This is the story of our family's sad journey into the "world" of abdominal aortic aneurysm, three weeks to the day after we said farewell to my brother Ralph.
My brother, Ralph, had the best sense of humor and had a special way of just taking life as it came, going with the flow. He was a very generous man and was loved by everyone who knew him. Six years ago he was diagnosed with renal problems stemming from hypertension. Fortunately, the kidney disease was managed well and two years later had surgery to insert a stent into his kidney to improve its function.
Two and one-half years ago it was determined that he was in need of quadruple cardiac by-pass surgery...he was considered high risk because of his renal problems but there was not much of a choice in managing his coronary artery disease without the surgery. With the help of wonderful surgeons and through God's grace he recovered very nicely from that surgery. It would seem that he had a charmed life and we were happy to keep him with us here on earth.
This past summer Ralph started to complain of tremendous back pain but, as was his nature, he initially did not seek medical attention. I guess he chalked it up to typical back pain associated with his large stomach.
This past fall he mentioned it to his doctor who thought it might be arthritis and ordered x-rays of his back. Nothing conclusive came of that and the doctor then ordered a lumbar spine x-ray which was taken just before Thanksgiving. On Monday, November 27, the results of the lumbar spine x-ray showed evidence of a 5cm AAA and an as yet undetermined "mass". I am still not sure why no one immediately reacted to such a diagnosis...why he was not referred to a vascular surgeon or at least admitted for monitoring. I'm still not sure why I was a little too casual about such alarming news. In any event, my brother was given an appointment to see a surgeon for an evaluation and MRI on Friday, December 1. After the appointment and testing he was told to go home to await the results, I know that both he and his wife were a little annoyed at this but there was little they could do. They lived close to the surgeon's office and to local hospital.
Shortly after they got home they received a call telling them to return to the hospital immediately and to meet the surgeon in the Emergency Department. The news was not good... the AAA had "grown" to 9 cm. and was leaking. I am sure that my brother did not fully comprehend the extreme criticalness of this information. He always had such tremendous and maybe misguided trust in his doctors ( hadn't he already been pulled through two other crises?). After he was told he had to have immediate surgery he was also given the option of being transferred to Montefiore Hospital in New York for a type of non-invasive surgery to repair the aneurysm. He declined and chose to have surgery in the local community hospital.
Although I was not present during all of this it appears to me, from the details I was able to pull together from my sister-in-law and nephews, that the seriousness of this surgery and its prognosis were not made clear to them prior to surgery. So with a smile and a joke about not dying now and wanting some favorite food when he was on the mend my brother, Ralph, went off to surgery. At some point during the operation the aneurysm ruptured, the bleeding could not be contained and he "coded" in the OR. After 20 minutes of attempts to turn things around my brother died. There was, indeed, a mass near the aneurysm although my brother's family is not interested in knowing what it was.
We all lost a wonderful presence in our lives that evening of December 1. My oldest brother and I lost our brother. My mother lost her son and his family lost their spouse and their father. Countless others lost a good friend. But today my brother lives in eternity with our dad and others who have gone home before him. I know he did not want to leave us but I imagine that the angels voices were sweet and God's light was so bright and warm that he could not help but want to be there. My brother was buried on my birthday. He had just celebrated his 64th birthday on November 16.
I wander aimlessly some days between sadness and anger. I think I would have pursued having some questions answered more completely but that is my nature. My brother's wife and children are devastated and I understand their need to let it go for now. I have read all your stories and I am impressed with your faith and your wisdom...may God keep us all in the palm of his hand.
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