Personal Stories: Ramon Pierson
About 3:30 on the afternoon of 3rd December, 2004. My wife and I were
walking along the shore near our home in West Sussex. The tide was in so
we’d been trudging through deep shelves of flint shingle high on the
beach. It was strenuous going, but on previous occasions I’d kept up a
good pace through the shingle in spurts to ‘get the circulation going’,
as it were.
Suddenly I felt a burning in my throat and down into my stomach. At
first I put this down to heartburn from the exertion after a full lunch,
but it was worse than any I’d experienced before. I told my wife I’d
have to hurry home to my stash of antacid tablets. She was content to
hang back and continue clipping twigs from bushes to force into leaf in
My fast walk quickly turned to a headlong lunge. I’ve since roughly
measured the way home. Just over 600 meters, but that day it seemed like
as many miles. The burning grew more intense and then began a ripping
pain in the middle of my back that spread out both sides. Breathing
became more difficult and I was only able to sip air and let it out in
spasms. Some part of my brain was working. By this time I’d discounted
dyspepsia and I wondered if I was having a heart attack, but I was
experiencing none of the signs I’d heard about. At last I reached home
and headed for my Rennies (antacid tabs).
When my wife arrived shortly after, I was crouched at the edge of the
bed and clinging to the radiator which was rattling to my spasmodic
breathing. She called the emergency services who said an ambulance would
be along soon and I was to lean back and breathe steady. This was hard
to do but it gave me something to concentrate on.
The paramedics found me slipped down on one knee and wedged in
between bed and radiator. When they couldn’t get a wheelchair around
close enough, I tried to stand but couldn’t. Neither could I roll across
the bed. My legs wouldn’t work. In the end they had to lift me across
the bed and set me in the wheelchair. They hooked me up to oxygen and we
went off in the ambulance. Breathing was a bit easier and I could speak
more than single rasped words, enough to give the paramedics some idea
of what I felt. Strange was the loss of the use of my legs. I could feel
them but not move them. As we drove, the paramedic continued to stroke a
pencil over the soles of my feet, but there was no reaction.
In the A&E I was breathing better and the sense of panic diminished.
I was x-rayed and questioned about what had happened by several doctors
who were puzzled by my inability to move my legs. Even after movement
slowly came back, they returned with questions, and with shift change a
couple of hours later another lot started. They called me ‘the enigma’.
When, by about 9 p.m., it looked like I’d be kept in over night, my wife
left for home.
Not long after, I was told that the x-ray showed that my aorta looked
a bit enlarged and I was taken for a CT scan, which revealed an aortic
dissection. The doctor said this might be treated with blood pressure
medication, less likely that surgery would be required. A while later
another doctor stopped by to ask me how much effort they should put into
resuscitation. This seemed a bit extreme, but I played along. I told
him, well, it’s my life, so give it a good shot.
Just before I was moved to the cardiac ward I was shown the CT film
and saw the dissection for myself. I was just getting settled in for the
night, when I was told I’d soon be transferred for surgery to either
Southampton or Brighton, whichever had a slot. In the meantime they had
to get my blood pressure down to 100. In the small hours of the Saturday
morning I was bundled into an ambulance and trundled off to Brighton
about 35 miles away with a young doctor in attendance and an automatic
blood pressure check every 15 minutes. In the meantime my wife had been
alerted and was heading the same way in a taxi.
On arrival in Brighton my wife and I were told that my condition was
life threatening. I needed immediate surgery and the surgeon had been
woken up and was hurrying from home. They described the operation
(they’d pack me in ice to slow my heart rate, stop my heart, patch the
aorta with dacron and then restart my heart) and the risks (not
surviving surgery, kidney failure, the chance that I’d lose the use of
my legs, plus a few more dire possibilities). None of this sounded
great, but without surgery I could expect to live about ten days. Tops.
I signed the consent form and was quickly prepped and wheeled off to the
I woke up several hours later in a morphine fog to see my daughter
and my wife floating near my bed. My daughter had driven down from
London very early that morning when she heard what was on. They stayed
that night in the hotel that the hospital had set up for such purposes
and when they came back the next day I was slightly more clear headed.
Two days later, Tuesday, I was moved from ICU. I could walk about and
a physical therapist ran me through some simple exercises. On ward
rounds Thursday doctors said I could go home next day if an
echocardiogram showed that my aortic valve was OK and if I could pass
their stairs test. That meant walking down one floor and back up again.
I cleared both tests and late Friday afternoon, a week after the
dissection, my daughter was driving me home.
Recovery over the next couple of weeks was flat. We started with the
advised 10-minute walks twice a day (more of a shuffle at first) and
gradually increased time and distance. The first week in January I had a
bout of shingles, which set me back a bit. On hearing about the
dissection, the substitute GP who diagnosed the shingles kept looking at
me in an odd way that suggested she’d never seen a live one. I figured
she’d love to take me on an exhibition tour.
By the time of my six-week checkup I’d got past the shingles and soon
afterwards the recovery curve eased northwards. Walks gradually
increased to a mile round trip to the shops. On Valentine’s Day I
started driving again, though daily walks continued, and around Easter
we took our first longer walk into the hills (with several stops for a
breather on the way) to see a field of wild daffodils and primroses. In
mid-April we managed a steeper hill where there were broad expanses of
bluebells, and as summer progressed we were walking everywhere we used
to go. Since June ‘05, after my six-month checkup, I’ve been doing
aerobic and strengthening exercises twice-weekly in the Phase IV cardiac
rehab scheme set up for those with heart attacks, shunts and bypasses.
I’ve never met another who has had a dissection. On the anniversary of
the dissection repair I had my latest visit with my cardiologist, who
had checked my August CT scan, echocardiogram and all the rest, and
declared me fi t. Next visit in a year.
So I’m a long way from where I was 18 months ago. Physically. Even
so, I still experience phases where my energy suddenly flags, and I’m
frequently cold, perhaps due to the beta-blockers and blood thinning
tablets. The Phase IV sessions have restored a good measure of lost
Mentally it’s another story. The 10-inch zip in my chest is like a
watershed mark. Partly as a joke early on, my wife and I took to
referring to the time before surgery as BZ (before zipper) and since
then as AZ. At first I wasn’t sure that the dacron graft wouldn’t blow
any time I sneezed or coughed. The thought of being a few miles from
home was daunting, so trips we’d planned were cancelled or put on hold.
Short-term memory has been a concern. I heard it might be from being so
long on the heart-lung machine. It could also be from inattention; since
the dissection I know I don’t focus as well: things don’t matter quite
so much. Or it could just come with being over 65, or letting my mind go
fat and flaccid since retirement.
The biggest thing to get my head round is how close I came to not
being here. It was luck that the ambulance was nearby. I was lucky, too,
that the doctors in A&E kept worrying me with questions until they knew
what was wrong and didn’t just send me off with a handful of antacid
tablets after a superficial examination. About every day I think of how
close the edge of the world is and how easy it can be suddenly to step
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