Name: Joyce Olaves
Age at time of Dissection: 59
Type of Dissection: Ascending
Date of Aortic Dissection: 4 January 2014
Tell Us Your Story:
It was January 4, 2014, and a pretty normal Saturday in Tallahassee for me. I worked around the house and ran a few errands. I didn’t really feel any different than I did any other Saturday. In the afternoon, my husband was gone to work on one of our rental properties that we own and I did laundry, etc. Around 4:30 he got home and we decided to go out to dinner. I had lost a bet with him and I was buying dinner. The restaurant was only about a mile and a half from where we live so we were there before 5:00. During dinner, I mentioned that my stomach hurt a little bit—an unusual type of pain. That pain passed and we finished dinner, paid, and walked to the car. I was not in pain at the time but I felt explainabley different.
Once in the car, I suggested to my husband that we drive the couple of miles to the grocery store to get groceries for the week. We drove less than a half mile down the road when a pain rolled through my chest and all the way down into my legs. This happened twice and my legs felt really weak. I also cannot explain the feeling of doom that I had but I did not express that to my husband. My husband teaches some first aid classes and a class about responding to emergencies so he felt something was unusually wrong and decided then that we would go to the doctor. He quickly turned the car around and took me to a walk-in clinic which happened to be right next to the restaurant where we had eaten. We both got out of the car and walked to the clinic door. Fortunately, the walk-in clinic was closed because they likely would not have been able to diagnose me or would have sent me home.
My husband then said we were going to the new emergency room that is about three miles back in the other direction into the city. Before we got there (approximately 3-4 minute drive as my husband was speeding) the vision in my right eye was blotchy. It was like I was having a migraine aura, but it was only one eye. When we got to the emergency room and walked in I was not in any pain that I remember and really thought they would be sending me home later. This emergency center is much newer and had not been open for long—maybe a year or less.
It is not attached to the hospital either so it had not yet reached the volume seen at the other emergency room at the Tallahassee Memorial Hospital. They tended to me almost immediately. This was around 6 PM and the timing of the rest was kind of a blur. I don’t remember much except I remember talking to the doctor and he told me that my EKG was normal and probably told me more than that but that because of my visual disturbances they may want to do a CT scan. A nurse gave me a couple of baby aspirins, too.
I remember going in for the CT scan and a while later the same doctor (who was their head of emergency medicine for Tallahassee Memorial Hospital) told me that it was a good thing I came into the emergency room and that they had determined the problem and that it was very serious. He told me I had an aortic dissection and tried to explain to me what that was. He said I would need immediate surgery. He continued to tell me the ambulance was pulling into the bay to take me to the hospital and that the surgical team had already been contacted and were on their way to the hospital for my surgery.
Earlier I would not allow my husband (Jorge) to call my two grown children until we knew what was wrong. I figured I would be going home. When we got the news about my problem, I could see the panic in his face. He got on the phone immediately and reached my son, Jamey. Even though Jamey is a police officer and it is rare that he has a Saturday evening off because of either his regular job or his extra duty jobs, he was home and Jorge got him on the phone. Jorge told him what was going on.
Jorge followed the ambulance to the hospital, and by the time the ambulance and Jorge got there, Jamey was there, too. Jamey had called my daughter (Laura) during his drive across town to the hospital. She was out of town in Orlando and I guess I spoke to her on the phone at some point before my surgery but I don’t remember that. I remember meeting the anesthesiologist when I got to the hospital and the last thing I remember was Jamey telling me, “Mom, everything is going to be alright.” I also have a memory of both Jorge and Jamey at my side but I thought I was sitting on a bench with one of them on each side of me. They told me later that I was being prepared for surgery and that the doctors had to kick them out so they could get started with the surgery.
At that time, I didn’t know that Jamey and Jorge had been told that 50% of those who have this problem never make it to surgery and then 50% of those who have surgery don’t survive. This was way more serious than I knew at the time. I guess that, too, was a blessing. Jamey later told me that my surgeon, Dr. Mohamed said I had a 70% chance of surviving the surgery.
Dr. Mohamed said the surgery was 5 hours long and that they were very pleased with that. I had an aneurysm near my heart which had ruptured by the time they opened me up and he had to replace the piece of my aorta from the heart to the arch and repair my aortic valve as well. It was a very long night for my family because I went into surgery around 10:00 PM and with the surgery and the time Dr. Mohamed spent observing me he came out at 5 AM. I had a leaking valve and he wanted to make sure it functioned alright so in addition to the surgery, he spent a good bit of time observing me. I guess Laura had arrived from Orlando around 2:30 AM from Orlando while I was in surgery.
