aortic
AORTIC DISSECTION: A SURVIVAL KIT
In the morning of Saturday March 26th 2011 I suffered an aortic dissection. A few minutes later I was admitted at the Hua Dong Hospital (affiliated to Fudan University) of Shanghai in "very critical conditions". I was treated for 9 days, and then I went through two operations, a peritoneal dialysis on Monday April 4th and an aorta surgery on Tuesday April 5th. Surgery was successful, the problem is now under control and I am safe. Less than three weeks after the operations I am home, I am independent, I can walk and go out, have a shower, eat any kind of healthy food in a balanced way, make love, in a word I am slowly going back to a "normal" life (if life can ever be "normal" after such an experience: I personally doubt it. After this, life become so precious, exciting and beautiful that it is difficult to consider it "normal", and one just wants to enjoy it as much as possible, in a very conscious and positive way).
Aortic dissection not always allows such a positive outcome: in my case, I strongly feel that a few factors combined together to favor a happy ending of the story. This is why I decided to accept the kind invitation of Doctor Li Li, Vice Director of Vascular Surgery at the Hua Dong Hospital (Doctor Li has directly followed my case; he is the second from right in the image here above) to write a short comment about my personal experience on his website (which I also post in copy on my blog) with the hope that it may be useful to others (patients and their families) who could go through a similar experience.
Aortic dissection doesn't usually have symptoms, therefore it is almost impossible to prevent. In my case, it was a strong punctual pain on my chest, totally out of the blue, like if someone had put a knife in my right lung. Nevertheless, the day before I had experienced a sudden, acute pain in my left jaws, like a strong toothache, during a moderate physical effort: it could have been a signal, but I decided to ignore it. However, my first personal recommendation is:
1) act immediately: as soon as you feel pain in your chest (or even a sudden, inexplicable strong toothache for that matter) call an ambulance or ask someone to drive you to the most qualified hospital in the neighbor.
When I arrived to hospital, no more that 10 or 15 minutes later, I was almost unable to walk, pain in the chest was becoming stronger, and was joined by strong pain in the back, violent headache and stomachache (stomachache became so strong later that I could not eat or drink anything for five days before the operations, and I had to be fed by intravenous drip). For hours I was only able to tremble and repeat "it is very painful, it is very painful". I even recall having hallucinations. Despite my wrong conviction that it could have been a lung problem (due to the fact that I had a lung operation for a bullous emphysema twenty years before) in a matter of minutes the doctors in the hospital correctly pinned down that it was a cardiovascular problem and more precisely that the walls of my aorta were collapsing and possibly breaking, with the risk of aneurysm. When they told me what was happening to me, the first reaction was, quite understandably, to panic. Even if no one says it, you immediately understand you are in a life-threatening condition. I had an extra reason to panic: my father had two heart attacks and then passed away because of an aneurysm. I felt like if a heavy, unwanted genetic heritage was going to make me pay a very expensive toll. And here it comes my second little piece of advice:
2) accept the facts: don't panic, don't hate what is happening, don't refuse it. Even if you don't want it, it is happening and it is happening to you. The best way to get ready to react is to accept it and focus on positive response. I didn't hate my father for the heritage he had brought into my veins: in a moment I understood what he went through in his own time, I felt him close to me, I felt that he was holding my hand and that he was ready to fight together with me. Since then, I have never felt that I was alone: this attitude led me to listen in a more positive way to doctors, to my girlfriend, to my friends and family, to my inner hopes. It was no me alone against an unfair destiny: it was a teamwork (me, the doctors, my girlfriend, my friends and family) against a specific problem that although tough and complicated could have been solved.
