Denial? Or doctorly deference?

by Carolyn Thomas     @HeartSisters  ♥   June 2, 2019

Last week, the British Medical Journal (BMJ) ran a compelling opinion piece from Boston physician Dr. Abraar Karan on why some patients just don’t seem to understand what their doctors are telling them.  Here’s how he opens his essay:

Why am I here?’ Mrs. S looked up at me for the first time since I had entered the room and begun speaking to her. I had spent the past five minutes talking about the need for her to start new medications for her heart failure. She had nodded along for most of the conversation, but I wondered if she had heard, or more importantly understood, anything I had been saying. She had had three admissions for worsening heart failure in the past few months. And yet she looked at me and said, ‘Do I have heart problems? No one ever told me!'”   . Continue reading “Denial? Or doctorly deference?”

Women’s heart health: why it’s NOT a zero sum game

by Carolyn Thomas  @HeartSisters  April 7, 2019

In the game of poker, zero sum game theory suggests that the sum of the amounts won by some players equals the combined losses of the others. So if one player wins big, then other players must lose big.

It struck me recently that it’s possible our healthcare system functions as if it were a zero sum game, too.
Continue reading “Women’s heart health: why it’s NOT a zero sum game”

MDs often tell women to lose weight rather than address cardiac risk factors

by Carolyn Thomas     @HeartSisters    March 31, 2019

This editorial, What Women (and Clinicians) Don’t Know Hurts Them, originally appeared in the Journal of the American College of Cardiology. As a woman with heart disease, I wanted to immediately read it to find out what might be hurting me.

But as is common practice in most medical journals, this editorial was behind a paywall, so it was not available for heart patients like me, or anybody else who wasn’t a subscriber to the journal.

I could pay a fee of $35 for the privilege of reading this one article, but the reality is that I can’t afford to pay for articles that aren’t being published in what’s known as an open access journal.* Continue reading “MDs often tell women to lose weight rather than address cardiac risk factors”

A solution in search of a problem

by Carolyn Thomas    @HeartSisters      March 17, 2019

I recently had the honour of being invited to speak to a university class of young students learning about chronic illness. (The word “young”, of course, is relative, since almost everybody on earth is now so much younger than I am). These students were absolutely terrific – enthusiastic, smart, full of questions and ideas about healthcare. But about halfway through our 3-hour class together, I began to observe a pattern in the way some of them approached their small group exercise assignment.  Continue reading “A solution in search of a problem”

The dilemma of the death certificate

by Carolyn Thomas     @HeartSisters    February 3, 2019
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In a good old-fashioned murder mystery, we know that the plot starts to heat up when the dead body is discovered and the cause of death determined. But in real life, most of us will not die quite so dramatically.
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If we live with one or more chronic illnesses, in fact, the name of at least one of those diagnoses will probably be listed on our official death certificates someday. (We could also get run over by a bus long before then, but let’s face it, chronic diseases cause 70% of deaths worldwide).
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It struck me recently that, had I died during what doctors call my widowmaker heart attack in 2008, the official cause of death would have likely read “myocardial infarction”. But that would have been wrong. The actual cause of my death would have been that I was misdiagnosed with acid reflux and sent home from the Emergency Department.
Continue reading “The dilemma of the death certificate”