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Evidently, I nearly died
April 29, 2016 - 4:55pm
♥ + † = ?
Last Saturday evening I was doing some housecleaning and waiting for my wife to return home from work. I’d given the bathroom a really good scrub, and was ready to empty the bathroom garbage when my eye spied a small scrap of paper – the ‘safety seal’ from a vitamin bottle – on the floor behind the radiator, and of course I couldn’t allow it to besmirch my cleaning job. I bent over kind of quickly and a bit awkwardly to try to reach it, and when I stood up I felt a strong, ripping pain in the centre of my upper chest.
I assumed I had strained, and pulled a muscle or something, so I went and sat down, but the pain didn’t subside. So, I went to the bedroom to lay down, but the pain remained. Worryingly, I also noticed that when I closed my eyes I got a free fireworks show. I sat up, I changed positions, I rubbed my chest, but it wasn’t going away. I won’t say that I panicked, but I did start to worry a bit, because this really didn’t feel right. I finally settled on just laying back, and trying not to freak out, and to wait. At a certain point I even wondered how I might know that it’s time to call someone, or time to write a note for my wife in case something horrible were to happen. And I also teased myself a bit for going paranoid over what I continued to hope was just a weird strain.
After about twenty minutes, I heard the downstairs door, and shouted a hello to my wife and she came up and asked why I was lying in bed, so I explained everything to her. We discussed it all for a few minutes, and she suggested erring on the safe side and grabbing a cab, which she knew I wouldn’t really want to do, but by this time all I could see out of my right eye was flashing purple lights. My left eye was mostly OK, but with both eyes open I had a hard time making anything out, so I OK’d the trip to the emergency room and started getting ready while my wife called the cab.
By the time we got there (about a five minute ride) my right arm was kind of numb and floppy, though it corrected itself quickly enough, but the pain was still there, and now my left foot was starting to go all rubberish. We registered at the front desk and waited. I was having some trouble walking at this point so my wife grabbed me a transfer chair, and soon enough a nurse called my name.
The nurse brought me to an examination room, asked a bunch of questions and went to grab a doctor, who came in and asked mostly the same questions. Then a bunch of waiting, some stethoscope action and so on, then more waiting. Soon a NP came in and slapped a bunch of ECG sensors on my chest and hooked me up to a monitor. Vitals OK, normal sinusoidal heart rhythm, slow but normal rate. My blood pressure measured a little on the low side, but that’s always been normal for me.
Then they sent me off for a CT scan. Ever have one? Lay on a table, hold your breath, get shuttled through a giant donut of technology. Science is great. Then, back to the exam room for more waiting. As we waited, we could hear the doctor conferring with someone by telephone, and we wondered if he was talking about me. And then we heard it: “patient, 48 year old male, upper chest pain with sensory issues in the left leg, and visual artifacts in the right eye. CT scan reveals a long tear from the aortic root to the transverse arch...”. That was me.
The NP came back and rechecked my blood pressure and told me she was going to start a couple of IV lines just in case. I asked whether there was time for me to go take a leak before getting tethered to stuff. She looked at me like I’d just asked to juggle some scalpels and said “no, you won’t be getting up for anything. If you need to pee I’ll bring you a urinal”. My wife and I laughed at it a little, because they’re made of cardboard now – the same kind of cardboard that egg cartons are made from. The NP assured us they’re good for about an hour before they get soggy.
The doctor then returned, and confirmed what we’d overheard: an aortic dissection. Funny enough, that possibility had occurred to me when I was laying down and hoping it would all go away, but I thought it was something immediately fatal, so I assumed I could rule it out. It’s what took John Ritter from us, but now that I go back and look, it turns out he didn’t die immediately either; he was misdiagnosed, and then died in surgery. Anyway, shit got pretty real at that point. The doctor told me that ironically, facilities at Toronto General were currently being used for someone with the exact same condition, and for someone getting a heart transplant, so I couldn’t really skip that line, and he assured me that he was phoning around to try to get me a table. He told me an ambulance was on standby for when they found one, and that the trip to another hospital would be fast, and that we probably wouldn’t be stopping for traffic lights.
A few surreal minutes later, they took one more BP and readied me for the ambulance. A few cool EMTs transferred me to a gurney, then out to the ambulance, and off we went, and as promised we flew.
More when I've got more energy.
***** SPOILER ALERT ***** Magoo survives.
I don't believe in God, but oh my God.
Thank you for sharing, thank you for surviving, and thank God for our health care system!
Get well and truly well, Magoo!!
Wow! Scary shit. Glad to hear you've survived!
magoo...thank you for sharing and surviving, strength and health to you!!!!
