Maybe the health-care system should coin a name for it: the baby boomer special.
In the past few weeks, several people I know, including, on separate occasions, both my husband and myself, have visited hospital emergency rooms because of chest pains and other symptoms that suggested a possible heart attack (instead of, say, indigestion, stress and unpaid bills).
My troubled-heart excursion took place on a sunny Sunday. After explaining that I felt alternately a heaviness in my chest and heart palpitations, I was whisked through an EKG, blood work and a chest X-ray. Three hours later, the doctor deemed my heart “perfect.”
That should have been reassuring except, of course, for all those stories you hear in which someone is pronounced “fit as a fiddle” and dies an hour later on the golf course. (Thank God I don’t golf.) Finally, though, after the doctor added “feel free to come back if you have these symptoms again,” I went home, relieved. She also told me to drink less coffee.
The next visit, a few weeks later, involved my reasonably fit husband, who woke up for the second morning in a row with chest pain and shortness of breath. His visit lasted 10 hours at a downtown hospital and, after initially being cleared by the same diagnostic procedures, he was told to get dressed and wait six more hours in the TV lounge for a second blood test to confirm there had been no heart damage.
To avoid going stir crazy – and with the doctor’s awareness – we finally went for a stroll and walked back through the Bay, where I persuaded my husband to buy a very nice orange polo shirt on sale for 20 bucks. We were both appalled and amused that we were shopping in the middle of a possible heart attack.
Again, all turned out well – we even spent the last hour chatting about Iranian politics with a fellow boomer who was also there for chest pains. He was cleared for takeoff around the same time my husband was. The two men were told to follow up with their GPs, take an aspirin a day as an extra precaution to avoid blood clots, and get a stress test.
Here’s the issue: There’s been so much good public education about the possible signs of a heart attack that it seems many of us are taking all our twinges, well, to heart. But especially at a time when the overall statistics on heart disease show a marked decrease in heart-related deaths, are we overreacting and needlessly overloading the system?
I called a friend who is chief of medicine at a Toronto hospital to ask if we’d done the right thing, and I couldn’t even finish my question before he answered: “Yes” Is there ever a time to stay home ? “No”
“People die staying at home thinking they have heartburn,” said my friend. “You can’t play doctor , you will be wrong. You don’t have the tools or the objectivity. If it’s heartburn, c’est la vie.”
Of course hospitals take middle-aged chest pain seriously – they play the numbers game, and every statistic shows that as you grow older your chances of heart disease or a sudden heart attack increase. Just two generations ago, my paternal relatives were dropping dead in their 50s. My father died relatively young of a heart attack. So I’m glad to see that after much re-education, the medical profession is starting to treat women as aggressively as men when it comes to heart disease. Good thing, given the news this week that, for the first time, more Canadian women are dying of cardiovascular disease than men.
Calgary cardiologist Eldon Smith, a former dean of medicine at the University of Calgary, wasn’t all that reassuring when I spoke to him about baby boomers and chest pains. Diagnosing heart disease is such an inexact science, he told me, that “cardiologists can find no evidence of heart disease and a patient can still die within two months.” Oh, great.
As for those stress tests – I had one and aced it – Dr. Smith says he has heard of doctors who gave patients full cardio workups, including a stress test, declared them fine “and the patient dies before leaving the laboratory.” Stop, Doc, you’re killing me.
Of course, there are facts that will tell the examining doctor a lot, including what you were doing when you first felt the pain. “If you were walking quickly uphill and the pain was there, but it subsided when you stopped, that’s pretty good evidence” that there may be underlying heart problems, Dr. Smith said.
He recently led a steering committee responsible for developing a new strategy to fight heart disease in Canada, and is more interested in drumming heart-healthy lifestyle practices into all of us, including being physically active, not smoking, maintaining a good weight, eating fruits and vegetables and less salt, regularly checking cholesterol levels, and – if you’re over 50 – taking an aspirin a day.
Okay. We can do all that. But because there is nothing more anxiety-provoking than thinking your heart is about to crash, we may be back in the emergency ward again. The most reassuring thing of all is to know we will be taken seriously.
In the meantime, it’s back to indigestion, stress and those unpaid bills.
Article by Judith Timson first published in the Globe and Mail on June 27, 2009.