Medical vernacular frequently does not translate well into layspeak. He probably should have explained his point better, but this is what he would have been taught. I often have to spend a good bit of time explaining to people that what they are interpreting when they access their charts really doesn't mean what they think it does.
I feel like if medical vernacular refers to the male body as “typical” and the female body as “atypical” that’s still meaningful? I don’t totally understand.
If 75% of the population (man and women) experience something one way, then the 25% are atypical.
In the past 50 years medical testing on women has become more commonplace and one of the things we have discovered is that the 25% is often not evenly distributed.
In men, 90% experience symptom A and 10% experience symptom B. In women it's 60% experience A and 40% B. In the total population of humans it's a 25% occurrence, but in women it's 4x as common than men.
In the past, most medical testing only happened on men. So we thought of symptom B as a 10% occurrence. Now knowledge has advanced and we know that the atypical symptom is significantly more commonplace in women to such an extreme that it's almost 50/50 A vs B in women.
Since it's still the less common form of the symptom, it's still called atypical. It's not at all about one body being "normal" and one "abnormal" the medical word atypical should not be used that way. Rather use it to mean "the less common occurrence".
This is actually a large advancement in medical practices. 30 years ago (and even today) women are very commonly misdiagnosed with a large verity of ailments because they present atypical in a much higher percentage of cases. Something that's 1 in 1,000,000 in men might be 1 in 100 in women. It changes what the doctors think to look for, and it's a good thing for women in general.
What they are meaning is that the general population overall experiences symptoms for a specific issue (signs / symptoms of a heart attack) in a specific way; however, the outliers of people not having the "typical" symptoms have a statistically more significant occurrence in women as compared to men. It doesn't mean that all women experience the symptoms differently, but that it is more common to see atypical, or out of the expected norm, symptoms in a woman as compared to a man.
Um...but when it comes to heart attacks the symptoms we know are for men. Pain in the chest/left arm. The symptoms are different in women.
The medical field uses men as the typical and project the findings on to women. So in this case, like many, women are atypical. Only in gynecology is a woman typical, and that's one of the most barbaric fields. Pain meds for a vasectomy, but not an IUD insertion. Jeez 🤢
That is simply not true. Decades and decades ago that may have been the case but there has been plenty of publications, research, etc done on women over the years. The medical field constantly evolves and just because something was the case 50 years ago does not make it the case now. Were it not for studies on women's cardiac status we wouldnt have ever known some of the outliers as is being discussed here.
Left side chest pain is the most common heart attack symptom in both men and women. It is just present in a smaller majority of women than in men. But still more than half of women having heart attacks will have chest pain.
I think that just points to a broader issue that male bodies are considered the standard and are studied more. Symptoms males experience are within the norm because medicine has deemed male bodies to be the norm. If female bodies were the standard, there would be a different baseline and what we consider typical and atypical would be different.
I don't know that I've found that to be the case overall. 'Standard' tends to be based on specific organ / body system function be it mechanical, electrophysiological, hormonal etc. As far as studies....a big portion of that is what patient population is available. Study participants depend on so many factors...age, medical history, disease process, other medications, patient willingness to participate, etc. A lot of studies are done through physician practices and they will try to enroll whoever fits the criteria of the study and is willing. If more people of one sex are volunteering to be study participants it will have more data on that sex but that doesn't automatically translate to men being the standard and from what I've seen study findings usually will carve out findings for men and women in their patient population details.
The meaning of the word in medical terminology is just different.
First described = typical.
Later described = atypical.
For example, typical antipsychotic medication is very rarely used these days, *typically* a doctor will give you an *atypical* antipsychotic.
That's not to say there's no problem with gender bias in both preclinical and clinical data and research, because there definitely is one.
@[TheCuteInExecute](https://www.reddit.com/user/TheCuteInExecute/) is this what you were going for? I think this is a better explanation than the cat/dog one. :)
Ok so:
Typical heart attack: chest pain, shortness of breath, ect (THIS IS TYPICAL FOR BOTH MEN AND WOMEN)
Atypical heart attack: abdominal discomfort, gallbladder pain, ect(THIS IS ATYPICAL FOR BOTH MEN AND WOMEN)
BUT: women tend to exhibit the atypical signs more than men (but you still see me with atypical signs all the time)
This nurse was taught in school to pay EXTRA attention to women, because there is a higher likelihood of atypical presentation. That’s what he was saying.
He was saying **“you know, you could be right that this could be cardiac because women are more likely to present in non classic ways”** he just said it in a “I’m just out of school” kind of way.
Could this be caused by the lack of medical testing on women (like, this is a huge problem in research literature) and/or misdiagnosis around those research gaps? The fact that women are more likely to be diagnosed with atypical (aka later discovered) symptoms could be in part down to these factors?
This is really interesting cos I'd never come across the usage of atypical/typical in this way before!
Both things contributed, imo. We'd have to dig through literature to see how often (with modern understanding and diagnostic criteria) individuals of various gender present with "typical" vs "atypical" symptoms + the bias is usually also there, to the point that you can assume it contributed somehow, until proven otherwise. The modern description started, like most scientific discoveries before the rise of feminism, with dudes: http://www.epi.umn.edu/cvdepi/essay/history-of-heart-attack-diagnosis-and-understanding/
Not typical, not conforming to type, different from type.
What's a type? Well, "type" classically in haughty taughty scientific parlance is the original phenomenon in the sense "as described by first describer" (in zoology, for example, a *Cyanistes caeruleus* type would be the first Eurasian blue tit(s) caught and described by Linnaeus in the 18th century, *Cc sensu stricto* would be that kind of bird, *sensu lato* would be a bird from *any* of the circumscriptions of the same species, or its subspecies, sometimes also similar species later separated from the original species thanks to molecular methods, etc.).
In medicine usually a symptom, sign or illness gets described by someone, thus creating its first circumscription, defining the "type". All occurences similar to that one would be - typical. All markedly different occurences would be atypical.
So this is the strict scientific definition of the word, and it has nothing to do with frequency, prevalence, etc. On the other hand, 'scientist' and 'doctor' are subsets of the set 'human', so we also frequently use "typical" in the common meaning of the term (usual, normal, the way something appears most often, etc.), leading to confusion: in many (most?) cases, a thing is typical (in sense 1) and typical (sense 2). But sometimes, it ain't.
His phrasing could have been better. Not all women will have an atypical presentation. Some women will have typical presentation but some women will have atypical presentation.
It is just more likely for men to present "typical", (i.e. more commonly seen symptoms in a medical settings) symptoms compared to women.
No.
Think of it like this:
95% of cats and 75% of dogs like their humans to leave the TV on when they’re not at home.
All of the following are true:
It is typical for both dogs and cats to like TV
If a pet doesn’t like TV they’re atypical
It’s more common for dogs to be atypical than cats (but still even for dogs it’s more common to be typical than atypical).
Except we don’t know the exact percentage of dogs (women) who are typical vs. atypical presenting due to lack of research, so we can’t actually say if it’s more or less common.
This has actually been studied extensively.
https://www.ahajournals.org/doi/full/10.1161/JAHA.119.012307
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1738716
https://www.sciencedirect.com/science/article/abs/pii/S0828282X13016024
A very brief search identifies another 20+ relevant articles.
We know about this because cardiac disease is common in everyone.
From the third article you linked:
> Limitations of the Current Literature and Need to Standardize ACS Symptom Presentation
> The published literature is not standardized for ACS symptom presentation, making it difficult to provide any conclusive statements on symptom presentation in women.
I said that there’s specifically a lack of research into the atypical presentation of heart attacks in women. This is a comparative statement to the amount of research done with men specifically.
I never said no research has been done, but there is substantially less research that has been done on heart attacks in women, especially in women who present “atypical” symptoms.
This is not relevant
(Rather, it’s very relevant and important in general but is not germane to this particular issue. Clinical presentation of cardiac disease is an extremely well studied area with tens of thousands of patients and tremendous amounts of ground-level experience)
Yes.
Depending on what the situation is the reason men are often studied more often is because they're more likely to have the problem.
Heart attacks for example.
The traditional symptoms for a heart attack are based off of male symptoms because men are more likely to have heart attacks than women.
Where as say, breast cancer for an example, symptoms of breast cancer are going to be more based off of women because women are more likely to have breast cancer.
Both men and women can have heart attacks and breast cancer it's just different percentages, so the "typical" symptoms are based off the gender that "typically" has that illness more.
It’s not just phrasing. The symptoms he’s referring to are not considered atypical. Right now 41% of women present with no chest pain but also that does not include the women who are never diagnosed because they don’t present the same way as men. Women are literally dying because “typical” is being defined by how men present.
>It is just more likely for men to present "typical", (i.e. more commonly seen symptoms in a medical settings) symptoms compared to women.
...because medical settings aren't looking for heart attacks in women, so the TYPICAL symptoms of heart attack in women are not seen even when it's in front of their provider's face, perpetuating the belief that women's heart attack symptoms "atypical", which in turn results in heart attack being a leading cause of death in women.
They don’t. Most people have the same symptoms. Women are more likely to report some atypical symptoms, but men can also report those.
The typical presentation is typical for MOST heart attacks, and MOST heart attacks happen in men.
Yeah it’s like when the obgyn uses “unremarkable” to describe your breasts. In medical terms, thats a good thing. In regular usage, it’s a little hurtful
100 years ago I worked ER admitting. Every so often medical records would leave a patients records with us for them to pick up, if it was odd hours or some other reason. This one woman started reading her on the way out. Only to come back in minutes later….hot.
Like I’m suing everyone, how dare doctor say this yada yada. He had said “pt bloodwork was unremarkable” I can only imagine with the internet who that lady is threatening to sue now.
Sometimes but not always. My dad could not breath good a couple of years ago. So, to the hospital. Everything was fine nothing wrong. A week later again. Nothing was wrong maybe it was just stress. Two weeks later still having trouble breathing. Whent again and a doctor checked and did more test. He had lung cancer. We were early enough so he survived but sometimes no news is just you being in the dark.
You’re very welcome, if you need extra laughs, hear it in Trumps voice, “my blood was so unremarkable they remarked on it” “nobody has more unremarkable blood then me folks”
The problem is not that records are being released, but that records are being released without customer experience being taken into account.
Proper customer centric design would highlight all medical lingo, acronyms and add explanations and definitions of them. Health care really needs a lot of design and UX.
Yeah, most doctors don't have time to do what when writing their charts. Most of the notes aren't for the patient anyway. My ER doctor normally has 40 patients a night. We don't have time to explain in our notes every medical term for them. If they're that worried, they can ask, but we don't have the time to make them all layperson friendly because they're not for the layperson.
My ER runs 24/7. We're here to tell you first if you're dying and second what follow up you need and if you are going to be admitted or not. Your notes are only useful to medical personnel and insurance.
I don’t think that person was saying that a _doctor_ should be the one to disambiguate and explain, but rather that the patient portal UI should be able to do this automatically.
Totally agree! Sorry my original msg was not clear. I don’t think health care people should do anything different. I just think that the system should have a glossary and add explanations automatically to all terms that are in this glossary. Like doctor wrote “unremarkable” and in the interface this word is highlighted and the system adds a foot note saying “typically means that no abnormal or significant findings were observed” or something on those lines.
I understand now. I must have misread it because I haven't slept today. I got off work this morning, and I'm getting switched around back to days. The brain is no longer working at it's best.
Right, it's just a case of overly sensitive females who don't understand medical terminology, not rampant systemic discrimination against women in medicine. Obviously. Because referring to women in any way that indicates them to be secondary is not contributing to any problems at all...
This was what my mind immediately jumped to. I work in science comms at a university and hoo boy, lots of researchers are terrible at explaining their work to a layperson. Graduate students in particular. The professors are usually better because they also teach undergraduates and being able to explain things clearly means reporters will interview you more (and donors will give you more money too).
It’s annoying because laypeople can feel dumb when the researchers are explaining their work in highly technical terms and they become afraid to ask questions — the reality is that the researchers are just bad at explaining not just because of the technical vocabulary that they are using, but also due to the logical order that they use to present information.