Thanks for the good wishes!
Cont'd:
So it turned out that they were able to rustle up an on-call team up at Sunnybrook, so that’s where we arrived. I got wheeled down a dim and quiet corridor, with my wife following beside, and ended up in the CVICU – Cardiovascular Intensive Care Unit. There, a small team of surgeons greeted me – my wife had been diverted to a waiting room – and they asked a few questions and got right down to business.
They re-explained what had happened, and told me what was soon to go down.
The surgeon asked if I had any questions, and of course one sprung to mind: what are my odds?
He informed me that even when caught early, the overall odds of mortality are between 20% and 40%, though he added that being relatively young and otherwise in good health would skew them in my favour. But still! I guess I was hoping to hear something like “well, there’s always a longshot chance...” or whatever. These weren’t “lottery” odds, or even “poker” odds, they were “dice” odds, and that was pretty chilling.
I also asked, out of curiousity, what my odds would be without surgery, and apparently the rule is this: +1% chance of mortality per hour for the first two days. So, 48 hours without surgery means a fifty/fifty chance. If you survive that then for the next three weeks the odds of mortality climb to 90%. And if you win that one, they climb to 99% by one year.
Blessedly, the other surgeon that was in the waiting room talking to my wife didn’t get into the scary math. He just told her that without surgery, this was basically 100% fatal.
They produced a consent form that probably said all sorts of important things, but I don’t know because I just signed it without reading.
Then the anaesthesiologist came over and explained what things would be like when I woke up.
With no further questions, they summoned my wife so we could have a moment or two. She appeared shaken but strong, and we said all the things you’d expect. Some things I guess neither of us cared to say out loud, but I did tell her that if something terrible happened, I hoped she wouldn’t do something just as terrible, and she agreed to that. We shared another “I love you” and a long kiss, and they wheeled me off to OR. I had presented to the ER at Western at about 6:30pm Saturday; it was now a little after 1am Sunday.
When I got there, they parked me outside for a minute, then wheeled me in. It was probably a big room with lots of cool technology, but from my position all I could see were the huge lights. And it was cold as balls. One member of the team went and fetched me a blanket – a heated blanket, no less – and I started to feel a bit loopy and realized that they must have injected the sedative into one of my IV lines. In the movies they always make you count backward from ten as everything kicks in, but I don’t recall having done that, nor do I recall the exact moment that the lights went out for me.
My wife could probably write this next bit in more detail than I can. All I remember is coming up from the depths, seeing blurry faces, feeling the tubes and wires and dressings, and hearing lots of beep-beeps and such around me. And being thirsty as hell. I remember a nurse asking me to try to cough, and when I did she yanked the breathing tube out of my throat, for which I was grateful. Other than that, most of this short time is gone to me. Apparently I could speak, weakly and hoarsely, and I was thirsty but could have nothing.
The next little bit of time consisted of me dozing, rousing, dozing, rousing, and occasional things being done to my IV lines, along with a dull roar of noise. At one point my nurse introduced herself, and then told me she wanted to remove my rubber drain hoses. She asked me to take a deep breath, exhale, then bear down like I was going to the bathroom. I briefly worried “what if I actually do go to the bathroom”, but as it turned out it would be days before that was even a possibility :)
I did as she asked, and she yanked on the rubber hoses and with a pop they came out of my belly. The sensation was exactly as weird as you would expect. She applied a dressing and I went back to napping.
The next thing I can really remember is being still very thirsty, and now I could have some ice. The nurse gave my wife a pitifully tiny cup of ice chips, each about the size of half a kidney bean, and she fed them to me one by one. Beautiful, glorious, delicious ice! I sucked some, crunched some, swished them around in my mouth, and finished the whole tiny lot like nothing.
The next many hours were fairly uneventful. I got more ice, people did things to my IV lines, I eventually got more ice, and I felt around on my chest for the dressings or other evidence of all of this. At one point the same nurse removed my pacemaker wires – also a strange sensation in its own way – and later that evening she gave me a wonderful wipedown, to remove all the betadine all over me, and she scrubbed my mouth with a little sponge on a stick, and some mouthwash. At some point she allowed me more ice, and this time it wasn’t in a thimble.
A lot of the next while consists of little more than me waking and me slumbering. Evidently I was being kept mellow by lots of hydromorphone, also known by the brand name Dilaudid. It’s great stuff. Get some if you’re ever hurting. But other than loopy thoughts, dreamy visions and the constant beeps of my monitor, there’s not much to tell. I’ll try to keep it to highlights for a bit when I can continue.
