By Heidi Smith, Contributor
It was a Thursday in November 2020. Joy and Ken Chard were at a Venice ice cream store when Joy nearly collapsed. Her right side, from head to toe, was numb and tingling. She was unable to walk. Ken had to carry her to the car.
“I had been having these episodes for a few weeks, once in a while,” said Joy, 70, who had no previous medical problems and considered herself fit and health-conscious. “But the episodes were happening more often and lasting longer. I would have trouble walking and using my right hand.”
Just a day earlier, Joy had sought help at an urgent care clinic where she learned her blood pressure was dangerously high. Urgent care advised her to go to a hospital emergency room in Sarasota. After running tests, doctors prescribed blood pressure medication, advised her to follow up with a primary care physician, and sent Joy home.
The couple had recently moved from Ohio, and Joy didn’t have a primary physician in Venice yet. She researched online and found Sophia Ciaravino, M.D., with Gulf Coast Medical Group. Over the weekend, Joy continued having episodes – up to seven a day. She was in Dr. Ciaravino’s office the following Monday.
“By that time, I had been on blood pressure medicine for a few days, but my blood pressure was still high,” Joy recalled. “The doctor called a neurologist while I was there. They decided I should be admitted to Venice Regional because they were concerned I could have a stroke.”
“Joy was having multiple TIAs (transient ischemic attacks), which are warning signs of possible stroke,” said Tonya Stephenson, M.D., a board-certified clinical neurologist with Gulf Coast Neurology Associates. Dr. Stephenson is a member of the medical staff at Venice Regional and directs the hospital’s stroke team. “This didn’t appear to be solely a blood pressure issue since the medication wasn’t resolving the problem.”
Finding the root of Joy’s problem wasn’t a simple matter. Dr. Stephenson, along with H.A. Shah, M.D., an independent hospitalist, went through the standard order of priority for Joy’s symptoms: brain, heart, carotid arteries. Everything checked out fine.
But then Dr. Shah used his stethoscope to listen to Joy’s abdominal region. Near the kidneys he heard a telltale sound called a “bruit” (pronounced BROO-ee), which indicates an abnormal narrowing of a blood vessel. The constricted blood flow makes a characteristic rushing sound.
Diagnostic imaging of Joy’s kidneys showed narrowing (stenosis) of the right renal artery, which supplies blood to the kidney. The narrowing was caused by an uncommon condition called fibromuscular dysplasia, which is thickening of the wall of the artery. It happens more in women than men, and while its cause is not well understood, the treatment is more straightforward.
“The kidneys have a role in regulating the body’s blood pressure,” said Lorraine Cho-Chung-Hing, M.D., a nephrologist who consulted on Joy’s case. Dr. Cho-Chung-Hing is an independent member of Venice Regional’s medical staff. “If a kidney is not getting enough blood flow, it triggers hormones that alert the brain to raise blood pressure, even though the rest of the body is fine. If you fix the narrowing of the artery, the problem usually is solved.”
Drs. Shah and Cho-Chung-Hing called in board-certified surgeon Issam Halaby, M.D., Ph.D., F.A.C.S., an independent member of Venice Regional’s medical staff. In the operating room, the surgeon inserted a catheter through Joy’s groin to access the aorta and then the renal artery. He implanted a stent to widen the narrowed section.
“While Joy’s condition was fairly unusual, it was amenable to stenting. The surgical intervention was straightforward,” Dr. Halaby explained.
Doctors advised that the kidney eventually would stop sending signals as the stent did its job to improve blood flow. Joy went home the day after surgery and continued to experience TIAs for about a week. While Joy’s native tissue grows around the stent, she’ll be on a blood thinner, blood pressure medication, cholesterol-lowering drug, and aspirin. Eventually, she may only need aspirin.
“My experience at Venice Regional was terrific,” Joy recalled. “The nurses and doctors were great. I felt like I got very personalized, one-on-one care from a professional team.”
“I thought I was in great health,” she added. “I had been exercising with a trainer for 15-plus years and swam laps at the Y. I’m going along my merry way thinking I’m on top of my game, then the episodes started.
“I would advise anyone who has these symptoms: don’t ignore it,” Joy continued. “Be proactive about getting to a root cause. I had a team at the hospital that was intent on figuring this out. It was really inspiring. I would have been lost without that group figuring out what was going on with me. It could have been a totally different outcome. I could have stroked out.”
When it comes to staying healthy, annual wellness visits with a health care provider are key. Routine exams and screenings can identify potential health issues early, when they are most treatable. And if you or a loved one gets sick, seeing a doctor is even more important. Make an appointment today. In person and telehealth visits are available. Visit GulfCoastMedicalGroup.com or call 844-366-9362.
Venice Regional Bayfront Health