An aorta tear requires immediate surgery and survival odds are good, yet delayed diagnosis often proves too late, said Dr. Edward Savage, cardiothoracic surgeon and director of the Heart & Vascular Center at Cleveland Clinic Florida near Fort Lauderdale, Florida.
“Most people assume it is a heart attack so sometimes the diagnosis is delayed,” he said. “So you have to have a high suspicion.”
Patients believe they are suffering a heart attack with pain in their chest, he said. But what’s distinctive with a tear is that as blood leaks into the space between the layers of the ascending aorta, the pain will often move upward and can work its way along the spine, Savage said.
Year: 2016 Page 1 of 4
Name: James Brown
Age at time of Dissection: 62
Type of Dissection: Ascending
Date of Aortic Dissection: 7 September 2016
Tell Us Your Story:
My aortic dissection came without warning, my wife and I had just returned home from the store and we stop by the mailbox, I got out of the truck checked the mail and all a sudden I felt a tremendous pressure in my chest. At this point we returned to the house where I tried to lay down on the bed, but the pain wa to intense, so I laid down on the floor and asked my wife to call 911 within fifteen or twenty minutes I was being transported to the hospital. After entering the hospital I have little memory of what happened.
I remember my sister in law was there and I asked her to take care of my wife, I was sure that I was going to die. My condition was treated as heart attack, but luckily for me they was not sure and sent me to another hospital. The admitting doctor on duty was a cardiologist he did not believe I was having hear attack.
He put a probe through my arm and found that my aorta had torn. He immediately had me prepped for surgery. The surgeon told me that my chance were not good but without surgery I would die, I agreed to surgery and I do not remember anything after that until I woke up in I.C.U four days later.
I had the best care and was in I.C.U for seventy days. My surgeon called me his miracle. I am here today to celebrate Christmas with my family because the cardiologist new I was not having heart attack and his quick actions and the skill of the surgeon and the good Lord above is why I survived when many others have not. The recovery process has been difficult for me, but I have a great support group to help me.
Alan Thicke’s official cause of death has been revealed.
The Canadian actor died of a “ruptured aorta” and a “standard type A aortic dissection,” according to his official death certificate, which ET obtained on Wednesday. The death certificate lists the time interval between the onset of the ruptured aorta and his death as minutes, while the time between the onset of the aortic dissection and his death is listed as three hours.
A median sternotomy was performed on Thicke on Dec. 13 — a surgical procedure in which a vertical incision is made along the sternum, providing access to the heart and lungs — though Thicke did not survive. His time of death is listed as 2:14 p.m. on the same day.
WATCH: Paula Patton Pens Emotional Tribute to Former Father-in-Law Alan Thicke
A type A aortic dissection is a tear beginning in the ascending aorta which progresses throughout the vessel. Symptoms include a sudden onset of severe chest or back pain, and may include vomiting, sweating and lightheadedness.
Thicke was initially vomiting and not feeling well prior to his death — when he was playing hockey with his 19-year-old son, Carter, at the Pickwick Gardens ice skating rink in Burbank, California — Pickwick Gardens vice president Darin Mathewson told ET last Thursday. Still, Mathewson — who placed the 911 call when Thicke collapsed at the rink — said the Growing Pains star was “coherent” when emergency personnel arrived, and was moving around and speaking to his son.
“He said he had pain in his chest, but his color was not good,” Mathewson said. “He was a little gray. When the ambulance got here they checked his vitals … and they put him on the gurney, sat him up.”
“When he went by us, he gave us the thumbs up, like, ‘I’m doing good guys, I’m good,'” he added.
Thicke was 69 years old.
Name: lloyd erickson
Age at time of Dissection: 55
Type of Dissection: Both Ascending and Descending
Date of Aortic Dissection: 9 July 1997
Tell Us Your Story: Celebrated my 20th survival year ////// My heart doctor thinks that is a world record. That length of time is exceptional considering I suffered a “total” dissection. I am known as the “miracle man” at the hospital.
I have two aneurysms that have been at a critical stage for the last ten years but have not failed. I have gotten very familiar with living day to day. Life is great, enjoy every moment.
Name: Robert Bidrowski
Age at time of Dissection: 60
Type of Dissection: Ascending
Date of Aortic Dissection: 29 April 2016
Tell Us Your Story:
I had just gotten off a flight from St. Louis to Omaha, NE at 11:30 pm. I lit up a cigarette as soon as I got outside the terminal. This became my last cigarette. As I was walking to my car I had what I can only describe as an explosion in my back and then a buzzing in my head and feet. I stopped and thought “what the heck was that. It probably wasn’t good.” I threw the cigarette down, decided I was OK and continued to my car. I had a 50 mile drive to my home and decided I would be OK once I got on the road.
So I started driving on the Interstate. I started feeling really weak, had some vision problems and felt numbness in my arm. I got off the Interstate at basically the point of no return. Something told me that if I continued I was going to die.
At this point I should have called 911, probably should have called 911 at the airport. But I decided to drive myself to the hospital. I arrived at the hospital, now not feeling well at all. Parked, walked in through the security door and said I think I’m having a heart attack. I was immediately attended to by the great ER staff and soon I was having a CT scan. Apparently I had some really different blood pressures (really low on one arm and normal on the other arm.)
The ER doctor talked to me after the CT scan and showed me what was happening. An ascending aortic dissection. He said I needed surgery now and the surgeon was on her way. I remember telling the ER doctor that I had a bowling tournament that weekend in Missouri and I remember him telling me “Yeah, your probably not going to make that.”
I remember meeting the surgeon, Dr. HelenMari Merritt. The next thing I remember was waking up with a breathing tube, lots of tubes and all kinds of medical apparatus. My girlfriend was there, my sons were there. Apparently, I had been in surgery for about 8 hours. I got a dacron graft and a valve repair. I was in the hospital for about 2 weeks, came home and started the recovery. When I got out of the hospital I thought I’ll be back to work in two weeks. It actually took 4 months.
I owe so much to Dr. Merritt and the staff at Nebraska Medicine. I owe so much to my girlfriend, Kathy, and my two sons, Erik and Mark and other family as well as friends. I also need to thank my cardiac therapy specialists at Bryan Lifepointe in Lincoln, NE.
So now I’m working on the blood pressure but it is proving difficult to control. I’ve got another followup in February with a CT scan, appointment with Dr. Merritt and another appointment with a vascular specialist. What I’ve been told is that I have a dissection in the descending aorta that may need some treatment or not.
I’ve made some lifestyle changes. No smoking and trying to eat better. I’m trying to keep my stress down but work is again making that difficult. I continued my cardiac therapy by joining the health club. I’ve added some strength exercises as well. Anyway, that’s my story up till now. I’ve been told I was lucky, fortunate, it was touch and go, etc. So I will try to do what the doctors tell me is best and hopefully be here for many more years.
Name: Scott Terry
Age at time of Dissection: 42
Type of Dissection: Ascending
Date of Aortic Dissection: 20 January 2016
Tell Us Your Story:
It started off as a normal Wednesday morning. I had just arrived at work and was on my way back to my desk from getting a coffee when I felt an unusual pain in my chest, unlike anything I had ever felt before. I initially thought it could be indigestion which I tried to clear with water. After that didn’t work I told a colleague that I needed an ambulance.
