NARRATIVES
TALK TO A
ADVICE
Established April 15, 1995
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Stuart Gibb
Stuart has been a gardener and horticulturalist for
his entire adult life. In 1981, he apprenticed at the historic
Chelsea Physic Garden in London, England. He then studied
horticulture at the Nova Scotia Agricultural College, and has
remained there in various capacities: as a greenhouse manager,
groundskeeper and teaching technician.
Stuart has been married to his wife Sarah since 1983. They have two
children, Duncan, 18 and Ian, 16. The family currently has two
pets: Kohl, a Labrador-border collie cross, who was adopted 10
years ago, and Bailey, an energetic Labrador whose first family
could not deal with her. Kohl and Bailey work hard at keeping
Stuart exercised and in good shape!
His Winnipeg childhood has given him many gifts. Most notable of
these are his wonderful singing ability (from childhood training as
a boy soprano) and his love of railways. He is equally at home
singing medieval motets or discussing little known facts about
steam engines!
29 October 2005
Seven years ago my husband Stuart survived a Type I aortic dissection. It took almost two days from the onset of the first, terrible pain until he underwent open heart surgery at the Queen Elizabeth Health Sciences Centre in Halifax. The dissection was about 1 cm from the aortic valve and the false lumen extended to the renal arteries. It required a Dacron graft, repositioning of a coronary artery and a carbometallic aortic heart valve. We were amazed at the ability of medical science to "fix him" and very grateful for the competence and care of the hospital staff. He made a wonderful recovery, and we thought it was all behind us. With his coumadin, betablockers, lean physique and our two big dogs to walk, I thought my 47-year old husband would live to 100.
At the time of his surgery, we knew nothing about familial aortic aneurysms. We now realize he has a connective tissue disorder, and that he inherited the gene that causes it from his mom, who died of a ruptured aortic aneurysm at the age of 58. Our two teenage sons, Duncan and Ian, have been told they each have a 50% chance of inheriting this and have regular monitoring by echocardiography. While we recognized that they may indeed have their own bout with this disorder, we felt that Stuart had dodged the bullet and was fine.
In August we had our usual summer vacation at the family cottage in eastern Prince Edward Island. It was a bit different this year: we left the teenagers 'home alone' and, unlike some years, had two full weeks of sunny beach days. With regular cell phone contact to the (partying?) teenagers, lots of swimming, sailing and rowing, we were truly blessed. When we returned home, I came down with the flu, and soon Stuart had it. Along with it, he had a pain in his abdomen. His GP was suspicious and arranged for a CT scan. While the pain eventually did go away, the CT scan revealed that he has a 5.8 cm abdominal aneurysm and even more worrying, the aorta had dilated in the thoracic region. In places, it is up to 6 cm wide.
Stuart is now facing two repairs for his aorta. While the use of stents has progressed, their use in a dissected aorta is problematic. Open surgery and a graft will be tricky too: the aorta in the thoracic region is thinned and subject to tearing. The surgeons decided they wanted some time to look into this. We are waiting to hear from the surgeons about how they've decided to proceed. Stuart and I are mostly optimistic. We continue to treasure our time as a family, and memories of our wonderful vacation buoy us up.
I've learned so much from reading these chronicles from aneurysm and dissection patients and from their families. I've waited a long time to include Stuart's story—he isn't someone who'll write it himself, so I figured after all this time of reading these and thinking of you all, it was time to "come out". Make sure you get CT scans regularly, all you survivors!
I'll let you know how it goes—but in the meantime, pray for us!
Update: 22 March 2006
Stuart embarked on this new byway of his medical journey in September, 2005. After experiencing abdominal discomfort, he had a CT scan, which showed an AAA and a dilation of the thoracic aorta. At first, the cardiovascular surgeon considered endovascular repairs, but then said that was out of the question. We waited expectantly to find out what he proposed. He said an open repair of the Stuart's aneurysms was too risky with only a 25% chance of a full recovery. Only if the aneurysm ruptured, the surgeon said, would he undertake a repair.
We were flabbergasted. Everything we had read at this web site and elsewhere led us to believe that surgery was a good possibility: Stuart is relatively young, and his heart and lungs are in great shape. As for "waiting for a rupture" -- we live 100 km from the hospital, and Stuart is on anti-coagulants. We thought that was a pretty dismal plan.
Two local GPs encouraged us to keep on looking for a solution. I researched as much as I could. I contacted centres in Canada and the US that specialized in complex aortic surgeries. We asked the surgeon to support our application to get an opinion from a centre outside our province. He refused to do so, on the grounds that the hospital was capable of doing aortic repairs -- just not on Stuart!
The next step was a second opinion at the QEII. We planned to again request support for an out-of-province consultation. Instead, another curve! The second surgeon studied the CT scans and told us that the aorta had whole sections in good shape; that Stuart was a great candidate for surgery; that the abdominal aneurysm should be repaired as soon as possible and that while there was a chance of complications with the AAA surgery, it wasn't likely.
Once again, we were flabbergasted. The second opinion was so different from the first. Who do we believe? Stuart took a deep breath and agreed to the operation. He had surgery on December 7, and came through with flying colours. The surgeons switched to a bifurcated graft because his dissection extended down into the iliac arteries, and later told us there was no more dissection below the graft.
At the end of January, he returned to the same hospital for a CT scan to assess the surgery and to monitor the dilation in the thoracic region. He was given great news. The AAA repair is fine. There has been no further expansion of the dilation, so he is stable for now. We are thankful for the good work that has gotten him through so far. I encourage all of you, if you get a negative prognosis, to make sure you get a second opinion.
Update: 25 February 2007
At his last CT scan, Stuart found out his thoracic aneurysm has grown to 6.23 cm. He's scheduled for open heart surgery on Thursday, March 1. They are admitting him two days early for tests. We don't really know why the additional testing is required...he didn't have that when he had the surgery for the AAA a year ago in December. And of course, his previous open heart surgery, for the dissection with the aortic root and valve replacement, was emergency surgery, so you don't get admitted early!
This is such a strange disease - he has no symptoms, yet we had a nice long walk in the snow today, knowing that he would not be feeling this good for a long while.
This group has been so strengthening - we've both appreciated your messages, information, thoughts and prayers so much. Stuart reads emails and other people's stories; he just finds he can't write about it so I do that instead.
So think of us next Thursday, Stuart having surgery and me in that awful waiting room with our boys - and once again, your thoughts and prayers are so welcome.
Update: 17 March 2007
Stuart is now home from the hospital after his surgery on March 1st. He had some hiccups along the way - a few problems during the surgery, but it overall went well, and then a difficult recovery immediately afterward, with lung problems, and a dramatic blood pressure drop with internal bleeding after the lung problem cleared up. He was unaware of most of this, thank goodness. He has gotten some new heart damage from his ordeal but we are hopeful that it will get better over time. All in all, he spent 10 days in the ICU. The nursing staff there has our gratitude. It wasn't only the competence and compassion that I noticed, but, at times, a pretty fierce determination to do the best for the patient.
Thank you to all of you who were concerned about his surgery and sent thoughts and prayers. My heart goes out to those who don't have such a good outcome.
Discussion, comments, or questions: Sarah Macdonald
© Copyright 2005 Sarah
Macdonald
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