by Carolyn Thomas ♥ @HeartSisters
Two weeks before being hospitalized with what doctors call the “widow maker” heart attack, I was sent away from the Emergency Department in that same hospital with an acid reflux misdiagnosis – despite presenting with textbook heart attack symptoms like central chest pain, nausea, sweating and pain down my left arm.
Before I was sent home that day, I apologized profusely to the Emergency staff for wasting their valuable time. I felt embarrassed because I’d just made a fuss over nothing, because I’d made genuinely sick people wait that morning, and because I was clearly incapable of telling the difference between a serious cardiac crisis and indigestion. Once discharged home, when my symptoms worsened (which, of course, they DID!), there was no way I was going back to that Emergency Department to be further embarrassed – until day after day after day, those symptoms became ultimately unbearable.
This post is Part 9 of a 10-part summer series called “What I Wish I Knew Back Then” – which revisits some of the most commonly reported experiences of freshly-diagnosed heart patients. For example, we know that not wanting to make a fuss is a valued trait for many of us strong women, but this common tendency can also cause disastrous cardiac outcomes if it makes us reluctant to seek immediate medical attention when we need it most. I wrote more about research on women’s alarming tendency to actually minimize our cardiac symptoms in “6 Reasons Women Delay Seeking Help During a Heart Attack”
Consider this compelling example of serial apologies shared by a 49-year old heart attack survivor from New Mexico. Like me, you too may be able to relate to her experience:
”It dawned on me how many times I said I was sorry when I had to go to the hospital to have another cardiac procedure done.
“The first time was when I phoned the doctor, even though he had told me to call right away if I had any more chest pain, and I’d already waited three days before calling. But still, I apologized for bothering him.
“When he told me to go to the Emergency Department, my 15-year old daughter was in the car with me. I apologized to her.
“I then had to go get my husband at work so that he could drive me the rest of the way to the hospital. He’d been getting lunch for his office colleagues for a very important meeting, so I apologized to him, too.
“All the way to the hospital, I kept saying how sorry I was for putting my family through all this.
“When I got to the cardiac unit, I told the nurses that I was really sorry to bother them – but the doc did tell me to come.
“When all the heart tests came back, I apologized again to the staff. I also said I was sorry that I had to go to the bathroom so often, but the Lasix medication I’d taken that morning was doing its job.
“And then I called my friends and apologized to them for not being able to have lunch with them the next day.
“I have sometimes laid in my bed silently wondering if I was having the Big One, but not wanting to wake my husband!
“It is now my mission to NOT be sorry for something that is real and out of my control. When I offer help to friends or family, it warms me when my help is accepted, and annoys me when they refuse help because they don’t want to bother me! So I pledge to not make others feel that way.
“From now on, I will ask for help when I need it, and accept it graciously.”
Linguists (these are academics who study language) have long suggested that, for women, saying sorry may be just part of our conversational arsenal, one of the tools we use to keep relationships steady, e.g:
“Women’s apologies are more a course correction than a U-turn. Women are more likely than men, for example, to say sorry when they’re not at fault as a way of expressing empathy.”
A Canadian study from the University of Waterloo compared men’s and women’s experiences with apologies. The study, published in the journal Psychological Science, found that women reported offering more apologies than men, but they also reported committing more offenses. Researchers explained that women demonstrate a lower threshold for what we would label offensive behaviour (like, say, seeking urgent help during a medical crisis?!?)
Seeking help when experiencing scary symptoms, by the way, does NOT translate into “offensive behaviour” or “making a fuss!” Seeking help is normal. It’s also what each of you reading this would intuitively insist on doing if identically frightening cardiac symptoms were happening to your Mum or sister or daughter or friend. So make sure you do it for yourself, too! And DON’T APOLOGIZE for it.
Generally speaking, as a basic life strategy, stop apologizing when you seek medical help. And don’t reflexively start sentences with the word “sorry” – as if you’ve already done or said something wrong. Every paramedic and Emergency physician I’ve ever met assures me that they’d prefer we called 911 to get potential cardiac symptoms checked out promptly – even if the diagnosis doesn’t end up being heart-related. And especially if you’re calling 911 for urgent help, don’t start with what Elizabeth Banks says to the 911 dispatcher in her brilliant 3-minute Go Red for Women film called “Just A Little Heart Attack”:
“Sorry to bother you, but I think I might be having a little heart attack!”
Better to know that we’re safe, than to die alone at home because we don’t want to be a “bother”.
♥
NOTE FROM CAROLYN: I wrote about why women wait far longer to seek medical help than our male counterparts (yes! even during alarming cardiac symptoms) in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or favourite bookshop (please support your neighbourhood 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).
Words matter when we describe our heart attack symptoms
Too embarrassed to call 911 during a heart attack?