Thankfully I worked five minutes away from the nearest hospital – Queens Medical Centre in Nottingham, UK. In emergency I had the usual ECG and blood tests for a heart attack. While the blood tests ruled out a heart attack the ECG showed a slight abnormality. I also had significantly different blood pressure readings in both arms. I ended up staying in hospital for a couple of days while doctors determined what the problem was. During that time I was allowed to walk around, have showers etc.
On the Friday morning my dissection was discovered after a CT angiogram. After that I was on complete bed rest. I was transferred by ambulance to the Trent Cardiac Centre at City Hospital in Nottingham as they deal with the Type A dissections. To cut a long story short I had aortic root surgery on the following Wednesday, 1 week after my dissection. I now also have a St Jude mechanical aortic valve and will be on warfarin for the rest of my life, along with my other heart meds.
After being discharged from hospital one week after my operation, I was readmitted after a couple of days due to a severe infection in my arm where the cannula was inserted. Following that I was readmitted a further two times – once I collapsed while having blood taken for my INR (it turns out I had flu). This meant another week in hospital. The second time my INR was dangerously low, which was another week in hospital.
It is now almost one year on and life is pretty much back to normal – a new normal. My lovely wife, wonderful 10 year old twin boys and I have now relocated back to Australia, the Sunshine Coast, and I am in the middle of having my first annual check-up.
The amazing thing about my story is that we had moved to the UK (from Melbourne, Australia) 18 months earlier to spend time with my family. We were actually planning to relocate back to Australia on the day of my dissection but had changed our minds about two months earlier, deciding to extend our stay.
Name: Paul Coomer
Age at time of Dissection: 53
Type of Dissection: Ascending
Date of Aortic Dissection: 13 October 2013
Tell Us Your Story:
Ihad a rear end accident which an hour after I realised I thought was a heart attack but was in fact an aortic -dissection type A ,I drove myself to the hospital on the Gold Coast in excruciating pain ,this was diagnosed thankfully very quickly and I was operated on within 5 hours by Dr Gilbert Ford a life saver I was in intensive care for 2 days then in Hospital for just over 2 weeks ,and 3 months off work ,then a further 3 months part time a long recovery ,I am now living a normal life with check ups once a year ,but I survived something that I have been told on many occasions is very lucky
Name: Gayle Cook
Age at time of Dissection: 56
Type of Dissection: Ascending
Date of Aortic Dissection: 9 February 2015
Tell Us Your Story:
My name is Gayle Cook and I LIVE in Albert Lea MN. On 2/9/2015, as I was getting ready for work, I began having severe chest pain. I work at the local hospital in ER Registration so finished getting ready for work and drove myself there, however, instead of clocking in for work, I was admitted to the ER. Six hours later after a CT scan revealed I had an aortic dissection, I was flown to Rochester MN.
I think I was aware of the severity of my situation, however, I was consumed with thoughts of my granddaughter, Kinley, who was flying to Chicago to have a REX shunt placed to bypass the obstruction (clot) in her portal vein. Her half brother, Carter, passed away from the same condition nine years ago when he was two. He underwent a liver transplant and, unfortunately, his heart failed two days after surgery. I am happy to say that Kinley survived her surgery and is doing quite well.
Unfortunately, as a result of the portal hypertension, she developed pulmonary hypertension that we are treating with meds. As for me, I was kept in the SCU over night in preparation for open heart surgery in the morning. Upon surgery, it was noted that I had an intramural hematoma which progressed to a type A dissection into the root with dissection into the left main coronary artery.
Well, you know the outcome of my surgery; I survived, but am still trying to wrap my head around what happened to me and the way I am now and it’s been ten months?! I have so much to say and ask but want to keep this short. Just wanted to introduce myself and reach out to someone who can relate to what I’ve been through. Thank YOU!
Format: AbstractSend to
Eur J Cardiothorac Surg. 2016 Mar;49(3):756-62. doi: 10.1093/ejcts/ezv197. Epub 2015 May 29.
Aortic wall thickness in patients with ascending aortic aneurysm versus acute aortic dissection.
Van Puyvelde J1, Verbeken E2, Verbrugghe P1, Herijgers P1, Meuris B3.
Recent studies have shown that aortic diameter alone is an insufficient parameter to identify patients at risk for aortic dissection. The aim of this study was to determine the value of the ratio of aortic diameter to medial wall thickness as a new marker of risk.
We obtained data from 181 patients with an ascending aortic aneurysm (n = 94) or an acute type A aortic dissection (n = 87), surgically treated at our institution (1996-2012). Measurements of the maximum aortic diameter and the medial wall thickness were conducted by retrospective review of preoperative imaging studies and histological specimens, respectively.
Nearly 60% of the dissection patients had aortic diameters smaller than 50 mm. There was a significant negative linear correlation between medial wall thickness and aortic diameter (P = 0.01) in the dissection group only. Among patients with aortic diameters above 50 mm, dissection patients had significantly thinner aortic media (P = 0.04). Among patients with a mildly dilated aorta (>45 mm), the aortic diameter to medial wall thickness ratio was significantly higher in the dissection group (P = 0.04).
Among patients with a dilatation of the ascending aorta of more than 45 and 49 mm, patients experiencing aortic dissection have a significantly higher aortic diameter to wall thickness ratio and a thinner aortic media, respectively. In the subset of patients with mild aortic dilatation, wall thickness might in the future serve as an additional parameter to help identify those patients who would benefit from prophylactic aortic surgery.
© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Aorta; Aortic aneurysm; Aortic dissection; Wall thickness
Too thin a beam of light in thick fog. [Eur J Cardiothorac Surg. 2016]
Name: Romney Mawhorter
Age at time of Dissection: 48
Type of Dissection: Both Ascending and Descending
Date of Aortic Dissection: 7 November 2014
Tell Us Your Story: I was a 48 year old white man who had an aortic dissection deBakey I or Stanford type A who was very physically fit; a college track star and since then an avid gym rat going 6 days a week to lift weights and play basketball up to the day of my surgery. I have a wife of 23 (then 21) years and 3 sons who then were 18, 15 and 11.
Iam from Los Angeles. My wife and I were on a romantic weekend on Catalina Island. We had just taken a 2 hour boat ride from Long Beach and got off the boat and went directly to our hotel to check in. They said the room was not ready so we sat in the outdoor lounge overlooking the beach to have lunch.
After only a few minutes I felt a terrible crushing pain in my chest. It was so bad that immediately I told my wife, “I think I’m having a heart attack!” and proceeded to lay down. My wife described my “laying down” as passing out but I never lost consciousness.
I was helped by the couple at the next table who held my head up to help me breathe, stopped others from pounding on my chest, giving me water, or giving me an aspirin. They calmly told others to call 911 and waited with me until the paramedics arrived.
I was in the paramedics’ care for about 20 minutes with my wife waiting anxiously outside. They were testing me for a heart attack but could find no enzymes or other signals that it was a heart attack. I was unresponsive to glycerine.
