NARRATIVES
TALK TO A
ADVICE
19 December 2000
I'm a sixty year old male, recently lost my occupation due to an aneurysm. Mine is AAA and a diameter of 3.7CM. Not large enough to be operable, but nonetheless too much in existence to be permitted to drive (according to DOT).
I have no idea as to which way to jump next. I can't foresee any employer willing to hire a person with this preexisting condition, at least not at a wage level I could survive on.
My purpose of writing is to see if there are others out there who have been in this situation, and to ask how they managed. I find no support locally. And there is no one (to my knowledge) to ask of. So I have no knowledge of what to expect or when.
I have been told I will become a candidate when the aneurysm attains a size of 4.5 CM. I have had this "little friend" for three years, or more. It hasn't grown in the time it has been monitored. Does that mean that due to my low blood pressure, it may never grow? I have low BP due to the beta-blocker I have been on since 1983. My pressure never was extremely high, but high just as well, and the beta blocker did just fine, then as now.
Update: 09 Jan 2004
Today I met with Dr. Benkart at Allegheny General Hospital in Pittsburgh. The stint surgery will take place on Jan. 21, 04. Stint, did you get that? Stint! No open cavity surgery, and I'm delighted!
Yes, there is a long drawn out post operative procedure to follow for over a year. Still is better than the post operative conditions of the open cavity procedure. And I won't elaborate on them for fear of scaring the begeebers out of anyone. If the answer to a condition is open cavity, then that is the best way to go. But I don't have to consider that option. I'm so relieved I can't tell you in words. But my neighbors will know there is something going on when I start dancing on the front porch tonight, when the temperature is going down into the single digits. I'll be celebrating, and they don't have to know why. But they are welcome to join.
Please excuse my wordiness, but I'm wound up, to think this whole "little monster" thing is near its end is nothing short of Glorious!
Update: 07 Feb 2004
I was not prepared for the amount of discomfort involved in the stint procedure, The pain was bearable without the use of pain meds. But the bruising and discoloration was not within any bounds I had expected.
And the day I was discharged I couldn't get my trousers closed. I spent the next week in some very loose fitting sweats, and even the recliner was a tight fit. But two weeks later, and I'm fitting into the furniture more easily, and the sweats fall off if not tied.
The bruising is diminishing and slowly turning back to human skin tones. The discoloration from all the needle sticks is gone, and I can't say I miss them. I was black, blue and yellow to above each elbow. Had I spent another night in the Hospital, they would have had to start on my legs for blood sources. And I wasn't ready for that. I had enough needles, and I'm not looking for anymore, for quite some time into the future. Possibly decades.
I have an appointment for the follow up CT scan on the twentieth of February, and I'm expecting a good outcome from that, and getting on with my new life sans aneurysm.
I close with regard to you and all the members.
Update: 22 May 2006
February of '05 I had a total hip replacement. I'm aware that isn't usually an item for this group, but it gets better. Then in March I had the staples out and the next morning I woke up screaming in pain. A pain in the thigh of the leg I had the new hip in, like I suspect a hand grenade exploding under it might be equal to. I normally have a pretty high threshold for pain, but this was far beyond anything I have ever experienced before. The ambulance arrived and it took 6 Mg of morphine to get the pain reduced enough to let the crew get me onto the gurney, and another 2 Mg at the hospital to get me to the hospital ER bed.
I spent the entire day at the local hospital receiving 8Mg's at a time, first of Morphine and later Demerol, every two hours. They determined I had lost two or three units of blood with no outward sign of a bleed, other than internal, say intramuscular. Hence the extreme pain. I didn't know our bodies don't like our own blood anywhere but where its supposed to be. And in a muscle the size of the thigh muscles is a large pain zone.
Another Ambulance ride to the Pittsburgh hospital where the hip was replaced. They gave me two units of blood, and the cell count came to within acceptable limits. They determined the leak would be absorbed by the body, nothing to worry about. And two days later, I went home.
And so did the pain. Not nearly as sever as it was, but it was always there when I walked, and at times there was no position or place I could put the leg into without grinding pain. The kind that throbs at three AM to wake you if you got to sleep, and makes sure you don't sleep any longer. Doctors all agreed, it was pain, and they were sure it was nothing but post surgery pain, and it would go away, just keep taking the pain pills and keep it rested.
January of this year, I dislocated the new hip three times in two weeks. The second time, in the surgeons office. After the third dislocation, I went to the hospital with the understanding the following Monday I would undergo corrective surgery. This would be a three and a half hour procedure.
I was sedated on Monday shortly after noon. When I woke, the nurse asked me if I knew what day it was, I knew I must be in trouble, so I said Monday. She said it was Wednesday, I was in big trouble, I just knew it. She said there were some difficulties in the procedure. Later my wife told me they found an aneurysm, and it ruptured. The doctor confirmed it, added it was the size of a football. To make a long story short, they gave me five units of blood on that OR table, and the next day a clot formed in my Femoral artery and they did an emergency operation, I received another ten units of blood and blood products.
