Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly
Speaker 1: conversation about mental health, personal development, and all the small
Speaker 1: decisions we can make to become the best possible versions
Speaker 1: of ourselves. I'm your host, doctor Joy hard and Bradford,
Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or
Speaker 1: to find a therapist in your area, visit our website
Speaker 1: at Therapy for Blackgirls dot com. While I hope you
Speaker 1: love listening to and learning from the podcast, it is
Speaker 1: not meant to be a substitute for a relationship with
Speaker 1: a licensed mental health professional. Hey, y'all, thanks so much
Speaker 1: for joining me for session three forty five of the
Speaker 1: Therapy for Black Girls Podcast. We'll get right into our
Speaker 1: conversation after a word from our sponsors. Did you know
Speaker 1: that February is American Heart Month. We're celebrating by bringing
Speaker 1: awareness to cardiovascular health disparities, especially those that impact black women.
Speaker 1: Joining me for this conversation is doctor Jane Morgan, cardiologist
Speaker 1: and the executive director of the COVID Task Force at
Speaker 1: the Piedmont Healthcare Corporation in Atlanta. In addition to being
Speaker 1: published in the areas of congenital heart disease and interventional cardiology.
Speaker 1: Doctor Morgan currently serves as a board member of the
Speaker 1: National Diversity and Inclusion Team at the American Heart Association.
Speaker 1: During our conversation, doctor Morgan explains what it means to
Speaker 1: have a healthy heart, how race and gender play a
Speaker 1: part in the healthcare system's treatment of heart related issues,
Speaker 1: and what black women should be aware of to preserve
Speaker 1: healthy hearts for a lifetime. If something resonates with you
Speaker 1: while enjoying our conversation, please share with us on social
Speaker 1: media using the hashtag TBG in session or join us
Speaker 1: over in the sister Circle to talk more about the episode.
Speaker 1: You can join us at community dot therapy for Blackgirls
Speaker 1: dot com. Here's our conversation. Well, thank you so much
Speaker 1: for joining me today, doctor Morgan.
Speaker 2: I am really pleased to be here. Thank you for
Speaker 2: having me.
Speaker 1: Thank you. So. Can you walk me through what a
Speaker 1: typical if there is a typical day for you, what
Speaker 1: does that look like as a cardiologist?
Speaker 2: Wow, that's a surprise question. So a typical day for
Speaker 2: a cardiologist versus a typical day for doctor Jane Morgan
Speaker 2: are completely two distinct things. I am a cardiologist. When
Speaker 2: formally trained cardiologists have spent quite a few years of
Speaker 2: my career in research, really hard R and D research
Speaker 2: at Abbott which is ABV now and solve A, and
Speaker 2: then also leading large clinical trial sites including where I'm
Speaker 2: working now at Piedmont Healthcare. Actually came here to lead
Speaker 2: the cardiovascular research program and then strategy across all of research.
Speaker 2: So that's clinical trials and enrolling patients and clinical trials,
Speaker 2: and so that is somewhat of a different lens of
Speaker 2: cardiology and medicine than other doctors who are more patient
Speaker 2: facing and are actually managing and seeing patients each day.
Speaker 2: I'm on the other side of that, providing the tools
Speaker 2: that they will need to continue to manage them better
Speaker 2: and better and better. So these tools that will go
Speaker 2: before the FDA and get approval such that all physicians
Speaker 2: who are treating patients can treat their patients to the
Speaker 2: top of evidence based medicine. And so I therefore straddle
Speaker 2: the line, so to speak, on one side with patient
Speaker 2: facing and then the other side back in behind the curtain,
Speaker 2: the behind the curtain part that people don't see. How
Speaker 2: do the drugs get there? How do the pharmaceuticals get there?
Speaker 2: How do our therapeutics get there? How do our devices
Speaker 2: get there? How do we use them? There's a whole
Speaker 2: process before we enter the doctor's office, before we enter hospitals,
Speaker 2: and look at all of those machines, all of that equipment,
Speaker 2: all of the algorithms, all of the processes, all of
Speaker 2: the medications that will be recommended. There's a process beforehand.
Speaker 2: So I've got a strong foothold in that part as well.
Speaker 1: Got it. Thank you so much for that. So what
Speaker 1: does it mean medically for us to have a healthy heart?
Speaker 3: A loaded question.
Speaker 2: So ultimately, when we talk about physically, let's talk about
Speaker 2: physically a healthy heart. We talk about something called an
Speaker 2: ejection fraction. So this is how we measure how strong
Speaker 2: your heart is pumping. Generally, a normal ejection fraction is
Speaker 2: sixty percent, So you might think it's one hundred percent,
Speaker 2: but it's not. Ejection fraction is measured from zero to sixty,
Speaker 2: So normal is sixty percent, and maybe you can drop
Speaker 2: down in a fifty percent range, but generally it's around
Speaker 2: sixty percent, probably not much lower than fifty five percent,
Speaker 2: so that maybe it would be a healthy heart with
Speaker 2: regard to its function. It's pumping, and then we've got
Speaker 2: arteries that feed the heart, and these arteries need to
Speaker 2: be open, what we call being patent. They need to
Speaker 2: have good blood flow, not have any blockages with plaques
Speaker 2: that can be caused by atheroskrosis. You've probably heard that
Speaker 2: term athorosclerosis, which is caused by cholesterol build up and
Speaker 2: fat things like that over a lifetime in our bodies.