At the small local island hospital, the doctor there was calling everyone she knew to help her diagnose what this incredible pain was coming from my chest. Finally she called my surgeon’s “aortic dissection hotline” which instructed her to perform a CT scan. When it was done, immediately the doctor could see I had “two” aortas running the length of where I should have one aorta.
This was a severe dissection from the aortic root to the legs including the left coronary artery and both carotid arteries all the way to the brain. A helicopter was scheduled to fly me to Keck USC Hospital.
On the roof being taken off the helicopter I could see the doctors running to receive me, and for a moment I juxtaposed my memory of the movie “A Few Good Men” when they astronauts came out of the elevator.
While on the gurney in the ICU the doctor was explaining to me all the risks of the surgery, as I still was a little confused as to what was wrong with me. I had survived now with this level 12 pain on a scale of 1-10 for the past 5 hours maybe this would just “go away.” So I interrupted the doctor and said, “can I live without the surgery?” He promptly replied, “no, this is a fatal event.” So I replied quickly, “then stop telling me about the risks and start the surgery!”
After 8 hours my wife was relieved to see the surgeon come out of the elevator and sit down next to her and said to her, “he’s going to be alright.” I remained in ICU for 3 days and released from the hospital in 7. He said my aortic dissection was the worst he had seen on a surviving patient. Immediately after opening my chest, my ascending aorta disintegrated as if it were wet tissue paper. After several minutes trying to determine some real tissue where to attach the prosthetic mesh, the assisting doctors and attendants said it was no use that I was beyond repair. But my surgeon persevered. He did have to forgo removing my aortic root and replacing my aortic valve with a mechanical valve (which I had elected) to save the time in surgery to “fix what was broken and save your life.” So I continue to be on the “probable” list of needing that surgery in the near future
Since then my health has been good, with the only ongoing complications are from my left carotid artery which has the most severe tear all the way to my brain, which slows my blood and causes some ocular muscle problems and once a stroke symptom (but no evidence of stroke found in any CT or MRI scans).
From this ordeal I learned that I must care what I eat. I must eat a low sodium, low red meat, high fiber diet and drink at least 4 8 oz. glasses of water, or better 8 glasses. The thinner my blood the better. While I do take a BP medicine, I only take it when my morning BP reading is above 120. My “normal” BP is 110. My dissection was not caused by hypertension. Doctor says it was congenital.
Name: Christopher Reed
Age at time of Dissection: 57
Type of Dissection: Both Ascending and Descending
Date of Aortic Dissection: 17 January 2015
Tell Us Your Story:
I am presently 58 years old and my dissection occurred while I was building a fence while working on my cabin at Eagle Lake, CA. I was setting the posts when it felt like someone drove a Bowie knife through my chest. It dropped me to one knee. I was lucky my wife was there talking with me when it happened. She asked what was wrong and I said I thought I had some bad indigestion. She knowing me, said I don’t think and called 911. We have a volunteer Fire Dept. near my cabin.
While she was calling I went down to my butt and then laid down on the ground. I finally picked myself up and walked over to the deck to change my shoes as they were muddy. I got in my truck and my wife drove me to the Fire Dept where the volunteers were headed. When we got there my right arm had lost all feeling and I couldn’t move it. The volunteers took my blood pressure and told me that life flight had been called and we needed to get to our small little airport. When we arrived at the airport, the trauma nurse took control. She check my blood pressure and told the pilot they had to leave now.
The gurney I was on would not lift me high enough to get in the helicopter so the nurse asked me to get in. The platform in the helicopter was about 4ft long and I am 6’6″. so after scrunching I was able to make it work. I looked out at my wife and told her that I loved her and to tell my kids I loved them. Then the nurse told the pilot to get in the air and hurry to Renown Hospital in Reno, NV. The last thing I remember before I past out was flying over the lake and wondering if it was the last thing I would see. I was told later that I died when I past out and the nurse revived me and was able to get me to the hospital. The next thing I remember, I woke up and I was on a gurney and being ran down the hallway to surgery.
I looked at one of the nurses and asked where I was and what we were doing. She explained that I was on my way to surgery and it was serious. I told her I needed to talk with my wife who was driving from Eagle Lake to Reno. The nurse pulled out her phone and asked what the number was, dialed it and handed me the phone. When the phone was answered, my Mother in law was on the other end and said my wife was asking directions from the service station attendant. When my wife got in the truck I told her I was headed to surgery and it didn’t look good, she told me she was 5 minutes away and would be there soon. When she got to the hospital the Dr. was there to talk with her before he went to surgery and explained that I had died in the helicopter on the way and again in the emergency room and was revived both times and was now going into surgery. He told her that I had both an ascending and descending Aortic dissection and that my artery to my right arm, the artery to my right kidney, the artery to my left leg and my carotid artery had also dissected.
He told her it would be a miracle if I pulled through and if I did I would be out for 7 to 8 days and be in the hospital for 30 to 45 days. After 10 1/2 hours of surgery and an ascending graph I woke up a day and a half later and my wife said I reached up and pulled all the tubes out of my throat. The nurse that was in my room called Code Blue and the Drs. came running. The respiratory Dr. told the nurse that I must not like the tubes and for her to put me on a mask. I don’t remember any of this, my wife said I past out as soon as the tubes were pulled out. I woke up in the morning and my wife was in my room. When she saw I was awake she started checking my feet and hands to make sure I could move and then she started asking these stupid questions. I looked at her and said what are you doing, and she said they thought I would have brain damage or possible paralysis. I told her I was fine and could move with no problem and I understood everything she was saying.
She called the nurse and she got a hold of the Doctors. By this time my family was all there and I realized that I had just dodged the Grim Reaper. If it wasn’t for the love of my family and all the prayers I don’t believe I would have made it. The next day I ask the nurse if I could get up and sit in a chair while they changed my bed, and the day after I asked to take a walk, I made it about half way around the ICU Unit, the day after that I completed a whole lap, I then moved up to two laps and at the end of 2 week in ICU I was discharged and got to go home with a pile of pills, 34 a day. The doctor couldn’t believe how fast I was able to go home. I believe it was God that kept me here for a reason that I have not figured out yet.
I will keep thanking him and hope to live a productive second life. I went back to work 1 year to the date of my dissection and have been back to work for 11 months now. I am so happy to be productive again. Being off work for a year was hard, and after gaining 40 pounds I realize my life has to change. I am on a diet and working to get control of my life. Good luck to all that go through this life altering issue and thank you for listening to my story.
The benevolence that Dallas W. Hartman has shown through his success has returned to him tenfold since he defied death four years ago.
Today, as the mega-attorney sits down to Thanksgiving dinner with his wife, Kristina, and their four adult children —Logan, Dallas, Nancy and McKenzie — in their lavish Wilmington Township home, they all are thankful for the many acts of kindness — even the smallest — that people bestowed on them while Dallas fought a series of battles that nearly claimed his life.
To Kristina, even a driver moving out of the way on the highway as she sped with Dallas to Jameson’s emergency room for a second time plucked at her heartstrings. Then there were kind doctors and nurses, Dallas’ caring office crew, friends who took food and gift cards, and the way their children all looked out for one another and their parents while they were at the hospital on two different occasions as he hovered between life and death.
