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Inside the interview
In May 2008, Carolyn Thomas suddenly became a member of an exclusive club that nobody ever wants to join: She was hospitalized for a myocardial infarction (heart attack) caused by a 99% blocked left anterior descending coronary artery. After recovering, she attended the annual WomenHeart Science & Leadership Symposium for Women with Heart Disease at the world-famous Mayo Clinic in Rochester, Minnesota. She started the website Heart Sisters , all about women and heart disease. And she was named a 'Women's Health Hero' in 2009 by Our Bodies Ourselves of Boston, one of 20 inductees from seven countries honored for women's health activism in our communities.
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I had a great life! I ran a disaster response program for the Salvation Army, did street outreach feeding the homeless, and worked as the communications coordinator at a hospice palliative care facility. The year before my heart attack, I decided to downsize to a little condo in a beautiful, leafy neighborhood. For the first time ever, I was able to afford a major renovation.
I was walking to work in 2008 when suddenly, out of the blue, I felt crushing chest pain, waves of nausea, sweating, and pain radiating down my left arm. It was this left arm pain that frightened me because I remembered hearing something about arm pain being a symptom of a heart attack! Terrified, I went immediately to the emergency room, but all cardiac tests — EKG, blood tests, even a treadmill stress test — came back "normal." The doctor told me that I just had a case of acid reflux and that I should go see my family doctor for an antacid prescription. The next two weeks revolved around my reluctance to "make a fuss" over what was happening to me. I continued to experience painful episodes exactly like that first attack: frightening chest pain, nausea, sweating, and arm pain. Two weeks of increasingly debilitating attacks later, I knew I was in serious trouble and needed to go back to the emergency room.
My second visit to the emergency room was entirely different than my first two weeks earlier. This time, I could tell just by the alarmed looks on the faces of the staff as they scurried around me that something was seriously wrong. Within minutes, a cardiologist was called in, who told me that he could tell just from my T-waves, the last bump in the EKG, and other preliminary test results that I had had a "myocardial infarction" (heart attack) and that I clearly showed "significant heart disease." I was taken immediately from the emergency room to the operating room for an emergency angioplasty. A stainless steel stent was implanted into my left anterior descending coronary artery, which was 99 percent blocked.
I believe so. In my opinion, many women still mistakenly consider heart disease to be a man's problem, and so do some doctors. Even I could not quite believe I was having a heart attack, because of my misconception that a "real" heart attack was like cardiac arrest: clutching the chest, keeling over unconscious, CPR, 911, and paddles. That's what I thought a heart attack was, but apparently not many women experience that. The first doctor I met in the emergency room sized me up very quickly, reviewed my "normal" cardiac test results, and let me go instead of keeping me for observation in the hospital.
Five months after my heart attack, I attended the annual the WomenHeart Science & Leadership Symposium for Women with Heart Disease at the Mayo Clinic in Rochester, Minnesota. At Mayo, I met dozens of survivors who had also been sent home despite heart attack symptoms. One woman told me that she had been sent home three times despite her severe symptoms. On the third visit, the doctor suggested she might want to consider taking anti-depressants. Her fourth visit was for double bypass surgery.
I started cardiac rehabilitation as soon as I was physically able to after my heart attack. It was twice a week, two hours at a time, for three months. The wonderful folks at our Mayo Clinic Symposium gave each of us a pedometer. My goal is to walk 10,000 steps per day. I even have a little exercise calendar where I give myself stickers every day that I do my 10,000 steps. Those stickers really work!
The biggest change came in my kitchen. My lovely daughter Larissa flew in from out of town immediately after my hospitalization. Her first mission was to go through kitchen cabinets and the fridge. She tossed out every single item that had too much salt, sugar, or fat, or not enough fiber or natural ingredients. The whole family became obsessive label readers.
I have also had to make drastic changes in my stress levels. At Mayo Clinic, we were taught many relaxation strategies like Tai Chi, Pilates, and meditation. For the first time in my life, I had to learn the art of p-a-c-i-n-g throughout the day, with lots of planned rest periods in between outings. I now carefully weigh each social invitation by asking myself, "Is this what I REALLY want to be doing right now? Is this who I REALLY want to be doing it with?" I finally understood the wisdom of that saying "Don't sweat the small stuff." And, let's face it, it's mostly all small stuff.
The most traumatic change in my lifestyle has been around my career. I returned to work, half days only to start, about three months after my heart attack. I felt desperate to get back to my job, to finally feel "normal" during a time when nothing felt normal anymore. At first, it was lovely to be back, with lots of "So glad you're back!" hugs from my colleagues — followed almost immediately with a big pile of overdue projects they'd been waiting for me to get done while I was on medical leave. But by the second week at work, I knew something was terribly wrong. I could not seem to cope with the stress, pressure, deadlines, and juggling multiple projects (all due yesterday) that are just part of everyday normal life in public relations. I had trouble remembering even the most basic facts at work. I was unable to focus or make simple decisions. I wept for no reason, and seemed unable to stop. And my ongoing chest pains, shortness of breath, and crushing fatigue convinced me that a second heart attack was imminent. I didn't recognize it at the time, but I was severely depressed. Luckily, my physician was very supportive and quick to offer immediate help. She also ordered me off work on extended medical leave to give me some time to really heal.
Even the clinical diagnosis of "depression" had a profound effect on me. In my opinion, I was certainly never the type of person to be depressed. In fact, I'm embarrassed to admit that through sheer ignorance, I used to make disparaging remarks about those with depression — if only they would just "pull up their socks" and get on with it, they'd feel better! How humbling to find myself suddenly among them.
I suspect that most women are unaware that heart disease is their number 1 killer and that heart disease kills more women than men each year. Also, at Mayo Clinic I learned that heart disease takes 20 to 30 years to develop. It's so important to reach young women, especially with information on risk factors that will result in heart disease decades from now. These factors include things like high blood pressure, high cholesterol, chronic stress, inactivity, diabetes, and smoking. Women can make simple, yet effective, preventive measures such as getting regular physical exercise, eating low-salt, high-fiber, low trans-fat foods, and stopping smoking.
Be your own best health advocate! You know your body. You know when something is not right. Pay attention to that little voice that says, "Something is wrong with me." I ask myself, what would I have done had it been my daughter Larissa having those symptoms of crushing chest pain, sweating, nausea, and pain radiating down her left arm for those two long weeks? Would I have just patted her on the head and reminded her that the doctor says it's nothing to worry about? I wouldn't. So why would I not demand the same quality care for myself?
Of course! But it wasn't until I spent five days at Mayo Clinic that I finally "got it." Heart disease is a long-term disease that can take time to develop. Doctors can patch us up, defibrillate us, bypass us or stent us, or put in a new valve or pacemaker, but unlike short-term illnesses, our treatment does not cure what caused the disease in the first place. Having a previous cardiac event is the biggest risk factor in having another one. That's a sobering thought and one that makes those lifestyle improvements even more important for survivors than for all other women.
Since returning from Mayo Clinic, I have done community presentations about women's heart health to thousands of women, including at my signature "Pinot & Prevention" parties. But probably the most surprisingly successful development in promoting heart health awareness has been Heart Sisters, my blog about women and heart disease, which I launched in April 2009.
Content last updated February 28, 2012.