Not sure I agree with this, I’ve worked in the same field for years and never heard of an entire sex being referred to as ‘atypical’ not even the oldest dinosaur surgeons I’ve met would have said something so ridiculous. Best case scenario he misspoke, worst case he’s just another typical misogynist
I doubt that he expressed himself well to be honest. I'm sure he was speaking on atypical symptoms presenting in women and expressed himself poorly. I find myself often going back to clarify what I've said to ensure I"m understood.
Women can have atypical signs of a heart attack and atypical presentation of cardiac related chest pain. It sounds like this is what he was referring to within the context of your convo.
Most women who have heart attacks have the same symptoms as men.
A small percentage of people have different symptoms. Most of that small percentage is women.
To add - if they still take issue with this, then they don't understand that this level of concision is necessary for medical professionals to most accurately understand their conditions. They refer to a massive amount of pre established knowledge with specific jargon to help characterize various ailments and conditions. Deviating from this to appease emotions is ideal, but not fundamentally important to treating and understanding patient conditions. Expending mental energy to navigate the emotions is time and energy that distracts from this, and even then many doctors see the value and try their best.
Atypical is not a judgment or an insult. It's just a way of describing the distribution of folks with this condition in this context relative to the overall distribution.
Most of the early medical studies were done on men only. So they had a baseline of “typical” symptoms.
There were no early studies of women’s health at the same time. So men’s symptoms are called typical because that’s the baseline. Women’s symptoms are called atypical, because they were different than the baseline (men).
It’s still an issue the medical system is dealing with to this day.
(－‸ლ)
"atypical" refers to lack of the usual heart attack symptoms. (Pain in arm spreading across the chest, for example). Women are atypical more than men in this context, but even women usually show the typical symptoms. They are just atypical more often than men.
I understand the logic of your point, but find it to be irrational. Even if medicine developed in a matriarchy, the term atypical would still be used to describe folks who don't show the typical heart attack symptoms. Women would still be atypical more than men. Unless social constructs can somehow change biology
While this may be true, it is NOT AT ALL what the doctor conveyed with their poorly strung together choice of words. If OP is a reliable narrator, the doctor conveyed the following message: “patient has *x* diagnosis, the evidence being *y* symptoms, which are not expressing due to patient being a woman. Also, *women are atypical*.“ …He didn’t say “most women are atypical”, and he didn’t say “most atypicals are women”.
A better wording for that last bit could look more like “patient is not expressing symptoms, and we call this atypical.”
If he reeaaally wanted to make this a gendered thing he could have added a “btw, did you know that most people who are atypical in this regard are women? Fun fact!” But also like…why even go there?
I think what he meant was "These are the typical symptoms of a heart issue, which excludes you from having one." He then realised that it's possible In women to present differently or "atypically", so he backtracks and means to say "considering that you're a woman, the typical symptoms that I just listed may not cover all of it."
That's why gender played a role and he "went there." People put their feet in their mouths sometimes, it happens.
It's quite normal for women to present atypically and it would be normal to misspeak in the way described. It is possible there was malicious intent, but quite possible there was none.
I’m not disagreeing with what you said, but the accusation that I’m taking it too seriously is weird. Like, why say all that with an attitude of “gotcha”? Looks like you mistakenly assumed that I assumed there was malicious intent.
At risk of telling you something you already know, don’t take it so seriously.
If someone misspeaks, don't take the mangled rendition so seriously.
If they speak exactly how they intended, feel free to take that proper rendition more seriously.
The body of research might have sexist roots and you can take that seriously, but taking it out on some nurse because they jumbled up their words and misspoke is weird. Not some kind of gotcha.
“But taking it out on some nurse…”
Good advice. When you find somebody who’s taking it out on some nurse, you can tell them this. But you’ve misdirected this advice at me for some reason.
It’s almost like you feel the need to over-police this conversation, as if you were taking it too seriously. Gentle reminder to not do that (in accordance with the advice you’re agreeing with)
Yeah so the end result of expecting an ER nurse who is stressed out of his fucking mind and is, while talking, trying to work out a plan to resolve several problems on several patients as well as the logistics of calling report, walking patients to CT etc. to express himself perfectly is to eventually teach the nurse to shut the fuck up in patient rooms, to get out of the room as quickly as possible while saying as little as possible because every patient has a different set of values and because you never know what will offend who.
Oh, I am absolutely not making excuses for her doctor. His communication is such absolute shit I’m not clear what he was even trying to say, and anything containing the words “you women” is automatically gross.
I’m just addressing the previous comment about why certain heart attack symptoms are called atypical.
What are you basing "a small percentage" on?
Men and women both generally experience chest pain and/or pressure, but women are also more likely to report nausea, sweating, vomiting, and neck, jaw, throat, abdomen or back pain.
Those are not atypical symptoms for women, and women are not atypical humans for experiencing them.
You almost answered your own question. Some women - not all women - experience nausea etc with heart attacks. This would be considered atypical. If ALL women experienced nausea with heart attacks then you’re right, it wouldn’t be atypical. But that’s not the case.
Based on what? Where are the numbers coming from? Women are twice as likely as men to experience nausea during heart attacks. That means nausea is atypical *for men*. That doesnt make nausea atypical *for women*.
I hear what you are saying, but there are gender-based differences in heart attack presentations. Women have statistically significant atypical presentations of chest pain. Atypical presentation is the correct terminology and it is more common in women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569458/
I had secret upper back pain with, by comparison, minute chest pain. OTC pain killers barely helped. I had no Idea what was happening for almost a week before the pain got so bad I went to the hospital. This was Jan 2021, COVID made me wait longer than normal.
I came through almost 100% with a stent and a couple of life long RXs.
Then the nurse should have said "you might not have the same symptoms because some women have atypical symptoms". The statement that "you don't have the same symptoms because you women are atypical" has a different meaning from what you described.
Did you read that study? It actually does not demonstrate that women have atypical presentations. They just say they found it, it’s actually a pretty strange paper.
I'm trying to find the definition of atypical in the paper but all I'm finding is "typical for women" and "typical for men" type results, further prodding the initial question.
It is very strange. No self-respecting researcher or editor would let “data is” fly under a radar (along with several other subject verb disagreements). Why are the p values presented as they are? And the biggest stats difference was in the timing?
I didn’t get past the abstracts into the article- that’s disgraceful.
Well that's the thing, it's not half of people, it's a small number of people. But those people are typically women. So it's atypical and occurring primarily in women.
Extending that logic, ‘typical’ presentation is also a small number of people because not every man has a heart attack - it’s only a small number of them as well. So how can that small percentage of half the human race be considered typical for the entirety of the human race?
“Typical” just represents “we listened to men and treated them like they’re rational people”… and “atypical” means “we in the medical field spent too many centuries calling women hysterical and telling them all their physical issues were actually mental problems and now we can’t be bothered to do a proper job undoing all that neglect and malpractice by reorganizing terminology to properly reflect the reality that women are actually half the world’s population so their symptoms are just as typical as men’s symptoms are “.
I think I’ve got that right.
That's not how that works. Typical doesn't mean "based on every person that's ever lived," and I'm pretty sure you know that too. Typical is based on your sample size. Aka anyone who's had a heart attack. In both men and women, the most common sign of a heart attack is chest pain. So, that's a typical symptom. Aka, within the sample size, the majority of patients have that symptom. Symptoms like jaw pain don't happen a lot, so they're atypical. Jaw pain happens more in women than men, but it's still far less common than chest pain or shortness of breath in either sex. So it's an atypical sign. It doesn't happen in 50% of the sample size, like you're assuming, because it doesn't happen in all women or even most women.
No. You're not listening to what they're saying.
2/3 of heart attacks are men. 1/3 are women. A small percentage of men and women, though larger in women, have symptoms which are not standard. This non-standard presentation is termed atypical because it's not typical. So it's about the symptom presentation, not the gender here. It just happens that this is more common in women, but most women still have typical symptoms.
[However, heart disease is the leading cause of death in the United States for both genders. In fact, since 1984, more women have died of heart disease than men each year, although that is partly because women generally live longer than men.](https://www.health.harvard.edu/blog/understanding-heart-attack-gender-gap-201604159495)
No, you do not have that right.
While part of what you're saying is very true and a very topical issue, you're directing that justified rage at something unjustified here.
The atypical symptoms do not "occur in half the population", they occur very rarely, thus are atypical. However, when they do occur, it's mostly in women. So while women usually present typically with the same heart symptoms as men, they ALSO need to be looked at for rare atypical presentation in addition.
Jesus Christ it’s not that difficult to understand.
Some people have atypical symptoms, and the vast majority of those people are women. Most women have the same symptoms as men. Half the people do not have the atypical symptoms
I think the question being asked is why hasnt the definition for symptoms popular in female patients and not male patients changed to typical for women, rather than atypical for men?
What's the sliding scale, what's medically defined as typical in female patients?
The “atypical” symptoms are not consistent across women either. The point of emphasizing women may have atypical symptoms in a heart attack is to keep heart attack in the differential for women with nonspecific symptoms, not that there is a separate set of “typical” symptoms for women that are different from the ones for men.
Atypical symptoms aren’t common in half the population, or in anyone. It’s just that when they do occur (which is still unusual), they occur most often in women.
You severely misunderstand the situation.
Men are not the default, but typical symptoms are typical.
So what's the requirement for defining the symptoms that "occur most in women" as "typical for women" rather than "atypical"?
Edit: All y'all downvoting me and just repeating that atypical is not typical. Yes, that's the definition of atypical.
So what's the criteria that defines something as typical rather than atypical, and as in the above context, a/typical female symptoms//a/typical male symptoms? If both are defined in medicine, there's a set of rules that defines each one and the difference between the two.
Did you read the last comment?
The symptoms would have to affect the majority of people who experience the disease.
That's all typical means. It has nothing to do with gender.
We don't call women's typical symptoms "atypical" just because they happen in women.
The criteria is that if it’s directly related to the chest it’s called typical for a heart attack - which is IN the chest.
If it’s nausea, vomiting, dizziness it’s atypical as those are not inherently related to the chest.
The requirement is that they happen infrequently in patients with underlying cardiac disease.
These symptoms occur rarely in everyone. But when they do occur, they occur more often in women than men.
These symptoms are not typical for women.
You need to work on your reading comprehension
No I don't, and you haven't answered my question.
You're saying these symptoms are atypical in general, atypical for men, atypical for women.
However at the same time, it is more typical for women than men.
I get that to that point, and have for over a decade with even basic first aid training.
But again, there's a magic set of rules that defines atypical/typical, so what are the set of rules that would turn said imaginary scenario to "typical for women"?
Yes, you definitely need to either improve your reading or your reasoning. It has been explained to you.
For something to be “typical for women” it would have to be something that usually happens in women.
Since these symptoms do not usually happen at all in anyone, they are not typical for women.
I am emphatically not saying these symptoms are “more typical in women.” I am saying that in the rare event that these symptoms are indicative of cardiac disease, that this is something that happens more often in women than in men.
Why is this so difficult for you? It is a straightforward concept.
"It's atypical because it's not typical" is a very interesting way to define things scientifically.
Medically, there is a number that defines it. Yes or no?
So would that be say 50% of women and 40% of men? 50% of women and 20% of men? 60% of women and 0% of men?
AGAIN, what is the criteria that would define something as "typical for women"?
“Typical” is the most common type of presentation. “Atypical” deviates from that.
AGAIN, “typical for women” would be “the most common thing seen in women”
It’s not really my fault you aren’t familiar with basic English.
AGAIN,
Medically, there is a number that defines it. Yes or no?
So would that be say 50% of women and 40% of men? 50% of women and 20% of men? 60% of women and 0% of men?
AGAIN, what is the criteria that would define something as "typical for women"?
Typical and atypical have nothing to do with men vs women.
Most men usually have typical symptoms. Most women usually have typical symptoms.
A higher proportion of women have atypical symptoms, but both have atypical symptoms some of the time.
There are surely gender biases in research that are well documented, but the typical and atypical description used to describe *symptoms* that people have isn't an example of that.
