Ask Dr. Annie K.

A new feature on Love+Medicine!

Here is where I take questions from you, my wonderful readers.
Any subject is fair game. Questions may be sent anonymously.

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Today I was asked an interesting question I’d like to share.
A patient asked me:

“Is there a such thing as broken heart syndrome?”

 

LoveAndMedicine_BrokenHeart

Broken heart syndrome is, sadly, a real malady. It is also known as Takotsubo cardiomyopathy.  Takotsubo, a type of octopus trap (!), was first described in Japan in 1990.  When someone suffers from an event that causes stress, it can take a toll on the heart. The stressor can be from any type of sudden news or confronting situation such as

  • loss or illness of someone close – a relative, friend, pet
  • intense fear – public speaking, while engaging in high risk sports
  • severe pain
  • rejection
  • domestic violence
  • receiving bad news – such as a cancer diagnosis
  • witnessing an accident
  • sudden financial loss
  • a surprise

Scientists believe that the event causes an increase in the “stress hormone” called adrenalin. Adrenalin causes the heart to overwork and eventually weaken, particularly the left ventricle. Clinically, it looks just like a heart attack. The patient complains of the typical symptoms of chest pain and shortness of breath. A complete work up to rule out a heart attack is needed, STAT! An EKG may show signs of a heart attack but in broken heart syndrome there are actually no blockages in the arteries surrounding the heart! Cardiac enzymes may increase, like in a heart attack, but the increase is small. Heart cells are merely “stunned”, they are not killed like in a heart attack.

The illness occurs almost exclusively in women, generally between the ages of 58-75. The good news is that it is reversible and most patients are better in one-two months. In rare cases it can be fatal, if the patient develops heart failure as a result of the weakness of the heart.

As humans we are very adaptable, but some situations are devastating to such a degree that, as we see, the heart can indeed be broken. No one should be alone while experiencing extreme physical and emotional stress. Even if the incident appears trivial and doesn’t warrant this degree of sadness, this is no time for judgement. There is no timeline for overcoming loss- so silly how we learned in medical school, one month of grieving for every year together- everyone is different. Be there, for as long as it takes.

 

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Studenterhue – The Student Cap

June in Copenhagen. One of the most notable sitings all over town is the presence of truckloads of students graduating from high school, all wearing caps, dancing to loud music. While walking through the park, a Danish fellow explained the tradition and agreed to share it….

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In the dark all cats are grey.
– Benjamin Franklin

What I’m Watching

What I'm Watching

People often ask me what I am watching these days. Not because I watch so much, but because I am very passionate (and vocal;) about what I watch. This is the age of great television, specifically not network television. People who ask me know that I have very particular preferences in what I watch and they are drawn to the same, or they tell me how horrified they are that I suggested it!

First let me tell you what I really disliked, if you like these, you may not be drawn to my recommendations. Notting Hill, Modern Family, anything with Sandra Bullock, reality TV, Star Wars, The Notebook, anything animated, anything PG13, comedies.

My kids say that I only like movies where “nothing happens.” So here is my list right now, subject to change:

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Steady Hand

Love + Medicine Steady Hand

Steady Hand

The Bris. The celebration of removal of foreskin
The first of his covenants with our Creator
Not in the presumed sterility of hospital walls
But done in one’s home surrounded by family and deli

Some choose to step back
Shout out the obligatory “mazel tov” on cue.
Others crowd around close to the makeshift surgical center
All are subject to the litany of moyel jokes that muster up an awkward chuckle

No one is as queasy as the infant’s father
Sweating, praying for a steady hand.
Questioning why didn’t we do this in the hospital, where it’s “clean”
Beginning to question why to do this at all,
Take a knife to his son, only 8 days on this Earth

Sucking on gauze soaked in Manishewitz,  the child lies peacefully
Placed on a pillow held by the Godfather, the highest of honors
He is then handed over to the  moyel who slices off the foreskin
The piece of flesh left on the table for burial In the yard.

As the generations before and the generations after,
Jews celebrate this act
Recognize the solemnity of the day
Feel a sense of tradition, respect and honor it

For the mother and father it marks a milestone
Of trusting and letting go
Loving, forgiving and coveting this child.
Always hoping for that steady hand

– Anne Koplin, M.D.