Dear Carolyn: “Did I have a ‘real’ heart attack?”

8 Jul

by Carolyn Thomas    @HeartSisters     July 8, 2018

As part of my occasional Dear Carolyn series featuring my readers’ unique narratives about how they became heart patients, I offer today a medical mystery from an Oregon reader. After dueling physicians differed in their opinions of her diagnosis, Lynn Bay now wonders if she actually did have a “real” heart attack, as one of them had diagnosed. Her story may seem familiar to you if you’ve ever had your medical experience dismissed or minimized. Here’s Lynn’s story, with her permission:

“Dear Carolyn,

   Lynn Bay

“I had chest and jaw pain, and went to the ER in my small coastal town of Lincoln City, Oregon. The ER physician there told me that the EKG showed an MI (myocardial infarction, or heart attack). The first cardiac enzyme blood test was ‘normal’, but he said we’d wait for further test results. I had more blood tests over the next two hours. When the enzymes began reacting, he shouted, “I knew it!” and pumped his fist. He showed me the EKG strip where he had circled one part, and explained, “That’s your MI.” The enzyme numbers kept rising, and that’s when he decided to send me to the trauma center in Salem, where they found a 70% blockage and implanted a stent. I was placed on blood thinners and prescribed nitro tablets.

I was so impressed with that local physician that I later sent him a thank you note after my stent was placed at the city hospital.

“I am a 75-year old retired law enforcement officer, in good shape otherwise. I am also a researcher who has studied forensic science, and many medical journal articles. My first husband had a massive heart attack at age 45. I was his caretaker for 13 years until a heart transplant was needed. He did not survive the wait for a new heart. So when I say I know about heart disease, I’m not kidding. I lived with it.

“Five months later, it happened again. I woke from sleep one morning with an awful chest pain, radiating front to back. I took a nitro pill. Five minutes later, I took a second nitro.  I then broke out in a wet, clammy sweat and started to pass out. My husband was with me the whole time and called an ambulance.

But before the ambulance got to the house, the pain was completely gone. Poof. They took me to the ER anyway. It was during shift change at the hospital, so they took one blood test (“normal”), then the doctor went home, and a second doctor who just arrived told me I had acid reflux and released me.

“My husband was stunned. He had had a heart attack years before and is also a retired police officer, and said: “(bad words) I know what a heart attack looks like and dammit, you had one!”

“I later followed up with a cardiologist, who asked: ‘So you have had some acid reflux?’  I said, ‘No, I had a heart attack.’  He angrily said, You’ve never had a heart attack! You have to have crushing chest pain that goes to your arms. YOU did not!
.
“But just to prove it, he ordered a nuclear stress test and an echocardiogram. When those test results came back, he said to me, ‘See? I told you. No heart damage. . . no heart attack.’
.
“He told me that neither this episode nor the one five months earlier was a heart attack because my heart was not damaged. They were just ‘events’.
 
“When I asked the cardiologist why I even needed a cardiologist, he said, ‘Well, you have a stent, and you have had hypertrophic cardiomyopathy for a few years. So that’s why.
.

“So, I take it that you cannot have a heart attack unless you have heart damage. True or false?”

“Your heart sister,

Lynn Bay”

My response to Lynn started with my usual disclaimer that I am not a physician so couldn’t comment specifically on her own experience, but I could share with her some credible resources to help understand just what is or isn’t a heart attack.

These resources include guidelines for diagnosing a heart attack, as described here by Harvard cardiologist, Dr. James Januzzi, Jr. (a member of the Joint Task Force for the Universal Definition of Myocardial Infarction). These guidelines suggested that a diagnosis of myocardial infarction (heart attack) is appropriate if a person shows a troponin (cardiac enzyme) level in the blood that’s substantially higher than normal, plus one or more of the following:

  • – symptoms of heart attack
  • – worrisome changes on an ECG (EKG) or imaging test
  • – identification of a clot in a coronary artery (e.g. during an angiogram procedure in the cath lab)

When doctors talk about a myocardial infarction, they typically mean that plaque inside a coronary artery that brings oxygenated blood to the heart muscle has ruptured. Cholesterol and other substances lining the artery spill into the bloodstream, and a blood clot forms at the site of that rupture. If it’s big enough, it can block the flow of blood through the artery, starving the heart muscle of oxygen and other nutrients. That’s a heart attack.