Speaker 2: That blocks the blood flow and also blood clots. And
Speaker 2: so when you get these blockages in those arteries that
Speaker 2: are feeding the heart, that's what we know of as
Speaker 2: a heart attack. And then probably the third thing I
Speaker 2: would think of as a healthy heart would be electrical
Speaker 2: activity of the heart that the heart is beating in
Speaker 2: a normal way, has normal electrical impulses, and you're not
Speaker 2: having any type of a rhythmias, so that means an
Speaker 2: irregular heart rhythm. And so perhaps at a high level,
Speaker 2: those are three big buckets of what I would consider
Speaker 2: a healthy heart physically, good electrical activity, open arteries, and
Speaker 2: good heart function.
Speaker 1: Got it, And so would the converse of those be
Speaker 1: not having good heart health.
Speaker 2: I would say the opposite of any one of those three.
Speaker 2: So you don't have to have all three any one
Speaker 2: of them, and then you have some heart issues and
Speaker 2: you probably are being seen by cardiologists, and depending on
Speaker 2: how severe they are will depend on how they're managed
Speaker 2: and to what degree of management is required. It's certainly
Speaker 2: not all three any one of those three. And these
Speaker 2: are big broad categories. I'm going to admit these are
Speaker 2: large buckets just to me make it easy to understand.
Speaker 2: These are big three large buckets. But any of those buckets,
Speaker 2: if they require any type of intervention, it does mean
Speaker 2: that you have some negative impact of your heart. Doesn't
Speaker 2: mean that it's life long, but it does mean that
Speaker 2: it probably requires some attention.
Speaker 1: So what kinds of factors, doctor Morgan, actually impact our heart.
Speaker 2: Health When we look at heart health. A couple of
Speaker 2: things that we think about with regard to factors always
Speaker 2: is lifestyle. How are we kind of live in our
Speaker 2: lives because a lot of things that we do at
Speaker 2: a younger age actually come back to either fortify us
Speaker 2: or haunt us later. It's like skin cancer in that way.
Speaker 2: We may not think about it that way, but the
Speaker 2: amount of sun exposure and sun burns that you may
Speaker 2: have received growing up can impact the risk of you
Speaker 2: developing skin cancer later. Even if you're wearing skin block
Speaker 2: every single day of your life, adult life. It can
Speaker 2: be related to that exposure when you are in your
Speaker 2: developing years and when you're in younger years, and that's
Speaker 2: the same thing for heart disease. And so we want
Speaker 2: to be able to watch our weight, make certain our
Speaker 2: weight is in a healthy range because we know that
Speaker 2: elevated weight increases your risk of a number of things.
Speaker 2: Increases your risk of high blood pressure. High blood pressure
Speaker 2: is a risk factor for heart disease, increases your risk
Speaker 2: for cholesterol. Cholesterol is a risk factor for heart disease,
Speaker 2: increases your risk of diabetes. Diabetes is a risk factor
Speaker 2: for heart disease. And then it also creates something called
Speaker 2: a chronic inflammatory state in your body. And we also
Speaker 2: now know that inflammation is a risk factor for heart disease,
Speaker 2: not just heart disease, but for cancer, for arthritis, and
Speaker 2: for a number of other chronic medical conditions in our body.
Speaker 2: The state of being obese creates enough stress on the
Speaker 2: body that it increases that state of inflammatory response, and
Speaker 2: the body being in a state of chronic inflammation as
Speaker 2: opposed to acute inflammation where we respond to trauma and
Speaker 2: then we heal and it goes down. We respond to
Speaker 2: an incident with inflammatory processes, then it heals and it
Speaker 2: goes down. With obesity, then that inflammatory state always remains,
Speaker 2: and we understand now that is toxic to the body.
Speaker 2: Of the duration of obesity over time can increase your
Speaker 2: risk of heart disease as well as increase your risk
Speaker 2: of a number of other medical conditions. So that's part
Speaker 2: of a healthy lifestyle. The other thing to think about
Speaker 2: is your mental health. That does have a lot to
Speaker 2: play in regard to your heart health and with regard
Speaker 2: to the social interaction that people have. And we've seen
Speaker 2: that now as we're coming out of COVID that isolation
Speaker 2: and loneliness are also related to heart disease, and the
Speaker 2: one that is most closely related. They both are related,
Speaker 2: but the one that is most closely related is loneliness.
