FORT WORTH, Texas — A retired Marine and North Texas businessman is warning people to know the side effects of their prescription drugs. The combination of his medication and a trip to the dentist may have been just the mix to send him to the emergency room with multiple strokes.
“By the time they did surgery, I was told something like 17 strokes,” said Ralph Marmolejo.
Marmolejo didn’t know that at the time. At first, during a family barbecue at his Fort Worth home on Martin Luther King Jr. Day, he said he just started feeling really bad out of nowhere.
“All of the sudden, it was a cool weekend, but I ended up coming in with the chills,” said Marmolejo.
The chills turned into a fever, stomach problems, and Marmolejo said even hallucinations over the next few days. Then he said he started feeling a lot better one morning and tried to take a shower and get back to himself.
But the Operation Desert Storm veteran would find that relief very short-lived, as relief turned into his worst symptoms yet.
“I guess I was in and out,” he said. “Really wasn’t registering what was going on. Wife called the ambulance.”
Marmolejo was quickly diagnosed with having a stroke. The news that he’d experienced more than a dozen other mini-strokes came later as he was transferred to a few different doctors before ending up in the care of Texas Health Dallas cardiovascular surgeon Dr. John Mark Pool.
“Long story short, he was found to have an infection inside his heart,” Dr. Pool said.
Dr. Pool described it like a clump of infection near one of Marmolejo’s heart valves that was chipping off pieces here and there. Those pieces were then traveling in his blood stream to his brain and leading to those strokes.
This does happen and can happen to anyone, said Pool, but it’s certainly not an everyday occurrence.
“Generally, there aren’t bacteria in the blood stream, but there are bacteria all over your body; certainly in your GI tract,” said Dr. Pool.
So, how did it get into Marmolejo’s blood stream? Well, Dr. Pool said it’s impossible to know for certain and they can only really go off of clues in his life leading up to the health problems, but that’s where they found a pretty solid lead on what happened to the Fort Worth man.
“I ended up going to the dentist a couple months prior,” said Marmolejo.
During a dentist trip or even just teeth cleaning, Dr. Pool said it’s not uncommon for bacteria in the mouth to get into the blood. According to experts, that bacteria is generally a non-factor for most patients though, as their immune system just takes care of it.
But this wasn't the case for Marmolejo, who had an X-factor in the mix.
“I was taking medication for rheumatoid arthritis,” he said.
That medication works by blocking parts of the immune system. So the thought is, that medication blocked Marmolejo’s protection from that bacteria and it ran free in his blood and to his heart.
The veteran said he now recalls being told that he needs to alert dentists and medical doctors to his use of that drug for that very reason, but as he, admittedly, hadn’t been to the dentist in some time, he said he didn’t even think to.
Luckily, Dr. Pool and his team were able to use advanced, robotic surgical techniques to get the infection out of Marmolejo’s heart and get him back on his feet. He’s still recovering and attending regular cardiac rehab, but says he feels back to his normal self again.
Dr. Pool said regardless of what led to the infection, Marmolejo did the right thing by seeking help for the stroke-like symptoms. He said he stresses to so many patients to not worry about overreacting to symptoms or seeking help for something that turns out to be nothing. He said to just get checked out.
“Pay attention to the symptoms you or a loved one may be having and respond to those,” said Dr. Pool.
The doctor also advises not skipping out on your dentist visits because of this, just let them know what prescription medications you’re on.
It might take a bit more convincing for Marmolejo, though, who said he’s not exactly chomping at the bit to get back in that chair just yet.
CORRECTION: This has been updated to correct the spelling of Dr. John Mark Pool's name. (May 23, 2022)