Medpedia

Jan 08, 12 04:41AM | 0 comments
Dr. Jerome Groopman, in his must-read book called "How Doctors Think", writes: "Physicians, like everyone else, display certain psychological characteristics when they act in the face of uncertainty. There is the over-confident mindset: people convince themselves they are right because they usually are. Specialists in particular are known to demonstrate unwarranted clinical certainty. They have trained for so long that they begin too easily to rely on their vast knowledge and can overlook the variability in human biology.”
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  • (Comment from original source - Yale Heart Study) on Jan 02, 12 12:06PM

    Congratulations on all of your accomplishments in 2011, Carolyn. You are a wonderful writer and should be recognized for all that you do. Wishing you continued success in 2012! Much thanks for your support! -YHS

  • (Comment from original source - NB) on Jan 02, 12 12:44PM

    This video discussion was well worth watching, thanks very much, I only wish that ALL women heart patients had access to female cardiologists who are this aware and skilled at women’s heart issues. It was so inspiring to watch. THX Carolyn for this. I’m a new subscriber as of yesterday and so appreciate what you’re trying to do here for all of us.

  • (Comment from original source - StressTest) on Jan 02, 12 04:47PM

    [...] Pregnancy: the ultimate cardiac stress test [...]

  • (Comment from original source - Carolyn Thomas) on Jan 02, 12 05:10PM

    Thanks so much for your kind comment. I encourage ALL heart attack survivors to participate in your study at Yale University – to help determine why people wait so long even in mid-heart attack before seeking medical help.

    Keep up the good work and Happy New Year!
    cheers,
    C.

  • (Comment from original source - Carolyn Thomas) on Jan 02, 12 05:45PM

    Hello Dawson, thanks for taking the time to let me know about your sister-in-law’s case. Good luck to her, and to you, Auntie!
    cheers,
    C

  • (Comment from original source - Rhonda) on Jan 02, 12 07:56PM

    I have been having what I think is heartburn that is really frequent accompanied by a persistent pain like muscle spasms behind my left shoulder blade and it radiates under my left breast area. I have seen my family practitioner and have had EKG’s done and he, my Dr. was not concerned and was given either a muscle relaxer or was told that I just had acid reflux and gave me more medication. Needless to say, none of this has helped my symptoms. I am scared to death that there is something going on that no one is listening. Does anyone have any suggestions?

  • (Comment from original source - Carolyn Thomas) on Jan 02, 12 08:07PM

    Rhonda, it may be time for you to become the “squeaky wheel”. Have you asked your family doctor for a referral to a cardiologist? Have you been referred to an internal medicine specialist to rule out acid reflux? Are you generally prone to anxiety? SOMETHING is causing these distressing symptoms – they may or may not be heart-related, but at this point, you simply do not know yet.

    Also, start immediately to keep a detailed journal of your symptoms – when they hit, what you’re doing when they hit (time of day, eating, sitting, moving around, resting, lying down), how you are feeling when they hit (stressed out, anxious, feeling calm), what activities are involved if any, do symptoms start slow and get worse or come out of the blue? etc. and bring this written report to the doctor. Also check out “What Is Causing My Chest Pain?”

    Good luck to you,
    cheers,
    C.

  • (Comment from original source - readytochangenow) on Jan 04, 12 04:21AM

    Great post – I find that if I allow myself to debate, I have already lost – great tips to help combat the urges.

  • (Comment from original source - Carolyn Thomas) on Jan 04, 12 05:40AM

    Agreed – that’s why dumping that plate of cookies in the hotel was the right way to go!

  • (Comment from original source - cave76) on Jan 04, 12 07:55AM

    Chocolate chip cookies! Would you believe ‘my dog ate the cookies’????

    What I’m going to post might seem like I’m weaseling out of this whole diet/exercise thing. And there’s probably a skosh of that at play, I have to admit. But give me that and then also read some of the articles I’ve found.

    Previous to one point in my life (but happily pretty late in my life) I could eat anything I wanted and never gain an ounce.

    At one point something changed. Maybe Lyme disease, maybe not. Now my leptin score is triple what is should be. And of course there was no leptin test taken 30 years ago to refer back to. I’m betting it was either normal or on the side of too low, which allowed me free rein with food.

    It would be great to have everyone have a leptin blood test done, but most insurance companies won’t pay for it. (Mine did) And there’s no approved way to treat it, yet.

    I think that someday, down the road, more will be known about leptin and maybe some enterprising drug company will make a pill! I’d buy it!

    I’ll post a few of my saved sources about the role of leptin in the body. Sadly, they end with a variation of this: ” much remains unknown”.

    [There are some indications that the thyroid might be implicated----- but I'm sure that's just one tiny piece of the metabolic puzzle---- but at least one that might be treated.]

    [I've not saved the source for this first one. If I find it, I'll post it.]

    Leptin

    Leptin turns on how tightly the body holds onto fatty acids. When Leptin is high, one holds onto fatty acids and stores them in fat. This leads to rapid weight gain, and because of the high Leptin, standard approaches to weight loss like eating less and exercising more will fail. The inflammatory responses that causes Leptin levels to rise lead to patients who are chronically tired, in chronic pain, and forever overweight.
    ****************************************
    “The role of leptin in the regulation of carbohydrate metabolism.”
    http://www.ncbi.nlm.nih.gov/pubmed/21717410

    *************************************
    “Leptin signaling, adiposity, and energy balance”
    http://www.ncbi.nlm.nih.gov/pubmed/12079865
    *****************************************
    “Clinical aspects of leptin”
    http://www.ncbi.nlm.nih.gov/pubmed/9529971
    ********************************************
    [Evaluation of leptin levels in plasma and their reliance on other hormonal factors affecting tissue fat levels in people with various levels of endogenous cotisol]
    http://www.ncbi.nlm.nih.gov/pubmed/14601484

    ********************************************
    Serendipity led me to this article, AFTER I experienced 2 pulmonary embolism events in one year! Not the doctors would have paid attention to it. :( I’m not diabetic (yet) but that was the only group this article ‘observed’.

    ***CONCLUSIONS:
    Leptin and resistin lead to a procoagulant state in HUVECs by inducing TF (tissue fat) expression. This mechanism might be one explanation for the prothrombotic state observed under diabetic conditions.***
    http://www.ncbi.nlm.nih.gov/pubmed/21733717
    ****************************************************
    From Yale J Biol Med 2011
    “Leptin and Beyond: An Odyssey to the Central Control of Body Weight”
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3064240/

    “ABSTRACT
    The 2010 Lasker Award for basic medical research was shared by Douglas Coleman and Jeffery Friedman for their discovery of leptin, a breakthrough that revealed insight into the genetic basis of obesity. This mini-review aims to review landmark studies on the physiologic system of body weight control. The basic research on the leptin system has broad implications for the genetic control of body weight, thus contributing to solve the global obesity crisis.”
    *****************************************************

  • (Comment from original source - Carolyn Thomas) on Jan 04, 12 08:03AM

    But Cave, what do you do while you’re waiting for that leptin pill to come out? Thanks for this list of links – and thanks for links that are from credible sources!

  • (Comment from original source - cave76) on Jan 04, 12 08:06AM

    Carolyn asked:

    ***what do you do while you’re waiting for that leptin pill to come out? ****

    Te audire no possum. Musa sapientum fixa est in aure. :)

  • (Comment from original source - Carolyn Thomas) on Jan 04, 12 08:22AM

    Luckily, dear readers, I studied Latin for five years in school: “I can’t hear you. I have a banana in my ear.”

  • (Comment from original source - Yale Heart Study) on Jan 04, 12 10:32PM

    Congratulations from Yale Heart Study, Carolyn.

    A new study published in JAMA suggests that HEART ATTACK PATIENTS are sent home too soon from American hospitals:

    “More than 5,500 patients who had a severe heart attack in which the coronary artery was completely blocked by a blood clot, a condition known as a STEMI (or an ST-segment elevation myocardial infarction). In the U.S., most STEMI patients in the study stayed no more than three days in the hospital after their heart attacks. But in the 16 other countries surveyed – Canada, Australia, New Zealand, and 13 European countries — most patients stayed about twice as long—at least six days.”