Speaker 2: And loneliness may be hard to identify because lonely people
Speaker 2: may actually be surrounded by tons of people and have
Speaker 2: a lot of interactions but not feel any connection and
Speaker 2: not feel understood and isolated. People who actually are not
Speaker 2: in contact with people may not actually feel lonely. They
Speaker 2: may be very content. So sometimes it's hard to identify
Speaker 2: the lonely person and the isolated person, but both of
Speaker 2: those are certainly at risk. And then you ask about genetics.
Speaker 2: Genetics always plays a role in everything that we do,
Speaker 2: but our environmental factors, our environmental choices, and our environmental
Speaker 2: exposures that are not of our choice influence genetics as well,
Speaker 2: positively or negatively.
Speaker 1: Doctor Marian, can you say a little bit more about
Speaker 1: like the loneliness and isolation, what is the science piece
Speaker 1: behind how that's connected to your heart?
Speaker 2: So a couple of things. People who experience loneliness and
Speaker 2: isolation also tend to demonstrate aberrant or abnormal sleep patterns,
Speaker 2: and sleep is a direct contributor to heart disease. We
Speaker 2: now know that not only the duration of sleep, quality
Speaker 2: of sleep impacts the progression of heart disease. And people
Speaker 2: who have isolation and loneliness who are able to express
Speaker 2: and identify that these are self identified, so we know
Speaker 2: they're probably even more than that if we were to
Speaker 2: have a standardized survey of standardized test and really identify
Speaker 2: people these are self identified, and we know that sleep
Speaker 2: has something to do with that. And anxiety and depression,
Speaker 2: which often go along with loneliness and isolation, also negatively
Speaker 2: impact sleep. As Homo sapiens, as human beings. We are
Speaker 2: social creatures, and I think what we have learned, you know,
Speaker 2: we've learned many things from COVID. I just this is
Speaker 2: just one small slice. We've learned a lot of stuff
Speaker 2: from COVID is that social interaction, certainly at critical periods
Speaker 2: of our lives, is incredibly important. And where we see
Speaker 2: this isolation and loneliness used to be prior to COVID
Speaker 2: in our older population sixty five seventy five years of
Speaker 2: age and older. As they've gotten older, their children have
Speaker 2: grown up and moved away, their friends maybe have died
Speaker 2: or become more debilitated. They've retired from their jobs, their
Speaker 2: spouses maybe have died, and they're increasingly isolated with fewer
Speaker 2: and fewer resources, may be no longer able to drive
Speaker 2: and become increasingly depressed. And depression leads to increased risk
Speaker 2: of death and increased risk of accidents. What we found
Speaker 2: with COVID is that demographic, yes, still remained vulnerable to
Speaker 2: isolation and loneliness, but now it was the demographic of
Speaker 2: eighteen to twenty five year olds. Now that was our
Speaker 2: number one demographic that was self identifying isolation and loneliness,
Speaker 2: and also the impact of and dependence on social media
Speaker 2: to fill that void. And obviously we increased our use
Speaker 2: of social media during COVID to increase to maintain our
Speaker 2: social contacts and our socialization. But what we have discovered
Speaker 2: is that it doesn't really substitute for in person human
Speaker 2: to human interaction. And as physicians, we're starting to learn
Speaker 2: that as well as technology in many ways has taken
Speaker 2: over our practices, how we're managing our practice, how we
Speaker 2: diagnose payations, how we may or may not implement the
Speaker 2: physical exam because we have so many tools to do
Speaker 2: these diagnostics for us, that human touch that used to occur,
Speaker 2: that connection between the patient and the physician has also
Speaker 2: been lost, and we're starting to dial that back to
Speaker 2: understand Wait a second, just coming in and putting hands
Speaker 2: on the patient and pal pating and oscultating and listening
Speaker 2: and touching and pushing and probing and touching that was
Speaker 2: part of the physical exam and part of the health
Speaker 2: of the patients such that they felt that someone cared,
Speaker 2: They felt that the sense of well being. But it
Speaker 2: also ties into us being Homo sapiens and understanding social
Speaker 2: interaction more so than technological advancements as much as we
Speaker 2: are pushing them forward. So we've got to find out
Speaker 2: what that balance is.
Speaker 1: Thank you so much for that. More from our conversation
Speaker 1: after the break. So what kinds of symptoms or experiences
Speaker 1: might we mean me having that would indicate to us that, hey,
Speaker 1: we might need to talk with our doctor about something
Speaker 1: going on with our heart. What should we be paying attention.
Speaker 2: To, my goodness, So let's just talk about the heart.
Speaker 2: As a cardiologist, I'm just going to focus on the heart.