Holy crap Magoo! I'm so glad you're still with us. And I'm impressed at how soon you've been able to write again. Get well soon!
Good to have you still around.
Thanks for thinking of us, considering you probably have far more weighty matters on your mind.
Reminds me too of a friend's experience, and her reminder of how the symptoms for women are far different than those for men. Fortunately she is a nurse. She was feeling these suspiciious symptoms (back pain was one of them, I think), and went to the hospital. They took a blood test, which came back negative. They took another which came back negative, and were really wanting to send her home. She was insistent about another blood test, which came back confirming that she had in fact had a heart attack, and that if she had gone home she would likely have died.
Get some rest, and don't worry about stuff here. I'm sure it will all be the same when you get back.
radiorahim just alerted me to this thread. Magoo, I'm so glad you're okay! What a relief.
Nothing like surgery, huh? I had major (elective) surgery a few years ago, first time ever under general anasthesia except for a tonsillectomy when I was too young to remember. My odds were a lot better than yours (basically, 300-1 mortality rate), but I was still terrified beforehand. I can't imagine what you were feeling with those odds you were given, although I guess you didn't have a lot of time to dwell on it, at least.
Here's to a complete and uneventful recovery! Enjoy the loopy-makers. :)
Good on you, Magoo for having not only the strength to get through all this, but also the fortitude to then reflect on the experience , write it up and share it.
I have spent much of the past three weeks in the intensive care units of a couple of hospitals here in Nova Scotia, with both spouse and mother having major health crises within a couple of days of each other. Its been quite an education. But even as an 'observer', I am still processing it all and certainly not ready to share.
All I can say at this point Magoo is more power to you and all the other folks currently struggling with health issues; a huge hurrah to the medical professionals that do this incredible work, - and many thanks to Tommy Douglas and all the others who struggled and sacrificed to make our health care system a reality.
Seems my post got eaten...or something.
Or I forgot to hit the "post comment" button or something.
Anyway Mr. Magoo just wanted to wish you the speediest of speedy recoveries! That's some scary stuff to go through.
All the best!
Best wishes on a speedy recovery.
Best wishes for a speedy recovery, Magoo.
That was very generous of you to share your experience and an important public service. I only had experience, second hand at that, with my father in law needing surgery for an aortic aneurysm (6 inches) and he was in his early 80s. But he did advise my husband to tell our GP because his mother died of something similar and that there was possibly a hereditary component. But knowing your step by step symptoms is really important. It's so easy to dismiss weird but not necessarily overwhelming pain and just go lie down to never awake again. So thankful that your wife got home when she did to rush you to the hospital.
Take good care and thank you.
What a relief - but also what a detailed account.
Knowing what a cook Magoo is, this line was a bit of comic relief:
So you'll think of that the next time you are spatchcocking a chicken...
You are in exalted company - Measha Brueggergosman suffered an aortic dissection a couple of years ago, when she was just 31. They fixed her up at the University Health Network.
As I'm sure they told you, you'll have to take it easy this summer to let your sternum heal, and take care!
..great writings magoo. may you live for many more years to come.
My dad delayed because he thought it was "just pneumonia". It was congestive heart failure.
The damage to his heart turned him from a vital person into a shrunken old man, and was a good part of what killed him a few years later. I try to avoid unnecessary visits or medications, and I am fortunate that I have that luxury, but I take this as a reminder to not be stupid and imagine I am invincible.
Holy cow Magoo, glad you survived! A well written and graphic account too.
It is really hard to know whether something is a serious symptom or just the inevitable aches and pains that come with getting older. Is there any way people can better learn to distinguish between the two?
Thanks for all the comments and such. I'm happy if this all gets you thinking about health and health care in a personal context. As promised, just a few highlights to finish the story, and later I'll surely comment on some of your comments because there are some interesting things here. Also funny for me to note that in about 3 hours it will be exactly one week since I just HAD to pick up that one last scrap on the floor.
- All of Sunday night, I don’t believe I slept a wink. My wife and I sometimes have a bad sleep, and we feel like we didn’t sleep at all, but then we realize that we also don’t have 8 hours of wakeful memories to corroborate this, so we must have. But I had a large LED clock above my bed, and I checked it and checked and I really don’t believe I slept. My chest hurt like mad, despite the narcotics, and I was uncomfortable, and I think sleep just never came.
- In the morning, now Monday, I woke up and met my new duty nurse, as much an angel as my first. She was Dr. Feelgood with the pain meds, and I really appreciate that. She’s also the first nurse that I noticed checking and emptying my urine. I’d always dreaded being catheterized, but in the end I found it remarkably convenient! By this time I could have ice or water relatively unchecked, but I just never had to pee. Why these aren’t popular at concerts and sporting events is beyond me.
