OUT OF THE BLUE!
By ANGELA SMITH
Saturday, April 24th, 2021, was an ordinary weekend day. There was no Water Aerobics, Tai Chi or Yoga classes and I got caught up with
some housekeeping, reading and light gardening. At 74, almost 75, I felt I was in good health and had monitored my health by attending yearly ultrasound scans. These measured for atherosclerosis, PAD, osteoporosis, and abdominal aneurisms. Each year, I passed with good results! I admit I didn’t always attend my yearly physical as my HMO doctor was not friendly and dismissed my claims of feeling well (“at your age!”).
I lived alone, and still do, in the little town of Boulder City, NV, supporting myself by writing and online consulting. I had made plans with a lady friend to travel to Green River, UT to visit a ranch and had a good social life. In addition, I prided myself on eating a healthy diet with occassional treats (I have a sweet tooth)! I had even decided to go ahead and have the Moderna Covid vaccines, as I had plans to fly to England in the summer. So far, I hadn’t tested positive for Covid and wore my mask and socially distanced. All in all, I felt that I was doing OK!
That Saturday afternoon, I decided to rest and sat on my bed watching a popular TV series. So, I was relaxing and enjoying the show, when I experienced a sudden, severe pain in my chest area that also went up both sides of my jaw. My first thought was “gas”, so I chewed a couple of mints. My next thought was “maybe” this is a heart attack, which I dismissed as I didn’t have left arm pain. My initial professional training was as a nurse, and nurses are terrible patients!
After a few minutes waiting to see if the pain would go away, it only got worse, and I decided to take a couple of baby aspirin, open up the locked front door and maybe call 911. I walked out to the living room, felt faint and decided to lay down on the carpet, where I passed out!
After, I don’t know how long, I regained consciousness and laying there thought ”Well, this must be IT, the passing over to the other side!” I felt calm and was quite prepared for what was to come. Then, I thought “I’m not ready yet!” I didn’t want neighbors to find me dead on the carpet! So, still in great pain, I got up, opened the front door, took several baby aspirin and decided to call 911.
The paramedics were wonderful, arrived quickly, did some tests, EKG, etc. and couldn’t find anything abnormal except for my sweating profusely and complaining of chest and jaw pain. They ambulanced me over to our small-town hospital, where they did a chest Xray and blood tests. And they were going to send me home, to come in the next day for a stress test! On the advice of my brother-in-law, I refused to be discharged home. Eventually, the Dr. ordered a CAT scan, bringing the radiologist from his weekend off, and found that I had a dissecting aorta! Panic stations!
I don’t remember much more of that visit, as they must have given me some strong pain meds and sedation, but I woke up in the ambulance that had been called to take me over to North Las Vegas, over an hour away. They had ordered an ambulance service with a critical care team, but I now feel sure, knowing the dismal survival rates of Aortic Dissection and my age, that they fully expected me to pass away before I got to the hospital. When I woke in the ambulance, I wondered where I was and was very confused. I thought that I was playing the part of a patient in a commercial for the ambulance company! But I decided to play along!
It was the middle of the night by the time I ended up at Spring Valley Hospital, Las Vegas, for open-heart surgery and only remember small parts of the preparation. The medications caused me to be very confused and suffered from delirium following surgery, where they placed a Dacron patch to replace my Stanford Type A dissected aorta. Fortunately, the dissection did not affect the valve or the arch where blood vessels went to the brain and other organs.
Recovery was difficult: this was during Covid, so for the next six weeks I was not allowed any visitors, only the medical staff. I gradually became lucid and from 9 days in the ICU, went to the step-down unit for several days. The meds kept me mostly pain free and I celebrated my 75th birthday in the hospital. There was talk of sending me to a medical rehab before I could go home. I had swollen up with retained fluid and couldn’t even use my hands properly. Eventually, when my surgeon Dr. Nauman Jahangir and Sheeba Kureekattil APRN visited, I was able to thank them for saving my life!
Never having experienced medical rehab, I thought, naively, that it would be something like a medical summer camp! I was so wrong! Silver Springs Medical Center in North Las Vegas was basically an aging nursing home with a doctor visiting once a week, peeking around the curtain. I was anoxic, my blood gasses were very low, one night they dropped to the 70s (normal is the 90s). When I was able to sleep I dreamed that I was being water boarded! I was on oxygen and had daily physio and other health personnel who did the rounds. I had no appetite and ate very little. I learned to walk with a walker to the bathroom and helped the nurses with my twice-weekly showers.
After a couple of weeks, it was decided that I should go home on oxygen and have a visiting nurse and physio. But before they sent me home they ordered an ultrasound of my chest that discovered that my heart was surrounded by fluid, I had a pleural effusion (fluid between the left chest wall and lung), and even more disturbing, multiple lung embolisms! They told me I was being sent by medical transport over to Mountain View Hospital in Las Vegas for a procedure to drain the pleural effusion. Then I would be returning to Silver Hills as all my belongings were there. I went over to Mountain View Hospital with just pajamas and my phone, no phone charger or purse, as I was expecting to return that evening.
I spent the first couple of hours in Mountain View Emergency Department where they declared me “critical” and delivered me upstairs to the CCU for the next 5 days where they treated me with IV heparin to dissolve the lung clots and installed a drainage tube through my ribs to drain the pleural effusion. An HMO doctor came to visit me and told me that it was a miracle that I was still alive! Towards the end of my stay at Mountain View Hospital I was weaned off of the heparin and oxygen, the rib drain, and IVs were disconnected, and I was discharged home.
Next week, I celebrate three years of survival from these ordeals and my 78th birthday! I call these my bonus years! My Drs are happy with my progress and I am basically back doing everything I did before the dissection including water aerobics, writing and working online, and attending social events. Life is good!