Aortic Aneurysm: To Be Continued

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Richard Longfellow

My name is Richard Longfellow and I am 48 years old. I work for the University of Florida as a Senior Telecommunications Specialist and job estimator. I was born in Muncie Indiana and grew up in nearby New Castle. After marrying my wife Liz in 1976 we lived in Cleveland Ohio, Erie PA. and then moved south to Florida for the last 15 years. I have 2 grown boys and 2 girls, 1 grandson and another coming around Christmas. I fly RC airplanes, played a little golf and enjoy motorcycles and my favorite sports car Pontiac's Fiero!

To Be Continued

22 August 2005

I found this group about six weeks ago while doing research into aortic aneurysms. I had gone to my regular doctor because I had blown out my right knee while exercising on the treadmill. The group of doctors I see are associated with Shands teaching hospital at the University of Florida where I work. I usually see a third year resident and have been fairly happy with the care I receive but I got a new resident this time.

I told her about my knee problems and she confirmed I had torn my right acl. She then asked me if I was having any other problems. I told her I was having some difficulty breathing at times and some pain and tightness in my chest. She checked my records and found that I had a stress test with ultrasound 2 month before and she went to look at the films.

When she returned she told me there was somthing unusual on the films and wanted me to see a cardioligist asap. She must have been very concerned because she had left me a voice mail before I could get back to my office.

Saw the cardiologist the next day and was scheduled for a heart cath four days later. After the cath he came in with the news. He told me and my wife that I had no blockages in the heart but there was a problem with the aorta being enlarged. I was sent for a CT scan the next day and was scheduled to see a vascular surgeon the next week. That was when I started doing research and found this site.

I was diagnosed with aneurysm of the ascending aorta of 5.5cm. that starts at the aortic valve and goes up to the beginning of the arch. That was mid July and now it's August 22nd. Tomorrow I go in for pre op testing and then I go back the next day at 5:00AM for the surgery. My surgeon said they may be able to save the valve because it appeared to not be leaking.

I feel blessed that I was diagnosed when I was and for the fresh mind of my new resident doctor and for having a special team of surgeons and doctors on the UFAST team that will be performing my surgery Wednesday. Hopefully in a few weeks I will be able to give an account of my surgical experience.

Update: 2 September 2005

Thursday August 24 I underwent 5½ hours of surgery. I don't know if that was actual operating time or time I was on bypass. I am now the owner of a St. Judes valve and a complete dacron arch. Unfortunately my valve was bicuspid and slightly leaking. The aorta was replaced almost to the descending bend thus bypass was stopped for 23 minutes with my head being chilled.

I awoke in SICU late the same day, still very foggy on that but I remember my wife and the surgeon litely shaking me back to the real world. I would have to say this last week has been coming to me slowly.

I came home Wednesday and am enjoying being out of the hospital, eating real food and relaxing in my LazBoy.

Update: 25 October 2005

Today is the two month anniversary of my aneurysm and valve replacement surgery. I have been back to work for two weeks and feel pretty good most days. Walking is still my biggest problem because of the torn acl and lack of meniscus in my right knee. Replacement of my knee is the next step in my rehab.

I have learned a lot more about my surgery from the post op report I had to file with my disability insurance claim. My surgery was performed by Dr. Tom Martin at Shands Hospitol in Gainesville Florida. I can't praise him enough for the outstanding work he performed. These are the procedures performed:

1. Ascending aortic replacement.

2. Proximal aortic arch replacement.

3. Aortic root replacement utilizing a 29mm St. Jude valve combined with a 32mm dacron tube graft.

4. Utilization of cardiopulminary bypass with profound hypothermia (18 degrees Centigrade).

5. Circulatory arrest time 11 minutes, cardiac ischemia time 92 minutes.

6. Cardiopulmonary bypass time 145 minutes.

Total surgery time was only 5.5 hours not including prep time.

Honestly I can't remember much from my stay in the SICU. I think the memories are there just can't find them at the moment. I do remember 2 of my 3 roommates in my stepdown room. My wife swears there were 3 but I only recall 2. The first was a really nice older gentleman in for a catherization and we found out he was a patient of my nephew who is a dentist. The next one was a royal pain and the only way I could sleep was to ask for pain meds even though I really wasn't in much pain.

Still have not hit the target range for my PT/INR either a little high or low because of the Amioderone I was taking for the a-fib I was having. Been off that for 10 days now so I hope my next PT will be in range, it is a pain and I miss my Friday beer at Chili's. Now if they would only let me play some golf.

Update: 12 November 2005

Went to see my cardiologist last week ( Nov. 2nd. ) and was given an excellent review. Doctor is now allowing my weight limit to go up to fifty pounds and gave the OK to start resistance training and play GOLF. Scheduled for Ct scan next August and annual follow up visit.

