Aortic Dissection and Me – part one 13 September, 2011

IT WAS November 1999. My then 72 year old father suffered from what he thought was heatstroke after a long day in the sun with friends at a picnic. He collapsed for a short while and complained that he couldn’t see, but after a short rest he felt well enough to drive home. Upon arrival, he told my mother he wasn’t feeling well and wanted to lie down. My mother took one look at him and told him he had to go to the doctor and called my sister over. My mother and sister saved his life with their actions.

Nobody knew it at the time, but he’d suffered an Aortic Dissection – a condition that is mostly sudden and fatal. Arriving at the emergency department at St George Public Hospital in Sydney, he was taken straight in and monitored. He seemed to settle and it was decided he’d stay overnight for observation. At this stage, none of the doctors had diagnosed what had happened.

There are only four ways to identify aortic dissection, with three of them via imaging – a CT angiogram, an MRI or a transesophageal echocardiogram. None of these are routine procedures at this stage of diagnosis, which is one reason why people die as the dissection remains untreated. Then there’s the fourth way – when the aorta actually ruptures. That’s what happened to my Dad. We’d only just walked in the door at Mum’s around 11pm when the phone rang with the hospital telling us to come straight back. The doctors said that his abdomen had swelled up like a balloon and he was haemorrhaging and they needed to open him up immediately.

The Cardiothoracic surgeon was Dr Gary Fermanis and he was quick to tell us of the grave situation my father was facing. About six hours into the surgery, Dr Fermanis came out to say that his ascending aorta had been repaired via a dacron graft, but they had been unable to stop the bleeding. He assured us that he would not be giving up, although later we were told the others in the operating theatre were all telling him it was a lost cause. After 11 hours of open chest surgery, my father was finally wheeled out of the theatre and rushed to Intensive Care where he was kept in an induced coma for a week.

A build-up of fluid on the lungs forced doctors to again open him up and a battle with Golden Staph (MRSA) infection just added to the battle my father faced. Nevertheless, his strong will saw him leave the ICU after five weeks, when he was moved to the cardiac ward to begin his rehabilitation. I visited twice a day throughout his four weeks in the ward, continually focussing on rebuilding his wasting muscles by walking the corridors with him. A week or so after the Y2K hysteria was shown to be a fizzle, my dad was able to go home, widely acknowledged as a “miracle man” and is still with us to this very day, twelve years later –  confounding all doctors and specialists who come to learn of his extraordinary case.

In 2003 at the age 54, John Ritter, the U.S. actor and comedian suddenly became the famous face of this uncommon, but silent killer known as aortic dissection. In an attempt to highlight this deadly condition to the world, his family developed  the Ritter Rules – a set of life-saving reminders to recognize, treat and prevent thoracic aortic dissection. And recently due to A.D., the world also lost Richard Holbrooke, the American diplomat who brokered the peace deal in Bosnia and was most recently Special Envoy for Afghanistan and Pakistan. Holbrooke was just 69 years old.

In part two, I’ll relive my own personal struggle with Aortic Dissection.

UPDATE: 13 September 2011 – Following complications with pneumonia, a leaky heart valve, myelodysplasia, kidney failure and arrhythmia, my father passed away peacefully this morning. I’d like to thank the doctors, nurses and medical support staff at St George Public Hospital for all of the care they’ve provided to my dad and for giving us many more wonderful years with him than we ever would have expected.

Enes Hasic – 4 June 1927 – 13 September 2011