Personal Stories: Stan Loeb

Dear Brian, and all of you brave survivors.

Four years ago my husband experienced a second episodes of shingles which weakened his immune system. We were scheduled to be on an Elderhostel and decided to attend. He was having trouble sleeping and his breathing was difficult. As soon as we got home I phoned our PCP, Neil Blair. Neil's dad was our kid's pediatrician and Neil and our older son had been classmates.

As soon as he saw my husband, took his bp, an EKG, he called 911 and zipped Stan off to the ER at Providence, ST. Vincent hospital in Portland. Stan was in great distress, but the cause was a secondary infection causing pleural pericarditis--the sacs around his heart and lungs had filled with fluid and causing his heart to struggle to beat and his lungs to be able to breath. But while testing him, they discovered that he had an ascending aortic aneurysm. It was not at a stage yet for surgery, but they watched it carefully and when It looked like it was getting into the danger zone it was repaired with the dacron apparatus

He was fortunate with this incident and that he was in the care of one of the best cardiac teams in the country--Starr-Wood. Storm Floten did the surgery--he has been the head of thoracic surgery at the Oregon Health Sciences University. Stan did very well after the surgery--but still overly loved his wonderful wines and good food. His blood pressure was hard to control in spite of taking calcium channel blockers, beta blockers, etc. and not exercising enough---He also often seemed angry.

Fast forward to May 22, 2004. We had driven to the coast--1 1/2 hours from Portland--to celebrate my birthday and enjoy the sea air for a few days. We were scheduled to have dinner with friends on Saturday night. Around 5:30 he suddenly developed excruciating pain and was looking and acting just like he had four years before. There are no nearby ambulances or cardiologists, so I piled him into the car and drove back to town to the ER at ST. Vincent--after all, his records were there and they did have excellent ER care.

His symptoms were terrible pain in his back just below the shoulder blades. The pain radiated down his back, into the kidney area, on to his buttocks and his right leg. He was wheezing for breath and his BP was high as usual. The ER staff pulled out all the stops to diagnose the problem, and the last test was a CT scan. It was 3 am and the ER doctor came in and said "we've found the problem and it's quite serious. You have had a descending aortic dissection."

The dissection was huge and Stan was immediately admitted to Critical Coronary Care. The cardiologist and surgeons explained the dangers of surgery--the worst being death, the less dire being a 30% possibility of paraplegia. They said that they had great success managing things medically--keeping his BP around 100/60. He was in CCU for about 6 days and then on the cardiac floor. I brought him home a week ago.

He's very weak, a little confused, he had a bad reaction to hydralazine and had to return to urgent care to get a different med--clonipine. He also had to get an anti-histimine injection.

We see the cardiologist in a couple of days and hope we can find a way to tweak the meds so his bp stays more stable.

We are staggering under this second assault on his aorta and have no idea how long it might take for the tear and dissection to scar over or if he'll ever be completely well.

By the way, I had a heart attack 5 years ago and CABG surgery. Stan is 71 and I'm 68.

Brian, I really grateful to have access to this site. I hope we can find ways to cope with this latest situation by messages with other survivors. Stan had read several articles by a wonderful writer with the WSJ.

It's very late--time to get some sleep.

Update: 8/20/04

The miracles of science never cease to amaze.  For three months my husband has been on bp meds to treat an aortic dissection.  He was scheduled for a CT scan this month to check the healing.  Bottom line, not only was he not healing, he was reaching critical mass. 
He complained of pain in the kidney area, weakness, and pain in the back.  We returned to the ER at St. Vincent hospital in Portland.  This is where he was taken 3 months ago.  Alerted to his current problem, the ER doctors did all the things you do in an emergency , including CT scans of the thoracis and abdominal area.  He had dissected more, was aneuristic and had signs that there was leakage. 
After admission to the CCU, the surgeon who had successfully repaired his ascending aorta aneurism 4 years ago, told us that regretfully, he did not have the team in place to do the huge open reapair, so we were medivaced to Stanford University Hospital in Palo Alto, CA.  He was heavily sedated by this time and there was great concern that the aorta would rupture. 
We were met by the intervention team headed up by Dr. Philip Oyer.  The team consisted of Dr. Conrad Vial, Dr. Kwon, the radioligist Dr. Daniel Sze and an amazing team of calm, positive medical people.  After a day and a half of evaluation, it was determined that Stan might be a candidate for a clinical trial using a stent made by the Gore  Co.  We held a sample of the stent and had our questions answered about his prognosis. 
The implant was done the next morning and he also had a stent placed in his left renal artery because the blood supply to the left kidney was severly limited by the dissecttion.  Stan did not come out of the anaesthesia for 6-7 days and was not really coherent for another 2.  He was combative, thrashing about, unable to process talk, etc.  Most of this is a result of the heavy drugs he was given. 
After he was stable, we were medivaced back to the hospital in Portland and kept there until his medications seemed to put him on the right track.  We brought him home a 2 days ago and he is slowly recovering. 
This has been a dramatic, trying and amazing experience.  We can't know where things will go from here--hopefully only upward.  But his cardiologist said they rarely see a dissection this bad.  He will be followed with blood teast, x-rays, CT scans on a specific protocol set up for the clinical study.  The stent has not yet been approved by the FDA.  But we were sent to the right place at the right time.  The trial will cover 100 candidates.  Stan was number 51.
New techniques are constantly being tested, giving much hope to people who experience this devastating and more often than not, catastrophic event.  ER doctors, cardiologist and other medical people need to be educated about this condition.  We will do anything possible to save others the anxiety we have experienced.

Contact Joyce


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