Personal Stories: James Hill

Hello. My name is Jim, and I'm a resident of Denver, Colorado. About 3 weeks after my 52nd birthday, I was assisting a fellow worker during the installation of a stainless steel air conditioning unit that weighed around 1600 pounds. It was supposed to mount in a hole in the side of a steel instrumentation shack that we were building. While sliding it into the hole, the unit got wedged, and it took some extreme effort to get it loose. The exertion left me shaking and a little out of breath. I felt pains in all of my muscles and joints, including some that I didn't even know that I had. Over the next few days, most of the aches and pains went away, except for a nagging little pain in the center of my back, right between my shoulder blades. I thought that I had a vertebra out of alignment, and I figured that it would pop back in place sooner or later, so I didn't worry about it.

The following Sunday, March 28, 2004, I was sitting in front of my home computer, drinking my third cup of "make-your-hair-stand-on-end" coffee, when I was suddenly hit by a searing pain through the center of my body. The first thing that I thought was that I had really damaged some muscles while wrestling with the air conditioner a few days earlier, and something finally tore. The pain was pretty severe, so I figured that I should go to a hospital and get it looked at. I told my wife that there was something wrong, and that I would need to have her take me to the hospital. (Yeah, she got spooked a bit. Her eyes were the size of dinner plates.)

I popped into the shower for a quick clean up, got dressed, and we headed out to the parking lot. About halfway to the car, I was having trouble walking. My right leg seemed to be really weak. I stopped there, and had my wife get the car and drive it up to me. It only took a couple of minutes. By the time she pulled up, my leg started to feel numb, and there was a pain building up in my back that was really nasty. I climbed into the car, and we headed off to Porter Memorial Hospital, which was just a few minutes away from our condo. During the ride, the pain became intense, and radiated up through my neck and shoulders, and through my chest. I could feel my heart beating really fast, and I was having difficulty breathing. By the time we reached the hospital, my leg had gone completely numb from hip to toe, so my wife had to get someone to help get me out of the car and into a wheelchair.

In the emergency room, the doctor went through the usual "what are you feeling?", "when did it start?", "what were you doing at the time?", and so forth. During that, he took my pressure and pulse, made some notes, and immediately gave me a nitro. Followed a few minutes later by another. I was on my third nitro tab when I was taken for an EKG. I was brought back, more doctors and assistants started flitting in and out of the room, and then I was taken for a chest x-ray. I was brought back, more doctors and assistants buzzing around, one kept trying (and failing) to find a pulse anywhere in my leg, and then I was taken for a CT scan. I was being pumped full of stuff to bring my blood pressure down, and I was starting to lose track of what was happening. I was given a shot of a heavy duty pain killer that had me fading in and out of focus for a while. It seemed that every time I blinked there were different people in the room.

Eventually, I remember a doctor, Myles Guber, patting my knee to get my attention so he could tell me what had happened to me. I had a descending aortic dissection, extending from just past the left subclavian branch down to the iliac bifurcation. The swelling had restricted the blood flow to my right leg and right kidney.

Dr. Guber is a thoracic surgeon who has a lot of expertise with dissections. He decided that mine could be controlled with medication. I spent a day in ICU, and a few more days in bed with frequent pressure checks. I finally got released after 4 days.

Shortly after this, I went to a cardiologist for tests. We needed to make sure that the trauma didn't damage my heart. I came away with a clean echocardiogram. I was also tested to check the blood flow and volume through my legs.

Since then, I had a CT scan at 6 months and 1 year, and now I'm getting it done yearly. The dissection is stable, so Dr. Guber is going to have me take the CT every other year unless it shows signs of expansion. Meanwhile, my pcp is trying to figure out the proper meds that I need to keep the bp under control. I started with 20mg Lisinopril and 100mg Atenolol once a day. The Lisinopril was causing me to retain tons of potassium, and the diuretics that he's tried on me kept giving me allergic reactions, so he took me off of the ACE inhibitor, and started me on a calcium channel blocker, Norvasc. The Norvasc helps, but it didn't help take the pressure down as much as the Lisinopril. So, now I'm taking Atenolol at 100mg in the morning and 50mg in the evening (and the obligatory 80mg aspirin and Lipitor). That gets me closer to my target bp, but we still need to get it down a little more. The drugs do keep me fatigued most of the time, so I have to pace myself at work, but it's a small price to pay to stay alive.

I thank God for having the right people with the right expertise in the right place at the right time. The diagnosis was correctly made, and it didn't take much time. I was luckier than a lot of people who have had this happen to them.

I also thank Brian for setting up this web site. After I came out of the hospital, I spent a lot of time on the internet looking into aortic dissections. I wanted to know everything there was to know about dissections. The more I looked into it, the more depressed I got. There was very little information about aortic dissections, and most of it was frightening and discouraging. I started feeling that every breath that I took could be my last. I stumbled across this web site one afternoon, and it helped me to get a sense of perspective, which I really needed. A little bit of knowledge can do a lot to dismiss fears and establish hope.

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