Heart Sense for Women by Stephen Sinatra, M.D. Click here to return to book details Introduction Unlocking the Mysteries of a Woman’s Heart An Emotional Epiphany Twenty years ago, after I completed my cardiology training and began my education in psychotherapy, a woman in her twenties named Christine came to see me. She kept passing out-literally having episodes of near sudden death. Her electrocardiogram showed arrhythmia-rhythm disturbances in her heartbeat, a potentially fatal abnormality. Despite the seriousness of her condition, her health was not her first concern. All she could talk about was her feelings of agony and guilt during a painful divorce and her financial struggle to take care of her son. Beyond resuscitating her, I did not know how else to help. Christine was sent to a clinic in Boston to determine whether she was a candidate for potent anti-arrhythmia heart medications. Her laboratory tests indicated that she was, but she refused to take the drugs, convinced that the stress of the divorce and concerns about her son were the causes of her heart problems. The doctors in Boston did not agree, expecting her to drop dead at any time without the medications. The cardiologists in Boston sent Christine back to me with a suggestion that I put her on some heavy duty cardiac medications. I realized that, despite our best intentions, she wouldn’t take the drugs. Christine was caught in the middle of a bitter divorce and she felt overpowered. She confided in me that her husband was using his personal connections and professional influence to gain custody of their young son. The male doctors who had advised her to take the heart medications were giving her the same kind of controlling messages she was getting from her husband. Once I understood this, I decided that my best intervention was to support her refusal to take the medication, no matter what the other physicians had recommended. “Don’t take the drugs if you don’t want to,” I told her. Christine was shocked! But I believe it was the right advice, because more often than not heart problems are more than medical problems: they are problems of the heart, of the fullness of our emotional life. In the end, she was right. After her divorce was finalized and she had the confidence that she could provide for her son, Christine’s dangerous arrhythmia stopped without any drugs or further treatment. Now, twenty years later, she is still my patient, and she has had no further episodes of arrhythmia. Christine’s case shows how ill-equipped conventional medicine can be when it comes to dealing with heart disease in women. Instead of acting as her partners in healing, Christine’s male cardiologists were authoritarian, and totally ignored the emotional dimensions of her illness. They insisted on using powerful, dangerous drugs instead of exploring other possibilities. And, most importantly, they had refused to listen to Christine’s intuitive knowledge of her own body, which turned out to be medically correct. Over my twenty-five years of practice as a cardiologist, I have learned more about heart disease from patients like Christine than from many of my medical colleagues who fail to see beyond what is taught in medical school and published in the mainstream journals. I prefer to learn from my patients. And one thing I have learned is that while heart disease is the leading cause of death among American women-one out of three American women die of heart disease-women’s needs are still too often ignored, misunderstood, and poorly treated by conventional medicine. Most women intuitively understand the importance of the emotional and psychological aspects of heart disease in ways that most men, and certainly most cardiologists, do not. For years, my wife Jan and I have conducted stress and illness workshops for cardiac patients. Even though the majority of my patients are _men, most of the participants in the workshops are women, because women are more in touch with and more willing to deal with the emotional dimension of cardiovascular illness. And because of that they have a distinct and powerful advantage to overcoming heart disease. I’ve also found that the spiritual dimension is just as strong a factor as the emotional and psychological perspectives in preventing and healing heart disease. I’ve seen what many other physicians and healers have also seen-especially in women-regardless of the illnesses being treated: that spiritual commitment, whether it be expressed through family connection, meditation, prayer, or other means, plays a crucial role in healing. I realized early in my career that because heart disease in women hadn’t been studied and was poorly understood, a specialized approach was needed-one that would take into account the unique nature and biology of women. I also realized, from listening to my female patients and their insights, that treating heart _disease effectively meant more than just focusing on a pump malfunction-it meant treating the whole person. Mainstream (also called Western or conventional) medicine is based on the assumption that the body can best be “cured” through outside interventions by a physician or