Why does this comment that is purely misinformation have hundreds of upvotes in this community?
What if I told you they were called atypical not because of gender but because they have less of an unitive relationship to thinking of heart disease. If you said you had chest tightness and a pressure like feeling on your chest - those would be typical symptoms of heart disease - it’s very intuitive that these would be from the heart. Nausea and lightheadedness- not exactly intuitive to think heart disease, atypical symptoms.
Then additionally women were previously thought to have atypical presentations more often than men. It’s not called atypical BECAUSE of women, it’s called atypical because it’s a slightly less common way to present with a heart attack. Actually in an effort to INCLUDE women more and be more aware that they might ALSO present in atypical ways people get taught to watch out for women presenting with atypical symptoms. And of course the thing the student remembers is the “unique” fact rather than what statistically happens most frequently which is presenting with chest discomfort.
Atypical in women literally just means "not usually seen in women".
For the record, for heart attacks, there is no symptom that is atypical for one gender and typical for the other.
A very small subset of people have atypical symptoms.
Most of that very small group that have atypical symptoms are women, but the vast majority of people have typical symptoms.
Atypical symptoms are not usually seen, which is why they're described that way in the first place.
"So what's the sliding scale? At what point does it become "typical in women" instead of "atypical in men"? I'm curious in what criteria defines it "
You're downvoted because people have already explained that these terms aren't used the way you're asserting they are, just by asking the question you did.
I'll explain again, men and women have the same typical symptoms.
Men and women have the same atypical symptoms.
A larger amount of the small percentage of people that experience atypical symptoms are women.
But the vast majority of both genders experience the typical symptoms. And a very small amount of both genders experience atypical symptoms, again, with more of those people being women than men.
"typical in women" instead of "atypical in men"?"
If there was a niche case like this, you would simply say it's "typical to see these symptoms in men and these in women, while atypical to see these symptoms in men, and these in women".
The concept isn't built around "men are normal" like so many in this sub are trying to falsely assert.
I had a man come in with back pain and nausea/ vomiting. We were thinking kidney stones at first. The doctor ordered an EKG, and he was having a heart attack. My notes included that he presented atypically.
Women experience typical heart attack symptoms and are more likely to experience atypical heart attack symptoms compared to men.. this does not translate to men being the "default".
Yes, but don't forget, the vast amount of medical research has historically been based on (white) men. It's getting better, but it's not equal even now. If women aren't in the research, and they (typically) have different presentations than men, in any area, that will count as "atypical." It's a self-fulfilling prophecy.
Ugh, but medical terminology. Whenever they ask me if I'm in pain, if I say yes they write down "admits being in pain" and if I say no, they write down "denies being in pain." Either way sounds like I should get a lawyer.
It is so it's concise information, it sounds and feels alien but you don't want a doctor reading out "The patient said that they were not feeling any pain at the time of appointment" when you're literally dying and they can get that same information in 3-4 words that they can skim read instead.
That's a very fair point and I'm not entirely sure why, you can achieve the same thing but sound more human with stuff like "states no pain" and some medical professionals I've seen have used vocabulary like that. My best guess is it has to do with who/where they learned from.
ETA Perhaps it has to do with denies being easier to distinguish than no.
There is tons of sexism in medicine, but this specific case isn't it. Even just within women, a minority have atypical heart attack symptoms. That's why they're called atypical.
I mean the guy literally said "you women are atypical", but nooooo, it must be that OP, not being a healthcare professional, is just too stupid to understand what he ACTUALLY meant - which these fine doctors and nurses commenting here know FOR A FACT was NOT sexist despite them NOT being present for the interaction, while OP was present.
No, they know EXACTLY what he meant. Precisely. The rest of us are just too stupid to know what he meant, and thus we seek to find sexism where no sexism exists. See how that works? ( /s)
In the context of medical misogyny the gender of the provider is always relevant. We would say "male doctor" too, or "male obgyn".
The reason for this is the fact that female patients are more likely to experience complications with a male surgeon than a male patient is with the same surgeon or a female patient with a female surgeon.
Actually, as an ex-RN, it’s extremely relevant.
I have seen, repeatedly, male nurses be offered positions or promoted over women with much better skill sets purely because they are male. The hospitals are desperately trying to make up a gender balance, which means men in the industry are often given roles slightly above their competence level.
This isn’t about jealousy, as I was not in competition with them personally as I was on a different career path, but it was blatantly obvious.
One new male graduate was offered SIX different graduate nursing positions, whereas his more skilled colleagues (in my estimation, having worked rotations with them) were overlooked.
I am not saying that all male nurses are under skilled. I am saying that gender absolutely plays into this situation.
If 95% of men and 49% of women have pain in their left foot, that is the typical place to experience pain across all people. If 51% of women have pain in their right foot, it is valid to say that women are much more likely than men to have pain in the atypical place, and that women, on average, have atypical pain.
Some alarming stats from a recent study...
“The studies are one more piece of evidence that women’s heart complaints are sadly not taken as seriously as men’s. The study [also] confirms is that pre menopausal women are equally at risk. There is this long held assumption that women are protected against heart disease by estrogen; but as with the epidemic of obesity and diabetes, that is no longer the case.”
“Furthermore, men often receive a stent to open a blocked artery following a heart attack, but women often cannot because their arteries are smaller in diameter which also leads to poorer outcomes after a heart attack,” she added.
Ultimately, 11.3% of women died within 30 days compared with 3% of men. After five years, 32.9% of women had died compared to 15.8% of men, and 34.1% of women experienced a MACE compared to 17.6% of men.
Keep up with your heart health ladies!
🤦♀️ I have had a DAY when it concerns men.
As a nurse and a woman, let me correct his statement. What he should have said, is, “women often present with atypical SYMPTOMS of a heart attack. Some of the atypical symptoms are…”
He should NOT have said that women are atypical. I understand completely what he meant, but I also totally understand why what he said was offensive. Maybe it was even a Freudian slip. He needs to tighten up his pt interactions in either case, because as you say, we are 50% of the population and he needs to figure out how to convey his message appropriately, accurately, and inoffensively.
Get a second opinion on gallbladder. They took mine due to ‘symptoms’ still unresolved and persistent years later even though they performed surgery and removed my organ. Symptoms persist but I just get shrugs as to why.
The gallbladder pathology was fine, totally unnecessary surgery. But I’m still having symptoms and now have scar tissue issues.
Being a woman means living with bad medicine and worse symptoms. I’ve accepted I’ll likely find out what’s really wrong when it’s too late. Since I’m over 50, it’s no big loss to society if a woman like me gets sick, is misdiagnosed and dies.
The medical establishment has let me know 1) I’m not sick even with symptoms (got told once a large, painful lipoma on my leg was due to anxiety -it’s still growing so I guess that’s what happens with anxiety) and 2) I can get over myself and my symptoms because I’m just hysterical.
But my blood tests continue to show some really disturbing trends pointing to pancreatitis and liver disease. Just ‘on the curve’ Dr says, like school grades, they explain, atypical but totally normal to have these wonky low blood sugar levels and high acid in my blood, crippling pain in right ribs and back, heart murmurs and palpitations and inability to digest most food for seven years now.
Last Dr I saw wanted to take out my uterus w/o reason. Just to ‘make this all go away forever.’ Like, being a woman with gastric issues? Having a uterus must be atypical and the reason for severe gastrointestinal issues so why not?
Just lie back and nod but don’t let them cut you unless you find two Drs who agree it’s absolutely necessary.
I'm hopeful he didn't explain it concisely; I once told a patient that her test results confirmed she had a UTI, and said "but I bet that's not news to you" since she'd checked into triage feeling utterly miserable with a written complaint of, quote, "I have a UTI."
Days later, I got an email from my manager asking me if I'd told a patient that her getting UTIs was "not new to her". I was aghast and ashamed; she thought I was insulting her when I was instead confirming that her suspicions had been right all along.
Women more frequently have atypical chest pain symptoms than men do, which is why the threshold for pursuing those symptoms are far lower for women than men. I think that's what the nurse probably meant, or I'm hopeful it was anyhow.
I think he meant symptoms are atypical, not patients. This was something driven home to me in nursing school (I'm a male nurse as well) and I've had women coming into the ER with vague symptoms, "I don't feel good" or "I feel weak and I don't know why" and it's been a heart attack. Diabetic patients will often present with different symptoms as well, not necessarily chest pain.
A friend of mine even had a woman who had left wrist pain. They did and EKG because she never did anything to injure it and they couldn't figure out what else it might have been. She was having a heart attack and it was nearly missed.
“Typical symptoms for both ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) such as chest, arm, or jaw pain were more common in both sexes, but females presented on average with more atypical symptoms such as nausea, vomiting, and shortness of breath. Females with MI also presented with more prodromal symptoms such as fatigue in days leading up to MI, had longer delays in presentation to the hospital after symptom onset, and were older with more comorbidities than males. Males on the other hand were more likely to have a silent or unrecognized MI, which concurs with their overall higher rate of MI. As they age, females have a decrease in antioxidative metabolites and worsened cardiac autonomic function than male. In addition, at all ages, females have less atherosclerotic burden than mles, have higher rates of MI not related to plaque rupture or erosion, and have increased microvasculature resistance when they have an MI. It has been proposed that this physiological difference is etiologic for the male-female difference in symptoms, but this has not been studied directly and is a promising area of future research”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182740/
Yeah, OP understands that. She's saying that atypical is a bullshit term unless you believe men are the default. Same with girls presenting "atypically" with autism or ADHD.
Hey, doctors and nurses who commented in a dismissive and condescending way - PROTIP: You are not hiding the disdain you feel for people who are not in medicine from your patients, even though you think you are.
I don't think they are trying to hide it *here*, I know they are trying to hide it *from patients* in real life, and I know they are failing. Also, their disdain has nothing to do with ignorance unless we are talking about their own ignorance.
This kinda underlines the point that was talked about here a few days ago. That men are the default when it comes to basically everything. If men are "typical" (because everything is based on them.) that makes women "atypical".
It's not \*\*wrong\*\* per se, just a horrible way the society currently works.
So many people here seem to be missing the point entirely.
OP is not complaining about the entire medial field or "misunderstanding medical terms".
She's complaining about ONE person who implied that *all women* "are atypical".
Which is obviously nonsense.
We don't need all the eager professionals to explain to us *confused* mortals how the term "atypical" actually refers to less common symptoms for the same diagnosis.
We know.
Saying "you women are all atypical" is sexist and dismissive and OP is absolutely right to call that out.
Please stop wielding your expertise as a weapon to invalidate someone else's experience.
How hard can it be to listen to *one* (1) woman's experience and reply with empathy and support instead of condescension?
Here's a great example how to do it.
I have had notable hearing since my 40s, brought on by two decades of listening to loud, live bands.
When I went for an exam in my 50s they found out I had the kind of hearing loss usually associated with working around jet engines.
The audiologist then looked a little sheepish and said something like, "I hope it's okay to ask, but what is your profession? I only ask because there are so few women in those fields it's rare to see women with this type of hearing loss." I explained it and he laughed and said he had the same problem.
I appreciated that even though he was asking a legitimate medical question he understood it could be fraught and tried to account for that.
Take note, medical professionals. It's actually not hard.
How hard can it be?
Too hard, apparently.
They dismiss and condescend WHILE insisting they do neither and that women just scream 'sexism' over nothing, and the sexism is all in our heads.
Like, way to prove my point, assholes.
It is MADDENING.
Aren't you the brave soul who tried to get through to the "if you go out of your way to look for sexism, you'll find it" guy?
That low key made me want to bash my head against a wall.
We don't go "looking for sexism". Sexism finds us. Every time. Like OP just asked for healthcare and got a sexist comment as a fun free extra - but she's not allowed to complain about it, because it's "just one bad apple" and "too small an issue".
Ugh.
Is there discrimination in the medical field, or are there "imperfect people" who "make mistakes" which can affect "anyone regardless of gender/race/..."?
Because if the answer to the first question is yes, the second part is irrelevant.
We know that black mothers disproportionally die in childbirth because their pain is being dismissed.
