Personal Stories: Stan Derr
On January 8, 2003 I had a total dissection of the Aorta, both thoracic and abdominal. Until that time I did not even know that such thing as an aortic dissection existed. The fact that I survived is due to a series of circumstances and actions by key people, the most important of which was the support and care of my dear wife Merrie Rose from the time she first arrived in the emergency room through today.
Without her loving support my prognosis could be much different. At the time of the dissection, I was a 59 year old president of a small research company that held many patents using Infrared to uniquely recognize and individual and do medical vital and other screening without touching a person.
In this job, tension was very high as we were a startup and always seeking funding or grants from the federal government or investors. This pressure exacerbated my long term hypertension and caused the dissection. My background included a 23 year Army career (including two combat tours in Vietnam), 13 years of high pressure new business development for a defense contractor and two years as president of the research company. My medical history is mixed but included gunshot wounds in Vietnam, type II diabetes and a serious weight control problem.
One of the factors that I think allowed me to survive was a gastric bypass surgery in March 1999 and follow on weight loss for a high of 400 lbs to 250 and the diabetes going into remission.
The story starts with me sitting and talking to my technical director and preparing for a noon meeting with a potential investor. At about 10:00 it felt like someone hit me in the chest with a sledge hammer. I suspected I was having something serious with my heart. I asked my technical director (also my sister in law Fran) to please get me to the hospital and called my doctors office. The doctor’s office encouraged me to call 911 and go by ambulance.
I really didn’t want to do that but all of a sudden I was not able to stand or move either legs or right arm. At that time my budget analyst (Pat) came into the room and took the phone and immediately called 911. This was the first of a series of critical actions that led to my survival.
Fairfax county EMT’s arrived in less then 10 minutes and I was transported to the emergency room of Fair Oaks hospital. My sister in law followed the ambulance while my budget analyst called my wife at the elementary school where she taught and picked her up and took her to the hospital emergency room.
What happened next is what I have been told by my wife Merrie Rose, Fran and Pat all who spent many long days with me. I remember nothing from the time the EMT’s arrived and I awoke 4 days later in an ICU. At the emergency room, my wife Merrie Rose (she had spent 20 years as an ER and OR nurse in NY) was insisting on me receiving immediate attention. After vital being taken and being placed on oxygen the ER doctor ordered a CT.
The CT showed a dissection starting at the aortic valve and extending the length of the aorta to the abdomen. The doctor was amazed that my vital signs were good all the time considering all the tearing occurring inside my body. In addition both legs had no pulse and were turning black.
The ER doctor told my wife, Fran and Pat that I had suffered a dissection and that they could not treat it at Fair Oaks and the prognosis for survival was poor. She was encouraging them to consider organ donation. Merrie Rose asked where there were surgeons that could address the problem.
The Doctor said that Fairfax Hospital had the capability but doubted that I could survive an ambulance ride of 50 minutes to get there. Merrie Rose brought up air evacuation and all three ladies became very firm with the doctor that she order an air evacuation which she eventually did. Merrie Rose said I asked the doctor if I was dying and she told me I was.
The helicopter diverted from another mission and arrived in only 10 minutes although the doctor told Merrie Rose that she didn’t think I could survive the helicopter ride. Even though the ER doctor was very negative, the fact that she quickly diagnosed the dissection was my second key event of the day.
I was loaded in and transported to Fairfax hospital where I was very lucky that a fantastic vascular surgeon (Dr. Albus) was waiting and had been repairing aortic dissections for 14 years. I was taken immediately to surgery and was on the operation room table by 2 PM or only 4 hours from the onset of the dissection. The operation continued until about 11 PM when I was moved to ICU. Dr.
Albus told my wife and others that he thought the operation went well but they were having trouble finding good tissue to suture the Dacron implant to. The prognosis was guarded and stayed that way for a number of days in the ICU. Dr. Albus and his expertise was a key factor in my survival.
The surgeons fixed the ascending dissection but did nothing with the abdominal dissection as I had been on the heart lung machine for almost 3 hours and the heart stopped for 35 minutes. When the operation started they thought they would have to also amputate both legs but that did not occur and I have total use of one and partial use of the other.
As any of those who have gone through this know that I was hooked to many monitors and my wife said I had 24 IV, drains or sensors hooked to me. Here was another series of key people for I was individually monitored by a nurse 24 hrs a day and these were the most professional people we encountered. After 8 days in the ICU I was stable enough to be transferred to a cardiac ward. I was not able to walk as there was serious neurological damage to the nerves in the right leg and right hand. I was not permitted to lift anything or get out of bed. After a week of getting better and being able to sit in a wheel chair a couple times, physical therapy began.
From here to the end of my hospital stay things went down hill fast. The nurses were not as qualified and they were trying to fill beds in the sister hospital (Mount Vernon) that had a fast rehab program. I questioned whether I was ready for such intensive physical therapy but was told that the therapists would not push past what I can do. So I was transferred via ambulance to Mount Vernon and within an hour of arrival they had me on a mat doing exercises. I immediately threw an embolism shortly after arrival there and was transferred to a cardiac ward to stabilize me.
Here my wife virtually took over my care as the nurses were contract nurses and didn’t even know where things were in the hospital. A series of potentially catastrophic mistakes were avoided through my wife’s intervention. When I was being discharged the choice was to go to a nursing home and rehab there or go home and rehab. My wife decided I would be better off at home where she could care for me. So we had a hospital bed delivered and put in the living room, rented a wheel chair and other medical items and had a temporary ramp built to the front door.
My wife took 12 weeks of family leave from teaching and became my caregiver. Thank God for her. What followed over the next 4-6 months was physical therapy and occupational therapy at home, nurse visits, and gradual improvement. First to a wheelchair and being able to take care of my basic needs. To water physical therapy and well as many visits to Dr. Albus, my family doctor, a neurologist and periodic imaging and blood tests. My right leg improved to the point that after about 7 months I was able to leave the wheelchair with a total leg brace and finally after about 1 year to be able to walk with a cane.
Currently, I am able to walk with a cane or in the house for short distances with no cane. My right leg and fingers of right hand are still partially paralyzed and it appears that this is as well as it will get. I was very lucky to have no brain or spinal cord involvement and the neurological damage was localized. Unlike many of you who are doing exercises, my doctors have put the following restrictions on me for life. No aerobics or weight lifting, no lifting of anything over 30 Lbs. and never get my diastolic blood pressure over 80. I see a cardiologist and neurologists every 4-6 months. My abdominal dissection is being treated by medications and I take 11 medications daily. My cholesterol is closely monitored and has been reduced to an unbelievable 110 total. Blood tests are conducted every 4 months and I have had 4 CT since the dissection. I will have a CT every year from now on if things stay the same.
So as you can see, I have been blessed by a continuing series of events that have brought me to where I am today. I am sorry this story is so long but as you all know there is much more to this then even mentioned here. I am very upbeat and optimistic about my future and look at the partial neurological problems to be minor vs. the alternative. I hope this helps others and if any of you have questions please contact me, I would be very happy to help.