There are three things to be wary of when someone close to you is in surgery. "This was really exciting!" "This was an interesting event," and "This was a procedure that has changed the way medicine is practiced!" I'm told the doctor said all three in the first discussion post surgery.
I'm terribly sorry I can't give a blow by blow account of what all happened, I was sort of "out of it" at that time, and for several days after they moved me out of ICU. The next Monday morning there was a line of doctors in the hall waiting to come in to examine the result of whatever their part of my procedur(s), including the chief of vascular surgery. And there was the Saturday night before when the nurse came in laughing, and asked me what I did, there were doctors at every writing space in the station rewriting seven pages of meds prescribed for me.
So another aneurysm story, they can form anywhere, and they don't have to follow any written procedure, but this was my second time, I had the first one stented two years ago. The chief of vascular surgery is the doctor who performed that. Which is why I recognized him. I hope of hope's I never have another addendum to add to my file, but if I have any other procedure, and it involves an aneurysm, I pray to be able to write again.
Update: 31 August 2006
The past three years I have been fully occupied with a bad hip. Feb. a year ago (2005) I had a replacement hip put in. That should have been the place for a period, and life moving on. Not so, in my case. I was in pain. Day long and all night long, and codeine wasn't making things any better.
June of 05 I dislocated the new hip. Was transported to the local hospital where the good doctor told me I was quite lucky, as they have developed some maneuver to get these replacement hips back into joint. I was greatly relieved. To say it mildly. Around one in the morning the same good doctor came in and told me they were going to give me a mild sedation which I would not remember.
The nurse brought in the equipment, and started the IV, and I was gone. I woke up the good doctor is standing there, and said "You are very lucky, this doesn't usually work." And it was in place. A week later I go to the Doctor who did the operation, and began the never ending lecture about not dislocating that hip again. I did everything I could possibly do to keep that hip from dislocating again.
Sitting in my living room on the first of Feb. of 06, I dislocated it again. An ambulance trip to the local hospital, and it goes back in, but not without a lot of difficulty. A week later I'm leaving the doctors office from the follow up visit and lecture. I sat in one of the chairs in the building lobby, bumped my hip against the side of the chair, and popped it out again. This took still another ambulance ride, and the hospital was the same as the surgery a year before. But the Versit wasn't enough to get the hip back in place.
Off I go to the surgery department to get the heavy duty anesthesia, and this time they successful. And ambulance ride home (I wasn't to move that hip for at least three days). A week later it came out while I was sitting, in the living room again. This was another ambulance ride back to Pittsburgh, for a Hip revision. Sounds like something that should be done with a local like the dentist uses. But, wait, it gets interesting from there.
On Monday afternoon they come for me for this revision. They are going to open the hip back up, and do a three and a half hour procedure. When I woke up the nurse asks me what day is it. I respond It's Monday, she said its Wednesday. I knew there was a problem.
It turns out that during the procedure, an aneurysm burst. The aneurysm was on the second largest artery in the leg. Estimated to be the size of a football. And I took five units of blood to replace what was lost. That nigh I formed a clot in the Femoral artery, and that caused another procedure. All told, I was victim to a total of seven different procedures through to Wednesday afternoon, when I woke up.
From what I gather from the surgeon, My being alive is nearly a miracle. In total, I was given fifteen units of blood. And now sport a lovely cork screw in my leg, another reason for me to not be permitted to fly. Imagine trying to explain to the security guard why I have a corkscrew in my thigh?
All things considered, it appear to me that an aneurysm can develop nearly anywhere, and anytime. But it does seem logical, at least to me, that keeping blood pressure under control must have a lot to do with these developing. Which mine is all over the map.
I'm progressing in my recovery, but I think I'm going to dependent on this cane to walk. And my goal is to walk without it. Every time I go to the doctors office, they treat me like the resurrected. That's OK, with me, I like a little pampering. Almost seven months after the surgery, I'm still able to laugh at the whole thing. Probably the best way to get through it. At least that never ending pain is gone. My leg is numb and has little or no sensation, but that's better than sceaming pain.
I'm writing to share the humor of the procedure, not the pain and discomfort. I would not wish to do it over, nor would I encourage others to put off the needed surgery. Just be aware, there are three things at doctors say to be aware of: This was really exciting, or this is going to change the way medicine is practiced, or I never expected to see this in my practice. Which were the opening statement to me daughter after the second procedure. All in one sentence. My daughter was aware that I was in deep trouble. But I haven't finished tormenting my wife, so I came out of it.
With that, I'll close.
Discussion, comments, or questions: Allan Swager
© Copyright 2000 Allan Swager
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