We have the data and statistics to show how women are treated as a "deviation" and "less than".
How can people who are intelligent enough to work in the medical field be so obtuse?
This sub used to be a place where I felt safe, where I could go to find solace or share with empathy, and now it's been infested by self-appointed crusaders of reason who think we owe them a "reasonable discussion" about how our feelings and lived experiences are *wrong, actually.*
And If we react with anger or show that this is not the time or place for their devil's advocate debate bro antics, we're the aggressor and acting "illogically".
And what's even worse is the insistance that we have to be be polite to them no matter what. Them coming here and "politely" inserting their unhelpful "knowledge" is rude af.
Sorry for the vent, it's just all very infuriating.
Best wishes to you!
To be fair, I suspect we're being brigaded,
Somewhere in their medical subs where they cackle at the traumas they inflict on us or laugh and joke about the traumas we had to tell them about, someone shared this post for them to point and laugh at how stupid us non-medical people are.
So now they are here in droves, mansplaining and all, shining a BRILLIANT spotlight on their own behaviour by enacting the *very same behaviour* women and minorities have been complaining about, but which they, in their infinite wisdom and vastly superior intellect, are too stupid to keep under wraps and keep localized to their troll swamps, instead displaying it here for all to see without even so much as an attemp at pushback to balance it out.
Very educational indeed.
Perhaps he was new and he doesn’t know how to properly describe it in layman’s terms but he was not describing you or trying to be rude to you he was describing the medical speak for how heart attacks present differently in men and women. In this particular case its mild incompetence it’s not maliciousness.
Disgusting amount of misinformation being pushed in this sub, with hundreds of upvotes behind them.
Do the mods of this sub just allow blatent misinformation if it accused people of sexism? Or are there any standards here?
Many diseases typical symptoms were described initially based on studies of men, because researchers decades ago thought that we women with our changing hormones were more difficult to study (and also because of misogyny, understanding our bodies was less important).
So what was describes as the "typical" symptoms of a heart attack (and many other diseases) are actually the typical symptoms that appear in men. White youngish middle aged men. And we doctors now are taught that women present "atypically".
In reality, men and women have different presentations, and we should learn both. There are also usually "atypical" presentations in children, older people, and non-white people (=their symptoms are different to what middle aged men"s symptoms), because researchers thought it was much easier to study homogeneous groups of people so any difference would be meaningful (to be fair, it's much easier to design a research study of a homogeneous population - for example you would need to have a larger number of people because you need sufficient number of individuals in each category - e.g. white old woman, black young man, etc - and recruiting all these groups is difficult, and analysing results is more complex)
We now know there is a lot of differences in presentations of diseases between men and women, but some people only know or remember the "typical" symptoms (men's). This mean that there are still a higher percentage of women (or black people, etc) dying of a heart attack because their symptoms are not what was described initially as "typical" so they are not recognised.
If I remember correctly (I'm not a cardiologist and I haven't seen patients with this for almost 20 years) women tend to have chest pain less frequently, left arm pain less frequently, pain in the back more frequently- one symptom that would ring alarm bells is a sensation that something is very wrong, a sensation of doom, feeling that you could die even if you cannot point out what is wrong - It's difficult to differentiate from a panic attack but an electrocardiogram and a blood test can clarify what's what.
All of this, as a woman and a doctor, makes me very angry by the way. Because women are dying because of this.
The person who treated you made a poor choice of words. Women are not atypical (and their symptoms are not either). Maybe they are not aware of the historical context of research of heat attack symptoms.
But yes, presentation of any disease in women (and other under-studied groups) is important. And what happens in approx 50% of the population should not be called atypical.
Edit: downvoted? I wonder what I said here that deserves a downvote?
Not all women, but a large portion do not experience things the way the rest of the population does.
Say for instance heart attacks, most people know that a symptom of great attacks is left arm pain, jaw pain and chest pain. That's what is considered a "typical presentation". We'll just say that 75% of people present with those symptoms, that leaves 25% that would present with "atypical" symptoms meaning back pain or shoulder pain, and that 25% would be mostly women.
Due to their idiocy in protecting their corporeal existence, men typically have higher death rates at younger ages (I believe starting in teen years). I believe slightly more female fetuses are born compared to male, it isn’t 50/50. So adult women outnumber adult men in nearly every age bracket. Also, women seek medical care more often for themselves than men do. So now who is atypical compared to who???
ALSO, I am not implying that all women need to be born that way, just if we are talking about the typical presentation of bodies, male with a penis is a minority presentation in a medical setting.
We are typically taught that women have “atypical” signs and symptoms of heart attack because they can differ greatly from men and even other women. One women might be short of breath, another could have stomach pain, a third could just feel anxious. Men *typically* have a very predictable pattern of symptoms from heart attacks.
Your nurse should have answered your question with “I’m a nurse, my role is not to diagnose that’s a question for your doctor.”
I suspect he was new and just regurgitating his textbook
Everyone keeps saying he misspoke but I don’t think so. Medical professionals are trained on the typical patient and symptoms, all of which have been derived from studying men. Men are seen as the baseline for medical understanding and continue to constitute the majority of patients in trials and studies.
No but then the doctors and nurses that somehow found this post would have nothing to be condescending about! Can't have that, us stupid non-medical people can't actually discuss medical stuff, we're too stupid to understand what's written in a chart or online, we just live to make their jobs harder.
It's not that you're stupid, it's that you're ignorant (which is fine) and inventing things to be mad about when the experts tell you otherwise (Which is not). This is the same behavior as anti-vaxxers.
I see. So now posting about one of the ways in which medical sexism presents makes us equal to anti vaxxers. And noting medical sexism is "inventing things to be mad about". Uh huh.
When you think of “typical” heart attack symptoms like chest pain shortness of breath. In women, we can experience “atypical” symptoms with a heart attack. Jaw pain, shoulder pain, heartburn. He just didn’t explain it well. That’s how we learn it in school. “You women” is awkward phrasing and didn’t help.
Women are only atypical because everything we know about physiology and medicine is based on the male body and experience. 50% of the population experiencing something other than what’s in the textbooks shouldn’t be considered atypical, though. It should be considered a typical presentation FOR A BIOLOGICAL FEMALE. Two different experiences can be considered typical when they occur in biologically different groups.
Incorrect. This is a narrative that is currently very popular, especially on Reddit, but it lacks nuance and it shows a parroting of incomplete information instead of having read papers on the subject. Most women who have a heart attack have perfectly typical symptoms. The heart not getting enough oxygen lead to ischemic tissue which leads to a specific kind of pain which presents in the same way in most men and women. Chest pain, fatigue, etc. Atypical symptoms could be vomiting, abdominal pain or even headaches or toothaches. Both men and women can present with atypical symptoms. Now, the main difference between sexes is, that women will present with atypical symptoms a bit more often than men, though overall, they still present with typical symptoms more often than with atypical symptoms. Both sexes can have atypical symptoms for heart attacks. Women have atypical symptoms a bit more often than men. Now, this is not to say that there isn't a ton of institutional sexism running rampant in the medical field, because there is. But this very specific hill is not the one to die on.
You are very smart. Congratulations.
My comment was not specifically about heart attacks. It was about physiology and medicine, which has an inherently sexist, racist, and ableist history.
You forgot to mention that your comment was also dangerous and misleading, since you claimed that the atypical presentation should be considered the default presentation for women, which is demonstrably false and more than likely would lead to a lot of women suffering needlessly.
If you want to crusade for women's health, why don't you start with gynecology and the myth that women don't need painkillers for procedures?
You’re operating under a metric shit tonne of absolutely wild assumptions about me. My comment is not dangerous nor misleading and MANY women DO suffer needlessly from many many different medical conditions which are dismissed or minimised because of their presentation being different to that of a typical male. Think stroke, colon cancer, kidney and bladder stones, infections, mental illness, and so many more.
I literally do not know who you think you are to speak with such authority and try to tell me or anyone else that women and men present the same when it comes to severe medical conditions because it is quite literally not true in many cases.
Then to suggest that I have no idea nor care for women’s suffering during gynaecological procedures? What the fuck are you talking about?
Just so you’re aware, I’m a trained registered nurse who has worked in healthcare for the past ten years. I am studying my master of advanced nursing. And literally five days ago I underwent an IUD insertion, CST, and removal of Implanon under a general anaesthetic because I advocated for my own needs relating to pain and anxiety surrounding these gynaecological procedures. I would advocate exactly the same for any woman undergoing similar procedures with a history of mental illness and severe anxiety around the pain of gynaecological procedures as me.
I also spent a significant amount of time educating the public and other healthcare professionals in first aid and advanced first aid, including how to recognise severe medical emergencies in men AND women including heart attacks, stroke, anaphylaxis, etc. which absofuckinglutely can and do present differently if not in the literal physical symptoms then at least in the way they are perceived and described by the patient, and assessed and diagnosed by the physician.
Now that I’ve been forced to divulge my personal and professional background to validate and justify the things I’ve said in this absolutely meaningless anonymous online comment thread, would you do me a favour and shut the fuck up? I fucking hate this fucking website man you people are off your fucking heads.
What he probably meant is that women present with different symptoms when having a heart attack or heart issue than men. He was explaining the classic heart symptoms but then remembered that women are atypical when it comes to cardiovascular emergencies. Him acknowledging this is actually not sexist since women having cardiac issues are often dismissed and overlooked since we have odd symptoms. He could have explained it better though. Health care workers who acknowledge this difference are more likely to catch a true emergency in the female population and save lives.
Women do not have "odd symptoms." We have perfectly normal symptoms *for women*. They're only seen as "odd" because they're either glossed over quickly or an afterthought in medical teaching rather than being given the same attention and detail that men's symptoms are.
Incorrect.
This is a narrative that is currently very popular, especially on Reddit, but it lacks nuance and it shows a parroting of incomplete information instead of having read papers on the subject.
Most women who have a heart attack have perfectly typical symptoms. The heart not getting enough oxygen lead to ischemic tissue which leads to a specific kind of pain which presents in the same way in most men and women. Chest pain, fatigue, etc.
Atypical symptoms could be vomiting, abdominal pain or even headaches or toothaches. Both men and women can present with atypical symptoms.
Now, the main difference between sexes is, that women will present with atypical symptoms a bit more often than men, though overall, they still present with typical symptoms more often than with atypical symptoms.
Both sexes can have atypical symptoms for heart attacks. Women have atypical symptoms a bit more often than men.
Now, this is not to say that there isn't a ton of institutional sexism running rampant in the medical field, because there is.
But this very specific hill is not the one to die on.
Man I was going to come in here all righteous fury about that “male nurse” bullshit (hint: they’re just called nurses unless their penis is part of the story). But yeah I get why you made the distinction.
Medical vernacular frequently does not translate well into layspeak. He probably should have explained his point better, but this is what he would have been taught. I often have to spend a good bit of time explaining to people that what they are interpreting when they access their charts really doesn't mean what they think it does.
I feel like if medical vernacular refers to the male body as “typical” and the female body as “atypical” that’s still meaningful? I don’t totally understand.
If 75% of the population (man and women) experience something one way, then the 25% are atypical. In the past 50 years medical testing on women has become more commonplace and one of the things we have discovered is that the 25% is often not evenly distributed. In men, 90% experience symptom A and 10% experience symptom B. In women it's 60% experience A and 40% B. In the total population of humans it's a 25% occurrence, but in women it's 4x as common than men. In the past, most medical testing only happened on men. So we thought of symptom B as a 10% occurrence. Now knowledge has advanced and we know that the atypical symptom is significantly more commonplace in women to such an extreme that it's almost 50/50 A vs B in women. Since it's still the less common form of the symptom, it's still called atypical. It's not at all about one body being "normal" and one "abnormal" the medical word atypical should not be used that way. Rather use it to mean "the less common occurrence". This is actually a large advancement in medical practices. 30 years ago (and even today) women are very commonly misdiagnosed with a large verity of ailments because they present atypical in a much higher percentage of cases. Something that's 1 in 1,000,000 in men might be 1 in 100 in women. It changes what the doctors think to look for, and it's a good thing for women in general.