But according to Mayo Clinic cardiologists: there are actually distinct forms of heart attack:

1. STEMI or ST-elevation myocardial infarction is caused by a sudden complete (100%) blockage of a coronary artery. It’s a heart rhythm abnormality that’s detected on a 12-lead EKG test, referring to the behaviour of S-waves and T-waves of the heart’s electrical recording.

2. NSTEMI or nonSTEMI is a heart attack caused by a severely narrowed artery, but the artery is usually not completely blocked, thus still allowing some (limited) blood flow to the heart muscle.

3. Another cause of a heart attack is a spasm of a coronary artery that stops blood flow to part of the heart muscle. See also: Misdiagnosed: women’s coronary microvascular and spasm pain

4. A less common but dangerous cause can also be Spontaneous Coronary Artery Dissection (SCAD). This heart attack is the result of spontaneous tearing in the coronary artery wall, and is most often seen in young, healthy women with few if any cardiac risk factors.

The blood test results that Lynn’s first Emergency physician was excited to see were likely blood tests for a cardiac enzyme called troponin T.

This enzyme is part of a family of proteins found in skeletal and heart muscle fibres; blood tests can measure the level of cardiac-specific troponin in the blood to help detect heart muscle injury. 

Normally, troponin is present in very small or even undetectable quantities in the blood. But when there is damage to heart muscle cells (for example, during a heart attack), troponin is released into the blood. The more damage there is, the greater the concentration of troponin. Troponin levels increase soon after heart damage occurs, and they can remain elevated for up to two weeks.

The tricky thing is that there are other conditions that can also raise troponin levels in the blood. These include heart conditions like heart failure or cardiomyopathy (which Lynn was diagnosed with a few years earlier). Some conditions are unrelated to the heart, such as severe infections or kidney disease. A number of studies have found that prolonged and intensive exercise (doing a triathlon, for example) can also cause elevated troponins in approximately 80% of athletes. (1)

Many of the various edits over the years to the definition of a heart attack have focused on the kinds of heart attacks experienced by (white, middle-aged) male heart patients, largely ignoring women’s heart attacks – especially in younger women.

That’s why Yale University cardiologist Dr. Erica Spatz worked on a unique range of heart attack categories (based on the international VIRGO study) that offer another list of possible heart attack descriptions specifically in women under age 55. I wrote about her work here.

 

Q:  Did Lynn have a “real” heart attack? Was that physician correct when he said, You have to have crushing chest pain that goes to your arms”?  *

NOTE FROM CAROLYN: If you are having alarming symptoms that you believe might be heart-related, please seek immediate medical help. Do NOT leave a comment here asking me what you should do. I am not a physician and I cannot advise you.

Need a translator? For definitions of confusing cardiology terms, visit my patient-friendly, jargon-free glossary. I included the entire 8,000 word glossary in my new book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press, 2017), and Chapter 1 is all about women’s heart attack symptoms.

See also:

.

* Trick question, dear heart sisters. . . As you may already know if you’ve been a regular Heart Sisters reader here, some women in fact do not experience any chest symptoms during a heart attack (studies have estimated a range of between 10%(2) to as many as 42%(3) of us).  And even women who do report chest symptoms often do not use the word pain to describe these symptoms (instead, using words like pressure, heaviness, fullness, tightness, etc.(4)  Researchers have also found that the severity of cardiac chest symptoms has no association with the severity of a heart attack or outcomes(5).

1) F. Sedaghat-Hamedani et al. “Cardiac Biomarker Changes After Endurance Sports: Expert Analysis”. April, 2016. American College of Cardiology.
(3) J. Canto et al, “Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality,” JAMA. 2012 Feb 22;307(8):813-22.
(4) C. Kreatsoulas et al. “The Symptomatic Tipping Point: Factors That Prompt Men and Women To Seek Medical Care.” Presented at the Canadian Cardiovascular Congress, October 2014. Canadian Journal of Cardiology Volume 30, Issue 10, Supplement, Page S132.
(5) M. Edwards et al. “Relationship Between Pain Severity and Outcomes in Patients Presenting With Potential Acute Coronary Syndromes.” Annals of Emergency Medicine, Volume 58, Issue 6, December 2011. 501 – 507

25 Responses to “Dear Carolyn: “Did I have a ‘real’ heart attack?””

  1. Yogi July 15, 2018 at 7:48 pm #

    I used to think I had a heart attack when I was 32 (I’m now 36), but I slowly realised it was not a heart attack but just because of my Mitral Valve Prolapse acting up causing it.

