s risk of heart attack increases after menopause. One theory for this age-related delay (compared to male heart patients, who generally tend to have their heart attacks a decade or so before we do) was the drop in female hormones at menopause, particularly estrogen. That timing seemed to intuitively make sense. Estrogen levels go down, heart attack rates go up. It’s why physicians believed for a long time that hormone replacement therapy in postmenopausal women could actually prevent heart attacks. (PLEASE NOTE: it doesn’t.*) Continue reading

First, there was compliance. Then, adherence. Now, concordance!

16 Jul

by Carolyn Thomas     @HeartSisters

Non-compliant patients who, for whatever reason, do not follow doctors’ orders are a pain in the neck to their physicians. But to me, the most problematic part of that statement is the use of the word non-compliant. Simon Davies of the U.K.’s Teenage Cancer Trust once described it as “a word that sounds like it has punishment at the end of it.”  Yet physicians are frustrated about why so many of us refuse to take their expert medical advice. Continue reading

How soon are heart patients safely fit to drive?

9 Jul
by Carolyn Thomas      @HeartSisters

Almost all freshly-diagnosed heart patients are warned not to drive for a specific period of time following hospital discharge, ranging anywhere from 24 hours to several months, depending on the specific cardiac issue.  And in the earliest days or weeks, we may have mixed emotions even thinking about getting behind the wheel of a car again.

Some of us might feel afraid to drive (“What if I have another cardiac emergency while driving by myself on the highway?”).  A Swedish study that followed drivers living with chronic illness (including cardiovascular disease) over a 10-year period found that very few road accidents were directly caused by either the disease or its treatment after early driving restriction time periods had passed (just 0·8% of all cases).  Despite those stats, the researchers reported that many individual drivers voluntarily surrendered their driving license post-diagnosis because of the personal decision that “my state of health was no longer compatible with safe driving.” (1)
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Excuse me while I bang my head against this wall…

2 Jul
by Carolyn Thomas      @HeartSisters
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Last week, the disturbing results of a study on women and heart disease were released, attracting media headlines like Women and Heart Disease: New Data Reaffirms Lack of Awareness By Women and Physicians. I had to go have a wee lie-down after I read this paper in the Journal of the American College of Cardiology.(1)

The study’s lead author, cardiologist Dr. Noel Bairey Merz, of Cedars Sinai Heart Institute in Los Angeles, announced that “increasing awareness of cardiovascular disease in women has stalled with no major progress in almost 10 years”, and (far more intensely disturbing, in my opinion): “little progress has been made in the last decade in increasing physician awareness or use of evidence-based guidelines to care for female heart patients.”

No wonder I had to lie down. But taking to one’s bed in response to yet another discouraging study about cardiology’s gender gap is no longer enough. Perhaps it’s time for female heart patients like me to simply throw our collective hands in the air while banging our heads against the nearest wall. Continue reading

Eight things you can stop apologizing for, starting today.

25 Jun
by Carolyn Thomas   ♥   @HeartSisters
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Despite textbook heart attack symptoms, I was sent home with an acid reflux misdiagnosis from the Emergency Department (in the same hospital where I worked!) My only reaction at the time was to feel embarrassed and apologetic because I’d just made a big fuss over “nothing”. I felt so embarrassed that I even sent my hospital colleagues in Emergency a sheepish little thank you note the following day, apologizing once again for wasting their very valuable time. I felt so embarrassed, in fact, that when my heart attack symptoms continued (of course they did!), I refused to return to Emergency for two horrific weeks.
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I wrote about this urge to apologize in The Heart Patient’s Chronic Lament: “Excuse Me. I’m Sorry. I Don’t Mean to be a Bother” – about a heart patient who was stunned to add up how many times she had needlessly apologized to her family, friends and especially to staff throughout her hospital stay.
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Why do we feel this urge to apologize?

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