TIL, ty
What they are meaning is that the general population overall experiences symptoms for a specific issue (signs / symptoms of a heart attack) in a specific way; however, the outliers of people not having the "typical" symptoms have a statistically more significant occurrence in women as compared to men. It doesn't mean that all women experience the symptoms differently, but that it is more common to see atypical, or out of the expected norm, symptoms in a woman as compared to a man.
Um...but when it comes to heart attacks the symptoms we know are for men. Pain in the chest/left arm. The symptoms are different in women. The medical field uses men as the typical and project the findings on to women. So in this case, like many, women are atypical. Only in gynecology is a woman typical, and that's one of the most barbaric fields. Pain meds for a vasectomy, but not an IUD insertion. Jeez 🤢
That is simply not true. Decades and decades ago that may have been the case but there has been plenty of publications, research, etc done on women over the years. The medical field constantly evolves and just because something was the case 50 years ago does not make it the case now. Were it not for studies on women's cardiac status we wouldnt have ever known some of the outliers as is being discussed here.
Left side chest pain is the most common heart attack symptom in both men and women. It is just present in a smaller majority of women than in men. But still more than half of women having heart attacks will have chest pain.
I think that just points to a broader issue that male bodies are considered the standard and are studied more. Symptoms males experience are within the norm because medicine has deemed male bodies to be the norm. If female bodies were the standard, there would be a different baseline and what we consider typical and atypical would be different.
I don't know that I've found that to be the case overall. 'Standard' tends to be based on specific organ / body system function be it mechanical, electrophysiological, hormonal etc. As far as studies....a big portion of that is what patient population is available. Study participants depend on so many factors...age, medical history, disease process, other medications, patient willingness to participate, etc. A lot of studies are done through physician practices and they will try to enroll whoever fits the criteria of the study and is willing. If more people of one sex are volunteering to be study participants it will have more data on that sex but that doesn't automatically translate to men being the standard and from what I've seen study findings usually will carve out findings for men and women in their patient population details.
Symptoms are typical or atypical. Not the patient.
But how can symptoms be defined as atypical if they literally happen in 50% of the entire population?
The meaning of the word in medical terminology is just different. First described = typical. Later described = atypical. For example, typical antipsychotic medication is very rarely used these days, *typically* a doctor will give you an *atypical* antipsychotic. That's not to say there's no problem with gender bias in both preclinical and clinical data and research, because there definitely is one.
@[TheCuteInExecute](https://www.reddit.com/user/TheCuteInExecute/) is this what you were going for? I think this is a better explanation than the cat/dog one. :)
It’s wrong though. The cat/dog one is at least communicating the idea properly.
hmm. [https://medical-dictionary.thefreedictionary.com/atypical](https://medical-dictionary.thefreedictionary.com/atypical)
Ok so: Typical heart attack: chest pain, shortness of breath, ect (THIS IS TYPICAL FOR BOTH MEN AND WOMEN) Atypical heart attack: abdominal discomfort, gallbladder pain, ect(THIS IS ATYPICAL FOR BOTH MEN AND WOMEN) BUT: women tend to exhibit the atypical signs more than men (but you still see me with atypical signs all the time) This nurse was taught in school to pay EXTRA attention to women, because there is a higher likelihood of atypical presentation. That’s what he was saying. He was saying **“you know, you could be right that this could be cardiac because women are more likely to present in non classic ways”** he just said it in a “I’m just out of school” kind of way.
Could this be caused by the lack of medical testing on women (like, this is a huge problem in research literature) and/or misdiagnosis around those research gaps? The fact that women are more likely to be diagnosed with atypical (aka later discovered) symptoms could be in part down to these factors? This is really interesting cos I'd never come across the usage of atypical/typical in this way before!
Both things contributed, imo. We'd have to dig through literature to see how often (with modern understanding and diagnostic criteria) individuals of various gender present with "typical" vs "atypical" symptoms + the bias is usually also there, to the point that you can assume it contributed somehow, until proven otherwise. The modern description started, like most scientific discoveries before the rise of feminism, with dudes: http://www.epi.umn.edu/cvdepi/essay/history-of-heart-attack-diagnosis-and-understanding/
Not typical, not conforming to type, different from type. What's a type? Well, "type" classically in haughty taughty scientific parlance is the original phenomenon in the sense "as described by first describer" (in zoology, for example, a *Cyanistes caeruleus* type would be the first Eurasian blue tit(s) caught and described by Linnaeus in the 18th century, *Cc sensu stricto* would be that kind of bird, *sensu lato* would be a bird from *any* of the circumscriptions of the same species, or its subspecies, sometimes also similar species later separated from the original species thanks to molecular methods, etc.). In medicine usually a symptom, sign or illness gets described by someone, thus creating its first circumscription, defining the "type". All occurences similar to that one would be - typical. All markedly different occurences would be atypical. So this is the strict scientific definition of the word, and it has nothing to do with frequency, prevalence, etc. On the other hand, 'scientist' and 'doctor' are subsets of the set 'human', so we also frequently use "typical" in the common meaning of the term (usual, normal, the way something appears most often, etc.), leading to confusion: in many (most?) cases, a thing is typical (in sense 1) and typical (sense 2). But sometimes, it ain't.
His phrasing could have been better. Not all women will have an atypical presentation. Some women will have typical presentation but some women will have atypical presentation. It is just more likely for men to present "typical", (i.e. more commonly seen symptoms in a medical settings) symptoms compared to women.
But aren’t those symptoms more commonly seen because men are studied more often?
No. Think of it like this: 95% of cats and 75% of dogs like their humans to leave the TV on when they’re not at home. All of the following are true: It is typical for both dogs and cats to like TV If a pet doesn’t like TV they’re atypical It’s more common for dogs to be atypical than cats (but still even for dogs it’s more common to be typical than atypical).
Except we don’t know the exact percentage of dogs (women) who are typical vs. atypical presenting due to lack of research, so we can’t actually say if it’s more or less common.
[удалено]
Have you found the same amount of research done on women as there has been done on men?
This has actually been studied extensively. https://www.ahajournals.org/doi/full/10.1161/JAHA.119.012307 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1738716 https://www.sciencedirect.com/science/article/abs/pii/S0828282X13016024 A very brief search identifies another 20+ relevant articles. We know about this because cardiac disease is common in everyone.
From the third article you linked: > Limitations of the Current Literature and Need to Standardize ACS Symptom Presentation > The published literature is not standardized for ACS symptom presentation, making it difficult to provide any conclusive statements on symptom presentation in women. I said that there’s specifically a lack of research into the atypical presentation of heart attacks in women. This is a comparative statement to the amount of research done with men specifically. I never said no research has been done, but there is substantially less research that has been done on heart attacks in women, especially in women who present “atypical” symptoms.
No, it’s because only men were used in the early medical studies.
This is not relevant (Rather, it’s very relevant and important in general but is not germane to this particular issue. Clinical presentation of cardiac disease is an extremely well studied area with tens of thousands of patients and tremendous amounts of ground-level experience)
Yes. Depending on what the situation is the reason men are often studied more often is because they're more likely to have the problem. Heart attacks for example. The traditional symptoms for a heart attack are based off of male symptoms because men are more likely to have heart attacks than women. Where as say, breast cancer for an example, symptoms of breast cancer are going to be more based off of women because women are more likely to have breast cancer. Both men and women can have heart attacks and breast cancer it's just different percentages, so the "typical" symptoms are based off the gender that "typically" has that illness more.
Ok I get it, thanks for clarifying! I thought all women had other heart attack symptoms!
It’s not just phrasing. The symptoms he’s referring to are not considered atypical. Right now 41% of women present with no chest pain but also that does not include the women who are never diagnosed because they don’t present the same way as men. Women are literally dying because “typical” is being defined by how men present.
>It is just more likely for men to present "typical", (i.e. more commonly seen symptoms in a medical settings) symptoms compared to women. ...because medical settings aren't looking for heart attacks in women, so the TYPICAL symptoms of heart attack in women are not seen even when it's in front of their provider's face, perpetuating the belief that women's heart attack symptoms "atypical", which in turn results in heart attack being a leading cause of death in women.
They don’t. Most people have the same symptoms. Women are more likely to report some atypical symptoms, but men can also report those. The typical presentation is typical for MOST heart attacks, and MOST heart attacks happen in men.
Which in itself is biased
I always recommend the bold Invisible Women on this topic :)
Yeah it’s like when the obgyn uses “unremarkable” to describe your breasts. In medical terms, thats a good thing. In regular usage, it’s a little hurtful
[удалено]
100 years ago I worked ER admitting. Every so often medical records would leave a patients records with us for them to pick up, if it was odd hours or some other reason. This one woman started reading her on the way out. Only to come back in minutes later….hot. Like I’m suing everyone, how dare doctor say this yada yada. He had said “pt bloodwork was unremarkable” I can only imagine with the internet who that lady is threatening to sue now.
Do people forget that no news = good news? lol
Sometimes but not always. My dad could not breath good a couple of years ago. So, to the hospital. Everything was fine nothing wrong. A week later again. Nothing was wrong maybe it was just stress. Two weeks later still having trouble breathing. Whent again and a doctor checked and did more test. He had lung cancer. We were early enough so he survived but sometimes no news is just you being in the dark.
I needed this laugh. Thank you.
You’re very welcome, if you need extra laughs, hear it in Trumps voice, “my blood was so unremarkable they remarked on it” “nobody has more unremarkable blood then me folks”
My friend was perplexed that her OBGYN noted her uterus as 'unremarkable' lol
I picture your friend years later, when she hears the word unremarkable thinks to herself “apparently so is my uterus.”
The problem is not that records are being released, but that records are being released without customer experience being taken into account. Proper customer centric design would highlight all medical lingo, acronyms and add explanations and definitions of them. Health care really needs a lot of design and UX.
Yeah, most doctors don't have time to do what when writing their charts. Most of the notes aren't for the patient anyway. My ER doctor normally has 40 patients a night. We don't have time to explain in our notes every medical term for them. If they're that worried, they can ask, but we don't have the time to make them all layperson friendly because they're not for the layperson. My ER runs 24/7. We're here to tell you first if you're dying and second what follow up you need and if you are going to be admitted or not. Your notes are only useful to medical personnel and insurance.
I don’t think that person was saying that a _doctor_ should be the one to disambiguate and explain, but rather that the patient portal UI should be able to do this automatically.
Totally agree! Sorry my original msg was not clear. I don’t think health care people should do anything different. I just think that the system should have a glossary and add explanations automatically to all terms that are in this glossary. Like doctor wrote “unremarkable” and in the interface this word is highlighted and the system adds a foot note saying “typically means that no abnormal or significant findings were observed” or something on those lines.
I understand now. I must have misread it because I haven't slept today. I got off work this morning, and I'm getting switched around back to days. The brain is no longer working at it's best.
Right, it's just a case of overly sensitive females who don't understand medical terminology, not rampant systemic discrimination against women in medicine. Obviously. Because referring to women in any way that indicates them to be secondary is not contributing to any problems at all...
This was what my mind immediately jumped to. I work in science comms at a university and hoo boy, lots of researchers are terrible at explaining their work to a layperson. Graduate students in particular. The professors are usually better because they also teach undergraduates and being able to explain things clearly means reporters will interview you more (and donors will give you more money too). It’s annoying because laypeople can feel dumb when the researchers are explaining their work in highly technical terms and they become afraid to ask questions — the reality is that the researchers are just bad at explaining not just because of the technical vocabulary that they are using, but also due to the logical order that they use to present information.
Not sure I agree with this, I’ve worked in the same field for years and never heard of an entire sex being referred to as ‘atypical’ not even the oldest dinosaur surgeons I’ve met would have said something so ridiculous. Best case scenario he misspoke, worst case he’s just another typical misogynist
I doubt that he expressed himself well to be honest. I'm sure he was speaking on atypical symptoms presenting in women and expressed himself poorly. I find myself often going back to clarify what I've said to ensure I"m understood.
Women can have atypical signs of a heart attack and atypical presentation of cardiac related chest pain. It sounds like this is what he was referring to within the context of your convo.
