by Carolyn Thomas ♥ @HeartSisters
Before I tear the last page from my 2022 calendar (yes! I still love my big paper calendars!), here’s my annual look back at what my readers were reading this past year on Heart Sisters. It was indeed a freakishly weird year for this site: the first time since its launch in 2009, for example, that I took a complete summer break from writing about women and heart disease. This happened unexpectedly after I became utterly obsessed with my newest passion: trying to grow roses in pots out on my balcony. (If you’re a rose lover, you can find the archived gardening updates I wrote all summer, starting here). Spoiler alert: like many things in life, this summer adventure turned out to be mostly about managing unrealistic expectations. . . Meanwhile, here are the five Heart Sisters posts that were most popular in 2022:
1. I’m still alive, post-influenza. I think. . . Never let anybody tell you that the flu is not a big deal. Influenza knocked me flat for the whole month of October this year. Ironically, symptoms hit suddenly just before my scheduled annual flu shot appointment. Sudden onset of severe symptoms is in fact a hallmark of the flu, often the first clue differentiating flu from COVID, colds, or other respiratory infections. This was the sickest I’ve ever been – and I’ve had some pretty serious diagnoses (ruptured appendix, heart attack) but nothing as awful as this brutal flu bug. NOTE: heart patients may experience both worse symptoms and deadlier outcomes compared to those who aren’t heart patients. My message to all: GET YOUR FLU SHOT!
2. Must women bring an advocate along so doctors will believe us? I wrote here about three books and three female authors, each one asking the eternal question behind many of the posts you’ll find here: “What is it about female heart patients that makes so many doctors treat them differently than male patients?” For example, in her book Sex Matters: How Male-Centric Medicine Endangers Women’s Health, Emergency physician Dr. Alyson McGregor explains that medical research (yes, even the lab rats were male) and medical practice are based on models historically designed to work in men, while ignoring the unique biological/emotional differences between men and women. Three books that should be required reading for all female heart patients!
3. Weird facts about women and heart disease: From weird typos in medical journals to weird cardiac symptoms and even weirder stories about ambulance rides (e.g. a large study found that when a female heart patient was being transported to the hospital, ambulances were significantly less likely to have flashing lights and sirens turned on compared to when that heart patient was a male). This – and many more fascinating facts to share with your friends and family during the holidays!
4. When heart disease isn’t your biggest problem: I didn’t see this one coming. This post explores what can happen when a new non-cardiac diagnosis arrives without warning. Out of the blue, heart disease – our #1 killer! – began to take second place to a painful new diagnosis for me. How can scary chest pain suddenly seem hardly worth mentioning? Maybe it’s because I’ve gradually learned over the years how to manage living with heart disease, but I’m a rank amateur at coping with debilitating new arthritis symptoms. Here’s what I have had to learn about osteoarthritis.
5. Heart Month awareness: doing the same thing, yet expecting different results: This was without doubt the toughest article I’ve written here since I first launched Heart Sisters in 2009. I’d just read the horribly discouraging results of the latest American Heart Association’s national survey on women’s awareness of heart disease – results such as: over half of women surveyed did not know that chest pain was a heart attack symptom. It turns out that – incredibly! – women are actually less informed about heart disease now than they were 10 years ago- despite a relative avalanche of information, facts, statistics, data and expensive awareness-raising campaigns like “Go Red for Women” shared over that decade by cardiac researchers, heart-related organizations and patient advocates like me. The AHA itself described the results of this awareness survey as “a decade of lost ground.”
What we learned from this survey’s results was that whatever we’ve been doing to raise women’s awareness of heart disease is simply not working.
(The demoralizing results of this survey, by the way, were the prime motivators in my ultimate decision to take the entire summer off from writing my Sunday morning Heart Sisters posts this year. In my despair, I knew I had to shift gears entirely and write about something that brought me pure joy for a change – which at the time was my new passion for growing balcony roses in pots).
I wrote 17 articles on this new topic all summer until rose season ended. I’m glad I listened to that little voice telling me that, after writing 900+ articles on women’s heart health here since 2009, I needed a break. Especially given what we had learned about the stunning failure of awareness-raising campaigns to actually do much good.
As Florida behaviour scientists warned in Stop Raising Awareness Already, published in the Stanford Social Innovation Review:
“Because abundant research shows that people who are simply given more information are unlikely to change their beliefs or behavior, it’s time for activists and organizations seeking to drive change in the public interest to move beyond just raising awareness.”
