Eunice has, insofar as it is possible to say such a thing,
completely recovered from her aortic dissection of May 2011.
But I'll leave this tale here for awhile.
Last update (AT BOTTOM) Sept 14, 2011
(link
to
picture
A
) A striking picture of an
artery filling with blood after a stent was placed.
(link
to
picture
B ) A picture from a cat scan,
showing the extent of blockage of the aorta
Late on May 31,2011
On Monday, May 23, 2011, Eunice Ordman (age 87) was diagnosed with a
major type B (descending) Aorta Dissection, an event comparable in
risk
and impact to a major heart attack, and more often fatal.
Google Aorta Dissection for some details.
Loosely, the inner lining of the aorta tore and blood rushed in,
separating the inner lining from the outer wall of the aorta.
There are several major consequences.
(1) The working aorta is much narrowed, increasing blood pressure
and
load on the heart. (There may be minor damage to the heart valve;
there
is some prior aortic valve stenosis. So there will be shortness of
breath.)
(2) The aorta is now much more fragile so blood pressure must be
kept
very low (below 120[more
flexibility
as time increases]). There is at least one substantial
aneurysm
(3.8
cm.)
(3) There can be blockage of the side arteries to other organs. The
brain is not affected. One kidney has been lost but the other is
functional. The real open question is whether enough blood is
reaching
the gut (intestines). Apparently one of the three arteries in that
area
is blocked, and two are damaged in an as yet unknown
percentage.
The surgery necessary to correct these blood
blockages would possibly be very major, very risky, and possibly
lead
to Eunice being a “weak old woman”. Eunice says she would decline
surgery on those terms. The doctors still hold out hope that
with
blood pressure control and an appropriate diet, she may well recover
and be able to live relatively normally (no heavy lifting and no
exercises likely to raise blood pressure.)
[later:
they
think they have a way to get blood to the essential places, by
rerouting some internal blood plumbing]
Her mind is fine. She is alert, enthusiastic, enjoys phone calls and
visitors. [remove the following: At earlier writing she was in the
cardiovascular intensive care ward
at Germantown Methodist Hospital. (No flowers in the
intensive
car ward). The best way to make contact is my cell phone,
,,,.]
Daughter Bev and adult granddaughter Heidi are here to help out and
support us.
Thursday June 2.
She is out of intensive care, is now in room 313 South,
Methodist
Germantown Hospital, room phone 901-.... Cards to the house
are fine, hold flowers until she is home. With relatives calling in
from as far away was Germany and Pakistan, and daughter Carol and
her
kids arriving today, there is some resemblance to Grand Central
Station.
She is now able to walk to the john instead of being on a bedpan, is
sitting in a chair, and eating normally. If there is no digestive
pain
for another 36 or 48 hours we expect they will (possibly do more
tests
and ) let her go home (late Friday or Saturday, we hope.)
For those interested in some details, the IMA artery is blocked by
the
aorta dissection; the other two digestive tract arteries are the
Celiac
and SMA. The SMA was pinched badly and the celiac pinched in some of
the CT scans. Not all doctors agreed on which pinch was more serious
or what could be done, but agreed that opening the abdomen was not a
likely solution. Tuesday morning the interventional radiologist Dr.
Shelton entered through a leg artery and ran a wire up the
aorta
and through the small opening into the SMA, threaded his
equipment onto that wire and slid it into position, and placed
a stent in the pinch of the SMA. The resulting increase in
blood flow was immediately visible and the vessels are enough
interconnected that apparently the area served by the IMA will also
be
OK. The Cardiologist (Dr Shala) thinks blood pressure is now
OK (increased Altace dose again) and the Vascular man
Dr.Gibson
thinks that blood flow is adequate. The gastroenterologist Dr
Gary Wruble is in a wait-and-see mode.
Picture at the Edward Ordman Facebook page, (link
to
picture
itself) (A striking picture of an
artery filling with blood after a stent was placed)
Thursday June 2 5 pm.
She has pooped a few times so apparently the backlog in her
digestive
tract is clearing up now that the organs have enough blood, and
evidently everything there is functioning. She is feeling much
stronger. So the doctors are talking of sending her home
tomorrow. Hour, of course, is quite unpredictable. I'd
suggest calling the hospital before noon or the house after 5
pm
I'll get updates here and on Facebook, but that may take a few hours
after we get home, with seven people in the house!
Friday June 3 1 PM
She is home from the hospital, sitting at the dining room table
eating
lunch with a large family group. She says "I knocked on death's
door,
and, this time, death wasn't home." We have a lot of followup doctor
visits in the next two weeks. I'll write some more as time
allows, but I probably can't expand much on the large paragraph
above.
Monday June 6, 2011
Eunice is doing fine. Today we got up early when it was cool out and
walked about 200 yards, including managing our two front steps, with
no
problem. The daughters and grandchildren who had gathered have
returned to Detroit and Kansas City. The phone calls of good wishes,
questions, etc., are tapering off (they've come from as far as
Germany
and Pakistan) and Eunice would enjoy more phone calls. 901-327-9735
Monday June 27, 2011
It's been slow and complex. First there was a struggle to get
blood pressure under control; the partial blockage of the aorta
increases blood pressure, reduces strength of the artery wall, and
there is an aneurysm. When that got under control (three new pills)
a
cold got suddenly worse and by June 20 she developed a fever. The
doctors found fluid in one lung and were unsure if this was
infective
pneumonia or just that with reduced aorta capacity (maybe 25 to 30
percent of what it was) and lowered blood pressure, the heart wasn't
getting fluid out of the lungs as well as it should. So she gets
antibiotics for the one and diuretics for the other, and more pills
to
counter their side effects, and is now taking so many pills she
wonders
if there is room left for food. The antibiotics have helped,
but
she is clearly still weak and is resting and sleeping a lot. She
mainly
is not in pain, still very much herself mentally, and when awake is
barreling through DVDS and audio courses from the "Great Courses"
series.
