Hello,

Dawn Trahern has just posted in the AorticDissection.com RULES-PLEASE READ! forum of Welcome to the AorticDissection Message Board under the title of Type A Dissection-Our Story.

This thread is located at http://www.aorticdissection.com/Forums/showthread.php?t=203

Here is the message that has just been posted:

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My name is Dawn Trahern. My husband Skip is a survivor of an extensive Type A dissection (I will explain what I mean by extensive later). I am posting our story for several reasons. First, I think this will be a great forum to purge all of the medical information and emotions that we carry around each day. Second, I hope that our story will encourage and inform others. And finally the third reason I wanted to post to this forum is because my dear husband wants his story in writing-he is a survivor and is proud to be with us today.

Skip at the time of the incident, December 14 2005 and was 44 years old. He was in relatively good shape and active. We have three young children. Skip had a very busy schedule and was a Vice President for a large technology firm and traveled extensively.

On December 15th 2005, I was contacted by 1 of Skip’s colleagues. She stated that Skip had fallen in the office and had hurt his nose and seemed a little confused. She mentioned the paramedics were on their way. I immediately felt a rush of doom go through my body. Skip was extremely healthy and strong man. He is a big guy at 6'1" weighing 250 pounds. A football player-type.

The paramedics suggested that I go straight to the emergency room and meet them there. I knew in my heart that something was very wrong. When I arrived through the large glass entrance of the hospital, I was met by a police officer and a nurse. They immediately knew me; I had no idea who they were. They asked me to follow them through a set of double doors and down a long hallway. All I kept saying was, please, I don’t want to go with you...please. They led me into a room where a chaplain was waiting for me-at that point the true seriousness of the situation had come to life.

I refused to speak to anyone and would not speak directly to any one in the room, I assume for fear of hearing the worst-that Skip had passed away. They blurted out that he was still alive but that they needed some medical information. At that point, the emergency room physician entered the room. He knelt down in front of me and said-"I am Dr. McGreevy-your husband is gravely ill, I have very little time to spend with you and I must get any pertinent medical information from you immediately." I did not even take a breath before the words came out---"my husband’s father has a history of aortic aneurysms". At that point the doctor turned and ran out of the room.

Dr. McGreevy escorted me back to see Skip. He told me he had a helicopter on the way and that Skip had had a Type A aortic dissection and that he was not sure that Skip would make it to the next hospital.

As soon as I saw Skip I knew things were not good. He was inverted head down, speaking incoherently, wanting to get up and go and was somewhat combative. He did recognize me and I told him how bad the situation was and that we needed to both calm down. We prayed and made sure that all was good between Skip and our Lord and Savior Jesus Christ. At that point we cried a little and tried to stay calm.

Dr. McGreevy informed me that they were having trouble getting Skip accepted at 2 of the largest heart specializing hospitals in our area but that their sister hospital had approved his arrival. Dr. McGreevy comforted me stating that the surgeon on call was an excellent surgeon and that we would be in good hands. I was not feeling very good about not being accepted to the areas premier heart hospitals but what choice did we have. Our fate was in the hands of an amazing surgeon, Dr. Adum Qazi at Washington Adventist Hospital in Maryland (right outside of Washington DC).

Before Skip left, Dr. McGreevy, his staff and I prayed for Skips healing. The emergency room physicians and staff at Shady Grove Adventist Hospital are great!

Skip arrived at Washington Adventist (WA) by helicopter about 2 1/2 hours after his initial fall. Seems like a long time but really it is amazingly fast given all that needed to be done. Emergency medicine in our area is absolutely amazing.

I arrived at the hospital about the time that Dr. Qazi was beginning the surgery to repair the dissection.