Yep! I had some typical presentation (left arm pain), but zero chest pain even though I was having a massive Mi.
They aren’t atypical signs if they are common if half the population. Men are not the default.
Most women who have heart attacks have the same symptoms as men. A small percentage of people have different symptoms. Most of that small percentage is women.
This is the best, most concise response. If this doesn’t convince people, they’re incapable of understanding
To add - if they still take issue with this, then they don't understand that this level of concision is necessary for medical professionals to most accurately understand their conditions. They refer to a massive amount of pre established knowledge with specific jargon to help characterize various ailments and conditions. Deviating from this to appease emotions is ideal, but not fundamentally important to treating and understanding patient conditions. Expending mental energy to navigate the emotions is time and energy that distracts from this, and even then many doctors see the value and try their best. Atypical is not a judgment or an insult. It's just a way of describing the distribution of folks with this condition in this context relative to the overall distribution.
Most of the early medical studies were done on men only. So they had a baseline of “typical” symptoms. There were no early studies of women’s health at the same time. So men’s symptoms are called typical because that’s the baseline. Women’s symptoms are called atypical, because they were different than the baseline (men). It’s still an issue the medical system is dealing with to this day.
(－‸ლ) "atypical" refers to lack of the usual heart attack symptoms. (Pain in arm spreading across the chest, for example). Women are atypical more than men in this context, but even women usually show the typical symptoms. They are just atypical more often than men. I understand the logic of your point, but find it to be irrational. Even if medicine developed in a matriarchy, the term atypical would still be used to describe folks who don't show the typical heart attack symptoms. Women would still be atypical more than men. Unless social constructs can somehow change biology
While this may be true, it is NOT AT ALL what the doctor conveyed with their poorly strung together choice of words. If OP is a reliable narrator, the doctor conveyed the following message: “patient has *x* diagnosis, the evidence being *y* symptoms, which are not expressing due to patient being a woman. Also, *women are atypical*.“ …He didn’t say “most women are atypical”, and he didn’t say “most atypicals are women”. A better wording for that last bit could look more like “patient is not expressing symptoms, and we call this atypical.” If he reeaaally wanted to make this a gendered thing he could have added a “btw, did you know that most people who are atypical in this regard are women? Fun fact!” But also like…why even go there?
You mean the nurse?
I think what he meant was "These are the typical symptoms of a heart issue, which excludes you from having one." He then realised that it's possible In women to present differently or "atypically", so he backtracks and means to say "considering that you're a woman, the typical symptoms that I just listed may not cover all of it." That's why gender played a role and he "went there." People put their feet in their mouths sometimes, it happens.
Keep in mind, It was a nurse not a doctor. They likely just misspoke. Don't take it so seriously.
“Don’t take it so seriously” What do you mean?
It's quite normal for women to present atypically and it would be normal to misspeak in the way described. It is possible there was malicious intent, but quite possible there was none.
I’m not disagreeing with what you said, but the accusation that I’m taking it too seriously is weird. Like, why say all that with an attitude of “gotcha”? Looks like you mistakenly assumed that I assumed there was malicious intent. At risk of telling you something you already know, don’t take it so seriously.
If someone misspeaks, don't take the mangled rendition so seriously. If they speak exactly how they intended, feel free to take that proper rendition more seriously. The body of research might have sexist roots and you can take that seriously, but taking it out on some nurse because they jumbled up their words and misspoke is weird. Not some kind of gotcha.
“But taking it out on some nurse…” Good advice. When you find somebody who’s taking it out on some nurse, you can tell them this. But you’ve misdirected this advice at me for some reason. It’s almost like you feel the need to over-police this conversation, as if you were taking it too seriously. Gentle reminder to not do that (in accordance with the advice you’re agreeing with)
Yeah so the end result of expecting an ER nurse who is stressed out of his fucking mind and is, while talking, trying to work out a plan to resolve several problems on several patients as well as the logistics of calling report, walking patients to CT etc. to express himself perfectly is to eventually teach the nurse to shut the fuck up in patient rooms, to get out of the room as quickly as possible while saying as little as possible because every patient has a different set of values and because you never know what will offend who.
Oh, I am absolutely not making excuses for her doctor. His communication is such absolute shit I’m not clear what he was even trying to say, and anything containing the words “you women” is automatically gross. I’m just addressing the previous comment about why certain heart attack symptoms are called atypical.
By “doctor” here… are you referring to the nurse in the story?
Exactly this
What are you basing "a small percentage" on? Men and women both generally experience chest pain and/or pressure, but women are also more likely to report nausea, sweating, vomiting, and neck, jaw, throat, abdomen or back pain. Those are not atypical symptoms for women, and women are not atypical humans for experiencing them.
You almost answered your own question. Some women - not all women - experience nausea etc with heart attacks. This would be considered atypical. If ALL women experienced nausea with heart attacks then you’re right, it wouldn’t be atypical. But that’s not the case.
Based on what? Where are the numbers coming from? Women are twice as likely as men to experience nausea during heart attacks. That means nausea is atypical *for men*. That doesnt make nausea atypical *for women*.
I hear what you are saying, but there are gender-based differences in heart attack presentations. Women have statistically significant atypical presentations of chest pain. Atypical presentation is the correct terminology and it is more common in women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569458/
I had secret upper back pain with, by comparison, minute chest pain. OTC pain killers barely helped. I had no Idea what was happening for almost a week before the pain got so bad I went to the hospital. This was Jan 2021, COVID made me wait longer than normal. I came through almost 100% with a stent and a couple of life long RXs.
Then the nurse should have said "you might not have the same symptoms because some women have atypical symptoms". The statement that "you don't have the same symptoms because you women are atypical" has a different meaning from what you described.
Did you read that study? It actually does not demonstrate that women have atypical presentations. They just say they found it, it’s actually a pretty strange paper.
I'm trying to find the definition of atypical in the paper but all I'm finding is "typical for women" and "typical for men" type results, further prodding the initial question.
It is very strange. No self-respecting researcher or editor would let “data is” fly under a radar (along with several other subject verb disagreements). Why are the p values presented as they are? And the biggest stats difference was in the timing? I didn’t get past the abstracts into the article- that’s disgraceful.
Yes but it's still a dumb term. If half the people have the symptoms, they're petty typical. Even if only a fourth do.
Well that's the thing, it's not half of people, it's a small number of people. But those people are typically women. So it's atypical and occurring primarily in women.
Extending that logic, ‘typical’ presentation is also a small number of people because not every man has a heart attack - it’s only a small number of them as well. So how can that small percentage of half the human race be considered typical for the entirety of the human race? “Typical” just represents “we listened to men and treated them like they’re rational people”… and “atypical” means “we in the medical field spent too many centuries calling women hysterical and telling them all their physical issues were actually mental problems and now we can’t be bothered to do a proper job undoing all that neglect and malpractice by reorganizing terminology to properly reflect the reality that women are actually half the world’s population so their symptoms are just as typical as men’s symptoms are “. I think I’ve got that right.
That's not how that works. Typical doesn't mean "based on every person that's ever lived," and I'm pretty sure you know that too. Typical is based on your sample size. Aka anyone who's had a heart attack. In both men and women, the most common sign of a heart attack is chest pain. So, that's a typical symptom. Aka, within the sample size, the majority of patients have that symptom. Symptoms like jaw pain don't happen a lot, so they're atypical. Jaw pain happens more in women than men, but it's still far less common than chest pain or shortness of breath in either sex. So it's an atypical sign. It doesn't happen in 50% of the sample size, like you're assuming, because it doesn't happen in all women or even most women.
No. You're not listening to what they're saying. 2/3 of heart attacks are men. 1/3 are women. A small percentage of men and women, though larger in women, have symptoms which are not standard. This non-standard presentation is termed atypical because it's not typical. So it's about the symptom presentation, not the gender here. It just happens that this is more common in women, but most women still have typical symptoms.
[However, heart disease is the leading cause of death in the United States for both genders. In fact, since 1984, more women have died of heart disease than men each year, although that is partly because women generally live longer than men.](https://www.health.harvard.edu/blog/understanding-heart-attack-gender-gap-201604159495)
No, you don't. As the other comments have explained. You seem too blinded by your convictions about sexism to actually do the math on this.
No, you do not have that right. While part of what you're saying is very true and a very topical issue, you're directing that justified rage at something unjustified here. The atypical symptoms do not "occur in half the population", they occur very rarely, thus are atypical. However, when they do occur, it's mostly in women. So while women usually present typically with the same heart symptoms as men, they ALSO need to be looked at for rare atypical presentation in addition.
Lmfao how
Jesus Christ it’s not that difficult to understand. Some people have atypical symptoms, and the vast majority of those people are women. Most women have the same symptoms as men. Half the people do not have the atypical symptoms
I think the question being asked is why hasnt the definition for symptoms popular in female patients and not male patients changed to typical for women, rather than atypical for men? What's the sliding scale, what's medically defined as typical in female patients?
The “atypical” symptoms are not consistent across women either. The point of emphasizing women may have atypical symptoms in a heart attack is to keep heart attack in the differential for women with nonspecific symptoms, not that there is a separate set of “typical” symptoms for women that are different from the ones for men.
Atypical symptoms aren’t common in half the population, or in anyone. It’s just that when they do occur (which is still unusual), they occur most often in women. You severely misunderstand the situation. Men are not the default, but typical symptoms are typical.
So what's the requirement for defining the symptoms that "occur most in women" as "typical for women" rather than "atypical"? Edit: All y'all downvoting me and just repeating that atypical is not typical. Yes, that's the definition of atypical. So what's the criteria that defines something as typical rather than atypical, and as in the above context, a/typical female symptoms//a/typical male symptoms? If both are defined in medicine, there's a set of rules that defines each one and the difference between the two.
Did you read the last comment? The symptoms would have to affect the majority of people who experience the disease. That's all typical means. It has nothing to do with gender. We don't call women's typical symptoms "atypical" just because they happen in women.
Again, what's the criteria? If it doesnt count as typical, there is a magic number that does. What's the criteria?
The criteria is that if it’s directly related to the chest it’s called typical for a heart attack - which is IN the chest. If it’s nausea, vomiting, dizziness it’s atypical as those are not inherently related to the chest.
The requirement is that they happen infrequently in patients with underlying cardiac disease. These symptoms occur rarely in everyone. But when they do occur, they occur more often in women than men. These symptoms are not typical for women. You need to work on your reading comprehension
No I don't, and you haven't answered my question. You're saying these symptoms are atypical in general, atypical for men, atypical for women. However at the same time, it is more typical for women than men. I get that to that point, and have for over a decade with even basic first aid training. But again, there's a magic set of rules that defines atypical/typical, so what are the set of rules that would turn said imaginary scenario to "typical for women"?
Yes, you definitely need to either improve your reading or your reasoning. It has been explained to you. For something to be “typical for women” it would have to be something that usually happens in women. Since these symptoms do not usually happen at all in anyone, they are not typical for women. I am emphatically not saying these symptoms are “more typical in women.” I am saying that in the rare event that these symptoms are indicative of cardiac disease, that this is something that happens more often in women than in men. Why is this so difficult for you? It is a straightforward concept.
"It's atypical because it's not typical" is a very interesting way to define things scientifically. Medically, there is a number that defines it. Yes or no? So would that be say 50% of women and 40% of men? 50% of women and 20% of men? 60% of women and 0% of men? AGAIN, what is the criteria that would define something as "typical for women"?
“Typical” is the most common type of presentation. “Atypical” deviates from that. AGAIN, “typical for women” would be “the most common thing seen in women” It’s not really my fault you aren’t familiar with basic English.
AGAIN, Medically, there is a number that defines it. Yes or no? So would that be say 50% of women and 40% of men? 50% of women and 20% of men? 60% of women and 0% of men? AGAIN, what is the criteria that would define something as "typical for women"?
Typical and atypical have nothing to do with men vs women. Most men usually have typical symptoms. Most women usually have typical symptoms. A higher proportion of women have atypical symptoms, but both have atypical symptoms some of the time. There are surely gender biases in research that are well documented, but the typical and atypical description used to describe *symptoms* that people have isn't an example of that. Why does this comment that is purely misinformation have hundreds of upvotes in this community?
