Possible Heart Disease Symptoms Are Written Off Due to Weight

DEAR DR. ROACH: I’ve been experiencing pain in my chest, dizziness and shortness of breath on exertion. The chest pain lasts for a few hours. At one point, it was so bad that I couldn’t walk a hundred feet, had to use a cane and severely limit my physical activity. I’ve been to the doctor about this before. They take an EKG, which comes back normal, so they chalk it up to anxiety, then tell me I’m fat. (I am not unaware that I’m fat, but even when I was doing intense martial arts twice a week, I couldn’t lose the weight. And my physical therapist told me not to do yoga.)

If it makes a difference, I’m also a Type 2 diabetic and have fibromyalgia as well as PTSD. This is not the only issue that doctors have refused to treat because they decide to blame it all on my weight. My diabetes went unchecked for a while because my doctor only told me to lose weight, instead of ordering blood tests when I complained about the symptoms. When these symptoms happen, my friends tell me to go to the doctor, but they don’t do anything to change the situation. Why should I pay over $1,000 and waste a few hours for an urgent care visit and an EKG only to get told that I’m fat and anxious, when I can cover my chest with stickers, play on my phone and tell myself I’m fat at home for free? Who’s right, me or my friends? -- S.T.

ANSWER: I am very sorry to hear how poorly you are being treated. I have heard from many people that doctors do not take symptoms seriously in people who are overweight or obese. (There is strong evidence that this is true, and that women and people of color are also treated worse systemically. People with any mental health issue, such as anxiety or PTSD, are often disbelieved.)

While I understand that you are frustrated, your symptoms are very concerning. Particularly if you are over 50, they are highly suggestive of heart disease -- especially in a person with diabetes, which increases risk of heart disease. Given your poor experience, how much you are paying and your PTSD, I can absolutely understand why you are reluctant to go. However, you deserve to get good care, and I believe you will be able to find a doctor who can treat you well and not automatically write off any complaint due to your weight and anxiety. I’d recommend you be completely honest about your concerns.

When I have a patient with multiple ER or acute care visits for possible heart disease, I often recommend a more definitive test than an EKG and blood testing, which is the usual acute care evaluation when looking for damage to the heart muscle. This may be a coronary CT angiogram, which is highly sensitive and specific. (The weight limit for this test depends on the scanner, but is typically 450 pounds.)

If you have blockages in your heart causing your recurrent symptoms, it needs to be treated to prevent a heart attack. If blockages aren’t the cause, the EKGs usually aren’t helpful, and you’ll need a different type of evaluation to find out where these symptoms are coming from.

*** Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

© 2023 North America Synd., Inc. All Rights Reserved

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Tame Stress And Improve Health

Stress can affect people of any age. While small amounts of stress may stimulate adrenaline responses and help people power through difficult projects or solve problems, chronic stress can impact the mind and body in harmful ways.

WebMD defines stress as any change in the environment that requires the body to react and adjust in response. The body may react to stress physically, emotionally and/or mentally. Positive stress, called eustress, can take the form of getting a new job with greater responsibilities. However, it’s the bad stress - distress - that can cause tension and other negative consequences.

Money, health and relationships are some of the common contributors to stress in the United States. Seventy-seven percent of Americans regularly experience physical symptoms caused by stress, and 73 percent experience psychological symptoms from stress. Statistics Canada indicated that, in 2014, the most recent year for which data is available, 23 percent of Canadians ages 15 and older (6.7 million people) reported that most days were “quite a bit” or “extremely” stressful.

Stress can have many implications. When the body is stressed, muscles tense up and chronic stress can cause the muscles in the body to stay taut and tense for long periods of time, says the American Psychological Association. This may lead to tension headaches and musculoskeletal disorders.

The Mayo Clinic advises that stress can cause fatigue, changes in sex drive, stomach upset, and difficulty sleeping. Stress also affects mood, potentially resulting in lack of motivation or focus, anxiety, sadness, and/ or angry outbursts.

Healthline links chronic stress to behaviors such as overeating, not eating enough, alcohol or drug abuse, and social withdrawal.

Reducing stress is a priority for many people. Although it is not an easy undertaking, slowly removing stressors from one’s life and taking steps toward changing one’s responses to stressful situations can help. There are many stress-management strategies, and not every one is right for all individuals. However, the following techniques may be helpful.

• Exercise: Regular physical activity can help reduce stress.

• Meditation: Mindful meditation, deep breathing, yoga, and tai chi are ways to focus the brain away from stressful situations.

• Socialization: Talking and spending time with friends or family can relieve stress.

• Hobbies: Crafts, hobbies and other engaging activities can direct attention away from stress.

• Talk therapy: Seeing a therapist may help some people work through stress and discover additional techniques to change how they respond to stress.

• Situation changes: Changing a job, residence or a condition that removes a source of stress may be handy. Manypeoplesufferfromstress,whichcanbeveryharmfulifnotdealtwith healthily and readily.

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When I was walking my dogs, these kids had a loud speaker playing rude music on max volume.Then they started to shout disrespectful comments to me and my dogs. Where are these kids’ parents?!

Shame on man who cussed out preschool child

On Saturday afternoon, 6/17/23, shame on the man who abruptly stopped his blue 4 door sedan in [a parking lot] across from [fast food restaurant] to cuss out a child. The man exited his car, opened the driver side rear door to shout obscenities at what appeared to be a pre-schooler strapped into a car seat in the back. The man then grabbed the child’s drink and threw it on the ground. Then he called the child a disgusting name, slammed the door, and proceeded to take off in the car at about 50 mph in the mall lot. Shame on you as an adult to act like that to anyone, much less a child. Still shocked by this unacceptable behavior! :O

Ridiculously Rough Railroad Tracks

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