Still Alive...

 Hello All... 

Sorry, I have been MIA. I have been a bit under the weather, and by that I mean I was in Memorial Hospital. I saw more of the hospital than I really cared to, but I am alive, which is the crucial part. I have not even opened up my mail yet. This all started last Saturday at 10:30am (May 27th). I was in my art room, happy as could be, indexing my new set of 12 honeybee stencils that I got from TEMU (OMG for $3.38!!) when I realized I was out of water. I got up to go get a refill from the kitchen. Suddenly, as I am walking down the hallway (a very short walk, mind you), a sharp pain started just under my breastbone/diaphragm. The thought came to me that is was similar to the gas pain I had after my laparoscopic hysterectomy in 2019. That sharp, sudden onset, stabbing sensation near the epigastric region then radiated to my upper back. The pain was so severe it doubled me over, still in the short hallway. I crawled to the front door because I knew Laureli was out front, working on camper. She heard the door crash open and came running. She asked if I wanted her to take me to Urgent Care, less than a mile from our home, and I said "yes!". Then a got a splitting headache on the entire right side of my head and broke out in a sudden profuse sweat. I guess she could see the change because instead of getting her keys she picked up the phone and called 911. By 11am I was in a bed in the ER. 

She was thinking heart attack, and so was I, at this point. I have never been in so much pain, even when hit by a Mitsubishi Montero while riding my Harley.  They were thinking some sort of gastric (gall bladder, pancreas, bowel obstruction) or cardiac issue. They gave me a "GI Cocktail", which is a shot of Maalox with liquid lidocaine. The theory was that it would numb the pain on its way through the GI tract, letting them know where the problem was. No change in my condition an hour after that so they started sleuthing a bit harder.  They did an XRay of my abdomen w/chest, then 2 EKGs (1 Prelim & 1 Final), followed by a CT scan of my abdomen/pelvis (with and then without Contrast), which is where the ER Doc caught up with me to administer morphine because I was never going to be able to be still. It was 1pm, so I had been literally writhing in pain for 2 hours before they addressed the pain. WTF PEOPLE?!?! Pain went instantly from an 8-9 to a 2, which was bearable. 

I was returned to the ER but the results of the CT scan made them take a chest X-ray once I got back. The cardiologist came to my room and said I was quite the surprise...not at all what she was expecting to see when she looked at all my scans. Not a GI problem. Not a heart problem. Turns out that a splenic infarction is a rare cause of abdominal pain.... and the cause of my pain. The infarction (they think) was caused by the left common iliac artery dissection, which never would have been found if it had not for the pain that made me go to the ER in the first place. On the plus side, for patients who survive the initial acute arterial dissection, the prognosis is good with complete recovery in nearly 80-90% of patients. 

The ER vascular surgeon found that I have a celiac artery dissection with splenic infarction as well as a dissection of the entire course of the left common iliac artery. With the incredible amount of pain I was in, my BP was in the 150s, pulse in the 90's. Both of those only make dissections worse. They placed 2 IVs and 1 midline brachial artery port. The goal was to keep heart rate less than 60 (so I got a leeft-side IV Esmolol drip) and to keep my systolic blood pressure 100-120 (they piggy-backed an IV Cardene drip to the Esmolol). I also had a constant heparin drip on the right side for the splenic clot. But, because the blood thinner was counter to the dissection (which needed to clot) I had to have cardiac output monitored 24/7. ARGH. That is why I went to ICU from the ER. Jess made a world of difference there, and Evan (night RN who rubbed my back when the paid broke though the morphine) was my hero. I got moved to a regular room on my birthday (May 29th) and Henry, bless his heart, could not find me any cake but he did bring me lemon sorbet!  And he found me some dinner since I had missed it in the changing of rooms. Darius (RN) helped get my pain under control as they weaned me off morphine and onto Percocet. They both certainly made a difference in my stay, lemme tell ya! 

Long story, I know... but it was a long several days. But I am now home...Got home the evening of May 31st. I am on Eloquis as a precaution for further clots, I have a blood pressure cuff to monitor BP and a medication to take should it get high with the pain. I also have a limited amount of pain meds and a follow-up visit next week. The cardiologist will do another scan in 4 weeks, and if all still looks the same I will do a scan yearly to monitor dissections. Scary shit right here y'all. I am still not sure what this means for me or my health further down the road. But I plan to stay on top of this as best as I can.