Name: Shawn Fisher
Age at time of Dissection: 35
Type of Dissection: Both Ascending and Descending
Date of Aortic Dissection: 16 August 2005
Tell Us Your Story:
Iwork from home and travel for a living mostly driving in the midwest. One morning I was preparing to travel when my customer cancel our appointment at the last minute. I hung up the phone and felt a huge stab literally in my neck. The pain was so strong that i had to sit down. It happened again. I broke out in a cold sweat. My hand and arm began to go numb. I am an ex-Emergency Room nurse and worked open heart surgery immediate recovery intensive care for 4 years as well.
As I lost the ability to move both my right leg and right arm, I called my partner who was in a business meeting and told him to come immediately to pick me up. As my brain raced, I thought I was having as stroke. I did not have the typical stabbing pain in my shoulder or pain in my back. All my symptoms were atypical. I crawled on my left side to the back door of my house. We have a German Shepherd guard dog, I knew the EMS would not be able to get past him.
It was pointless to call the EMS because they would take me to a facility that was close to our house but not able to handle what i thought was a stroke. So, my partner arrived and he took me to a hospital I worked for. The ER is inner city and I am presenting with diaphoresis and numbness as well as somewhat disoriented. Immediately the ER assumed I was a drug user and began asking me a series of questions about what substance I might be using. Of course I am NOT a drug user.
I had no previous health history EXCEPT my father had dies of an aneurysm at the age of 60. I was not thinking AA at that time. I arrived at 1115am in the morning to the ER. They took some blood but never performed a routine drug screen. 2pm that day a surgery resident came to see me and told my partner that there was no surgery today they were going to have pysch evaluate me and instructed my partner to leave.
My EKG was normal but no one bothered to do a CT scan nor did they do bilateral blood pressures or they would have noted the abnormality. By 4pm I was going into DIC (clotting disorder which causes patients to hemorrhage due to depletion of clotting factors.) I was bleeding from just about every orifice. About 5% or less patients dissect their messentary artery.
At 430pm I started to vomit frank blood with clots. The suggestion was made that I might be an alcoholic and they needed to make sure this was not a esophageal varcies so they would do an EGD. After the EGD the GI doctor said order a CT SCan stat with contrast this patient has massive mucosal hemorrhaging from messentary ischemia in the GI tract likely due to dissection.
A CT Scan with contrast and at 630p- 7pm at night they made the decision to transfer me to a Heart Hospital in the city via life flight. My aorta had dissected from the aortic root down and including the illac bifurcation as well as the bilateral renal arteries, bilateral carotid arteries and messentary artery. Torn valve and I was hemorrhaging internally. By this time due to the lack of care and diagnosis, i had lost about 60=70% of my blood volume and was fading fast. I was flown and taken to surgery at 11pm and returned to ICU at 400pm the next day. I spent two weeks completely sedated and paralyzed.
Most everything we see with post operative patients that can go wrong did go wrong for me. I was allergic to heparin and developed HITS Heparin Induced Thrombocytopenia. I showered clots to most of my major organs. Infarcted my spleen and shut my both my liver and kidneys down. They also had missed a large section of bowel which 2 weeks out had become necrotic and gangrenous. At 2 weeks my bowel ruptured and I ended up septic. So for the next two months I was on kidney dialysis and plasmapheresis. Developed MRSA and fungus infection in my lungs. At that time they discovered I also had a clotting disorder called Antiphospholipid Syndrome which only occurs with 4% of the world’s population.
I spent 3 months in ICU and 3 months in rehab. My kidneys did start working as well as my liver at about 2 and half months. They left me open from my sternum to pubic bone for 3 months. No one has an explanation for why the dissection occurred. Completely healthy prior to all of this and now I am at doctor every other month it seems like. I did have to do some physical therapy because I did not eat for 10 weeks and lost 80#’s. I had some muscle atrophy and wasting.
I have done some research and seem to fit the profile for Ehlers-Danlos syndrome which have vascular abnormalities. This is the only thing that seems to correlate with why I had a dissection at such a young age. It was SO difficult being on the other side as a patient ,when for years I had taken care of patients like myself. As a health care professional it also taught me about patients presenting with atypical symptoms.
I am very thankful and lucky to have had a loving family and partner. I was never alone in the hospital or after for more than an hour. Someone was with me every day. Tell your story so others can learn. Maybe you will help that one ER nurse look a little further when a patient presents with symptoms.