Dad has a broken heart

Wikipedia Creative Commons - Contrast-enhanced CT scan demonstrating abdominal aortic aneurysm

Non-fiction Friday

A lot was going through my mind. As a former EMT and someone who had planned a medical career just five years prior, I understood the implications of an aortic aneurysm rupturing. My father was incredibly lucky to have this medical emergency while in the hospital, and at a VA hospital that specialized in cardiac care. The grim reality was he had an 80% chance of dying before leaving the operating room, even under the ideal conditions.

One of my favorite movie lines is, “work the problem,” and I like to add, “don’t let the problem work you.” When I’ve gotten into crisis mode, I have found this mantra has an immediate calming effect. Work the problem, no need to drive like an idiot and put me in the hospital. Houston traffic was a ball of suck back then, and a worse ball of suck today. I had a cellphone, but it was impossible to work a manual transmission and an old school Motorola Startac at the same time. Calls to the family would have to wait.

I arrive at the hospital and find my way to the ICU. I sign in and identify myself as a relation to my father. They page the attending. It could be a shock when I see my father, I am told; I tell them I understand. Work the problem, don’t let the problem work me.

Dad survived the surgery. It turns out that when I talked to dad the night before, and he sounded tired, the bleed was already starting. The pain got worse, and when they couldn’t identify why the VA ordered a CAT scan. While in the scanner I was told, dad’s aneurysm ruptured. In another complete stroke of good luck, an entire cardiac surgical team had just finished a major procedure and was still in the hospital. Not only did the rupture happen while in imaging, but the resources to do immediate surgery were in place.

Dad may have survived, but his prognosis was grim. He was in a coma and likely had a hypoxic injury due to the length of time his aorta was clamped off to repair. He was on a respirator, and I stopped counting at 18 tubes entering or exiting his body. The list of complications that could follow was extensive; brain injury, loss of toes, fingers, or limbs, lethal blood clots, infection, pneumonia from being on the vent longterm. There was a good chance dad would never wake up, the attending put dad’s odds at ever leaving the hospital at 100,000:1. I had a lot of phone calls and decisions to make.

In another stroke of good luck, however, I still had power of attorney on dad’s affairs from doing the closing on his home. At least for this aspect, the basic issues of maintaining his house and paying related basic bills would not be a problem. My sister in California would be able to come out within a day. Another sister in Pennsylvania would not be able to get out.

Hours turned to days, and dad continued to hold his ground. His toes swelled and turned black. A surgeon was called in for a consult with growing concerns of gangrene. A decision was made to make a wait and see approach, but the doctors felt it was likely dad would lose at least his right foot. His coma continued, and he wasn’t doing much fighting of the vent. Medications flowed, and days turned into weeks.

Dad did start to improve gradually. The skin fell off of his toes, but the black turned to the blues of deep bruises, and the swelling went down. By day 37 he was starting to stir, kept under heavy sedation for the respirator.  On day 38, he started to communicate, although he was very confused. Using a pencil, he scribbled on a pad of paper held up for him to ask basic questions.  Already suffering from Parkinson’s, his handwriting was shaky. The good sign was the hypoxic injury was mild to moderate. On day 39, dad was taken off of the respirator and spoke his first creaky words. His road to recovery was just beginning, and he was still fighting 100,000:1 odds he would ever leave the hospital.

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