    Liked by 1 person

    • Carolyn Thomas July 15, 2018 at 9:55 pm #

      Glad you figured that out, Yogi – takes a lot of unnecessary stress off your mind (and your heart!) Best of luck to you…

      Like

  2. meshack July 11, 2018 at 1:53 am #

    Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
    Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.Shortness of breath with or without chest discomfort.

    Like

  3. Charlotte Burnham July 8, 2018 at 8:39 pm #

    Lynn’s story sounds so familiar to me!

    In February, I had what was diagnosed as a non-STEMI heart attack by the nearest hospital that admitted me directly from the ER (after being transported by ambulance, after the EMTs spotted irregularities on their initial EKG, after my calling for help unable to breathe and about to collapse). The next day, the echocardiogram showed a definite heart dysfunction; I had 3 stents placed in what was a 95% blockage in the LAD as well as other areas I don’t remember exactly due to the fog of the experience. Nevertheless, I know my discharge papers specifically stated that I had been treated for a non-STEMI heart attack.

    For my follow up care, I chose a cardiologist in a practice that was closer to the other specialists I see for care that operate outside of the area where I had been hospitalized. When I saw this cardiologist, while perhaps he was kinder than Lynn’s doctor, he also seemed (and still does) determined to convince me that I had not had a heart attack.

    Rather that use intimidating tone, he used complicated medical-speak language that seemed to be intentionally chosen to go over my head. I’m pretty savvy when it comes to a lot of medical terminology, but he really was able to talk circles around me and my understanding. I kept asking him over and over again how I could not have had a heart attack when it says right here on the papers from the hospital that I … ? And he’d start over again with his ‘explanation’ that still didn’t make any sense.

    I finally had to decide to go with an approach like Bonita’s and ask myself “does what he has to say affect me or my treatment differently?” (what does it mean to me?) He knows what happened, he knows what my current tests are saying, he knows what my current meds are doing for me and he is aware of my concurrent health conditions. For the first few months, that worked for me.

    However, a few weeks ago I began to experience chest pain, jaw pain, dizziness and shortness of breath again. I was smarter this time and didn’t put things off, and went right to the ER. Because of my history, they kept me overnight for observation, even though the 2 troponin tests & EKG were showing negative for MI. I had a stress test the next day with results that showed no heart damage. Three days later, I saw my cardiologist for an already scheduled appointment, still experiencing the same symptoms, with less intensity and the sense of needing to stay calm “because the hospital had proven nothing was wrong.” He all but shrugged his shoulders and told me to try a new antacid.

    This is when I realized that the nagging voice in my head was right, it was time to find a new cardiologist – one that works out of the hospital where I go when I need emergency care. It makes more sense to have someone who has ready access to my electronic records as well as actual social/professional contact with the doctors who see me in the hospital, or even come see me in the hospital when I am there. I also need to find someone who is willing to really listen to my questions, fears and anxieties.

    I do think in the end, it can be important to understand what exactly happened to us.

    Having a heart event of any kind can be traumatic for most of us, as I’ve learned about myself and the people I’ve met in my cardiac rehab. We have experienced an intensely frightening event, and we need to wrap our minds around it.

    It’s not helpful when our doctors start discounting each other’s diagnoses by parsing definitions or making things more complicated than we need them to be.

    Did I have a heart attack? Yes, I did. Did Lynn? Yes, I believe she did.

    And why would it be so important to convince us otherwise?

    Liked by 1 person

    • Carolyn Thomas July 9, 2018 at 5:44 am #

      Charlotte, your last few sentences sum up precisely my own reaction to Lynn’s story. And when you write that your former cardiologist’s “complicated medical-speak language seemed to be intentionally chosen to go over my head”, you bring up an important issue that is one of my pet peeves.

      Is the purpose of using unintelligible medical jargon simply to end the medical encounter? I believe it is. It’s certainly not meant to promote appropriate communication.

      This is an important practice to stop because if a physician uses enough bafflegab, most patients will shut up and eventually leave the room, not informed but confused. Why are we allowing this to go on?

      I now recommend to both my readers and audiences that if this ever happens again, in any medical encounter, we must immediately raise a hand to interrupt and politely ask the doctor to repeat what was just said, but this time using plain language that will help us understand. And if that medical-speak is repeated, put that hand up again.

      There’s no excuse for ever speaking to patients as if they’ve been to medical school. It’s arrogant and disrespectful.

      Like

  4. Martha C July 8, 2018 at 11:38 am #

    I’m pretty new to this world (heart attack 6/5/18, stent in circumflex artery 6/6). But I can tell you that I was diagnosed with NSTEMI type heart attack. I had absolutely normal EKGs, even during the “event” and a normal echocardiogram. Doctors kept telling me “your heart looks really good”. They explained that with an NTSTEMI attack the heart attack does not usually cause major loss of heart function and heart damage. (At least that’s what I THINK they said, and some of this is still a blur).