His cardiologist, Dr. Elizabeth Piccione, says that anyone else who endured what Dallas did most likely would be dead — and for someone to totally change his lifestyle and come out healthier than he was before is almost unbelievable.
Both Dallas and Kristina have said at different times that a power stronger than modern medicine was at play here.
AN UNHEALTHY LIFESTYLE
Dallas, 59, remembers five years ago being a driven workaholic at his law firm. Time at home was shorter, hours in the office were becoming longer each day.
A noted personal injury lawyer, business had become Hartman’s main objective and success, a prime vocabulary word.
“It was the high point of my career,” Dallas said. In addition to his flagship office in Neshannock Township, he was overseeing offices in New Castle, Hermitage, Butler and Erie and sharing office space in Ohio and in Pittsburgh. To quote his wife, “everything he was touching was turning to gold.”
But this pace had begun to concern her. She urged him to slow down, but he kept on plugging.
“I had met every personal goal and was exceeding them by five to ten times,” he said. “I was knocking it out of the park. I couldn’t work enough, I couldn’t litigate enough, I couldn’t spend enough hours at work. It was so satisfying I couldn’t quench that thirst for achievement.”
But there was one important goal he had set that he almost didn’t make — to live to see his youngest child turn 18.
His life was out of balance, he realizes now, and it taught him that he is not invincible.
With that fast pace of accumulating clients and business came chronic high blood pressure — so high that his hypertension nearly cost him his life.
Reality changed for Dallas on June 5, 2012, three days after his 55th birthday and a week after his son’s 18th birthday. A car buff, he had gone to Sewickley in Allegheny County to look at cars when he suddenly was stricken with searing chest pain that extended into his back. He qualifies the rest of his story as accounts he has learned from others, because from then on, he has no first-hand recollection of what happened to him.
He knows he called his doctor, R. Elbert Acosta, who directed him immediately to UPMC Jameson’s emergency room. He drove himself there from Sewickley. A fast-thinking emergency room doctor visiting from Florida ordered an immediate CAT scan, and a technician reading the results recognized something potentially deadly. Within minutes, Dallas was in a helicopter to UPMC Shadyside in Pittsburgh.
He was diagnosed with aortic dissection.
According to mayoclinic.org, an aortic dissection is a serious, relatively uncommon condition in which the inner layer of the aorta — the large blood vessel branching off the heart — tears. Blood surges through the tear, separating the inner and middle layers of the aorta. If the resulting blood-filled channel ruptures through the outside aortic wall, aortic dissection is often fatal.
Piccione explained that basically in an aortic dissection, the layers are supposed to be like three layers of Saran Wrap and are supposed to be stuck together. In some people with high blood pressure, the force of the blood tears the lining of the aorta, causing blood to go behind it, which can crush the vessel. She likened it to the same effect as water getting in between layers of plastic wrap. The pressure then causes the middle of the pipe to close off, and that can shut off blood supply to the vital organs, she said.
Dallas learned his condition was the direct result of extremely high blood pressure. His aorta had ripped from a second of three layers. He learned that his blood pressure was so high that when the aorta dissected, his aortic valve became unseated and the descending aorta ripped all the way down through to his legs.
Kristina, 62, credits UPMC Jameson for recognizing that it could not effectively treat him and for sending him immediately to a facility that could.
While Dallas was in flight, Kristina contacted the children and they headed for Pittsburgh. When she arrived at Shadyside, the nurse told her she had better go and spend time with Dallas, she said. “I had five or 10 minutes with him and we basically said our good-byes.”
Dr. Thomas Gleason, a cardio-thoracic surgeon and head of the aortic valve center at UPMC Shadyside and Presbyterian hospitals, had just finishedan hours-long heart surgery on another patient when Dallas arrived. Gleason scrubbed up again for an 11-hour procedure that saved Dallas’ life, keeping him on a heart and lung machine for the duration.
“For those 11 hours he concentrated all of his attention on me,” Dallas said.
Kristina recalled that when Gleason finally finished in the operating room, “he came out and was quaking.”
Meanwhile, she encountered two key hospital employees from New Wilmington who gave her a sense of familiarity and reassurance. One was a surgical physician’s assistant. Another was Patti Kaufman, a neighbor of the Hartmans in Wilmington Township, who is a registered nurse. Kaufman was in the operating room and was texting Kristina throughout the operation to comfort her.
“They were so, so kind,” she said.
The surgeon reseated the aortic valve and implanted a synthetic arch for the ascending aorta, Dallas explained, adding that the descending aorta could not be repaired.
Piccione said of Dallas, “He did fabulously. He was relatively young. The tear had gone all the way around and down but it didn’t affect the arteries. He really was remarkable in his recovery.”
THE ROAD HOME, THEN BACK AGAIN
Dallas was discharged within a week after his surgery, and his ambulatory recovery was rapid.
But less than three weeks later, he was back in Shadyside on June 21, having suffered a mini stroke. On June 30, he was flown to Presbyterian after a major stroke.
Kristina recalled being at home and Dallas sitting outside on the porch when he sneezed and lost the feeling in the whole left side of his body.
Not wanting to wait for an ambulance, Kristina rushed Dallas in their car to Jameson’s emergency room. The hospital has a mobile stroke clinic where the doctors conferred from Pittsburgh. Then he was in the air en route to Presbyterian Hospital, where again, Dr. Gleason ran to his rescue.
Another CAT scan showed he had no blood supply to the right side of his brain, according to Piccione.
“He basically was having a massive stroke,” Kristina said. “The pressure had caused that artery to worsen beyond the surgery site and it compromised the blood flow to the head and brain.”
The neurologists were saying there is nothing they could do, she added. Then Gleason took Dallas into the operating room at 9 p.m. and bypassed the vessels to his brain into the carotid artery in the neck and the subclavian artery where the tear was, restoring the blood to his brain.
“I’ve never had any other patients who had that surgery done,” Piccione said.
Dallas’ left side was compromised, and in rehab when he would pick up a row of cones, for example, he’d leave the ones to the left of him. At first, he had to relearn to swallow, then to tell time, and to regain many abilities that most people take for granted. He pushed himself to get better at rehab in UPMC Mercy Hospital, then when he went home he continued at Jameson Rehabilitation Center.
He has since overcome about 98 percent of that limitation but still has residual neglect with his visual acuity and brain processing speed.
He has learned that the odds of overcoming both afflictions are less than 1 percent.
“God has gifted me with that 1 percent,” he said.
It took Dallas about a year to return to work. He has resumed the role of owner and mentor of the law firm, delegating some management responsibilities to attorney Douglas J. Olcott. The firm includes nine lawyers who are among 20 to 35 employees.
Piccione said her job has been to help Dallas get his blood pressure under control.
“We started to develop a plan, looking at how we can change the reasons why this happened.”
Dallas’ survival gave him a new goal, she said. “He looked at it as a challenge and realized he needs to be here for his wife and his children.”
“This has been a journey for him to find his way to wellness,” Piccione said. “He looks younger than he ever did. He has a much better balance in his life due to significant lifestyle changes. This made him realize that a lot of the things we take for granted — getting enough sleep, eating right and exercising — matter at lot.”
Hartman adopted an expert trainer who taught him how to breathe, why he should eat what he eats. The trainer changed his exercise routine so he could maximize shorter exercise times to resolve joint pains.
