A patient patient: Sarah Kucharski writes about life with fibromuscular dysplasia

Over many years, through many moves, many medical appointments and many medications, Sarah Kucharski lived with excruciating stomach pain, gastrointestinal distress, high blood pressure and migraines. No doctor was able to provide an explanation for her progressing symptoms, and family members invented their own. (“She must have been suffering from an eating disorder.”) Finally, after her left arm went numb, a doctor recommended an unusual test: an MRA to look for narrowing of the arteries that carry blood to the kidneys. It came back positive. Her left renal artery was 90 percent stenosed, and her celiac and mesenteric arteries were completely occluded. The diagnosis: intimal fibromuscular dysplasia. The disease has no known cause and no cure.

Today, after one triple bypass surgery, one stroke, one lost kidney, one gastric rupture and four cerebral aneurysms, Sarah lives to chronicle her odyssey as a patient. She teaches, she edits, she advocates, she cuts to the heart of matters on her blog The Afternoon Nap Society. And this year, we’re honored that she’ll be joining us at Medicine X.

Below is a Q&A, the first in a series of profiles on our 2011/2012 ePatient advisory panel members.

What’s it like to live with greater health risk than most of us think we face on a daily basis?

Living with greater risk of a major health event is both annoying and a tremendous gift. There have been times in which all I could do was dwell on my mortality and how my passing would affect those I love; however, spending time thinking about these things has allowed me to get my priorities straight. There’s so much we worry about that just really doesn’t matter. I’ve learned to avoid getting worked up over trivial matters; I control what I can. I started a bucket list this summer. I am trying to make the things on my list happen. One of those things is raising awareness of fibromuscular dysplasia.

Do you have any symptoms from your FMD?

My symptoms thankfully are relatively benign. I’m tired a lot. I have a lot of aches and pains. I don’t have the muscle structure that I used to have, but I’ve basically been cut in half twice, so it could be worse. My inseam is only two inches longer than my cumulative scars. I’ve officially earned “road map” status.

Your most recent blog posts were published at 3:12 am, 4:11 am, 3:01 am, 2:39 am, 1:45 am, 3:47 am and 12:00 am.  Do you write exclusively in the middle of the night?  Do you have a regimen, or do you just sit down at the computer when the fancy strikes you?

I write something most days. Granted, that something may be an email, but I try to put as much care into my day-to-day communications as I do into my professional writing. I admit that I most like to write at night, which my husband doesn’t necessarily like, but at least he understands.

People look at patient behaviors and interactions on the web and make quite a bit of it.  What does the movement of patients to the online world mean to you?

It’s about putting the doctor-patient relationship back at the forefront of care. Patients are humans. Doctors are humans. Let’s be humans together.  Doctors and patients are coming back to this caring place thanks to technology, which is allowing for the greater exchange of information and communication. I would like to see more of the overall attitude in medicine be one of collaboration and continual learning. No one knows everything all the time. Being open to new ideas and new ways of doing things can bring about positive change. Of course, those who are true innovators are the ones who are willing to throw all the rules out the window, take great risks and suffer great failures. Those who are afraid of failing will not be the ones to change the system.

What effect do you see ePatients having on the medical world?

ePatients are pushing the boundaries of what is “acceptable” in medicine. They are not passive. Some doctors don’t like a patient who comes in with printouts and questions. I wonder if those same doctors like patients who fail to adhere to their medications, miss appointments and don’t adequately describe their symptoms. Which is worse? ePatients can play a huge role in fostering reception for participatory medicine.

[When I suffered] my stroke—doctors told me that it was vertigo and that my symptoms would go away as suddenly as they had come on.  [They also] failed to see the four brain aneurysms on my scans from the day I had the stroke. The only reason these two issues were addressed is because I acted as my own health
 advocate. Patients must be involved in their care and not passively accept whatever they are told. Patients should work with their doctors and realize that they have the responsibility to communicate as clearly and effectively as they can to improve their care.

What are the limitations you face as a patient advocate?

Patient advocates must realize that not everyone is like us. Not everyone is ready for a head-on conversation about advance directives; not everyone has the health literacy to read and digest an article in a medical journal. We must be patient patient advocates and work within each situation’s context; otherwise, we risk damaging our relationships.

