By Joy Stephenson-Laws, JD, Founder

I don't like to read tragic stories but being aware is a necessity of life. Just last month, 41-year-old Stefanie Smith, a mother of two, died on an airplane that was coming back from the Dominican Republic where she was vacationing with her boyfriend and friends. 

“Stephanie Smith was in seemingly good health when she fell ill and began convulsing. She was later pronounced dead at a hospital,” according to a news update from ABC World News.

The plane Smith was on did an emergency landing in Turks and Caicos where she was brought to the hospital and pronounced dead.

"There was nothing anyone could do to save her," her brother, Chris Volz, said in an interview with PEOPLE.

"They tried CPR to no avail."

Smith was a fit, young woman. Her friend that was on vacation with her even said she would get up to run on the beach every morning. Her brother said she coached cheerleading and softball and did CrossFit (a very intense exercise program).

Smith’s cause of death was ruled as a carotid artery dissection. In order to understand what this is, we need a basic understanding of the carotid arteries.

The carotid arteries are extremely important blood vessels that provide blood to the face, brain and neck.

“Some of the most important conduits of blood flow are the carotid arteries, which consist of the common carotids, external carotids, and the internal carotids,” according to the National Institutes of Health (NIH).

We all have two common carotid arteries (pictured above) - the left common carotid artery and the right common carotid artery. These common arteries run from the upper chest to the skull. At some point, they divide and branch off into the internal and external carotid arteries.

“The internal carotid artery, being one of the most clinically relevant and vital arteries, supplies oxygenated blood to crucial structures such as the brain and eyes,” (NIH).

To put it simply, it is a tear in one of the carotid arteries. 

More specifically, “A dissection is a tear of the inner layer of the wall of an artery. The tear lets blood get in between the layers of the wall and separate them. This causes the artery wall to bulge, and the bulge can slow or stop blood flow through the artery. It can also cause problems by pressing on nearby structures, such as nerves,” (John Hopkins Medicine).

“The tear can also trigger the body's clotting system. A clot can then block blood flow at the site of the tear. Or pieces of the clot can break off and block blood flow in smaller branches of the artery. Blocked or decreased blood flow can lead to a transient ischemic attack (TIA) or stroke.”

What is particularly shocking to me is that John Hopkins states that carotid dissections are a common cause of stroke in people under the age of 50.

(A reminder that Stefanie Smith was only 41-years-old).

A common cause of carotid dissection is some kind of injury to the neck. However, “Carotid dissections usually develop without a clear cause (called spontaneous carotid artery dissection) or as a result of some sort of trauma (such as a car accident, sports injury, surgery, or chiropractic neck manipulation),” according to Mount Sinai.

The mention of chiropractic neck manipulation really got my attention. A chiropractor is a licensed healthcare professional. I have visited one myself many times, and the treatments have provided much relief for neck, shoulder and back pain. I had to investigate this more, and I honestly did not like what I found. I came across a recent story about a 36-year-old man who got a carotid dissection after receiving a chiropractic adjustment on his neck. Fortunately, he sought medical treatment and survived.

In another incident involving a visit to the chiropractor, one young woman was not as fortunate. Back in 2016, a 34-year-old model died of a stroke due to a dissection after receiving a chiropractic adjustment. 

And in this shocking story, a young woman became paralyzed after enduring four dissections from receiving a chiropractic adjustment on her neck. 

Visiting the chiropractor is a personal choice, however, it is always good to visit someone who is licensed and reputable. I would also recommend voicing concerns about carotid dissections before undergoing adjustments and make sure you have clearance from your regular doctor that it is safe for you to receive treatments from a chiropractor.

Underlying health issues may increase risk of carotid dissections.

Having pre-existing health issues may make you more prone to carotid dissections. It turns out that Stefanie Smith, the woman discussed who sadly passed on the airplane, had high blood pressure. She was very athletic and fit, however, this does not necessarily make a person immune to hypertension. I am not saying that Smith’s high blood pressure was the cause of her dissection. I cannot definitively determine that, however, high blood pressure does increase the risk of a carotid dissection. Perhaps this is because hypertension can damage the cells of the arteries. Smoking may also increase the risk of having a dissection. For additional risk factors, click here.

If you have atherosclerosis or any type of condition that may cause weakening of the artery walls, know that activities such as the following increase the risk of experiencing a carotid dissection:

• Swimming or scuba diving
• Skating
• Dancing
• Playing certain sports
• Yoga
• Riding a roller coaster and other rides
• Jumping on a trampoline
• Giving birth
• Having sex
• Sneezing or coughing

This, of course, isn’t to say that you shouldn’t live and enjoy your life. It’s just important to know the risks and work on correcting any health issues such as hypertension and type 2 diabetes. If you are overweight or obese, this is great motivation to get to a healthier weight.

Sometimes things just happen. This young dad suffered three strokes after getting a dissection from turning his head too quickly while playing pickleball. He heard his neck pop and then started experiencing symptoms such as a change in his vision and really bad vertigo. Luckily, he sought medical attention and survived. Again, this all isn’t to suggest that people not enjoy their lives and do activities that bring them joy. It’s just important to be more mindful of our bodies, take care of our health and never ignore symptoms or  avoid getting medical attention.

Although I highlighted multiple stories about carotid dissections, the good news is that these occurrences are relatively rare. According to the Cleveland Clinic, it occurs in two or three people per 100,000.

Be proactive.

Be proactive by keeping your blood vessels healthy and talking to your doctor about your risk of dissections.

Heart disease is still the leading cause of death for both American men and women. Be proactive by taking care of your overall metabolic health which will help keep your blood vessels healthy. You can help do this by engaging in regular physical activity, maintaining a healthy weight, managing stress and following a balanced, nutrient-dense diet. Regarding blood pressure specifically, I highly recommend giving this blog a really good read.

As always, be sure to take routine nutrient tests. Having nutritional deficiencies and imbalances has been shown to increase the risk of disease developing or exacerbate existing health issues. If the test reveals you are not nutritionally balanced, a competent healthcare professional can work with you regarding making the necessary dietary changes and recommend quality supplements in a safe manner if necessary.

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor or another competent healthcare practitioner to get specific medical advice for your situation.       

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses, and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products, and services. To learn more about the pH Medical Advisory Board, click here.