Geoffrey Donaldson's Story
"I was lucky — I was able to have this operation that was necessary to save my life."
When Geoffrey Donaldson, an active 78-year-old grandfather and marketing consultant from Long Island, began to experience fleeting vision loss in his left eye, he chose not to ignore the problem. According to Geoffrey's ophthalmologist, the vision loss was a symptom of something more serious, and needed to be addressed immediately.
The vision loss, characterized by temporary and painless darkening in one or both eyes, is known as amaurosis fugax. An ultrasound revealed the source of the problem; carotid stenosis. The carotid artery branches into two smaller vessels, one of which goes to the brain. One of Geoffrey's carotid arteries was ninety percent plugged, and the other was eighty percent calcified.
Upon learning the diagnosis, Geoffrey made an appointment with Dr. Jared Knopman, director of cerebrovascular surgery and interventional neuroradiology at NewYork-Presbyterian/Weill Cornell Medical Center.
"When the pathway that leads to the brain is blocked or narrowed by plaque, pieces of plaque can spontaneously break off, which can lead to retinal hypoxia, thus the temporary loss of vision," says Dr. Knopman. "Symptoms like this may resolve, but they can lead to a significant subsequent stroke if they're ignored."
Geoffrey was surprised by the diagnosis. Though he suffers from transverse myelitis, an inflammatory spine condition that causes loss of balance, leg discomfort, and “pins and needles” sensations, Geoffrey is fairly active. He spends most of his time with his grandchildren, reading and working, and even going on limited hikes with the help of walking sticks. Carotid stenosis put a sudden pause on his otherwise idyllic life.
"I went from thinking that I knew everything about myself to not knowing anything," he says.
Following the diagnosis, Dr. Knopman performed two carotid endarterectomies. During these procedures, the surgeon makes a small incision in the neck to open the artery, removes the blockage, and reconstructs the artery walls.
"There are a couple of surgical techniques to treat carotid occlusion," says Dr. Knopman. "Usually, something nuanced about a particular patient's anatomy makes one technique slightly better for that individual patient. All our therapies are individualized."
Donaldson went home the morning after his first procedure and took it easy until his second three months later. After the second endarterectomy, he returned to the gym one month later. Today, he is at the gym four times a week and feeling well.
"I felt the same post-op as I did pre-op. But my carotids are clean, and that's one thing off the table," says Donaldson. "I was lucky — I was able to have this operation that was necessary to save my life."