“His blood pressure now is better than it ever has been, and we’ve been able to decrease the number of medications he takes,” Piccione said.
“Through exercise and good living, I’m down to two blood pressure pills a day,” Dallas said. He still goes to his offices and works, but he has cut back his hours.
“He just works like a normal person now,” Piccione said. “The dissection actually saved his life. Had it not happened, he would have continued down the same road and he would have died.
“Now the person who comes to see me is healthy and vibrant and enjoying his life. As much as the dissection almost took his life, it saved him,” she said.
Dallas still works five days a week on building his muscles, energy and strength.
Dallas believes that he has been blessed with many gifts in his life, and his mantra has always been to give back.
Long before his illness he made contributions to the community that he feels has given him so much, he said, “and I’m still not done. When you come this close to being nonexistent, you re-evaluate everything. I try to use my economic resources in my office to perpetuate good.”
He has given more than $1 million to local agencies, fundraisers and people in need. Each year his firm spends $25,000 to $30,000 in gifts to schools, “because education is important to me,” he said.
The first contribution he made after his illness was to gift $150,000 to Penn State Shenango in Sharon, one of his alma maters, to provide the facilities for a physical and occupational therapy program.
Kristina says she is thankful this Thanksgiving Day.
“I’m thankful for people whom I’ve never met, who shared their gifts and their time to take care of us. I’m thankful that I didn’t lose my faith and the peace that I have,” she said. “I was never a big believer in miracles, but our friends in the community who were praying for us reaffirmed our faith.”
Most of all, she is thankful to have her husband of 28 years still by her side at their 100-acre farm that is completed by four dogs and six Texas Longhorn cattle that they raise as pets.
Piccione credits Kristina for being a dedicated wife and nurse to Dallas and monitoring and adjusting his blood pressure medicine.
“Everyone who gets better from a catastrophic illness has had somebody there to support them,” Piccione said. “He’s so incredibly thankful for his wife and his children and his friends. They are so important to him and it really brought him through this. Kristina has been there for him every day, and always was a source of light for him.”
“We are a team,” Kristina declared, seated with her hands folded on their long, marble-topped kitchen table with Dallas sitting beside her. “We’re a team about everything we do.”
“I’m thankful to God for the spirit he has given me and for my family and for a wonderful wife,” Dallas said. “My spirits are great. My love and appreciation of life are better than they’ve ever been. I am truly grateful that this has happened to me. I can taste and feel all of the colors of life.”
Name: William Koch
Age at time of Dissection: 45
Type of Dissection: Ascending
Date of Aortic Dissection: 6 November 2016
Tell Us Your Story: As told by wife Cricket:
It was a normal Sunday. Watched football and then chores. We are in the process of remodeling our bedroom and Bill needed to get nails from our son’s house who lives about a mile away. He told me he would be right back. I continued the “demo” and my cell phone rang. At first it sounded like Bill was having a stroke as he said, “I….I….I….pulled over.” I immediately knew something was wrong. He told me where he was at and I grabbed my keys calling 911 at the same time heading out the door.
(Later I was told that I was actually Bill’s 2nd call. His first was to 911 who didn’t answer)
I reached Bill right as the ambulance arrived. He was rushed by ambulance to ER about 2pm of a suspected heart attack. Preliminary EKG was normal but still had chest pain and trouble breathing. Dr.’s kept asking what he ate for lunch and dinner the night before eluding to heartburn. They said they would keep him overnight for observation. I sent the kids home (boy 19, girl 15). As morphine wore off, pain increased and I insisted on a CT scan.
CT scan ordered. CT scan showed Thoracic Aortic Aneurysm causing an aortic dissection (rip). Cardiothoracic surgeon and team were immediately called. Surgeon explained seriousness of diagnosis and gave him a 35-40% chance of survival. Dr said mortality rate very high. Thank God his aorta (just) ripped because if it had ruptured he wouldn’t be here with us.
I called the kids to come back at 11:30pm to see their dad before surgery.
Bill went in to surgery shortly after midnight. Surgery done at about 5am. Dr said an anuerysm had been on his ascending aorta at least a couple years but it wasn’t found until it started to rip. They removed and replaced 7cm of his aorta.
Bill has 0 risk factors: non-smoker, low blood pressure, low cholesterol, 45 years old, athletic, not overweight, etc. Dr.’s attribute all of that to his survival but surgeon 100% sure genetic and insisted on having the children scanned and tested on a regular basis.
Bill has been home from the hospital a little over a week now. (He went to ER on Sunday and came home Friday) He is healing but gets short of breath just putting his socks on. Right now, we are just taking it one day at a time.
The Rev. Tim Anderman likes to drop by a Mount Joy coffeehouse called Higher Grounds when he completes his morning devotionals.
On the morning of Aug. 13, 2014, higher ground almost became his eternal destination.
Upon returning home from the coffeehouse that morning, Anderman felt uneasy.
“I laid down, but it wasn’t going away,” he said.
Anderman said he rarely worried about his own health. But on that day, he told his wife, Julie, that he thought he should go to Lancaster General Hospital.
His self-diagnosis saved his life.
“They took one look at me and they knew something was wrong.”
That something was an aortic dissection — a tear in the lining of the aorta that allows blood to flow between the walls of the aorta. If not treated in time, it can lead to death. Actors Lucille Ball and John Ritter are among those who have died of aortic dissection.
Anderman, who returned full time to the pulpit at Glossbrenner United Methodist Church in Mount Joy in July, survived. But his trip to LGH was just the beginning of a harrowing experience.
While his situation demanded immediate attention, all of the hospital’s surgeons were in surgery at that time. He was offered the option to be life-flighted to either Hershey Medical Center or the Hospital of the University of Pennsylvania.
A Philadelphia-area native, Anderman chose Penn. There he came in contact with Dr. Nimesh Desai, a cardiovascular surgeon whose clinical focus is on advanced aortic surgery.
Anderman underwent 8 1/2 hours of surgery. The surgeons repaired the tear — which he described as “like having a winter coat tear away from its lining.”
Desai inserted a dacron polyester stent to stabilize his aorta.
On Feb. 13, 2015 — six months to the day of his illness — Anderman returned to Philadelphia, where Desai implanted an experimental side-branch stent made of a woven plastic.
“We feel incredibly blessed that the emergency room doctor (in Lancaster) got him the care he needed immediately,” Julie Anderman said, “and that Dr. Desai, who was one of a handful of surgeons nationally who could do this procedure, was available at that moment in time.”
It was, she said, one of a number of times she felt God’s presence on this journey.
“When we really needed support and a sense of God’s presence, it was there,” she said.
That included her stay at the hotel. The room service attendant, she explained, was a tenor. Every morning, he would bring her a list of hymn titles. She would pick one and he would sing to her.
“In many ways,” she said, “it was faith-changing for me.”
Anderman comes from a family of pastors — he counts 11 in his immediate family. His grandfather was the Rev. William Anderman, and his father, Carl, served as pastor at Columbia United Methodist Church — formerly Salome United Methodist Church — from 1971 to 1980.
A 1976 graduate of Columbia High School, Anderman said he was not certain what he wanted to do when he graduated. He took classes at Millersville University and began working.
