When people find out that I have heart disease, they are often surprised, especially people who know me. I have a very active life. I was an aerobics instructor, I am involved in yoga, and one of my favorite things to do is jump rope. I always made an effort to eat right and take care of myself.
I do have a family history of heart disease, but I thought that because I didn’t look like the type of person who gets heart disease, I was fine. I wanted to avoid the many health problems my mother faced. As my mother got older, her health began to decline and I became her caretaker. She has undergone multiple surgeries for her heart disease but it continues to progress. I became determined to live a different, healthier lifestyle.
I thought I was doing everything right, but as many women do, I put off getting a physical. Too often women tend to everyone else’s needs and ignore their own. Even with all the exercise and healthy eating, I was leaving out an important step towards truly taking care of myself: seeing my doctor on a regular basis.
I started to find that I was tired a lot of the time. I was getting headaches and having neck pain. I brushed all of these aside as symptoms of something else: menopause, previous injuries flaring up, or just stress. I didn’t want to worry my family so I didn’t make a fuss. I was taking four medications for my headaches and trying to fit in time for weekly massages to deal with the pain I was experiencing. I never thought that these could be signs that my heart was struggling.
I never make New Year’s resolutions, but last year I decided that I would finally get that physical I had been putting off for so long. I am rarely sick, and it had been so long since I had seen my doctor that when I went to book the appointment, I found that she was no longer working at my hospital. I had to go through the process of finding a new doctor. It was such a hassle that I almost gave up several times. I told myself that I was healthy and there was nothing to worry about. But I had made this New Year’s resolution so I felt like I should see it through to the end.
When I finally saw the new doctor and had the physical examination, they noticed on my paper work that there was a family history of heart disease. They decided to run some additional tests and found some abnormalities. I told myself it was nothing. I truly believed that there was no way anything could be wrong with my heart.
The doctor did an angiogram and saw that I had a 90 percent blockage on the left side of my heart and a 20 percent blockage on the other.
So, even though it was something I never saw coming, I’m so glad that I invested the time to complete that resolution and to get a check up. If I had given up, who knows what could have happened or how much time I had left.
Go Red For Women movement when my company signed on as a national sponsor of the campaign. I incorporated Go Red For Women into training activities and staff programs, and encouraged my coworkers to eat right and exercise, but I never suspected the campaign to educate women about heart disease would save my life five years later.
One Saturday morning, I had a string of seemingly unconnected symptoms. While doing the dishes, I felt as if a heavy bowling-ball was pushing down on my stomach for 10 seconds. And then I had a growing pain in my lower ribs and the tip of my shoulder blade. A minute later, I experienced a hotter than normal hot flash and a whisper of heartburn. I just felt odd so I laid down to rest.
As I was lying there, the words of a nurse who spoke at a Go Red meeting popped into my head. She had told us that women often don’t experience classic heart attack symptoms. She said, "If you feel something sort of odd, you should take it seriously." I was definitely feeling some unusual sensations, so I decided to call the advice nurse at my health care provider and described my "odd sensations." I was told to hang up and call 9-1-1 immediately.
I responded, "Are you’re kidding?"
"I can’t tell you you’re having a heart attack at this moment," the nurse said sternly, "but I can’t tell you are not having a heart attack either. Call 9-1-1."
Paramedics arrived and began tests after giving me a spray of nitroglycerin in my mouth. The pain subsided, so I thought everything was okay.
Not quite. The paramedics told me nitro helps people with heart trouble and rushed me to the hospital where blood tests revealed I had had a small heart attack. Further tests revealed that my three main arteries were 60 to 70 percent blocked.
I returned to work nine weeks after surgery and continue to be involved with the Go Red program. I'm always telling people how important it is for women to know their risk for heart disease. Anywhere I have a captive audience…in elevators…in line at the grocery store…I tell them. If something is not normal for you, go to the doctor or dial 911, you could be having a heart attack.
Before my heart attack, I never felt like I could make a difference in this world, but now I feel that I can play a role in reducing the number of women who die of heart attacks. Every woman I share my story with is a little better educated and perhaps they share my story with someone else, and maybe somewhere down the road, a life is saved because a woman was motivated to take action.
Dr. Tremmel is an interventional cardiologist and Clinical Director of the Women’s Heart Health Center at Stanford University Medical Center
In my practice, we often see female patients who come in for a second opinion, feeling like their doctor either doesn’t understand or doesn’t believe that heart disease can manifest differently in women than men. This is a disappointing reality, and one important for women to understand; to some extent, the quality of care depends on your own persistence and empowerment through knowledge of the differences in symptoms in women. However, there is some good news in women’s heart clinics that exist in growing numbers across the country. At clinics such as ours, there are definitely common threads in the “atypical symptoms” we see in women – and seeing them often, it may be easier for us to diagnose and treat.
In the medical profession, part of our challenge is that research on heart disease has come from predominately male patients. We are learning that disease in women is different – that the female body responds differently to heart disease. And we are also learning new ways to test for heart disease in women in a way that is more meaningful and tailored to women. Although we are one of few centers in the U.S. employing this testing today, my hope is that more and more physicians will take the time to learn about these tests and put them into practice to advance care for women.
My career mission is to help reduce the gaps in outcomes for women – mortality, complications, applying medical guidelines, etc., by educating my colleagues and patients about cutting-edge data and contributing to the medical literature through my own research. I am committed every day to sharing information with my patients to educate them and to make their diagnosis less of a mystery – and hopefully less frightening.
AHA Go Red, NHLBI Heart Truth, and other organizations have brought awareness of heart disease in women a long way. As the next step, women need to recognize that heart disease is not only not a “man’s disease,” it’s also not a “some other woman’s disease.” Internalize that we are all at varying levels of risk for heart disease, and empower yourself to know your risk and seek diagnosis and treatment. Women need to talk more not only to their doctors, but more importantly to each other about heart disease. There is no need to feel alone, embarrassed, or ashamed. Together, we can advance the care of heart disease in women.
AP2930836 Rev. A