I care for this restless fluttering in my heart as if it were a bird with a broken wing, in the hope that it will one day heal and fly.
~ Hazel Gaynor
When talking to healthcare providers, we are very transparent about what we do and don’t do and why.
This week, we met with a leading Canadian cardiologist. It was easy to fall under his spell. He was attractive, well dressed, young looking for his 70-plus years of age, and very accomplished in his field.
Not only does he practice medicine but teaches and researches electrophysiology (repairing the rhythms of the heart) and pharmacology (study the interactions of chemical substances with living system) in world class institutions. We felt privileged and grateful to get access to his care and expertise.
Like other conventional medical experts I’ve come across, he quickly made it clear that my husband didn’t do anything to cause his strokes.
No, pushing himself hard in a workout within two months of the first stroke and finishing on the inversion table had nothing to do with the stroke.
Daily cold plunges in an icy lake, no problem.
Drinking lots of coffee, dehydration and a long flight from overseas are not likely to have caused the first stroke.
An upper molar extraction causing chronic nasal congestion is highly unlikely to be associated.
Maybe the chemo in 2019 might have hurt the heart a little, but thats hard to know.
The doctor acknowledged that Dave did not appear to have any of the risk factors for stroke, other than the new onset atrial fibrillation (Afib), asking lots of questions that revealed, aside from the strokes, my husband has not felt the common symptoms of AFib.
His sleep has always been restful and there has never been any indication of sleep apnea.
With nasal congestion that started in April 2023 after a molar extraction, he has never relied on medicinal nasal sprays, just saline or salt water.
The very comprehensive blood work Dave had just completed revealed no signs of inflammation or stickiness of the blood.
The thyroid panel results were normal.
His blood pressure was well below 120/80.
The heart rhythm was normal during assessment, as was the ability to circulate blood throughout the body and brain.
Other than having started to take the blood thinner, Dave takes no other prescribed drugs.
Wise men don't judge: They seek to understand.
~ Wei Wu Wei
I was impressed when the doctor asked about Dave’s retirement, a noteworthy social determinant of health.
He also asked how physically active Dave was, whether he smoked (never) and drank (very little), quickly adding that he does not judge.
Having seen in the past how drinking adversely affects Dave’s liver enzymes, I was a little disappointed when the doctor seemed to be encouraging a daily drink. Current research shows that alcohol increases Afib.
Alcohol crosses the blood-brain barrier. We are trying to heal Dave’s brain, not inflame it. And the medication Dave now has to take is largely metabolized by the liver.
Recognizing that the doctors are assessing any damage lingering after two strokes, I am quiet for the most part during consultations, allowing Dave to answer all questions to the best of his ability.
Post-assessment recommendations were for Dave to take blood thinners for life. The doctor made it clear that it was not his job to make us do anything, but he warned about the risk of a devastating stroke should Dave not comply. If his heart rate becomes too elevated, a drug that will slow down activity will be added.
We were discouraged from pursuing any other procedures, including the left atrial appendage closure which we’d been told can reset heart rhythm and eliminate need for blood thinners. The doctor said there were unnecessary risks associated with the procedure. His intent seemed genuine.
Becoming curious about why so many are being diagnosed with Afib
If we fail to become important to those who control medical spending, we will be unable to make any important long-term contribution to those who matter most - our patients.
When someone says there is nothing you can do to prevent disease but take a drug for life, I become curious.
According to this doctor, only a small fraction of people with atrial fibrillation suffer strokes, but Dave happens to be one of them. When I asked why, he said the cause was unknown.
We can’t prevent it if we don’t know why it happens. Why are we not researching the underlying cause?
While working with corporate health providers in prevention, and prior to that in finance on Bay Street, it became clear that unless we can monetize a product or service and scale it, investors will not invest.
Could it be that there is no interest in finding a cure?
Could it be that the emerging market for managing atrial fibrillation symptoms promises to be highly lucrative, with 3.4 billion people expected to be diagnosed by 2030?
The new oral anticoagulant drug market, is projected to surpass US$ 67.5 billion by 2032.
Sadly, profits trump patient recovery and safety in the medical industrial complex.
For conventional medical practitioners to continue to manage chronic disease in Western medicine, they have to buy in to biologic determinism or the idea that most human characteristics, physical and mental, are determined at conception by hereditary factors passed from parent to offspring, or that we break down as we age.
When Western doctors can’t help their patients and loved ones with what they were taught in industry funded medical school, or know how to guide them in dietary and lifestyle changes that help mitigate harm and prevent disease, I suspect the only way they continue to function is to believe that we are victims of our genes and circumstances.
Closing thoughts
I am not a victim.
No matter what I have been through, I'm still here.
I have a history of victory.
~ Steve Maraboli
Dave will take his medicine as prescribed. But we will continue to look into possible underlying causes with the hope of not having to rely on drugs for life and an objective to help empower others with the knowledge to prevent heart arrhythmias and stroke.
While it may be comforting to have doctors tell us with great compassion
...you didn’t do this to yourself,
it is disempowering to believe we are victims of our genes and circumstances.
A victim, feeling helpless, is more likely to become dependent.
When we believe we contributed to the cause, we are more likely to feel empowered to fix it and/or prevent it from happening again.
Yet, even as I write this, the word resistance crosses my mind. Should we just accept what is, take the drug, mitigate any harm, and live life to the fullest as the doctor recommended?
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