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Let it go!

The Annals of Cardiology No.42 | Let it go!

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When cardiologists get together and talk about their profession, the conversation inevitably turns to how lucky we are. We get to think about physics, hemodynamics, and vascular biology, and we’re shielded from messier tasks like rectal exams or sputum inspection – chores that some of our hardier colleagues undertake every day. The thing is, the heart connects to everything, so cardiologists still need to be attuned to how other organs are working. Your heart’s most active connection is with your brain (see previous posts: “Octopus Pots and Your Heart,” “Depression and Your Heart,” and “Cheer Up People!”). I’ve also written about the heart as it relates to your microbiome (“Bacteria and Leaky Guts”). So, as a further nod to our gastroenterology colleagues, today we’ll explore another heart/gut connection – the relationship between your heart and, here it comes … your bowel movements.

One thing they don’t teach in Cardiology school is how much patients love to discuss their bowels. Here’s an example: My 65-year old patient returns from Johns Hopkins Hospital, where he just underwent aortic valve surgery and a 3-vessel bypass. The procedure involved sawing his breastbone in half, then re-wiring it together. He recounts an array of complications including bleeding, transfusions, a punctured lung, a racing heart, a bladder catheterization, and an infection. I marvel at his resilience. Then he leans in, locks his eyes on mine, and whispers, “None of that mattered, Doc. The most awful thing was 6 days without a ****. When my bowels finally opened, I knew I had survived.” He’s not the only one. Last week, I asked a different patient how she was doing. I expected an update on her heart symptoms. Instead, she looked into the middle distance and said, “Doc, I’m blessed. I have a movement every day. I don’t strain. It’s soft, and requires little effort to get out.” That’s nice, I think. But, really, sometimes I wonder if people know I’m a cardiologist…(continued)

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