An aortic aneurysm can burst and kill within minutes, but a simple test – an ultrasound like the kind that detects a baby's heart beat – can spot a bulge in the aortic wall and surgery can repair it.
Blockages in the carotid arteries that run up both sides of the neck and into the brain can cause a major stroke. Yet that same ultrasound wand can spot a blockage and that, too, can be remedied.
Dare to CARE is a program started by Annapolis vascular surgeon Dr. John Martin, and he has screened – for free – more than 30,000 people since 2000, half of whom were found to have some vascular disease.
Of those, some 5 to 10 percent were in critical need of surgery, including the woman who is now the program manager, Elaine Gairy.
She dragged her husband "by the ear" to Martin's office for the free screening six years ago and decided to have one herself. He was fine, but one of her carotids was found to be 99 percent blocked, and she needed surgery immediately to clear it.
"I was in shock," Gairy said. She was only in her 50s, had no symptoms and no risk factors. After recovering, Gairy was so grateful she volunteered to help Martin administer his program and has been there ever since.
"The real meaning of success is not how many problems we spot," Martin said in his Anne Arundel Medical Center offices. "It is getting people to pay attention. There are ways to lower the possibility that you will ever need our services."
To that end, Martin conducts free seminars five times a year, teaching about cholesterol, high blood pressure and how to avoid cardiovascular disease. The attendees are then encouraged to be screened.
"The education is as important as the screening," said Martin, who also offers satellite screening programs in Bowie and Kent Island.
Martin used to advertise Dare to CARE, but word-of-mouth has kept the phones ringing and the office full.
"I am not looking to operate on anyone," he said. If a problem is found, the patient is referred to his primary care physician for the next step.
"We are starting to change the culture of thinking about this disease," Martin said. "Now we have doctors saying to their patients, 'Have you been screened?' The bulk of our referrals now come from primary care physicians."
The screening takes about 15 minutes and only requires socks and shoes be removed so technicians can check circulation in the lower legs to detect peripheral artery disease.
But the most critical part of the test is on the aorta. The largest artery in the body, it is located in the abdomen and carries blood from the heart. If the wall is found to be weak and pouching, it can be repaired with surgery. Undetected, it can burst and the patient — most often a man — can be dead before anyone can dial 911.
When Carl Bayard, a retired State Department employee living in Annapolis, was screened, his aorta was found to be slightly swollen. Martin monitored him regularly for seven years until it was determined that a surgical repair was needed.
"I walked in, and 24 hours later I walked out," Bayard said.
Though the test is free to patients, each one costs Martin's practice about $145 for technicians, equipment and office staff. He applies for grant money and seeks donations, but some patients are so grateful that they write him a check.
Martin says everyone over 60 should be screened, but certain risk factors — smoking, high blood pressure, diabetes, obesity — dictate that a patient be screened in his 50s. If nothing is found, he will suggest another screening in five years.
There are other, similar programs, but they often charge a fee. And they also suggest patients get screened every year when that isn't necessary, Martin said.
Martin said he began Dare to CARE after realizing that he was "spending a lot of time on the back end of this disease. I realized I could give more to this community by screening than I could ever do by operating."
Dare to CARE
The "CARE" in the program's name stands for Carotid, Abdominal aortic, Renal artery stenosis and Extremity artery disease. The next lecture is scheduled for Tuesday, Feb.15, 7th floor conference room, Health Sciences Institute Pavilion, 2000 Medical Parkway, Annapolis, followed by a screening on Tuesday, Feb. 22. Please sign up in advance by calling 410-573-9483.