Teresa Heinz Kerry Hospitalized- UPDATED

Teresa Heinz Kerry, wife of Secretary of State John Kerry, is hospitalized at Massachusetts General Hospital after suffering what may have been a seizure.

Details are sparse at this time, but this much is known. Mrs. Kerry, 74, heiress to the Heinz Ketchup fortune had a medical emergency while on vacation with her husband in Nantucket, MA. Sources report that she may have had symptoms consistent with a seizure. She was stabilized at Nantucket Cottage Hospital, then flown to Massachusetts General Hospital. She was listed in “critical condition” last night, and this morning is described as “critical, but stable” condition.

Teresa Kerry was diagnosed with breast cancer in 2009, and was successfully treated with lumpectomy and radiation therapy.

What do hospital medical conditions mean?

Unfortunately, we’re been getting a lot medical condition reports from hospital spokespeople lately- the Boston Marathon bombings, Oklahoma tornadoes and this weekend’s crash of Asiana flight 214, just to name a few.

The reports give the number of patients listed with various categories of medical conditions such as stable, critical, good, or fair. What does this actually mean?

Medical states or medical conditions are used to describe a patient’s condition in a hospital. These terms are most commonly used by the news media and are rarely used by physicians, who typically prefer to deal with medical problems in greater detail. However, since the passing of the HIPAA, the laws ensuring patient privacy in 1996, physicians are much less willing to give out any medical specifics about patients and tend to resort to these vaguer terms.

ekgThe following terms are recommended by the American Hospital Association (AHA):

  • Undetermined: Patient is awaiting physician and/or assessment.
  • Good: Vital signs (which include body temperature, pulse rate (or heart rate), blood pressure, and respiratory rate) are stable and within normal limits. Patient is conscious and comfortable. Indicators (prognosis) are excellent.
  • Fair: Vital signs are stable and within normal limits. Patient is conscious, but may be uncomfortable. Indicators are favorable.
  • Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.
  • Critical: Vital signs are abnormal and unstable, the person may be unconscious, and indicators are unfavorable.

The term “stable” is frequently used by in the media, although it’s use is discouraged by the AHA: “The term ‘stable’ should not be used as a condition or in combination with other conditions”

Dr. Robert H. Shmerling, an associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School points out another problem with these terms:

Another term that ought to be retired is “critical but stable.” Presumably, such a person is very ill, but not getting worse — clearly a better situation than the critically ill person whose situation is declining. However, since abnormal and unstable vitals signs are part of the designation “critical,” the notion of “critical but stable” is confusing and best avoided.

SO what does Teresa Heinz Kerry’s “critical but stable” condition mean?  We don’t know, but will update you as more information becomes available.

UPDATE 7/9/2013

Although she is still hospitalized, Mrs. Kerry’s condition has been upgraded to “fair.”  It has been confirmed that she suffered a “grand mal seizure”.

A grand mal seizure is an older term which denotes generalized tonic-clonic seizure. A generalized tonic-clonic seizure is a seizure involving the entire body. They may occur in people of any age. They may occur once (single episode), or as part of a repeated, chronic condition (epilepsy).

Many patients with generalized tonic-clonic seizures have vision, taste, smell, or sensory changes, hallucinations, or dizziness before the seizure. This is called an aura.

The seizures usually involve muscle rigidity, followed by violent muscle contractions, and loss of alertness (consciousness).

Other symptoms that occur during the seizure may include:

  • Biting the cheek or tongue
  • Clenched teeth or jaw
  • Loss of urine or stool control (incontinence)
  • Stopped breathing or difficulty breathing
  • Blue skin color

After the seizure, the person may have:

  • Normal breathing
  • Sleepiness that lasts for 1 hour or longer
  • Loss of memory (amnesia) regarding events surrounding the seizure episode
  • Headache
  • Drowsiness
  • Confusion
  • Weakness of one side of the body for a few minutes to a few hours following seizure (called Todd’s paralysis)

Kerry is undergoing tests to try to determine what caused the seizure, although about half of all seizures have no known cause.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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