For the first time in over a year I actually played a round of golf today. I was very surprised at how the upper body has healed so quickly. Absolutely no pain or problems except for my knee being weak and stiff at the end of the round. BTW: shot a 91, sure feels great to be back playing.

Update: 4 October 2006

It has been almost a year since my last update and I have already passed my one year anniversary. Things have mostly gone fairly well since last November when I updated my narrative. I have been playing a lot of golf and trying to prepare for my upcoming knee replacement in mid November. The knee pain that saved me has not let up and has made exercising difficult even with daily pain meds. The meds also make me slow and groggy which has effected my work, I'll be relieved when the pain and the meds are gone.

In July I had an episode with burning chest pain and visited the local ER where they ignored what I was telling them and tested for a heart attack. All the blood work was negative of course and nothing was on the X-ray they took. Saw the cardiologist a few days later and they did an echo which I enjoyed watching as I could see the St. Judes valve happily clacking away. Also could see the outline of the Dacron graft and all the chambers working properly. They told me everything was fine and had no explaination for the chest pain.

The next week I tried to get in to see my family doctor (the resident that saved my rear) only to find that she had graduated and went into practice at a different clinic. I e-mailed her and thanked her caring and taking so much interest in my health, think I may have made her day with my sappy letter. Now I have to find a new GP and maybe a new Cardio as I am not pleased with him only checking the heart and valve and not even looking at the remaining aorta which I thought was just as important. I guess I am pretty lucky as I am down to two BP meds and the Coumadin. BP stays 110/60 and PT/INR in the middle for ten straight months.

I am currently restoring an older motorcycle and awaiting the arrival of grandson number 3 in early January. Hopefully by then I will be totally painfree and back on the course grippin it and rippin it.

Update: 20 November 2006

Just wanted to let everyone know that my knee replacement surgery went off Wednesday. Although the knee is very sore and stiff I had no heart or vascular related problems.

Nurse and Physical Therapist both visited today at my house. Thigh was so weak I couldn't lift it off the bed but now am able to elevate it a little without assistance.

Don't know if I can stand being home for six to eight weeks, bored and not much on the tube even with a free movie weekend.

Thanks for all the thoughts and prayers.

Update by Susan Weinholtz: 9 Dec 2007

It has been a while since my last update as I wanted to have all my thoughts together. The last year has been a little bumpy and eye opening experience. In my last update I told of my knee replacement and I can honestly say it has been well worth the risk as I have full mobility and zero pain. Unfortunately all the pain meds I was taking led to severe constipation and I believe is where my new problem originated.

In January I started having problems with headaches and loss of feeling in my left hand. I was having trouble flying my RC airplanes and my reactions and timing just weren\'t right.About this time we found out one of our grandsons heas BAVD and will have to be monitored annualy. I was really upset and depressed but am thankful we know and can do the right things to keep him healthy. Then in March I spent three days in the hospital with chest pains and a vision problem. X-rays and CT scans were inconclusive and I was sent home. I continued to have headaches and vision problems so I scheduled an appointment with a neurologist and another CT scan was ordered. This was in June and I heard nothing until my follow up with the neuro. That is when I found out I have an aneurysm on the left internal carotid that is causing the vision problems and headaches. The neuro was confused because he had ordered a conventional cerebral angiogram July 7th. and it was August 28th. and I had no knowledge of the aneurysm or the need for the CCA. We then started trying to schedule the procedure at the local hospital and at first they said it would be no problem doing it as an outpatient. By the next day they changed their minds and said I had to got to Shands and be inpatient because of my Coumadin and the need to be bridged with Heparin. The ball was dropped again and another two months passed without word of the procedure being scheduled. I then had my primary physician refer me to a Neurosurgeon at Shands and was seen November 15th by Dr.Stephen Lewis and Dr. Brian Hoh. It was decided that Dr. Hoh would do the CCA and coil the aneurysm and I was to be admitted Nov. 26th. and surgery would be the 28th. It is now December 4th. and I am writing from my desk a work. The aneurysm was coiled and stented with no obvious problems. I spent seven days in the hospital with heparin running constantly and Plavix and asprin added to my warfarin after the surgery. I will have to take both for at least six months as a precaution for strokes. I still have the headache and was told not to expect it to go away but it should not get worse. The doctors were very upfront about the reasons for doing the procedure was to prevent rupture and risk of dying not the elimination of the symptoms. My doctors said I was one of the lucky ones. Most brain aneurysms have no symptoms and burst with more serious consequences. I call it being blessed.

Discussion, comments, or questions: Richard Longfellow

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