Marvin Joseph/WASHINGTON POST - Her blood pressure now under control, Karen Good regularly exercises near her home outside Baltimore.
FMD is most often diagnosed in women beween 25 and 50. The cause is unknown, although genetics are believed to play a role; about 10 percent of cases are familial, according to the Cleveland Clinic. There is no cure, but the disorder can be treated through medication and in more severe cases by angioplasty to reopen blocked arteries in the kidneys and elsewhere.
Biology as destiny
Specialized tests to confirm the diagnosis were performed at Johns Hopkins and the University of Maryland and took several weeks to complete. One specialist noted Good’s “extraordinarily strong” family history of hypertension. Three grandparents had suffered strokes, one dying before age 40. Her biological father, who had suffered several heart attacks before he was 60, had been given a diagnosis of high blood pressure at 17; one of her sisters was found to have hypertension in her 20s. None have been tested for FMD, according to Good.
Good, who had learned about her family history only a few years earlier after meeting her birth parents, was floored. A triathelete who never smoked, she had assumed she had little in common with her relatives, some of whom were overweight, sedentary smokers.
In February, as tests were underway, Good’s sense of urgency increased. She spent a night in a Baltimore emergency room for treatment of “the worst headache I ever had.” A CT scan revealed a lesion indicating an earlier small stroke. “I realized I could have a brain aneurysm at any time,” she said.
Good began making appointments with vascular specialists in Washington and Baltimore. After conferring with her ex-husband, a radiologist, and members of an FMD support group, she traveled to New York to consult specialists at Mount Sinai School of Medicine, who are experts in FMD treatment. “I didn’t want to see just anyone, because I knew this was rare,” she said.
In April 2008 Good underwent renal angioplasty, which opened the narrowed arteries to her kidneys. A month later, for the first time in decades, her blood pressure was under control, dropping to 100/50.
She takes medicines to maintain her blood pressure and reduce her cholesterol, since she remains at elevated risk for a stroke or heart attack. Every six months Good undergoes ultrasounds of her kidneys and neck and other tests to monitor her condition. Since the angioplasty, her night sweats have vanished, along with the noise in her ears, the urinary problems, as well as her headaches and dizziness.
Good said her experience has taught her to stop shopping for specialists and to eschew treatment from friends. “Now I don’t mess around,” she said. “I collect all the tests myself and send the results to all my doctors. And if I have a new symptom or problem, I go see my internist and we figure it out.”
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