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Saturday, August 12, 2017

The Heart of the Matter: You're Only Getting Half the Story (Part 1)

I watched the documentary, The WIDOWMAKER, a 2015 documentary chronicling political and financial positioning of stents and the coronary heart scan.  

The repeat question through the movie was how do we stop people from dropping dead from a silent heart problem?  People are dying without any warning symptoms.  Sudden cardiac arrest is still the number one cause of death. (http://www.sca-aware.org/about-sca)

It was an eye opening film about the challenge of heart disease. It showed how the invention of the stent became a booming business for cash strapped hospitals.  Doctors, hospitals and medical device manufacturers make loads of profit from the stenting procedure. 

The problem is there is no change in later outcomes.  Life span is not increased. Compared to people on medications without the procedure there is no difference.  (And I would add, quality of life may not be any better) The stent industry was being attacked for looking only at financial gain and not patient well being.  It has been shown that stents do help people with severe chest pain, but, in my opinion, the patient is still responsible for his or her own health habits hoping to not cause anymore clogging of coronary arteries.  Focusing on the patient's own self care was not the intent of the documentary.  Diet and fitness were barely mentioned.

The film also noted that a future bypass (if needed) cannot be performed where there is a stent, so it is a concern to people who develop new blockages. The film doesn't attempt to tackle the  question regarding restenosis or additional clogging.  It does seem if you talk to enough people in your own community that people go in for repeat procedures.  Since the thesis of the WIDOWMAKER was to only address sudden death, an entire conversation related to long term health was not included.  

The coronary artery scan has been available for a number of decades but has been ridiculed by doctors who didn't see the value in it.  It is a CT scan of the heart.  Blocked arteries are able to be viewed and graded for it's calcium content. As a screening tool, it was hoped it would alert doctors to people at risk so they didn't become a sudden death victim.  Doctors remarked the information wasn't helpful and they didn't know how to treat a patient in that situation. Some argued that a low cost scan is not as lucrative for hospitals compared to the surgery.  More recently the heart scan is now being accepted as part of the screening process, but in my view, it's forcing more people to go on risky medications. 

Overall, the movie was informative as a historic detailing of the two health care interventions. It did not provide any clear notions on what creates and maintains health. And, death from sudden cardiac arrest is still the number killer of Americans.

So, at the heart of the matter is how do we obtain a fuller perspective?  You are only getting half of the story.  If you are a watcher of documentaries like this, you probably know that they are a simple way to learn about a topic.  It should spur you on to do your own research.  

On a lazy Saturday night, I actually enjoy watching these types of documentaries.  These films show me there is enough global interest in empowering people with health information. But, I know there are a lot of gaps that need to be filled. 

The tag line of the movie is  "Watch this film, it could save your life."  But I believe you need more than this film.

In Part 2 of my blog post, I will share with you the other half of the story.   (Visit Part 2 Here)

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