Name: Thomas Krug
Age at time of Dissection: 58
Type of Dissection: Ascending
Date of Aortic Dissection: 27 January 2011
Tell Us Your Story:
2010 Was a hard year to stand tall. I was in my late fifties and beginning to feel the aches and pains that come with it. For several years I had lower back pain, and now it was excruciating. After a conversation with my daughter, who works at Columbia University Medical Center as a fundraiser, on 25 Oct 2010, I found myself in the surgery room at Milstein Hospital at NYPH, Columbia having a Micro Disc Laminectomy with Dr. McCormick. I felt a million times better and after being out of work for some time I was to return to work on the 1st of Feb. 2011. I was given strict orders not over exert or do any heavy lifting.
January 27, 2011 is a day I will never forget. The snow came down in soft fluffy mounds and needed to be removed. I was home from work along with my two youngest daughters while my wife was at work at a Nursing Home. I knew I wasn’t supposed to clear the driveway, but I hated not being able to help and they snow was light plus I had use of a snow blower, I felt safe. I dressed in layers to be warm and after about 35 minutes I was huffing and puffing, feeling short of breath and starting to sweat.
BAM, I was hit in the chest with a baseball bat. I fell backwards into the snow and my legs and arms went numb. I was shocked and out of breath and realized this was no random baseball bat attack; it might be the big one.
I had to lie in the snow for several minutes until I caught my breath and I called out to my daughters. The older of the two came out and saw me in the snow and she ran to call for an ambulance.
In the words of Red Fox, I thought this was the, “big one.”
The ambulance showed up along with the fire department and city truck with a plow. Soon after the paramedics arrived and they put large IVs in both arms and put me on their field heart monitor. I was loaded into the ambulance and my daughter Victoria came with me as my youngest daughter Patricia stayed home to notify my wife and two other daughters.
After we arrive at the hospital, well the tests and timeline is better described in bullet points:
• I am moved into the ER and my clothing cut of, blood drawn, an EKG is done and I am given pain medication.
• None of my enzymes are elevated.
• I wait for four hours to re-take the tests.
• My wife, daughters, my daughter’s in-laws, as well as my god-daughter and good friend arrive.
• I am speaking with the ER physician and tell him I am followed by a cardiology group, he told me it is my LUCKY day; one of the MDs in the group was in the ER checking on someone else. Dr. Lombardo came to see me and review what had been done; he also did his own physical evaluation. He remained in the ER with me.
• Around the four hour point more blood was drawn, again no elevation in the cardiac enzymes, but the d-dimmer was starting to elevate.
• I was maintained in the ER for an additional four hours, they completed another blood draw with basically the same results, no elevation of the cardiac markers but the d-dimmer continued to rise. (indicates clotting of blood is taking place in the body somewhere).
• Dr. Lambardo requested a cat scan of the chest and upper abdomen.
• I was moved to a room to await the results. I am laying there with my wife and daughters in the room. A nurse walks in and announces she has the results for me and my youngest children leave the room. My wife and eldest daughter are there to hear the news. It is not a heart attack. The nurse says the aortic dissection, I see my wife and daughter put on big smiles not grasping what the nurse is saying. My daughter later tells me that my face went immediately pale and that’s when they began to worry.
• My oldest daughter, Kate – the one who works for Columbia University Medical Center, began to text and calls her colleagues giving them my status and situation.
• Dr. Lombardo called a nearby facility and in the area that does open heart surgery and discovered they were available to take me. They had two surgeries ahead of me and another PT waiting, it could be the next afternoon before they got to me.
• The aortic valve team at Columbia said they would accept me as a patient, send an ambulance and could prep me for surgery right away.
• I arrived at Milstein Hospital of NYPH-Columbia at 2:00 a.m. on January 28, 2011. It was explained to me that the Surgical Team had been notified and was attempting to get to the hospital in the snow.
• I was moved to a surgical ICU suite right outside of the OR, I was told I would be monitored and if anything started to show any additional stressors, or in laymen terms I started to go south I would be rushed into the OR and the surgery would be started with team members who were on site.
• My wife stayed with me all night, in a small uncomfortable chair feeding me ice chips, while my children were sent to my eldest apartment to nap and come back.
• I had many doctors stop by the room checking on me and asking questions about what had happened and what my sensations were when the dissection was first occurring.
• Two anesthesiologists came in around 6:30 am and preformed yet another physical exam, explained that they would transport me into the OR. They made sure the IVs I had in were open and functioning.