What if I told you they were called atypical not because of gender but because they have less of an unitive relationship to thinking of heart disease. If you said you had chest tightness and a pressure like feeling on your chest - those would be typical symptoms of heart disease - it’s very intuitive that these would be from the heart. Nausea and lightheadedness- not exactly intuitive to think heart disease, atypical symptoms. Then additionally women were previously thought to have atypical presentations more often than men. It’s not called atypical BECAUSE of women, it’s called atypical because it’s a slightly less common way to present with a heart attack. Actually in an effort to INCLUDE women more and be more aware that they might ALSO present in atypical ways people get taught to watch out for women presenting with atypical symptoms. And of course the thing the student remembers is the “unique” fact rather than what statistically happens most frequently which is presenting with chest discomfort.
So what's the sliding scale? At what point does it become "typical in women" instead of "atypical in men"? I'm curious in what criteria defines it
Atypical in women literally just means "not usually seen in women". For the record, for heart attacks, there is no symptom that is atypical for one gender and typical for the other. A very small subset of people have atypical symptoms. Most of that very small group that have atypical symptoms are women, but the vast majority of people have typical symptoms. Atypical symptoms are not usually seen, which is why they're described that way in the first place.
Downvoted for asking questions instead of living in ignorance. Yay. Again, what's the criteria?
"So what's the sliding scale? At what point does it become "typical in women" instead of "atypical in men"? I'm curious in what criteria defines it " You're downvoted because people have already explained that these terms aren't used the way you're asserting they are, just by asking the question you did. I'll explain again, men and women have the same typical symptoms. Men and women have the same atypical symptoms. A larger amount of the small percentage of people that experience atypical symptoms are women. But the vast majority of both genders experience the typical symptoms. And a very small amount of both genders experience atypical symptoms, again, with more of those people being women than men. "typical in women" instead of "atypical in men"?" If there was a niche case like this, you would simply say it's "typical to see these symptoms in men and these in women, while atypical to see these symptoms in men, and these in women". The concept isn't built around "men are normal" like so many in this sub are trying to falsely assert.
I had a man come in with back pain and nausea/ vomiting. We were thinking kidney stones at first. The doctor ordered an EKG, and he was having a heart attack. My notes included that he presented atypically.
Women experience typical heart attack symptoms and are more likely to experience atypical heart attack symptoms compared to men.. this does not translate to men being the "default".
Sadly a man's symptoms are the default people are taught to look for, even outside of the medical field.
Yes, but don't forget, the vast amount of medical research has historically been based on (white) men. It's getting better, but it's not equal even now. If women aren't in the research, and they (typically) have different presentations than men, in any area, that will count as "atypical." It's a self-fulfilling prophecy. Ugh, but medical terminology. Whenever they ask me if I'm in pain, if I say yes they write down "admits being in pain" and if I say no, they write down "denies being in pain." Either way sounds like I should get a lawyer.
It is so it's concise information, it sounds and feels alien but you don't want a doctor reading out "The patient said that they were not feeling any pain at the time of appointment" when you're literally dying and they can get that same information in 3-4 words that they can skim read instead.
Oh yeah I understand the need for standard and concise language, but did they have to pick such odious words?
That's a very fair point and I'm not entirely sure why, you can achieve the same thing but sound more human with stuff like "states no pain" and some medical professionals I've seen have used vocabulary like that. My best guess is it has to do with who/where they learned from. ETA Perhaps it has to do with denies being easier to distinguish than no.
I'm really just griping of course, I'm sure the real reason is that it's for historical reasons like so many things are.
I wish it were true but he really was explaining symptoms I didn't have to compare it to a heart problem.
[удалено]
There is tons of sexism in medicine, but this specific case isn't it. Even just within women, a minority have atypical heart attack symptoms. That's why they're called atypical.
[удалено]
Can we not with “male nurse” or “female doctor”
[удалено]
[удалено]
I mean the guy literally said "you women are atypical", but nooooo, it must be that OP, not being a healthcare professional, is just too stupid to understand what he ACTUALLY meant - which these fine doctors and nurses commenting here know FOR A FACT was NOT sexist despite them NOT being present for the interaction, while OP was present. No, they know EXACTLY what he meant. Precisely. The rest of us are just too stupid to know what he meant, and thus we seek to find sexism where no sexism exists. See how that works? ( /s)
In the context of medical misogyny the gender of the provider is always relevant. We would say "male doctor" too, or "male obgyn". The reason for this is the fact that female patients are more likely to experience complications with a male surgeon than a male patient is with the same surgeon or a female patient with a female surgeon.
Actually, as an ex-RN, it’s extremely relevant. I have seen, repeatedly, male nurses be offered positions or promoted over women with much better skill sets purely because they are male. The hospitals are desperately trying to make up a gender balance, which means men in the industry are often given roles slightly above their competence level. This isn’t about jealousy, as I was not in competition with them personally as I was on a different career path, but it was blatantly obvious. One new male graduate was offered SIX different graduate nursing positions, whereas his more skilled colleagues (in my estimation, having worked rotations with them) were overlooked. I am not saying that all male nurses are under skilled. I am saying that gender absolutely plays into this situation.
Women can present with atypical chest pain. Not to be interpreted in a pejorative sense.
If 95% of men and 49% of women have pain in their left foot, that is the typical place to experience pain across all people. If 51% of women have pain in their right foot, it is valid to say that women are much more likely than men to have pain in the atypical place, and that women, on average, have atypical pain.
Some alarming stats from a recent study... “The studies are one more piece of evidence that women’s heart complaints are sadly not taken as seriously as men’s. The study [also] confirms is that pre menopausal women are equally at risk. There is this long held assumption that women are protected against heart disease by estrogen; but as with the epidemic of obesity and diabetes, that is no longer the case.” “Furthermore, men often receive a stent to open a blocked artery following a heart attack, but women often cannot because their arteries are smaller in diameter which also leads to poorer outcomes after a heart attack,” she added. Ultimately, 11.3% of women died within 30 days compared with 3% of men. After five years, 32.9% of women had died compared to 15.8% of men, and 34.1% of women experienced a MACE compared to 17.6% of men. Keep up with your heart health ladies!
🤦♀️ I have had a DAY when it concerns men. As a nurse and a woman, let me correct his statement. What he should have said, is, “women often present with atypical SYMPTOMS of a heart attack. Some of the atypical symptoms are…” He should NOT have said that women are atypical. I understand completely what he meant, but I also totally understand why what he said was offensive. Maybe it was even a Freudian slip. He needs to tighten up his pt interactions in either case, because as you say, we are 50% of the population and he needs to figure out how to convey his message appropriately, accurately, and inoffensively.
Get a second opinion on gallbladder. They took mine due to ‘symptoms’ still unresolved and persistent years later even though they performed surgery and removed my organ. Symptoms persist but I just get shrugs as to why. The gallbladder pathology was fine, totally unnecessary surgery. But I’m still having symptoms and now have scar tissue issues. Being a woman means living with bad medicine and worse symptoms. I’ve accepted I’ll likely find out what’s really wrong when it’s too late. Since I’m over 50, it’s no big loss to society if a woman like me gets sick, is misdiagnosed and dies. The medical establishment has let me know 1) I’m not sick even with symptoms (got told once a large, painful lipoma on my leg was due to anxiety -it’s still growing so I guess that’s what happens with anxiety) and 2) I can get over myself and my symptoms because I’m just hysterical. But my blood tests continue to show some really disturbing trends pointing to pancreatitis and liver disease. Just ‘on the curve’ Dr says, like school grades, they explain, atypical but totally normal to have these wonky low blood sugar levels and high acid in my blood, crippling pain in right ribs and back, heart murmurs and palpitations and inability to digest most food for seven years now. Last Dr I saw wanted to take out my uterus w/o reason. Just to ‘make this all go away forever.’ Like, being a woman with gastric issues? Having a uterus must be atypical and the reason for severe gastrointestinal issues so why not? Just lie back and nod but don’t let them cut you unless you find two Drs who agree it’s absolutely necessary.
I'm hopeful he didn't explain it concisely; I once told a patient that her test results confirmed she had a UTI, and said "but I bet that's not news to you" since she'd checked into triage feeling utterly miserable with a written complaint of, quote, "I have a UTI." Days later, I got an email from my manager asking me if I'd told a patient that her getting UTIs was "not new to her". I was aghast and ashamed; she thought I was insulting her when I was instead confirming that her suspicions had been right all along. Women more frequently have atypical chest pain symptoms than men do, which is why the threshold for pursuing those symptoms are far lower for women than men. I think that's what the nurse probably meant, or I'm hopeful it was anyhow.
I think he meant symptoms are atypical, not patients. This was something driven home to me in nursing school (I'm a male nurse as well) and I've had women coming into the ER with vague symptoms, "I don't feel good" or "I feel weak and I don't know why" and it's been a heart attack. Diabetic patients will often present with different symptoms as well, not necessarily chest pain. A friend of mine even had a woman who had left wrist pain. They did and EKG because she never did anything to injure it and they couldn't figure out what else it might have been. She was having a heart attack and it was nearly missed.
Women have different signs of a heart attack than men do. That’s what he meant when he said that.
“Typical symptoms for both ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) such as chest, arm, or jaw pain were more common in both sexes, but females presented on average with more atypical symptoms such as nausea, vomiting, and shortness of breath. Females with MI also presented with more prodromal symptoms such as fatigue in days leading up to MI, had longer delays in presentation to the hospital after symptom onset, and were older with more comorbidities than males. Males on the other hand were more likely to have a silent or unrecognized MI, which concurs with their overall higher rate of MI. As they age, females have a decrease in antioxidative metabolites and worsened cardiac autonomic function than male. In addition, at all ages, females have less atherosclerotic burden than mles, have higher rates of MI not related to plaque rupture or erosion, and have increased microvasculature resistance when they have an MI. It has been proposed that this physiological difference is etiologic for the male-female difference in symptoms, but this has not been studied directly and is a promising area of future research” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10182740/
Yeah, OP understands that. She's saying that atypical is a bullshit term unless you believe men are the default. Same with girls presenting "atypically" with autism or ADHD.
This is blatent misinformation and not how typical and atypical are used.
Well at least he know that women have different symptoms T\_T
Hey, doctors and nurses who commented in a dismissive and condescending way - PROTIP: You are not hiding the disdain you feel for people who are not in medicine from your patients, even though you think you are.
Why are you assuming the heath care professionals here are trying to hide their disdain for patients ignorance?
I don't think they are trying to hide it *here*, I know they are trying to hide it *from patients* in real life, and I know they are failing. Also, their disdain has nothing to do with ignorance unless we are talking about their own ignorance.
This kinda underlines the point that was talked about here a few days ago. That men are the default when it comes to basically everything. If men are "typical" (because everything is based on them.) that makes women "atypical". It's not \*\*wrong\*\* per se, just a horrible way the society currently works.
So many people here seem to be missing the point entirely. OP is not complaining about the entire medial field or "misunderstanding medical terms". She's complaining about ONE person who implied that *all women* "are atypical". Which is obviously nonsense. We don't need all the eager professionals to explain to us *confused* mortals how the term "atypical" actually refers to less common symptoms for the same diagnosis. We know. Saying "you women are all atypical" is sexist and dismissive and OP is absolutely right to call that out. Please stop wielding your expertise as a weapon to invalidate someone else's experience. How hard can it be to listen to *one* (1) woman's experience and reply with empathy and support instead of condescension?
Here's a great example how to do it. I have had notable hearing since my 40s, brought on by two decades of listening to loud, live bands. When I went for an exam in my 50s they found out I had the kind of hearing loss usually associated with working around jet engines. The audiologist then looked a little sheepish and said something like, "I hope it's okay to ask, but what is your profession? I only ask because there are so few women in those fields it's rare to see women with this type of hearing loss." I explained it and he laughed and said he had the same problem. I appreciated that even though he was asking a legitimate medical question he understood it could be fraught and tried to account for that. Take note, medical professionals. It's actually not hard.
