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Dad was on his way to work Thursday morning (Sept 5th, 2019) when he began having chest pain. He stated that he began having pressure all across his chest and he was also having pain radiating to his jaw and back. He said he felt like he was going to pass out. He managed to make it to work where the dizziness subsided, but the pain continued. He worked for two hours before the pain started getting worse. He also began experiencing nausea at this point and became profusely diaphoretic. His co-workers called for their emergency response team to come and assess him. After seeing dad, the team quickly called 911 and dad was transported by Greenville County EMS to Greenville Memorial Hospital.
Dad arrived in the ED shortly after 8:00am and they immediately ran an EKG and blood work to see if his Troponin (cardiac enzymes) was elevated. They were suspecting a possible heart attack, but his EKG and Troponin came back okay. During this time, they tried multiple times for IVs and were waiting to do a repeat Troponin at 3 hours to determine if he had any blockages. They eventually ordered a CT scan and quickly identified that he was having an aortic dissection. For those that aren't familiar with this term, this is when a tear occurs in the Aorta and blood begins to leak out between the layers of the Aorta. The Aorta is the artery that comes off the heart to pump oxygenated blood to the body. Needless to say, this is a life-threatening emergency and he was rushed for emergency surgery.
The surgery took over 8 hours to complete as it was very intensive. Dad was put on bypass for the surgery and his entire Aorta was replaced with a tubular graft. The surgeon said that dad lost a lot of blood during the surgery and ended up receiving 8 units of blood. Dad also briefly went into cardiac arrest during the surgery, but they defibrillated him once and got his heart restarted. Per the surgeon, this isn't necessarily uncommon due to the nature of the surgery. Due to the extensive bleeding, the surgeon had to leave his chest open in case he had to go back in and address further issues. Dad was transferred to the cardiovascular ICU at GMH in room 2510. Thankfully, they were able to wash out his chest and close it up the following day on Friday. It took almost 5 more hours just to clean out his chest and close it up. They closed his chest with a metal plate and screws, which will be permanent.
For the first couple of days, dad remained on numerous medications to keep his blood pressure steady, reduce pulmonary hypertension, keep his blood sugar under control, perfuse his kidneys, and to keep him sedated. He still remains on the ventilator, but began opening his eyes to voice on Saturday. He would not follow any commands and doesn't attempt to talk, but would open his eyes briefly to voice. Due to him being slow to wake up, they took him off all sedation to ensure that he could wake up and that he did not have any neurological impairments. The surgeon said this was imperative since blood flow to his brain was decreased for awhile due to the critical nature of the surgery. After removing all sedation, dad did begin to move more in bed, but would still not follow commands and did not demonstrate any purposeful movement. The nurses state he just became restless and was fighting the ventilator. Due to his high oxygen needs, the doctors made the decision to re-sedate him to allow him more time to heal. They did not want his body under additional stress, especially since he required more oxygenation. Therefore, dad was re-sedated with Propofol and allowed more time to heal.