Aortic dissection

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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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7 Replies

  • Posted

    I dissected on 26th June 2006. I was fit and healthy 46yr old woman, with no history of high blood pressure and a cholestorol level of 3.2! It took nearly nine hours to diagnose and then I had to be transferred from North wales to Manchester for sugery. I had dissected from the arch to the iliax - the whole way. I lost my left kidney, but I survived the surgery and the Teflon! Was chilled to the bone and hung upside down to for the glue to dry / stop bleeding - literally. Took 16 weeks off work and managed to get a tan! I'm still dissected near the iliax which is under surveillance and the Beta Blockers and Ace Inhibitors keep everything in check. It's messed about with my thyroid after damage in my neck and there are days when i'm so damned tried - but I'm here.

    It's such a shame there isn't a chat forum for us (AD survivors) - all the people who've had heart surgery seem to have completely different problems and experiences and there is little information available in the uk, of any relevence, of patients' experience post surgery.

    Hope you are doing well Phil.

    All the best

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  • Posted

    Hi Phil - good luck to you on your recovery and I hope it's progressing well. I stark contrast to your experience, I was admitted as an emergency in May 2008 and after a six day diagnosis period was operated on at the 'final hour' - The whole experience and recovery has been horrendous; I was off work seven months, still only working 4 hours a day and am now forced to seek the semi-retirement route because of the effects on me. My GP thinks I am suffering from Post Traumatic Stress and have got Fybromyalgia since the operation. Having spoken to another patient and seeing your experience it would be good for us to have a forum as another reader suggests. Although I feel a great deal better now, the experience won't go away for me - and I've taken to writing the 'dreams' as I was in a drug induced coma for five days and really believed everything I dreamt as I couldn't wake up from it being just under the threshold of consciousness. A wierd experience in itself.

    Hope you have time to read my experience on this site, and all the best to you.

    Robert

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    • Posted

      Hi Robert

      A long time since you posted your above reply to Guest. However, it struck chord with me, many do but yours in particular! Six Day Diagnosis, my Dissection from just after left subclavian artery down to my abdomen, that happened on 13/4/15 and I was EVAR Stented 8pm Saturday night 25/4/15, 12 days later and at the Very Last minute, I would have died that night without it... They tried to treat my BP with drugs but it stubbornly refused, so I go into surgery with a 95% chance of Kicking the proverbial! I get the impression a lot of us on here are that Miracle 4/5% who do survive (my elder brother dissected 2001, had part of his Aorta replaced, they said the rest was in a bad way and he would last 7 or 8 years before needing more surgery, he died on the table just before his 60 birthday in 2009). I was in Hospital for seven weeks, a lot of that time on Morphine and Ketamine, now I could do with the Ket on demand - Dreams are not the word - Lucy in the Sky with Diamonds indeed haha...  Like you, the tiredness since the surgery is also something I am experiencing, I manage 4 - 6 productive hours a day, then start falling asleep! My Extras were collapsed left lung, left Kidney failure, and a Tracheostomy, that took seven months to heal. The Hangover is the tiredness, a slightly strange mental effect, not as quick as I was.. weird sensation and effect, some back pains, occasional chest pains (scary) but with a Gore PTFE coated metal EVAR Stent, 44.2mm wide at the top I suppose I can expect some sensations? And thanks AL Gore ex US VP! My Surgeon says I still have a small dissection lower down in my abdomen but they will just monitor that??? Before I found this site, I joined http://www.aorticdissection.co.uk/ and I got some answers from AD and AAD sufferers on there.  Anyways, hope you sre still on the upward path.

      Take care

      David

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    • Posted

      I hope that everyone is well - The day after Thanksgiving 2015, as I was preparng to leave for Black Friday, I noticed that I had a back ache. It didn't bother me too much because I thought I had probably strained a muscle as I was dressing. Before I get into more detail, I need to mention that at the time I was a 41 year old, healthy woman who worked in the HVAC industry. As the day continued, the pain had got so bad, one of my children had to call an ambulance. The ER doctor sent me home with muscle spasm and naseau meds and I was still in pain.

      The very next day, the pain had got even worse. I fell out unconscious...twice. That night, my kids called the ambulance. The hospital performed a CT scan and found a ruptured aortic aneurysm. I was airlifted to another hospital in Atlanta for emergency surgery and (with my understanding) was in surgery for 7 hours. They also removed my gall bladder. During all the procedures, I was given 7 units of blood...yes "7". I had to return to surgery the next day to close me up due to the swelling. 

      I never thouht that this would happen to me. I'm only 42. I am now in recovery and am wondering when I can return to work. I still have major pain in my leg but was given an ultrasound so all is well there. I know I can't do what I use to do but I'm starting to become stir-crazy just being at home all the time. 

       Robert, I can relate to you regarding the dreams. I talk to my family about these dreams often. I've even written some down in my journal. And yes, they ALL seemed very real...to the point where I remembered sharing one in the hospital (while on morphine) and my daughter looked at me like I was crazy. But I was serious. 

      I hope that more people find this board and/or I hope I find a board so that I can relate to others who's experienced the same thing as I have.

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  • Posted

    I posted twice on this, and they both got deleted because I had put a URL on them for a UK Aortic Dissection site as the other one I use for info. So I am off here... Good Luck to all :-)
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