    So perhaps Lynn’s heart attack was similar to this? I don’t know why a cardiologist wouldn’t call that a heart attack, though.

    Mine was diagnosed by elevated troponin levels three hours after the event. The first troponin test was normal. I’m grateful to the cardio consult in the ER. He insisted I stay for the repeat test.

    He and everyone else in the ER including me were very surprised when the troponin came back elevated. I am medicated for acid reflux and anxiety for years. I understand why they thought I was either having horrible heartburn and/or a panic attack. But I am very glad they went ahead with the extra testing anyway.

    I’m especially grateful for your work, Carolyn, and that of others who have helped to change ER protocols (at least in some places!) for women with chest pain. And a shout-out to the folks in the ER at Salt Lake Regional Hospital who were willing to be “proved wrong”. On the way to the CCU, a number of doctors, nurses, and even an EMT from my ambulance run all gathered around my gurney and said “We’re so glad you came in. You did the right thing.”

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 6:57 pm #

      Thanks for your comments here, Martha. So many great points!

      First, I love-love-love hearing stories like yours because we know that people like you with one or more other diagnoses are significantly more likely to have cardiac symptoms misdiagnosed (blamed on one or both of those other conditions). Your expert ER team at Salt Lake Regional Hospital definitely deserve a shout-out for that! It’s also not uncommon for that first troponin (cardiac enzyme) blood test to come back “normal” at first; it can take time for subsequent tests to reveal an elevated troponin T result (unless your hospital is using the new high-sensitivity troponin testing tools) so again, your ER team was on the ball by not rushing through those subsequent blood tests.

      Finally, I really wish all med and nursing school students could be taught the importance of that “You did the right thing by coming here today!” message to patients as you were told. It’s both reassuring and respectful to communicate that message to worried patients.

      Like

  5. Bonita Kennedy July 8, 2018 at 11:05 am #

    I find it interesting, both as a heart attack survivor and as an RN, to hear those kinds of phrases requoted--“You haven’t had xyz because you haven’t had such and so, while others have been equally sure that you have had…

    However one wants to phrase it, having a troponin elevation with serial blood tests cannot be explained by many other reasons. Yet, what is the point of debating the initial issue? She now has stents and medication, and all the other things to go along.

    Personally, I was in a state of denial and thought that it must just be GI, or maybe some form of seizure. I have a cardiologist who takes me seriously, doesn’t assume he’s a god, and also is willing to say, “This isn’t quite the way I would like to have symptoms present, but it is cardiac until proven otherwise.”

    In a perfect world, one could use good communication techniques and question the physician as to conclusions. However, asking one question does seem appropriate: Whatever you want to call it — what does it mean for me.

    There is a whole other issue here — rural vs city medicine. I’ve worked in small rural areas and have witnessed events, only to hear (or read reports) later discounting the patient’s issues because, if they weren’t seen in a fancy hospital, they didn’t happen… That is an entirely different story, but it does affect women’s health.

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 1:45 pm #

      Hi Bonita – I love that one question that all patients should remember: “What does it mean for ME?”

      I’m so glad you mentioned something that is rarely discussed, and that is the issue of rural vs. city medicine (or in some major cities, ‘big fancy’ hospital vs. ‘smaller’ hospital). I know that docs might choose to openly disagree with a previous doctor’s opinion because of a sincere belief that the opinion was not in the patient’s best interest, but I’ve heard a number of scary stories suggesting instead some kind of narcissistic turf war between professionals in the accepted hierarchy that is medicine. In Lynn Bay’s case, her doctor made what even I know is a preposterous comment about heart attack symptoms – perhaps to point out that he’s far smarter than that idiot. As you point out, however, it’s hard to argue with troponins. And symptoms.

      Lynn afterwards wrote to me that she now suspects that “he was just trying to convince me I didn’t have a heart attack and this was the quickest way to do it.” And his words, delivered “angrily” as Lynn describes, sure were an effective conversation-stopper!

      Re “the point” in reviewing Lynn’s initial issue: I interpreted her question (did I have a real heart attack?) as a reflection of the confusion that such doctors are willing to inflict upon their patients, perhaps in order to shut them up – a confusion that’s expected whenever a diagnosis is clearly disputed. Lynn already knew she was a heart patient. A far more professional and courteous response from her physician would have been to treat his patient like a competent adult (Lynn clearly is one!) instead of as an annoying child wasting his time.