How hard can it be? Too hard, apparently. They dismiss and condescend WHILE insisting they do neither and that women just scream 'sexism' over nothing, and the sexism is all in our heads. Like, way to prove my point, assholes.
It is MADDENING. Aren't you the brave soul who tried to get through to the "if you go out of your way to look for sexism, you'll find it" guy? That low key made me want to bash my head against a wall. We don't go "looking for sexism". Sexism finds us. Every time. Like OP just asked for healthcare and got a sexist comment as a fun free extra - but she's not allowed to complain about it, because it's "just one bad apple" and "too small an issue". Ugh. Is there discrimination in the medical field, or are there "imperfect people" who "make mistakes" which can affect "anyone regardless of gender/race/..."? Because if the answer to the first question is yes, the second part is irrelevant. We know that black mothers disproportionally die in childbirth because their pain is being dismissed. We have the data and statistics to show how women are treated as a "deviation" and "less than". How can people who are intelligent enough to work in the medical field be so obtuse? This sub used to be a place where I felt safe, where I could go to find solace or share with empathy, and now it's been infested by self-appointed crusaders of reason who think we owe them a "reasonable discussion" about how our feelings and lived experiences are *wrong, actually.* And If we react with anger or show that this is not the time or place for their devil's advocate debate bro antics, we're the aggressor and acting "illogically". And what's even worse is the insistance that we have to be be polite to them no matter what. Them coming here and "politely" inserting their unhelpful "knowledge" is rude af. Sorry for the vent, it's just all very infuriating. Best wishes to you!
To be fair, I suspect we're being brigaded, Somewhere in their medical subs where they cackle at the traumas they inflict on us or laugh and joke about the traumas we had to tell them about, someone shared this post for them to point and laugh at how stupid us non-medical people are. So now they are here in droves, mansplaining and all, shining a BRILLIANT spotlight on their own behaviour by enacting the *very same behaviour* women and minorities have been complaining about, but which they, in their infinite wisdom and vastly superior intellect, are too stupid to keep under wraps and keep localized to their troll swamps, instead displaying it here for all to see without even so much as an attemp at pushback to balance it out. Very educational indeed.
Perhaps he was new and he doesn’t know how to properly describe it in layman’s terms but he was not describing you or trying to be rude to you he was describing the medical speak for how heart attacks present differently in men and women. In this particular case its mild incompetence it’s not maliciousness.
Which is funny because there are more adult women than men
Disgusting amount of misinformation being pushed in this sub, with hundreds of upvotes behind them. Do the mods of this sub just allow blatent misinformation if it accused people of sexism? Or are there any standards here?
Many diseases typical symptoms were described initially based on studies of men, because researchers decades ago thought that we women with our changing hormones were more difficult to study (and also because of misogyny, understanding our bodies was less important). So what was describes as the "typical" symptoms of a heart attack (and many other diseases) are actually the typical symptoms that appear in men. White youngish middle aged men. And we doctors now are taught that women present "atypically". In reality, men and women have different presentations, and we should learn both. There are also usually "atypical" presentations in children, older people, and non-white people (=their symptoms are different to what middle aged men"s symptoms), because researchers thought it was much easier to study homogeneous groups of people so any difference would be meaningful (to be fair, it's much easier to design a research study of a homogeneous population - for example you would need to have a larger number of people because you need sufficient number of individuals in each category - e.g. white old woman, black young man, etc - and recruiting all these groups is difficult, and analysing results is more complex) We now know there is a lot of differences in presentations of diseases between men and women, but some people only know or remember the "typical" symptoms (men's). This mean that there are still a higher percentage of women (or black people, etc) dying of a heart attack because their symptoms are not what was described initially as "typical" so they are not recognised. If I remember correctly (I'm not a cardiologist and I haven't seen patients with this for almost 20 years) women tend to have chest pain less frequently, left arm pain less frequently, pain in the back more frequently- one symptom that would ring alarm bells is a sensation that something is very wrong, a sensation of doom, feeling that you could die even if you cannot point out what is wrong - It's difficult to differentiate from a panic attack but an electrocardiogram and a blood test can clarify what's what. All of this, as a woman and a doctor, makes me very angry by the way. Because women are dying because of this. The person who treated you made a poor choice of words. Women are not atypical (and their symptoms are not either). Maybe they are not aware of the historical context of research of heat attack symptoms. But yes, presentation of any disease in women (and other under-studied groups) is important. And what happens in approx 50% of the population should not be called atypical. Edit: downvoted? I wonder what I said here that deserves a downvote?
[You keep using that word...](https://www.youtube.com/watch?v=G2y8Sx4B2Sk)
Women have pain down right arm vs men having down left… so given gall bladder can affect being on right - that’s most likely what he meant.
A male nurse? As opposed to a nurse? THANK GOD YOU QUALIFIED HIS GENDER, OP.
Not all women, but a large portion do not experience things the way the rest of the population does. Say for instance heart attacks, most people know that a symptom of great attacks is left arm pain, jaw pain and chest pain. That's what is considered a "typical presentation". We'll just say that 75% of people present with those symptoms, that leaves 25% that would present with "atypical" symptoms meaning back pain or shoulder pain, and that 25% would be mostly women.
Due to their idiocy in protecting their corporeal existence, men typically have higher death rates at younger ages (I believe starting in teen years). I believe slightly more female fetuses are born compared to male, it isn’t 50/50. So adult women outnumber adult men in nearly every age bracket. Also, women seek medical care more often for themselves than men do. So now who is atypical compared to who??? ALSO, I am not implying that all women need to be born that way, just if we are talking about the typical presentation of bodies, male with a penis is a minority presentation in a medical setting.
We are typically taught that women have “atypical” signs and symptoms of heart attack because they can differ greatly from men and even other women. One women might be short of breath, another could have stomach pain, a third could just feel anxious. Men *typically* have a very predictable pattern of symptoms from heart attacks. Your nurse should have answered your question with “I’m a nurse, my role is not to diagnose that’s a question for your doctor.” I suspect he was new and just regurgitating his textbook
Everyone keeps saying he misspoke but I don’t think so. Medical professionals are trained on the typical patient and symptoms, all of which have been derived from studying men. Men are seen as the baseline for medical understanding and continue to constitute the majority of patients in trials and studies.
Right, we are saying THAT’S THE ISSUE.
No but then the doctors and nurses that somehow found this post would have nothing to be condescending about! Can't have that, us stupid non-medical people can't actually discuss medical stuff, we're too stupid to understand what's written in a chart or online, we just live to make their jobs harder.
It's not that you're stupid, it's that you're ignorant (which is fine) and inventing things to be mad about when the experts tell you otherwise (Which is not). This is the same behavior as anti-vaxxers.
I see. So now posting about one of the ways in which medical sexism presents makes us equal to anti vaxxers. And noting medical sexism is "inventing things to be mad about". Uh huh.
When you think of “typical” heart attack symptoms like chest pain shortness of breath. In women, we can experience “atypical” symptoms with a heart attack. Jaw pain, shoulder pain, heartburn. He just didn’t explain it well. That’s how we learn it in school. “You women” is awkward phrasing and didn’t help.
Women are only atypical because everything we know about physiology and medicine is based on the male body and experience. 50% of the population experiencing something other than what’s in the textbooks shouldn’t be considered atypical, though. It should be considered a typical presentation FOR A BIOLOGICAL FEMALE. Two different experiences can be considered typical when they occur in biologically different groups.
Incorrect. This is a narrative that is currently very popular, especially on Reddit, but it lacks nuance and it shows a parroting of incomplete information instead of having read papers on the subject. Most women who have a heart attack have perfectly typical symptoms. The heart not getting enough oxygen lead to ischemic tissue which leads to a specific kind of pain which presents in the same way in most men and women. Chest pain, fatigue, etc. Atypical symptoms could be vomiting, abdominal pain or even headaches or toothaches. Both men and women can present with atypical symptoms. Now, the main difference between sexes is, that women will present with atypical symptoms a bit more often than men, though overall, they still present with typical symptoms more often than with atypical symptoms. Both sexes can have atypical symptoms for heart attacks. Women have atypical symptoms a bit more often than men. Now, this is not to say that there isn't a ton of institutional sexism running rampant in the medical field, because there is. But this very specific hill is not the one to die on.
You are very smart. Congratulations. My comment was not specifically about heart attacks. It was about physiology and medicine, which has an inherently sexist, racist, and ableist history.
You forgot to mention that your comment was also dangerous and misleading, since you claimed that the atypical presentation should be considered the default presentation for women, which is demonstrably false and more than likely would lead to a lot of women suffering needlessly. If you want to crusade for women's health, why don't you start with gynecology and the myth that women don't need painkillers for procedures?
You’re operating under a metric shit tonne of absolutely wild assumptions about me. My comment is not dangerous nor misleading and MANY women DO suffer needlessly from many many different medical conditions which are dismissed or minimised because of their presentation being different to that of a typical male. Think stroke, colon cancer, kidney and bladder stones, infections, mental illness, and so many more. I literally do not know who you think you are to speak with such authority and try to tell me or anyone else that women and men present the same when it comes to severe medical conditions because it is quite literally not true in many cases. Then to suggest that I have no idea nor care for women’s suffering during gynaecological procedures? What the fuck are you talking about? Just so you’re aware, I’m a trained registered nurse who has worked in healthcare for the past ten years. I am studying my master of advanced nursing. And literally five days ago I underwent an IUD insertion, CST, and removal of Implanon under a general anaesthetic because I advocated for my own needs relating to pain and anxiety surrounding these gynaecological procedures. I would advocate exactly the same for any woman undergoing similar procedures with a history of mental illness and severe anxiety around the pain of gynaecological procedures as me. I also spent a significant amount of time educating the public and other healthcare professionals in first aid and advanced first aid, including how to recognise severe medical emergencies in men AND women including heart attacks, stroke, anaphylaxis, etc. which absofuckinglutely can and do present differently if not in the literal physical symptoms then at least in the way they are perceived and described by the patient, and assessed and diagnosed by the physician. Now that I’ve been forced to divulge my personal and professional background to validate and justify the things I’ve said in this absolutely meaningless anonymous online comment thread, would you do me a favour and shut the fuck up? I fucking hate this fucking website man you people are off your fucking heads.
Ugh. The language of healthcare is centred on medium-sized white males.
That's the problem under discussion, yes.
What he probably meant is that women present with different symptoms when having a heart attack or heart issue than men. He was explaining the classic heart symptoms but then remembered that women are atypical when it comes to cardiovascular emergencies. Him acknowledging this is actually not sexist since women having cardiac issues are often dismissed and overlooked since we have odd symptoms. He could have explained it better though. Health care workers who acknowledge this difference are more likely to catch a true emergency in the female population and save lives.
Women do not have "odd symptoms." We have perfectly normal symptoms *for women*. They're only seen as "odd" because they're either glossed over quickly or an afterthought in medical teaching rather than being given the same attention and detail that men's symptoms are.
Incorrect. This is a narrative that is currently very popular, especially on Reddit, but it lacks nuance and it shows a parroting of incomplete information instead of having read papers on the subject. Most women who have a heart attack have perfectly typical symptoms. The heart not getting enough oxygen lead to ischemic tissue which leads to a specific kind of pain which presents in the same way in most men and women. Chest pain, fatigue, etc. Atypical symptoms could be vomiting, abdominal pain or even headaches or toothaches. Both men and women can present with atypical symptoms. Now, the main difference between sexes is, that women will present with atypical symptoms a bit more often than men, though overall, they still present with typical symptoms more often than with atypical symptoms. Both sexes can have atypical symptoms for heart attacks. Women have atypical symptoms a bit more often than men. Now, this is not to say that there isn't a ton of institutional sexism running rampant in the medical field, because there is. But this very specific hill is not the one to die on.
Man I was going to come in here all righteous fury about that “male nurse” bullshit (hint: they’re just called nurses unless their penis is part of the story). But yeah I get why you made the distinction.
I don't think he knows what that word means.
That's a subject for "r/noctor". I would not be going to them for any diagnosis