My Experience with Fibromuscular Dysplasia and
Stroke
By Pamela Mace
My
name is Pam Mace and at the age of 37, I had a Transient
Ischemic Attack (TIA).
It started with a headache.
I woke one morning with a dull headache. Over the course
of the day my head became tender to touch. I thought I might
feel better after going for a run. As I went to leave, my
granddaughter, Ashley, asked if she could ride her bike
along side of me and although I knew it would slow me down I
agreed. Thank God, I did! Since Ashley was with me, I had to
stop at every intersection, gas station and fast food
restaurant we came upon to help her with her bike.
After returning home and showering, I noticed my pupils
were unequal. My headache wasn't any worse, but my left
pupil was very tiny and my right was huge. Being an
Emergency Room nurse, I concluded that these were
neurological symptoms. If someone arrived at the ER looking
like I did, I would think something bad was going on, like a
stroke or brain tumor.
I called a close friend of mine, an ER doctor with whom
I've worked, and described what was happening to me. She
urged me to get to the ER right away. I felt really stupid.
I wouldn't describe it as the worst headache of my life...
at least not yet.
After arriving at the emergency room, the pressure in my
head was worsening. The ER was backed up with trauma cases
so I approached the triage nurse to ask how long the wait
would be. I explained that I was a Registered Nurse and that
my headache was getting worse. I asked her to just look at
my pupils. She started explaining that they were backed up
because of all of the traumas and as I again told her I was
a nurse (which wasn't getting me anywhere) my face started
to go numb. The numbness started at my left temple and
slowly moved all the way down my face. I was scared to
death.
The nurse then took me right back. My blood pressure was
210/130. I had never had high blood pressure, being a
runner. After being sent for a CT scan that came out
negative, a young resident presented me with discharge
papers and a diagnosis of unequal pupils. Mind you, my blood
pressure was still elevated and my pupils were unequal and I
just had a TIA (small stroke).
The next day I ended up in another ER where I was given a
spinal tap and MRI. The MRI showed that I had dissected my
left vertebral artery. After being stabilized, I was sent
back to the first hospital I had been to because that is
where my primary physician was on staff. By this time I had
the "worst headache of my life".
The rest of my story involves almost being sent home
again. Being a nurse, I challenged the doctor's knowledge
and he re-evaluated my case. Had I been sent home I would
have had a massive stroke and died. Even after that I was
misdiagnosed again. If it weren't for my nursing training, I
most likely would not have survived this ordeal.
I ended up dissecting my left vertebral and bilateral
carotid arteries. I was then diagnosed with Fibromuscular
Dysplasia, which I also have in my right renal artery. From
my dissections, I formed carotid aneurysms and needed to
have stents placed in my carotid arteries (which is still
not approved by the FDA for my purpose).
FMD is more common in women and is a cause of stroke.
Most of my physicians were not familiar with FMD. Everywhere
I go I need to educate my doctors. Others with FMD have had
the same issues. I was lucky to survive with no permanent
disabilities. Others have had and continue to have multiple
TIAs, strokes.
I'm one of the lucky ones.
Sincerely,
Pamela Mace
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