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Conquering Surgical Studies and Deficiencies in Women's Healthcare - A Conversation with Dr. Najah Adreak

May 3, 2023

This week we had aspiring surgeon/scientist, TEDX speaker and advocate for Women's Heart Health, Dr. Najah Adreak on the Caring Support Podcast! We talked about becoming a surgeon and her drive to conquer the deficiencies in women's healthcare.

Tell us about yourself.

Of course. Thank you so much for the invitation to be on your amazing platform and podcast. I did my medical training in my home country, Libya, and I did my cardiac surgery training as well there. Then I decided to move to Canada for further education and training. Meanwhile, I finished a master's degree from the University of British Columbia, and I became a scholar in teaching by completing a one year program in advanced teaching and learning. Since I have made my way here to Canada, I have become so involved in many initiatives and organizations and become an advocate for women's heart health. Because I, myself, as a doctor, was unaware of these differences. I thought, I will use my voice, my platform to advocate for that.

I joined the Canadian Women’s Heart Health Alliance, which is a national organization that advocates for woman's heart health by doing different things like educating doctors, public health, the public and students. Because of my dedication and commitment to this mission, I’ve been nominated to be the trainees representative for the alliance. I led the Wear Red Canada campaign for the fourth year now on the West Coast with my amazing team with the main mission being we need to make this information available for the public so they become more empowered and become more aware of the differences. At the same time, working at a higher level by educating the doctors because we don't know this information when we are in med school, and we need to do better to improve our women's life.

Can you tell us about the most influential person in your life and how they impacted you in your career choice?

This could be a typical answer to say my mom, but my mom plays a huge role in my life. Since I was very little to the moment that I came here. We are a family of nine, so she does a lot of things. Watching my mom from a very young age taking care of nine kids at the same time, pursuing her career and working and she was able to do this magic combination of doing everything perfectly and being at the same time, a mayor for the family, the glue that connects the families together.

From that moment, I realized, I don't have any thing that can prevent me to do my career. When I become passionate about being a heart surgeon there was a perception that women cannot be a surgeon and of course, my question was why not? My mom did everything, so why I can't do the stuff? She always supported me at the moment, up to now. I came here to Canada alone and she was super supportive. Every time that I face any challenges, she's the one that I call. She always tells me, Najah I know you can do it and I believe in you. I have a lot of people in my life who helped me throughout this journey and I'm grateful for all of them because every one of them, they make up all the little pieces of Najah. I can’t count names, but they know themselves, but my main person that I can say is my role model is my mom.

You sit here with us as an influencer for Women's Heart Health, and you've even been a TEDx speaker, what was it like being on the TEDx stage?

Terrifying. Just kidding. First of all, being on the next stage was a dream come true for me and I was truly thankful for that great opportunity. As I mentioned before, when I came here to Canada in my first year, I entered English school and my ex-teacher who become my friend now, Scott Mallory, was always giving us TED talks as a class assignments that we needed to listen to them and analyze them. From that moment, I fell in love with TED talk and the impact of storytelling, how to impact people's lives and inspire them. Then he invited me to one of the TEDx that he was organizing, and I remember that that experience was itself eye-opening for me, and it was a terrific experience. I told myself one day I’ll be on that stage sharing my passion.

When I became a women’s heart health advocate, I couldn't find better than TEDx Stage to reach to have a huge impact, and I made it my mission to reach as many people as we could nationally and globally. I had been applying to be a speaker for many years and the last year my application got approved and it was an interesting coincidence because I was writing my medical license exam at the same time with the campaign. I had a lot on my plate, and I was like, okay, I'm not ready, but you know, when you have the fight inside yourself, you can't give up.

I remember calling one of my friends and career coach, Jennifer Deane, PCC (she/her)  and she asked, Najah, what do you want to do? My response was: I really want to do it, and she said, go for it. I get a lot of help from my friends and many other people who have helped me throughout this journey because English is not my first language and despite the fear and the doubts, sometimes what matters most is the mission and how this needs to reach more people. I need to shout out to the people  that have helped me along the way. Dene Rossouw. He's a presenter coach. He was giving a workshop at UBC and I just sent them a random LinkedIn message and he encouraged me to go through the process and out of his pure heart He was helping me with my script and how to organize my thoughts. Kevin Pendergraft spent all of his weekends with me rehearsing all my stuff, and all of my friends, the alliance who provided whatever information that I was able to share.

If you are really passionate about something, go over what you think you're capable for because what scares you, it could be your growth point.  At the same time, think about the big picture and how this could benefit people. Overall, it was an amazing experience, and I would love to do it again and again.

What would you say to someone to motivate them to pursue a career as a surgeon or a physician?

I feel like being a doctor, or even entering medical school, is something that requires a lot of hard work, a lot of preservation, a lot of determination, long years of training and studying and continuous training. I would say if this is something that you really like and comes from your heart, you will be happy doing this. Every time you think about the challenges, you recognize this is something that could help you to help other people and save their lives and improve their quality of life.

If someone aspires to be a surgeon or physician, they need to reflect on their passion and what is the right why for them because, usually I say, if you’re looking for fame or money, there's a lot of easy things that you can do to get this, but if you're looking to help other people and be a saviour for some, some of the times and prevent someone to lose their family, then this is the why that will make you endure all the challenges and be able to overcome that.