One of the reasons I was able to convince myself to return to my Sunday morning heart articles this fall was my realization that, unlike women in the general public (i.e. the ones responding to that AHA national survey), the women I’d been writing for weren’t generally just the general public, but far more likely to be women already living with or at high risk for heart disease – and their families.
And while raising public awareness of women’s heart disease is clearly not working, learning more about becoming a heart patient is the crash course nobody ever wanted to sign up for – and that’s where informational homework can help.
To those learners, and to all of my readers from 190 countries worldwide, I wish a Happy Christmas season wherever you are, and a safe, heart-healthy year ahead. ♥
♥
NOTE FROM CAROLYN: I wrote more about becoming a heart patient in my book “A Woman’s Guide to Living with Heart Disease“. You can ask for this book at bookshops (please support your local independent booksellers!) or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher Johns Hopkins University Press (use their code HTWN to save 30% off the list price when you order).
Heart Sisters 
Just read this article and wanted to make sure you saw it.
https://wapo.st/3WAi9Wq
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Thanks so much for thinking of me, Sara. The story is tragically typical in women – especially when her husband wanted her to go to Urgent Care to have her symptoms checked out! Minimizing cardiac symptoms is so common, in fact, that there’s an entire research focus on this topic: treatment-seeking delay behaviour in women during heart attack! Arrrrgh!
Take care, stay safe out there. . . ♥
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Thank you for your books and these weekly emails!
My father’s family had numerous heart issues which lead me to become a Registered Nurse.
I worked many years in small hospitals with ICUs. After back issues, I spent my last 10
years as Parish Nurse for our church. Your book rallied me on when I gave talks.
Thank you!
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Hello Karen – thank YOU for such a lovely note. I’ve met a number of nurses over the years who entered the profession because of a close family member’s medical history. I believe that nurses like you are uniquely compassionate because of those personal reasons.
So glad my book has helped you in your important work!
Take care, stay safe. . . ♥
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I really appreciate your writing. I learn something new from each post and feel less alone with my variety of heart disease. I especially appreciate your recommendation of the book, The Exquisite Machine: The New Science of the Heart by Siam E. Harding. I asked my library to get a copy and read through it slowly. There is so much I want to reread and remember that I bought a copy. I do like to highlight and underline!
Thanks for continuing to write.
Sara
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Hello Sara and thank you so much for your kind words.
I too really enjoyed Dr. Harding’s book – a unique book from “a world leader in heart research”!
Like you, I found myself taking notes on entire paragraphs – although the first sentence that grabbed my attention was this sobering one:
“We’re winning the war against heart attacks, but by surviving with damaged heart muscle, we are in growing danger of heart failure.”
That was a scary reality that I’ve often wondered about, too. Heart muscle damaged during a heart attack does not heal like arm or leg muscle injury.
Take care, and Happy New Year to you. ♥
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Merry Christmas, Carolyn, and all Best Wishes for a Happy and Healthier (we can only hope) New Year!
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Thank you Susan – happy and HEALTHIER is what I’m hoping for, too. Happy New Year to you! ♥
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Merry Christmas, Carolyn!
For 2023, I’d like you to expand on patient behavior that hurts themselves and others. From the doctor’s point of view.
Majority of patients cannot provide their own accurate medical history (crime of omission) which creates a delay in every patient’s treatment because now the intake physician has to start from scratch.
Combine that fact with cost cutting measures that don’t account or provide sufficient resources to work up patients who can tell you who won the Stanley cup back to 1972 but can’t tell you their medications.
Medical teams are dropping from overwork, exhaustion, and emotional distress (mostly abuse from coworkers, patients, patients families, and management). Now add on the emailed inquiries from patients.
Those ER docs triage and need to make rapid fire decisions on what tests must be run and when. How can they function efficiently when burdened with responsive (ie alive and talking) who made themselves unresponsive by not be responsible for themselves?
The patient may appear to be stable enough to discharge with orders to see their primary doc the next day. Hmmm. Do they have a primary doc? Can you get an appointment that does not mean waiting 6 weeks? Will the patient follow through? Unlikely. But they have cleared an ER bed so the next patient doesn’t die waiting.