    Suzanne O’Malley

  • (Comment from original source - Vetia) on Jan 05, 12 01:47PM

    Hi Carolyn,
    Most who see me would never believe that I had a weight problem but it happened at a very formative point in my life. True that that weight problem didn’t last more than six mouths, it was a real problem for me. Edema moved me from the under weight group to the normal weight group but I still feel myself as being too heavy.

    At the age of sixteen I was 4′ 10″ tall and weighed 73 pounds. I started getting sick and could not walk 15 feet without going to sleep, in 3 months I went from 73 to 139 pounds. The doctors never found out just what was the problem other then my metabolism stopped and I blew up like a balloon. I got out of school in June and slept until September, then my energy kicked back in and just as quickly as I gained the weight, I lost it, taking my my weight down to 78 pounds.

    At the age of 55, I stood 5′ 4″ and weighed 108 pounds. Edema took my weight up to 129 pounds, It is an uncomfortable weight gain and because it doesn’t look bad no one sees it as a problem.

    Vetia

  • (Comment from original source - John) on Jan 06, 12 06:36AM

    Massage Therapy is also a very helpful tool.

  • (Comment from original source - melissa ray) on Jan 08, 12 01:46AM

    I’m sitting in bed and have been up for hours. For 4 days I have been having upper right back pain and up to the neck. I cannot turn my head left. I thought that it was maybe just a pulled muscle. I haven’t been working out this week so I thought some how it happened in my sleep. Tonight I woke up with more severe back and neck pain and now pain in my elbow and a tingling all the way down my right arm and to my fingers. It hurts for me to try and get out of bed. Not having any chest pain. I’m only 29 and a healthy weight. I need some answers. Do I need to go to the ER?

  • (Comment from original source - Carolyn Thomas) on Jan 08, 12 05:06AM

    Typically, not being able to turn your head doesn’t sound like a heart symptom. This may or may not be heart-related – but at this point you just don’t know. If the symptoms do not ease up if you take a muscle-relaxant, call your doctor.

  • (Comment from original source - Elaine Schattner, M.D.) on Jan 08, 12 06:21AM

    Nice post, Carolyn. You’re right: a “lesson” from Groopman’s earlier book is that patients can help themselves by asking questions of their doctors – to make sure they’re thinking hard, actively and without prejudice.

  • (Comment from original source - Carolyn Thomas) on Jan 08, 12 06:31AM

    Thanks Dr. S – there seems to be a clear reluctance for many patients to question their doctors’ diagnoses (for many reasons). We need to get over that, pronto!
    Cheers,
    C.

  • (Comment from original source - cave76) on Jan 08, 12 07:50AM

    I think that Dr. Schattner is probably one of the doctors that DO think hard, actively and without prejudice, and there are some. I’ve been to a few but they’re hard to find.

    The answers to the three questions posed by Dr. Groopman are usually these, if the patient is a woman:

    “What else could it be?”
    Answer: Nothing. Depression can cause a lot of symptoms. Here, take this antidepressant.

    “Is there anything that doesn’t fit?”
    Answer: No. Depression fits everything. Here, take this antidepressant.

    “Is it possible that I have more than one problem?”
    Answer: No. But if you do, an antidepressant will help you.

    The doctor will then give you that cutesy little story that they all learned somewhere in med school about zebras and horses.

    Oh, Carolyn, you just opened the can of worms that’s in my brain about how some (many?) doctors treat people, especially women, and not just about heart problems. Shame on you. :)

  • (Comment from original source - Carolyn Thomas) on Jan 08, 12 08:16AM

    Sorry about that old can of worms, Cave. I met a woman at Mayo Clinic who told me she kept returning to the E.R. because of debilitating cardiac symptoms (but each time, she’d been sent home with a pat on the head and varying misdiagnoses). On her 3rd visit to the E.R., she was told: “Perhaps you should take an antidepressant”. On the 4th visit, she had double bypass open heart surgery.

    The key message here, however: SHE KEPT GOING BACK. She essentially kept saying to the docs: “I don’t care WHAT you say – SOMETHING is very wrong here!” Too many women (myself included) do not do this, for fear of being a bother, making a fuss over nothing, upsetting the medical experts, blahblahblah….

  • (Comment from original source - Ch411) on Jan 09, 12 03:39PM

    [...] Misdiagnosis: the perils of “unwarranted certainty” « Heart Sisters[...]

  • (Comment from original source - Dev) on Jan 10, 12 05:55PM

    Here in the UK, the NHS is notorious for this. People just have no respect anymore, no politeness. Oh well . . .

  • (Comment from original source - Carolyn Thomas) on Jan 11, 12 08:26AM

    Hello Dev – there may be many excuses for this lack of politeness, but no good reason for it.

  • (Comment from original source - Lora Frisch) on Jan 12, 12 01:27PM

    I was sent to a cardiologist for a stress test by my gp. He misdiagnosed my situation, he recommended me to someone else to put in a stent. The stent re-stenosed. I had another stent put in by another cardiologist. I should have asked more questions, but I didn’t even realize I should. I thought that what was presented to me with certainty was the truth.

  • (Comment from original source - Carolyn Thomas) on Jan 12, 12 01:46PM

    Of course you would, Lora. Why wouldn’t patients trust that what’s presented with certainty is indeed the truth. Yours is a good reminder to be educated about your own health, do your research, ask those questions, and become as informed a patient as you possibly can be.

  • (Comment from original source - All About Coffee) on Jan 12, 12 04:16PM

    [...] Take your pick: carrots, eggs or coffee beans [...]

  • (Comment from original source - Barbara Halbig) on Jan 13, 12 06:34AM

    Great presentation – a real eye opener!!! Thanks!

  • (Comment from original source - Carolyn Thomas) on Jan 13, 12 07:00AM

    Thank you, Barbara!

  • (Comment from original source - cave76) on Jan 13, 12 09:26AM

    That’s great that you were published in a magazine that will reach people who aren’t ‘actively’ searching for heart attack stories. It will put that seed into their minds and hopefully prevent a death.

    You wrote:

    “I was there for five hours, but believe it or not, everything came back normal”

    What other tests besides the EKG, treadmill tests did they do? For instance what blood or other tests? (If that’s too personal to answer, please excuse me.) It would be nice to know just WHAT a person should expect to be tested for ‘in case’ they’re in the ER with pains in the chest.

    What do you think of the Framington Heart Study?

  • (Comment from original source - Laura) on Jan 13, 12 09:42AM

    Congratulations, Carolyn! This is fantastic. You’re going to reach a lot of women with this article.

  • (Comment from original source - Carolyn Thomas) on Jan 13, 12 11:00AM

    Hi Cave – two cardiac enzyme blood samples taken one hour apart showed “normal” troponin levels during my first visit to the E.R. (“false negative” findings are not uncommon in women heart attack survivors, by the way, particularly for those of us with single vessel disease like mine = more common in female patients than in our male counterparts).

    Framingham? Since 1948, it’s been considered the granddaddy of all big longterm cardiac studies, but it may have limitations in accurately predicting women’s cardiovascular disease risks. For example, in a December 2005 study reported in the American Heart Journal, 98% of asymptomatic women whose sisters under the age of 60 had suffered a premature cardiac event were, according to the standard Framingham Risk Estimate, considered at “low risk” but 32% of these “low risk” women actually turned out to have coronary artery blockages.

    For women, there are also considerable sex-based risk factors that are entirely missing from Framingham’s focus, like family history, pregnancy complications (preeclampsia, gestational diabetes, miscarriage, low birthweight babies, preterm delivery), chronic stress, or sleep breathing disorders. And consider the mostly-female and mostly-deadly diagnosis of Spontaneous Coronary Artery Dissection that tends to strike young, healthy women with few if any cardiac risk factors. Framingham would have ‘passed’ these women entirely.

  • (Comment from original source - Carolyn Thomas) on Jan 13, 12 11:12AM

    Thanks Laura! I just found out that the venerable Ladies Home Journal has been around for 128 years! :-)

  • (Comment from original source - cave76) on Jan 13, 12 12:40PM

    Are older adults well‐represented in clinical trials?

    “Unfortunately, despite recent improvements, older adults are significantly underrepresented in clinical drug trials”

    ***Another study published in 2001 in the Journal of the American Medical Association found that the elderly are underrepresented in the clinical trials of acute coronary syndromes (ACS).

