Interview with Dr Kevin Campbell, Assistant Professor of Medicine, Division of Cardiology, University of North Carolina, North Carolina, USA, by Tom Klar, Editorial Administrator for EMJ.
EMJ recently sat down with a previous contributor to this blog, Dr Kevin Campbell, at the UK launch of his new book ‘Women and Cardiovascular Disease: Addressing Disparities in Care’ to discuss the book and, amongst other things, how raising a child with diabetes has impacted upon both his life and his career.
Heart disease (HD) is the number one killer of women worldwide, more so than all forms of cancer combined. More women than men die every year of the disease, yet in much of our society HD is considered a disease of men. Dr Campbell says that his book “addresses these disparities,” with a view to determining “what the root causes are, and then how we, as physicians, patients, and families of patients, can make changes; to effect change.”
Dr Campbell says that “awareness is the first step” to effecting that change; “once we become aware of what threatens us, I think then we can move towards making significant changes.” One of the areas in which awareness is most vital is risk assessment; it is important for women to view their own medical history and habits within the context of HD. For example, if there have been previous instances of the disease in family members, if they smoke, or if they suffer from hypertension, then their risk of HD is higher.
He also firmly espouses the belief that every woman must “know their numbers,” By which he means “your blood pressure, your body mass index, whether or not you have diabetes, what is your fasting blood sugar, your cholesterol numbers” – all key indicators of risk for HD. By raising awareness of the signifiers and predictors of this disease, it can be more effectively combatted and the gender gap in treatment can be narrowed. “We want to make sure that women understand what their own risk is. We want to make sure that women understand that their greatest health risk is from HD, as opposed to breast or uterine cancer,” says Dr Campbell.
We asked Dr Campbell if he felt that we as a society were close to diminishing the disparity in the wake of the book’s release, and while Dr Campbell readily admits that the fight is far from over, he remains hopeful for the future. “I think that maybe ‘around the corner’ is a little too soon, but within the next 5 years I would expect that we will make some difference. We are already making inroads in the US and it is my hope that by releasing this book here in Europe, and in the UK in particular, we are able to narrow the gender gap here in the UK.”
Dr Campbell was of course compelled to address these issues when, in 2005, his young daughter Bek, aged 4 at the time, was diagnosed with diabetes, a condition likely to lead to early-onset coronary artery disease (CAD). Dr Campbell describes this time as initially traumatic: “I can tell you, when your kid has diabetes, it does not matter whether you are an MD, or not an MD, you are helpless, you are hopeless, and you feel like the world is over.” But Dr Campbell states that the key to overcoming this initial shock is simple: education. “When you educate yourself and realise that diabetic children can grow up to be healthy, happy adults if cared for properly, then you realise that these are really special children.”
Experiencing the condition first-hand at home had a profound impact on Dr Campbell’s career. “We all, as cardiologists, treat diabetes every day,” he concedes, “but I think that when it is your family, it totally changes the way you look at the world. For me, I had a better appreciation for what it is like to be a diabetic.” He also argues that managing his daughter’s condition has made him a better advocate for men and women with diabetes; “[it has] made me a better father and made me, certainly, a better physician in the long-term.”
But what about other parents of diabetic children, perhaps those not from a medical background? Dr Campbell says, “It’s all about informing yourself. Understand the disease. Understand the treatments of the disease. Make sure that you have a good understanding of how the different types of insulin work, what the effects of the insulin are – what the symptoms of both diabetic highs and diabetic lows are, so that you can help your child.” Dr Campbell also states that one of the most valuable tools a parent can receive is simply another person who understands what you are going through: another parent of a child with diabetes. “Reach out to that person and ask them questions, and bond with them, because the most important resource I had when my child was diagnosed was another parent.”
For young sufferers of diabetes, Dr Campbell knows that the prospect of managing their disease can be daunting, but he believes that it can and should be perceived just like any other responsibility that a young person might acquire growing up. In the case of his own daughter, he says that her desire to become more independent “motivated her to learn how to do her own insulin pump site changes and deal with blood sugars. And we very carefully gave her that independence, just like you would with any teenager with driving or everything else that we do.” He added: “We are there only if she needs us.” Dr Campbell also suggests that social media, the mainstay of every young person’s life the world over, can provide a much needed network of support for young sufferers of diabetes, and indeed any disease or disorder. “There are support groups. If you search a hashtag for whatever your medical condition is, that can be an incredibly effective way to connect people with similar problems and diseases.”
10 years on from her diagnosis, Dr Campbell says that his daughter (now 14) “took control of her diabetes”. “She made it an asset to what she does. She realises that it is something that is certainly a pain in the neck for her, but she has overcome it and looked at other things that make her a very talented young lady,” Dr Campbell explained. Indeed, Bek created the cover art for Dr Campbell’s book, and he admits jokingly that “even though her pancreas does not work like mine, she can draw and I cannot draw anything more than a stick figure.”
Dr Campbell’s book is available now, and we fully support him in his fight to bridge the very sizeable gap in society’s knowledge of female cardiovascular disease, to learn who those most at risk are, and how we can help them. Dr Campbell urges all women to “find a healthcare provider that they trust, and that they can engage with, and if they can engage in their own healthcare we know that outcomes are improved.” And so, perhaps the final message to you, our conscientious readers in the medical community, is to be that trusted healthcare provider, because it is within your power to provide the education and advocacy needed to save lives.