Diagnostic uncertainty: when we just don’t know

~ Carolyn Thomas ~ 5 Comments

by Carolyn Thomas    ♥   @HeartSisters

The image above is all about uncertainty. It’s like a 5-step roadmap that you’d use when traveling an unfamiliar road to a new destination you know nothing about and do not want to visit.(1)  For people experiencing scary symptoms they fear might be heart-related, for example, uncertainty about what’s happening now and what will happen next is pervasive. But a new study published in the journal Patient Education and Counseling reminds us that patients aren’t the only ones facing uncertainty around a medical diagnosis: “Both patients and clinicians experience diagnostic uncertainty, but in different ways.”(2)        .        .   Continue reading “Diagnostic uncertainty: when we just don’t know” →

New chest pain guideline: “atypical” is OUT!

~ Carolyn Thomas ~ 19 Comments

by Carolyn Thomas   ♥  @HeartSisters

At last! This long-awaited first-ever Guideline for the Evaluation and Diagnosis of Chest Pain for physicians and their patients has done a deep dive to help improve accuracy in evaluating and diagnosing cardiac symptoms(1)  – a huge and overwhelming effort.  I’m hopeful that updated guidelines might represent a turning point for all women presenting with those symptoms – and for the physicians who diagnose them.  Here’s my take on the impressive new Chest Pain Guideline  – along with a few concerns:      .       .  Continue reading “New chest pain guideline: “atypical” is OUT!” →

False hope: better than no hope?

~ Carolyn Thomas ~ 14 Comments

by Carolyn Thomas    ♥   @HeartSisters

My former colleagues in palliative care often spoke about the concept of hope as being a fluid, ever-changing state of being. When we’re suddenly face-to-face with a frightening medical crisis, for example, we hope at first that maybe the diagnostic tests were wrong. When the diagnosis is confirmed, we hope that this treatment/this procedure/ this drug will be the cure. But if we’re not cured, we hope that our symptoms can be managed so we don’t suffer. If we do get worse, we hope that our suffering won’t become a burden to our families. Then we hope that after we’re gone, our loved ones will be taken care of.

There was never talk about “no hope”.  There is always hope.  But our hope changes.     .             . Continue reading “False hope: better than no hope?” →

“Do I belong here?” Unintended barriers to cardiac rehabilitation

~ Carolyn Thomas ~ 23 Comments

by Carolyn Thomas    ♥   @HeartSisters

It was 10 a.m. sharp when I walked into the gym where my cardiac rehabilitation classes were about to begin. The group’s coordinator was a friendly former cardiac nurse who now spent her mornings with freshly-diagnosed heart patients in the rehab program. She greeted me warmly, and toured me around the facility, introducing me to my fellow cardiac rehab buddies. And “fellow” was the apt word: it turned out that in that particular class, I was the only female heart patient in a gym filled with men. Old men. Old men who all happened to be golfers – which I would soon learn was the sole topic of their conversations.  My initial reaction was: “Do I belong here?”        .             .     Continue reading ““Do I belong here?” Unintended barriers to cardiac rehabilitation” →