Getting help during a heart attack: ‘delayers’ vs ‘survivors’
How women can tell if they’re headed for a heart attack
How does it really feel to have a heart attack? Women survivors tell their stories “The heart patient’s chronic lament: “Excuse me. I’m sorry. I don’t mean to be a bother…””
Heart Sisters 
Carolyn–I’ve been reading your blog for several years now, learning from you all the time. While I’ve used what I learned, and your blog and book have been useful all along, the past three weeks your writing has been a huge support.
I moved into a new condo on July 28. Over the next few days, I though the exhaustion and chest pressure were fatigue from the move until dizziness forced me to leave denial behind.
Even then when I checked my pulse and found it to be 38, I thought, “I must have made a mistake.” Sure, after 42 years of nursing I forgot how to count my pulse. This time, I didn’t drive myself to the ER! When the nurse put a monitor on and told me my heart rate was 36, my first thought was, “Well, I guess I didn’t make it up.” The good news is that I got competent care with an expedited appointment with a cardiac electrophysiologist.
He turned my thinking upside down when he said I didn’t have true bradycardia but “functional bradycardia” because every other beat was a PVC that didn’t pump blood effectively. I reluctantly took his advice to increase metoprolol to stop PVC’s and am currently muddling along with a pulse between 42 and 52.
Actually feeling better though relatively inactive. I’m scheduled for an ablation on September 8 which I hope restores me to greater functionality.
I have used everything I learned from your writing and teaching. Asking for help hasn’t been easy. Calling my son to ask him to take my dog because I can’t take her for walks was tough. Asking without apologizing was tough. Accepting limitation is not my strength but I don’t have a choice. Accepted the Apple Watch my kids wanted me to wear, so if I fall they will know. Overcame my resistance to realize the thing is actually helpful and I’m grateful for their loving concern.
I didn’t know you could survive with a pulse this low, but cardiology tells me as long as my systolic blood pressure stays above 90 and I’m not dizzy, stay the course until I get to the OR.
Thank you. Keep writing.
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Hello Sara – thank you for sharing your recent experiences – and for your kind words. I’m so glad that the timing worked, that you saw your electrophysiologist, and that you now have a date booked on your calendar (all good!) – but I am sorry you have had to go through this. You’ve gone through a lot in the past month (starting with your new home – moving is inherently overwhelming in itself, even without new cardiac issues).
Congratulations on asking for help!! (You remind me of ME – until I learned that most people WANT to help those they care about!) Your kids love you and need to feel less helpless – so please continue to ask without apologizing. If the tables were turned, you know you’d gladly step up to do whatever you could to help them.
September 8th will be here before you know it. You’ll be in good hands! I sure hope you will feel much better after your ablation and will be soon be walking and snuggling your dog once more. Meanwhile, enjoy your new Apple Watch!
Good luck to you, Sara! ♥
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Since Covid and during Covid, I have found that my HCA nearest hospital has been staffed with brand new LPNs who haven’t the slightest clue about heart symptoms and told me it was all in my head — while I was infarcting in front of them and losing blood pressure.
Then I was trying to call 911 but the phone doesn’t work with a mask on. Next “Quick, take her phone away!” I had to fight them, but I was not letting them take my one contact to outside. All doctors ignored critical markers (troponin) at 20 max for 4 days.
I have grown up fast and now anticipate ignorance. The magic cure is:
1. Demand to see administration
2. Tell them you have contacted your lawyer. Like magic you will be treated.
Bottom line: as women we will be told it is just a tummy ache unless we take the reins.
I do so wish it was only a masculine disease!!
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Hello Mary – it’s a sad day when “tell them you have contacted your lawyer” is a recommended step in seeking urgent medical care.
I have no clue why LPNs would be tasked with diagnosing (or misdiagnosing) patients, but all nurses (RNs, LPNs, ALL nurses) and certainly ALL docs should be appropriately informed about women’s heart disease.
Take care. . .
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Hi Carolyn,
I would be the odd woman out, as I never apologized to anyone at any time. I was bad-tempered at most times between vomiting and points of unconsciousness.
My thing was: are you finished so I can go home? Not the normal woman patient.
Robin
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Hi Robin – I suspect that vomiting and being unconscious would make anybody bad-tempered… And I’ve yet to meet a “normal” woman heart patient – our experiences are all so different and completely unique, aren’t they?
Take care….
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I really like your blog BUT the font is too skinny and too light to be able to read easily. At LEAST change it to black! (I know that’s not stylish, but…)
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Hello Susan – I too wish I could change the font colour to BLACK. WordPress, my blog host, used to have a ‘font colour’ option that made this simple and effective. I used this option routinely for every new post, but recently during an update of their editing features, they removed that option. Very frustrating for me, also! The only remedy, I think, is making the whole screen larger (control plus + if you’re on a Mac). This might improve the readability for you.
Take care. . .
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