Screening reveals stroke risk – An update on Norman

Norman and Mary Louise Clarke - carotid artery screening

Norman and Mary Louise Clarke

Norman Clarke had no reason to think that there was anything amiss when he stopped by for a preventative screening including a carotid artery screening at TMC two years ago. At 81 years old, the retired automotive engineer exercised three times a week at the gym, saw his doctor twice a year for checkups, took medication to keep his cholesterol in check – and his blood work always came back great.

He and his wife, Mary Louise, were stunned at his results of a preventative screening.

A scan of his carotid artery showed a blockage of more than 70 percent on the left side.

“I was shocked. There had been no symptoms and nothing to indicate this was a problem,” Norman recalled. “It was serendipity that we went that day, because I would never have known otherwise about the great risk I was facing.”

The carotid artery screening, part of the vascular wellness screening, uses an instrument called a transducer to scan the carotid artery in your neck. The transducer scans the carotid artery to check the flow of blood and can identify plaques and blockages that put you at risk for an ischemic stroke.

A stroke on the left side of Norman’s brain would have impacted the right side of his body, possibly impacting his mobility on the right side of the body, as well as speech and language problems, and memory loss.

Following the screening results, Norman’s doctor cleared the calendar to bring him in on a Monday morning, and by Monday afternoon he was having a scan of his arteries. The news was even worse than he had learned initially: the blockage was 90 percent.

Instead of being on a plane to Michigan, where the Clarke’s spend six months of the year, Norman was scheduled for surgery. The 90-minute surgery, known as a carotid endarterectomy, required one night of hospitalization and a week of good behavior at home: no lifting or dragging of heavy objects and listening to every instruction from Mary Louise, a former medical-surgical nurse and retired nursing professor.

Fast forward to 2017, Norman and Mary Louise are planning their return to their Tucson home from Michigan, to the magical pink mountains, the town and the network of Tucson friends, to volunteering at TMC, and to see Norman’s Tucson doctor.

Norman’s doctor monitors both the left and right carotid arteries every six months. The initial screening alerted the Clarke’s to the danger lurking in Norman’s left carotid artery. A subsequent screening has revealed a growing plaque in Norman’s right carotid artery. At this time there is no surgery planned, but monitoring is critical. Norman’s advice: “Be your own health advocate … get screened. Everything looked rosy for me, but just because your blood work is OK, it doesn’t mean everything is.”

 

Three reasons to have a vascular screening

3 reasons to have a vascular screeningMeet Ashley Marcolin, registered vascular technologist at TMC and one of six RVTs that perform vascular screening exams at TMC. Ashley is the newest addition to the team, but manager Sarah Yeager reports Ashley reflects the kindness, compassion and empathy typical of the whole team.

“When people come in for a vascular exam they’re often very nervous. Whether they’re in the hospital for a vascular-related concern or a vascular wellness screening, I want them to know that they can relax, this is a very non-invasive test. We use no radiation, no dyes, no needles, and it takes just 30 minutes.” Ashley said. “This really is a very simple way to catch serious conditions early before they become life-threatening. The screening can save a life, and it takes very little time.”

While Ashley is a new member of the team, she has a lot of experience with performing exams of this kind. In her training, she had to complete 960 clinical hours using the techniques she now uses every day. We calculated how many exams she has performed since she started at TMC, where she also completed her clinical training. It runs into the thousands. “You know when you come to TMC that your technologist is a registered vascular technologist and has undergone a two-year intensive or four-year course before they can even take the certification exams,” Sarah explained.

What is involved in a vascular wellness screening?

We do three separate tests that together take about 30 minutes. You need to fast for four hours beforehand and wear loose-fitting clothing that allows easy access to the abdomen, neck, legs and arms. You do not need a doctor’s referral to schedule an appointment, but we will need the name of your primary care physician to send the results.

Ankle-Brachial Index

We use ultrasound scans along with blood pressure cuffs on the ankles and arms to screen for blockages or signs of disease in the arteries of the limbs. For this exam, you need to take your shoes and socks off. This is a screening for peripheral artery disease. PAD is a very common condition, especially in people over the age of 50. PAD can cause chronic leg pain when you’re walking or performing other exercises.

Abdominal Aortic Aneurysm Screening

This screening uses ultrasound scans looking for a ballooning of the wall of the abdominal aorta. If this ballooning or aneurysm ruptures it can be fatal. For this screening, you lie on your back while an RVT places the ultrasound transducer on several areas of your abdomen. The transducer has a bit of warm gel on the end. The gel helps us get clearer pictures and will not hurt your skin. You may feel slight pressure from the transducer as it moves along your body.

Carotid Artery Duplex Evaluation

Using an instrument called a transducer, the RVT scans the carotid artery in your neck to check the flow of blood, which informs us of plaque and blockages that put you at risk for an ischemic stroke.

Should you get a vascular screening?

Sarah and Ashley suggest that everyone over the age of 50 with any of the below listed risk factors get a vascular screening, and that any additional testing or screenings should be repeated at your physician’s direction.

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You may also be at increased risk of arterial vascular disease if you have one of the following:

  • Have a family history of abdominal aortic aneurysm
  • Smoke or have a history of smoking
  • Have diabetes
  • Have high cholesterol and/or high blood pressure
  • Have coronary artery disease

When will I get the results?

Our exams are read in house by a vascular surgeon and the results sent to you within 3-5 days.

Three reasons to have a vascular screening:

  1. It’s quick, easy and painless
  2. It’s affordable
  3. It can help prevent stroke and detect abdominal aortic aneurysm and peripheral artery disease

Call (520) 348-2028 to schedule your vascular screening.

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Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461