Coming Up for Air
Posted by Tom Benedict on 13/05/2014
It’s been a rough three months.
I have no clue if I’ve written about any of this, so bear with me if this covers stuff I’ve already talked about. Some months back my wife was diagnosed with a coarctation of the aorta. This is a birth defect that’s typically caught in the teen years. Left uncorrected it usually results in permanent damage to the internal organs, but by virtue of her active lifestyle, her diet, or by sheer providence, Rydra’s internal organs have taken no damage at all. Even better news, it’s a treatable condition. So about two months ago she went in for graft surgery.
Because of complications that only came to light the day of the surgery, the graft never happened. Plan B was to install a stent, but at that point no one knew how much her aorta could be dilated, and stents for aortas aren’t exactly off-the-shelf items. So they went with plan C and performed a balloon angioplasty during which her aorta was dilated to 12mm. (A normal aorta runs from 22 to 26mm in diameter. Prior to surgery hers was constricted to 3mm.) A couple of days after the procedure we flew home so she could recover and her doctors could see about getting an appropriately sized stent.
Recovery was supposed to take a couple of weeks, but she never really recovered. For the first few days she couldn’t digest anything except oatmeal and cream of wheat cereal. That improved a little as the days went by, but not by much. Her legs had their full strength, but no real stamina. After a few weeks she could walk to the end of the driveway and back, but that was it. Clearly something was not right.
Her surgeon ordered a CTA of her abdomen to see what was going on. The evening after the CTA he called to tell her he’d scheduled a CTA of her chest for the next morning. Something was wrong with her aorta: it was splitting. Just downstream of the coarctation, the inner lining of her aorta had torn. As blood flowed into the tear it inflated the lining, separating it from the aorta wall further and further down toward her abdomen. As it inflated it blocked the flow of blood through the rest of her aorta. This was restricting flow to her legs and internal organs. He booked the OR, and we booked plane tickets back to the hospital.
This time the surgeons installed a stent across the constricted area of her aorta and down over the tear. The idea was to cut off the entrance to this false path so that blood could no longer flow into it. Over time her body would reabsorb the blood in that false path, restoring her aorta to normal function. But complication is her middle name. The operation called for a small incision over her femoral artery so the surgeons could insert their tools. But because of the coarctation, her femoral arteries are atrophied. The surgeon made a longer incision, then a longer one, then a longer one, trying to find a large enough section of artery to insert the tools. She came out of the OR with a seven inch incision leading up from her leg to her abdomen. But they got the stent in place!
She was discharged less than a week later. We flew home for the second time – me a little more rattled, her feeling a little more beat up. But hey, she was well on the road to recovery, right? Right… Less than 24 hours after we got home one of the things I’d been terrified of happened: a hard knot started to form over her femoral artery. This is a sign of potential internal bleeding. One of the points that was drilled into the class when I did my EMR training is that internal bleeding is bad bad bad. Internal bleeding from an artery is worse worse worse. And internal bleeding from the aorta or femoral arteries can leave only a few minutes to respond, depending on the severity of the injury. We called her surgeon, packed a bag in case she had to be transported back to the hospital, and drove to the ER.
As it turns out it was a combination of a seroma – a buildup of fluid – and a hematoma – a buildup of blood – both associated with the incision site rather than the femoral artery itself. We spent most of the night in the ER, but when she was released it was to go home, not to be air lifted to a larger hospital. We both sighed a big sigh of relief. But it delayed her recovery. The pressure of the seroma made it almost impossible for her to sit down, stand up, or get in and out of bed by herself. I wound up taking an extra week off from work to assist her as the seroma was slowly reabsorbed.
Rydra made steady progress over the course of the last two weeks, and on Saturday she gave me the green light to step out of the house for some R&R. There was no wind for flying kites, so I grabbed my recently repaired Bixler 2, my battery bag, and my transmitter, and headed into town. After that long a break I probably should’ve started with a couple of hours on a simulator, but I didn’t. I just stuck a battery in, pre-flighted the plane, and tossed it. I was rusty, and the flying was unremarkable. But it was like seeing sunlight for the first time in months.
I’m back at work as of today. I went home for lunch and spent most of my lunch hour going for a walk around the neighborhood with Rydra. Already she is better than she was before the second operation, and it’s only been two weeks since the ER visit. Things are finally really looking up.