Ultrasound technologist Eric Eisner does a carotid artery screening on board the FirstHealth Mobile Health Services van. The Mobile Health ultrasound screening program also includes screenings for peripheral vascular disease and abdominal aortic aneurysm

What you don’t know can hurt you, and early detection is often the key to preventing serious health issues later on.

The staff of FirstHealth Community Health Services realizes this. Thanks to physician interest, funding support from the Foundation of FirstHealth and a lot of legwork from Community Health Services, FirstHealth Mobile Health Services now offers three new ultrasound screenings for vascular disease.

Since March, the Mobile Health Services van has offered carotid artery, abdominal aortic aneurysm and peripheral vascular disease screenings to detect abnormalities, some of them life-threatening.

These conditions “can be asymptomatic, but can put people in life-or-death situations and they don’t even realize it,” says Roxanne Leopper, policy director for Community Health Services. “People are walking around with undetected problems.”

Peripheral vascular disease is caused by cholesterol and scar tissue that forms plaque on artery walls. The process, known as atherosclerosis, can lead to the loss of limbs, stroke or death. Abdominal aortic aneurysm is a weakening in the walls of the aorta, the major artery leading from the heart to the abdomen. The wall bulges and can burst, causing sudden death.

Carotid artery disease is the leading cause of stroke in the U.S. The screening provided by the Mobile Health Services van detects the level of contributing plaque buildup (cholesterol and other substances) in the artery.

According to Leopper, the ultrasound screenings are limited diagnostic examinations, but they can detect abnormalities, which are then reported to clients and their physicians for preventive treatment if necessary. “Ultrasound screenings are quick, accurate and have no known side effects,” says Samuel Wahl, M.D., an interventional radiologist with Pinehurst Radiology Associates and FirstHealth of the Carolinas. “They are an excellent tool to help patients and their physicians learn more about what is happening inside their bodies even when they have no symptoms. Ultimately, early detection provides for better management and treatment outcomes. It’s a win-win.”

Eric Eisner, Imaging supervisor at FirstHealth Richmond Memorial Hospital, performs the screenings three times a month at various locations throughout Moore, Hoke, Richmond and Montgomery counties. Each screening is quick, easy and painless. The Moore Regional Hospital Foundation provided funding for the Mobile Health Services ultrasound equipment.

The carotid artery screening checks the blood flow’s velocity to the brain. With an imaging probe, “we can actually see inside the vessel and see if there’s any plaque,” says Eisner. “The velocity and ratio obtained during the exam determine the vessel’s opening. If the vessel opening is significantly smaller than it should be, there’s great potential for stroke. Once a vessel to the brain is completely blocked, surgery can’t fix it.”

Eisner uses a non-imaging probe to listen for blood flow during one part of the peripheral vascular disease screening. During the procedure, “we put a blood pressure cuff on a limb, inflate it and listen for the sound of blood to return while the blood pressure cuff deflates,” Eisner says. “We compare the numbers obtained from the arms to those obtained at the ankles. This gives us an Ankle Brachial Index (Score), which we use to determine the presence of peripheral vascular disease.”

The second part of the exam uses the ultrasound machine. Eisner monitors the blood flow and looks for three possible results: tri-phasic, bi-phasic and mono-phasic. Monophasic is an abnormal finding that indicates disease.

The abdominal aortic aneurysm screening is technically the most simple, according to Eisner.

“With ultrasound, anything we measure greater than 3 centimeters in the aorta’s dimension could be an aneurysm,” he says. “What we do is measure the size of the vessel. We don’t use the sound and color Doppler that we do in the PVD or carotid screenings. If we see plaque during the exam, we take pictures of how much and where the plaque is within the vessel.”

As of May 14, the Mobile Health Services van had done 212 screenings. Of 62 PVD screenings, 11 detected abnormalities; 13 abnormalities were detected out of 78 abdominal aortic aneurysm screenings; and 14 abnormalities were detected out of 72 carotid artery screenings.

Clyde Davidson, an 83-year-old Rockingham resident, was one of those who showed an abnormal carotid artery screening. He had seen an ad in the newspaper and decided to have all three screenings done.

Although Davidson leads a healthy lifestyle, his carotid artery screening showed some plaque buildup. “I just figured the blood went down one leg and up the other,” he says. “I carried the papers over to my doctor, and he said there wasn’t anything unusual for a person my age. I guess we get barnacles built up over time.”

Although Davidson’s plaque buildup isn’t unusual for an otherwise healthy man of his age, his physician will continue to monitor the artery.

The FirstHealth Mobile Health ultrasound screenings take about 40 minutes for all three and cost $30 each or $85 for all three. While insurance does not cover the screenings, financial assistance is available for those people who qualify for it. For more information, call (800) 213-3284 toll-free.

Screening produced results Lee Moore, a 64-year-old Southern Pines resident and a community liaison with the Foundation of FirstHealth, decided to go for an abdominal aortic aneurysm screening on the FirstHealth Mobile Health Services van. He’s glad that he did. Moore’s screening showed a slightly enlarged area in the artery, an indication of a possible aneurysm in the making. He consulted his physician, who said he will need a full vascular work-up at his next annual physical early next year. Lee Moore “My doctor told me not to worry about it in the meantime, but I’ll have more in-depth tests done in January,” Moore says. “The level where I am right now is only a little more than normal, but I’m told if it gets between 3 and 5 centimeters, I would have to have something done.” Surgery is recommended to correct an abdominal aortic aneurysm enlarged to between 3 and 5 centimeters in diameter. That can involve stent repair or removing the enlarged section of the aorta and replacing the area with a graft. Fortunately, Moore now knows that he could have an abdominal aortic aneurysm, and he’s grateful for the screening opportunity. “There was no reason that I knew of to have the screening done, but I thought it was a good idea,” he says. “Having the mobile unit capability is fantastic, so now my doctor can do the full-blown work-up in January.”