I always remind myself of one phrase from the Holy Book `“save someone's life as if you saved the whole nation’’.  I remind myself what my passion is and I go for it. If I can only give them one tip it would be to make sure this is what you really want, make sure this is what comes from the heart. Make sure this is the thing that sparks your heart and makes you happy to wake up to go to the hospital because you know that you will save someone life.

What would your advice be to med students to make sure that they are taking into consideration their mental health while they're going to school?

One of the lessons that I learned the hard way is you need to know when to say yes, when to say no, and when to say yes, but later on, because we have limited time, 24 hours and we need to prioritize and know what things that matter most at that time. You need to be able to prioritize your tasks and know what things need to be done in urgent matter and start working on them in a small task every day.

They need to find time for themselves, and this could be either going for a walk, going to the gym, always connecting to friends and family no matter what, and no one can succeed alone.

Teamwork makes dream work. Try to work in teams, find a supportive team and work together, study together and they will help keep you motivated at the same time. Learn from each other's strengths. Everyone has their unique strengths and you don't have to suffer if you don't have the strength. You can learn from your colleague.

Finally, never take your health and mental health for granted. You need to work with it and you need to make action to work at maintaining them and working with them.  

What should women watch for when it comes to their heart health, heart attacks and heart disease?

I'm so glad you asked this question because as a woman, sometimes we don't put ourselves as a priority. We put other family things and all other commitments first. Then we think about ourselves. If you think about yourself first, you will help everyone around you. Your kids need you to be a healthy mom. If you don’t take care of your health, you cannot take care of your kids or your sibling or your husband.

Women need to know that their heart attack is different. We have a unique risk factor. We have different symptoms than the man heart attack. This is why we need to recognize all the differences now and take this opportunity to educate women.

As I said in my TEDx talk, the main difference is that we have a smaller heart than men, our arteries are smaller and even how the lipid plaques would accumulate in our blood is different than the man's. This is very important because this shows how our heart attack could be different in the man’s typical heart attack.

Secondly, our risk factors are different. We all know diabetes, high blood pressure, smoking are risk factors for all men and women. But women, have unique risk factor different from men. For example, if they have high blood pressure in pregnancy or have premature delivery and also that traditional risk factor, they have a greater impact on women’s heart than a man, for example, diabetes. Women have three or four times more likely to die from heart attack than men who have diabetes. This is something we need to keep in our mind and woman need to take action toward their heart from early on. Any time they take action, no matter of the age, that matters in the end.

Thirdly, the types of heart attack. We know like the common cause of heart attack is atherosclerosis. There is where the lipid plate accumulates in the heart, but in women, they come with different types of heart attack like   Spontaneous dissection of a coronary artery, which is a tear in the blood vessel, and this commonly comes to women who are old or have risk factors. They could come for someone who looks athletic more than I am, who look younger than I am. This is unique for women and we don't know why is that, but we need to keep that in mind.

We all know if I tell any younger kids how a heart attack can manifest, they see it in the movie, right? Some old man is clutching their chest and screaming. Women could come with different symptoms, like feeling fatigued and they are sweating, palpitation, rising in heart rate, and insomnia like they come with insomnia sleep disturbance. This could be a sign of a heart attack.

As women, we need to understand our bodies and know where something looks different or off from our usual daily habits. We need to take ourselves seriously and go and seek medical care because, 78% of the early signs of heart attack are missed by women themself and their healthcare provider and we need to keep this in mind when comes to the emergency department. Women need to be their own advocate because there are still some doctors that are not aware of the differences. We have the information that allows us to advocate for our health, our heart health.

Can you tell us about the gap in the healthcare system in regards to women's heart healthcare and how you are advocating for change?

his difference doesn't come from nothing. There's many reasons why a significant knowledge gap in women’s heart health, but one of the core factors is medical strategy that we use to identify and treat heart disease have been based on research data done by men, on men for men and who are primarily middle-aged white male research subject despite the fact that women make just over half of the population.

You may wonder why? Because two-thirds of the clinical study that we have now and we study in med school based on research, focus only on women. This is an important point because in all the clinical guidelines that we use to diagnose and manifest, we usually rely on research evidence. This is an important point because clinical guidelines are based on research evidence. Therefore medical decisions for women are being made based on research evidence about how heart disease manifests and is treated in men.

First of all, a safety concern because woman could be pregnant – so they're afraid to harm the fetus. Secondly, the hormonal changes in women could confound the research data. So usually, researchers avoid using women, even female animals, in their study to keep their data clean. Lastly, because women, they tend not to participate in research because they have other family commitments that they need to do. As if they have more time, they try to use it to take care of their family or take care of the house. But this is very concerning because if you keep the same trend, everything that we get to go and learn in the future will be based on research that is done only on men and there are important positive changes right now that most of the funding agency requires research to include women in the study to get funded and supported. If they don't do that, they need to give a good reason why they don't have women in their research, because at that moment, we will know if we're providing the right treatment for the woman, if this is the right test for them based on the research that we have done on women.

Read More:

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About The Author
Cali Wiersma
Social Media & Content Specialist

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