When your doctor mislabels you as an “anxious female”

by Carolyn Thomas  @HeartSisters

Take it from me: the only thing worse than a heart attack is being misdiagnosed and sent home from hospital while you’re having it. And for women in particular, this is a tragically all-too-common reality.  Research on cardiac misdiagnoses reported in The New England Journal of Medicine(1), for example, looked at more than 10,000 heart patients (48% of them women) who had gone to their hospital Emergency Departments with chest pain or other significant heart attack symptoms. Women younger than 55 were SEVEN TIMES more likely to be misdiagnosed and turned away from the E.R. than their male counterparts.

The consequences of this reality for women were enormous: being sent home from the hospital in mid-heart attack doubled their chances of dying.

Some of the most popular cardiac misdiagnoses that heart attack survivors have told me about include physician guesses like indigestion, menopause, stress, gall bladder issues, exhaustion, pulled muscles, dehydration and more. But perhaps the most distressing misdiagnosis to trip from the lips of an Emergency Department physician is “anxiety”. This one single word is instantly both dismissive and embarrassing. And worse, to have the diagnosis of “anxious female” recorded permanently on a woman’s chart virtually guarantees a definitive psychiatric stereotype for all future medical visits.  

Kathleen is one woman who knows what it’s like to be saddled with that “anxious female” tag.  After surgery to remove a brain tumour, she wrote me in April from Oakland, California to share her own experience of being so labelled:

I discovered that my original primary doc had added ‘anxiety’ to my official list of conditions back in 2005. I was severely hypothyroid, it turned out, with a TSH of 11.2, but he never reconsidered his ‘anxiety’ diagnosis, which, from that day forward, was at the top of my medical record.

“And that diagnosis isn’t just a comment:  in my medical record, The Problem List is the very first thing every single doctor sees, after my name and file number, and (being an alphabetical list) ‘anxiety’ is at the very top.

“When I began to search for another doctor, I was unaware that this diagnosis would follow me. I have no doubt that it set the stage for the references to ‘anxious female’ that then appeared throughout my HMO files.

“My medical history is long and complex, including an ominous family cardiac history on both sides as well – certainly not suitable for docs who like easy cookie cutter diagnoses.

“I am convinced that ‘anxiety’ has been an obstacle to my appropriate diagnosis and treatment.”

In 2008, the disturbing results of a Cornell University study(2) called Gender Bias in the Diagnosis, Treatment, and Interpretation of Coronary Heart Disease Symptoms were presented at a scientific meeting hosted by the Cardiovascular Research Foundation. The study examined whether physicians tend to evaluate heart patients differently despite comparable symptoms and risk factors – based only on their gender.

The study’s results might seem distressingly familiar to any woman who has ever been (mistakenly) told, as I was: “It is NOT your heart!” by those with the letters M.D. after their names. 

Half of the patient charts used in this study indicated that a patient had recently experienced a significant life stressor and that they appeared anxious. Each physician read one version of the record and was then asked to specify a diagnosis, make treatment recommendations, and indicate the probable cause of the described symptoms.

Results showed a significant gender bias when heart disease symptoms were presented in the context of stress, with fewer women receiving coronary heart disease diagnoses (15% vs 56%), cardiologist referrals (30% vs 62%), and prescriptions of cardiac medication (13% vs 47%) compared to the men.

Researchers also found that the presence of stress shifted the interpretation of women’s chest pain, shortness of breath and irregular heart rate so that these were thought to have a psychological origin.

By contrast, men’s identical symptoms were perceived as cardiac whether or not emotional stressors were present.

As Dr. Alexandra J. Lansky, director of the Women’s Health Initiative at the Cardiovascular Research Foundation said at the time:

“We know that there is a delay in diagnosing coronary heart disease in women, and this study is an important step forward in understanding why.”

The trouble is, dear readers, there are very few experiences in life more anxiety-producing than fearing you might actually be experiencing a heart attack.

Unless you present to Emergency in a coma, in fact, my guess is that most of you would certainly be displaying clear signs of extreme anxiety while in the throes of a cardiac event.

So if you’re a woman, you might be alarmed to learn that this study’s results predict that your heart attack symptoms are significantly more likely to be misinterpreted as merely stress-related compared to men with the same symptoms. And then, on top of physically distressing cardiac symptoms, you’ll also be suffering profound embarrassment and shame over “making a fuss about nothing”.

As another of my readers explained:

“For 10 years before finally being correctly diagnosed with atrial fibrillation, I experienced: palpitations, pounding heart and accelerated heart rate, sweating, trembling/shaking, shortness of breath, chest pain/discomfort, feeling dizzy and lightheaded, and fatigue. My inexperienced (and former) PCP was convinced the symptoms were due to anxiety, and a young cardiologist was quite dismissive (those pesky “women of a certain age”).

“Eventually my episodes were so frequent that A-Fib was captured on an ECG. Years later, I pulled my medical records and read that the 28 year old PCP had written I had ‘magical, mythical thinking’ about my health.”

What can women do about this systemic gender bias? Here’s what our patient Kathleen reported that she has done since discovering that “anxious female” descriptor in her own medical records:

“I have called those docs on their use of that ‘anxious female’ label and will NOT accept explanations like: ‘It’s really not what you think. Anxiety is normal in a setting like this’ or ‘That’s my way of saying that a patient needs a little extra time…’ 

“I sent several relevant links to one of those ‘anxious female’ docs who was humoring me. When I told him that a growing body of research shows that these biases and labels are detrimental and dangerous, he said he would be interested in references. Perhaps he is humoring me this time too, but I gave him a bunch – including a link to that New England Journal of Medicine study reported here on Heart Sisters.(1)

“A false ‘anxiety’ flag on my chart does not help me.

UPDATE:  See Kathleen’s comment (below) in which she tells us: “I would like to report that ‘Anxiety’ has been removed from my official Problem List,  finally. Past records will not be changed, but it no longer tops my records. I’m still working for educational discussion of this experience, to reduce likelihood of others suffering from the same error and dismissal.”

.

© Carolyn Thomas   ♥  Heart Sisterswww.myheartsisters.org

Q:  Have you been mistakenly labelled an “anxious female” during a serious health crisis?