      Like

  6. helenakinc July 8, 2018 at 10:15 am #

    I worked for years as a university administrator in a business school with predominantly male professors as colleagues. I learned then that I had to adjust my preferred communication style to have any hope of being heard by them or being respected. And no, it isn’t fair and it isn’t right but it is the way the world operates.

    I believe a similar approach is necessary with many doctors. I don’t want to make a blanket generalization, but it is worth considering. I have found, that to be taken seriously by my physicians, that I often have to adjust how I communicate. There is quite a bit of info available on gender differences in communication and while no one pattern is applicable for everyone, there are trends.

    Plus it is important to really listen to how one’s physician talks, what he/she emphasizes, so that you know what he/she values in terms of communication. Most of my doctors are male and are highly evidence-based people. The decisions they make are almost always backed up by hard data, evidence. So, when I talk with them I try to couch my concerns in terms of data. For example, instead of saying that I’m having trouble with angina, I will say that I had four episodes of angina last week, which lasted x amount of time. Or, angina happens whenever I get over-heated. I prefer to view what is going on in my life as an impression or a general pattern, but the doctors (and formerly professors) wanted cold hard facts and specific observations and data or they would not take me seriously.

    I believe that people should be open to different kinds of communication styles but often they are not. When my life is on the line, I am willing to adjust my style. I think it is also important to be very “out there” with physicians. Name what you are afraid of. If you are concerned that you may be having a heart attack, say it. And say that you want to be tested for a heart attack. Ask for the blood enzymes test. It doesn’t matter if they think you are stupid.

    I’d rather be thought stupid and be alive than be “compliant” and dead.

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 10:44 am #

      Terrific overview of the importance of communication, which applies even more in medicine which is by definition a hierarchy-based profession. I can’t generalize about gender role specifics (because I happen to have a cardiologist who is the best listener I’ve ever met, and is never threatened or offended by any cardiac study or question I bring to his attention). Your advice is 100% correct, whether you’re speaking to a male or female physician, e.c. “four episodes of angina last week, which lasted x amount of time.” That’s exactly the kind of reporting that makes a doctor’s brain start analyzing your data. This is important because there is a widely acknowledged “cardiac gender gap” in this profession.

      This is also important because the other reality is a valid fear of being considered a “difficult” patient – justified or not.

      When I was in the ER, the cardiac nurse told me sternly to “stop asking questions of the doctor. He is a very good doctor and he does NOT like to be questioned!” That ER doc had just misdiagnosed my heart attack despite textbook symptoms, and the question that I’d had the temerity to ask him was: “But Doctor, what about this pain down my left arm?” I was humiliated and embarrassed to be publicly scolded as if I were a wayward child, and that embarrassment kept me from going back to the ER when my “acid reflux” symptoms returned (which, of course, they did).

      Being considered a “difficult” patient can and does result in inferior care, and patients know that – which makes our own communication skills by necessity so important.

      Like

  7. Dr. Jitesh Arora July 8, 2018 at 9:38 am #

    In my view Most of the Chest pain are false alarms. But we cant ignore such symptoms. One should go through all the routine investigations.

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 10:00 am #

      Yes, absolutely, Dr. Jitesh. Even if symptoms do turn out to be ‘false alarms’, they must first be believed. And unfortunately, we know that women’s cardiac symptoms are less likely to be taken seriously. For example, the 2018 Heart and Stroke Foundation’s annual report bluntly warns: Women’s hearts are victims of a system that is ill-equipped to diagnose, treat and support them.”

      Liked by 2 people

      • Dr. Jitesh Arora July 9, 2018 at 11:28 am #

        Its same in my part of world Chest pain in Women is often interpreted as Anxiety or panic

        Liked by 1 person

        • Carolyn Thomas July 9, 2018 at 4:42 pm #

          Indeed, here too. And once a woman has the word “anxiety” on her medical records, future medical visits will often default to that diagnosis.

          Like

  8. Jacqueline Michaud July 8, 2018 at 5:59 am #

    I also had a heart attack that was misdiagnosed – as pneumonia. I spent a week in my small town hospital getting worse everyday…till they sent me to a bigger hospital for more testing.

    From there I was rushed by ambulance to the nearest heart trauma center 50 miles away…where I stayed another week. I had 90% blockage of an artery in the heart. However, they were not able to put in a stent. They called my husband and told him they didn’t think I would survive. However, by inserting a needle through my back, a young doctor asked me if he could try to remove the water that had accumulated around my lungs. I agreed and he was able to remove close to two quarts of water.

