When I first saw exhaustion described as the “leaky emotion of chronic illness”, it reminded me of something else. (This happens to me a lot, by the way, a fizzy stream of consciousness that bubbles ideas around my cranium like pinballs until one finally settles in with a *plink*). The plink this time was that, along with the chest pain, exhaustion and the damned relentlessness that can so often accompany episodes of my refractory angina (or many other symptoms of chronic illness for others), there’s another response I’ve only recently begun to learn about.
And that’s the sound of soft little moaning, groaning, or sighing noises.
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 Parkdescribed 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.
When one of my Heart Sisters posts was picked up by MedPageToday’s popular blog Kevin MD.com in December, I was thrilled by the response that this article attracted. But one of the most intriguing reactions came from Dr. Steven Park of New York City.
When I was about eight months pregnant with Ben, my first baby, I was diagnosed with something called preeclampsia. This is a serious condition affecting about 5% of pregnant women, identified by symptoms like sudden spikes in blood pressure, protein in the urine, severe swelling, and headaches or vision problems. It’s also women’s third leading pregnancy-related cause of death. Preeclampsia is clinically described as:
“…a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks’ gestation”.
Whenever you see the words “vascular” or “endothelial” or “vasospasm” in the same sentence, you know you’re likely talking about the heart. And although preeclampsia typically goes away after pregnancy, its diagnosis may well be an early indicator of underlying heart conditions that may simmer for decades. In fact, studies now show that pregnant women who develop preeclampsia have more than twice the risk of having a heart attack or stroke later in life.