NOTE FROM CAROLYN:   I wrote much more about both misdiagnosis and anxiety in my book, A Woman’s Guide to Living with Heart Disease . You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the code HTWN to save 20% off the list price).

See also:

Hysterical Female? Just Anxious? Or Heart Attack?

How Does It Really Feel To Have a Heart Attack? Women Survivors Tell Their Stories

Am I Having a Heart Attack?

Stupid Things That Doctors Say to Heart Patients

“It’s Not Your Heart. It’s Just _____” (Insert Misdiagnosis)

“But What About The Men?”

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(1) Pope JH et al. “Missed diagnoses of acute cardiac ischemia in the emergency department”. N Engl J Med. 2000;342:1163-1170.

(2) Chiaramonte G et al. “Gender Bias in the Diagnosis, Treatment, and Interpretation of CHD Symptoms”. Cardiovascular Research Foundation. 2008, October 12. ScienceDaily. 2008/10/081012121314

151 thoughts on “When your doctor mislabels you as an “anxious female”

  1. I am currently going through all of the EXACT symptoms as you.

    It all started after giving birth to my fifth child, Adelle. After being discharged from the hospital, I felt my heart pounding and racing. My husband called the doctors office and it was dismissed as a side affect from the blood pressure medicine he put me on for delayed pre-eclampsia. Well, the symptoms went on and on and had gotten to the point where I was short of breath, trembling, shaky, weak, light headed, and dizzy. I noticed that after eating salty and unhealthy foods that my symptoms would come on and strong!

    Because of this I decided to change the way I eat and have been on a strict low sodium, clean food diet. Well, i was never overweight , but after having my baby I was 160, 5 ft 7. I am now 122 pounds and still miserable. My daughter is now 15 months and the episodes are more frequent…. I have no energy and symptoms worsen with exertion.

    I am scared that I will constantly be overlooked due to my age(26) and my appearance (African American and slender build) I switched cardiologists and just turned my Holter monitor in yesterday morning and awaiting my results. Hoping that whatever it is can be fixed.

    Liked by 1 person

    1. I do want to thank you for sharing your story, I’ve had to call an ambulance just about everyday for the last two weeks, some of the EMS team have been able to catch it as its happening and have said it looks like a-fib or tachycardia… however by the time of arrival to the hospital, symptoms have subsided and nothing has been done! ANXIETY had been shoved down my throat and it’s scary, humiliating and alarming. The thought haunts me of my heart giving out because of this going on so long without treatment…it makes me feel as if I’m just being sent home to continue on a journey to death… By heart issues…

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    2. Hello Lyddia – I’m so sorry you are going through all this and feeling “miserable”. Right now, you simply don’t know if your distressing symptoms are heart-related or not, but something is causing them, and it will be a relief to find out exactly what. At this point, no matter what the diagnosis, at least your physicians will then have treatment guidelines in place so you can feel better and get back to enjoying your beautiful babies… Best of luck to you…

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  2. I can’t thank you enough for this article.

    37yr old with the same issues and frustrations. Symptoms started late into my second pregnancy 2yrs ago, and cleared up after birth. Struck with fainting spells last Nov that culminated in syncope while driving. Two hospitalizations later, and I’m still the “anxious female” nowhere near having an official diagnosis of what’s causing these symptoms. “Anxiety” still rules supreme at the very top of my medical conditions. This despite uncontrolled hypertension (w/BP meds), abnormal EKGs, and other failed cardio workups. Anxiety discussion came up every single time during consults that PCP finally placed me on anti-anxiety medication with no positive results. This after the classic, “Just give them a try to see how it goes.” After keeping a detailed daily journal of symptoms, cardiologist is finally beginning to rule out anxiety. Tilt-table test and neurological checkup coming up.

    Meanwhile, this happened: I’ve had to bring my husband along for the most recent visits to “corroborate” for me. During one of them, doctor asked, “Are your explosive temper outbursts under control after taking anxiety medication?” Before I could even answer, my husband demanded clarification of non-existent symptoms. Wait for it…doctor answered, “Wrong patient!”

    Liked by 2 people

    1. Wrong patient?

      WRONG PATIENT!?

      WRONG PATIENT?!?!??!

      Arrrrrgggh!

      It’s bad enough coping with that “anxious female” label. But when you also have to cope with the medical history of an entirely different patient mixed up in the doctor’s mind, that is simply too much!

      I sure hope your upcoming tests help to solve your medical mystery, Nhoel!

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      1. N.B. If you would rather not print this rant, I quite understand.

        More has to be done to stem the quick diagnosis of anxiety. I just came from the ER. I received no informational sheets that dealt with my presenting problem. Instead, the doctor told me I had generalized anxiety disorder, and, now, I have an informational sheet as testimony. The National Association for/or whatever Mental Illness has done squat to counter this unceasing bias against women, and I consider that organization (which I know of due to my mother’s serious psychiatric problems – another reason for bias against their daughters, right?), worse than useless; damaging.

        So, here I am. There were objective findings on exam, validating my finding of a hard lump in my anterior right leg. which was validated as being warm to the touch. I’ve had this for almost one month, but symptoms changed yesterday, with spasms/pulsing/ or throbbing setting in. I had had no injuries.

        I’ve been going through an extraordinarily hard time. I don’t know what kind of presentation would have kept the physician from leaping to “generalized anxiety disorder” but, as other women have documented, once the word “anxiety” is in the medical records, it’s a free pass for any provider who ever sees you as long as you live.

        Did I mention I was not given one bit of instruction for my leg lump? Not – try a warm cloth, cold cloth, wiggle toes – -nothing. Three pages on generalized anxiety disorder. Oh yeah – doctor says, “You roll your eyes every time I say, “anxiety.” Actually, I looked away. It was either that or experience cardiac symptoms – or curse.

        I really wanted to curse. I’m elderly now. I barely made it through the summer. The four-letter, and other choice words, I wanted to use were pressing hard. Of course, one cannot use them.

        I’ll say this: I think every woman should record every single physician or other provider encounter. I don’t have an electronic device, like an ipad. I sure do wish I’d had one today. Despite knowing better, there is one part of me that always believes them.

