exploring the State of the Heart – a book review

Our brain controls the actions of the body’s other organs, but the heart supplies the power that keeps everything working smoothly, including the brain.

Since my blog’s tag line is “exploring the HEART of health”, I couldn’t pass up the chance to read a book about exploring the heart.

State of the Heart by cardiologist Dr. Haider Warraich explores the history, science, and future of cardiac disease.

Most people recognize the seriousness of heart disease and want to know how to maintain heart health, it’s hard to believe that in ancient times people did not consider the heart a vital organ. The liver was revered as the driving force of the circulation responsible for maintaining life. Even now, the heart is sometimes thought of as just a pump, and not the complex organ that it is.

Dr. Warraich weaves the heart’s story with threads of medical history, explanations of basic cardiac anatomy and physiology, and stories about real patients he has treated for a variety of heart conditions.

  • The congestive heart failure patient who didn’t know he had heart failure
  • The woman who had a heart attack but whose coronary arteries were clear
  • The man who needed a heart transplant to stay alive but couldn’t afford the anti-rejection drugs
  • The man who couldn’t die until his mechanical heart (LVAD) was turned off
the heart and COVID-19

Dr. Warraich explains why coronavirus is especially threatening for people with heart disease.

“Of COVID-19 patients who develop serious heart complications, most don’t see this problem until late in the disease’s progression. However, some are turning up with extensive heart inflammation at the outset.”

Dr. Haider, The Washington Post

Dr. Haider reports that 59% of COVID-19 patients who died had heart damage vs. only 1% of survivors, reminding us that heart disease is still the No. 1 cause of death in the U.S.

“heart disease is not ready to give up that distinction any time soon. With the right precautions and with heightened vigilance, we can try to ensure that COVID-19 doesn’t help increase that toll.”

diagram of the human heart
Heart diseases affect any and sometimes multiple parts of the heart- the atria, ventricles, the valves, the aorta, the pulmonary artery and veins, the walls and the coronary arteries (not shown in this diagram. )
advances and stumbles in the medical treatment of heart disease.

Our brain controls the actions of the body’s other organs, but the heart supplies the power that keeps everything working smoothly, including the brain. Using the intricate “highway” system of arteries and veins, the heart pumps blood carrying oxygen, water, and nutrients to every cell in the body. Learn more in this post.

Although we use the term HEART DISEASE , there are many diseases that involve the heart.  HEART conditions affect people from birth to death. Find out more in this post.

Our modern lifestyles are particularly harsh on the heart-our diets, our lack of exercise, and the stress we expose ourselves to-

Dr. Warraich in State of the Heart
HEART HEALTH

7 Keys to a Healthy Heart

Recognizing that you may have a heart problem can be the first step to getting effective treatment. That’s why in this post I share 7 keys to a healthy heart.

Expedition HEALTH exhibit at the Denver Science Museum

Health is a lifelong expedition

Thanks for joining me to explore the heart, heart disease, and this new book by Dr. Warraich. Find it at your local public library or consider purchasing at one of these affiliate links which help me fund this blog.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use this form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn where I also explore the HEART of health.

                              Dr. Aletha 

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Questions you must ask your doctor before and after care

You can master medical terminology . How many new things have you learned in the past 5 years? Each of those had a vocabulary and instructions that you learned and now use regularly. Think of your first computer, smartphone, tablet, digital camera, or even a coffee maker . You make the effort to learn what is important to you .

In another post I discussed the importance of establishing a connection between doctors and patients before trying to communicate. The goal is to establish effective patient engagement. You might want to read it now, but this post will make sense even if you don’t; you can always read it later. (The current post was previously published as part 2)

3 keys to effective communication with your doctor

Now we’re going to look at some practical aspects of exchanging information with doctors- remember, exchange means give something and receive something  in return. 

Doctors want to give patients the information they need and most of the time believe they have done so. We are surprised when patients come back and say we didn’t explain their problem and its treatment, or they didn’t understand what we told them about it. I think this happens for 2 reasons.