And since we are talking about teamwork, here there are the next two suggestions:
3) trust your body: the aggression of the illness is very violent, and the medical and surgical response is at least as violent. The dynamic of the events exposes your body to continuous risks and the body balance becomes extremely delicate. I have done active sport on a regular basis for forty years; I am not overweight, I've always cared about what I eat and drink, and despite the fact that I used to be a smoker (which of course didn't help prevent my vascular problem, more likely the opposite) I felt very strong from a physical point of view: I therefore trusted the capability of my body to resist to those aggressions. I knew it was going to be difficult, but I also knew that my body could make it. Treat your body well, if you can: walk an hour a day, exercise, drink a lot of water, eat well, sleep well, do yoga and meditation, do things that are good for your body. When you will need your body to be really strong, when you will need to count on your body to survive, you will not regret to have taken good care of yourself;
4) trust the doctors: this is not an easy task because it doesn't only depend on you (as the previous point 3) but also on the doctors who follow your case, on reciprocal interaction. I find it very important though, because if you develop trust for your doctors, you relax and make their work easier and at the same time you develop a team spirit (because you feel that everybody is genuinely, passionately working to overcome the enemy: your illness) and the doctors become your coaches: therefore you listen to them when they ask you to do impossible things (like to remain motionless in bed for days despite the unbearable pain in your back) or when they make you believe that you can reach unexpected results (like successfully surviving a dangerous operation, as if it was like winning a very difficult football match).
I have been very lucky: the entire staff at the Hua Dong Hospital, doctors and nurses, proved to be highly professional, extremely well trained, competent, updated, and gifted with an evident sense of humanity and the capability to approach the patient from the right angle. I am grateful to every doctor (senior or junior) and nurses which I had the chance to interact with; in particular, I have been personally, deeply touched by the work of Doctor Li. I found he had the rare gift to be able to say to me the right things at the right time, with the right tone, with the right smile: and by doing so he got my unconditional trust. I fully believe that this greatly helped to make his work and the work of his colleagues successful.
I also have to thank you another doctor, Doctor Fu from Zhong Shan Hospital in Shanghai (also affiliated with Fudan University). Doctor Fu joined the team of the Hua Dong Hospital which performed my aorta surgery and brought his very valuable experience and knowledge to the operation room; I am therefore also grateful to him for his engagement and availability. I sincerely hope that every patient can count on a professional team as reliable, competent and human as the one I was so lucky to have.
The next piece of advise is to me as important as it may seems redundant:
5) find the right motivation to survive: in fact, it may seem meaningless to say that we need motivation to stay alive. Of course, we want to stay alive. Of course, we don't want to die. But the truth is that life is also hard. Most of us struggle to keep a balance. Most of our dreams don't come true, and most of the time life is not what we expected it to be. We experience delusion, frustration, sometimes rage. Giving up sometimes may seem to be a reasonable option. Well, don't give up, if you can. In my case, the urge not to give up, the urge to survive, the almost certainty to make it depended on two elements: my girlfriend, who has been close to me all the time - and in particular a conversation I had with her alone, just before the second operation, which made me feel how important it was to win against the illness - and my friends and family. When you feel that there is people around you who sincerely loves you and really cares about you, finding the energy to fight becomes easier. When you have love and friendship in your life, "you never walk alone", as the hymn of a famous English football team says. I wish all of you to always feel that you are not alone. Our destiny may not depends entirely on us, but in my experience I strongly felt that my wish to win against my illness counted a lot, and that wish was multiplied by all the people who physically or mentally held my hand during those difficult moments.
And finally, the last little suggestion (this was also an important element for me):
6) make an effort to see things from an higher perspective: when I entered the surgery room for the second operation I was of course afraid. Before getting the anesthesia I had a very long nail inserted into my neck and another smaller nail in my wrist, which didn't help me to stay calm. But after the first moment I had the feeling that at a certain point, after you and the doctors have done all you can, the fact that you will re-open (or not) your eyes after surgery ultimately depends also on whatever you want to call it: chance, destiny, god, the energy of the universe...
Before the operation, my girlfriend showed me two Buddhas she feels particularly close to. In the surgery room, I felt the presence of those two Buddhas. Despite the fears and tension, I started to feel very calm, relaxed, safe. When the doctors started to give me the anesthesia, I was ready to release the tension, entrust myself, and I was confident that things were going to go well.
We are small human beings, life is bigger than us. Love life, look also at the spiritual side of it, and perhaps life will love you back. I wish this to happen to all of you, wherever you are, whatever your condition.