        As someone else noted, why wouldn’t you be less than calm if you are presented in an ER, although I do see people coming through the door on stretchers who, I’m coming to the conclusion – that they don’t DARE show any emotion whatsoever. They tend not to even speak. (I was parked in the hallway by the ambulance door, again, so you do get to make these observations).

        I’ll cut this somewhat shorter: I already have a diagnosis of Post Traumatic Stress disorder. I’ve had that diagnosis for 17 years. I am upfront about it. I think we should take a poll: out of all the times when a woman had, essentially, hysterical woman thrown at her, how often did the physician actually DO anything about it, even to offer some semblance of compassion – “Tough times, eh?” The diagnosis is in my medical records because I made sure it was there. Now, can we please get on with my presenting chest, leg, or other concern?

        But today, I was calm. I wasn’t thinking the worst – although the physician swore I was insisting that might be an embolism – completely ignoring that I said, “muscle spasm? nerve compaction? and, then thrombosis of some type?

        Fortunately, because there is the palpable lump in my leg, an ultrasound was ordered, and it was thorough. But then, the physician said it was “over-the-top” because the u/s technician did a completely thorough job of it.

        Also, two nurses told me I was being discharged, and then the physician shows up asking me if I was leaving without being discharged. (The nurses later told me there was a foul-up). If you think this blankety-blank ‘physician’ didn’t still “blame” me, or didn’t dump that on me, then I’d be mighty surprised.

        Still, none of this is going to change them, or the way individuals who have some run-of-the-mill kind of neurosis, are treated. We will continue to present with our hearts in their hands, until there are measures in place to ensure that attention is given where it is not only needed, but demanded. The problem is this: trying to convince anyone that you were fine, mentally, against what the physician says, is like trying to convince someone that tobacco is the best medicine ever created. The stigma is too great. It is so great that part of me always internalizes the labeling. After all, they’re the ones with the power. — Do you ever have the thought that violent criminals are treated better, and without as much stigma? I do. Somehow, just being female is “just cause.”

        With this hospital system, there is no point in filing a complaint with quality assurance, either. And, I’d bet you that there are few women who aren’t given some kind of psychiatric-related comment, if not label, when they – we – present with even objective problems. (And I was told they would call me tonight when all the lab work was in. It’s been four hours since I left. Shall I hold my breath).

        Oh right. I was also given an information sheet for GERD. Now, I’d just told the doctor that I was recently started on medication for that. … did the doctor think that what he dished out was going to heal my gut? Lower my physician-induced raised systolic blood pressure?

        It took last night, and most of today before I decided that a throbbing, warm lump in my leg necessitated an ER visit, rather than waiting. The ER doctor grilled me on why I chose to come to the ER today – Saturday – even though my first statement was that the throbbing/spasm whatever it is began yesterday, and that was a significant change. What the heck kind of test was being given here?

        I wish there was someone with greater authority, who was fully sanctioned by the powers-that-be, who could be called the second a woman sees that sideways glance that tells her, she’s not in any danger – she’s just anxious. Well, more than that, now. NOW, I feel nauseated, almost paranoiac, and hopeless that this situation will ever change. I’m too worn out to keep up the fight, myself.

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        1. This is an important addition. Once the physician threw out anxiety, I could not fully attend to what he said about my test results or findings. This blanking out occurs in non-bias medical situations as well. Another reason to record everything, even if you have someone with you. Also, for the first time in my life, I signed a paper that may or may not have been some kind of discharge form, that I did not read.

          I want to add that nurses, and other hospital staff could do more to support patients when they observe this bias. It is unlikely they would lose their job; there is a significant nursing shortage. Then again, maybe the hospital systems don’t care. One more point: 4 hours in the ER – 7 hours, and counting, trying to combat the lousy emotional state I am now in. To other ladies writing here – I believe you.

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    2. OMG! That is just unacceptable! 😤 you know, I’ve recently brought my husband along to my last appointment, before I was placed on a heart monitor the following day, to speak up for me. This appointment I saw the Physician’s Assistant, the doctor thinks I’m crazy. However, he was very kind and listened and said he just wants to help me. I broke down in tears. I hope that everything is okay with you, its very hard to deal with this stuff.

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  3. I’m not alone. I’ve had some serious heart symptoms and they’re getting worse. Heart problems do run in my family. But my latest doctor who is a female doctor said something vague about it being just “nerves” and suggested that I see a psychiatrist. I told her that that doesn’t do anything at all. They can’t/don’t help me. She suggested it twice.

    I’m looking for another doctor. I’m just going to see a specialist, as I’ve experienced such severe weakness & shortness of breath that I almost lost consciousness, which is not just nerves. I really thought that having a female doctor would make a difference. But they’re guilty of the same bias. So appalling, the amount of negligence in the medical community.

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    1. Hello Goth Writer – I’d be careful about making assumptions about male vs female docs (I have a wonderful female GP, but two equally wonderful male docs – my cardiologist and my pain specialist, for example). As you know, so much of medicine is just trying to figure out what the problem is NOT, as docs work their way down the path of solving a mystery. Inability to hit upon an accurate first diagnosis may not be a sign of physician bias at all – but just a really tricky set of symptoms. By the way, I believe that ALL patients suffering with chronic illness symptoms would do well to get support through talk therapy, so don’t shut that door while you’re trying to solve other mysteries. Best of luck to you..

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      1. No not assumptions, I’ve had plenty of experience with bias from docs. And it doesn’t just come from male docs, but female as well. After all you’ve pointed out here in a few places many examples of this, not to mention many other’s experiences. I was commiserating, but it seems as if now I’m being told that I’m mistaken. Just because there is a lot of stress in my life doesn’t mean that I’m not experiencing things as I’ve stated (bias, serious medical problems) I already suffer with a disability, which is difficult for doctors to figure. I’ve been dealing with stigma for over a decade.

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        1. It can be very frustrating and stressful when we feel terrible and then to pick up that our reports are not taken seriously.

          But throughout the years in which I struggled to get appropriate medical diagnoses and treatment, my counselor (initially referred because of my Anxiety) played a valuable role.