Maybe they are admitted. Patients discharge through the day shift. They may have no supportive family or worse yet, the dysfunctional family drama plays out at discharge. The patient doesn’t want to be discharged or the family doesn’t want to care for them. Or skilled nursing centers not wanting dementia patients. A lot of raw hurt there. Now multiply that by the number of patients. You know that old saying about minding your own business? Not applicable to doctors. Every single day.
The delay in discharge means the same doctors are coordinating the newly admitted patients still housed in the ER. Which means they are trying to determine medical history and medication history. What do the patients have in their body? Illegal and legal? Oh wait, another patient page from the ward. Add 30 pages per day. Some are relevant, but there are no shortage of patients complaining they don’t like their chair, requests to fluff their pillows, don’t like the food, too noisy, bored, etc. You know the type – the ones that leave their shopping cart in a parking spot for someone else to collect.
There is a very real issue with entitled behavior that becomes dangerous when it means another patient may lose their life. And those patients don’t care for themselves, much less others.
Medicine is supposed to be evidenced-based. That means testing. If that’s not happening, then why? Is your physician overloaded and resorting to judgement calls? It happens. And it might be because of other patients. So help the medical team help you!
Guidelines:
1. Hospitals are not hotels. Treat your doctors and nurses as professionals.
2. Prepare a written medical history summary and have it available.
3. Prepare a current drug list. Be honest if you are using illegal drugs.
4. Have a list of all allergies including drugs. It’s good idea to visit an allergist to verify what you think/remember.
5. Have a primary doctor and annual physical, at the very minimum.
6. Ask yourself why you don’t have a support network? Best make arrangements while you can. For some, it’s mending the past. You also must care for others. Don’t want to be a burden and indebted to others? Then don’t be a burden.
If you take care of your mind and body, you are helping yourself and others.
Sent as a gift for you to construct into another meaningful article. ❤️
Anne
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Thank you Anne for this Christmas gift! Much of what you write is what I’ve been saying to my Heart-Smart Women audiences for years: basically, don’t blow your own chances of an appropriate diagnosis.
For example, we know from published research on doctor-patient communication that women are different communicators than men are – and this difference may be one of the many factors (besides the Big One – implicit gender bias) in our poor outcomes compared to our male counterparts.
Women tend to minimize their important symptoms. Men generally stick to the basics: “Doctor, I think I’m having a heart attack!” That statement gets a doctor’s attention pretty darned swiftly.
Women on the other hand are generally more likely to want to tell stories about their symptoms: “Well, it started on Tuesday when I was gardening. It’s possible I may have just pulled a muscle digging. And I’ve also had a really stressful week at work. It’s probably nothing, but I thought I’d pop in to get this checked. . .” Story-telling like this is almost guaranteed to put your symptoms at the end of a very long priority list. I’ve written lots about the research of Harvard linguist Dr. Catherine Kreatsoulas (whose unique focus is how women speak to Emergency staff during a heart attack). She told me that she’s witnessed first hand female heart patients arguing with Emerg docs: “Well, it’s not exactly chest ‘pain’. . . “ = another way to get yourself dismissed and discharged.
Instead, I urge the women in my audiences to stop the stories once they’ve communicated the specific alarming symptoms that brought them to seek medical help. “I THINK I’M HAVING A HEART ATTACK!” – then SHUT UP!
Everything you list is smart advice (with the possible exception of “see an allergist” which for some families (and given the year-long wait for many specialists) is not always practical in solving immediate problems. Where I live (Victoria, BC) there are over 100,000 city residents who do not have a family doctor. Doctor shortages are a real crisis here.
But YES YES YES to knowing your own meds (and supplements! If taking Biotin for nice nails and shiny hair, for example, women should know that this supplement interferes with troponin tests, the cardiac enzyme that doctors rely on to indicate heart muscle damage during a heart attack). So YES tell the doctor about EVERYTHING you’re taking, prescription or over-the-counter.
Personally I loved Guideline #6 – which is Tough Love at its most effective and least politically correct. We pussy-foot around what patients do to unwittingly push away the care and support they desperately need. Most women are hyper-sensitive about not wanting to appear to be a “difficult patient”, but some are clearly NOT – and thus make things harder on themselves and their unfortunate healthcare professionals.
Thanks again Anne: your definition of the kind of person who leaves their shopping cart in the parking lot for somebody else to collect? That sums it up nicely!!
Take care, stay safe – and Merry Christmas to you, too. ♥
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