I was born in 1927 so that makes me 73 years old. After I got out of the Army in 1947 I went to work for a bank. Three years later I left the bank and went to work for the Pacific Gas and Electric Co. I retired in 1984 after my AAA surgery. Sure glad my retirement package included hospitalization with Kaiser Permanente. Joy and I have been married 32 wonderful years. She is a great woman. We have 4 children, 18 grand and great grand children. I like to build and fly radio controlled model airplanes, play and work on my computer and travel around the States in our motor home.
We wish to thank all those who replied so quickly to our initial query. We need all the input we can get so that my husband makes the right decision. I am writing this on behalf of my husband.
There is a lot of info on AAA but not so much on Thoracic Aorta Aneurisms. It seems there are greater risks associated with the Thoracic type.
In November of 1983 at the age of 56 my husband underwent abdominal aortic surgery for an aneurism. After we rushed to the hospital and he was diagnosed, we were allowed to go out to a close-by restaurant for a "last supper". The doctors did not hold out much hope for his surgery or recovery. We ate dinner holding hands and weeping. Total relief after he came through the surgery a-ok only to be told by the surgeon "We usually lose smokers the second day".
Five and a half days in ICU and one week later, I got to bring him back home. While he was in ICU he was in such tremendous pain from a clot (fragment? or ?) that went down his leg and into his big toe, that he was begging them to cut off his toe. He said the pain and discomfort from his surgery site was absolutely nothing compared to the excrutiating pain in his toe.
Possibly the memory of this has something to do with holding back on surgery now. The Doctor said 5 to 7% of the surgery patients become paraplegics. We were told he has only a 30% chance of lasting two more years without surgery. He now has a 5 centimeter Thoracic Aortic Aneurism. He has had it for one and a half years. I feel like he is a Time Bomb waiting to go off.
We are with Kaiser and have been told that they don't do that surgery. It would have to be "approved" and "jobbed out". That will all take time, too.
Again, thanks to all those who replied and for your helpful responses.
Update 24 May 2001
After quite a bit of e-mail advice, my husband bit the bullet and asked our HMO to look for a surgeon and to get the operation approved. A month later we were informed that the threshold for TAA surgery is 6 to 6.5 centimeters. We are now waiting to get several tests scheduled so that the doctors can determine if my husband is a candidate for surgery and/or a stent. Our educated guess is that they won't do anything until the aneurism reaches the threshold size. ----and so we wait!
Update: 19 Mar 2002
After numerous phone calls we finally got tests scheduled to find out if my husband was a candidate for surgery. He passed the tests a-ok. After we had all the papers in order giving permission for the surgery to be performed at Stanford we learned that the operation would not be done unless the aneurism reached 6 centimeters.
May 10, 2001, my husband started taking Diltiazem to lower his blood pressure. A CT Scan done Sept. 18th showed no change in the aneurism. We were both relieved.
January 28, 2002, he was admitted to the hospital with what we thought was a chronic obstructive pulmonary disease episode. It turned out that his heart was not pumping sufficiently to clear his lungs of fluid. He was taken off the Diltiazem and given Diuretics and meds to help his heart pump.
He went in for another CT Scan March 12, 2002. We were told that his kidneys have "worsened". They couldn't use the contrast material for the Scan because of his kidneys and so did the Scan without it. Again we were relieved to hear that his aneurism is still the same size.
My husband has been taken off all medicine except Lasix. He is really between a rock and a hard spot now. It is highly unlikely that the surgery can be performed unless under an emergency dissection situation. Even if his kidneys cooperate and he is able to take meds again, his Congestive Heart Failure is not reversible. He needs to be able to keep his blood pressure low because of the aneurism, and also he needs to keep his systolic pressure up because his heart is only pumping at 20% of normal. This is turning into quite a balancing act.
We're taking each day as it comes and are thankful for each one we get. It was difficult at first dealing with the "time bomb" aspect of the aneurism. Because nothing shows on the outside our lives didn't change too much. He took some pills, we monitored his blood pressure, he slowed down a bit and stopped lifting heavy things.
Now, with this chronic heart failure everything is different. We've had to change our total life style. He's having a difficult time letting go of the reins and letting me pick them up. It's emotionally distressing when you can't do all the things you've been doing all your life. We're keeping our sense of humor active and do find lots of things to chuckle about. I think if we couldn't find something to really roar and laugh about each day we would both go stark raving bonkers.
Hopefully I won't have to write another update for a long, long time.
Update: 22 Sep 2002
This is to let you know we are still hanging in there. My husband just had another CT Scan to check the size of his aneurism. The doctor told us there was no real point in checking because my husband can't have the surgery anyway. We still wanted to know the size so insisted on the scan.
The first time it was measured they told us 5 centimeters. The next time, six months later, they told us 5 1/2 X 3 1/2 "No change". Now they tell us it is 6 X 4 at the widest and "No change". This just blew my mind. The doctor calmed me down with the explanation that the size depends on who is reading the scan, on what slice they are looking at, and at what angle the slice is taken.
What this tells me is that from one scan to the next we will never really know the size of the aneurism since no two people will be taking it and reading it in the same way.
We thought this info might be useful to some readers.
Update: 17 Feb 2004
We're still hanging in there. My husband has been in the ER seven times since our last update. His troubles have been Bronchitis, Breathing problems because of C.O.P.D., Gout because his kidneys are not doing their job, a Heart Attack, and Pneumonia. He has lost over 50 pounds.
The last time he was in the ER was on Thanksgiving evening, 2003. Two doctors talked to me about "how far do we take this" meaning does he want to be put on Life Support. I told them he did not want any heroic measures taken and that he did not want to be put on Life Support. They said they would help him just up to that point. I held his hand for several hours expecting the worst. A passing doctor finally got me a chair to sit in while I held his hand. About 11:00 he started feeling better. I believe it was in answer to our prayers. He continued to rally Six days later I brought him home. He is still improving and is even gaining a bit of weight. We are still very thankful for each day we get, and we still find something to uproariously laugh about each day.
Update: 15 Apr 2004
It Is with a totally saddened heart that I write this last update. My husband passed away on March 31st. It wasn't his aneurysms that got him. He had been failing for quite a while from other things.
I took him in to the Emergency Room at Kaiser Hospital on a Monday morning. They worked on him through that day. Tuesday he was on a Respirator all day and not awake at all. The doctor told me that he would not make it and he recommended that I take my husband off of the Respirator. My husband had told me many times that he did not want to be kept alive by a Respirator and he had signed a paper to that effect. This made it easier on all of us, including the doctor.
Nine of our 21 grandchildren and three of our children were at the hospital with us. On Wednesday morning I asked that he be taken off of Life Support then I held his hand for three and a half hours until he took his last breath.
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