  • We doctors tell patients what we think is important, but it may not be what you the patient or family considers most important.
  • After patients hear part of what we say, they get saturated and don’t hear the rest, especially when it is emotionally charged.

That’s why it is so important for patients and families to ask questions; don’t just rely on what the doctors volunteer. What is important to them may not be what is most important to you. And the more specific questions you ask, the more detailed the information you receive will be.

one question you should always ask at each visit

“What is the most important problem today, and what is the next step in treating it?”

The most important problem that the doctor finds may not be the one you were admitted for or came to the office for. Or if you came with multiple problems, the most important may not be the one that seemed most urgent to you.

and the answer you need to know at each doctor visit

For example, you may go to an emergency facility for an injury that caused a large gash on your leg, one that needs stitches. This is an urgent problem that needs to be treated. But the doctor finds that you have high blood pressure that you didn’t know about.

High blood pressure can lead to heart failure and stroke  if left untreated. So the doctor is going to instruct you to see your primary care doctor to have this problem addressed. In terms of your long term health, the high blood pressure is your most important problem today.

Sometimes these unexpected problems can get lost if you and the doctor only communicate about the urgent problem and what happens next with it.

It is important to control blood pressure
High blood pressure can cause a heart attack.
questions, questions, questions

You will get more helpful information from your doctor if your questions are as specific as you can ask; always inquire about how tests and procedures this will affect your treatment and recovery. Here are some examples-

  • What did the xray show and what does mean for my problem?
  • What was blood test result and will it change my treatment?
  • How will this procedure change my condition?
  • What needs to happen before we move to the next step?

Write important things down. Questions that you want to ask. Information that the doctors need. Answers to the questions. Refer to it each time you speak with the doctors.

It doesn’t end when you are discharged

When you or a loved one is in the hospital, your main concern is going home. When the time comes to be discharged, it is just as important to ask questions and understand the plan as during the illness. Too many times I have had patients return to my office after a hospital stay  unable to give me any information about their illness and care . Important information to know include

  • What problems were treated during this admission and how did they change?
  • What will we need to do at home to continue the recovery?
  • When do we need to see a doctor and which doctor do we see?
  • What medications will I need to be on when I go home?
Understanding your doctor– medical jargon may not be the problem

Doctors are being encouraged and taught to use “plain language” when talking to patients, meaning limiting the use of medical jargon. I agree that a string of highly technical terms of any kind makes communication harder. But I’m not sure that simply using plain words solves the problem either. Whatever terms you use to exchange information must be understood by both persons. And that is not always the case.

Here’s an example.

If a doctor says that you or a relative has had a Myocardial infarction , do you know that that means a Heart attack? 

But, do you know exactly what heart attack means? Probably not.

What causes heart disease?
A heart attack means the heart muscle is injured from too little oxygen reaching it, usually due to blockage in the arteries.

So,  if the doctor says “heart attack” without adding any additional information, you should ask

  • “I understand a heart attack to mean ________. Is this correct?”
  • “I do not understand what a heart attack is. Please explain.”
Learning the language

You can master medical  terminology . How many new things have you learned in the past 5 years? Each of those had a vocabulary and instructions that you learned and now use regularly. Think of your first computer, smartphone, tablet, digital camera, or even a coffee maker . You make the effort to learn what is important to you . 

Make an attempt to learn about your and your family’s medical issues; even if you don’t understand it completely, your doctor will appreciate that you are trying.

In addition to  doctors you have nurses, pharmacists, dieticians, physical therapists, social workers who can answer questions. Ask for referrals to community resources.

There are helpful resources on the Internet so anyone with a laptop, tablet, or smartphone has access to medical information anywhere anytime.

Learn the basics of medical terminology here-

Understanding Medical Words: A Tutorial from the National Library of Medicine

Find the meaning of medical words and terms here

A.D.A.M. Medical Encyclopedia

rhinoceros
It’s easy to remember that “rhino” refers to the nose, as in rhinosinusitis.

Also on this topic, my previous  post

How to tell your doctor what’s wrong with you 

exploring the HEART of communication

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use this form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn where I also explore the HEART of health.

                              Dr. Aletha