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If asked if the current state of your heart disease is acceptable, how would you answer?

It’s a tough one; I know.  Just yesterday I was asked this very question.  “If, when we first met, your chest pain and quality of life was terrible, 10 being terrible, what number would you assign your quality of life now?” asked my super-hero of a doctor, Dr. Bairey-Merz.

Looking her straight in the face, I responded, “That’s a tough thing to quantify”.

How do you assign a number to the quality of your life?  Of course, I understood the question.  I realized that she needed a figure to determine where I am on my journey.  How else is she to know what to try next. 

Leaning back in my chair, I looked down at my hands and fiddled with my ring.  Slowly raising my eyes, I assigned a number to my life. 

“I estimate my quality of life currently to be a 3”.  Her face relaxed a bit, but I saw no smile.  “About 75% better than when we first met; would you agree?” she asked. 

That’s when it occurred to me.  Her face gave her away.  This was the best it would ever be.

The Best Compared To What?

Every six weeks I visit my wonderful doctors.  With each passing week, however, something very interesting has happened.   My visits with both Dr. Bairey-Merz and the fabulous Dr. Margo Minissian focus more on managing my condition and less on curing me.  ‘Curing me’….  Only now am I beginning to realize how stupid I was to think that I would be cured.  After all, I have Microvascular heart disease.  You can’t operate on the tiny vessels around your heart. 

Why Compare?

I know my life will not be returning to the old ‘normal’.  To be sure, 75% better is better than 0% better.  Even still, the problem isn’t so much in the number assigned to my quality of life as in having to assign a number. 

It’s hard not to compare.  But remember; comparisons do one of two things; they either make you feel bad because others have it better than you or make you feel better because others have it worse than you.  Either way you lose.

So, I will stop comparing my current self to my old self.  I will stop comparing what I could do then to what I can do now.  I’ll stop comparing — period. 

Call it a compromise if you will.  But life is worth living.  Nothing compares to that.

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I ask that question because the term ‘heart disease’ is generic.  Heart disease or cardiopathy is an umbrella term for a variety of different diseases affecting the heart.  It covers all things wrong with the heart, from coronary heart disease to ischemia to heart failure.  This shouldn’t surprise us, however, as the same can be said for cancer.  The term ‘cancer’ obviously covers the nature of the disease.  However, it’s only when you focus on where the cancer lies that one is able to determine appropriate treatment.

Just the same, it took me a while before I realized that I had a specific type of heart disease.  When first diagnosed, I figured one size fit all.  Thankfully, I have a cardiologist who knows the difference; especially as it affects women. 

Information from the Cedars Sinai Women’s Heart Center tells us, “For men, heart disease often manifests as blockage in the large arteries of the heart.  One of the major discoveries of the WISE study is that many women with chest pain or other symptoms have microvascular disease, a narrowing of the small arteries and blood vessels of the heart.  Blood flow to the heart is restricted by fatty plaque buildup, but the restriction does not show up in traditional diagnostic exams.” 

Could It Be Coronary Microvascular Heart Disease?

Information from The Women’s Heart Center continues, “until recently, this difference led physicians to discount the possibility of heart disease in many female patients.  These women often found themselves making repeated visits to physicians and hospitals trying to unravel the mysteries of their symptoms.”

I continue to read of dozens if not hundreds of women asking for advice as to what their symptoms mean.  Tests are run but no conclusive evidence of heart disease is found.  So many of them faced with apathetic doctors who, because this is a relatively new diagnosis, find themselves frustrated and thinking that it’s all in their heads.

Well, it’s not.

Women often experience chest symptoms differently than men.  It’s all of those tiny microvessels that surround the heart that malfunction.  Traditional testing, such as angiograms and EKG’s may not be able to identify the problem; at least not at the outset.  Specialized testing must be done in order to determine if it is in fact CMD.  For instance, there is a specific type of angiogram one can undergo which tests how your microvessels respond to different medications. 

Identifying the Culprit

Only after determining what kind of heart disease you have can you obtain appropriate care.  If you find yourself in the hands of a doctor who is not familiar with CMD, find a doctor who is.  Don’t give up because the answers are out there.

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