- When lunchtime rolled around, none had been ordered for me, but my nurse went and swiped an unused lunch tray and told me to just go with the “clear” items, which turned out to be tea, broth and jello. Luckily I have, all my life, loved jello, so big +1 there. I drank some of the tea and told my wife “not to be a complainer, but this is the worst, weakest tea I’ve ever had”. I even made her try it. When I’d drank ¾ of it I noticed, on the tray, my still-sealed teabag! I’d been drinking hot water flavoured with plastic cup. Very embarrassing, but I blamed it on the drugs and finished my “silver tea” anyway.
- At some point the central line tube came out of my neck, but I don’t remember when. When? Anyway, gone.
- At some point on Monday I got transferred to a new room on the same floor, and got another new nurse. She gave me another sponge bath, and was kind enough to remove my catheter. I’d enjoyed the convenience, but at a certain point it started to always feel like I had to pee just a little, and there was nothing to do about it. Peeing in more cardboard jugs was awesome.
- My wife came by during visiting hours, and they wheeled me and my fancy bed to somewhere off to the side. My wife had brought her e-reader, and as I put it to a friend, for about five hours she read quietly while I rode my unicorn through Morphineland. Finally getting some shuteye felt like a million bucks.
- That night I awoke to a godawful noise of some sort, coming from someone in the ward with me, and I recall having some exceptionally paranoid thoughts, including “what if I actually died and this is all just purgatory” and “Is that nurse out to kill me the way she probably killed him?”. Hehe. That wonderful, delightful, pleasant nurse. Once again, I blame the drugs, and the fact that nothing in my last 60 or so hours was making any sense at all.
- I was given my “heart pillow” – a little red pillow shaped like a heart, sewn and stuffed by volunteers. It’s not a memento – you hug it to your chest when you cough, to dull the pain (by at best about 5%, I’d say). And my exercises began: deep breaths in through the nose, out through the mouth, and each fifth time, try to cough with the pillow to keep pneumonia at bay. Also, every hour, flex both feet backward and then point toes like a ballerina. This is to stave off blood clots in the legs. Easy enough, but I didn’t love them.
- The next morning I woke up feeling like complete crap. One of my surgeons came around for a look-see and gave me a hard time over basically being in a fetal position and moping. My physiotherapist was a bit more forgiving, but all the same warned me that I’d need to man up soon because there’s no other way.
- Lunch was some chicken noodle soup – not so bad, but as I would discover, it was completely sodium free, like EVERYTHING in the hospital. This time I knew how to deal with my tea, so at least I had that going for me.
- Despite feeling like crap, I guess I must have been making progress, because they transferred me out of ICU and up to the ward. Now I had two “bunkies” – I’ll call them Mr. A and Mr. M. They were both about 55 and in for cardiovascular issues. Mr. A had been through the system and knew all about it. Mr. M was clearly a first timer and was beyond miserable. He had great family support – his boys and his family would come by every day and he always sounded “up” when they were there, but the rest of the time he was clearly living in hell. He couldn’t keep food down, he couldn’t sleep, he couldn’t stand the ‘hospital smell’. I felt really bad for him. I’m not sure exactly what his medical condition was, but I got the sense it was worse than mine.
- At one point a very nice volunteer came to my bed and asked whether I’d like something to read (“yes, please!”) and left me with that day’s “Metro” paper, and a National Geographic from 2005. So I can tell you where our health care dollars aren’t going. But I still read every word of it. Ask me anything about Box Jellyfish.
- On my second to last day, Mr. A was discharged, in pretty good shape, and I wondered if this is how it is in prison. Someone gets to go, and you make sure to be happy for them even when you’re a little jealous. He was promptly replaced by Mr. D.
- I’ll mention more about Mr. D only because it’s kind of interesting. The veins in his leg are totally screwed up, and he had natural grafts that collapsed, an artificial vein that worked for a while then failed and got fixed, then failed again. He was in for his fourth kick at the can, some new procedure involving “vacuum packing” his leg, whatever that means, but he told me that his actual preference was for an amputation, his thinking being that then it’s just done. You adapt to your prosthetic and you go back to life. Apparently they won’t do that unless you’re over 65, and he was only 55. In fact I think all of my bunkies were 55.
- On the ward, my appetite came back, though not so strongly that the small portions were insufficient. But I ate everything they gave me, I was up and going for strolls through the halls, and things were looking good. The crap I’d felt a day earlier just lifted, and now it was just the pains and strains you’d expect. My PT and NP were starting to talk about discharge and I was down with that.
