posts here focus on a variety of topics all about the heart and how it works
by Carolyn Thomas ♥ @HeartSisters
This amazing image is this year’s winner of the British Heart Foundation’s “Reflections of Research” medical image competition, an annual celebration of the U.K. charity’s groundbreaking research into cardiovascular diseases. This is not a painting – it’s a real image of the blood flowing within an adult heart, frozen in time. Continue reading “A beating heart frozen in time”
by Carolyn Thomas ♥ @HeartSisters
When 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?”
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?”
by Carolyn Thomas ♥ @HeartSisters
During my first evening attending our “Heart to Heart” 7-week education series for recently diagnosed heart patients, the man sitting next to me leaned over and asked me: “What are you in for?”
I told him that I’d had what doctors call the “widow maker” heart attack two weeks earlier, and that I now had a stainless steel stent implanted in a major coronary artery that had been 99% blocked. He interrupted me with a cheery:
“I have THREE stents!”
As he went on and on in exquisite detail about his cardiac event, I felt like my own was suddenly pretty puny by comparison. Three stents? How could I possibly compete with that? My previously-fascinating heart attack misdiagnosis story now seemed hardly even worth mentioning, really.
I came to observe during the following weeks and months that heart patients, consciously or not, seem to slot themselves arbitrarily into what I now call the unspoken Hierarchy of Heart Disease. Continue reading “My unofficial (but weirdly true) Hierarchy of Heart Disease”
Heart Sisters 