March 27th, 2007
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Tuesday 27-March-07
Hello,
Before I lose your attention, I want to comment on the most important lesson I learned over the last two weeks:
Accurate and rapid diagnosis of medical issues greatly increases your likelihood of survival.
Aortic dissections are both rare and hard to diagnose. Roughly, only 1 of every 1000 cardiac events are aortic dissections. There are no tell-tale symptoms, and the only certain way to identify an aortic dissection is via a fairly expensive CAT scan.
Looking back on the events of March 10th, I believe that most people who were in my situation would have died because of inaction or misdiagnosis. The reason I am alive is due to the persistence of Erin and Holly more then anything else.
My main agenda in sending out this eMail is to create awareness. If you ever find yourself in a similar situation, you need to exhibit the same persistence Erin and Holly did. It was my nature to downplay the symptoms and try to sleep it off. Nothing could have been more dangerous. Life expectancy drops rapidly every hour that a catastrophic medical issue is not identified and addressed.
To go into a bit of detail, specific to myself, the greatest risk was the likelihood of a misdiagnosis. There were many factors working against me:
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•The discomfort in my chest was persistent but mild. This could have meant indigestion of something equally minor.
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•Both the EKGs and the blood tests were normal. The only certain way to identify a rip in the aorta is via a CAT scan. Since this is 1 in 1000, it is not common practice to take a CAT scan. To be clear, my heart is very heathy and this is the reason those tests showed normal.
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•Saturday is a bad day to get sick, especially in a small town. On Saturday, in the Emergency Room, I saw two different physicians. Neither one was able to diagnose the torn aorta. Both took EKGs and blood work. The second doctor wanted to have tests done, but no one was around to give them. I saw a third ER doctor on Sunday, more then 24 hours after I first felt light headed, Luckily he had an interest in cardiology and was able to coerce a CAT scan technician into coming in on Sunday afternoon.
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•People are only human. Erin suspects that one of the nurses felt I was faking in an effort to score some pain medications. Remember I checked in, left, came back. I had only vague symptoms. Erin observed that I was rather upset when they offered me adavan, apparently I insisted on percocet. While we are not certain if this was the case with us, it is certainly possible that this happens from time to time.
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•Speaking of small towns, it was only recently that Sun Valley got a CAT scan device. We used to have a mobile unit that would visit twice a week.
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•I was lucky flight conditions were favorable. We were in the mountains and had the weather been worse, it would have been over 3 hours in an ambulance.
Academically I found it educational to realize how advanced we are at fixing the human body once we know what is broken, yet how comparatively primitive we are diagnosing problems. It is an area that I might give some cycles to in the future.
Much better know, and often ignored, is the need for everyone to have their affairs in order. I hear frequent horror stories of friends who died and did not have proper wills, or got sick and did not have living wills. For years Erin and I have
kept these documents up to date:
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•Last will and testament.
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•Living will.
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•Organ donor forms.
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•A text file on my computer that contains my medical history, including allergies, along with the medical history of my family members.
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•Many of my close friends know my preference of cremation vs burial, resuscitation guidelines, where my financial records are kept, and the other bits of information that would be close to impossible for someone to unravel without knowing what to look for or where to look.
The Lenny Update
Now that I have my rant out of the way, I am delighted to give you an update on my health. I had a follow up appointment with the cardiac surgeon, Dr. Cleveland, on Wed 21-March. I got the all clear and Erin and I flew to New York later that day. As a reminder, I was discharged from the hospital after only 5 day. Then only reason I stayed in Denver was to allow for this follow up appointment. Erin and I were walking around a Denver and visiting with friends while we waited for this appointment.
Thursday, ten days after surgery, we walked around Tribeca (lower manhattan), had lunch with Erin's brother, and dinner with friends.
The reason we went to NYC instead of Sun Valley was because Holly wanted to examine me. We had a Friday morning appointment with her. She took a quick look at me, said I was looking good, and gave me a hug.
A few minutes later, Holly had listened to my heart, examined my scar and sent me off for a echocardiogram. After viewing the echocardiogram, she also gave me the green light and told me I should be very appreciative of what Erin had done and instructed me to visit her jeweler and get Erin something nice. If I passed that exam Holly promised to by me lunch.
I must have done OK, because Holly suggested The Four Seasons, bought a bottle of champagne and picked up the lunch bill. Monday (yesterday) was our 14 year anniversary, and next week is Erin's Birthday. At this point, I am a bit concerned that while the medical bills will be manageable, the jeweler bills will be a bit extreme.
Friday, Saturday, Sunday, and Monday night we went out to dinner with various friends. During the day, various friends have been over to say hello, or go to lunch. In general, I am exhausted from the active social life. Tonight I blew off friends for dinner just because I felt the need to take a night off. I also wanted to get this eMail out.
Going forward, I am told that full recovery will take up to 8 weeks. I feel like I am at 95%. My chest is still a bit sore, but I guess that is understandable considering they had to saw my sternum in half and split me open with rib spreader , which is sometimes confused with rib splitter.
We seem to be getting deliveries of flowers, food, or toys hourly. I think we have more thank you cards to send out then we did when we got married. While every one was appreciated, there is no need for anyone to send anything.
Erin and I are planning to spend the next few weeks in the New York area. We will then head to Idaho for the spring.
