Within the changing story of fear of John Fetterman’s health

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With five hours to go before voting last month, John Fetterman’s Pennsylvania Senate campaign issued a confusing statement on the day of the primaries: he would undergo surgery before the ballot boxes were closed to install a pacemaker with a defibrillator. after his recent stroke.

“It should be a brief procedure that will help protect your heart and address the underlying cause of your stroke, atrial fibrillation (A-fib), by regulating your heart rate and rhythm,” he said. unsigned May 17 statement.

This ruling, which campaign advisers say was passed by the hospital, raised more questions than it answered. Although pacemakers are sometimes used to treat patients with A-fib (an irregular heartbeat caused by the upper chambers of the heart), devices that include defibrillators are usually not.

“You should never use a defibrillator to treat atrial fibrillation,” said Christian Thomas Ruff, an associate professor at Harvard Medical School and director of general cardiology at Brigham and Women’s Hospital in Boston. “The defibrillator is used to treat the dangerous heart rhythms of the lower ventricles.”

The Fetterman campaign would take 17 days to explain the inconsistency. A letter from her cardiologist, published on Friday, said the defibrillator had been installed to treat previously undisclosed cardiomyopathy, first diagnosed in 2017, which reduced the amount of blood her heart could pump.

The fact that Fetterman, 52, and his campaign have won the nomination without fully revealing the extent of his physical illness has raised concerns among Democrats that there is more bad news to come, which could jeopardize the party hopes to maintain control of the Senate this fall. The politician, whose advisers have portrayed him as a “genuine, outspoken, BS-free populist” – wearing a shaved pâté, a gray knob and a Carhartt sweatshirt – now faces the challenge of explaining the confusion to voters. .

Fetterman, the current lieutenant governor of Pennsylvania, responded Friday with a more extensive written statement, making it clear that he “almost died” of the stroke, had not yet fully recovered and had seen the mistake of not taking the medication. prescribed to treat your heart disease from last year. 2017.

“I didn’t do what the doctor told me to do,” he wrote. “But I will not make that mistake again.”

Fetterman says he “almost died” after ignoring heart disease

Their campaign advisors say they have been working to be as transparent as possible. According to one advisor, Fetterman’s campaign only learned of the surgery on the morning of elementary school, and doctors never mentioned separate heart disease at the time. Doctors described the defibrillator as “an insurance policy,” the advisor said.

Lancaster General Hospital spokesmen did not respond to a request for comment on Saturday.

“We don’t have doctors on our campaign team,” said Rebecca Kirszner Katz, a senior Fetterman campaign advisor. “We’ve been learning about these conditions and explaining them in real time.”

Concerns have been heightened by the progress of her stroke recovery after her wife, Gisele, described her situation on election night as “a little hiccup” and predicted that her husband would return to get up in a very short time. The campaign adviser said the stroke was severe and that Fetterman had escaped the severe effects in large part due to his wife’s early intervention and his proximity to Lancaster Hospital, where he received treatment. fast.

Her physical well-being has improved since the stroke.

“He walks a few miles a day,” Katz said.

However, he has not yet appeared in public, and his appearances in the video posted by the campaign have shown him speaking only a few sentences at a time. His ability to hold conversations quickly has not fully recovered, although he is improving and doctors are still predicting a full recovery.

Two Democratic political consultants, who, like others for this story, spoke on condition of anonymity to describe private conversations and a sensitive topic, were concerned that the campaign’s management of Fetterman’s health was undermining his image. of direct speaking.

“When you’re the godfather of transparency and social media, and you get dark, people realize it,” said a strategist who has long supported Fetterman. “It’s not like admitting a health problem immediately causes people to look for a replacement.”

Another Democratic consultant who did not work for any Senate primary candidate said the disclosure of campaign information has been, at best, “opaque” and, at worst, “misleading.” which “blows your imagination a little.” Fetterman will face Republican candidate Mehmet Oz, a retired cardiothoracic surgeon and television character.

“There were so many red flags,” the consultant said in the days following Fetterman’s stroke, and later added, “If Oz and the Republicans wanted to get to the [health] indirectly, they would do so through the issue of trust. “

Republicans have already jumped on the bandwagon. “Wow, @JohnFetterman is starting his Senate campaign by lying about his health,” Chris Hartline, communications director for the National Republican Senatorial Committee, tweeted Friday.