Daughter Bev and granddaughter Heidi
have come (for a
second time) from Kansas City to help out and keep company.
Carol
and her two kids, and Jilana, have also visited.
She still enjoys phone calls, 8
am
to 8 pm CDT recommended.
One of the specialists commented to us that if the doctors seemed
slow
to answer some questions early on, it may have been since that among
80+ year olds with aortic dissection, the majority die before there
is
time to answer the common questions. At this point, while
Eunice
is still more fragile than before mid-May, she has survived the
issues
that they don't know how to treat and they are now dealing with
problems that they see every day in their normal practice, problems
that they feel they know how to overcome. But of course pneumonia
can
take quite awhile, even in an otherwise healthy patient.
Monday July 4, 2011
Well, it was not pneumonia, it was
fluid
accumulated between the outside of the lung and the inside of the
rib
cage, tending to compress the lung. It is responding well to the
diuretic (e.g. amount of fluid reduced an estimated 25 percent in
the
first week of treatment.) We did get out and go to church
yesterday (her first outing other than to doctors in two weeks) but
Eunice found walking in the parking lot and church corridor put her
out
of breath almost immediately, so we put her in a wheelchair.
It's
now been about six weeks since she had any real exercise (Onset of
digestive pain was about May 18 and the aortic dissection was not
diagnosed until her gastroenterologist couldn't identify the problem
with easier tests and ordered the CT scan on May 23) and we are told
it
will take on the order of four times that long to regain the muscle
strength lost during that time - and that she will be somewhat short
of breath in the future due to the reduced aortic capacity.
She's also been told that with reduced blood flow to the digestive
tract, she should plan on taking it easy for awhile after meals to
digest or she may have stomach pains.
We had our 28th wedding
anniversary yesterday. Luckily, there are well accepted and
appropriate
ways to enjoy celebrating a wedding anniversary that do not require
standing on one's feet.
We are still hoping that Eunice
will be well enough in two weeks or so for us top go up to New
London,
New Hampshire, for a few weeks to visit with the assorted children
and
grandchildren up there, particularly with daughter Mary who is in
her
third year of fighting Ovarian cancer and not able to travel here
due
to her chemo schedule.
Phone calls do taper off as the
weeks pass in an illness. Do give us a phone call at
901-327-9735.
Monday, July 11, 2011
We saw the cardiologist today.
(Unreasonably long wait in an overcrowded waiting room.) He
says
that fluid around the lung is still declining satisfactorily and
blood
pressure now seems well under control. (I take her blood pressure
before breakfast and supper and adjust the amount of blood pressure
medicine to suit, a system we adopted several days ago.)
We now have reservations to fly to New Hampshire and
will
get to spend quite a bit of what is left of summer up there, health
permitting. Sunday July 10 we went to church, with her using a cane
instead of a wheelchair but not standing up much.
Saturday July 16, 2011
While Eunice still rests a great deal, the
amount of time that she wants to do something is visibly
increasing. She's going into the kitchen to help a little with
fixing meals, and spending a few minutes a day packing for the
trip. On Friday evening we went to a show opening at a local
art
museum, with her sitting in a wheelchair and me taking her through
the
exhibits. Saturday morning we went to our "Sunday School"
class
at Temple Israel, with her using a cane instead of a wheelchair, and
later Saturday went to another art museum (using a
wheelchair.) New London NH is not quite as wheel-chair
friendly as Memphis but since she can walk short distances and we
can
probably borrow a wheelchair from the Council on Aging in New London
(we've borrowed one from our church in Memphis) we expect we'll be
able
to get around.
September 14, 2011
It may not be fair to say "fully
recovered", but as close to it as one can reasonably hope. Eunice is
again up to walking a couple of hundred yards (slowly and with
pauses for breath), and needs to watch her salt intake for the first
time in her life. But she is as enthusiastic about life as ever, and
we are manageing to get out to three and four events a day. We
have made a second trip to New Hampshire to visit a daughter with
cancer. The main restriction in life style at the moment is
that right now neither of us is driving after dark; I don't know if
we'll overcome that, or just get used to relying on friends and (in
Memphis) taxis.
On the occasion of our first
trip to New Hampshire, one of the Memphis specialists said "as soon
as you get to New Hampshire, go to the hospital at the Dartmouth
medical school and get a vascular surgeon and a cardiologist, so
they'll have your records and know you, in case of emergency. But
get doctors with gray hair, no young doctor will believe you."
The appointments desk had trouble with this condition, so I went to
the Med School website and read faculty resumes, found a likely
vascular surgeon (Dr. Fillinger), and called his assistant to make
an appointment. We hit it off famously, and he tried the experiment.
He sent in a Fellow, that is, an M.D. working to become a specialist
in vascular surgery. After looking at Eunice and a few pictures, the
Fellow asked "how many years ago was the aortic dissection?... this
says May 2011, that can't be right, you couldn't possibly be in
thgis good shape just two months after x-rays like these...."
I probably won't update this sequence
of reports again, as we seem to be well past the crisis.