          She confirmed that my assessments most certainly were not imbalanced, that I had plenty of reason for “situational anxiety,” given that serious medical problems were not taken seriously, and on a few occasions she helped me find doctors who were a better fit. I was sorry when she retired and was not replaced. But that is the way of cost-cutting in healthcare in the US.

          Liked by 2 people

          1. Good points, Kathleen. I’ve often said that anxiety is indeed a common (some might say universal) companion of patients without accurate diagnoses and/or treatment plans. And no wonder! When professional counseling is available, it can indeed play a valuable role. Sometimes, we just need all the help we can get…

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          2. I used to go to therapy & before I discovered that I actually have Hashimoto’s, suffered with depression for years. Spent years going to the same place for therapy & antidepressants when I gradually began to feel & get worse my clinic discharged me for not being able to make it to my appts. I was, and still am, really bitter about that. They didn’t even try to work with me due to my worsening condition. So then that didn’t help me at all. I am now too sick to make it to many appts. at all. The weakness, fatigue, & sleep issues have made it so I’m usually too sick to even go to even one appt. I did start treating my thyroid which helped me considerably (no more depression for several years & no need for antidepressants), but I was never able to return to that place that I went for therapy. Now I’ve cycled through several doctors still looking for someone who will listen & take me seriously & stop suggesting things that I’ve already tried.

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      2. Also wasn’t implying that there aren’t good docs out there of both genders, just that the gender bias that we experience comes from both as well. I was just making sure that I was clear.

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  4. I have read so many blogs and feel somewhat disheartened with the bedside manners of many doctors. Women have so many different medical problems from males, symptomatic. And still the medical field dismisses a high percentage of women and their health issues labeling them as anxious, depressed and so forth. This is what is happening and women are suffering because of the repercussions and sheer neglected in the initial stages of diagnosis. We need to question why is this still occurring in today’s modern society? The extremities that woman go to just to get diagnosed and then to be prescribed anti depression medication or anti anxiety medication without the proper diagnosis or correct treatment. The medical field is failing because their model is so backwards in treating females. Why is this so? Why isn’t there changes to their model(s)? Does it go back to the individual doctors that aren’t listening to their patients and dismissing symptoms as described above?

    Liked by 1 person

  5. Back in 2012/2013/2014, I had many episodes of severe, burning chest pain, frequently occurring with tachycardia. I also had extreme fatigue which no amount of sleep would cure. Between the severe episodes of pain my chest constantly ached. I couldn’t ignore it and it didn’t go away. On about 4 or 5 occasions, when the pain became too much to bear, I went to A&E (the British version of the ER). I was given an ECG, x-rayed, given blood tests. I was constantly told I was fine and sent on my way, still in pain and none the wiser. I started ignoring the pain.

    In the end I found the cause of my chest pain, tachycardia and fatigue on my own and cured it myself. I was severely anaemic/anemic as a result of a long-term bleed which I’d had for three and a half years before the cause was found and fixed. I treated my own iron levels with prescription-strength iron supplements and regularly paid for my own blood tests to make sure I didn’t go overboard. I didn’t bother telling my doctor what I was doing – she was happy to give me a prescription for two months of iron supplements but no more. I don’t absorb iron very well, and it took me nearly two years to get all my blood test numbers (which were affected by the low iron) up to optimal levels.

    I do still have a lingering problem with intermittent tachycardia. I take beta blockers for that but only when I absolutely have to. Before I became so severely anaemic I never had any issues with my heart at all.

    So, anyone who is constantly being fobbed off and told their chest pain is all in their head may want to consider getting their iron levels checked. And there is lots more to getting iron checked than just a ferritin level, which is what usually happens in the UK. Do some research into how to diagnose iron deficiency anaemia/anemia, and don’t stop treatment until all those iron-related numbers are optimal, not just at the bottom of the reference range.

    There is another factor that probably affected my heart. I also had untreated hypothyroidism. And low levels of T3 (one of the thyroid hormones) is a major factor in heart problems. Do some research into “Low T3 and the heart”. There is lots of info on the web. I’m still struggling with that one!

    Liked by 1 person

    1. Hello Susan – thanks for sharing your story here. I’m not a physician so cannot comment on your specific experience, but I can tell you generally that anemia can indeed lead to a rapid or irregular heartbeat because the heart has to pump more blood to compensate for the lack of oxygen in the blood. We also know that heart rhythm, cardiac output, and blood pressure problems resulting from thyroid problems are also well recognized. As Harvard endocrinologist Dr. Giuseppe Barbesino says: “The connection to the heart is well established, but thyroid problems are often overlooked as the cause.” It’s tragic that during your 4-5 visits to the A&E, your doctors suspected neither of these causes. Best of luck to you…

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  6. Well, because of that “anxious female” stereotype, I’ve been sitting here for 5 hours, avoiding going to the Emergency Department. My PCP refused to see me, so the ED looked likely. Looks like incredible stress is the culprit this time, or I wouldn’t have been sitting here for 5 hours, but no woman should have to avoid the ED due to these labels. (I think they have a special tome of label-selections for us). I used to get hard copies of all physician visits, which included their subjective notes. Even cardiologists who told me I was gonna die wrote crap like this..

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  8. Thank you so much for this article, I recently sent this to my doctor after another 2 day ECG and a disappointing cardiologist appointment. I have bradycardia and I’ve been labelled anxious, accused of being underweight (though I am in a healthy weight range for my age and height confirmed by my own doctor and a lovely nurse) and also dehydrated though I drink 3-4L a day and my blood tests were fine. He also told me a little story about King Kong when the woman sees him and faints, to which I replied so she had a extreme fear response what has that got to do with me?? He also said to try getting back into my normal routine and that it could just be in my head. I felt like he was saying I had done this to myself which obviously upset me and made me furious. I miss my life so much, I was very active and own 5 horses, before July this year I was competing in 20 mile endurance rides. Now I can’t even walk over to see them without feeling shaky and weak. I’ve had blackouts, palpitations, chest pain, breathlessness, exhaustion and when my heart rate goes up it’s painful. I really hope this will be figured out soon. I’m only 25 and I feel like I’m missing out on so much.

