Aortic dissection, aortic aneurysm - The aorta - Life after an aortic dissection
It all started last November. I had been to Houston on a business trip and then visited my parents the weekend I got back. As I was still fairly jet-lagged, my wife had driven us to and from Shropshire, and we returned home late Sunday afternoon. Late that evening while reading, I suddenly had a very sharp spasm in my stomach and lower chest. For a few moments I couldn't breathe, and after the pain passed, I was left with aching muscles across my stomach. I was thankful that it did not appear to be a heart attack, but I told my wife what happened just in case. Through the night my heart pounded, and I did not sleep a wink.
Next day, I visited our local surgery and the GP checked my BP, listened to my heart and took some blood tests. As nothing appeared seriously amiss other than a slight temperature, she diagnosed gastric flu and said to rest and take paracetamol. The blood tests came back later that week, indicating I had an infection, so the GP felt her initial diagnosis was correct. Although the temperature dropped as the week progressed, my heart continued to pound and I was feeling unusually cold. The following Saturday I visited the out of hours GP for a second opinion. He confirmed my temperature was now normal, but noticed a loud heart murmur and recommended I see my GP again. I saw a different GP the following Monday, and he noted the murmur was very loud and new (not mentioned in my records) and called Worthing Hospital to book me in for tests. At Worthing, I was feeling more optimistic when the ECG was fine, but with such a loud murmur, the duty consultant skipped the chest x-ray and sent me for an echocardiogram. The technicians immediately saw a large amount of regurgitation at the Aortic Valve, and a suspicious shadow (flap) in the Aorta beyond. After a review with the consultant cardiologist, he gave me the good and bad news… The good news was that I was a survivor and in a minority who had lived that long since having a Type A AD. The bad news was that I urgently needed open heart surgery, and this would be risky. After breaking the news to my wife, I was blue-lighted to the Royal Sussex in Brighton, where a CT confirmed the diagnosis. My wife and I spent a short time talking to the surgeon and then to each other before the nurse gave me a sedative to help me rest for the night.
The following morning, I was prepped and taken into surgery. 7 hours later I was resting in the high dependency unit, and a few hours later, they woke me up. My first thought was thank god I was awake, and amazingly, in no pain. It was uncomfortable breathing with the tube, but a short while later it was replaced with an oxygen mask. I realised they had replaced the Aortic Valve, as I could hear the tick tick of my new mechanical valve. Based on what the cardiologist had said the day before, I knew it had been a large job. A little while later I spoke to my wife and father on the phone, which was amazing.
After a sleepless night I was helped by the nurse to sit in a chair the next morning, and had some breakfast! I don’t remember too much of my wife and father’s first visit, but they tell me I looked much better than they expected. After another night in the HD unit, the wires were removed and I completed my walking test by walking to my new bed in the recovery ward. The next day, I did the stairs test, and by the following day was well enough to walk to the day room and watch some TV. Watching TV and talking to the other patients really helped me come to terms with the shock of what had happened and reconnect with life outside. The daily visits from my wife, children and parents, even more so. 6 days after surgery, I was discharged and my wife drove me home. I have to say that the whole team at the Royal Sussex were fantastic that week, and I really felt I was in good hands.
Sitting in the living room that first evening felt great. Being home brought new stresses however. Sleep was not a pleasant experience, and without the sleeping tablets the nurses gave me in hospital, it was short and disturbed. Not having the comfort of a medical team to hand to check your stats every 4 hours and ask about the strange new sensations in your body, was also distressing at first. The afternoon of my first full day at home, I suddenly became disoriented and could not remember what had happened over the past 7 days. Worried that I may be experiencing a stroke, my family called 999, but by the time the ambulance arrived, my memory and sense had returned. I was taken back to Worthing to be checked out, but was discharged a few hours later and told such sensations are quite common following cardiac surgery. Very relieved, once again my wife drove me home, this time just beating the falling snow (by the next morning, we were snowed in)!
The following days and weeks passed slowly, but were helped by family visits. My birthday and Christmas were subdued, with my wife and I often in tears as we thought about what had happened, how our lives had changed, and wondered about what the future might bring. The Internet is a fantastic source of information, but it can also expose people with unusual conditions like this to fragmented knowledge that can be extremely worrying and stressful without knowledgeable doctors to provide context and assurance. Conversely, it can connect people with similar conditions who otherwise might never meet others going through the same experience.
As 2010 became 2011, my daily walks became longer and more enjoyable, and I began to reconnect with friends. The six week check went well, and I was given the green light to drive again and return to work when ready. I’m now walking 2-3 miles a day, and have my cardiac rehab workout once a week in Shoreham. I find that I feel much better in mind and body after some exercise, although I do get tired much more easily than I did before the event. I go back to work next week, initially part-time. My employer is a very large US energy company, and my Manager, Company Doctor and my colleagues have been very supportive. It will be good to get back to work, but I have no illusions that it will not be hard at first.
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