    Despite the fact that up to 60% of Myocardial Infarction (MI) deaths occur in patients 75 years of age and older and that elderly patients experience more MI complication including heart failure, shock, and ventricular rupture, the elderly are still under‐enrolled in clinical trials compared to younger individuals. This study found that between 1966 and 1990, only 19% of ACS trials enrolled any patients 75 years of age and older.

    During this time period, the elderly accounted for a mere 2% of all patients enrolled in these trials. Since 1990, enrollment increased to 9% and for those studies published since 1995 enrollment increased to 10%. Despite minor improvements, more than half of ACS trials published from 1996 through 2000 failed to enroll at least one patient 75 or older.***

    One reason, explained in this article:

    *Older adults are also unrepresented because the trials often have exclusion criteria that are most likely to affect older adults, such as exclusions for people who have multiple diseases and take multiple medications.*

    Well, that makes some sense—– because the mixing of different drugs/conditions does not make for a neat and easily defined ‘Conclusion’.

    So what to do?

  • (Comment from original source - Carolyn Thomas) on Jan 13, 12 12:57PM

    Thanks for this link, Cave – these appear to be the same kind of limitations that have excluded women from many cardiac studies (e.g. women’s fluctuating hormones might skew study results!)

    cheers,
    C.

  • (Comment from original source - Amelia Harnish) on Jan 13, 12 04:27PM

    Carolyn, thanks again for sharing your story with me! It really blew my mind that you were having symptoms for two weeks. It was eye-opening to have all of my misconceptions about heart attacks blown out of the water, and I hope our readers feel the same.

  • (Comment from original source - Carolyn Thomas) on Jan 13, 12 05:36PM

    Thanks for leaving a comment here, Amelia. You did a skillful job editing my (long-winded!) telephone responses to your interview questions in such a concise fashion for your Ladies Home Journal readers.

  • (Comment from original source - Best Gifts) on Jan 14, 12 03:57AM

    Hello there, You’ve done an excellent job here. I will personally suggest to my friends. I’m confident they will benefit from this gift list.

  • (Comment from original source - John RN. MT.) on Jan 14, 12 10:12AM

    I worked in Interventional Cardiology and it might surprise you to know that smokers have a higher rate of surviving a major blockage than non smokers. This is related to The fact that smokers have much better Collateral circulation.

    This is due to years of lowered O2 saturation. Most cardiologists would claim that the cigarette is what gave them the blockage. But it has been my experience that these patients had many other contributing factors.

  • (Comment from original source - Carolyn Thomas) on Jan 14, 12 10:46AM

    Hello John. This is the so-called “smoker’s paradox” theory. But as scientists like to remind us: “Correlation does not equal causation”. For example, the theory has also been attributed to the younger age, lower co-morbidity, more aggressive treatment, and lower risk profile of the smoker. A recent BioMedCentral journal review (August 2011) reported that the “smoker’s paradox” had been observed in some studies of acute myocardial infarction patients in the pre-thrombolytic and thrombolytic (clot-busting drug) era, whereas “no studies of a contemporary population with acute coronary syndrome have found evidence for such a paradox.”

    On the other hand, if you Google “benefits of smoking”, you’ll find approximately 185 million search results. Go figure . . .
    cheers,
    C.

  • (Comment from original source - Erika Perez) on Jan 14, 12 11:21AM

    Hello, I was reading your story and I found it very interesting. My name is Erika. Last year I had my baby boy who is 11 months now. Ten days after I had my baby I suffered a massive heart attack. During my post partum, I developed very bad anemia, I was having palpitations, dizzines, and nausea; my doctor told me it was due to the anemia, but it wasn’t the reason. I had a clot and a tear in one of my arteries.

    One night I put my baby to bed and was ready to go to sleep and a few minutes later I had the pain in my chest, and felt like I had gas and burping, pain in my jaw and down my arm. I ended up in the ER, stayed in intensive care for two days.

    I am so happy and blessed to be alive, taking care of my baby boy and my two daughters. My life changed completely forever. I really wish that there will be an article to educate pregnant ladies on heart attacks.

  • (Comment from original source - Carolyn Thomas) on Jan 14, 12 11:42AM

    Thanks for taking the time to tell your story here. Sounds like what you survived was Spontaneous Coronary Artery Dissection (SCAD). We now think that as many as 30% of SCAD cases might be seen in post-partum women. I’ve written about SCAD here and here.

    Have you applied yet to participate in two Mayo Clinic research studies on SCAD? Please check this out if you haven’t done so already.

    Good luck to you, Erika, and enjoy those precious little children of yours!

  • (Comment from original source - Erika Perez) on Jan 14, 12 12:16PM

    Thank you very much for the information. I Didn’t know about the SCAD, I will read more about this heart disease. I also want to know how to apply for the Mayo Clinic research. Can you please provide me more information? Thank you very much for reading my story.

  • (Comment from original source - Carolyn Thomas) on Jan 14, 12 12:28PM

    Erika, just click here and this link will take you directly to the Mayo Clinic SCAD website for more information. Or you can email Mayo researchers directly at: MayoSCAD@mayo.edu to ask any specific questions you may have.
    cheers,
    C.

  • (Comment from original source - Robert Brink) on Jan 15, 12 01:55PM

    Tenacious T, I will wager that you ate a lot of French fries and onion rings along with those steaks and cheeseburgers. These are fried in oils containing deadly trans-fats that cause inflammation and clog our arteries. You also probably drank a lot of soda pop and ate white bread, pasta and perhaps rice, and a lot of packaged foods that contain high-fructose corn syrup and vegetable oils that have been chemically treated, all of which also clog your arteries and cause inflammation. The steaks and cheeseburgers, except for the buns, contained health saturated fats and were not the cause of your heart attack.

  • (Comment from original source - Articles On Teaching) on Jan 15, 12 09:15PM

    [...] Year in review: top 10 Heart Sisters posts for 2011 [...]

  • (Comment from original source - Lynnie) on Jan 16, 12 08:01AM

    Great story! I could feel myself softening, hardening and ‘going with the flow’ as I read it. This will certainly make me be more conscious as I approach my day – especially the more difficult situations.
    love your blog,
    Lynnie :-)

  • (Comment from original source - Carolyn Thomas) on Jan 16, 12 08:12AM

    Thanks so much, Lynnie!

  • (Comment from original source - Leticia) on Jan 16, 12 05:19PM

    Erika, wow what an event to have to go thru with having such a tiny baby to have to take care of, not to mention your other babies. Its sad to think just how many women go thru something as dangerous and life changing as a heart attack (or anything as life threatening). I feel the same, it would be nice to hear that we arent alone in our challenges….

  • (Comment from original source - Weight loss on trial) on Jan 16, 12 08:40PM

    This one of the most difficult things about weight loss, seeing the foods we love and finding a reason to say no. Even if you try to reduce the number of cookies you eat each time you make cookies, it’s so easy to just grab one more, one more won’t hurt. But it always leads to another one and then the guilt of knowing you ate more than you should have. The only way to get through this is to say no completely and then reward yourself for saying no with something other than food.

  • (Comment from original source - Rebecca O.) on Jan 16, 12 10:20PM

    Another brilliant article! Thank you so much for writing this blog and sharing your story in Ladies Home Journal. I am so glad that you survived! You are amazing!

  • (Comment from original source - Carolyn Thomas) on Jan 17, 12 05:24AM

    Thanks Rebecca . . . :-)

  • (Comment from original source - Joy Hinsley) on Jan 18, 12 09:50AM

    I have been a nurse for 31 years, talked to people everyday about their health and medications, but when it came to my own health, I was always in denial. I would put off going to get check-ups, knowing in my heart and my knowledge of things that this was wrong.

    Then, BOOM – on 8-8-11 my day started out with heartburn after eating breakfast, stopped to purchase Tums, ate almost the whole roll, without much relief, I drove my route (100 miles) to visit my patients. By noon, I began having pain down both my inner arms, and that vise-grip pain in my frontal chest and left shoulder blade, s.o.b., and anxiety. I even called two of my nurse buddies asking them to say something to help me cry, I just thought I was anxious.

