Aortic dissection

I am a 55 year old male, fit, healthy, non-smoker and with a perfect BMI (body mass index). My last visit to the doctor was 10 years ago.

On Christmas Day, at 6 p.m., while sitting down to drink a cup of tea with my wife, I had a sudden sharp pain in my chest. It was intense, but slowly moved to my back, and became less painful. I decided to take a bath to ease the pain, whilst my wife phoned our daughter who is a trainee anaesthetist. She was driving to work but immediately advised a trip to A&E. I was not so keen since the pain had eased, but our next-door neighdour, who is a GP, concurred so at 10 pm we set off.

By this time daughter had phoned back with a diagnosis - she thought I had suffered an aortic dissection. My father had died (aged 39) from an aortic aneurism, so she was extremely concerned. Wakefield Pinderfields A&E department was emply, and as luck had it the on-call Registar was a heart specialist. I was ultrasound scanned (twice) and then wheeled upstairs to go through the CAT scanner. This confirmed daughter's diagnosis, I had a very long dissection.

At 3 a.m on Boxing Day I was transferred by ambulance to Leeds General Infirmary; at 4 a.m. the surgeon was talking to me and explaining the risks (very significant risks to boot) and I signed the consent form. The surgical team were assembled by 8 a.m. and I was operated on.

I was cooled down to 12 degrees (apparently that's the coldest any of my daughter's medic friends and colleagues have ever known) and underwent a 5 hour valve saving aortic root replacement. The very good news was that my heart was very sound, my valves were all excellent and so all that was needed was a teflon replacement for the damaged part of the aorta.

In my case the gap between talking to the anesthetist and waking up was instant. No dreams, nothing. Over 24 hours had elapsed but it was as if only a few seconds had passed - except that I had all these medical bits plugged into me. By the time I woke up the ventilator had already been removed, and I was in no pain at all. And I had been warmed up from 12 degrees back to body temperature. Only 2 units of blood were used - none in the operation itself, just 2 to help boost haemaglobin levels after blood had been thinned earlier.

My family had visited on Boxing Day but I was fast asleep. On the 27th I was in Intensive Care but awake and a bit disorientated. My first question was - can someone find my specs? But I was wearing them - and that's the clue to the only side effect I suffered - more on that later.

On Dec 28th I was a different person. I was moved from Intensive care to an ordinary ward but with hourly obs. By now most of my tubes had been removed so I was freer (central line was still in my neck). By 29th I could walk up and down the ward and sit in my chair, or snooze as I wished. It's amazing how excited nurses get when they discover you have been to the toilet!

On the 30th my pacing wires were removed so I was now completely original - just a nice scar to prove what had happened.

In all I spent 8 nights in hospital, only 2 were in intensive care and I was unconscious for one of those.

I was allowed home on January 3rd - although I'd been ready for a few days. Within a couple of days I was walking to the shops, and I was in contact with work by email and phone.

Whilst my GP wrote a sick note for 10 weeks I have ignored it. I have been working from home about 50% since 3 weeks after my operation (had my first conference call on Day 3 at home); and in week 4 I travelled to work (200 miles from home) and spent 2 days catching up. I had to keep telling everyone that I was not ill - I had simply had a repair job done.

Side effects - the most serious for me is my vision. When I woke up I could not focus at all - I could see the right hand side of faces but not the left. That quickly improved but now, 5 weeks after the operation, I still have minor difficulties with reading. The surgeon said this is a common side effect and it can take 1-3 months to get right. I can manage emails but book reading is not relaxing - so I bought a new ipod and some audio books.

My left leg has been affected by the heart machine - and I have a nice groin wound which is now healing (I think they missed a stitch when they sewed me back up). The nerves close to my skin in my left thigh don't work very well, but everything else is fine - walking is not a problem at all.

Pain - hardly any at all. I get a twinge of back ache from time to time, but very little pain. My paracetemol dose has reduced close to zero.

I was very lucky - I got to hospital at a time when A&E was very quiet. The right kind of doctor was on duty. Leeds is a specialist cardiac centre and only 20 minutes away in an ambulance. I had not been ill before the dissection happened so I was fit. I was determined to get home as fast as possible and pretty well managed to do that.

The NHS were brilliant - including giving my daughter 3 weeks compasionate leave so she could visit/stay with us while I recovered. The only complaint I could have would be the food - hospital food is not at all good, except for the ICU ice cream, so I had meals smuggled in!

An aortic dissection is a very, very serious event - 40% die before they get to A&E and 40% of the remaining 60% don't survive the operation. My surgeon says I am one of the 4% that makes the fastest recovery - so I was/am very lucky.

But, I am proof that this very serious condition can have a very positive outcome.

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