• I was moved into the OR suite, I was introduced to the different nurses and told what their duties are; I was also introduced to the profusionist and the surgeon, Dr A. Stewart.
• The anesthesiologists told me they were giving me something to make me drowsy so they could intubate me. Well it put me out and I did not wake up for several days.
• My family tells me the surgery took almost 12 hours, I saw the inter op report, it was 11.5 hrs. My daughter Loretta spent the nights with my wife in the hospital, while my eldest took the other children home to rest. Soon my son-in-law, who was working in the Philippines at the time and cancelled his business trip to come home arrived. My family spent several days living in a waiting room waiting for me to wake up.
• When I woke I found out that I had the aortic valve replaced; I now have an equine valve. They also replaced the aortic root, ascending aorta, aortic arch and a portion just distal to that with a Dacron tube. I was on by-pass twice; each time was for a period of about 2 hours. I was in an extreme trendelburg position with my head packed in ice and my body temp lowered. I must have been strapped in very securely. This type of surgery is never planned and I assume the surgeon doesn’t know how extensive the damage is until they have the chest open. Dr. Allan Stewart performed the surgery and since I am writing this it was a very successful outcome. Dr. Judah Weinberger, MD, Ph.D. followed me post op during the remainder of my hospital stay.
In the New York metropolitan area they run commercials where different patients explain how they experience excellent outcomes with surgeries and hospitalizations at the New York Presbyterian Hospital, Columbia Campus and if I was ev
er approached I would gladly be a cheerleader for them. My family and I, my parents, brother and sister and multitude of friends are all thankful the surgeon, doctors and staff at NY Presbyterian are so exceptional with their expertise.
• After the surgery I was moved to a post surgical ICU and maintained in an induced coma for a day before I was allowed to awaken. I stayed in the post ICU for several days then moved to a medical ICU.
• I had to learn how to walk again before I was allowed to leave the hospital.
• I was hospitalized for 15 days before I was released. I caught a condition called c-diff, a severe form of diarrhea and broke out in a rash from head to toe.
• I left the hospital using a walker, could not get far without it. Had to regain my strength just to stand by myself let alone walk unsupported.
• I have to mention my health insurance company was very at tentative; they assigned a nurse manager to me and called me several times a week when I first went home. They, the INS Company, provided visits by physical therapists, occupational therapists, psycho therapy all providing care for me in my home.
• I learned that many males experiences uncontrollable bouts of crying for no particular reason, I can attest to this and other facts that open heart patient’s experience.
• During the surgical procedure I experienced a crushing injury to my right ulnar nerve at my elbow. I woke with my right fourth and fifth digits numb and numbness running from my elbow to the finger tips. My surgery was performed 28 January 2011 and it is now 20 June 2012 and my fourth and fifth digits are still numb. Sensation is returning but it a very slow process.
• It is still numb in the area of the bypass incision. That area is also decreasing in size.
• I did participate in cardiac re-hab, a great way to learn how perform aerobic exercises and build up stamina. I am restricted from any heavy lifting and no straining of my upper body. When the insurance coverage for re-hab ran out, I joined a local wellness center and realize my party is over.
There is no way I expected this to happen to me but I did not do anything to avoid it. I retired from the U.S. Navy after completing 21 plus years of service. I left the Navy standing 6’4” and weighing 235-240 lbs. I experience the dissection when I was 58 and good 18 years after retiring from the navy, I was still the 6’4” but had increased my weight to just shy of the 380 lbs mark. A good 140 lbs more then when I retired, I drank too much alcohol and eat entirely too much of whatever I wanted. Besides the over consumption I was lacking any physical exercise, all positions I held post Navy were / are sedentary and I did not do anything on my own. So I did not expect it but did little to avoid it or setting myself up for other physical ailments.
I thank god I was afforded the opportunity to reform. I continue to take too much for granted and am struggling to get down to the 250 lbs mark. I exercise more, consume less, and ETOH is off the menu it does not mix well with the numerous medications I take to stay well.
This did not just happen to me, it happened to my entire family. My wife took care of me when I returned from the hospital, bathing me and assisting with all the things I took for granted prior to the dissection. I am grateful to so many people who did so much to keep me around and those who cared for me.
I will gladly speak with anyone who wants to discuss their experience or would like further or more detailed information on what I experienced. My email address is firstname.lastname@example.org and a phone number I can be reached at is: 908-230-9363.