Speaker 2: If you are feeling short of breath, if you are
Speaker 2: having chest pain, if you are feeling light headed, if
Speaker 2: you have what we call diaphoresis sudden episodes of sweating,
Speaker 2: those are probably some of the more common ones. Maybe
Speaker 2: even left arm pain. Those could be signs that you
Speaker 2: may be at risk of having a heart attack and
Speaker 2: you should see your physician. Now I'm going to talk
Speaker 2: about something that we call a typical symptom. So this
Speaker 2: term a typical, which I don't really care for because
Speaker 2: for the most part, it denotes and characterizes symptoms that
Speaker 2: a woman may have in comparison to a man, and
Speaker 2: that word a typical also tends to be interpreted and
Speaker 2: used as an understood as a deviation from normal, a
Speaker 2: standard away from not the usual, something additional to learn,
Speaker 2: not the main thing. But the fact of the matter
Speaker 2: is women are more than fifty one percent of the population,
Speaker 2: So maybe we're actually the ones having the main symptoms
Speaker 2: and it's the men who are not. Maybe need to
Speaker 2: relearn this, We need to unlearn it and relearn it.
Speaker 2: And it just goes to show you how male dominance,
Speaker 2: like almost everything, and our culture has driven our culture
Speaker 2: and even the lexicon of the language that we are using,
Speaker 2: and it really impacts our action. Think about seeing a
Speaker 2: patient and they're having the typical symptoms, right, what are
Speaker 2: you more likely to do as opposed to a patient
Speaker 2: who's having the atypical symptoms? How are your actions going
Speaker 2: to be different? And that impacts position. So, okay, I
Speaker 2: said all that, I'm gonna get off my soapbox on that.
Speaker 2: You can follow me if you want to hear me.
Speaker 2: Just really hammered down on that atypical symptoms. You might
Speaker 2: have some jaw pain, right, and you may not relate
Speaker 2: that to your heart. You may think it has something
Speaker 2: to do with your teeth. You might actually go to
Speaker 2: the dentist or something. You might have some back pain.
Speaker 2: Who doesn't have back pain, especially women as you get
Speaker 2: older and you've had children, you're running around back pain,
Speaker 2: or you might just have like a cold or a flu,
Speaker 2: something you just can't shape. You just can't seem to
Speaker 2: completely get over it. Or you might just be run down.
Speaker 2: Who isn't run down, especially a woman at mid age,
Speaker 2: who isn't just feeling run down. You have a million
Speaker 2: reasons to feel tired, to have back pain. And so
Speaker 2: because we don't recognize those as the main symptoms, they
Speaker 2: are relegated to this atypical category. Then the patients and
Speaker 2: society itself doesn't recognize them. We don't as women, we
Speaker 2: don't recognize that because we haven't been taught that right.
Speaker 2: We're not the main priority, and doctors themselves may not
Speaker 2: recognize it. In fact, forty two percent of primary care physicians,
Speaker 2: when they were surveyed, admitted that they felt uncomfortable treating
Speaker 2: a woman with heart disease. And if you can believe this,
Speaker 2: twenty two percent of cardiologists in the survey stated that
Speaker 2: they felt uncomfortable treating a woman with heart disease. And
Speaker 2: so that seems amazing until you really think about it.
Speaker 2: And if you think about it. Most cardiologists are men,
Speaker 2: so it makes sense because these are not symptoms that
Speaker 2: we are taught to understand, and so these are all
Speaker 2: symptoms of which we need to start to think about.
Speaker 2: What about things like palpitations? Absolutely think about palpitations. If
Speaker 2: you start to have palpitations, don't ignore them, make certain
Speaker 2: you see someone for it. But here's something else to
Speaker 2: think about. I'm kind of moving on into another subject,
Speaker 2: so pull me back in, rain me in.
Speaker 1: I do have some follow up questions, though, so before
Speaker 1: you go to for it. So you mentioned the pain
Speaker 1: in the left arm. I want to know why specifically
Speaker 1: the left arm and not like either arm.
Speaker 3: So that's an interesting question.
Speaker 2: But generally it is in the left arm, and it
Speaker 2: could be just neurologically, but it generally is a left
Speaker 2: arm and sometimes numbness in that left arm. Now can
Speaker 2: it happen in the right arm? Can it happen in
Speaker 2: the right chest? Yes, atypical, but can it happen yes,
Speaker 2: of course it can't.
Speaker 1: Got it? And you also mentioned sudden bursts of sweating,
Speaker 1: which made me think of a conversation we hit on
Speaker 1: the podcast recently around like perimenopaul symptoms and menopaul symptoms.
Speaker 1: So how would you know, like the difference between oh,
Speaker 1: this is like a hot flash versus like a heart concern.
Speaker 3: How would you know, Doctor Joy?
Speaker 2: Yeah, here we go, let's have this conversation. So if
Speaker 2: you are going through parimenopause and menopause, a couple of
Speaker 2: things to think about. I was just getting ready to
Speaker 2: jump into that with palpitation, So this is a great
Speaker 2: segue palpitations as you go through perimenopause, and perimenopause means
Speaker 2: that you are starting to have estrogen levels drop. You
Speaker 2: may still be having regular menstrual periods, but you are
Speaker 2: approaching a time when your menstrual periods may stop. And
Speaker 2: so perimenopause can go on for ten years or so
Speaker 2: before you actually hit menopause. And menopause is when you
Speaker 2: have gone one full year without a menstrual cycle at all,
Speaker 2: So that's menopause. So perimenopause could be ten or fifteen
Speaker 2: years before you get there, right, And those are ten
Speaker 2: and fifteen years where your body's changing and you don't
Speaker 2: know what's going on, and nobody knows what's going on.
