Aortic dissection, aortic aneurysm - The aorta - Life after an aortic dissection
I will warn you for two things. First I can’t be brief so this will be a long story. Second. My English is not perfect, especially the medical terms, but I’m learning, so I apologize if my English is poor sometimes. However I think you will understand me anyway (I took help of Google translation sometimes). Now to the story.
My name is Stefan Manning and I'm a dedicated ultra-runner born 1956. I'm living in a small town called Partille about 10 km east from Gothenburg in Sweden. I use to run about 70-80 km per week. I’m not that fast, but I’m deeply in love with running. For me it’s a life style. My highest dream is to run Badwater Ultramarathon – 135 miles through Death Valley in USA. Badwater is considered as one of toughest foot race in the world. All my training, my thoughts and planning is focused on that race. I planned to be at the starting line in 2016. But something came between.
But at May 11:th 2012 my life became a mess. It was the day before the Sport & Helath Expo at Gothenburg Halfmarathon. I was supposed to help up in one of the monters. Suddenly! As I was strucked by a lightning a terrible pain comes over me in my chest and this pain spread to my back. Strangely I realized very quickly that this has nothing to do with my heart. I thought that I had gotten back my kidney stones. This pain remind me about that episode (it occurred 2005), but this pain was more intensive. My thought was to get back home and take some Voltaren suppository (they did the trick back in 2005) and rest on the sofa.
In this moment I really did believe that I was strucked by pain from a kidney stone. I didn’t realize what’s really going on. So I took the car and drive back to home. A travel through Gothenburg for approx. 20 km. When I’m arrived at home the pain getting worse and slowly I came to the insight that this could not be any kidney stone. It must be something else and I better get to the emergency at the hospital. But I was dressed in running clothes, so I have to change first and take a shower. I will not appear to an emergency and smell sweat. So I took a shower! Then I packed a little bag with handy things. Like a book, paper and pen, water bottle, cell phone with asseccories like battery loader, credit card, coins etc. My experience from the emergency department at hospitals is that it will take a very long time. I use to call this bag: Emergency survival kit.
Now I get into the car for a second time (!) and drove to the East hospital, about 5 kilometers away. From the car I called my wife and notified her about the situation. I still didn’t realized the real cause for my pain. Arriving to the hospital I circled a few minutes to find a parking spot, checked in for a parking ticket and walked the last 300 meters to the entrance of the emergency. The pain is now getting more and more intensive and I have huge problems to walk and keep me in an upright position. The medics at the emergency must observe my struggle and at the same the moment I went in through the entrance, two nurses came out and meet me with a stretcher.
I tried to explain for them what´s happen and try to point out where my pain was, but I couldn’t. The pain was “moving” and I couldn’t say exactly where it came from. This frightened me up a bit. They gave me a morphine shot. The pain was so intensive so now I have to yell out. The tried to measure my blood pressure without success. I couldn’t lie still. Now I got a second morphine shot and I felt the pain ease a bit. Now they could take the blood pressure and that was a bit over 200 systolic. The doctors were very fast to diagnose me I understood afterwards. I was now very dizzy and I heard somewhere someone talking about some aorta thing. I understood I was in real trouble, but I couldn’t focus on that with all morphine inside me.
After a CT scan I got the diagnose Aortic dissection type B. There was some uncertainty for a while, before they got the answer from the CT, if there was a type A or type B. The CT shows that there were some indication s to a type A dissection, but here was no danger for this. Meanwhile my wife arrived to the emergency and the staff briefed her about the situation. She was pretty shocked when they told her. The doctors were still unsure whether they should open me up and do an open heart surgery or treat me by medications. The decision was to transport me to another hospital and let the cardiovascular doctors take over. The other hospital was also better technically equipped. So I was transported to the Sahlgrenska University hospital in Gothenburg. A short trip with ambulance. I do not remember much from that transport. I do remember that I was in an intensive care room at Sahlgrenska for critical cases. There I spent 8 days before I was moved from this intensive care to an “ordinary” intensive care.
They treated me by lower my blood pressure dramatically. I think they tracked down all medical concerning blood pressure and just throw into me. I even had a nitroglycerin drop. They gave me a lot of blood pressure medicals. Before this incident I normally had a blood pressure approx. 160-170/90-100, despite medicals. In a few days they manage to lower my blood pressure to stay on 120/70 and below. I was impressed. After about 1½ week I was transported back to the East hospital I Came from at the first time.
