CHANGE OF HEART

Until she had a ministroke at 31, writer Amanda Scriver had no idea that heart disease and stroke is one of the leading causes of death for Canadian women—and risk factors, symptoms and even treatment might vary by age.

IT WAS DEC. 13, 2014. I was getting ready to go out for dinner when suddenly everything went wrong. I lost coordination, almost like I was drunk. I went numb, as if the local anesthetic that dentists use had been applied to half of my body. My arm went limp, I could barely walk and, out of the blue, I got a raging migraine.

At 31 years old, I was in the midst of a transient ischemic attack, often called a ministroke, but I had no idea. It wasn’t until the next day, when I was feeling only slightly better, that I realized something was really wrong. I didn’t want to wait for an appointment with my family doctor, so I called Telehealth Ontario, the provincial service that connects callers to a registered nurse via telephone. In the very back of my mind, I wondered if I’d had a stroke—but I was too young, or so I thought. But when I described my symptoms, it became clear that I wasn’t too young. In fact, the nurse who took my call was worried enough to send paramedics to my house. Soon, I was in the back of an ambulance, rushing through Toronto’s busy streets on the way to the hospital.

Luckily, my stroke was mild, and, in July 2015, I underwent surgery to have a patent foramen ovale closure device inserted to close the hole in my heart. But, to this day, I’m still shocked at how little I knew about the risks associated with stroke and heart disease, or just how common they are. As I soon learned, about 1.6 million Canadians—557,000 of them women over the age of 24—report having cardiovascular disease. And, according to a study looking at factors and behaviours affecting cardiovascular health published in 2013 in the Canadian Medical Association Journal, fewer than one in 10 adult Canadians were in ideal cardiovascular health from 2003 to 2011, which means 90 percent of us are making choices that are increasing our risk for a cardiovascular event. In fact, heart disease and stroke is one of the leading causes of death for Canadian women, and most of us have at least one risk factor.

It’s a club that I didn’t particularly want to be a part of, but having joined, I began wondering what other women’s experiences had been like.

Unlike me, when Victoria resident Carolyn Thomas started having a range of symptoms— crushing chest pain, nausea, weakness, sweating and a persistent ache down her left arm—on her 58th birthday, she immediately thought it could be a heart attack and went straight to the ER. But when she got there and told the doctor on duty about her symptoms, he said it was just acid reflux. “I remember exactly what he said,” she recalls. “‘You’re in the right demographic for acid reflux. Go home and call your family doctor for a prescription for antacids.’ ” Embarrassed and apologetic, she did just that. But her symptoms persisted for two more weeks. She eventually went back to the hospital, and this time, she was told she was suffering from what was actually one of the most serious types of heart attacks—a complete blockage of her left anterior descending artery, which is often referred to as the widow-maker.

Since then, she has recovered, but it’s far from full—she had to retire early and continues to see a specialist at her regional pain clinic.

Irmine Mackenzie also went to the hospital immediately. It’s been 35 years since the New Waterford, N.S., resident lost the use of her left arm and leg after suffering a stroke caused by carotid artery stenosis, narrowing of the arteries that carry blood from the heart to the brain. She was 61 years old and, having just finished eating breakfast with her husband, John, she headed to the kitchen to tackle the dishes. Suddenly, plates started dropping from her hands, shattering as they hit the floor.

After a six-week hospital stay and a threemonth stint in a rehabilitation program in Halifax, she eventually learned to walk again. Her ability to manage quite well over the past three decades is clearly a testament to her grit— and maybe some kind words from a stranger. “I won’t ever forget the ambulance driver who took me to the rehabilitation centre,” she says. “He told me, ‘We’re taking you by stretcher now, but you’ll be walking out of there with a cane.’ ” Sure enough, that’s exactly what she did.

It has now been two years since I suffered my transient ischemic attack, and I feel like I’m still learning about heart health. I now understand the importance of cardiac rehabilitation, for one thing. When I had my stroke, I didn’t know this kind of program existed—my cardiologist didn’t refer me to one, but having access to dedicated professionals in a safe, encouraging environment could have helped me navigate the health-care system and guided me toward healthier choices.

One thing I found myself, Carolyn and Irmine echoing is how, as women, we must advocate for ourselves in the health-care system, ensuring that our voices are heard and our health is looked after. We need to put ourselves first, without shame or guilt. As Dr. Paula Harvey, director of the cardiovascular research program at Women’s College Hospital in Toronto, says, “It comes back to education and partnership with your health provider. Don’t be afraid to ask questions and be informed.”