Speaker 2: What's really happening is that your estrogen levels are gradually dropping,
Speaker 2: and we now know that estra has anti inflammatory properties,
Speaker 2: and you know what it just said that inflammation now
Speaker 2: is known as a part of progressing heart disease. We
Speaker 2: also know that estrogen has cardioprotective factors. So as your
Speaker 2: estrogen levels drop, inflammation increases, heart disease risk increases, and
Speaker 2: you also lose that protection of your heart. And so
Speaker 2: what happens is before menopause, women actually only have fifty
Speaker 2: percent of a risk of a heart attack of a man,
Speaker 2: only half. But by the time you reach menopause, our
Speaker 2: risk of a heart attack is equal to that of
Speaker 2: a man. And actually by the time that we are seventy,
Speaker 2: it has surpassed that of a man. And the reason
Speaker 2: I think that it has surpassed it is because of
Speaker 2: all the twenty five years before when we ignored all
Speaker 2: the pair ofmenopause and menopause, and we didn't treat it,
Speaker 2: and we wouldn't give menopause a hormone therapy, and we
Speaker 2: thought estrogen was bad and we thought progesterone was bad
Speaker 2: and nobody had been trained on it, and YadA, YadA,
Speaker 2: YadA YadA. So what happens is you can get palpitations
Speaker 2: this fast beating in your chest, sensation of a fast
Speaker 2: heartbeat just from estrogen levels dropping. But you wouldn't know that,
Speaker 2: and your physician may not know that. So you may
Speaker 2: go to the doctor, get a big work up, they
Speaker 2: can never find anything, and then what happens you get
Speaker 2: put on an antidepressant. In fact, the prescription for antidepressants
Speaker 2: doubles in women during the ten or fifteen years of menopause.
Speaker 2: That is not a coincidence. That is because women come
Speaker 2: in complaining of symptoms that people don't understand, many male physicians.
Speaker 2: You run test the test or negative, there are no
Speaker 2: test for the symptoms of menopause, and then you're just
Speaker 2: determined to be stressed out. Let me just give you
Speaker 2: this antidepressant. Good luck to you. You're just depressed. These
Speaker 2: symptoms are real and we need to think about them.
Speaker 2: So it's not just palpitations. And I'm not saying if
Speaker 2: you have palpitations, go straight to your physician, hopefully who's
Speaker 2: menopause certify and get your estrogym repleated, or get some
Speaker 2: estrogen progesterone combination. What I am saying is see your
Speaker 2: cardiologist and after your work up is negative. If it
Speaker 2: is negative, because if it's positive, you want to do
Speaker 2: something about it. Let me be clear on that heart
Speaker 2: disease is still the number one killer of women. So
Speaker 2: if you're having palpitations, see your position, get a work up.
Speaker 2: If that work up is negative, don't accept the antidepressant.
Speaker 2: If that workup is negative, now it's time to have
Speaker 2: a conversation with your physician about hormone replacement and resolution
Speaker 2: of those symptoms. The antidepressant is not the answer. So
Speaker 2: to your question about sweating, the same thing. You can
Speaker 2: have diaphoresis or sweating or in mini paus. We call
Speaker 2: them hot flashes now known as hot flushes, where you
Speaker 2: get these sudden periods of getting hot. You're sort of
Speaker 2: warm up inside your body and explode from the outside.
Speaker 2: So it's not from the outside coming in like the sun.
Speaker 2: It's the inside starts to cook and you start to sweat.
Speaker 2: Your internal temperature thermometer really starts to get hot. And
Speaker 2: those are also symptoms of perimenopause and menopause. We now
Speaker 2: know that hot flushes, the duration and the severity is
Speaker 2: also connected to heart disease, and women more likely to
Speaker 2: have more severe hot flushes and suffer from them. The
Speaker 2: longest are black women. So black women then also have
Speaker 2: this increased risk of heart disease just by de facto
Speaker 2: of the severity of the hot flushes and hot flashes.
Speaker 2: I'm using those terms interchangeably, but the new term is
Speaker 2: hot flushes. But I'm saying hot fleshshes and hot flushes
Speaker 2: just that everybody can follow along if you've never heard
Speaker 2: the term before. But we are transitioning to hot flushes.
Speaker 2: And let me just say this. They don't ask me
Speaker 2: about the terms. I had nothing to.
Speaker 3: Say with it. I don't know who the body is
Speaker 3: that makes these decisions.
Speaker 2: Well here's what I heard when I asked, why are
Speaker 2: we calling out hot flushes and a hot flashes? They said,
Speaker 2: a hot flash means that it's something that happens suddenly
Speaker 2: and disappears, And that's not what these are.
Speaker 3: They happen and they last sometimes for minutes and thirty minutes,
Speaker 3: and you're burning up and it just goes on and on.