    Liked by 1 person

    1. Hello – I’m not a physician so cannot comment on your specific symptoms except to say generally that it does appear your symptoms have been seriously considered (tests ordered, cardiologist consultation etc – which is far better than many women experience). When you say you had a “disappointing” meeting with the cardiologist, I’m guessing it’s because no cardiac diagnosis was offered – which could also mean that this issue is in fact not heart-related at all, which would be good news. Something is causing your symptoms, and anxiety could be the culprit too. I’d start keeping a symptom journal if I were you (be very specific, date, time, your activity prior to symptom starting, what you ate in the hours leading up to symptoms etc) rather than just listing general overall symptoms. This may reveal a pattern. Best of luck to you…

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  9. How can I convinced my dr to check my heart? the last dr said he thinks it is all in my head. I wake up at night out of breath, I am on Venteze most of the day because I am out of breath. I am so tired in the day, I get headaches mostly every day, some days I feel my heart pump out of my chest, my feet swell and my ankles, I get a funny pain at my back many nights. I have heartburn every single day and night for the last 2 years,and nothing works for it. Some days my blood presure is too high and some days too low, Today I had a dizzy feeling, it felt like when you get glasses to wear for the first time and you get that dizzy feeling and off balance. I am really fed up with the doctors, they just don’t seem to care. All they say is it’s all in my head, or stress.

    Thank you.

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    1. Hello Petro – I’m not a physician so of course cannot comment on your specific situation. It does sound like you have a whole range of distressing symptoms all at the same time which makes it far harder for doctors to identify what exactly is causing any one symptom. You might want to start keeping a Symptom Journal for the next few weeks in which you write down what you’re feeling, what time of day, what you were doing in the 1-2 hours leading up to that symptom starting. Sometimes doctors can spot a pattern when everything is precisely written down, rather than hearing the patient say something vague like: “I get headaches mostly every day.” Something is causing your symptoms, you just don’t know if any of them are heart-related or not at this point. I’m guessing your doctor is at least partially correct in saying you’re stressed (having that long list of problems would stress anybody!) Best of luck to you…

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  11. Hi ladies, I just found this site and it’s a big relief! I’m really young, had an episode of congestive heart failure when I was 18, along with other health issues. I was later diagnosed with relapsing polychondritis, a rare disease where the immune system attacks anything with collagen, so all my cartilage, kidneys, and heart chambers. After 5 years of fighting this with Immunosuppressants and chemo, for the past year it has been in remission.

    Then a month ago, my kidneys started acting up, and things got worse. On Thursday evening before going to bed my jaw began trembling, and my lower face went numb, then my abdomen began hurting and spasming really bad. The pain spread to my chest.

    My husband said we should go to the hospital, and we got ready but as I went down the stairs to the first floor of my house it felt like my heart exploded. It was one of the worst stabbing pains, but I thought I could pee before heading out to the hospital. I got to the bathroom and the pain radiated abruptly to my neck, back, and my left arm. My left arm went entirely numb and the pain was excruciating, my heart was completely out of control and breathing was impossible so I collapsed to the floor. I lost consciousness and don’t remember what happened during the event.

    My husband called 911, and the paramedics showed up 20 min later. I regained some consciousness a few min before they showed up, but I could not move from the floor and was clutching my chest from the pain and could barely breathe.

    The paramedics felt my pulse and said that I seemed to be coming out of pre-cardiac arrest. Then they asked my husband how old I was, and he said 24. Well they flipped out, and said that it was IMPOSSIBLE for me to have any heart issues!!! They did not bother to do an EKG, and didn’t want to take me to the hospital!

    My husband told them about my health history and they completely dismissed it, eventually they decided to measure my blood pressure and my pulse was 187, with my blood pressure through the roof. They once again said that it was impossible and the machine was probably broken. I was dismayed and in shock. They pushed me to get up, and told me that I just had an anxiety attack.

    I know that it was not an anxiety attack, and they had no right to misjudge me and treat me like that, especially without even doing an EKG! Isn’t that mandatory for them to do?
    After much pleading, they finally took me to the Kaiser hospital, and everyone at the hospital treated me like shit. My chest was in so much pain and I could barely breathe or walk, they made it clear that I was just wasting their time with an anxiety attack. The hospital had to do my EKG 3 times because it kept coming up abnormal! And guess what they said? “Hmm, looks like the machine is broken, this is impossible you are just a young woman” Ugh, worst most humiliating experience. They sent me home with high blood pressure and with an antibiotic for my kidney infection. Isn’t it illegal to send a patient home with high blood pressure?

    I feel terrible, been bed-ridden since the event, my heart has continued to act up and I’ve only managed to maintain it by chewing on aspirin tablets. I don’t know what to do, and worse of all is the paramedics labeled me as “low priority” in case we call them again, and the hospital diagnosed me with “anxiety”. Any advice would be greatly appreciated.

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    1. Hello Mrs. TooYoung – your story is shocking on many levels. It’s hard to believe that medical professionals would repeatedly blame faulty diagnostic technology based only on unexpected results. I’m not a physician so of course cannot comment specifically on your symptoms, but I can tell you generally that if your polychondritis began acting up one month ago, you should ideally be under the regular care of your physician by now rather than relying on calling 911 in the middle of the night, or repeatedly chewing aspirin tablets (which can irritate the stomach and cause potentially dangerous internal bleeding). If you haven’t already done so yesterday, make an appointment with your family doctor as soon as possible to review all aspects of your case. Best of luck to you…

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    2. What a horrible experience! Even I am shocked, Mrs. Too Young. I was trained in statistics once upon a time, and find that an outrageous number of doctors understand so little that they think it is appropriate to dismiss “unlikely” results. Please see your PCP asap, and write up your experience to date as well as you can, with dates, times, test and results. Your well-being depends on finding the right doctor.

      Liked by 1 person

        1. All excellent posts, Carolyn. A common error, indeed, but it is an absolute fallacy to dismiss a diagnosis because “That would be unusual/improbable.” Even if a particular condition is uncommon in a general population (not merely under-diagnosed), some people have it, and each of them has it 100%. I have been diagnosed with 4 different “rare” conditions, each of which initially was not considered (or was dismissed). In the end, the “improbable” condition best fits the evidence.

