Well it has been a year and a half since that traumatic day in August of 1998 yet it still feels like yesterday in so many ways. My name is Veronica and I was 28 years old when the incident occurred. I was born with a bicuspid aortic valve and lived a very normal childhood and young adulthood. At age 21, I developed hypertension and was put on a beta-blocker incidentally. The BP appeared to be in control and quite frankly the medical personnel I sought over the years were not impressed as well. I just had essential hypertension (meaning no known cause) and that was it.
Being a nurse myself, I either ignored the combination of events before me or maybe it was that I so easily trusted those who were involved in my care. I realize this series of events would have happened no matter what, but I feel ignorant to the fact that I now know a stenotic aortic valve and hypertension are the key ingredients to an aortic dissection. If I had this knowledge prior, would I have changed my lifestyle. Oh, I don't know. When you are young and pretty much have the world in your hands you seem to automatically feel invincible. And boy was I ever. It's funny I try not to blame myself but I can't help but wonder if I did this to me. Like many young adults, I was out partying, excessively??...well that's a matter of opinion. The bottom line is my friends continue to party hard and they are fine. Truth is so am I, I'm just a little different now and in some ways the aneurysm has redirected my focus in life to what's important.
As I mentioned this aneurysm reared its ugly head on August , the 18th to be exact. Incidentally, this was four weeks after my last cardiac ultrasound (routine visit) which revealed no problems other than the aortic valve was starting to thicken and we would reevaluate it in 6 months versus a year. This day was a beautiful summer Tuesday morning. I woke up and felt fine. The day before I did have what I thought was mild indigestion but it didn't even last an hour. So I got dressed and headed on my way to Paoli Hospital, an account that I call on as a hospital sales representative. I wasn't even in the account for 10 minutes when I felt crushing chest pain, dizziness, just a horrible feeling of "doom" coming over me. I tried to enlist help from a volunteer to get me to the ER which she did. I don't remember; however. I apparently was put in a wheelchair that I fell out of when I completely loss consciousness.
I awoke on my back in a hallway to people touching me and asking me questions from every angle of my vision. It was unbelievably scary. I could not speak because quite frankly I could not breathe. It was just how they depict it on the movies. almost like an out of body experience. I knew it was my heart and I knew I was going to die, just when. I was able to manage to tell them it was my heart, my doctor, and even my parent's phone number with the help of a nonrebreather mask. My BP was around 60mm I believe and it felt like it. I have poor memory of time frames other than it took just a little while before they did an echo which revealed the 10cm aneurysm which had torn downward into the valve and the pericardium. I was bleeding into the sac around my heart and the gorilla on my chest was only getting more painful and heavy.
The people at Paoli Hospital I owe my life to--if it were not for their prudent measures I would not be here. Within no time, I had an arterial line with several IVs placed and was soon on my way via helicopter to Hahnemann University Hospital. I remember the chopper ride was only 8 minutes. I remember the trauma guys squeezing the IV bags with all their might. I remember looking at their monitor and thinking "oh, boy, I'm toast" Being a nurse at this time was definitely not a plus. I watched and felt myself going into hypovolemic shock. I watched the blood shunt away from my arms and legs. They were turning gray and cool.
In the CCU, awaiting to go to the OR I began to feel nauseous and threw up. I was getting worse by the minute, becoming unable to stay awake and believe me I was fighting to stay alive. All I could think of was of all the things that I would never get to do, like get married, have a baby, etc. Funny because they always say your life flashes before you, mine flashed in front of me of all the things that I have dreamed of since I was a little girl. At this point, it all becomes a little fuzzy. I just remember my nurse awaiting anesthesia and her saying "There is no more time". With that she pulled up all my side rails, threw some emergency syringes on my bed and ran me to the OR. All I could see was ceiling tiles flying by, and then I remember slamming into the OR doors where they flung my naked body onto the table. The last words I remember hearing were "This is going to burn a little bit" (the induction agent). And than that was it.
I woke up that night on a ventilator... I was alive!!!!! I knew something had happened but not to what extent. Now I know that when they opened me I truly was knocking at death's door with a 250cc clot trapped in my pericardium, but you know what my little heart was still beating. God just didn't want me. With need of reconnecting three coronary arteries, a new valve, and a new ascending aorta, God just held my hand. I realize now they were my surgeon's hands but God was there the whole time. That night I was taken off the ventilator rather quickly. Even drinking ginger ale with pills and talking extremely intelligible and coherently. I didn't sleep the whole night...could you blame me? My thought, would I ever wake up? The nurses were wonderful and by the next morning I had called my sisters to bring in my makeup bag because "I looked terrible". Gee, what was I thinking with a Hemoglobin of around 5.0 - I surely couldn't win a beauty contest.
So So there I was with a big bandage on my chest, tubes coming out of every orifice but I felt great because I was alive!!!! My surgeon, Dr. Morris had reconnected all my coronaries and gave me some new hardware, a #23 St. Jude valve with composite graft. I was then started on coumadin in addition to metoprolol which I remain on to this day. My recovery initially was a brisk one, but slowed by sequela related to surgery. Two weeks after my surgery, I developed a pericardial effusion just under a liter which a pericardial window was needed. Then, my groin bypass site went ahead and got infected putting me back in the hospital for IV antibiotics. That was the last of the hospital stays and then the "fun stuff" ensued --- getting on with my life.
At first I was plagued with all sorts of chest discomforts, the scarier being arrythmias secondary to the trauma most likely from surgery. These events bought me a ride to the local ERs a few times. Funny how I only wanted to go to those hospitals with open heart programs or helicopters!!! Now a year and a half later, things are quieting down. I realize my age along with the medical team I've entrusted my heart and future to is greatly responsible. Incidentally , a more in depth echo called a TEE done 2/99 revealed a stenotic bicuspid pulmonic valve. Very interesting , huh?!
I don't know how I would have gotten through this all without the help from my friends and family. My faith in God is stronger than ever and I try not to forget all the blessings he has bestowed upon me. I have suffered no complications from this event other than the obvious new parts and scars. I have no missing limbs nor loss function and no brain damage to boot! I have gained a wonderful boyfriend throughout this whole mess which has helped me to remember that beauty really does come from the inside. My employer was unwavering in their support and I am doing very well as a hospital sales representative for them.
I will be followed in an aortic clinic annually for the rest of my life as well as annual TEEs. As we all know, prognosis for young people is hard to determine with all the limited data so I will not deny it when I say that I still get very scared and depressed. I would probably be abnormal if I wasn't. I am still not married, who knows if children will ever be an option for me (although many say it's very possible). The bottom line is I'm alive, doing very well and need to remind myself of this fact.
I have read this site often, sometimes to find support and I'll be honest sometimes this site has really upset me but I was finally ready to share my story. No one will ever understand what it is like to be in our shoes, sympathy is good, but empathy is better. As I sit hear and listen to my valve click I know I will never be the same but then again that may be a good thing. Now I am getting the medical babysitting I should have had all along and now I can be proactive in preserving this wonderful gift we call life.
I settle on a brand new single family home in the next few months...a dream I've always wanted. My first niece, Sara Veronica, as well as Godchild, was just born 12/29/99 and I want to watch her grow up healthy and strong. I would truly enjoy any correspondence with this elite group we belong to...thank you for listening to my story!!!!!
A special recognition to St. Jude....keep up the good work!!!!!!