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Guest Editorial: The anniversary of my aortic dissection

Posted: September 29th, 2017 | Editorial, Guest Editorial, Opinion & News | No Comments

By Eric Carroll

It was a hot summer in 2011, by San Diego standards. A few years into any relationship, things tend to slow down and a few pounds come on. But I was noticing that I would eat, go for a short walk and break into a sweat. I wasn’t an athlete, but I certainly wasn’t a couch potato. I was very active. Something felt wrong.

Later that month, I went to a regularly scheduled yearly checkup and left with flying colors. All good. I could lose some pounds and eat more vegetables. Who couldn’t? However, by the beginning of that September, I was in a class literally sweating like I was in a sauna. I excused myself, but dismissed it as hormonal. I thought it was man-o-pause.

Local community member Eric Carroll shares a very personal experience (Courtesy the author)

About a week later, I found myself on my sofa, eating a bowl of ramen (this was before ramen was cool). My partner was away on a business trip. I just wanted a quiet night on the sofa. As cliché as it sounds, out of nowhere my heart began to pound. Incredible, unfamiliar pain, along with shortness of breath; I was dizzy and began sweating profusely. Sharp, throbbing pains in my — (Oh crap, am I having a heart attack?) To be honest, I really didn’t know what a heart attack would feel like, and all I had for reference was the old man on TV clutching his chest and dropping dead.

I called my partner and explained my symptoms. He said, “Call 911!” but like any completely sane 42-year-old man, I decided it was important to consult Google before I make a premature assessment of the situation.

Let’s see, type-type-type “heart pounding, shortness of breath, dizziness, chest pains,” hit enter.

In big red bold underlined letters that stared back at me, it said: DIAL 911 NOW. YOU MAY BE HAVING A HEART ATTACK.

Thanks Google! But first I should tidy up the kitchen. If I drop dead I don’t want my mother to know what a slob I was. Oh god, all I have in the fridge is chocolate syrup and baking soda.

I dialed 911 and spoke with someone who had a calming, yet stern voice. Not sure what I said, but I did have just enough wherewithal to unlock my front door, gather some comfy clothes (changed my underwear, of course) and my cell phone (remember your charger!) and throw them in a bag. Somewhere in this blur, I think my partner, who no longer could reach me on my cell, made a call to my good friends — one of whom, is a registered nurse. We’ll call him Nurse Pepper to protect his anonymity. I probably asked Nurse Pepper if he thought I might be having a heart attack. It gets fuzzy.

Then I went out front, sat on the stoop, waited for the EMT and pondered for a minute what a bummer it would be if I just died here. Like who, for no good reason, is sitting on the sofa and drops dead? Bam.

It’s funny, in those moments I came to accept the possibility of dying. Not a bright white light kind of acceptance. Just poof. A dead poof. Moments later, the fire department was at the gate. It was very “Chicago Fire” from how I selectively remember it.

The ambulance arrives. (Pump me full of more drugs, please. How much will this cost? I bet this will cost me $2,500! Thank Obama I have insurance.) Pass out. Oxygen. Wake up. Emergency Room. Lots of questions.

Note: Don’t make snarky comments about your denomination when they ask. They are quite serious. (Why on earth has no one written down what I am allergic to?) Tests, lots of wires, monitors. Questions. Beeping things. My friend the nurse and his husband showed up. I came to learn later that no one could find out which hospital I was at, so my partner thought I might be dead. Poor thing. I said to them, “They think I’m having a panic attack. Why would I be having a panic attack?” Reminder, I was sitting on the sofa, and just had a full physical.

Back to the ER. 2 a.m.? 4 a.m.? Test for enzymes or something. Another EKG. Those little round things attached to wires that rip out your chest hair and leave sticky glue on you for weeks. My friends were still hanging out with me, so we were chatting about random things. At some point, it seems like they turn the lights down in the ER to keep things calm and give you a sense of time.

Nice doctor-type person comes to my side. “Well, we can’t find anything that suggests you had a heart attack. We’re going to release you in the morning.” (What? Oh no, no, no … This isn’t normal.) Sure, I’m delirious from Demerol and deprived of oxygen. (What do I know? Maybe I did have a panic attack?)

And here’s where the story takes its turn. Spoiler alert! You see, since I’m writing this, I am not dead.

Nurse friend, being in “the biz” and all, asks another medical-type person if they should maybe perhaps run another test … just to be sure.

They agreed and brought me to one of those big MRIs or CAT scanners. Some acronym.