surgeon. As a result, our prevailing model of medicine has become mainly rescue- and crisis-oriented, geared to intercede with treatment only after something has gone wrong. Its treatments are analogous to home or auto repair: diagnose the malfunctioning part and then repair it, often through a process of trial and error. Sometimes this approach works, but more often than not it means repeated trips back to “the shop” for additional rounds of treatment. While this medical model can be lifesaving for many acute illnesses and conditions (such as heart attacks, infectious diseases, emergencies, and traumatic injuries), it has proven to be limited and ineffective for a surprising number of other health conditions. Patients are often subjected to powerful drugs and/or painful surgical procedures, both of which carry inherent risks. All too often this method fails to address the underlying medical condition, which eventually recurs. Diagnostic Dilemma Many people, including doctors, long believed that a woman having a heart attack would perceive her symptoms in the same way that a man would. But now, thanks to more recent research, we know better. A woman’s symptoms, both for a heart attack and for earlier signs of heart disease, can be very different and far more subtle than a man’s. Because so many physicians are still unaware of women’s unique heart attack symptoms, they are more often misdiagnosed as anxiety, stress, or indigestion. Three decades ago, the ratio of people admitted to coronary care units was roughly nine men to every woman. Unfortunately this was not because women required less treatment but because they received less treatment. In days past, women’s pain was often written off by physicians as anxiety or “all in your head.” More often a woman with chest symptoms or shortness of breath was sent home with a pat on the head and a prescription for Valium, or maybe an antidepressant. Add to this the always present pressure for physicians to keep medical costs down and not to admit anyone to a hospital without a great deal of hardcore evidence, and you have a real treatment dilemma-especially if you’re a woman. Even today, when a woman goes to her health care provider for an assessment of her symptoms, she may find herself caught up in a diagnostic dilemma. Because her symptoms are often less definitive or dramatic than those of her male counterpart, her doctor may disregard them or fail to order follow-up tests. Anytime a man over forty years of age with arm or chest pain comes into the ER, the decision is easy… admit him. But with a woman, the symptom may be discomfort in the chest that mimicks indigestion, or it might be in her back, jaw, or teeth. Or, it might show up as severe fatigue. Cardiologists call these confounding cardiac signs “atypical,” meaning they do not fit the “textbook” picture of what they’re expecting. Even after twenty-five years as a cardiologist, and being aware of the unusual symptoms displayed by many women, I still find that coronary artery disease (CAD) in women often presents itself like a complex mystery, where following the “clues” is still one of the most difficult challenges that I face. That’s why I want you to become familiar with the symptoms of heart disease-so you can gain control of your health, implement alternative methods of treating your heart, and prevent a more serious event such as a heart attack. Toward a New Model of Medicine Complementary and alternative therapies-also increasingly called integrative medicine-are grounded in the ancient wisdom that the body is capable of healing itself. As a result, treatments do not attempt to “cure” medical problems by suppressing symptoms, but rather gently assist the body in returning itself to health and balance. Essential to this viewpoint is the idea that the body is not separate from the mind, emotions, or spirit-all actively affect your daily health. This, we have come to realize, can be a double-edged sword: while a positive attitude can help heal you when you are sick, a negative mindset can sometimes increase your vulnerability to disease if your mental state is unbalanced or in distress. Alternative medicine is oriented toward finding ways to support the whole person, not just the ailing organ or system. Groundbreaking research by Dr. Candace Pert helped forge a whole new field in this realm called psychoneuroimmunology. She discovered that receptor molecules called neuropeptides provide a two-way link between the brain and immune system which gives us a “thinking” immune system that is continuously informed and influenced by our emotional health. Prevention Before Intervention Where conventional medicine is based on aggressive intervention, alternative medicine is geared to prevention. In the case of natural healing, “interventions” are usually aimed at lifestyle (diet, nutritional supplements, stress reduction), either to help remedy a medical problem or to prevent one. The alternative approach also aims to detoxify the body of excessive amounts of sugar, caffeine, saturated fats, animal petrochemicals, and environmental toxins such as pesticides, which can depress the immune