“Operating on Assumptions” Published in Focus on the Coast January 2013
Operating on Assumptions: New Information on Preventative Care Can Help Avert Strokes
published in Focus on the Coast January 2013
It was July in Wilmington, North Carolina, a beautiful day in a beautiful home nestled between the Cape Fear River and Wrightsville Beach. Betsy Fouros was reaching into her refrigerator, engaged in one of the many dishes her and her husband Alexis have spent their lives crafting. Suddenly Betsy found herself on the floor, heart racing and head pounding, blood flowing from a scalp laceration thoughtfully provided for her by the kitchen counter. Rewind six months; Betsy is shopping at Harris Teeter when she notices the third finger on her left hand has gone numb, its' complexion shifting to a startling white. Betsy knows something is wrong, but isn't sure just what. She finishes her shopping and drives home. Several hours later, as she stands up in her home, she notices a marked weakness in her body, and the muscles in face feel sluggish and numb. She immediately recognizes the symptoms of a stroke, though it passes after mere moments. The following day she decides that, rather than regret it later, she would visit her regular doctor. Right away a brain scan is ordered, and an ultrasound performed on her neck. The doctor tells her what many would: the buildup in her arteries wasn't so much as to cause concern for a stroke. The numbness in her body was caused by a transient ischemic attack, or TIA. A TIA, according to the U.S. National Library of Medicine, is not the same as a stroke. The flow of blood ceases only briefly, typically causing stroke-like symptoms for 1 or 2 hours, though they can last as long as 24. The blockage breaks up quickly and, while it does not cause brain tissue to die, can be an indicator of a stroke yet to come. In fact, recent studies have shown that there can be as high as a 17% chance of a stroke within 90 days of suffering a TIA. Last year studies such as these prompted the director of the Clinical and Translational Science Institute at the University of California, San Francisco, Dr. S. Claiborne Johnston, to establish new clinical guidelines and a general shift in philosophy in regards to transient ischemic attacks. These guidelines were published by the American Heart Association and the American Stroke Association, as it had been determined that of the over 800,000 reported strokes each year, as many as 30% of them were preceded by TIAs. Now, new studies are ongoing to determine if the current method of treatment, which is to provide TIA patients with aspirin immediately following an attack, could be coupled with high doses of clot preventing drugs such as Plavix (clopidogrel) to further reduce the risk of future strokes. Betsy Fouros has a lot to say about this type of preventative care. Her passion for wanting to help and inform people, which I learned can not be stifled by time of day, cooking, or a pair of friendly retrievers trying to make a new friend, was something I couldn't ignore. Betsy warns that “[if] you have a TIA that's identifiable, go immediately to an emergency room. It is an emergency! Within a few hours, days or weeks you're gonna have a big one. That's what happened to me. Only it didn't happen until July.” The stroke had come on within seconds, gave no immediate warning, and could have spelled the end of Betsy’s' visits to local and regional Farmer's Markets, where she and her husband Alexis sell their wares. If she hadn't been on Pradaxa, a blood thinner she was taking for atrial fibrillation after her TIA, they might not have spent a weekend together this last December catering a party for Wilmington Health. Betsy came to realize that assuming statin drugs (such as Lipitor or Crestor) alone will keep one safe from a stroke could prove a fatal mistake. Betsy Fouros counts herself lucky, after a fashion. Following a rushed trip to Cape Fear Hospital to receive stitches, Betsy was transferred to New Hanover Regional Medical Center, where after another array of CT scans and ultrasounds, it was determined Betsy was not a candidate for a stint-a piece of wire-mesh inserted to widen an artery. Instead she was operated on by vascular surgeon Dr. David Weatherford of Coastal Surgery Specialists, who had to enter through her neck in order to clear out plaque in her carotid artery. Under the care of Dr. Weatherford and cardiologist Dr. Michael Yarnoz, of Hanover Cardiology (formerly Hanover Medical Specialists), Betsy has made a startling recovery. She began physical and occupational therapy just a few days after being released from the hospital, and immediately set to work patrolling her garden, her driveway, and her neighborhood. To meet and speak to her one would might note that she has a scar, if you are not immediately distracted by her fire, a determination brightly fueled by experience and lifelong passions of reading, cooking, and writing (she published a fantastic cookbook with her husband Alexis, a former four star chef in New York City, called “Feast For the Gods”). Most recently she has added helping and educating people to that list of passions. Betsy is a woman that has come to understand that assumptions can be dangerous, and she urges everyone to understand that when it comes to your health, assumptions can be deadly.