What is the real prediction for John Feterman, a Democratic Senate nominee from Pennsylvania, who had a stroke on May 13?
The 52-year-old Lieutenant governor of Pennsylvania received his party’s nomination just days later, placing one of the most fruitful Senate contests in the midterm elections. But emergency medical questions remain.
He was released from the hospital, his campaign said Sunday, and Mr Feterman said doctors had assured him he would fully recover – but the campaign did not say when he would return to the campaign.
“I’m going to take the time I need to rest now and get to 100 percent so I can go full speed soon and turn this seat blue,” Mr Feterman said in a statement on Sunday. Felt but intended to “continue to rest and recover.”
With such an important race for balance, which could determine the majority of the Senate, Mr. Feterman’s health condition is in the public interest. Yet, despite repeated requests, her campaign did not make it available to her or her doctors to discuss her stroke and her treatment.
And stroke, cardiology and electrophysiology experts say some of the campaign’s public statements do not provide adequate explanations for Mr Feterman’s described diagnosis or the treatment he received.
The stroke, he said in a statement released by his campaign, was caused by a blood clot. He said that the clot is the result of atrial fibrillation, a condition where the upper chambers of the heart vibrate erratically and are not compatible with the lower chambers of the heart. Doctors at a community hospital near Lancaster General Hospital have successfully removed the clot, the campaign said.
On May 17, the day of the primary election, a pacemaker and a defibrillator were implanted in Mr Feterman’s heart, which his press office said in a statement, “will help protect his heart and address the underlying cause of his stroke, atrial fibrillation (A-fib), Controls his heart rate and rhythm. ” Her press office said she was expected to fully recover from her stroke.
Medical experts used a defibrillator to ask questions about Mr Feterman’s treatment. They say it can only be understood when he has a different condition that puts him at risk of sudden death, such as cardiomyopathy – a weak heart muscle. This type of heart condition can cause blood clots. Or, doctors say, the propaganda about clot-causing affib may be correct.
Thrombectomy, the method most likely used to remove the clot, also indicates that Mr. Feterman experienced more than a minor stroke, although rapid treatment can prevent damage and protect his brain.
“I was in the hospital for more than a week,” Mr Feterman said in a statement. “I’m aware it’s serious, and I’m taking my recovery seriously.”
In a brief interview on May 20, Mr. Fitterman’s wife, Gisele Barreto Fitterman, told the story of her stroke from her perspective.
“We were on the street campaign,” he said. “We had breakfast, and she was feeling well.”
The couple got into a car to go to an event at Millersville University when he said, “The left side of his face was bent for just a second.”
“I had a gut instinct that something was happening,” said Mrs. Feterman. “I shouted at the soldier, ‘I think he has a stroke.’ Said, ‘I’m fine. What are you talking about? I feel good. ‘”
State troops soon took Mr. Feterman to Lancaster General Hospital, where he began treatment. Ms Feterman said it involved her going through her groin, which suggested she had a thrombectomy, a procedure where doctors slide a small plastic tube through the groin, pushing it into the brain and then using a suction or wire mesh to draw blood. Lets out the clot. .
Two days later, his campaign announced that Mr. Feterman had been hospitalized with a stroke. When asked about the delay, Ms. Feterman said, “Less than 48 hours is a very impressive time when dealing with sensitive medical issues.”
Shortly after this question, Rebecca Katz, a senior adviser to Mr. Feterman’s campaign, abruptly ended the call with Miss Feterman.
Medical experts say some aspects of the story were difficult to reconcile with their knowledge of stroke treatment.
Massachusetts General Hospital stroke specialist and professor of neurology at Harvard Medical School. Doctors treat thrombectomy only when a large artery in the brain is blocked, said Lee Shoyam.
“You don’t usually do this for someone with a slight drop in the face,” he said. Dr Shoaib was surprised that doctors examining Mr Feterman at the hospital noticed other symptoms, such as a loss of vision on his left side or a lack of awareness on his left side, often referred to as “neglect”.
“These strokes tend to be very serious,” said Dr. Shoaib. “She is OK. She went to a hospital that could treat her.”
Overwhelmed by the signs of a stroke described by Mrs. Fitterman, a spokesman for Mr. Fitterman wrote in an email that he “told The Associated Press last week that Giselle ‘noticed that John was not himself, and that he began blurring his speech shortly afterwards.’ ”
But what caused the stroke?
Ms Feterman said her husband knew she had atrial fibrillation, which carries a high risk of stroke, and she took anticoagulants as an ideal way to reduce the risk of stroke in people with atrial fibrillation, “on and off”.
But treatment with pacemakers and defibrillators is a mystery, if all of them had atrial fibrillation, medical experts say.
“It doesn’t make perfect sense,” said Dr. Brahmaji Nallamothu, an interventional cardiologist at the University of Michigan.
Defibrillators – which always come with a pacemaker – are used to prevent sudden death, said Dr. Elaine One, an associate professor in the Department of Cardiology and Cardiac Electrophysiology at Columbia University Medical Center. They are usually implanted in people with weak heart muscle, or who have survived an episode of heart failure, or in people with a genetic predisposition to sudden cardiac death.
“We will not use it for atrial fibrillation,” said Dr. One.
Dr. Rajat Deo, an associate professor of medicine and a cardiac electrophysiologist at the Pearlman School of Medicine at the University of Pennsylvania, agreed with the use of the defibrillator and said he shared Dr. One’s suspicions that Mr. Feterman had a damaged heart.
“I think it would be fair to say that he has at least two separate issues,” said Dr. Deo about Mr. Feterman. “One is Afib, from where he probably suffered a stroke that was successfully treated.”
He added, “The second problem is that he probably has some underlying heart condition that increases his risk of ventricular arrhythmias and thus increases the risk of sudden cardiac death.”
Afib may be related to another condition, Dr. Deo said. Patients with weak heart muscle are also at risk for atrial fibrillation.
On the other hand, Dr. Dio states that Mr. Feterman’s weak heart has nothing to do with atrial fibrillation. It is impossible to know without further information from his doctors.
Dr. Dio added that if Mr. Faterman received appropriate state-of-the-art medical therapy and was protected from sudden cardiac death with defibrillators, “he should do well while continuing his campaign.”
Experts also raised concerns about the potential of former Vice President Dick Cheney, who performed a defibrillator implant in 2001. He completed two terms at the White House in 2004, including a hard-fought re-election.
And there’s a time before the general election campaign in Pennsylvania begins in earnest: it’s not clear who will be Mr. Faterman’s opponent, because the Republican race is very close to being called and could lead to a recount.
But Dr. One was less transparent about Dr. Feterman than Dr. Dior.
“She is at risk of sudden cardiac death,” he said. “For someone on the campaign trail that could raise concerns.”