          Liked by 1 person

          1. So true, Kathleen. Remember that old zebra analogy that med students are taught? “When you hear hoof beats, think of horses, not zebras.” This strategy virtually guarantees that the “rare” diagnostic possibility will be discarded right off the bat – even when it may actually be the correct answer. Docs are also taught to treat to numbers, so if the “numbers” aren’t there to clearly point to a specific diagnosis, they may feel eager to quickly move on to what seems the next most likely culprit. Or, as in Mrs. TooYoung’s examples, providers might simply doubt the test results they do see if there’s a computational disconnect.

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            1. Hi Carolyn and Kathleen, thank you so much for your input and advice.

              There’s some things I want to clarify. I have been being seen by my PCP constantly, especially with the kidney issues. Just that Wednesday before my heart event on Thursday he saw me and scheduled me for an ultrasound on Friday. The relapsing polychondritis (RP) was diagnosed by a group of the best rheumatologists, and from the specialty doctors of the RP center in Seattle. I was even part of one of their studies.

              However none of my history mattered to the paramedics that night of my heart event. We also had no choice but to call 911 given the abrupt symptoms that presented. They simply judged me and labeled me and treated me as such rather than taking the time to listen and help me out when I needed help the most. With such a label of an “anxious young woman” the hospital they took me too, followed suit by keeping the same judgement and label. No matter how many times I begged them to check my heart, given my medical history, they did not even care to know what RP was and the implications that had on my current health.

              They neglected me, because they were superior and had more authority than my husband and I or any of my symptoms. It was also the first time we had ever called 911, and after that experience we’ll never do that again. It’s easier for most doctors, paramedics, etc. to place you in a box, than spend more than 10 min using their brain to figure out your complex issues.

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              1. Hello again – so glad that you’re under the regular care of your own doctor. I hope you have seen him/her since Thursday’s ER incident, and that a treatment plan is now in place (your solution of repeatedly chewing aspirin tablets, for example is very concerning, and your doc should be addressing this). I also hope that you and your husband will file reports about your experience to both Kaiser and the ambulance company.

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              2. I am very glad that you are under regular care, and are satisfied with your day-to-day care, though concerned about the effects of long-term aspirin use. Hope you do follow up with Kaiser, as your experience was terrible, as are its implications for the care of others. You have spurred me to finish with one of my own projects with Kaiser, which is a training ground for the next generation of doctors. Yes, sometimes there really are zebras in town…

                Liked by 1 person

                1. Hi Kathleen! That would be incredible, doctors need to reconnect back with the patient, and actually listen. It’s been too many times that doctors just want to get you out of their office within 5 min. Especially here in the US, when they just throw pills at you without addressing the underlying issue of your symptoms. Best of luck in your project, hope it yields great results!

                  Also, I would like to let you ladies know that it was 911, who told my husband that I should chew an aspirin if my chest pain got out of control since my event last Thursday. I’m not sure where it was misunderstood that I “repeatedly chew on aspirin tablets”? I have only needed to do this twice, as a last resort. Trust me that I know very well the dangers of medications and their interactions, especially when you have a life-threatening disease, I have to be very careful with what I take.

                  Today I have a cardiologist appointment, so hopefully I’ll get some answers soon 🙂 thank you Carolyn and Kathleen for your kind words and wishes!

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                  1. I suspect we may have mistakenly assumed you were taking aspirins when you wrote “my heart has continued to act up and I’ve only managed to maintain it by chewing on aspirin tablets”. Good luck with your cardiologist’s appointment today!

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                  2. Thanks for clearing that up, Mrs. TooYoung. Carolyn is right: I certainly misunderstood and am glad that you haven’t needed aspirin long-term. (A relative recently did have a perforated ulcer caused by exactly that.) Best wishes with your cardiologist appt.

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  12. I just looked up my patient care summary on my (alternative!) physician’s web portal, and I see that “Anxiety Disorder” has been added since my last visit. I don’t feel anxious at all, except about the fact that my muscles constantly burn, I can barely crawl out of bed and am exhausted all day, and have frequent nausea, as well as hair loss when I eat gluten or dairy. And my anxiety is because it’s hard to drag through the day like this, not because I’m ‘worried’ about what’s wrong, per se.

    My life is great, I have a career, a family, and have finally gotten on track as far as taking care of myself mentally and physically. My mind is clear and I just can’t believe I would be stressed and don’t know it.

    It’s insulting and embarrassing when doctors suggest that it’s all in my head. I’m just so tired of feeling sick. And I don’t even care that much what the diagnosis is, because I’m barely living anyway. I just want to know what’s going on.

    It’s hard for me to believe that these seven years of declining health is related to anxiety. If it weren’t me speaking, I would tell someone with these symptoms to get their thyroid tested, but I was diagnosed hypothyroid 20 years ago, and haven’t been well no matter what my levels are. T3 didn’t help either.

    Wishing wellness (and being taken seriously) to all of you.

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    1. Well, no wonder you feel ______ (fill in the blank) considering the distressing symptoms you live with, Gemma. I agree – it is insulting and embarrassing to be labelled as anxious as if that’s the sole cause of the symptoms. Speak to your physician for an explanation of that “anxiety disorder” written on your chart. I wish you the gift of being taken seriously by your health care providers…

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  13. And this is the exact reason why I don’t have Kaiser anymore. Once a doctor tappy taps into that computer and places a label on you like anxiety it will forever be in there and you will NEVER get a honest second opinion. My doctor put that I had “generalized anxiety disorder” in my chart WITHOUT telling me just because I wanted another opinion..