    Nothing worked, by 2:30 that afternoon, I was really in pain and knew deep down what I was experiencing, just still couldn’t accept it. My husband practically picked me up and threw me into the car to the ER. I was there only 30 minutes, the Dr. filled me full of Plavix and Aspirin – and off to the Heart Center I went.

    The nurse in me couldn’t stop looking at the monitors, watching my heart throw those PVC’s, and stressing even more. But I will say, I was so impressed with the heart team I had, I felt at ease when they took over my care. I had two 100% blockages that required two stents. Then, two-weeks later, had my first stress test, and failed miserably, found out that I had another 95% blockage (not life threatening), and two 30% blockages in smaller vessels. At the present I am completing ECP therapy, feeling some better, have not worked in 5 months ( I really miss that), but I have learned to take time for me, take care of me for a change, I also stopped smoking completely.

    I am trying so hard to stress less and to laugh more, and I know that being diagnosed with CHF will be my new goal to keep in check for the rest of my life, now my goals are to really live my life differently, take more moments for myself, and talk to other women about heart disease and the symptoms.

  • (Comment from original source - Carolyn Thomas) on Jan 18, 12 11:04AM

    What a story, Joy! Interesting that you needed your hubby’s insistence before you went to the E.R. Read Knowing & Going for more on why we sometimes won’t listen to our own inner voice, but may listen to others! Also, I hope you will participate in the Yale Heart Study to tell your story there, too.

    Good luck to you,
    cheers,
    C.

  • (Comment from original source - cave76) on Jan 20, 12 08:03AM

    Carolyn, you said ***This story has been told for over five years, and it deserves to be told again***

    And again and again. This story should not be forgotten, nor the many, I would imagine, like it, sans the homicide ruling.

    ****“The definition of homicide that I give to the jury is either a willful and wanton act or recklessness on the part of someone, whether that’s by their actions or by their inactions. Certainly, by that definition, this death is a homicide.”***

    What gives a doctor the right to get away with murder? Above the law? Why?

    Michael Chancey said:
    ***“After a careful review, it is the determination of this office that there is insufficient evidence to support the filing of criminal charges against any person or institution.”***

    Another “undetermined determination”?

    I’m aghast but, sadly, not surprised. Acts of omission can be just as dangerous as acts of commission.

  • (Comment from original source - Mary) on Jan 20, 12 08:37AM

    Carolyn – I have attached a clip from Wikipedia on the definition of FEMICIDE. The second to the last paragraph seems to reflect the generic proposed definition of Femicide.

    There is a positive to having this defined as Homicide, in that the definition of the act is generic to humans as defined by default of the male definition, however, Beatrice Vance was ignored (we suspect) because the institutional bias against women and heart disease is well entrenched into our medical education and system. It is not hate. It is research that was compiled from decades of incorrect research assumptions: women are just smaller men. It is changing, though. It is changing.

    Best, Mary
    ************

    “In addition, Diana Russell’s definition of femicide includes covert forms of the killing of females, such as when females are permitted to die because of misogynistic attitudes and/or social institutions. For example, when male children are valued more highly than females, many girls starve as a result of this sexist attitude. Hence, these deaths qualify as femicides.”

  • (Comment from original source - Carolyn Thomas) on Jan 20, 12 08:47AM

    Another tragic case last March in California resulted when a toddler was kept waiting for over five hours in the E.R. despite rapidly worsening signs of infection. By the time she was finally seen, the infection had spread so ferociously that she had to undergo a number of amputations to save her life. And last August, a Montreal woman filed a lawsuit against three local hospitals that had all missed her uterine cancer diagnosis, resulting in delayed treatment; by the time she underwent surgery, her cancer had progressed from stage 2 to stage 4. She claimed that the hospitals told her “the delays were due to a lack of resources and operating time”.

    Had criminal charges been laid in the Beatrice Vance case, it would have meant a catastrophic firestorm in every hospital Emergency Department, already described as “overburdened, underfunded, and highly fragmented” in an Institute of Medicine report.

    A systemic change has to happen to make things right.

  • (Comment from original source - cave76) on Jan 20, 12 09:13AM

    ****Had criminal charges been laid in the Beatrice Vance case, it would have meant a catastrophic firestorm in every hospital Emergency Department****

    But that firestorm is needed. Desperately. Not just in the ER but for all doctors and hospitals.

    **** every hospital Emergency Department, already described as “overburdened, underfunded, and highly fragmented” in an Institute of Medicine report.****

    I’m sure that’s true—- at least for the main part. But looking to the larger picture — should that excuse one preventable death (in the ER)?

    So I’m already into this ‘larger picture’ and come to this quote, attributed to many different people through the years.

    “…the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped. “
    Last Speech of Hubert H. Humphrey
    November 1, 1977, Washington, D.C.****

    Aristotle also chimed in, in his prequel ***you can judge a nation by the way it treats its most vulnerable citizens.***

    Now, I ask myself—– how is it that doctors and hospitals can ignore that—- again, ‘above the laws’ of government, ethics and morality.

    How do the ethical and moral doctors (of which there are many) try to counteract sweeping the detritus of the medical profession under the rug? What do (or can) they do? Is it like spitting into the wind?

    ****A systemic change has to happen to make things right.***

    Yes, but how? (Rhetorical, I guess.)

  • (Comment from original source - Stephanie) on Jan 20, 12 09:50AM

    Thank you Carolyn, for re-posting this story, one I’ve never forgotten! This actually happened near my hometown, so I will also be re-posting for Heart Awareness month.

    Have our efforts for early detection, proper diagnosis & treatment made a difference? Yes, I believe, we are starting to.

    But we have a long way to go. I have been “diagnosed” with panic or anxiety disorder more than I have a definitive heart disorder. From age 39, 6 heart events in 6 years. Just one year ago, I called 911, aware of my non-typical symptoms & convinced I had another blocked artery or closed stent. “We can’t find anything wrong with you….” as the story goes.

    Didn’t get to the cath lab for 24 hours. Yep, closed stent with complications. In fact I have NEVER been taken straight to the cath lab! On a positive note, I now meet with my hospital’s Chest Pain Committee 1x/mo, as a patient advocate, to help improve these outcomes!

    Steph Hammar, Colorado Springs, CO

  • (Comment from original source - Laura Haywood-Cory) on Jan 20, 12 09:55AM

    Thank you so much for re-telling Beatrice Vance’s story. I’ve told it and told it and told it myself but it bears repeating, so women with heart attack symptoms are taken seriously and not left to die alone.

  • (Comment from original source - Carolyn Thomas) on Jan 20, 12 10:15AM

    Thanks for your perspective Steph – unfortunately an all-too-common reality for many of us. This is fantastic that you’re now a member of your hospital committee! Go get ‘em!!

  • (Comment from original source - Carolyn Thomas) on Jan 20, 12 10:17AM

    This is the maddening reality, isn’t it? We need to get past the E.R. ‘gatekeepers’ in order to get to actual cardiac treatment. Thanks, Laura.

  • (Comment from original source - Carolyn Thomas) on Jan 20, 12 12:20PM

    Interesting: “…females are permitted to die because of misogynistic attitudes and/or social institutions…” As you say, this is NOT hatred of women, but merely an accepted “social institution”. Even the kind of heart attack I survived is what doctors used to call the “widowmaker” - which instantly tells you the gender of the only heart patients (male! of course!) who were supposed to experience it. Thanks, Mary.

  • (Comment from original source - The People's Health) on Jan 21, 12 12:41PM

    [...] link to HEART SISTERS [...]

  • (Comment from original source - Elaine Bedlion) on Jan 21, 12 08:18PM

    I too, am excited about this study! I shared my SCAD experience on the Mayo Study Blog and I am looking forward to being a part of the SCAD study if they can use me. I was wanting some feedback regarding another angiogram. My Dr. wants to repeat it in Feb. (6 mo post SCAD). I am a bit nervous as I know even the procedure can cause a dissection. I would rather get a CAT scan or ? Would appreciate feed back.

  • (Comment from original source - SCAD research) on Jan 22, 12 07:17AM

    Hi Elaine. I’m so glad you’ve found support and are interested in the Mayo SCAD research! Have you had a chance to call the study coordinator at (507) 255-0473? She can get you started with the process.