system and cause health problems. This approach addresses not only the biochemistry of a disease condition (as does conventional medicine), but also explores the person’s energy and mind/body dynamics. It recognizes the musculoskeletal system as a barometer of overall emotional and physical condition: muscle, joint, and bone pain (such as tightness and other problems) are seen as indications of disruptions in the physical or emotional state of the individual. Perhaps most significant, alternative medicine is not “practiced upon” or “done to” the patient. Rather, the client is an active participant in her own treatment, and one who collaborates with the healer to distinguish which interventions are helpful and which treatments are not. This integrated approach seeks to empower each woman so that she can accept some responsibility for her own recovery and subsequent health. “C’mon Doc... There Must Be a Pill For This!” I hear statements like this every day. And, although some of them are made in good humor, the truth is that many of my patients expect the medical establishment to have a “quick fix” for them. Pause for a moment and examine your own attitudes about health care. Are you looking to take a cholesterol-lowering drug so you can keep eating the way you always have? Do you resist making dietary and lifestyle changes and watching your fat intake? Would you prefer to take a pill to reduce your blood pressure rather than lose weight or take an honest look at what it is that is really making you hyper-tense? Are you still looking for that miracle drug or cure to “make” you stop smoking? When it comes to weight loss, are you looking for a better television remote control instead of investing in a good pair of walking shoes? Are you still waiting until science comes up with another “magic bullet” (like the Fen-Phen disaster) to help you drop those extra pounds, instead of watching your diet or starting an exercise program? As far-fetched as it may sound, many of my patients still express disappointment-sometimes even anger-when there’s no “quick-fix,” offsetting many years of poor lifestyle choices with a drug that can be added to their morning routine, like brushing their teeth. Don’t get me wrong. Traditional treatments such as medication are valid players in an integrated strategy to overcome cardiac problems, but they should never be the primary players. Relinquishing your health care needs to “insurance-only” covered services is a form of giving up active participation in your own care. In a way, you become a passive, “fix me” recipient, vulnerable to getting only what today’s over-regulated, profit-motivated health care providers determine to be the most appropriate options for you. Learn to trust yourself to make informed decisions and take personal responsibility to expand your choices. This may mean spending some of your own money-or making a request for funds-in the name of your own healing. It may mean stepping out into the unknown and declaring that you are worth it. It takes courage to leap into something new without knowing how things will work out. But I can assure you-the rewards can be enormous and life-changing. Bioenergetics Besides being a physician, I am a certified psychotherapist, and use an approach called bioenergetics, a type of body-oriented psychotherapy that addresses the physical changes and damage to the body that can occur as a result of unresolved emotional pain and trauma. In the bioenergetics view (and as I have seen in my own practice and those of my colleagues), emotional trauma, psychological conflict, and psychic pain can disrupt and damage the very structure and function of our bodies’ musculoskeletal, circulatory, and internal organ systems. This often leaves us vulnerable to chronic physical problems or illnesses, including heart disease. The damage can be halted and even reversed through various therapeutic techniques. Consequently, one of the cornerstones of my approach to heart disease (and health in general) is to address the psychological and emotional factors that affect the heart. In Molecules of Emotion Candace Pert states, “All honest emotions are positive emotions.” I agree with Dr. Pert wholeheartedly, and in the following pages we will explore some of the ways in which you can use your own emotions and intuition to prevent or even help heal heart disease. I will show you how to reclaim a healthy heart and to avoid being one of the victims of heart disease. My “prescription” for you will not only save your heart but will also enhance your overall health and vitality. The four pillars of my program are really quite simple: (1) a Mediterranean-type diet, (2) nutritional supplements, (3) daily exercise, and (4) stress reduction. Following this program, you will lower your blood pressure, break up the plaques in your arteries, strengthen your heart, and renew your independence. This book will teach you how to explore and strengthen your emo-tional and spiritual connections to prevent or heal heart disease and inspire you to take charge of your heart health. You can’t lose! Click here to order from Amazon: Click here to return to book details