Posts Tagged ‘study’

Change to the Blogroll

February 16, 2010

I’ve made a change in the blogroll, the list of websites and online resources that appear on the right side of the home page. Clicking the link labeled RESEARCH: Congenital Heart Defect Clinical Trials now takes you to a page maintained by Medpedia.

This change was made for two reasons: Medpedia offers summaries of Clinical Trials in either “Plain English” (easy to read) or “Clinical” (More technically correct, but uses a lot of medical terms that you might not be familiar with). Medpedia also offers you a lot of search options: You can search for a clinical trial based on location, actively recruiting participants (or not), Clinical Trial Phase, age of the participants, and other factors. If there is a clinical trial studying retired 70-year-old left-handed tugboat captains, you can find it!

I’ve preset the words Congenital and Heart as the search terms, but feel free to change them if you wish.

Becoming a Heart Warrior, Part III

December 31, 2009

The most important step to becoming a Heart Warrior is probably the most difficult: You will have to be able to discuss your heart defect intelligently.

This doesn’t mean that you’ll need to go to medical school and get an MD after your name. (Unless you want to – I know two CHDers who are physicians!) There are different ways to discuss something intelligently. You will need to know some medical terminology to discuss your CHD with a doctor, but you’ll use a different mindset when you discuss your heart with a potential boyfriend/girlfriend. And if a child asks you a question about your heart, you’ll answer their question in an entirely different way.

The first thing you should do is learn the anatomy of a normal heart. It doesn’t have to be a detailed knowledge, but you need to know the four chambers, the four valves,  and the major blood vessels. The heart has four chambers: two on the top and two on the bottom, and a wall (called the septum) right down the middle that divides them into left and right. The top chambers are the Left and Right Atrium, and the bottom chambers are the Left and Right Ventricle. The right side of the heart captures blood returning from the body and pumps it to the lungs. The left side of the heart takes blood coming from the lungs and pumps it back out to the body. So when people tell you that the heart is a pump, they’re wrong. It’s really two pumps in one case.

You need to understand the Cardiopulmonary cycle. Cardiopulmonary is a big word, but it’s really two smaller words: Cardio, from the word Cardiac, means anything having to do with the heart. Pulmonary means anything having to do with the lungs. And the Cardiopulmonary cycle is the path the blood follows as it moves through the heart and lungs.

A normal Cardiopulmonary cycle looks like this:

Vena Cava→Right Atrium→ Tricuspid Valve→ Right Ventricle→ Pulmonary Valve→Pulmonary Arteries→Lungs→Pulmonary Veins→Left Atrium→Mitral Valve→Left Ventricle→Aortic Valve→Aorta

Note that the first step is simply labeled “Vena Cava”, because there are two Vena Cavas: the Superior Vena Cava and the Inferior Vena Cava. The Superior Vena Cava brings blood from the upper half of the body and the Inferior Vena Cava brings blood from the lower half of the body. Both vessels send blood into the Right Atrium.

The Pulmonary Arteries and Veins seem to be backwards: The Pulmonary Arteries carry deoxygenated blood, while the Pulmonary Veins carry oxygenated blood. It doesn’t make any sense until you remember another definition of arteries and veins: arteries carry blood away from the heart, while the veins carry blood towards the heart. Since the Pulmonary Arteries carry blood from the heart to the lungs, and the Pulmonary veins carry blood from the lungs to the heart, this conundrum is solved!

Once you understand how a heart is supposed to work, you need to know how your heart works. Ask your parents, and ask your Cardiologist.

Your parents are going to be a great source of information, but remember something important: They were riding a wave of emotion when you were born, when you were diagnosed, and any time you went through an operation. Their memories are going to be clouded by that emotion. So ask your Cardiologist too, and use your critical thinking skills to combine the information you get from both sources.

Your doctor can also draw diagrams to help you understand, and you can test your knowledge of the medical terminology by talking with him or her. And if the doctor throws something at you that you don’t understand, you can always ask them to explain it in plain English!

If you have a Cyanotic heart defect, you should learn why it is called Cyanosis (From the word Cyan, which means blue) and what causes you to be Cyanotic.

You should learn what might happen to you down the road – any future operations that you may have to prepare for, and new medical advances. So read the medical literature. This is easier now than when I was trying to learn about my heart. Medical Journals are expensive, but a lot of information is available on the internet. Just enter your diagnosis into a search engine and click the enter button. Back in the old days I had to have a medical dictionary to figure out what some of the words meant, now you can just Google whatever you don’t understand. Be prepared to do a lot of Googling, especially at first! But don’t let that discourage you.

You will have to learn how to read carefully to see what an article is really saying. As I have mentioned before, if you do an internet search for Congestive Heart Failure, you’ll see that the  average time of survival after diagnosis is five years. That can be depressing… until you read further and learn that the study group included some very sick patients. So the “five years” isn’t true, a lot of it depends on how motivated the patient is. There’s really no way to teach this skill, you just have to read and learn.

And be prepared to find out some information that you may not want to know. You doctor may tell you that they have done all the surgical procedures that are possible, and from here on your life is going to be based on how well you take care of yourself. You may find a study that says CHDers don’t live as long as heart healthy people. That’s true – and almost every CHDer who has thought about it realizes that we might not be around as long as everyone else.

But remember that those medical journals can not account for the medical advances of the future. Seventy years ago, a kid with a heart defect lived a sad, miserable life and the vast majority of us died before our first birthday. And twenty five years ago, children born with Hypoplastic Left Heart Syndrome (HLHS) didn’t live a week. All that has changed! And Medicine makes new advances every day!

But it is not about length of life, but quality of life – and as long as you live your life to the fullest, figure out how to do what you want to do despite your health limitations – never give up and never give in! – then you will have become a true Heart Warrior!

A Common Goal

June 12, 2009

Triage, the health care blog of the Chicago Tribune, has a post about patients who don’t stand up for themselves. Especially if you have a Chronic Illness, you may unconsciously put yourself into an especially compliant position because you rely on the doctor for so much. If your illness gets out of your control your life gets out of control, and it is tempting just to say “Yes, doctor, No, doctor, May I have another pill please, Doctor?”

You shouldn’t wimp out at the doctor’s office, but you shouldn’t turn every instruction you receive into the SALT II arms negotiations, either. Work with your doctor rather than against him, and try to hit a happy balance. The Happy Hospitalist gives us tips on how to be a better patient, and one of his suggestions is “Ask questions.”

Study, to show thyself approved,” the scriptures say, and it works just as well in healthcare as it does in Theology. Your doctor sees many more patients than just you, and he can’t keep current with all the medical literature relevant to your situation. Get a medical dictionary (Search your local Goodwill store or eBay, those are probably the best places to look) and read the books and reports yourself. It will be difficult at first, but get easier with time.

But please, make the information relevant to your situation and don’t greet your doctor by waving a stack of computer printouts at him. You’ve been on the Internet for an hour or so; he’s been in Medical School for 8 years and quite possibly more. Printouts = insult!