I spent 9 days in the hospital with the first two in ICU. I do not remember much in ICU during those two days other than some bits and pieces. I became fully alert the morning that they were moving me from the ICU to the cardiac care unit. I had all the IVs, the oxygen tubes, and the chest tubes. The chest tubes were what bothered me the most. I was expected to get up and walk several times a day and, while I didn’t mind that, it was such a hassle with all the equipment attached. At one point, the chest tubes were not draining as the doctor had hoped so I was given some steroids which then kept me awake and jittery. I was getting no sleep and that made me very crabby so my cardiologist prescribed Ambien. I had adverse reaction and tried to remove my chest tubes myself during that night. Someone had spent the night with me every night and Jorge was spending the night with me so he stopped me but apparently he had to hold me down while he yelled for the nurse who the
n handcuffed me to the bed. No more Ambien for me.
During one of my CT scans, it was also found that I had a nodule on my thyroid. It was biopsied while I was in the hospital and was benign. A subsequent ultrasound was done on it but my regular doctor said it had grown slightly. I did another test where I swallowed the iodine and they measure the radioactivity and found the nodule was “cold” which means there is still a chance it could be cancer, but all indications are that is not. I have had another follow-up ultrasound but have not yet heard the results. If it has continued to grow, we will decide what to do from there. Thyroid cancer is usually very slow growing and so to wait is not all that serious. The last time I saw the doctor for it, he said all indications were that it was not cancer, but we still aren’t sure.
Other than that, my stay in the hospital was pretty calm. I hated being in bed because I have back problems so I had back pain from having to stay in bed so much. I tried to walk several times a day, but with the chest tubes and the heart monitor I had to haul around, that was no fun and I was pretty weak so it wore me out quickly. You know that you are getting better when you start bugging the doctor to let you go home. They wouldn’t let me go until I had the chest tubes removed for 24 hours so, of course, then the milestone became when I could get the tubes out.
The tubes came out on January 12 and I was released from the hospital on January 13, 2014. I had to take two 100 mg of metoprolol tartarate (AM and PM), 325 Ecotrin aspirin, 25 mg of losartan, and 20 mg of simvastatin daily. My one year anniversary is coming in a few days and I have gotten back most of my strength. Walks are now pleasurable again and not a chore. My medicine has been reduced to two 50 mg of metoprolol tartarate (AM and PM), two low dose (81mg) of aspirin, the losartan increased to 50 mg, and 20 mg of simvastatin daily. My cardiologist tried to reduce my metoprolol to 25 mg twice a day but my bp got out of whack immediately so he bumped it back to two 50 mg pills again and increased my losartan.
I did have one bump in the road. January 28, 2014, I woke with pain in my left leg and then I got some numbness in my foot. Jorge drove me to the emergency room at the hospital this time because I told him I didn’t want to have another ambulance ride and, just in case I had to stay in the hospital, I would already be there. The numbness was later determined by the neurologist not to be related but was likely due to a pinched nerve. However, the doctors found that my pulse in the left leg was not very strong and not the same as my right leg so I was admitted to the hospital for a couple of days for observation. Unfortunately, the hospital had no rooms available so I spent most of the first day in the emergency room area. Eventually that evening I was moved to a transitional room where I stayed for a couple of days before being sent home again. No real cause was determined except that it may have been a small blood clot that the body was trying to absorb. Since the pulse was back to normal a couple of weeks later when I had a follow-up with Dr. Mohamed (my surgeon), it was no longer an issue.
One problem that has gotten better but not resolved is my migraine auras. Before having to go on all these medicines, I only took a probiotic daily and no other medicines and my migraine auras were about one every three months or so. When I got out of the hospital, they were daily and sometimes more than once daily. They decreased after the blood pressure was reduced to about 4 times a week. Now they are sporadic. Sometimes I don’t have one for 10 days or more but then they come back and I might have 2-3 in a week. My cardiologist thinks I need to see a neurologist, but I wanted to see if the migraines decreased after the reduced dosage of metoprolol, even though I read that it is sometimes used to prevent migraines. The good thing is I don’t actually get the headache except on rare occasions but the auras interrupt my work and my life.
I have been told by a number of doctors and nurses how fortunate I was to have survived this and that because I was in good physical shape that certainly helped me to survive it. I am about 5’9 1/2” tall with a BM in the normal range. I eat and live a pretty healthy lifestyle (lots of fruits and vegetables, low fat dairy, whole grains, not much red meat, etc.). Because Dr. Mohamed’s report revealed that the aneurysm had actually burst by the time my chest was cracked, I really dodged a bullet.
Now that nearly a year has passed, I am feeling more normal but I still wouldn’t say that I am 100%. I am not able to be as active as I was before this all happened because I tire more easily.