Monday, June 27, 2011

Whatchu Talkin 'Bout?

We've all heard the warnings:  "heart disease in women ...." or "heart disease in African-Americans ..." or "African American Women have a greater chance of dying from heart disease than .... or the ever popular "heart disease is the number two killer behind ...".  WTH?   What exactly does that mean?   Am I going to have a heart attack tomorrow?  Are my genetics and/or lifestyle putting me at high risk for coronary heart disease?  My arteries are clogged?  Double, triple, quadruple by-pass?  Congestive heart failure.  Valvular heart disease?  Cardiomyopathy.  Murmurs.   Mitral valve prolapse.  Whatchu talkin 'bout doctor?

If your doctor uses the term "heart disease", then "whatchu talkin 'bout" definitely needs to be your follow-up question.   "Heart disease" is a term that covers a multitude of diseases that affect the heart.  In my opinion, as a cardiac patient, it really doesn't tell you anything.  The causes, treatments, recovery rates, all differ depending our your diagnosis.   Yes, there are some treatments that apply to virtually any heart disease such as low sodium/fat diet, consistent exercise, no smoking, limited alcohol consumption.  That applies to everyone and is it really heart disease specific?   No.  That's just common sense recommendations that so many of us refuse to follow until "heart disease" is thrown into the doctor's vocabulary when discussing the results of your physical.

My cardiac rehab group consists of about 12 people now (we had some graduates) and I'm amazed at how different all of our diagnoses are.  Yet, we're all following the same program.  Of course, we have different medications but part of everyone's recovery is to get consistent exercise, eat a heart healthy diet, and learn to cope.  Some of us are doing better than others with that coping thing but that's another post.

So what do you need to ask the doctor?  You need to know the specifics of your particular heart disease for one.   I knew I had rheumatic fever when I was a kid.  I knew I spent a long, long time in the hospital with it.  I knew it left me with a murmur and I knew I had to take antibiotics before dental work.  I'm ashamed to say that's all I knew for sure from a pre-teen until a few weeks before my first surgery.   Keep in mind, I was initially diagnosed during a time when doctors didn't share a lot of specifics.   I know my mother was told to let me do what I felt like doing (no restrictions) so I did.  I swam, played volleyball, rode a bike, attempted basketball (I totally suck) and took my antibiotics before dental work.   I was doing fine with an annual EKG and that's about all it took for years.  I should've picked up on something different when they started wanting to do echos (echocardiograms) but I just assumed technology kept changing so they were using it.

Now we mere mortals have access to a lot more information.  It is up to us to make sure we fully understand any diagnosis we receive from our doctors.  Ask questions until you do.  Then do research from a reputable medical web sites about your specific diagnosis and prepare more questions for your next visit.  Side note:  be really, really careful about reputable web sites.  I usually go with my local hospital and other well known national hospitals' sites as a start.  Never, ever self-diagnose using Web MD (no shade).

If your doctor prescribes medication, make sure you understand why you're taking it, when you're supposed to take it, do you need to avoid any foods -- yeah all that stuff the pharmacy prints out that often gets tossed in the trash.

Then make sure you know what symptoms the doctor wants you to inform them about.  I had been having "flutters" for weeks and just "happened" to tell my cardiologist about them on a follow-up visit.  I just thought I was having anxiety attacks.

It is up to all of us to partner with our doctors and do our part to help him/her manage our health.   That should the standard with any chronic illness we may, unfortunately, be diagnosed with; but because heart disease is such a far reaching diagnosis, it is particularly important to know all you can find so you can participate in your care.

So if the doctor says you show signs of heart disease, you say, whatchu talkin 'bout and pull out your notebook.  

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