Later, nice doctor-type comes back in and says something like, “Mr. Carroll, blah blah blah, we’re going to schedule surgery for you in the morning. We have a team coming in. We’ve discovered you have an acute dissection of the ascending aorta.” (What the hell is an aorta?) “Also, you have a congenital defect of one of your heart valves and we’re going to need to replace it.” (Huh?)

He drew what looked like a bunch of circles and tubes and arrows on some piece of paper. I had the option of replacing a valve with a pig valve or a mechanical valve.  Hmmm, let’s see … I’m against medical experimentation on animals, so I’ll take the mechanical heart valve behind door No. 3. Nurse Pepper helped me make that decision. (Really, I have no idea what a heart valve is, so go for it.)

I would end up having open-heart surgery. Thank goodness I wore my clean underwear!

Now, I want to be 100 percent clear about something. Despite all the tests, the hospital had previously come to the conclusion that I was not having a heart attack. It is not standard protocol, if the symptoms aren’t there, to perform a detailed scan of your heart. According to the National Institute of Health, most aneurysms are actually found during tests done for other reasons. Advocate!

I have the utmost respect of everyone in the health field. Lots of people did an amazing job keeping me alive. My partner and friends were treated with respect and consideration. I was blown away by the professionalism of everyone.

However, the problem was undetected because no one was looking for it. This is important. Aneurysms are asymptomatic, so 95 percent of the time people don’t even know if they’ve had one. This story about television actor Alan Thicke, who recently died from a ruptured aorta, explains: bit.ly/2y4A7sv.

Mind you, as a gay guy, having survived the first years of the AIDS pandemic, several car wrecks, and numerous times stumbling home through bad neighborhoods at 2 a.m., the last thing I thought about was having an actual real health problem.

I’ve lost dozens and dozens of friends to AIDS and watched numerous people die of other long-term illnesses. Women in the community have known this for a while. Yup, if you don’t die, you get older and human stuff happens to you, too.

This was the first time I had something truly scary happening to me. Did I see this coming?

I want to jog your memory, as you may or may not have heard about the untimely and sudden deaths of “Three’s Company” star, John Ritter in 2003 and fellow TV star Thicke last year. Thicke was playing hockey, felt chest pains, collapsed, was taken to the ER and was dead in three hours. The assumption was he had a heart attack — later it was revealed in the autopsy report that he had a ruptured aorta.

According to the CDC, aortic aneurysms were the primary or contributing cause of about 25,000 deaths in the U.S. The John Ritter Foundation says that aortic dissections can mimic a heart attack and if not detected and treated, nearly 40 percent of all incidents of aortic dissection can lead to death.

Aortic dissections. Aneurysms. Ruptured aortas. Aortas are the large arteries that leave the heart and bring blood to your brain and other parts of the body. In layperson’s terms, it’s kind of like when there’s a leak in a dam … you can fix the hole, or eventually the dam bursts. Aortas can split open, burst like a balloon and you bleed out. The mortality threat increases 1 percent for every hour it goes untreated.

An aortic dissection refers to the tearing of the aorta, which if not repaired, can lead to an aneurysm … a balloon-like bulge in an artery that can burst, and cause immediate death. An aneurysm in a blood vessel that bleeds into the brain can lead to stroke or death.

A patient with an aneurysm may not experience any symptoms until the aneurysm begins to expand or “leak” blood into nearby tissue. The symptoms come on suddenly, and if not detected, mortality is high.

So it wasn’t a heart attack. I don’t know why that gives me a greater sense of comfort, but ironically, people tend to think it is something you were doing wrong that causes a heart attack. Go figure. Contributing risk factors for me, however, were likely the pre-existing condition — a malformed valve, and the fact I had two chest wall contusions (when a steering wheel hit the heart area).

So in my totally non-professional opinion, here is some food for thought:
1) Always dial 911 if you think you’re having a heart attack.
2) If you’re not feeling right, tell your doctor. If they’re not available, go to urgent care. Don’t hesitate to tell them everything. Speak in real words. Sometimes I think we put physicians on such a high pedestal that we don’t think we are worth their time. You are ultimately responsible for your health. You know your body better than anyone else.
3) As far as I understand, you have one human body. It isn’t replaceable. Many people don’t have the luxury to have $500,000 worth of health care. It’s a shame, and sadly for many, a far-off possibility.

I just celebrated my six-year anniversary. I’m not dead and life goes on but it’s pretty real. Now I know what an aorta and heart valve are and I wanted you to know, too.

Find out more about the warning signs by reading the Ritter Rules at the John Ritter Foundation website, johnritterfoundation.org.

—Eric Carroll is the membership and marketing coordinator for the Greater San Diego Business Association (GSDBA), the local LGBT Chamber of Commerce. You can follow him on Facebook, facebook.com/ericcarrollsd.

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