David McCormick cedes Mehmet Oz to the Republican Senate primaries in Pennsylvania

“While John Fetterman has earned the trust of Pennsylvania, Mehmet Oz is a fraud who will do, say, and sell anything to help himself,” said David Bergstein, communications director for the Campaign Committee. Democratic Senate.

Pennsylvania is the open-ended Senate midterm election contest that gives Democrats their clearest chance of securing a seat after the pending retirement of Sen. Patrick J. Toomey (R-Pa.). Aside from his health challenges, the Fetterman campaign has got off to a good start, winning all 67 Pennsylvania counties in the recent four-way Democratic primary, with Rep. Conor Lamb (D-Pa.) In a distant second. In 33 counties, their vote share was 70 percent or more, according to the campaign.

A former mayor of the small town of Braddock, Pennsylvania, Fetterman has made a name for himself as a politician who can attract support beyond his party’s brand, with strong appeals to legalize recreational marijuana, revitalize communities of manufacture and remove the Senate obstruction to achieve this. more done.

Those close to Fetterman say one of the problems with his campaign has been his discomfort in talking about his own health problems, or in caring for them properly, which the candidate admitted in Friday’s statement.

“Like so many others, and so many men in particular, I avoided going to the doctor, even though I knew I wasn’t feeling well,” she said.

It was a message some Democrats hope will appeal to cross-voters that Fetterman hopes to reach in November.

“Would I have liked more information to come out of the campaign more quickly? Yes. But in the end, you know, I don’t think it’s indicative of the type of campaign [Fetterman] shows up, “said Democratic consultant Mike Mikus, who voted for Lamb in the primary. He said Fetterman seems” similar “to admitting Friday that he didn’t take his medication and ignored his doctor.

“He is recovering well and following the doctor’s orders. I look forward to campaigning with him soon,” said Sen. Robert P. Casey Jr. (D-Pa.) In a statement, after having a Zoom call with Fetterman on Friday. “I’m not sure I’ve seen a candidate in recent history who’s better prepared to serve the people of Pennsylvania.”

Alliance Cardiology’s Ramesh Chandra said in a statement Friday that he had seen Fetterman in 2017 after experiencing a swelling in his feet. “I diagnosed him with atrial fibrillation, an irregular heartbeat, along with a decreased heart rate,” he wrote in the letter.

Fetterman, who is 6 feet 8 inches tall, previously announced that from 2017 he changed his diet and began exercising more regularly, leading to significant weight loss. A June 2018 article in the Pittsburgh Tribune-Review reported that he had lost 148 pounds in one year, dropping from a weight of about 418 pounds.

“He was fat,” Fetterman said at the time. “It’s a shame to talk about it.”

Several cardiologists said the description of a “diminished heart pump” coincided with the diagnosis of cardiomyopathy, which Chandra said was the reason Lancaster doctors decided to implant a pacemaker with a defibrillator. Cardiomyopathy is a disease of the heart muscle that makes it difficult for the organ to deliver blood to the body, sometimes causing the feet to swell.

“There are two major reasons why we implant defibrillators,” said Matthew Tomey, an adjunct professor of medicine and cardiology at Mount Sinai Icahn School of Medicine. “One is for someone who has already had a cardiac arrest. The other reason is primary prevention for people who have never had a cardiac arrest but have risk factors.”

Tomey said recent pharmaceutical innovations have made cardiomyopathy a much more manageable condition than it was 10 or 20 years ago. Treatments are usually determined by a series of tests, which include a measurement of the ejection fraction of blood pumped from the left ventricle of the heart and the CHA2DS2-VASc score, which takes into account age, diabetes. , hypertension, vascular disease and other factors.

The Fetterman campaign did not publish this data.

“The prognosis I can give for John’s heart is this: if he takes his medications, eats healthy and exercises, he will be fine,” Chandra wrote in the statement. “[H]We should be able to campaign and serve in the United States Senate without any problems. “

Annie Linskey contributed to this report.

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