John Fetterman had a stroke in May. Here’s what we know about his health.

Amid a sea of high-stakes policy issues — from crime to abortion access to inflation — John Fetterman’s health has been a near-constant focus in the Pennsylvania Senate race since his stroke.

It’s been nearly six months since the Democratic lieutenant governor suffered a stroke that he said almost killed him. In that time, Republicans have questioned his ability to hold office, and his opponent, Mehmet Oz, has pressed Fetterman to release more detailed medical records.

There’s a lot to unpack here at the crossroads of modern medicine and electoral politics — especially if you’re just tuning in before casting your ballot. But we’ve got you covered.

Here’s a rundown of everything we know about Fetterman’s health.

Fetterman, 52, suffered a stroke on Friday, May 13, just four days before the primary election in which he trounced his Democratic rivals by a more than 30-point margin.

The campaign announced the lieutenant governor had a stroke on Sunday, May 15. They announced he’d had a defibrillator and pacemaker implanted on the afternoon of primary day, emphasizing that he was “well on his way to a full recovery.”

» READ MORE: John Fetterman got a defibrillator after his stroke. But doctors say the campaign’s story ‘doesn’t make sense.'

Fetterman’s wife, Gisele, noticed the telltale sign of the stroke in her husband — a drooped mouth — as they were headed to a campaign event on May 13. Fetterman’s family whisked him to the hospital, where doctors removed a blood clot in his brain in time to prevent any cognitive damage, according to the campaign.

The campaign said the stroke was the result of a heart condition — a common, irregular rhythm called atrial fibrillation (A-fib). This is a common cause of strokes, according to medical experts.

Fetterman’s medical problems trace back to at least 2017, according to the campaign. He had swelling feet — a possible sign of A-fib — and was later diagnosed with the abnormal heart rhythm. The condition, which can be hereditary, runs in his family.

Fetterman, who is 6 foot 8 inches and previously weighed 400 pounds, said he lost almost 150 pounds by 2018.

Recovering from his home in Braddock, Fetterman avoided detailed questions about his health in the initial days after his stroke and resounding primary victory. Medical experts questioned whether the candidate had another heart condition that his campaign hadn’t disclosed.

Fetterman later said the stroke nearly killed him, and thanked his wife for catching the signs so that he could seek fast treatment. He’s also said he’s lucky he was campaigning so nearby a hospital with a major stroke center.

Experts largely agree that the timely removal of a blood clot is a highly effective treatments for stroke victims.

Fetterman did not hold major public campaign events for nearly three months, mostly sticking to small gatherings and closed-door fund-raisers. His absence on the trail left him open to criticism from Oz that he was avoiding voters due to health issues.

Instead of voter events, Fetterman ramped up his social media campaign, taking often viral jabs on his opponent’s ties to New Jersey, various campaign trail flubs, and allegations about his medical practices as a celebrity doctor.

Fetterman held his first post-stroke rally in August in blue-collar Erie, where his wife introduced him as “a stroke survivor.” He has ramped up his public activity considerably in the lead-up to Election Day.

» READ MORE: Why John Fetterman picked Erie for his first big rally after a stroke that nearly killed him

Oz and other Republicans have raised questions about Fetterman’s health and his campaign’s transparency, urging Fetterman to release his full medical records.

Fetterman’s campaign has declined to provide those full records or make his doctors available to reporters.

The campaign released a letter from Fetterman’s cardiologist in June saying that he was fit to continue campaigning with his pacemaker-defibrillator.

“The prognosis I can give for John’s heart is this: If he takes his medications, eats healthy, and exercises, he’ll be fine,” Ramesh Chandra of Alliance Cardiology wrote.

Fetterman also released the results of cognitive tests that showed his brain functioning at normal levels for his age, though some experts said these tests alone were not sufficient to determine his ability to work.

In another letter released last month, Fetterman’s primary care physician, Clifford Chen, a doctor at UPMC in Duquesne, wrote that Fetterman is in good health: clear lungs, normal heart rate, and no signs of weakened strength. Chen said he’d been in contact with Fetterman’s cardiologist and neurologist and that Fetterman showed no cognitive impairment.

But Chen did note Fetterman’s lingering auditory processing difficulties — a condition that, while common in stroke victims, has continued to draw attention in the final weeks of the campaign.

Chen, who campaign finance records show is a frequent Democratic donor, gave $500 to Fetterman’s campaign this year.

» READ MORE: John Fetterman is in good health, his doctor says in a new medical report

Communication challenges are common in stroke survivors. Sometimes, a stroke can affect all four major language functions — reading, writing, listening, and understanding.

Fetterman has said he is dealing with auditory processing challenges. Although the term auditory is associated with hearing, auditory processing issues relate to how the brain interprets language, and is not a cognitive issue.

Fetterman occasionally has difficulty retrieving some words as well as processing words, particularly in loud environments, he’s said. He’s used closed captioning in interviews and at the debate to ensure he can follow the conversation.

Rehabilitation specialists said routine therapeutic exercise — like practicing ways to describe a stuck word or come up with an alternative — is effective in retraining the brains of stroke victims. Experts said some victims make their biggest recovery strides with communication problems in their first six months to a year after the stroke, but some patients take years to bounce back.

» READ MORE: What are auditory processing issues, and how are they treated?

During interviews with news outlets, including with The Inquirer, Fetterman has used closed captioning or real-time captioning to ensure he understands the questions being asked.

Some outlets took heat for making his auditory processing struggles the primary focus of interviews. Republicans have continued to seize on his obvious flubs — especially during the only televised debated with Oz — to further question his mental and physical fitness.

Fetterman, for his part, has been open about his lingering speech issues and attempted to use his public recovery to connect with voters.

» READ MORE: John Fetterman has lingering speech issues after his stroke. What’s the impact on his Senate run?

— Staff writers Julia Terruso, Jonathan Tamari, Abraham Gutman, Tom Avril, Aubrey Whelan and Sean Collins Walsh contributed the reporting that informed this article.