    I completely understand your concerns about a repeat angiogram. Have you talked to another cardiologist for a second opinion? It may feel strange or disloyal, but truly, you have every right to hear another professional’s opinion on something this important. We must be our own advocates.

    Also wondering if your cardiologist has referred you for other testing to rule out connective tissue disorders, such as Marfans and Ehlers Danlos, or a vascular disease called fibromuscular dysplasia (FMD) — these are conditions that may be related to SCAD. The testing for these include blood or tissue samples, and CT scanning, which as you say, is another non-invasive way to view your arteries.

    Perhaps your cardiologist would consider these options and create a plan that you’re more comfortable with. If you aren’t having symptoms, it seems like a conservative approach would give you peace of mind and reduce stress!

  • (Comment from original source - Laura) on Jan 22, 12 07:33AM

    Hi Elaine,

    Welcome to the SCAD club! I joined in March of ’09… this is my experience.

    I had my first catheterization 24 hours after being hospitalized (90-minute door to balloon time? Fuggedaboutit!). Their “this will only take around half an hour” turned into four hours, as they discovered my dissection and put in six stents.

    That night, after the cath procedure, my blood pressure dropped through the floor, and the night staff freaked out. They did a cardiac echo, more EKGs, and even an abdominal CT–to make sure I wasn’t bleeding internally. Which, as is turns out, I wasn’t.

    Ultimately, they decided that I was just incredibly dehydrated, and that was the cause of my plummeting blood pressure, so they moved the IV from my arm to my neck in order to get fluids into me faster. And voila, my blood pressure came back up to an acceptable, if still low, level.

    The doctors were concerned about what had happened though, so two days after that first cath and stenting, they went in and did another cath, to look around and make sure everything was OK.

    I can tell you that in the hospital, when they first explained to my husband and me that I’d had a SCAD, they didn’t give us any other info, really. What I knew about SCAD would fit into a thimble–a really SMALL thimble, at that.

    So I’ve had one angiogram after my SCAD, and as far as I know, that second one–which really did only last half an hour this time–didn’t cause any further problems.

    But that’s just my own medical history; everyone is of course different.

    Knowing what I know now, though, if my cardio said that he wanted to do another angiogram on me, I would speak up and ask about other diagnostic imaging options. And if he were open to talking to a SCAD expert, I would offer to put him in touch with Dr. Hayes.

    Also, if you haven’t yet, you might want to check out the WomenHeart message board over on Inspire; there are a lot of us SCAD survivors there, and most of us are vey open about sharing our stories and experiences, and answering questions.

    best wishes,
    Laura

  • (Comment from original source - julie) on Jan 23, 12 06:46PM

    I been feeling my heart beat fast every time I go up my stairs I can’t breath my lips been feeling numb and tingling my left arm gets swollen and numb I also have tacky cardia I been to the doctors and he said that I can still work I dont know what to do

  • (Comment from original source - Carolyn Thomas) on Jan 23, 12 10:05PM

    Julie, you need a second opinion, particularly if any of these symptoms are unusual FOR YOU (for example, tachycardia can often cause exercise intolerance, which could be “normal” for you). But left arm “swollen”? – not typically a cardiac symptom. Go get a second opinion.

  • (Comment from original source - Jen Thorson) on Jan 24, 12 06:25AM

    Thank you for this very informative history! What a tremendous amount of work. I really appreciate the information and resources.

    Jen

  • (Comment from original source - Carolyn Thomas) on Jan 24, 12 06:35AM

    Glad you found it interesting, Jen!

  • (Comment from original source - Lynn Wilson) on Jan 24, 12 04:45PM

    Great article. I took notes to have with me on my 1st visit to a cardiologist on Thursday. Thanks Carolyn for a great site!

  • (Comment from original source - Carolyn Thomas) on Jan 24, 12 05:28PM

    Good luck on Thursday, Lynn. Thank you for your note. :-)

  • (Comment from original source - Alana in Canada) on Jan 24, 12 10:33PM

    Interesting. Thanks for this. It helps to know that only three percent of people who are slim are in the “never think about it” category. 97% of us are in the same boat –whether fat or thin.

  • (Comment from original source - Mirjami) on Jan 25, 12 05:15AM

    Thank you for this great information, Carolyn.

    I looked in internet: the first bypass Op in Germany was 1969 in Erlangen. My triple bypass was 1983. I had luck to have such a good surgeon. This hospital had done only 2 years heart operations at that time. I would not have gone there, if I had known it. But I did not know like many other things about heart disease, which I know now. Afterwards I think, it was all to my best. I had been too anxious. What you do not know, you cannot be afraid of.
    How are you with your heart?

  • (Comment from original source - Carolyn Thomas) on Jan 25, 12 05:20AM

    Hi Mirjami – you are now a longterm survivor of your triple bypass. Congratulations! You’re right, most of us know nothing when we have our first cardiac event, and then suddenly we get the opportunity to learn A LOT! I’m doing well, thanks for asking.

  • (Comment from original source - Connie) on Jan 25, 12 06:25AM

    Oddly enough when I started my cardiac rehab a year ago it was vastly more women than men in the class. 10 people…9 were WOMEN! Poor old guy never knew what hit him lol. The youngest women were myself and another woman both 47, the rest were mostly in their 60′s and 70′s.

  • (Comment from original source - Jean) on Jan 25, 12 07:08PM

    Late for a response but BMI is often out of kilter for fit people because it is a calculation based on a certain percent of body muscle weight. Find a place where you can get a percent body fat test and that will give you a better sense of whether or not you are ‘healthy.’

  • (Comment from original source - Chris Corbit) on Jan 28, 12 09:10AM

    Thank you Carolyn for these 16 things. I need a bonk on the head to remind myself to take care of myself first. This is a great blog. You always provide thoughtful and intelligent information. Thank you,
    Chris

  • (Comment from original source - lauren) on Jan 28, 12 09:14AM

    Very good column Carolyn. Keep bonking us on the head!

  • (Comment from original source - Carolyn Thomas) on Jan 28, 12 11:30AM

    Okay, Lauren – I will! ;-)

  • (Comment from original source - Carolyn Thomas) on Jan 28, 12 11:32AM

    Yes, we all seem to need a reminder to take care of ME FIRST sometimes! Thx Chris!

  • (Comment from original source - Sandy Schmucker) on Jan 28, 12 02:29PM

    Thank you for the bonk on the head.

  • (Comment from original source - Carolyn Thomas) on Jan 28, 12 03:14PM

    You’re welcome, Sandy!

  • (Comment from original source - Susan D.) on Jan 28, 12 09:37PM

    Thanks for the reality check. Sometimes it gets confusing but this helps keep it in perspective.

  • (Comment from original source - Carolyn Thomas) on Jan 29, 12 07:50AM

    Thanks for your comment, Susan.

  • (Comment from original source - Laura) on Jan 29, 12 01:22PM

    After my heart attack, there were times that I joked about sounding like a two-year-old who’s just learned a new word: NO!

    It seemed like every time I turned around, I was having to take a firm stand and say “No,” and finally put my own needs first.

    Almost three years later, though, I find my self-discipline slipping and I need the reminder that NO is not a bad thing to say. Especially as someone born in the Southern United States–we Southern women are raised to be polite, to not talk back to our elders, to call people “Ma’am” and “Sir,” and one of the unspoken messages of that kind of upbringing is that it’s not polite to say “No.”

    Well, it’s not exactly polite to fall face-first into the bowl of potato salad at the church pot-luck, either, so NO it is.

  • (Comment from original source - Carolyn Thomas) on Jan 29, 12 02:06PM

    Laura, that image of you doing a face plant into the potato salad is not a pretty sight. So keep saying “NO!”

  • (Comment from original source - Campykid) on Jan 29, 12 05:23PM

    Carolyn, I’m fortunate not to have had a heart attack (just an A-fibber who’s had three ablations), but I really get a lot from reading your posts. Especially this one. It’s a reminder to appreciate what we can still accomplish. I’m not sure I’ll ever be able to forgive dismissive healthcare professionals, however. Any suggestions?

  • (Comment from original source - Carolyn Thomas) on Jan 29, 12 05:48PM

    Hi Campy – I’ve had both the most wonderful AND the most dismissive health care professionals, all at the same hospital – including the E.R. doc who misdiagnosed me with acid reflux in mid-heart attack and sent me home. It’s not so much that I’ve “forgiven” him as much as I’ve just decided to move on and focus on what I am able to control these days. I could stay justifiably pissed off at this guy forever – but that would not be good for my heart, right?