    Although I still had significant damage to my heart, from then on, I started recovering. That was four years ago. Although I am still on 3 heart medications, I can lead a normal life.

    Our body and our heart are complex. Problems can manifest themselves in many ways. I am so thankful for “my heart sisters”. I discovered I am not alone, and that my feelings are normal.

    Jacqueline

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 6:11 am #

      Hello Jacqueline – I am still trying to imagine those two quarts of fluid being sucked out! You have been through quite an ordeal, starting with that pneumonia misdiagnosis. If only that small hospital had made the decision to refer you elsewhere for proper testing much sooner! I am so glad to hear that your recovery has been positive. You are SO right – our bodies are amazingly complex – from your very first symptom, your body began working hard to save you! And you are not alone, for sure…. Thanks for sharing your experience here.

      Like

      • Jenn July 8, 2018 at 11:59 am #

        Within a month of my mitral valve replacement I was back in hospital with a severely congested lung. My cardiologist withdrew 1 1/2 quarts of fluid from it by needle aspiration. This was 18 years ago and I still remember the relief I felt at my sudden ability to breathe easily and therefore walk more than a few steps.

        Liked by 1 person

        • Carolyn Thomas July 8, 2018 at 6:37 pm #

          I can picture that sense of relief, Jenn! Your story is a good reminder to others to immediately report any troubling symptoms, especially so soon after a major chest procedure. We know that there’s a significant risk of pulmonary complications following cardiac surgery so all patients should be made aware of that possibility before being discharged from the hospital.

          Like

          • Jenn July 8, 2018 at 7:15 pm #

            I was very fortunate that at that time (before budget cuts) an RN visited my home several days a week to check on me after my discharge from hospital. She listened to my lungs each time, and arranged for my rehospitalization. Since I had been almost immobilized with congestive heart failure before my valve replacement, I didn’t recognize that I wasn’t doing well.

            Liked by 1 person

            • Carolyn Thomas July 8, 2018 at 7:26 pm #

              That visiting nurse saved your life! You are indeed fortunate, Jenn…

              Like

  9. Brenda Whitley July 8, 2018 at 5:49 am #

    Hi Carolyn – I wrote to you a few years ago, after finding your website while browsing. I like your approach.

    I am doing ok heart wise now, just taking it easy. This May I had requested a mammogram. Here in Northern Ireland breast screening stops automatically once a woman reaches the age of 70 (although research shows the biggest group of breast cancers are picked up in the 70 age bracket); it will be done if you request it.

    This I did at end of May, got a appointment within a week, had it done and a fortnight later got a letter asking me to come for more tests. I had not found any lumps nor did I feel there was anything to worry about. I was told I had a lump in my right breast which was cancerous.

    Last Monday 2 July I had a lumpectomy, now awaiting the results of a lymph node biopsy done at same time. I was very well looked after; as they knew my heart history, I had been monitored throughout the operation. I’m at home recovering and feeling positive. I will have to have radium later.

    What I wish to ask you if there is any research about heart conditions and cancer that I could read up on or any good alternative treatments that could help?

    Thank you for all the hard work you have been doing on women’s behalf, it does not go without appreciation.
    Brenda

    Liked by 1 person

    • Carolyn Thomas July 8, 2018 at 6:33 am #

      Hi again Brenda – I’m sorry to hear of this breast cancer diagnosis, and am hoping that your lymph nodes will be clear. Because of age, many cancer patients do have pre-existing heart disease when they’re diagnosed with cancer, so cancer hospitals are very aware of this dual diagnosis challenge. In fact, there is now an entire field of medicine called cardio-oncology (a conference called the 4th annual Global Cardio-Oncology Summit is being held this fall in Florida). Much of their focus is on the effects of early cancer treatments on later heart problems, and trying to minimize the risk of cancer treatment-induced heart disease.

      I’m not a physician so of course cannot advise you specifically, but this article may help to address some of the issues your doctors will be looking out for in your case. Best of luck to you, Brenda…

      Like

      • Brenda Whitley July 8, 2018 at 6:57 am #

        Dear Carolyn – Thank you for the link you sent, I am trying to remain positive in the face of all and look forward to getting your blog every week.
        Bless you,
        Brenda

        Liked by 1 person

        • Carolyn Thomas July 8, 2018 at 8:10 am #

          I’m keeping fingers and toes crossed for good luck to you… ♥

          Like

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