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    1. Well, Jomama, it wasn’t easy but I did get that “Anxiety’ label removed, and have been doing much better with that very HMO ever since. Several serious conditions have been correctly diagnosed, now are treated appropriately, and I feel better than I have for decades. For years I had reported symptoms and even had suggested those very diagnoses – to MDs who chalked up yet another note for Anxiety with barely-tolerant smiles. None of my conditions are the cookie-cutter variety, but I do have them 100%. My current docs acknowledge that my presentation of these conditions is fairly classic. One of them said, “You diagnosed yourself! And they treated you like that!” Just more evidence of what an Anxiety label can do…

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  14. I have an auto-immune condition and have had a number of episodes of Pericarditis. I am lucky in that all of the specialists I have seen during these episodes took them seriously, even when nothing showed up on the ECG or ultrasounds. I suppose that it helped that after the first time of nothing showing up after suspected Pericarditis, I had a flare where I had a significant amount of fluid around my heart: 2cm at the back, 1cm at the front. Also, all my other flares where I’ve ended up in hospital, something has shown up on the X-rays, CAT scans, MRI’s etc (except this very last episode). As said: all SPECIALISTS have taken me seriously, not so other medical professionals such as GPs, nurses and physiotherapists.

    Recently after hip-replacement surgery I had a Pulmonary Embolism, and I experienced similar symptoms to Pericarditis and so I assumed that’s what I had. At the time I was in a Rehabilitation hospital and the Registered Nurse didn’t listen, care or want to know. It was in the middle of the night and she didn’t call for a doctor (doctors weren’t on site at night, they had to be called in). Apparently my “Obs were normal” (I know that because she told me so about 10 times).

    She got extremely cross at me when I insisted I had pressure in my chest and couldn’t breathe. (“You can breathe”, she said “You’re breathing aren’t you?”). What upsets me most of all was that I wanted to call an ambulance, or call my husband to call an ambulance, but didn’t. I stayed awake all night, terrified, until the doctor visit the next morning.

    I’ve had this happen a number of times: a GP or nurse dismisses me and I start doubting myself, and feel like I don’t want to “create a fuss”. I kept thinking that the nurse would be pissed off if I called an ambulance to a rehabilitation hospital… how stupid is that?

    The next day when I saw the doctor she immediately organised to send me back to the hospital I came from. As the ambulance men were strapping me on the bed another (different nurse) said (in a loud voice), something to the effect “She says it’s Pericarditis. It’s probably nothing and she’ll be back this afternoon”.

    As I said… it ended up being a Pulmonary Embolism. (I did call the Manager a week later and complained on the phone and in writing. I did receive an apology and an assurance they would improve the training of their staff!)

    After the above episode, a few months back, while still on blood-thinners for the PE, I started having pains like Pericarditis again. The problem was now that I had experienced similar pain for the two different issues. If this had happened prior to the hip-replacement, I would have just assumed that I had a flare coming on and increased my Prednisone, and made an appointment to see my Rheumatologist. But I just wasn’t sure: was it possible the blood thinner wasn’t working well and I had another blood clot?

    So I went to my GP. She said she didn’t think it would be the PE as I was on blood thinner. She also didn’t think it would be Pericarditis because I was on 10mg of Prednisone at the time. I had a blood test for the Troponin enzyme and she called me the next day.

    She said that the Troponin test was negative. She said it was probably anxiety.

    I knew that the Troponin test did not rule out Pericarditis, and I queried her on that, but didn’t push it when she insisted it did. She kept saying it was anxiety. I doubted myself and didn’t increase my Prednisone. (It’s important to catch it before it results in an effusion, otherwise there is a risk of scar build up on the Pericardium!).

    About three weeks ago I stopped the blood thinner on the advice of my Orthopedic Surgeon. A few days later I started having the symptoms again, and I didn’t know whether it was Pericarditis or a Pulmonary Embolism (or anxiety, or nothing!). I ended up going to the ER, was admitted and they ran a battery of tests.

    From the moment I got to hospital they took me seriously and ran every test imaginable for both the PE and Pericarditis- nothing showed up. My managing doctor told me it was probably Pericarditis (Troponin tests measure blood enzymes, nothing to do with inflammation of the lining of the heart!), and of course there can be inflammation without fluid build up. As I knew. After a week on high doses of steroids I am getting back to normal.

    The problem is that the only “proof” of Pericarditis before fluid build-up is “the rub”, and I have never, ever had the rub. My Rheumatologist in the hospital interstate (where all of my previous admissions were) knew me well and saw me through all my flare-ups with fluid on my knees, in my hips, eye-inflammation, with inflammation markers through the roof , so didn’t think to doubt it when I told them I had pressure in my chest, and described all the classic Pericarditis symptoms. So the fact that I didn’t have “the rub” didn’t make them doubt me.

    I am worried that the paperwork going to my GP may say “Suspected Pericarditis”, as there was no “rub”, and she’s going to think she was right and it was Anxiety. I have an appointment the day after tomorrow.

    I’m wondering if I should change GPs. I do like her and have no problems with her until this. If I wasn’t anxious before, I’m now anxious about this.

    Liked by 1 person

    1. What an awful, awful story, Maria. No wonder you start to “doubt yourself” and are reluctant to “make a fuss”. That image of you waiting all night long, terrified, until the doctor visit the next morning for what was a pulmonary embolism is horrifying.

      Your statement:“I kept thinking that the nurse would be pissed off if I called an ambulance to a rehabilitation hospital” was particularly compelling for me, as I experienced the same fear of upsetting a nurse during my heart attack after my Emergency nurse had warned me sternly: “You’ll have to stop asking questions of the doctor! He is a very good doctor and he does NOT like to be questioned!” (The question I’d had the temerity to ask was: “But Doc, what about this pain down my left arm?”)

      It can often feel like we are rewarded for being meek and silent, and punished for speaking up or ‘making a fuss’ when asking about appropriate care.

      I can’t respond to your dilemma about changing GPs or not – only you know if that feels like the right option for you. But before deciding, you might want to clearly discuss your frustrations at your next appointment and see how that chat goes. The trouble is, docs tend to treat to numbers: if the tests say *this*, then it must be *that* (or it CAN’T be *that*) – for many, it can be challenging to look beyond the test results to really get what the patient is actually experiencing. But I can say that if you’ve lost trust in her ability to support/believe you, changing GPs might be an option. There’s no way to predict, of course, if a new GP will be more or less supportive. Best of luck to you…

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  15. This is frustrating in terms of what to do. I have suffered anxiety for around six years and most of my symptoms are physical manifestations from IBS, GERD, muscle aches, to fatigue. Just the last two years, I’ve been suffering frequent chest pains and shortness of breath that travel to my left arm and after extensive diagnostic tests including numerous EKGs, echo, stress, and holter monitor , my doctors could not find anything wrong and attributed my symptoms to panic attacks.