Speaker 3: It is not a flash, and we want people to
Speaker 3: take it seriously. These are flushes, not flashes. So there's
Speaker 3: the background behind what it is. So it's being called
Speaker 3: if you see hot flushes, you heard it here. That's
Speaker 3: what it means. It's the same thing, but we're now.
Speaker 2: Calling it hot flushes.
Speaker 3: So we see this more.
Speaker 2: So in black women, and we know that black women
Speaker 2: also intermnopause about a year and a half earlier than
Speaker 2: white wo women for a number of reasons, which also
Speaker 2: means that further increases your risk of heart disease or member.
Speaker 2: Prior to menopause is when your heart is protected. So
Speaker 2: the earlier intermenopause, the sooner you remove that heart protection.
Speaker 2: So we don't actually want to go into menopause earlier,
Speaker 2: whereas it might be nice to not have to.
Speaker 3: Manage your minstral cycle anymore.
Speaker 2: From a health perspective, it means that your risk of
Speaker 2: heart disease now starts sooner and starts to build over
Speaker 2: a longer period of time, and is an indicator of
Speaker 2: your health status as well. Back to doctor Joy's original
Speaker 2: question of how do we stay healthy? How do we
Speaker 2: know if we're healthy? The age at which you inter
Speaker 2: menopause is an indicator of that health status.
Speaker 1: Wow, thank you so much for that, Doctor Warings. More
Speaker 1: from our conversation after the break, I do want to
Speaker 1: go there because my next question for you was a
Speaker 1: stat that we have from the American Heart Association that
Speaker 1: says among Black women ages twenty and older, nearly fifty
Speaker 1: nine percent have cardiovascular disease. And you've already mentioned some
Speaker 1: of the menopause, and like answering menopause earlier, I'm curious
Speaker 1: about any other disparities or susceptibilities that Black women have
Speaker 1: related to cardiovascular disease.
Speaker 2: So it's complex, I'm gonna start. We can't talk about
Speaker 2: the whole maternal mortality disaster that is America right now,
Speaker 2: so I'm gonna talk about just a couple of slices.
Speaker 2: When a woman is pregnant of any race, if she
Speaker 2: develops any complications during that pregnancy, and the complications are
Speaker 2: very specific. If you develop something called gestational diabetes, gestational hypertension,
Speaker 2: pre eclampsia, eclampsia, an older term toxemia. If you've ever
Speaker 2: heard any of those terms with regard to your pregnancy
Speaker 2: or someone in your family or someone of a friend,
Speaker 2: then those are long term indicators of heart disease. Not
Speaker 2: only do they put the baby at risk, but there
Speaker 2: are long term indicators of heart disease for the mom.
Speaker 2: Now the way that we used to practice and when
Speaker 2: I say used to practice. I mean like this morning,
Speaker 2: because we're still practicing this way unfortunately. The way that
Speaker 2: we used to practice as of this morning is that
Speaker 2: the way that you treat these conditions, which is how
Speaker 2: we were all trained, the way that you treat these
Speaker 2: conditions in a pregnant female is to safely deliver the baby,
Speaker 2: because once the baby is delivered and baby are healthy,
Speaker 2: then that disease process regresses goes away. It's something you
Speaker 2: see in pregnancy. So if you can't deliver the baby,
Speaker 2: then everything is fine. And it doesn't mean deliver the
Speaker 2: baby early. It means that the birth of the baby
Speaker 2: is the beginning of all of those medical symptoms going away,
Speaker 2: like those medical symptoms and conditions were actually caused by
Speaker 2: the pregnancy. We're not trying to induce early pregnancy. What
Speaker 2: we do is manage the mom's symptoms and conditions, sometimes
Speaker 2: with hospitalization, through her pregnancy, and then once the baby
Speaker 2: is born, we're like, shoot, we're done, good job, Mom's good.
Speaker 2: But now we know that what we should have done
Speaker 2: as of this morning is hand that woman off to
Speaker 2: a cardiologist. There should be a hand to hand referral
Speaker 2: from the obgyn to a cardiologist because what has happened
Speaker 2: is that that woman has just declared that she has
Speaker 2: an increased risk of heart disease over her lifetime, and
Speaker 2: in fact it will be two times higher than a
Speaker 2: woman who doesn't have those complications. So here's the way
Speaker 2: you look at it, and that's why we have different
Speaker 2: specialties in medicine. And OBG Guyanne that exact same patient
Speaker 2: looks at that patient, and this is how we all
Speaker 2: look at the patient. But now we're changing. Obgu i
Speaker 2: n looks at that patient and we describe that patient
Speaker 2: as a pregnant female with a complication of gestational hypertension.
Speaker 2: A cardiologist would look at that patient and describe that
Speaker 2: patient as a volume overloaded female with a failed stress test.
Speaker 2: See the difference. A pregnancy is a woman's actual first
Speaker 2: stress test because of volume overload. If you develop any
Speaker 2: of those symptoms, you actually have failed your stress tests.
