Heart attack: is it a clogged pipe or a popped pimple?

by Carolyn Thomas      @HeartSisters

decisionsWhen my little sister Bev was booked to have her tonsils removed at age six, our family doctor declared that I must have mine out at the same time – not because there was anything at all wrong with them, but because I was already 12 years old and, for some inexplicable reason, I still had my tonsils intact!  (Back then, kids with tonsils were apparently an endangered species. As New York ear/nose/throat specialist Dr. Steven Park described the historical take on tonsils: “In the 50s to 70s, it was a given that if you had tonsils, they were removed.”)

On our designated procedure date, Bev and I were admitted to the pediatric ward at St. Catharines’ Hotel Dieu Hospital together.  I remember this experience vividly because the archaic rule at the Hotel Dieu back then was that all pediatric patients had to wear diapers overnight.  DIAPERS! As a humiliated almost-teenager, I pleaded with my mother to convince the ward nurses that I most certainly did NOT need to wear diapers at my mature age! But rules were rules, and I somehow managed to survive both an unwarranted surgical procedure and its associated diaper humiliation.

It turns out I wasn’t the only person questioning the wisdom of taking out a perfectly fine pair of tonsils based on flimsy if any medical evidence.  Decades later, many researchers – including in this U.K. study published in the journal Archives of Disease in Childhood (1) – blamed not only the physicians who recommended the routine surgical removal of tonsils (and often adenoid glands at the same time) to treat childhood sore throat, but also “parental enthusiasm” as the factors influencing an entire generation of higher-than-necessary rates of surgery.

“Despite the enthusiasm with which tonsillectomy is offered and sought, there is little evidence of efficacy.”

I like this tonsil analogy to illustrate how medical attitudes, no matter how pervasive, can indeed change over time as our physicians rethink the status quo in order to embrace evidence-based medicine.

In other words, just because we’ve been doing this for a long time, is there any evidence that it’s actually what needs to be done? 
Continue reading “Heart attack: is it a clogged pipe or a popped pimple?”

What if I’d had my heart attack decades earlier?

by Carolyn Thomas  @HeartSisters

“When I first became a GP in England well over 30 years ago, the early diagnosis of myocardial infarction (heart attack) was a matter of slight importance, since there was no intervention which made any difference to survival.

“You tried to reach patients in their homes quickly to relieve their pain with heroin, but only sent them to hospital if their pain was not controlled, or they were going into shock.  Studies at the time indicated that patients with heart attacks survived better at home, where they were less likely to be killed with injections of lidocaine.”

Quite a difference, according to Dr. Richard Lehman, writing this in the British Medical Journal (BMJ) compared to modern cardiac care options like clot-busting thrombolytic drugs or invasive coronary angioplasty procedures that are now routinely available to patients presenting with heart attack symptoms these days. (Unless, of course, you happen to be a woman in your 50s presenting to the E.R in mid-heart attack, in which case, as reported in the New England Journal of Medicine (1), you are seven times more likely to be misdiagnosed and sent home compared to your male counterparts with the same symptoms).  But I digress . . .         .   Continue reading “What if I’d had my heart attack decades earlier?”

A year in review: Top 10 Heart Sisters posts in 2015

by Carolyn Thomas      @HeartSisters

It’s that time again, when navel-gazing pundits everywhere compile their Best Of or Top 10 lists of movies, political stories, books or bloopers for the year that’s just about to slip away.

Same here at Heart Sisters. So let’s take a nostalgic look backwards today at this website in 2015, at what I like to describe as “cardiac rehab for my brain”.    Continue reading “A year in review: Top 10 Heart Sisters posts in 2015”

How soon are heart patients safely fit to fly?

plane-drawingby Carolyn Thomas     @HeartSisters

Five months after my heart attack, I boarded a plane from the West Coast of Canada bound for Rochester, Minnesota.  Considering that I’d suffered two horrific cardiac events on another long flight just five months earlier made this trip just a wee bit terrifying for me.

Only the reality that I was headed to the world-famous Mayo Clinic in Rochester helped propel me onboard. I told myself that if anything happened to me and my heart during this flight, the cardiologists at the Mayo Women’s Heart Clinic would know exactly what to do for me. If I survived the flight, that is . . .  

Continue reading “How soon are heart patients safely fit to fly?”