Lessons of Heart Disease, Learned and Ignored

Re: Lessons of Heart Disease, Learned and Ignored


This is the thing that, to me, stands out the most. I think a lot of us see how much 911 has been abused so we think, oh, we don't need it. Sad.

I'm still more than glad that mother's friend, who found her after an heart attack, had read similar in our local paper, more than six years ago now.

So she called the ambulance (and an emergency doctor) at first before calling us.

Getting an ambulance and getting proper care, once you arrive at the ER for your heart attack may be two very different things.

An adult female went to an ER in the Boston area ( a major hospital) and complained of chest pain and stated that she thought she was having a heart attack. She was evaluated and tested and was then told she wasn't having a heart attack.
She was then sent home.

She walked to the exit doors of the ER and as she passed through the doors she suffered a massive heart attack and died right there
on the ER floor.

Her family is now suing the hospital.

The emergency dodctor comes to your home here (in a different emegency car to the actual ambulance).

Shouldn't patients with heart problem have their exercise program be approved by a gym teacher or something like that, to avoid strain on some types of muscle? I read that the doctor said that if he had taken his drug, there would not have been a problem, but still, I think some caution should be followed.

Some people seem to have had minor strokes without even knowing it, probably because the symptons were not strong or different enough to recognize. I was told that if your sternum hurts, then it would be a serious sign.

Could you please comment more on this, Miller?

I think doctors may be reluctant to tell patients that they would have to take drugs for the rest of their lives not to discourage them to take them, especially to start taking them. Also, they don't really know what would happen in the future, maybe after years of treatment, the patient gets better and can stop taking the drugs. They want to leave the door open to hope, maybe someone will find a better treatment. But I think certain drugs, once you take them, your body gets so used to them, there is no way to stop taking them without incurring risks. I don't know if your doctors explain carefully to you the consequences of stopping taking drugs in the middle of treatment.

I read in another thread about someone stopping taking an antibiotic for an ear infection after a few days. I was really surprised by that as I have been told that antibiotics should be taken for all the 10 days even if one feels better, otherwise they don't work and they may cause side effects. The only exception is if you become sick or allergic to them, then you should tell your doctor to prescribe another one.

After the first few days, often the annoying symptoms of a disease abate, and the patient thinks that the illness is controlled. That is a misconception. The bacteria have not all been killed, and stopping the medication may just promote a relapse of the illness.

Miller- I had a friend who had a lot of heart disease in her family, with early deaths. Her dad (who may have been in his fifties, at the time) faithfully went to the cardiologist, who gave him a clean bill of health, and told him not to worry. The last time that he went, he dropped dead on his way out the door.


If a person lives in a big city, he should determine which hospital, which is in a reasonable distance from one's home, has the best reputation in dealing with heart attacks. My husband and I both know, that if either of us get into trouble, not to go to the local hospital, but to the one that is about 20 minutes away, in the city.

You can check out the quality report for a hospital here:

http://www.qualitycheck.org/consumer/searchQCR.aspx

It might be a good idea to buy the house that's right next door to the good hospital!

:wink:

Antibiotics:

Rules about duration are shifting! Now, one idea is to up the doasge, but us the antibiotic for a shorter period of time , three days vs 10 days.

Time will tell which approach is correct.

Even for children, Miller? That's pretty heavy to take antibiotics worth for 10 days in 3. If you are allergic to it, it may cause serious problems.

one thing i've learned recently is that the best way to get into ER quickly , is to call what in ontario is called "tele-health-nurse' , which is available 24 hours a day free-of-charge .
mre h become quite sick overnight - reaction to a drug , as it turned out and not life-threatening .
i phoned the "tele-health-nurse" , explained the symptoms - which she correctly diagnosed - and an ambulance arrived within less than five minutes to take mrs h to the ER .
by the time i arrived at the hospital she had already been admitted and seen by a ER doctor .
about three hours later i was able to take her home - there was no specific treatment . she just could not tolerate the new prescribtion medication and had to wait for the body to flush it out .
was a little scary ... but the tele-health-nurse and para-medic who arrived with the ambulance were just great !
hbg

Another article from the NYT on heart disease published the same day as the thread article -
Elizabeth Nabel on women and heart disease

Controlling the Risk Factors Can Provide Aid in Preventing Heart Disease
By THE NEW YORK TIMES
Published: April 8, 2007

Dr. Elizabeth Nabel, a practicing cardiologist and researcher studying the genesis of plaque in coronary arteries, became director of the National Heart, Lung and Blood Institute on Feb. 1, 2005. A firm believer in prevention, she exercises vigorously nearly every day and can recite her blood pressure, blood cholesterol and body mass index. She thinks everyone should know five things about heart disease:


A KILLER Heart disease is the leading killer, killing one in four women and one in four men.

PREVENTION The overwhelming majority of heart disease could be prevented by controlling blood pressure, cholesterol and cigarette smoking. About 85 percent of people who had fatal heart attacks had at least one of these risk factors.

Men 45 and older and women over age 65 should take an aspirin every day to prevent heart attacks and strokes. Those at high risk should take up to 325 mg daily; all other men and women over 65 but at lower risk should consider 81 mg a day or 100 mg every other day. Consult with your doctor before starting aspirin.

SYMPTOMS The symptoms of a heart attack may not be what you think. The most common is chest pain or discomfort. But warning signs also include pain or discomfort elsewhere in the upper body, including the arms, back, neck or stomach.

Women in particular may experience shortness of breath, exhaustion, nausea or vomiting, and back or jaw pain. If you have these symptoms, call an ambulance right away. Prompt treatment can open blocked coronary arteries, preventing areas of heart muscle from dying for lack of blood.

PLANS If you are at high risk, develop a heart attack action plan in consultation with your doctor. That means knowing the warning signs of a heart attack and taking a nitroglycerin, a drug that widens blood vessels, if you have heart attack symptoms. If they don't go away in five minutes, take a second and third nitroglycerin.

Have a list of your medicines ready for emergency personnel. And plan ahead with your doctor on how to get to a hospital that can provide emergency heart attack care, including angioplasty, a procedure in which a cardiologist opens a blocked artery with a tiny balloon and then, usually, inserts a stent, a tiny metal cage, to keep it open. Many hospitals do not offer this procedure to heart attack patients, but, if at all possible, you need to go to one that does. If your symptoms stop completely in less than 5 minutes, you should still call your health care provider.

URGENCY Everyone who has symptoms of a heart attack should call 911. Do not drive yourself to the emergency room. And do not dismiss symptoms because you think you are not at risk of a heart attack. Every minute of delay in getting treatment can mean death of heart muscle. Time is muscle, as cardiologists say.

HBG, that must have been scary. Glad Mrs. is OK...

What needs to be added is that many heart attack victims don't have any risk factors. Think of how many individuals develop lung cancer who've never smoked.

If you're allergic to a specific antibiotic, you shouldn't be taking any dosage of the medication.

My comment should have been:
For instance, some Docs will prescribe 500 mg Cipro for 5-7 days ( old school ), but now will prescribe 250 Cipro for 3 days ( new school ).

Likewise for some of the penicillins, the time, by some MDs is reduced from 8-10 to 3-5 days.

A known fact in microbiology, is the development of drug reisitant microbes,as incubation time in the presence of the drug increases. On the one hand, you want a long enough exposure time to kill off the pathogens, but a short enough time to reduce the rate of spontaneous mutation to drug resistance.