- On my last day we got woken at 5am for pills, and I never went back to sleep, but I simply couldn’t wait for breakfast, which took forever. Suggested improvement to the system: have someone come around with coffee, like in a restaurant.
- My nurse finally told me it was shower day. By this point my hair looked like it had product in it, and for some reason the bed baths had stopped, so I was beyond excited about this. That meant removing pretty much all of my remaining dressings, and frankly I hated that worse than the endless needles. I have big patches all over me where there used to be hair, but now they’re smooth and waxed, just in time for beach season. But Ow Ow Ow.
- The shower is basically a whole room, with a shower head and a bench, and they just send you in to enjoy. I’m pretty sure I used almost half a cup of shampoo/body wash just on my head, and it was glorious. This was also the first time I got to see my scar. 21cm of angry flesh! And below it the two still open drainage sites, which I now call "the Snakebite" One of my dressings, on my groin where the cardiac catheter went up, felt like there was a big strip of plasticy goo left behind, and I was all set to bite a stick of wood and just rip it off, then I realized it was a nice neat row of 20 surgical staples – they’re still there.
- When I got back to the room, feeling like a thousand bucks, it was breakfast time and it smelled amazing. A warm blueberry scone, some bran flakes (I knew what they were trying to do there) and a hard boiled egg, with pepper even.
- And that’s about it. A few hours later I was receiving prescriptions to be filled, discharge papers, pamphlets and other stuff, and waiting for my wife to bring me my street clothes. We hopped in a cab at a little after noon on Thursday, and now I’m home.
if you're up walking the sponge baths stop. ;)
Yes, good luck with the recovery, and not to scare you with the story about my dad. I could also tell you about my father-in-law, who also had the open heart thing (six years ago, I think it was), and did the whole pillow and exercise thing for healing. I was out with him just this afternoon, throwing around boxes of metal scrap in the shop. He can still do harder work than some people half his age.
Hi Magoo!
Glad you're still with us and able to write so well and interestingly about the experience. Get well soon!
Me too. Tonsils, 1970. When I got my wisdoms done I elected for local over general. I'll be the first to admit that I've always avoided the medical system whenever possible -- "'tis but a flesh wound" -- but I'm giving that a rethink.
At some point I'll probably have more to say about this, but the TL;DR version of it is just that I give the care I received full marks. Part of my scribbling this down is because it was also an interesting experience in a lot of ways.
I think this is a recurring theme in this thread, and it's true. We pride ourselves on our medical system, then we pride ourselves on not using it. Who wants to explain that to a developing country?
And also the converse -- I thought of spatching a chicken when they did that to me (minus the garlic, rosemary and butter). But for what it's worth, that's 99% of my hangover right now. The new aorta doesn't feel a thing, but oy, the chest! Mrs. Magoo likened it to when the dentist cranks your mouth open for an hour to fit a crown or whatever, and then your jaw aches for two days. But as she notes:
a) this is your whole chest
b) they need to saw a pretty big bone in half to do it
c) your jaw is actually intended to be opened
Not to sound corny, but your body will probably know. In my case, what sealed the deal was the purple lights. I couldn't think of any good reason why straining my chest would bork my vision. And even from the first minute, I kind of knew, but I wanted to rationalize it away because I had a nice quiet evening planned. But even before my wife returned home, I was starting to come to terms with a bit of a hassle. At first I thought "OK, I'll go, and they'll send me home with some pain pills and we can still get takeout", and then "OK, I'll consult with the surgeon and he'll tell me they can treat this with medication", so I kind of worked my way up to it.
I guess that's it. But the real baths don't start! I was getting really annoyed at being able to smell myself. Not sweaty BO, but just a basic oiliness that drove me nuts.
No worries. At this point I'm already feeling like I beat this. I told my wife today that once it's all good, I might get a small commemorative tattoo of a heart. But not a heart from a playing card, an anatomical heart. Then, when I'm boring people with my story I can point to it and say "see this little part here? That's what I don't have one of".
Jesus Magoo. I'm so glad you're able to share this with us, and wish you the speediest possible recovery.
A tip for anyone in a hospital. Baby wipes are a lifesaver. Not like a shower but they can keep the oder at bay. They are better than "wet ones" which have too much scent in them (for my taste).
Holy smokes! Sorry to hear this happened Magoo. Really happy that you are still here to talk about this.
Like others have said, never take anything for granted.
Now, of course, comes the rest and recovery. Of course for the time being you just have to relax, but you like to keep fit, and can be a factor in surviving after such "insults" to the body. I guess they'll be telling you what you can and can't do.