“I worked 20 years in industry before I went into ministry,” he said, “working at New Holland at a hardware store and for 15 years at what is now the New Holland Fleur-de-lait processing plant.”
While in college, his father became ill and underwent a kidney transplant.
That impacted his education — he did not earn his undergraduate degree until 1995.
Although he felt he was being pulled toward the ministry, he wanted to make sure the call was real.
The sense of call
During that time, he attended First United Methodist Church in Lancaster.
“One of the things that kind of refined my sense of call was that First United Methodist started Stephen Ministry, where they teach lay people to do pastoral care,” he said. “That was very helpful for me. It empowered me more as a superviser and I learned to listen and understand and have compassion.
“It affirmed that sense of call for me. That one hour of Stephen Ministry meant more to me than 60 or 70 hours in industry some weeks.”
He then enrolled at Lancaster Theological Seminary, eventually becoming the pastor at Glossbrenner Church.
Health coverage advocate
Anderman said he is grateful for the level of care he received and for the health care coverage provided by the United Methodist Church.
His experience has encouraged him to speak out about the need for leaders of this country to ensure that all people receive adequate heath care coverage.
“Many of the greatest threats to the scurity of our nation, our people, come from inadequate health care. Substance abuse and the common flu will take a far greater toll on our people … than all of the terrorist attacks combined.”
Last year, Anderman celebrated Thanksgiving with his side of the family.
This year, the Andermans will celebrate with Julie’s family in Manheim Township.
For them, Thanksgiving is more than a one-day holiday. It is a sense of God’s presence in their lives.
November 18, 2016
Among patients unsuitable for urgent surgical repair of ascending aortic dissection, endovascular treatment with stent grafting appears to yield acceptable outcomes, according to recent findings.
ENGAGE: Endovascular abdominal aortic aneurysm repair …
Preoperative statins may improve survival after endovascular …
Endovascular repair of mycotic aortic aneurysm shows …
International Society of Endovascular Therapy
European Society of Cardiology Congress
Society for Cardiovascular Angiography and Interventions Scientific Sessions
In the study, researchers evaluated 15 patients with type A aortic dissection (mean age, 65 years; range, 45-78 years) who were admitted to Changhai Hospital, Second Military Medical University, China, from May 2009 to January 2011, and were unfit for open surgery.
Eligible participants included those considered poor candidates for endovascular surgical repair based on the following criteria: advanced age (older than 70 years), American Society of Anesthesiologists classification of IV or higher, NYHA functional class III or worse, prior sternotomy or dysfunction of other essential organ systems.
Patients underwent endovascular repair with stent grafting (aortic dissections consisted of one acute dissection, seven subacute dissections and seven chronic dissections) and were monitored closely for a median of 72 months (range, 61-81 months).
The mean period between onset of aortic dissection and treatment was 25.5 months (range, 61 to 81 months). Follow-up included physical examination, echocardiography, CTA scans and morbidity/mortality documentation at 6 months after the procedure and yearly thereafter.
The researchers found that the procedure had a 100% technical success rate and yielded no perioperative major morbidity or deaths. During follow-up, there were no deaths, eight morbidities and four reinterventions. One new dissection in the aortic arch occurred and was treated with a branched endograft. One patient experienced a retrograde aortic dissection and a left ventricular pseudoaneurysm, and this was successfully treated with open surgery, the researchers wrote. Stenting was used to treat one CV ischemia during follow-up, and radiofrequency ablation was used to treat one supraventricular tachycardia. The following additional morbidities were seen: perigraft endoleak, a bird-beak sign at the distal landing site, a temporary pericardial effusion and a left kidney atrophy.
At 12 months, there were significant enlargements of true lumens and shrinkage of false lumens and overall thoracic aorta. After this time point, no significant changes were observed. The researchers documented only a minor influence on aortic valve function over time.
The preoperative LV end-diastolic diameter was 38.9 mm ± 10.6; it was 42.1 mm ± 5.4 (P = .324) at the end of follow-up. LV ejection fraction was 53.6% ± 2.5 before the procedure and 52.5% ± 2.1 (P = .219) after follow-up.
Ready for next phase
In an accompanying editorial, Michael D. Dake, MD, of the Falk Cardiovascular Research Center and the department of cardiothoracic surgery, Stanford University School of Medicine, wrote these findings are encouraging for endovascular repair, but larger studies will be needed to provide conclusive evidence.
Michael D. Dake, MD
Michael D. Dake
“As the first report to provide details of long-term outcomes following [thoracic endovascular aortic repair] of patients with type A dissection, [the researchers] have succeeded in moving beyond the novelty level of ‘look, it can be done’ to the next developmental stage, poised on the threshold of a prospective clinical trial,” Dake wrote. “This is a valuable contribution. I wonder, however, if the current [thoracic endovascular aortic repair] technology is ready to withstand the rigors it will face when we enter the next phase.” – by Jennifer Byrne
After just reading this article:
These conclusions are puzzling to say the least. What about checking the BP at all four extremities? Both legs (ankles) and both arms, I thought one of the “clear” signs was the difference in BP is a clear sign of a possible AD and or what about the d-dimer test like I had? As a concerned love one, you had better make sure if you have ANY doubt to stress the need for a CT and not an Echo or sent to the CATH Lab. I just heard a horror story about a person who had this happen to him and had he had an ER doctor like I had, he’d been in a much better place than he is now.
The diagnosis of aortic dissections by emergency physicians is rare and challenging. An emergency physician seeing 3,000 to 4,000 patients a year would diagnose an aortic dissection approximately every three to four years.
We found aortic dissections to be rare, diagnosed approximately once for every 12,200 ED patients and once for every 980 atraumatic chest pain patients. Although ordering CTs in low-probability patients may not be the best strategy, missing the diagnosis can have devastating consequences for the few patients that actually have a dissection. These findings may be useful for clinicians as they weigh the risks and benefits of ordering CTs, and also for physicians currently involved in litigation regarding failure or delay in diagnosing aortic dissection.
Name: Rosalie Wetherell
Age at time of Dissection: 49
Type of Dissection: Ascending
Date of Aortic Dissection: 2 February 2009
Tell Us Your Story:
Hi, I’m Rosalie, AKA, Roe. I’m a Stafford type B ascending survivor. My dissection goes back a whooping 7 and a 1/2 years. It happened on Super bowl Sunday. I had spent the day alone because I had felt to lousy to go to a party with my husband. I was crazy restless and had, had extreme gas building up under my rib cage for the past 6 days. I had been throwing up every thing I tried to eat or drink. That night I finally fell asleep on the couch when an insane tearing woke me up. I knew some thing epic had just happened.
To shorten my story, 3 days later was when a young Dr. had the where with all to order a CT scan. and saw the very small part of a tear. He ordered a second scan on my chest and found the tear went up another 58 cm. They found room for me in an ICU unit in a hospital 30 miles away from my very small home town.
I don’t remember a whole lot about the ride over. I remember doctors swarming around me. Being rolled up and down hallways, in and out of elevators. The sound of nurses telling me to be still. I was in and out of my senses for what seemed a very long time.
