Do NOT drive yourself to the E.R. in mid-heart attack!

23 Oct


by Carolyn Thomas    @HeartSisters

I don’t know why this even needs saying, but apparently it does. People talking about heart patients with severe chest pain (or offering advice to heart patients with severe chest pain, or speaking onstage at Stanford University’s annual Medicine X conference showing this slide about heart patients with severe chest pain) must never and I do mean NEVER even hint that patients should drive themselves to hospital while experiencing “severe chest pain” unless you are “too dizzy to drive yourself”. 

REALITY UPDATE: I am posting this slide as a warning to others about giving bad advice, not to offer an opinion on hospitals that engage in patient communication tools. 

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Does your hospital have a Women’s Heart Clinic yet? If not, why not?

16 Oct

by Carolyn Thomas    @HeartSisters

teacup-heartFocused Cardiovascular Care for Women is the name of an important report about women’s heart health published in February of this year. One of the report’s highlights (or lowlights!) was that very few if any hospitals actually offered focused cardiac care specifically for women before the year 2000.(1) One reason for this may have been that, as the report’s authors explained, “the concept of Women’s Heart Clinics was met with hesitation from many cardiologists.”

Yes, you read that right, ladies. Until recently, even the very idea of establishing a heart clinic devoted to the unique realities of the female body was not warmly welcomed by the very physicians you’d think would be most supportive.  Continue reading

If you get ill, will you follow these “Medicine Sick Day Rules”?

9 Oct

by Carolyn Thomas    @HeartSisters


Earlier this year, I spent a few days collapsed in bed, fighting off the death grip of some kind of horrible flu-like symptoms that included a high fever, chills, drenching sweats and uncontrollable shivers. I was miserable. But I didn’t call my family doctor because:

  • (a)  I felt too sick to leave home, never mind sit in a crowded waiting room infecting other patients, and
  • (b)  I already knew that this virus was making the rounds and, like all viral infections, there was very little my doc could order to make it better while this bug ran its course. (Antibiotics, for example, fight bacteria, not viruses – so please stop asking your doctor for an antibiotic prescription to treat a cold or other viral conditions). See also: Do Bugs Need Drugs?

Like a good little heart patient, I continued taking my regular fistful of daily prescribed cardiac medications day after day while I was deathly ill. I did this because nobody had ever told me that, while suffering the dehydrating symptoms mentioned here, many patients should consider taking a temporary holiday from certain drugs that can make dehydration worse. Dehydration means the body lacks enough fluid to function properly, and if it worsens over time, can lead to potentially serious side effects, including kidney injury.  Continue reading

Denial and its deadly role in surviving a heart attack

2 Oct

by Carolyn Thomas      @HeartSisters

Dr. John Leach is one of the world’s leading experts on survival psychology. He likes to tell a story about London’s tragic King’s Cross underground station fire in 1987.(1) As the fire spread, trains kept on arriving in the station, and hurried commuters headed right into the disaster. Officials unwittingly directed passengers onto escalators that carried them straight into the flames. Many commuters followed their routines despite the smoke and fire, almost oblivious to the crush of people trying to escape – some actually in flames! Thirty-one people perished in the King’s Cross fire, and incredibly, the Underground staff never sprayed a single fire extinguisher or spilled a drop of water on the fire.

Dr. Leach, who teaches at Lancaster University, has a name for this phenomenon. It’s called the incredulity response. He explains that people simply don’t believe what they’re seeing. So they go about their business, engaging in what’s known as normalcy bias which is incredibly powerful and sometimes even hazardous. People can act as if everything is okay, and they underestimate the seriousness of danger. Some experts call this analysis paralysis.

What he’s describing is precisely how I felt while undergoing two weeks of increasingly debilitating cardiac symptoms before being finally hospitalized. Although all signs clearly pointed to a heart attack – crushing chest pain, nausea, sweating and pain radiating down my left arm – I seemed fatalistically determined to go about my life acting as if everything was fine, just fine until – when symptoms became truly unbearable – I finally returned to the Emergency Department that had sent me home two weeks earlier with an acid reflux misdiagnosis. Continue reading

How we adapt after a heart attack depends on what we believe the diagnosis means

25 Sep

by Carolyn Thomas    @HeartSisters

There are at least 12 commonly used measurement tools available to the medical profession that look at how patients navigate “the search for meaning in chronic illness”. Clinical tools like the Psychosocial Adjustment To Illness Inventory or the Meaning of Illness Questionnaire have been used on cancer and AIDS patients, as well as others living with chronic disease. But research, including this study, has found that limiting factors in the success of such tools included “the infrequent use of some of the instruments clinically or in research.”

I can’t help but wonder why these readily available assessment tools are not being administered routinely to patients who are freshly diagnosed with heart disease – a serious medical crisis that begs to be examined for its influence on our “psychosocial adjustment” to it. I only learned about these long-established tools two years after my own heart attack, and by then my adjustment period was pretty well done.
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