“Stay home if you feel sick!” – and why we don’t do that

by Carolyn Thomas     @HeartSisters

“Don’t go to work when you feel sick!   Stay home if you have symptoms!”

This sounds like plain old common sense advice when it comes from public health experts during a pandemic. Most people, however, WILL go to work sick if they don’t have employee benefits like paid sick leave. And among healthcare staff, we know that even those lucky enough to have a good benefit package will often go to work when they’re ill.  Here’s why: .     .           . Continue reading ““Stay home if you feel sick!” – and why we don’t do that”

Empty beds: when heart patients are afraid to seek help

by Carolyn Thomas       @HeartSisters

Barely a month ago hey, remember a month ago? – my GP ordered a number of routine blood and urine tests following a meds review. So I booked an appointment online at my local testing lab – but within hours, I decided to cancel. All I could think about was this: “Lab waiting rooms are filled with sick people!”  There was no way I was going to put myself at further risk during this COVID-19 pandemic.

It turns out that heart patients like me are not only reluctant to walk into lab waiting rooms, but cardiologists are now reporting that many of us are reluctant to seek urgent medical care – even during a heart attack.       .       . Continue reading “Empty beds: when heart patients are afraid to seek help”

Is it finally time to change the name ‘heart FAILURE’?

by Carolyn Thomas      @HeartSisters

When McMaster University cardiologist Dr. Harriette Van Spall asked her Twitter followers recently to offer topic suggestions for the upcoming Heart Failure Summit, I responded with a suggestion of my own:

“Please please please can we STOP calling this condition heart FAILURE?”    .

Continue reading “Is it finally time to change the name ‘heart FAILURE’?”

Signals, noise, context – and your doctor’s brain

     .    . Emergency physician, professor, author, and patient safety expert Dr. Pat Croskerry

by Carolyn Thomas      @HeartSisters 

Emergency physician Dr. Pat Croskerry tells the story of the day he misdiagnosed a patient who was experiencing unstable anginachest pain caused by coronary artery disease, and often a warning sign of oncoming heart attack. But this is what he’d said before sending that patient home:

“I’m not at all worried about your chest pain. You probably overexerted yourself and strained a muscle. My suspicion that this is coming from your heart is about zero.”

In a later interview with Dr. Jerome Groopman (author of a book I love called How Doctors Think), Dr. Croskerry explained how easily that misdiagnosis happened: Continue reading “Signals, noise, context – and your doctor’s brain”

Stents vs. bypass surgery vs. TRUST

by Carolyn Thomas        @HeartSisters

In 2018, Dr. Dhruv Khullar warned his colleagues at an American Board of Internal Medicine conference that patients need answers on three dimensions of trust:

  1. Competence:Do you know what you’re doing?”
  2. Transparency:Will you tell me what you’re doing?”
  3. Motive:Are you doing this to help me or yourself?”        .     .

Continue reading “Stents vs. bypass surgery vs. TRUST”

Coronary stents: interventions that come with a cost

by Carolyn Thomas       @HeartSisters

Remember last month when I covered the topic of stretch pain” in heart patients who have had a coronary stent implanted?

To recap, temporary post-stent stretch pain in the chest is due to the dilation of an artery when a metal stent is being implanted inside that artery, and it typically occurs in about 40 per cent of stent patients.  A number of you wrote in with some variation of this question: “Is it still stretch pain if it’s happening months afterwards?”

And now a new study published in the Journal of the American College of Cardiology  suggests that something entirely different might be going on.2 .      .      , Continue reading “Coronary stents: interventions that come with a cost”