  • (Comment from original source - AussieGal) on Jan 30, 12 04:32PM

    I used to read Alexander’s Terrible, Horrible story to my children years ago, too. Thanks for bringing back this fond memory! It still has wisdom for adults, too.

  • (Comment from original source - Junie) on Jan 30, 12 05:15PM

    Congrats! Wow! Ladies Home Journal is a huge magazine!

  • (Comment from original source - Carolyn Thomas) on Jan 30, 12 05:42PM

    I still love that story too, AussieGal, especially since it doesn’t have one of those happily-ever-after endings – just like real life. :-)

  • (Comment from original source - Carolyn Thomas) on Jan 30, 12 05:44PM

    Thanks, Junie. :-)

  • (Comment from original source - Barbara Shine) on Jan 31, 12 11:16AM

    Hi Carolyn Thomas, I don’t know that sugar is so dangerous. I have to be more careful.
    Thanks B.

  • (Comment from original source - Paula Roberts) on Feb 01, 12 05:48AM

    Dear Carolyn,
    Your post inspired me to send a link to 4 dear friends & give them “homework” for our next date night. I requested they read the post & report which of the 16 things they are doing and which ones they are not. The menu of the evening is now “heart healthy” & you can be sure there will be lots of heart healthy wine being served!

    Seriously Carolyn, I look at my dear friends (all in their late 40′s and early 50′s) & their risk for heart disease is terrifying! I hope to be able to complete the assessment for each one of them or at least encourage them to go on-line & complete in private. Thanks for a thought provoking and motivating post.

    As the nurse in the group I am trying to lead by example & have successfully made some much needed changes in my life. Keep up the amazing work.

  • (Comment from original source - Carolyn Thomas) on Feb 01, 12 05:54AM

    Wow! I love your idea, Paula. Should make for an evening of lively discussion. Would likely work best, however, if each one does her own “assessment” (’cause nobody likes a list of their shortcomings handed to them!) Your heart healthy menu suggestion sounds perfect for Heart Month! Good job!
    cheers,
    C.

  • (Comment from original source - Rhonda) on Feb 01, 12 03:42PM

    I am 44 years old. I have been experiencing numbing of hand and arms, indigestion, fatigue and pain in my neck, shoulders and behind my left shoulder blade area. These symptoms are really scaring me. I went to my Dr. And he told me that I just had indigestion and that I was probably just sleeping wrong. I know that I have a heart murmur but I cannot get rid of the above mentioned symptoms. Any suggestions?

  • (Comment from original source - Carolyn Thomas) on Feb 01, 12 03:54PM

    Rhonda, these symptoms may or may not be heart-related, but at this point you just don’t know. Something is causing them – if it’s indigestion, what course of action is being recommended and is it working? Ask your doctor for a referral to a cardiologist. Be persistent.

  • (Comment from original source - Event Management Tales) on Feb 04, 12 11:27AM

    [...] to relate to. If most of your company consists of young females, invite a young female to speak. Here are a few survivor stories to give you a better understanding of what you can expect to hear. [...]

  • (Comment from original source - Icha) on Feb 04, 12 01:09PM

    As a graduate of the 2009 WomenHeart Science & Leadership Symposium for Women With Heart Disease at Mayo Clinic, my thanks for everything that you and all of our heart-sisters from that first class started and accomplished! Tomorrow I will be wearing red for myself and all of us.

  • (Comment from original source - Carolyn Thomas) on Feb 04, 12 01:31PM

    Thanks, Icha, for leaving your nice comment! Happy Heart Month!

  • (Comment from original source - Stephanie) on Feb 05, 12 02:26PM

    Another informative, invaluable piece, Carolyn – Thank you!
    I will re-post & utilize some ideas during my WomenHeart @ Work presentations this month! :-)
    Cheers!
    Steph Hammar

  • (Comment from original source - Carolyn Thomas) on Feb 05, 12 02:55PM

    Hello Steph – thanks for passing this info on to your workplace audiences. Good luck!
    cheers,
    C.

  • (Comment from original source - Judith Westerfield) on Feb 06, 12 03:40AM

    Great post. Thanks!

  • (Comment from original source - Lorraine McInyre) on Feb 06, 12 09:53PM

    The truth is this is cute but when you have a mountain of stuff to do in front of you and lots of house stuff to do it is not very funny. I did the same last week, I sat and cried with what I wanted to get done but cannot get myself up to doing it. I’m one month from surgery and I also have a lot of arthritis pain. Heart surgery doesn’t help that. I am hoping now that the holidays are over with I will be able to not be so tired and painful.
    Cheers, Rae

  • (Comment from original source - Carolyn Thomas) on Feb 07, 12 05:24AM

    Hi Rae – you are in VERY EARLY DAYS still. This is the post-op stage when all we want is to feel “normal” again, even when our bodies are clearly telling us to rest and recuperate instead. LISTEN TO YOUR BODY! – that “house stuff” will wait, believe me.
    Take it easy . . .
    C.

  • (Comment from original source - Margaret Pearce, UK) on Feb 08, 12 03:42AM

    Excellent informative site – I’m so glad I stumbled across it whilst looking up the difference between indigestion and heart problems!

  • (Comment from original source - Carolyn Thomas) on Feb 08, 12 04:58AM

    Thanks Margaret – welcome to Heart Sisters!

  • (Comment from original source - Physician List) on Feb 11, 12 04:50AM

    This is really helpful. I have read as well the other article in this website about how it really feels to have heart attack and I find myself really taking down notes; this is because I don’t want to lose a loved one because of a heart attack. Thank you so much for sharing.

  • (Comment from original source - Laura) on Feb 11, 12 09:28AM

    I haven’t even read past the first paragraph yet, Carolyn — I’m laughing too hard!

    Also, what planet does this person live on, where doctors have a laser-like focus on women’s heart health? Because that’s a planet I’d really like to live on, and so would millions of other women.

    Still laughing,
    Laura

  • (Comment from original source - Carolyn Thomas) on Feb 11, 12 06:05PM

    Yeah, I’d be happy to just go VISIT that planet of his . . . ;-)

  • (Comment from original source - quilterlynn) on Feb 13, 12 09:15AM

    Good Carolyn! Put on my FB page!

  • (Comment from original source - Carolyn Thomas) on Feb 13, 12 10:03AM

    Thanks Lynn! :-)

  • (Comment from original source - Ava) on Feb 16, 12 02:24PM

    As matter of fact they eat a lot of bread and potato in the Eatern Europe, specially in Ukraine and Russia. In the past it was difficult to get anything else, so it was bread for breakfast, lunch and dinner eaten with soup, salami, bacon.

  • (Comment from original source - Violet) on Feb 16, 12 10:32PM

    It happens to a younger population too so that’s where it is connected to the thinking that nothing really happened and it tells that our way of life needs to be changed, for the better and if possible. That’s what I get from this video and we need a way to have healthier and more fulfilling life in order to prevent any disease from happenning in the first place. But, we’re not living in the ideal world and we have to go to work, have some nice amount of stress there, eat whatever is available if we have time to eat at all, and keep up with all the bills and troubles at home. So, it can be quite hard to, for example, quit smoking and live healthy in such life I guess?

  • (Comment from original source - kaylen) on Feb 17, 12 09:29AM

    I had an angioplasty last year for unstable angina that was found to be a 99% blockage (LAD), so it wasn’t optional and I did talk to a heart surgeon at the time to see what he recommended – though I was a bit drugged up by that time. When I first met with the cardiologist and learned of my issue, I was in a panic over the procedure and my cardiologist kept insisting there was no reason for me to be upset and angioplasties are very common, they do them all day, low-risk, etc.

    I was all alone and crying nonstop for about an hour before they started the procedure and he didn’t think anything of my anxiety, just kept insisting that it was going to be fine and I was over-reacting.

    I have a new cardiologist now. But I’m a bit surprised to read of the risks involved, as these were not presented to me when I was being admitted for an angioplasty. They made me feel like it was the same as having a root canal really, but less painful.