Two days later I was being filled in on my situation. I had been admitted with a blood pressure of 260/190. and a heart rate of 136 and climbing. My prognosis was grim at best Here is where my story gets interesting. Three years earlier on Nov.2 cnd of 2006 my dad had been life flight to the very same hospital with darn near the exact same condition. My father was 83 years old when he suffered his AD. His dissection was located at his aortic arch. It was a complete blow out. The arch was actually severed in 3 pieces. He survived this impossible condition for 11 days.
I found out via an Aunt at my dad’s funeral that 1 of his brothers died during surgery at an attempt to fix an AD in 1996, my uncle was 83.
My team of doctors decided against surgery for my case. I was in ICU for 12 days and sent home with a sack of blood pressure medication. At the time of my release my blood pressure was at 138/127, my heart rate was 72, and I was some thing of an oddity. The nurses aid who was wheeling out to checkout area made this very odd statement, “I’ve never checked any one out of here before, I usually take them to the basement.”
On that note, here I am 7 and a 1/2 years later. I’m taking care of myself by staying on my medication and living an incredibly laid back life style. I have to say this one thing. (maybe this is why after all these years I’m reaching out to people who know exactly what it’s like to live with condition.) I’m not sure where or when this amazing turn of events will take me, but I know this for sure, my dissection changed my life for the best. I’ve been reunited with Christ, my family, met some brave,courageous people and found that my own life has meaning and boundless forward motion. I truly believe a positive out look is more than half the battle. I thank you for all the information you have provided. There was a lot of new things I have at my disposal if I decide to look into some different treatment options.
Stay alert and be ever on the look out. God bless you, Rosalie M. Wetherell.
Cottageville resident Dean Nelson rides an exercise bike inside the cardiac rehab unit at Summerville Medical Center Friday while his nurse, Sandra Nelsen, takes his blood pressure. Nelson undergoes rehab tri-weekly after suffering an aortic tear in July and nearly dying.
Three notable scars mark his body — one along his right thigh, another covering his collarbone and the most significant, down the center of his chest. They are reminders to Dean Nelson of the day he nearly died.
On July 7 the Cottageville resident was boating with his wife on the Edisto River when an intense pain in his heart overtook his body.
“It felt like someone slapped me in the chest with a hot skillet,” Nelson said. “It burned and it hurt.”
Nelson slowed the boat, grabbed his chest and fell onto one knee. He also looked over at his wife, struck with fear.
“My wife said, ‘I’ve never seen that look on your face before so I’m calling 911,’” Nelson said.
The couple believed he was suffering from heat stroke or dehydration. Heart trouble never crossed their minds, he said.
Despite the intense pain, he managed to steer his boat to Jellico’s Landing where his wife called 911, and Dorchester County EMS later arrived to treat him.
“I was sweatin’ bullets,” Nelson said.
In the meantime, he “flopped” into the water to cool off. Noticing something was wrong, other fishermen in the area approached and asked how they could help. Nelson said they waited at the top of U.S. 17-A to direct EMS where to go.
Nelson eventually lifted himself from the river and laid along the front of his boat, and his mind went blank.
“I don’t remember anything after that,” he said. “I don’t even know how I got on the gurney.”
Paramedics were in shock Nelson had made it to the landing in his condition and even instructed his family to say their goodbyes before transporting him to Summerville Medical Center.
“My wife and kids were telling me how much they loved me and to hold on,” Nelson said.
After hospital officials at Summerville Medical hooked him up to a heart monitor and discovered he had an 8-centimeter tear in his heart. Nelson was rushed to Trident Medical Center, a level two trauma facility, for emergency surgery. He didn’t wake up for four days.
During that time, Nelson said, he experienced two different dreams he’ll never forget. In the first one, his dad, who had passed a year earlier, and an old neighbor, also deceased, appeared to him and told him to come to him then turn around and go back.
“It’s giving me chills just thinking about it,” Nelson said. “As much as I wanted to hang out with my dad and Walter, I turned around.”
Defying the odds
When Nelson finally awoke on a Monday — the river incident occurred on Thursday — he had little to no memory of the events leading up to his ICU stay, other than what people told him. Most importantly he learned his condition was hereditary, and the same one that claimed his grandma’s life in her 50s. But Nelson is much younger — just 42, and according to Summerville hospital officials, the condition usually occurs in men ages 60 to 70.
“They said I should’ve died in the boat. I should’ve bled out right then and there,” Nelson said.
But that wasn’t the only miracle; he’s defied the odds every step of the way, including leaving the hospital just eight days after he was admitted.
“They all thought that was pretty amazing,” Nelson said of hospital staff. “They said that was very rare to have something (a condition) like that and even more rare to make it to the hospital, and even rarer to live through it.”
According to Dr. Eric Brittain, Nelson’s main ER doctor at Trident Medical, Nelson suffered an aortic dissection and aortic root aneurysm — a pretty rare condition that strikes about 200,000 people annually. That number is quite low when compared to 1.5 million heart attacks and strokes suffered each year, medical experts said.
In addition, of the 200,000 who encounter an aortic tear, many don’t survive.
“It is a sudden event, and it is usually lethal,” said Nelson’s surgeon, Dr. Charles Roberts, with Palmetto Cardiovascular and Surgical Associates. Roberts said high blood pressure is the condition’s prime culprit, and to save a life, surgical intervention is necessary within six hours of the event. The surgery is also a risky and challenging process.
“It’s the hardest operation we probably do in heart surgery,” Roberts said.
The seasoned surgeon replaced part of Nelson’s ascending aorta and aortic valve.
Nelson said most memorable to him was his first doctor’s appointment four days after returning home from the hospital.
While he should’ve been the one praising medical minds and hands for saving his life, instead they were the ones in awe of him.
“Just about the whole surgical team came in there wanting to shake my hand and told me (that) I was a very lucky man to have made it through,” Nelson said.
Road to recovery
Nelson’s summer scare provided a wakeup call for him, and in light of World Heart Day on Thursday, he said he felt compelled to share his story so others might also review their habits.
For the last 23 years he said he had smoked more than two packs a day, failed to eat healthy, consumed too many energy drinks and rarely worked out.
“I couldn’t even run around the yard with my kids without getting winded,” Nelson said.
He knew he needed to make a lifestyle change, and during the last two months that’s exactly what he’s done, starting with his pantry.
“My wife and I changed up our whole eating habits,” Nelson said. “When I got home from the hospital, we loaded up a couple of totes from the pantry and threw them out.” He’s also stopped smoking and drinking and trying to “go through the whole healing process” correctly.
The incident also reignited his faith.
“I’ve always been religious, but never have I ever experienced such a thing,” Nelson said. “I dusted the Bible off and wanted to research a few things I was curious about.”
He now “looks at things differently” and is not only grateful to be alive but also grateful that the tragedy resulted in positive change, including strengthening his family.
“My wife and I said, ‘More good has come out of this than bad,’” Nelson said.
For the last four weeks, Nelson has worked to regain his physical strength through cardiac rehab at Summerville Medical.
Three times a week he meets with rehab nurses, lifting light weights and working out on the bicycle machine and completing other cardio routines. In November he’ll graduate from the program, and like all other graduates before him, will ring a loud bell on his way out, signifying his success.