What will you do in your role as an advisory member on the Medicine X e-patient board? What do you hope to achieve by your participation?

My hope is to encourage more interaction between patients and doctors outside of the exam room. I know that I, and many fellow FMD patients, are practically pleading to be studied so that there are advances in science and more information for future FMD patients. Even if doctors aren’t looking for formal study subjects, at the very least they can take the time to talk to patients and learn from them. Medicine stands to take a few pages from a basic customer service manual. Conferences like MedX that bring doctors and patients together are a great way to foster dialogue, as lessons learned are then taken back to each individual’s community and dispersed. With its focus on emerging technologies, MedX has an added cool factor that makes for excellent talking points, whether that be around the surgical table or around the dinner table.

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Showing 15 comments
  • karla racavich

    thank goodness its not only me.

  • AfternoonNapper

    Karla –

    Are you referring to being an FMD patient? If so, please join us at facebook.com/FMDChat.



  • Tom Farrell

    Curious, Sarah: what are your credentials to be able to read and understand medical journal articles?

    • AfternoonNapper

      Tom –

      Though I am not a doctor, I consider myself a reasonably intelligent person. My undergraduate degree in journalism is from UNC-Chapel Hill and comes with an outside concentration in political science. My master’s degree is from UNC-Greensboro. I’ve spent the past 14 years as a journalist covering everything from courts to economic development commissions, and my writing has garnered several awards from state press associations. All that aside though, I am curious. I look up what I don’t understand, and I keep looking up terms until I come to an understanding. When I have the opportunity to get an explanation from medical staff, I seize it. I’m not about to present a case study, but I’m no dummy either.

      My point in the interview is that health literacy overall is an issue and some patients are more equipped than others to read and process information. Some patients simply don’t want to read about health. Some patients spend so much time reading health articles that it is detrimental. Overall, if we can make strides to improve health literacy and help patients determine what information online is valid, then we are doing the healthcare system a service.

  • Chris PJ (Aussie Chris, FMD)

    Thanks so much Sarah. As patients, we have to be our own advocate. I too underwent numerous tests, was told my symptoms were in my head by one doctor, despite having severe hypertension and heart enlargement. Fibromuscular dysplasia is a little understood vascular disease, especially Intimal FMD. As a fellow FMD patient I seek out the latest information, tests, and research on FMD, and share it with my doctors (those who are willing to learn) Im a psych student, so have become accustomed to reading medical journal articles. Im so grateful that the days of “only the doctor knows” are fading away. I realize doctors are intelligent, and have studied hard. FMD is affecting my body severely. It is my responsibility to be aware of my condition, and inform myself with reputable information. I encourage any FMD patients to follow the link Sarah has given for the facebook page. For those who dont feel they can read medical journals, others are happy to help 🙂 Thanks Sarah for all you do. AUSSIE CHRIS

  • Catherine Anderson

    Tom, I appreciate your question (which is an interesting one and encourages needed discussion) – I do not work in the medical field, but I can read and understand medical journal articles. Why do you feel someone would need credentials? There are many resources available to explain a term, medication, or procedure. Sarah’s experience shows the ability and need for a patient to learn as much as possible in order to be an advocate for their care. Thanks-

  • Jan wilson


    I have a 12 yr old granddaughter who had a stroke on Christmas Eve. Her short term memory is poor which is stopping her from attending high school. As any grandmother does I want to know as much about this disease FMD, her artery which is affected in deep with the brain.. All we know is that it is heridary (not a nice thought). Is there web sites I can go to for information. Thanks you

  • David

    Now I know that it is not only me ha2 … nice post. By the way I love your quote, “”those are afraid of failing will not be the ones to change the system” … It inspires me ‘_’

  • Andy

    Hi afternoon napper,

    Thank you for a wonderful article, extremely informative. I have FMD bilaterally in my renal arteries and in 2011 angioplasty was performed twice on the right side. I have for the past year been experiencing pain in my stomach, inability to eat large meals and gastro. High velocity readings were found on Doppler, epigastric bruit is present, however CTA did not show any significant vascular disease.

    I thank you for sharing your experiences as I certainly would not have known or considered that the mesenteric arteries could have FMD.

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