  • (Comment from original source - Vetia) on Feb 17, 12 10:23AM

    Hi Carolyn,

    I understand that a patient with a 70-80% blockage may have equal footing with just using medication with stable angina and their outcome being somewhat the same as those having angioplasty and stent. Very good research “IF” you are stable, the operative word being stable. I can see a doctor taking time with a patient in this condition.

    In saying that, I know of no medication that works right away. They can give you something to break up a clot, but I know of nothing that can instantly remove plaque or make a collapsed artery open. Nor of a drug that will make it stay that way until the heart heals. I fully understand the need for all of this research but at what cost. Something of this nature doesn’t effect just those with a small amount of blockage but it will effect us all. I truly understand that there is always a margin for error, and that we have doctors that are only in it for the money. Btu it has always been my understanding that ruling on things of this nature hurts the good as well as stops the bad.

    I had been suffering an AMI for just about twenty four hours. I fully understood what my cardiologist was saying, the thing that threw me off was my having a HA. I didn’t just have a HA, I died and I am now living with CHF but I am living. I never want a doctor to have to think on if I truly need this form of treatment or if a tiny piece of chicken wire will save my life.

    True I didn’t know all about a stent at that point but that was not a time to go into a discussion about the stent. Sometimes we have to trust and I do mean TRUST someone other then ourselves. Heart medicine is not an exact science and no one is perfect. But I want you to look at the stent in terms of science.

    Chicken wire/stent both are metals. One is outside in the elements, the other inside a blood vessel. The man who sold you the chicken wire can not tell you that over time that the chicken wire will not deteriorate, there are corrosive elements in our air that will cause it. Common sense should tell you that no one can put a wire in your heart and tell you it will last forever, your blood contains far more corrosive elements than does the air. Your own antibodies are attacking it on a daily bases and each time your heart beats your artery constricts around it. All any of us can do is follow orders for maintaining it as long as possible. I am fully aware that if I live long enough I will have to under go bypass surgery. All any of your doctors are doing is teaching you how to maintain your stent so that it is later and not sooner. Simple high school science.

    Robin

  • (Comment from original source - Carolyn Thomas) on Feb 17, 12 12:06PM

    Only a physician who has never actually been in your shoes (or rather in your flimsy hospital gown) while experiencing frightening cardiac symptoms would ever dare to describe your response as “over-reacting”. See more info about this very common problem of doctor-patient miscommunication at: “Do Patients Really Hear What Doctors Are Telling Them?”

    You make a good point here, Kaylen, about the difference between “stable” (symptoms come on with exertion, go away with rest) and “unstable” angina (symptoms come on more frequently, more intensely and even when at rest). Current practice guidelines do not recommend angioplasty/stenting for treating stable angina.

  • (Comment from original source - Carolyn Thomas) on Feb 17, 12 12:31PM

    Hi Robin – please read my response to Kaylen for the definition of “stable” vs “unstable” angina. My (limited, patient-only) understanding is that the degree of blockage does not necessarily define stability.

    Clot-busting drugs (called thrombolytics) are actually demonstrably effective in dissolving clots in coronary arteries. For example, an analysis of the National Registry of Myocardial Infarction found that women treated with the clot buster tissue plasminogen activator (tPA or Activase) were twice as likely to survive compared with those women studied who had not received clot busting drugs.

    You might also be interested in the work of cardiac researcher Dr. Rainer Hambrecht of Germany on the superior protective role of regular exercise vs angioplasty for heart attack survivors. In his 2004 study published in the journal Circulation, he found:

    “Nearly 90% of heart patients (non-angioplasty) who rode bikes regularly were free of heart problems one year after they started their exercise regimen, compared to just 70% of patients who were problem-free after undergoing coronary angioplasty instead of exercising.”

    In 2009, Dr. Hambrecht presented findings from his five-year follow-up research to the 2009 European Congress of Cardiology meetings, confirming his earlier results that regular exercise training is superior to angioplasty at preventing subsequent cardiovascular events. He said at the time:

    “It’s difficult to convince people to exercise instead of having an angioplasty, but it works.”

    More on this at: “What Prevents Heart Disease Better Than Any Drug?”

    Also, I believe that it’s counterproductive to say things like “I died”. No, you did not die, or you would most certainly not be reading these words right now. You did survive an acute myocardial infarction – congratulations!

  • (Comment from original source - Carolyn Thomas) on Mar 04, 12 02:22PM

    Thanks so much for your kind words, Lynn. Your mother must have died at a relatively young age. I was just reading this yesterday: “We may have lived enough years to be an adult, but we will always be a child in relation to our parents. Even if we find ourselves ‘parenting our parents’ before their deaths, it is the parent of our youth and childhood that we bury.” Isn’t that the truth?

    BTW, If I took your friend’s good advice, I’d have nothing in my fridge but liver and brussels sprouts.
    hugs
    C

  • (Comment from original source - Karinne) on Mar 04, 12 04:39PM

    Brilliant. Sums up perfectly what our family experienced last fall after my dad’s death, we just could not seem to stop these crazy cravings for sweet and starchy comfort foods. Luckily for our heart health and our waistlines, they did not last long and we soon got back to “normal” eating. Funny thing was that my father had been a lifelong health nut – he would have been very disapproving of our sudden crazy menu choices.

    My condolences to you on the passing of your mother. Sweet photo of her and her Easter “paska”.

  • (Comment from original source - Carolyn Thomas) on Mar 04, 12 06:49PM

    Thank you for your comment, Karinne. It seems that “bereavement eating” may indeed be a common phenomenon. I too love that happy picture of my mother.

  • (Comment from original source - Treating Scoliosis) on Mar 07, 12 02:47PM

    People deal with sadness and stress differently. While some eat more, others eat much less. While it’s sometimes hard, it’s important to be aware of how we are treating our bodies during difficult times.

  • (Comment from original source - Carolyn Thomas) on Mar 07, 12 04:28PM

    Quite true. I was very aware – I just didn’t care.

  • (Comment from original source - lauren) on Mar 08, 12 02:21PM

    Oh boy, does this hit a nerve with me! I have endothelial dysfunction with no risk factors for heart disease and recently had surgeries to repair an aortic aneurysm which could only be explained as a cellular weakness there since birth.

    I have no heart disease, live(d) a very healthy life and there is no “fix” for my dysfunction. When I encounter people (and there are so many) who have the option of improving their heart disease by making healthy life style choices and still carry on the old path, I see red, no pun intended.

    How do we convince a culture that has come to depend on instant everything – from food to gratification to cures – that ultimately we are responsible for our choices? Why is it acceptable to sue McDonalds or the tobacco company when your choices produce unwanted consequences? Some days I struggle to walk 2 blocks and I love exercise so I know that change is hard, but I believe that too many people have embraced the idea that when something is too hard just don’t do it.

    I continue to live healthy because even though it won’t reverse or cure my condition it helps me manage my symptoms, boosts my overall health and will enable me to really “live” my life for longer.

  • (Comment from original source - Carolyn Thomas) on Mar 08, 12 05:03PM

    Thanks for your comment, Lauren. You ask some important questions – I don’t know if we have any answers to them yet, however.

  • (Comment from original source - Go Girl Magazine) on Mar 08, 12 10:14PM

    [...] Some women experience gaslighting when actually in mid-heart attack (You can read the article from HEART SISTERS [...]

  • (Comment from original source - Deborah Walker) on Mar 12, 12 11:33AM

    Carolyn – This has nothing to do with your current post, so forgive me, but I’ve just read an article recommended by a friend on FB. Here’s the link.

    I’m interested to know what you think about it.

  • (Comment from original source - Ashleigh Folks) on Mar 12, 12 11:40AM

    Don’t trust people. They’re able to greatness. There isn’t any tips for success. It does not take response to preparation, efforts, and gaining knowledge from failure.

  • (Comment from original source - Carolyn Thomas) on Mar 12, 12 12:29PM

    Hi Deborah, yes, I’m familiar with this article. Inflammation is widely considered to be one of a number of likely culprits in heart disease, although Dr. Lundell’s illustrations seem a tad extreme.

    It may also be relevant to note here that in 2008, the Arizona Medical Board revoked Dr. Lundell’s license to practice medicine, the fifth of five previous regulatory actions the Board had taken against him. Always helpful to “consider the source” in All Things Scientific.