Dr. Qazi came out a couple hours later and said-"I am all done and I repaired the aorta". He went on to explain that Skip had virtually "blown up"- that he had “fully dissected”. As I understand it Dr. Qazi repaired Skip arch (the area that dissected) by stitching and wrapping it with Dacron he then re-suspended the flaps of his valve using another stitching technique. Skip dissected at the arch into the ascending aorta all the way up through the carotids, to the descending aorta, through the abdomen and to and including the both iliac. He also had restricted blood flow to one of his kidneys. Dr. Qazi said that Skip’s dissection was extremely extensive dissection and that our emergency room doctor saved his life. Dr. McGreevy and Dr. Qazi will always be special to us. I very pleased to say that Dr Qazi took pictures and video of the operation and uses it to train doctors on the type of repair that Dr. Qazi performed on Skip.

This begins the long journey. Skip remained in ICU for 10 days. The beginning was rough-not sure if he would be paralyzed or there had been any brain damage due to the lack of blood to the brain and if there were any complications from the heart-lung bypass. Skip was very confused for 5 of those days. The ICU physicians found that Skip had suffered 2 strokes probably either during surgery or on the flight to the hospital. When Skip was accepted from the helicopter his blood pressure was reading 40/20. The diagnosis of 2 strokes is very scary. We met with a wonderful neurologist by the name of Dr. Poltorak. He was very reassuring that the strokes were in areas of the brain that should not cause Skip too many problems and that he expected Skip to recover nicely. Wow!

Skip remained confused for several weeks but slowly regained his senses, etc. Amazingly Skip returned to work in 8 weeks.

For the first 6 months we saw tons of specialists in search of anyone knowledgble with aortic dissections. As we all know, these doctors are rare. In any case, Dr. Poltorak, our neurologist, took a nice liking to Skip (and me, I hope) and helped direct us to some excellent physicians. The bottom line is that skip and I had to manage the case and work with a variety of doctors. We actually had a friend that was a nurse practitioner. She helped us get through the system and understand the medical system as well as how we could act as our own advocates.

One suggestion to anyone facing a similar situation is to make sure you have a full set of records including the, MRI’s & Cat Scans and physician notes. You will need this information as you work with new doctors to help get them up to speed with the situation. In the beginning, repeat tests were being done because we did not have copies, etc.

Skip is now being followed by a prominent vascular surgeon at Georgetown Hospital in Washington DC. He is also being seen by a very well respected neurologist from the University Of Maryland Medical Center. This doctor specializes in strokes and their prevention. Skip also regularly visits his cardiologist.

We receive almost quarterly MRA’s/MRI’s and they use 3D imaging models to check the aorta and the flows to the carotids and down through the iliac. The doctors suspected that Skip had/has an underlying genetic connective tissue disorder that started this whole story. However, to date we have been unable to isolate any specific syndrome (i.e. Marfans, Elers, Loeys-Dietz).

Skip’s current medicine protocol is pretty much prescribed to lower his blood pressure to a range of 100/60 or lower. Losartan was the drug that really helped lower the pressure. It took almost 6 months to get his pressure where we need it. Skips only physical change are some numbness in his left arm, hand and foot. He is more tired probably because of the low pressure. Skip also limits his physical activity and keeps away from high intensity working out and absolutely no weight training other than the little 25 pound weights (poor guy...he is used to lifting lots more than that :). He continues to exercise by walking and has recently taken up cycling.

Since the initial incident, Skip celebrated his 45 birthday with 65 of his closest friends. We celebrated our 13th wedding anniversary this year, and he has he has been present at 2 birthday for each of our 3 children. Skip also retired from his executive position at Hewlett Packard (he had been with the company for 24 years!). The pressure of the job and the heavy world wide travel secured our decision for Skip to retire. He would like to work in a less stressful environment after he has taken some time off to re-energize and re-focus. All in all he feels good has a positive outlook on the future. He lives every day to the fullest

We feel very blessed to have survived our extensive Type A dissection. We believe that all of the physicians were perfectly placed by God and that our prayers and conversations with Jesus, healed our "Skippy".

Thank you for reading. There is a ton more medical information that I could write but I thought the story first and the full medical stuff could come later.

Also, we would like to thank Brian Tinsley for developing this website. It was a great resource for me during a time when I did not know which way to turn. The website also continues to be a great resource for updated medical information related to Aortic Dissections. So thank you Brian for all you do!

Warmly,

Dawn Trahern

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