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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.