  • (Comment from original source - Jodi) on Mar 12, 12 01:36PM

    Last fall at 42, I survived the “widow maker”. I was in the cath lab within about 55 minutes of the onset of symptoms. I was extremely embarrassed to call, but if I hadn’t, I would be dead. Because of the quick timing, I was fortunate to have very little permanent damage. Always call!

  • (Comment from original source - Carolyn Thomas) on Mar 12, 12 01:48PM

    Great advice, Jodi! Your quick response time is a good role model for the rest of us – 55 minute “door to balloon” time is awesome. Stay healthy…

  • (Comment from original source - Vetia) on Mar 12, 12 08:25PM

    Hi Carolyn,

    I didn’t wait, I have asthma and I was having the symptoms of an asthma attack. My doctor told me that when I woke unable to breath to just use my inhaler, something in my head told me not to, that something was wrong. I waited from 1am until 7am to call 911 and no one answered. I got my sister to take me, had I listen to my doctor I would not be here. I have massive heart damage.

    Robin

  • (Comment from original source - Carolyn Thomas) on Mar 12, 12 09:11PM

    Robin, it sounds like you DID wait – at least six hours before making that 911 call.

  • (Comment from original source - say6amaka) on Mar 13, 12 01:44PM

    I read interview and I think. That you are one lucky woman, you are also lucky that your family and friend’s gave you all the support that you needed, am sure that this recipe that you have given out most be great.

  • (Comment from original source - Carolyn Thomas) on Mar 13, 12 02:26PM

    PS Jenn – just got an email from a reader who suggests giving a light spray of Pam or something similar just before baking to give a shiny and slightly “crispy” touch.

  • (Comment from original source - Vetia) on Mar 13, 12 05:32PM

    Carolyn, my doctor said it was asthma and not my heart. I was told to use my inhaler to relax my air ways. When I used the inhaler I would fall into a deep sleep, I didn’t use it that night and yes I waited. Asthma isn’t an emergency.

    Robin

  • (Comment from original source - Katherine) on Mar 14, 12 06:16AM

    I feel similarly about “new normal,” a phrase so many heart attack survivors use as a benchmark of recovery. Just the idea of it mourns the loss of a state of being that may or may not reflect who we are (or were). The “new normal” implies a negative state that the patient is forcing herself to embrace.

    Acceptance of ourselves “warts and all,” as you say, is a lifelong challenge in itself!! Surviving a heart attack definitely heightens our awareness of who we are and how we want to live.

    As always, enjoyed your thoughts, Carolyn, and insights of Dr. Holland.

  • (Comment from original source - Carolyn Thomas) on Mar 14, 12 07:05AM

    Thanks Katherine,
    For me, “new normal” is actually an accurate term to describe my life now compared to my life, BMI (before heart attack). There is no doubt that what I’m able to do now is far different, so “new normal” is not so much a benchmark of recovery, but a simple statement of reality. I could grieve those daily losses (and admittedly sometimes do!) but it seems healthier (physically, mentally, emotionally) to just try to accept this “new normal” – as Buddhists say: “What is, is.”
    cheers,
    C

  • (Comment from original source - Pharmacist) on Mar 16, 12 07:29PM

    I had exactly this dx with my first pregnancy too – never gave it another thought once Baby #1 was delivered,everything just fine afterwards. Well until my STEMI/double bypass surgery 22 years later that is. None of my cardiologists even asked about my pregnancy history. Thx for this, I’m going to folow up more on this important and under-appreciated topic.

  • (Comment from original source - Outlet Gal) on Mar 17, 12 03:10AM

    This made my day. I am DEFINITELY happier now than when I was 18. Would not turn back the clock, no sir!

    Thx for this, Miss Carolyn. Wonderful perspective here esp for all of us aging boomers. You’re as young as you feel, right? Love your site here!!

  • (Comment from original source - airedalelover) on Mar 17, 12 07:02AM

    Good for you.

    I had the opposite experience with my dentist and his hygienist. They are honestly interested in me, how I am coping with a bad cancer diagnosis and treatment. They are so careful not to cause any pain or discomfort unless necessary (even numb my gums before a novicaine shot or rub something on gums before cleaning). They see ME when I am there. I am more than grateful to them, they soothe my soul.

  • (Comment from original source - Carolyn Thomas) on Mar 17, 12 07:14AM

    Your experience is just as it SHOULD be for all of us, isn’t it? Your dental staff are role models for other health care providers.

  • (Comment from original source - Carolyn Thomas) on Mar 17, 12 04:30PM

    Thank you Outlet Gal – yes, in more ways than one, apparently!

  • (Comment from original source - Mirjami) on Mar 18, 12 03:37AM

    Oh Carolyn! It is terrible to have such experiences.

    My dentist is an angel. He always asks me at first: How is your heart? Have you got new stents? He makes the hygienic procedure himself once a year in my case.

    But not all doctors and nurses are so nice.

    We have a cardiac center about 20 km of here, but I refuse to be brought there once again having had 9 days of rude and unfriendly nurses. As I had my heart attack because of a stent thrombosis 4 years ago, the ambulance came, wired me with EKG and wanted to bring me to this nearest cardiac care, because it is the usual practice. I cried: “I do not go to this hospital. They are so unfriendly and terrible. I prefer to die than go there.”

    The doctor in charge looked at me as if I were a fool. My hubby said them: If you do not bring my wife to the cardiac care she wants to go, you can took all the wires away and I bring her myself to the other hospital. The problem is that the the doctor has to order a helicopter to bring me to my favourite hospital, because it is over 100 km away from our village. This has been the case 3 times.. Till now we have always won. But it has always been a matter of dispute.

    Usually my hubby brings me to my cardiac hospital 100 km away from here, when my family doctor orders it. I have only to go to my family doctor and say that I have unstable angina. The cardiac hospital is one of the best in Germany and I am happy to be a patient there.

    In the case of a heart attack ( when I think it is one) we have to call the ER and this has always been a great dispute. I hope I will never bee alone at home and have to call ER.

    AT the moment I have no problems with my heart and I am very happy about it.

    Greetings.
    Mirjami

  • (Comment from original source - Carolyn Thomas) on Mar 18, 12 06:31AM

    Hello Mirjami – I’m so glad your heart is doing well these days. Having to debate where the ambulance should take you must be horribly stressful in the middle of already stressful cardiac symptoms. Most patients just go where the nearest hospital is, despite the quality of care.
    Thanks for sharing your perspective here.
    C.

  • (Comment from original source - Healthy Heart and Living) on Mar 18, 12 02:29PM

    I was excited to discover Heart Sisters. I wanted to thank you for this wonderful read!! I definitely savored every little bit of it and I have you bookmarked to check out new stuff in your heart site.

  • (Comment from original source - Sharecare.com) on Mar 19, 12 08:49AM

    [...] For more on this, read How Does It Really Feel to Have a Heart Attack? Women Survivors Tell Their Stories. [...]

  • (Comment from original source - Campykid) on Mar 19, 12 07:31PM

    Right-on Heart Sister! I’m fortunate that my dentist and his assistants know me well and focus on my care while I’m in the chair (hey-that rhymes!). However, I’ve had some absolutely awful experiences with cardiologists.

    -While taking my history (the first one I’d ever had with a cardiologist), the Dr. interrupted, telling to be quiet and let him talk.
    -In preparation for a trans-esophageal echocardiogram, the same doc smirked and giggled when I gagged.
    -An electrophysiologist allowed a doc into the exam room to chat about another patient and then took a phone call from someone else.
    -The same electrophysiologist called to scream at me after I ended-up in the ER upon being overdosed on warfarin post-ablation.
    -After I told my primary care physician about the smirking, giggling cardiologist, the cardiologist cancelled a pre-procedure appointment at the last minute and then fired me at the rescheduled appointment. Hilariously, one of the things he said during his 20 minute rant was that I shouldn’t tell my friends how he’d disrespected me.

  • (Comment from original source - Carolyn Thomas) on Mar 19, 12 07:39PM

    Campy, the part that disturbs me about this list (more than the screaming, the smirking, the giggling) is: “…allowed a doc into the exam room to chat about another patient and then took a phone call from someone else.” A perfect example of the patient as merely an invisible piece of meat on a slab…

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