Personal Stories: Michael Madsen
 

Hello.  My name is Lori Madsen, and I lost my father Michael Madsen on July 18, 2004.  He was 63 years old.  They tell us it was an aortic dissection.  I need someone to "talk" to about it. 

 

He had several earlier warning signs, that went undetected as to the aortic dissection. After a completely healthy life, in February 2003 he had what they called a mini stroke.  He felt confused fell to his knees, had trouble communication and could not speak.\

The episode lasted for about 15 minutes.  He was taken to emergency, tests were run and they determined that the cause was unknown.  "Just one of those things"  He was put on Plavax and aspirin.  Then in November of 2003, he had an episode where he had been home, he felt some type of strange pain, he had a hard time describing it.  Said it felt like it was in the center to right of his chest extending upward and resulted in a burning pressure sensation into his ears.  He described the initial pain as "being shot".

He was a tough man.  He felt it went away some and likened it to bad indigestion, took an aspirin and went to work.  An hour later it presented again,  he called my mom, who picked him up, took him to emergency and he was kept in the hospital for several days.

They did numerous tests, determined that he had a small amount of narrowing in one vessel and they did surgery to put in a stint.  He was switched from the first hospital to a second for surgery, and the doctor there told us that the narrowing was so minor that in his estimation, it didn't cause this episode, but that it could be done none the less. 

We thought based on his symptoms that it could have been a pulmonary embolism because of the location of the pain and because he complained of additional pain upon deep breathing.  In the end, they still didn't know what it was.  In February of 2004, he had another episode with some chest pain and alot of coughing.  Although he had no other signs of illness (like fever, or expressing mucus)  they did a chest xray and told us he had pneumonia. 

 

Life went on, he was extremely frustrated by the lack of the medical staff's ability to really find out what was happening with him.  He hated hospitals and didn't have much faith in them.  With this last episode on Saturday (July 17, 2004), I came home from shopping to find him sitting upright on the sofa.  I said hello and he didn't respond at first.  I approached him and asked if he was okay, he looked gray.

He answered ":he was not feeling well, woke up from a nap on the couch with a pain in his back.  Told me it felt like the last time because it was radiating up his sternum and into his ears, burning and giving him a headache.

Mostly on the right side.  I wanted him to go to the emergency room immediately, but he balked, saying it could be nothing and they would leave him sitting there forever.  He got up and went to use the the bathroom.  He was there for about 15 minutes, Then he came out and agreed to come to the hospital.  He said his legs felt a little as if they were falling asleep.

He laughed that he sat on the toilet too long.  We drove to the hospital, he walked in himself.  We had called his doctor beforehand, and they expected us.  They did a brief information and then got him in in about 10 minutes.  He was put on a gourney.  Blood was taken.  Heart monitor and pressure cuff were put on.  He wanted to sit upright, said it felt better.

He determined his pain was a 5 on a scale to 10.  His blood pressure was taken, it was very low, like 87 over 37, and they asked about it.  We told them that he always has had low blood pressure.  We were there maybe 20 minutes and the doctor examined him.  I told her he said his right leg felt a little numb.

He said he mostly felt like he had been in a fight, and that the pain in his chest was not bad anymore.  She asked me repeatedly if he had a heart murmur, we told her no. 

Then they put him on iv fluids.  About ten minutes later, they rushed in and were very worried about his blood pressure.  It was down to about 76 over 27 and they said they had to get it up.  They made him lay down and raised his feet so he was laying in an inverted position.  They were also giving him alot of iv fluid and II believe dopamine to raise his pressure.

They didn't have the mobile cat machine because it was a saturday night and whoever ran it wasn't there and they had to get his pressure up to send him to cat scan. 

 

All of this caused him excruciating pain.  He begged me to help him sit up, I had the nurse in and she said he had to stay that way until his pressure came up.  He lay there writhing in pain.  Telling me that "this isn't right, they are making me feel much worse, ever since they laid me down I can't stand it.  The pain was excruciating he begged me to help him.  I tried to get a nurse.

He told me that he was dying.  That he was sorry, but this one was killing him.  I ran into the hall an yelled for help.  I went to his side again before they came and tried to hold his had, he as clenching so hard I couldn't get a hold of it. He said "lord please help me, somebody help me, I'm dying, Lori, I'm sorry, I'm not going to make this one."  They got there then, told me they had to put a urinary cath in and intubate him to get an open airway.

He would be put to sleep.  They did this and then sent him off to cat scan.  The cardiologist then told me that he had a tear in his aorta, and aortic dissection.  Either in the top or arch, in which case he would be air lifted to another hospital for surgery or if it was in the lower abdominal region, a vascular surgeon would do the surgery there.  He couldn't call anyone until the cat scan came back because it was a Saturday night, and the first thing they would want to know is what the cat scan shows.

I asked him if he had a chance to survive this and he said," oh yes, once we get the cat scan, and know where the location is, we'll get him to surgery"  I went outside to call my sister out of town and let her know what was going on.  A nurse ran out of the hospital to get me, and told me my dad had coded on the cat scan table.  I asked if he was alive and she told me they did all they could, but he died. 

 

The biggest problem I now have is the fact the if they thought he was having an aortic dissection, why did they try to raise his blood pressure.  He was alert and talking the whole time, he was showing no signs of lack of blood to his brain.  It seem to me the wrong thing to do. 

  

I feel now that he was not diagnosed earlier, and should have been.  That he was not treated properly in the ER and I want to know what to do.   
 
Can you help me understand? 
 
Sincerely,
 
Lori A. Madsen  561-745-6776

 


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