Age at time of Dissection: 57
Type of Dissection: Both Ascending and Descending
Date of Aortic Dissection: 19 January 2006
Tell Us Your Story:
This is my husband’s story as best as I remember it. I submitted it earlier in the discussion board, but can’t find it any longer, so I’m recapping the events for the new site.
My husband was working from home, in the basement, and at around 10 a.m. came up two flights of stairs to tell me I should “probably call the doctor.” Any such statement from my husband is cause for alarm, as he avoids anything but routine visits like the plague. I asked him what was wrong and he said he was having some chest pain and his left arm was numb. He said he’d waited about 20 minutes for it to subside before walking up the stairs to get me instead of just calling me on the other phone. I took his pulse, (am a retired OB nurse, knew next to nothing about dissections) and couldn’t get a pulse on his left radius. It took me a bit to think straight enough to call 911, partly because he kept insisting he didn’t feel too bad and I should just call the doctor.
When they arrived, the paramedics said all his vitals looked good (of course) but I could tell one was very concerned nevertheless. My husband claimed not to be in too much pain, and was in good spirits. Although they wouldn’t tell me, I think they were also missing pulses and/or having differing BP readings on the left and right. Thanks be to God, they didn’t blow him off, and transported him to the hospital, also, thanks be to God, which had just finished a state-of-the-art cardiac care center. It’s a rather small-town hospital, not even a teaching center, so this was indeed a blessing.
When he arrived at the hospital, he had the best of attention. First they did a portable chest x-ray, then they did a TEE (Trans Esophageal Echocardiography) and had the diagnosis within minutes. Thank the Lord again, the whole process took only about 20-30 minutes. It took a lot longer for the surgeon to arrive, and by the time they were completely prepared, they went rather running down the hall with him. He was very apprehensive, as could be expected, but he had been highly sedated and wasn’t even aware of the diagnosis until the TEE sedation began wearing off.
He spent about 2 hours in surgery. The surgeon had warned me of the risks of death and poor recovery, which were very much a shock to me. Especially concerning was when he told me they only had about 45 minutes for him to be on bypass before there was risk of brain damage.
We thank the Lord that he came through the surgery well. It was determined that he must have had an aneurysm, and a week or so earlier, he had decided to go off his BP meds, thinking that they were not helping his BP – huge mistake. The dissection went from the root of the aorta down into his groin, and he received a replacement valve and a stent. The abdominal area of the dissection was not repaired, which made us pretty anxious for a while, despite it was accepted practice.
I was told they would keep him sedated most of the first day, and begin to allow him to wake up the next morning. However, every time they would withdraw sedation, his blood pressure would rise alarmingly, so they would desist. He wound up under sedation all the following day and most of the next. They weren’t happy with the BP readings, but gradually decreased the sedation and increased the meds to a point they were not delighted with, but could accept.
When he first woke up he was pretty unresponsive and I was so worried about brain damage. The only thing he responded to for the first 12 hours or more was when the nurse disturbed his chest tubes. He would get an alarmed look on his face and stare at her. He rarely looked in our direction even when we spoke to him. It was scary. Finally, the third day after surgery, he recognized us and responded a bit, but was, of course, very tired.
By the time he went to the step down unit he was his old self, praise God. They even had to put a bed alarm on him because he was threatening to take himself to the bathroom without help. He did well in cardiac rehab, and was pretty much back to old things within a few months, with no substantial after effects. We know how blessed we are!
The worst thing about the after care was that within about a year, the cardiac surgeon discharged him to the care of a cardiologist, who discharged him to his PMD within another 6-12 months. No one ever told us he would require more surgery down the line until this year. In fact, after the first couple of years of CT follow-up, he didn’t even know for sure that he was supposed to continue yearly CTs/MRIs. The ball was really dropped. Finally, his PMD told him he needed to continue these indefinitely, referred his MRI back to the surgeon this year, and that’s when the surgeon told him once the dissection passed about .5cm, he would require further surgery.
It was also only under further research of my own that I learned he is still not supposed to be lifting much weight ever – something I’ve had to continually fight with him about. If the doctor doesn’t spell it out in writing, he doesn’t think he has to do it!
We are really grateful to you, Brian, for this site. It was the only thing that helped me keep my sanity in the first weeks after his discharge, as I had so many questions about allowed activity and what to expect. Sometimes being in the medical profession is worse than not, as your education doesn’t usually cover much about rarer problems such as AD, most especially in the post-discharge phase.
Thanks for stopping by to view our stories. Please help me keep the site going by shopping at Amazon.com-It’s very much appreciated. Brian Tinsley founder of AorticDissection.com (please book mark the link once you get to Amazon.com for future purchases!)