In a number of recent posts, I have analyzed and dissected some of the medical terms that appear in my clinical summaries. My analysis of this bewildering and sometimes peculiar vocabulary has led me to the conclusion that some medical terminology should be devised much more carefully.
Here is one example. It is confusing when medical diagnoses do not clearly define what part of your body is impacted, or what is wrong with it. This is typically the case with medical terms named after people. As an example, calling something a Mobitz Type II conduction disorder still doesn’t tell us within the four corners of the medical term exactly what and where the problem is. Seriously, how many people ever use the word "conduction" in a sentence? But, if you say atrioventricular block or even AV block, it might be easier for a patient to discern that the term means that electrical signal impulses between the atria and the ventricles are being blocked.
Yes, I understand that the term may be intended to honor someone who made significant contributions to treating the particular disorder, or who helped determine the nature of the disorder. But perhaps it would make more sense to name a hospital wing or a medical procedure after the person. We the patients really need you to develop a more concise, descriptive term to tell us know what the medical issue is.
Another condition that has been used to describe one of my heart problems is sick sinus syndrome. This is a little better than Conduction Disorder – Mobitz Type II, in that it tells me a body part that is impacted. Obviously in this particular name, the sinus is sick. I would point out, however, that since there are two sinuses in the body, it would be important to know that it is the sinus node of the heart we’re talking about and not our sinus cavities.
But sick is kind of a useless, non-informative term if one is trying to describe a problem with the sinus node of the heart. Why? Well according to the Oxford English dictionary, the definition of the word sick is “affected by physical or mental illness.” I mean, that’s it, that’s all that the word sick lends to the entire term “sick sinus syndrome.” As the patient, the fact that I made a doctor’s appointment means that I have concluded that my heart is affected by physical illness. Why else would I be spending time and my ever increasing co-pays to visit a cardiologist and a heart failure specialist? Heart doctors who treat lawyers, may have been advised that the term “sick sinus syndrome” is “void for vagueness”. What does that mean? In very simple terms it means that a law is not sufficient clear – just like the medical term at issue is not sufficiently clear. How about something like sinus node rhythm disorder?
But let me do more than just criticize confusing heart diagnoses. Trust me, patients with other conditions could also use some help in deciphering or modifying intimidating medical terminology. Let me point out an example many women hear or see on their medical documents every day. Let’s say you are a woman in your mid to late thirties who has just received the happy news that you are pregnant. You’re about to crack open the bottle of champagne when your doctor drops the term “geriatric pregnancy” into the conversation. Watch the figurative bottle of champagne flow quickly down the drain.
Really - geriatric pregnancies???? I found a number of references to this term on the web. According to healthline.com: “In the medical world, a geriatric pregnancy is one that occurs anytime a woman is over the age of 35. Here's what to expect if you become part of the geriatric pregnancy club. First of all, you should know that a geriatric pregnancy is just a label from the medical world that was created a long time ago. Today, more women than ever have babies after 35. According to the Center for Disease Control and Prevention, the number of women between the ages of 35 and 39 who had their first babies has increased in all race groups.”
As I understand it, the term is intended to note that the following risks are present with a pregnancy when the mother is in or over her mid-30s: premature birth; low birth weight in the baby; stillbirth; chromosomal defects in the baby; labor complications; cesarean section; high blood pressure in the mother, which can lead to a serious condition called preeclampsia, and an early birth for the baby; and gestational diabetes, which also increases the risk of diabetes later in life.
Okay – I get it. Medical professionals need to make women in this age range aware that there is a higher risk associated with these pregnancies. But why don’t we focus on the nature of the risks to the child and the mother, rather than on the age of the mother. I mean – geriatric? According to the thesaurus feature of Microsoft Word, geriatric means either elderly, aged or old. Since when did someone in their mid-30s become old? She won’t even qualify for AARP membership for about another 15 to 20 years. I don’t think anyone would dispute that we need to come up with a better term. I mean come on – when you commit to motherhood, you are embarking on a lifelong commitment to a child. You don’t need someone making you feel like you are too feeble and old to take on this task.
Healthline.com also indicated that the medical world now uses the term “advanced maternal age.” But the term “advanced maternal age” has challenges as well. A gynecologist told me that her patients who are in their 30s hear that term and worry that they are too old to have children. Great – in the 1960's, Cary Grant became a father when he was over 70, but women in their 30s worry that they are beyond child-bearing age. What is wrong with this picture?
Let’s take the recent example of actress Brigitte Nielsen, who recently became a mother at 54 years old. That’s right – almost 20 years older than the women who are now referred to as being in a geriatric pregnancy. If I were Nielsen’s doctor, I would hesitate to use this term around her, as she portrayed the Amazon warrior Red Sonja in the mid-80s. But hey, maybe she has mellowed in the last 30 years.
But now we return to heart diagnoses. Because even if Brigitte has mellowed, I can guarantee you that Melanie has not mellowed when it comes to the term “heart failure”. This is probably my favorite pet peeve, as readers can attest that they have seen me on many occasions implore doctors to come up with a better term than heart failure. Why? Well let’s just look at what the American Heart Association says about heart failure: “The term "heart failure" makes it sound like the heart is no longer working at all and there's nothing that can be done. Actually, heart failure means that the heart isn't pumping as well as it should be.”
That’s right – your eyes are not deceiving you. They (meaning those in the field of medicine) have given a condition that impacts millions of people worldwide an inaccurate and misleading name! Why would they do that – I mean, isn’t it in the best interest of the patient to call this chronic condition something that doesn’t sound like you’re already dead? I mean, wouldn’t treatment projections be a little more upbeat if we didn’t make you and your heart feel like abject failures? I would note that the AHA page on heart failure says that they are here to help us learn more, improve symptoms and feel better. Well I am pretty sure that all of us heart failure patients would improve and feel a lot better if we had a more motivational and optimistic term to describe our condition.
The Collins English dictionary has the following definition for the term dysfunction: “If someone has a physical dysfunction, part of their body is not working properly.” The example that is provided is “kidney and liver dysfunction.”
The Free Dictionary’s medical webpage also gives the following definition: disturbance, impairment, or abnormality of functioning of an organ. The example that is provided is “erectile dysfunction impotence.” So let me be about as blunt and irreverent as I can be. How would men like it if ED (Erectile Dysfunction) was actually EF (Erectile Failure)? Just as much as guys don’t want to hear the word failure in this context, I can guarantee you heart patients don’t want to think their heart has failed either. As my sister pointed out, it's like the line in the movie Apollo 13: Failure is not an option!
So let’s end the silliness and maybe call heart failure what it really is: heart dysfunction. If that doesn’t work for the heart experts, let me propose this. At your medical conferences, you have happy hours right? Yeah, I know, you refer to them as networking opportunities – all of the occupations do. But let’s face it. If there is liquor and food and lots of people mingling, it’s a happy hour! So over that beer or glass of wine or a Martini, bounce ideas off each other for some better medical terms that not only adequately describe a condition in terms the patient can understand, but also helps them to feel that there is hope to eventually manage the condition. I bet you could come up with some real winners!
Melanie discovered that she had heart failure in 2013. She spent the next 7 years learning how to live with the condition, and how to achieve balance and personal growth. Then in October 2020, she received a heart transplant. This blog is about her journey of the heart.