Speaker 2: And just like any stress test that you fail at
Speaker 2: a doctor's office, you go straight to the cardiologist for
Speaker 2: a workup. So now a curdiomologists with the lens on
Speaker 2: the same patient is not looking at a pregnant female
Speaker 2: with a complication of gestational hypertension. The cardiologist says, I
Speaker 2: see a volume overloaded female with a fail stress test.
Speaker 2: You see how two different doctors looking at the same patient,
Speaker 2: treating the patient, but treating the patient from two different lenses.
Speaker 2: So we need the whole three hundred and sixty degree treatment.
Speaker 2: And now we know that delivering the baby is not
Speaker 2: the end of the story for the mom and that
Speaker 2: handoff does not happen. I talk about this all the time.
Speaker 2: We're trying to socialize that actually have written a book
Speaker 2: where there's a chapter in this book, hoping I can
Speaker 2: get it published and you guys can actually read any
Speaker 2: number of things that go on that impact black women,
Speaker 2: that impact women and impact minority populations within our healthcare system.
Speaker 2: The other thing that I will say about this, just
Speaker 2: in case my book doesn't get published, I mean as well,
Speaker 2: I just tell you guys some of the rest of
Speaker 2: it right, hopefully or to get polish. But if it doesn't, hey,
Speaker 2: I'm still talking about it. Is that black women are
Speaker 2: more likely to develop these pregnancy complications than white women.
Speaker 2: And here's the kicker. Black women who are born in
Speaker 2: the United States of America are more likely to develop
Speaker 2: these complications than black women who are born outside of
Speaker 2: this country. So there is something inherent in the soil,
Speaker 2: in the fabric of being generationally here in this country
Speaker 2: that lends to this, the ongoing infrastructural struggle of survival,
Speaker 2: something that is termed the weathering effect, the constancy of
Speaker 2: high effort coping, the constancy of being forced to be
Speaker 2: agile to survive and to navigate and to maneuver, being
Speaker 2: forced to be silent when things are working against you
Speaker 2: but you are powerless to speak up in order to
Speaker 2: survive or for your family to survive, the ongoing struggle
Speaker 2: of the navigation of corporate America. And not the glass ceiling,
Speaker 2: but the glass floor. You wish you had a glass ceiling.
Speaker 2: The glass floor is where you're trying not to fall
Speaker 2: through and get cut to shards. That weathering effect causes
Speaker 2: a shortening of the telomeres. Tilomeres are the ends of chromosomes,
Speaker 2: and the ends of chromosomes as they shorten the body ages.
Speaker 2: And so we talk about blacked on crack. That's on
Speaker 2: the outside because we're protected by melanin and we're looking
Speaker 2: good a long time, but on the inside our age
Speaker 2: is advanced. Iological age is more advanced than our chronologic age.
Speaker 2: Regardless of what our outward appearance is. Because of this
Speaker 2: weather ing effect, and because of the weathering effect the
Speaker 2: shortening of the telomeres, which also impacts brain health. I
Speaker 2: know I'm kind of walking you through. Read my book.
Speaker 2: I hope it gets published. And as we walk through,
Speaker 2: this is what we see being represented in our pregnancies.
Speaker 2: And when we think about the risk factors for gestational diabetes,
Speaker 2: gestational hypertension, pre eclampsia, and eclampsia, it is not by
Speaker 2: coincidence or happenstance. We rarely believe in coincidences in medicine,
Speaker 2: or poor physician is one who believes in a coincidence.
Speaker 2: It just so happens that the same risk factors for
Speaker 2: all of those pregnancy complications are the same risk factors
Speaker 2: for heart disease.
Speaker 1: So, doctor Morgan, there are lots of screenings and tests
Speaker 1: that we typically have to have, right like pap smears
Speaker 1: and talking about a mammogram when you're age forty and
Speaker 1: all of these things. Is there some kind of test
Speaker 1: or screening we should be talking with our physicians about
Speaker 1: for our hearts at a certain age. What kinds of
Speaker 1: things should we be asking for?
Speaker 2: Probably should talk about calcium scores and maybe some genetic screening,
Speaker 2: just one panel of genetic testing such that you know
Speaker 2: what it is, and then your calcium score, which gives
Speaker 2: you an idea of kind of your lifetime risk of
Speaker 2: heart disease. The genetic screening is a blood test. The
Speaker 2: calcium score is sort of like a cat scan. It
Speaker 2: is more like an X ray that you would have
Speaker 2: to do. Those are probably the two things that I
Speaker 2: would talk about. There's something that you're going to be
Speaker 2: hearing more and more and more about called LP little as,
Speaker 2: a very specific type of cholesterol, and if you have
Speaker 2: high levels of this LP little a, this specific type
Speaker 2: of cholesterol, it increases your risk of heart disease at
Speaker 2: an earlier and earlier and earlier age. And we believe
Speaker 2: that we're seeing more and more of that in the
Speaker 2: black population and other populations. So we're taking a close
Speaker 2: look at this LP little a. So if you have
Speaker 2: an opportunity to have that drawn. We don't have a
Speaker 2: treatment for it yet. We're working on it though. They're
Speaker 2: clinical trials underway, and I know that because I'm involved
Speaker 2: in the clinical trials in overseeing them and guiding them.