    I have gone through many stresses in my life and have gone to a therapist for help, including doing meditation and relaxation. After switching my job and getting more hours of sleep, I expected my symptoms would subside by now. Instead, my chest pains have increased and lasted longer. The pain is more of pressure and burning and nagging. I’m getting more fatigue than usual and I feel a lot of pressure/discomfort on my shoulders that is not relieved my massage. I have intermittent jaw pain and what worries me is that I started to have pressure, tight pain on my RIGHT arm. I’ve never had right arm pain when I have anxiety so that is something new.

    I then started to have unusual nausea and indigestion even tho I’m on proton pump inhibitors and taking additional antacids are not relieving the pain. The worst part is that I suddenly have throat pain that is sharp and burning that is not relieved by antacid and food.

    All of this is too coincidental and I’m really afraid this is an actual heart attack. My job is very laid back and I’m not going through tough situations so I have no reason to be anxious (except the symptoms I’m going through). I went to the ER two weeks ago and they went through the diagnostic procedures and again, EKG and blood tests are normal (except they didn’t do troponin test). I’m 29 years old with no history of heart disease so there is no reason for me to be sick and yet I’m getting worse and my doctors are not taking me seriously because of my anxiety.

    At what point do I have to fight for my life? Do I have to chain myself to the hospital and protest until they decide to take me seriously? I’m at my wit’s end. I’m seriously scared I’ll drop dead or my heart is so severely damaged that I will be disabled for the rest of my life and in debt of my medical bills.

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    1. Hi Bicky — I’m not a physician so cannot comment specifically to your specific symptoms. I can say that, in general, a heart attack would not typically produce symptoms over a two-year period as you describe. But convincing yourself that you will “drop dead” or have a “severely damaged” heart (especially at your age) or – worse – be disabled for the rest of your life can in itself increase your anxiety over what may or may not be causing these symptoms. It also sounds like you’ve had a number of cardiac diagnostic tests. Please make an appointment with the therapist who helped you previously to help you sort this out. Best of luck to you…

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  16. I realise this is an old post but wanted to share & perhaps get some feedback.

    Just over 5 months ago, we’d been back in the UK for about a week, following a trip to Disney with the kids.

    All of a sudden I got palpitations (have had loads so wasn’t worried). But they quickly got extremely strong & were literally pulsing in my chest – then I felt light headed & short of breath. I went dizzy & fell onto the sofa, on my back. I then felt the pulsing & squeezing sensation in my lower jaw. I managed to turn onto my left side & after a short while everything subsided, but I continued to feel drained.

    Coincidentally, found out that I was pregnant with number 3 a couple of days after this & then had the usual extreme morning sickness that lasted 16 weeks.

    Naturally I felt fatigued, & now at 25 weeks I still do but it could be because of the pregnancy. I’ve also had several days of dizzy spells & nausea. Who knows?

    I have a very dismissive doctor & just wanted to hear what you ladies think – should I go & mention this weird episode & prepare for the ridicule or do you think it sounds like nothing much? I don’t know what to think anymore.

    Hope you can shed some light.

    Tamsin xx

    Liked by 1 person

    1. Hello Tamsin – “extreme morning sickness for 16 weeks!?!” That seems awful! And it sounds like you had this during your first two pregnancies too!?

      I’m not a physician, so can’t comment specifically on whether your symptoms are heart-related or not. I can tell you, however, that a number of studies have suggested that both palpitations (“arrhythmia”) as well as feeling dizzy/light-headed are quite common symptoms in pregnancy.

      The good news is that both complaints are usually benign – meaning they may feel upsetting, but don’t indicate heart problems. There are some cardiovascular conditions that involve very high blood pressure – like preeclampsia – but few if any actual symptoms during pregnancy which your doctor will be checking you for.

      Always mention to your doctor any odd or confusing symptoms just to make sure he/she is right on top of any changes (with or without the “ridicule” – which by the way has no place in doctor-patient communication, don’t you think?!) Best of luck to you with Baby #3!

      Liked by 1 person

    2. Tamsin – Get a new doc! Dismissive docs are worthless when it comes to finding out what is really going on with your health! Find one who listens and who then feeds back what you are saying in his or her attempt to understand what you are communicating! This can mean the difference between life and death!

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  17. Thank you – I stumbled across this looking for gender-bias research for a social psych assignment. I’d like to share my own story – but I am not sure that my story results from gender bias so much as a doctor’s preconceptions.

    I have a long history of anorexia, with a long history of admissions, including very severe problems, and I’ve always gone to one particular hospital. It’s a 20 year history. At the time I had, documented, severe heart problems as a result of this history of anorexia.

    One afternoon my case worker took me to emergency as I’d been having chest pains and she was worried. After a very long wait, the young registrar came out, and without having examined me or done any testing – no bloods, no blood pressure, no ECG – proceeded to lecture me on how I was a spoiled, manipulative brat, attention-seeking, wasting his time, and should go home and eat a sandwich. Of course, I got out of there as fast as I could, very hurt and upset. I collapsed that night and was taken back to the hospital where I ended up in ICU – I had extremely low blood pressure, arrhythmia, fluid around my heart, low potassium, and I was severely emaciated.

    Because of this doctor’s preconceptions of me as a spoiled brat, I could have died.

    They need to teach sensitivity and objectivity in medical school.

    Liked by 1 person

    1. Thanks so much Fiona for sharing with us this disturbing example of the dangers of a doctor’s preconceptions. I was reading recently about how selective such negative preconceptions can be. If a snowboarder or extreme skier goes to Emergency with yet another sports-related injury, it’s unlikely that he/she would be scolded and psychoanalyzed and sent home, humiliated and untreated. The only focus would be on appropriate diagnostic testing and treatment. But with anorexia (and a number of other conditions sharing the stigma of being self-inflicted), the patient must not only worry about alarming symptoms, but also about having one’s character judged by ignorant strangers. Best of luck to you…

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