Until then, he thanks family and friends for support and God for new life — the “clock ticking” of the artificial pump inside his heart a daily reminder, Nelson said.
He’s since been cleared to drive, allowing him to somewhat return to normalcy. He’s also cut back on his hours at work — he owns his own plumbing business.
“I’m grateful to still be here — very grateful,” Nelson said. “It was a wild ride.”
Name: Gracie Stanwyck
Age at time of Dissection: 47
Type of Dissection: Ascending
Date of Aortic Dissection: 17 April 2013
Tell Us Your Story:
My name is Gracie, and I am a survivor of an ascending aorta dissection. I had been home from work with a very bad headache, as well as something that I couldn’t quite pinpoint. I was very restless and had a feeling of doom before my husband showed up at home unexpectedly.
He had just asked if there was anything he could get me to help me feel better when it happened. My heart jerked twice before I lost my eyesight as well as any feeling in my right leg and arm. My husband immediately called 911.
I live in a very small community, so getting an ambulance to my house only took 5 minutes. I was taken to our local hospital and then flew by helicopter to Boise, Idaho, which took 57 minutes. A team was already waiting for me to arrive.
The surgeon that saved my life will always be my hero. I now have an abdominal dissection that I have to live with, and continue to have scans to make sure there are no changes.
It is very hard to live with the knowledge that I have a very fragile aorta, but the good news is that I survived.
Name: James LeClaire
Age at time of Dissection: 57
Type of Dissection: Both Ascending and Descending
Date of Aortic Dissection: 18 April 2016
Tell Us Your Story:
I‘m a recent survivor of an Ascending and Descending Aortic Dissection. I worked full time as an automotive technician, and had just recently switched shops so that I could be closer to family members. I started the job on April 1st and was looking forward to working there, because they are a great crew, and the insurance benefits that I would qualify for would take effect on May 1. I had gone in on the Saturday, previous, to fulfill my weekend obligation, which happened once every month. I had, absolutely, no symptoms that were apparent on that day. My wife had left for Texas to visit relatives, while I stayed behind, because I hadn’t accumulated any paid time off, yet.
The following day I had my 5 year old Granddaughter over for a fun day at the park and we were out, together, for about 5 hours or so. On returning home, I was exhausted, and asked her if she could hang out with her Great Grandpa while I took a short nap. While they played in the other room, I noticed a very slight pain in my abdomen and back that I attributed to, possibly, pulling a muscle in my previous days work (It happens quite often in this business.). My Stepdaughter came by at around 5pm, after her5 work shift, and picked my Granddaughter up. I continued to sleep.
That evening around 8pm, my wife called from Texas and we chatted a little, but the pain was a little worse now, and I told her that I wasn’t feeling well, and that I would call her the following day.
I went to work the following morning after eating a light breakfast and felt okay, except for the pain that hadn’t changed from the previous night. I brought in my first vehicle of the day and had to pry on a part with considerable force to make the new part fit properly. I dropped the vehicle down from the lift and proceeded to finish some other repairs that were needed on the vehicle.
The pain from the previous night was intensified, and I marked it off as probable indigestion from my breakfast, when, suddenly, the pain intensified incredibly. I also began to feel dizzy and somewhat out of breath. I still debated whether this was a true medical emergency, however, which was very dumb on my part. I finally asked a co-worker to call 911 as I suddenly felt very weak, and thought, finally, that I was having a heart attack.
Surrounded by co-workers, the ambulance finally arrived and I was shipped off to a local heart hospital. Nitro and an EKG were started and IV lines were set. The pain was incredible… it felt like my heart was being ripped from my chest while I was still fully awake. I remained conscious throughout.
Arriving at the ED I was given another EKG and a series of blood tests, that, basically, told the staff that my heart was fine. I was pulled out of the triage and moved to the hallway (The ED was incredibly busy that morning, around 9:30AM), to await an X-Ray of my chest. I assumed that my case wasn’t dire, as the staff had moved me out into the hall and seemed far less urgent, than when I had first arrived. I did remain uncomfortable and in a lot of pain, but figured I would get a shot of something, and be told to go home and rest for a day or two. I called my wife and told her that I was in the ED and might have had a heart attack.
I went for my X-Ray and was pushed back into the hallway and noticed that there were a lot of people who seemed more critical, than I was, at the time. I waited and waited, until the Hospitalist came over and told me that I would stay overnight for observation, and have a stress test the following morning. Cool, I thought, maybe a blockage or something and I would possibly miss a little work, but nothing major.
The PA on duty looked at her triage board and my case had come up in the rotation and she came to discuss, with me, how I was feeling. I told her I was in pain and she ordered some morphine and told me to sit tight and relax while she discussed me with her colleagues. I was then visited by a Cadio-Thorassic surgeon who asked me where my pain was and he promptly went away. The Hospitalist then ordered a CT Scan and I was returned again, to my previous hallway location.
Within a half hour or so, the PA returned and brought along a few more people, and I was suddenly back to the head of the line and was being prepped for surgery. I had had many more injections of Morphine and Fentanyl and was pretty much still in the same pain. I remember my step daughter and her fiancee asking me how I felt as everyone around me was feverishly working to get me prepped. I asked the PA to please call my wife, in Texas. I was told that I was going to have my chest opened and I was suffering from an “Aortic Dissection”. I had no idea what that meant, but figured it was “Serious!”. Where was my phone? I need to look that up.
The next several hours (7 or 8, I’m told) vanished, while I was in the ER as the hospital staff worked to save my life. Unknown to me, Te PA contacted my wife, and told her that she needed to get here as soon as she could and that I probably wouldn’t survive the surgery, and prepare to have me removed from life support.
I woke up and noticed that the ICU nurse was sitting beside me and that my Stepdaughter was reading her textbook, from the nursing course she was taking. I remarked that it was awful bright, still, at 8PM in April, and was amazed at how long the day had become. I was informed that it was the following morning.
I made it through the worst of the mess and my wife arrived, to find, to her amazement, that I was awake and doing pretty well, considering. I was in the ICU for a couple of days and was then sent to the Cardiac Care ward, with the intent that I would be soon released to rehab.
Toward the end of that first week, the pain returned and my wife noted to the staff that something was still seriously wrong (I thought I was merely constipated from the pain meds), and she relayed that information to the Cardiac PA who ordered another CT scan. They found that I also had a descending dissection and that a TEVAR procedure was needed, so they brought me back to the ICU so they could administer Lobetalol intravenously to keep my blood pressure below 120 Systolic. The TEVAR was scheduled and I waited. I was, also, informed that the TEVAR procedure may result in the loss of a kidney, and, even worse, could render me a paraplegic.
Unfortunately, the blood thinners they had prescribed (Assuming that the second dissection didn’t occur), had a long half life and my scheduled surgery was pushed back a week. Finally, on May 2nd, I had a successful surgery and spent the following 2 weeks in the ICU and Cardiac care ward.
I am going to lose a Kidney at some point in my life, but it will be a slow degeneration. I still have the use of all of my facilities, and count myself extremely lucky to have, not only survived this killer, but also with virtually no serious complications!
I have to thank all of the people who got me through this, because without them, I wouldn’t be here typing this story.