But Good’s did not. Her blood pressure remained dangerously elevated, sometimes reaching 180/120 mmHg, far above the 120/80 considered the upper end of normal. She had severe headaches and sometimes would see stars. Doctors had started her on one drug, but it hadn’t done much. Before her pregnancy no one had told her she had high blood pressure.
“I was really scared,” recalled Good, a physical therapist in Baltimore. She had worked with young stroke victims and didn’t want to join their ranks.
Four months after her baby’s birth, Good would look with new understanding at the seemingly disparate problems that had plagued her for much of the previous decade and at clues that had been overlooked for longer than that.Her situation resembled the fable of the blind men and the elephant. Each of the men touches only one part of the animal — tusk, hide or trunk — and assumes it is the totality, missing the larger truth.
“I didn’t have a primary-care doctor, so no one could see the whole elephant,” Good said.
“She saw a lot of doctors, and sometimes the big picture does get missed,” said Kantha Stoll, the Alexandria internist whose hunch led to the correct diagnosis.
Good’s case was complicated by another key variable. Adopted shortly after her birth at Georgetown University Hospital in 1966, she knew nothing about her medical history for more than three decades.
Worried about a brain tumor
Looking back, Good realized that the first sign of a problem was not, as she’d long believed, a fluke. In 1984, when she was 18, Good decided to have her blood pressure checked at a drugstore. The reading was high: 140/90, which would indicate hypertension. A student athlete and vegetarian, Good assumed the reading was simply wrong.
“I never told anyone, but there was no one to tell,” she said. Beginning in college and until she was well into her 30s, she had no primary-care doctor.
“I was married to a doctor then, and if I had a problem I would go right to a specialist related to the problem. And I often got health care from people I knew socially,” sometimes relying on advice casually dispensed at cocktail parties. Often, she said, one doctor didn’t know what another had prescribed or advised.
In 1997, when she was 31 and living in St. Louis, Good began having frequent headaches and dizzy spells. A neurologist friend began treating her for migraines. Good, who had only recently met her biological parents when they sought her out, was worried about something far more serious: a brain tumor. Her biological mother had undergone surgery for a very large meningioma, which can cause headaches and dizziness, and Good knew that these usually benign tumors can run in families.