Speaker 2: So we are working on therapy for LP little A.
Speaker 2: But here's why it still could be important for you
Speaker 2: to get that drawn now, because you may say, well
Speaker 2: I get it drawn if you don't have any treatment
Speaker 2: for it, why am I doing it? Because if you
Speaker 2: end up with a high level, then we now can
Speaker 2: begin counseling on how you need to mitigate your risk
Speaker 2: fectors and really be aggressive about it. If you're smoking,
Speaker 2: you need to quit smoking, and you need to quit
Speaker 2: smoking yesterday, like we can start to get serious about
Speaker 2: smoking and weight loss and diabetes control and all of
Speaker 2: these because we know you now have this really elevated
Speaker 2: risk factor, this LP little A, and we also know
Speaker 2: that there's no therapy for so the best thing to
Speaker 2: do is to try to cut it off at the knees.
Speaker 2: And we can be super super aggressive about that if
Speaker 2: we know you're in that category, because you do run
Speaker 2: a risk of having heart disease heart attack at a
Speaker 2: very young age. When I say young, I mean in
Speaker 2: your thirties or twenties, so very young age. We want
Speaker 2: to be aggressive. So those are maybe some things to
Speaker 2: think about. Hopefully we'll have some good endpoints on our
Speaker 2: clinical trials and we have a therapy soon for LP
Speaker 2: little A, So stay tuned. Maybe I'll throw that in
Speaker 2: my book too.
Speaker 1: Thank you so much, doctor Morgan. You have shared such
Speaker 1: incredible information with us today. Please tell us where we
Speaker 1: can stay connected with you. It's your website as well
Speaker 1: as any social media channels you'd like to share.
Speaker 3: Yeah, listen.
Speaker 2: I'm on Instagram at doctor Jane Morgan d r j
Speaker 2: A y N E M O r g a N
Speaker 2: doctor Jane Morgan. Also you can find me on the
Speaker 2: other social media pages the same thing, x, threads, TikTok YouTube.
Speaker 2: I'm also on LinkedIn. You can find me doctor Jane Morgan.
Speaker 2: I do something pretty much on Wednesdays called the Stairwell
Speaker 2: Chronicles where I sit on the stairs. Those are my
Speaker 2: stairs as my house, those are my clothes, and I
Speaker 2: answer a single question about medicine in sixty seconds or less.
Speaker 2: I call it Wellness Wednesday. Those are my stairwell Chronicles.
Speaker 2: You can follow along and listen to little Pearls on
Speaker 2: Wednesdays where I give you a little bit of some
Speaker 2: pearls from the stairs and follow along there with my
Speaker 2: sterwell Chronicles. I do have a website, stairwell Chronicles dot
Speaker 2: com or doctor Janemorgan dot com. Feel free to go
Speaker 2: on there. You can see all of my media interviews.
Speaker 2: I was on CNN just a couple of days ago.
Speaker 3: I do media.
Speaker 2: Interviews all the time. I do Stawell chronicles. I've written
Speaker 2: a book that hasn't been published, hopefully.
Speaker 3: That'll be out.
Speaker 2: And we just keep trying to spread the gospel. So
Speaker 2: I keep banging the drum. I appreciate everybody who's listening
Speaker 2: and follow along. I talk menopause, I talk women, I
Speaker 2: talk minorities, I talk clinical trials, so I only talk science.
Speaker 1: So thank you, doctor Morgan. We would be sure to
Speaker 1: include all that information in our show notes. Thank you
Speaker 1: for spending some time with us today.
Speaker 2: Yeah, absolutely, thank you, Doctor Joy.
Speaker 1: Thank you. I'm so glad doctor Morgan was able to
Speaker 1: share her expertise with us for this episode. To learn
Speaker 1: more about her and the work she's doing, be sure
Speaker 1: to visit the show notes at Therapy for Blackgirls dot
Speaker 1: com slash session three four five, and don't forget to
Speaker 1: text two of your girls right now and tell them
Speaker 1: to check out the episode. If you're looking for a
Speaker 1: therapist in your area, visit our therapist directory at Therapy
Speaker 1: for Blackgirls dot com. Slash directory and if you want
Speaker 1: to continue digging into this topic or just be in
Speaker 1: community with other sisters, come on over and join us
Speaker 1: in the Sister Circle. It's our cozy corner of the
Speaker 1: Internet designed just for black women. You can join us
Speaker 1: at Community dot Therapy for blackgirls dot com. This episode
Speaker 1: was produced by Frida Lucas, Elise Ellis and Zara Are
Speaker 1: You Taylor. Editing was done by Dennison Bradford. Thank y'all
Speaker 1: so much for joining me again this week. I look
Speaker 1: forward to continuing this conversation with you all real soon.
Speaker 1: Take good care
Speaker 3: What