As requested, I’ll fulfill the obligation of a lengthy explanation of what happened to me this spring.On April 23, my aorta basically exploded. Technically, it dissected, which means it came apart. Think of what dissection means in biology class. My aorta dissected without any help from a knife. But thank goodness for tools that fixed it. There are three layers on the aorta, and the inner two layers of mine shredded. Here’s the scoop.
I was in the kitchen, headed to the bedroom to change clothes for a bike ride like any Friday evening, when suddenly, SUDDENLY, my chest hurt like a son of a gun. I doubled over, leaning on the counter and told Tom, “Something’s wrong.” I don’t remember what he asked me first, but he’s well aware of my high pain threshold. So far, the three times I’ve said “something’s wrong” in that manner, it’s been life-threatening, so he was worried. I asked if we should call the cardiologist, and he said that no, we should call 911. I wobbled over to the recliner and sat. He tells me I changed clothes first because I had my favorite shirt on and didn’t want someone in the Emergency Room to cut it off me (Aha. Experience. Been there, had clothes cut off before). I have NO memory of changing clothes. I do remember him asking if he should call 911 and my saying yes, I guessed he should.
Then I remember the first First Responder showing up who happened to be my former student Sheriff Mitch Gahler. I have never been so happy to see a familiar and kind face. I don’t remember much more. I remember saying good bye to Mitch when he left. I remember the ambulance squad coming into the house, and I remember nothing else for three days.
But Tom has filled in these details for me:
They couldn’t get the stretcher through our door, so they asked if I could walk. I walked out and got on the stretcher and into the ambulance (remember, I have no memory of this). Neighbors have since told me they were relieved to see me walk out the door. That should indicate that nothing life-threatening was happening, correct? Tom says I was chatting with them like I would normally. I hope I didn’t make a fool of myself! Turns out there was not enough oxygen getting to my brain for memory to kick in; I do hope there was enough oxygen for not sounding like a lunatic.
The ER in Mankato assumed I had a heart attack, but when they scanned my heart, they found no signs of attack and were stymied at first. Tom tells me that I told the ER nurse that my hands and feet were numb and tight. She told the doctor, who then scanned my aorta (“tighness” or numbness in the extremities is a symptom of aortic problems, which makes sense because hands and feet aren’t getting decent blood flow) and then they immediately threw me on the helicopter for Rochester, which the doctor had already alerted to be ready.
The only vague memory I have here is asking “Where are we?” and being told we were flying over Byron.
The surgical team wasted no time. By the time Tom drove to Rochester, I was well into the several-hour surgery. Dr. Stulak and Dr. Pochettino were rock stars. They repaired/replaced the shredded ascending aorta and the aortic arch with dacron, of all things, and teflon in the “root.” A Gore stent graft (think mesh liner like a mesh tube) was placed inside the descending aorta that could be reached through the open aortic arch, because the aorta was dissected all the way up, over the arch, and down the descending pathway. If you want to know more, you can look this stuff up online.
There are lots of details that I absorb as I read the clinical notes on my patient portal. Shortly after discharge, I was in no emotional place to read it, but I have tried to absorb it in chunks through the summer. They had to cool my body for “circulatory arrest” to do some of the procedure. This awed me when I read it: “Core cooling was then begun with the goal of achieving flatline EEG.” EEEK. Flatline. If you watch medical shows, you don’t want to read that in your own medical record. That’s a scary thought, but less so since I already survived it. I wonder if that cooling procedure was more advanced than stashing me on ice. I assume so, but I need to ask my cardiologist when I see her. Then after they’ve completed what they need to do, they rewarm the body. I also received 6 units of blood, 3 units of platelets, 4 unites of plasma, and 2 units of something else that I didn’t catch during the course of all this.
They couldn’t stop all the bleeding, so they couldn’t close up my chest after the repair. (That helps make sense of why I needed so much blood). So instead of closing me up, they packed my chest to leave it open, and placed a strut between the edges of the sawn-open sternum to hold it open. (I realized later that this is the second time I’ve had to have bones sawn in order to receive life-saving surgery. When I count the number of bones I’ve broken in my life, do I count sawn bones? Naw). My sternum was braced open for three days. Obviously, with that going on, they kept me in an induced coma. So that’s why my memory picks up again after three days, and I missed all of this fun. Thank goodness.
What I do remember is having nightmares that I was in the ICU. I vividly saw the windows in my ICU room. Then I must have drifted into some other dream and I remember thinking in my other dream, “Oh, whew, that was only a dream. Well of course, because there’s nothing wrong with me. I’m not in the ICU.” But the nightmare recurred at least four times. Now I wonder if that was when they were checking me for brain function, bringing me to consciousness out of the induced coma for those three days. Tom said they did it about every twelve hours, so that would make sense. I do know that when my eyes fluttered open, everything hurt. A lot. I didn’t come fully awake until they’d wired my sternum shut again and closed my chest, thank goodness, which was sometime three days after this all started.
Then when I finally did wake up, I saw those same ICU windows I had been visiting in my “nightmares.” But this time, they didn’t go away, I did not lapse into a different dream, and it slowly dawned on me that whatever was going on in the ICU was reality. But I still had no idea why, what happened, or how long it had been.
Everything hurt. Too much. And it was too much work to breathe. I remember lying there, hurting so much that I thought it would be easier to just quit breathing. And then I thought about my kids and Tom, and the grandkids. I wanted, needed to see them. Plus I didn’t know what had happened, and I needed to find out what I was doing in this situation, unable to move except my hands and feet and my head a bit. So I kept breathing. Breathing.
Now, looking back, that was a clear decision in my head to keep on keeping on.
As I became more aware of my surroundings, Tom and Josh appeared. Water in the desert.
I couldn’t speak because of a breathing tube, so I gestured for a pen. I couldn’t see the paper with all the paraphernalia in and above my chest, so I wrote from muscle memory, “Where?”
They answered “Mayo in Rochester.”
“What” I wrote.
They answered, “You mean what happened? You had open heart surgery.”
I could feel my eyes flying wide.
“Your aorta dissected, or basically shredded,” they said. “And the surgeons fixed it.”
When I got over that shock, I wrote “How…”
They asked, “How long?” I nodded.
“Three days,” they said. They laughed at my shocked reaction.
The nurse asked me if I was in pain and I wrote “ES-Y” but tried to put the Y in front of the E as an afterthought.
It was a lot to take in, but Tom and Josh were there. And they told me Nikki was flying in at the end of the week, as soon as she could.
When my breathing tube finally came out, I could talk, but my throat felt sore for a long, long time, even after I got home. The ICU nurse kept reminding me to breathe. “In through the nose, out through the mouth, nice and easy.” It was still too much work, and I occasionally thought of quitting, but by then, I knew Tom was there and Josh was there, and quitting was no longer appealing. I wanted to keep going on.