After totally two weeks staying at hospital on a Sunday, my wife has bought some buns we supposed to have to the coffee. About a half-hour later I got terrible pain in my abdominal and it increase. I got totally two morphine shots to ease the pain. They took me to an emergency CT and discovered an angina in my abdominal artery, from the kidney to the aorta, caused by the dissection. I was immediately transported back to Sahlgrenska hospital for cardio vascular surgery. The put a stent in the artery during this surgery. The day after a physiotherapist asks me if I want try to sit up. Of course I will try, but I only came half way up and was struck by a terrible pain again. It was impossible to get into an upright position. A new CT show that I this time got an infarction in my spleen. It was a little fragment from the surgery that has drifted away with the blood and caused it. For this I was treated with blood thinners, like fragmin or waran. The pain subsided within a couple of days. I was transported back to the East hospital again.
On Friday june 15:th, after totally 35 days at hospital I could return to my home with two directives. Keep track on the blood pressure and do not lift any heavier than 5 kilo. The doctors encourage me to exercise with walking and that stuff. Not running! It has been a really traumatic time, from being close to lost my life to get the insight of what’s happen.
During this entire journey I was determined to hold on to my dream – to run Badwater Ultramarathon – whatever it takes. Badwater is considered to be the toughest footrace in the world. It’s a 135 mile long run though the hottest place in earth – Death Valley in USA. Starts in the Badwater basin about 86 m below sea level and the goal is on the Mont Whitney portal in Sierra Nevada – 2500 m above sea level. The course also contains totally about 4000 m of altidtude. I was training for this race when I got my dissection.
Now I have resumed my training. I started with walks and very short distances – about 2 km and after a couple of weeks I switched to Nordic walking and increased the distance. This has worked well. In July I did 140 kilometers of Nordic walking and increased to 201 km in august. And there was no running! I must be patience here. In the late august I participated in a 6 hours ultrarun, but I walked (33,3 km). All went fine. During the entire period I meet my blood pressure several times a day, at least 4 times a day since I left the hospital and have noticed all measures in an excel file. And totally my blood pressure is on OK levels.
At September 12:th a tried a short spinning class which went OK. No problem. At September 24:th I did Nordic walking to my job (23 km) without any problem. I still did some Nordic walking. I did another spinning class at October 1:st. At September 21:st I did a new CT and got an OK from the doctor that there were no changes in the status, despite all this training. I was very happy for this. This means that I could start to run again. I did my first run at September 30:th and that was a very short one – approximately 6 km and it was not a fast running. 8 min/km and my pulse were in average 121. This due to the beta blocker I eat. I did two more run for approx. 7 km. And they went OK as well. For the moment I feel great. And my original goal to be at the start line at Badwater in 2016 is still a reality for me. This is my dream and this is keeping me going and fight for it whatever it takes.
At October 27:th I will participate in an event for the Pink Band organization who’s raising money for the breast cancer research. I will enter a spinning bike and do a 25 hour spinning. I do this for the six year in a row. Of course I have to adapt my workload and that sort of thing to my situation. I’m really looking forward to it and for the first time in my life I will perform one hour as an instructor of the class. That will be the great challenge. The class is about my aortic dissection narrated with suitable music. Like Chris Rea:s - The Road To Hell, Judas Priest – Painkiller, etc. (J) and about my way back to a normal life. The message for the class is: “it will not probably gonna kill you, but if it’s not gonna kill you – what’s the big deal?”
This is a way for me to train for Badwater, but also a way to inspire others to not give up. If you survive there are always possibilities. I don’t see problems, only opportunities. In November I plan to run (very slowly) a 6 hours ultra-run and a week later participate in an event called ultra-intervals. This means that you run 10 km, starting the first interval at midnight, then you start a new 10 km run every third hour during in the coming day. Totally 8 intervals that day. And that will not be any fast run either. You can be sure on that and I will monitor both pulse and blood pressure during these events. If I do this three events, then I really have won a huge victory over myself and over my dissection. I have victory in my mind.
Well. As usual I can’t be brief when telling a story. But this is it. I will continue my training and competition, but with the difference that I must consider my condition every time and never give up my dream. If there is some one of you who’s reading this and do ultra-run or marathon, don’t hesitate to contact me and share your experiences. The most important thing is to never give up.
Thank you for reading.
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