from my upper left chest area to my upper left thigh. I am currently just
on medication to keep my blood pressure under control. Toprol XL and
an ACE Inhibitor. No limitations on anything except to not do any activity
that is very strenuous. Doctors will continue to monitor the blood flow to
my internal organs and for aneurysm. Main problem I have experienced so
far is that my right leg fatigues quite easily due to less blood flow. I created
a support group on Google Groups to talk with others in this situation:
Derek, Seattle WA
He was back in the hospital twice after that in December of 2005 with chest pains, but was send home after 3 days of testing, each time.
He was treated at Ingham Regional Medical Center in Lansing, MI. It has been suggested (by Dr.'s that I work with) that he consult with the Cleveland Clinic but one of his current Dr.'s doesn't think that is necessary.
He sees a cardiac surgeon, a cardiologist, a nephrologist and is general practitioner. I attend his medical appointments, so I am able to advoate on his behalf, should he need it.
I have wanted to ask his physicians about long term prognosis and life expectancy, but have been afraid to in the presence of my husband.
I am grateful that we have more time together and cherish every moment. God is good!
Due to the fact that his dissection was found so late, after he came out of surgery, they did put him into a induced coma for 5 days to help heal him, with no movement. As my husband is quite strong they needed to give him 3 and a half time of duladin in order to somewhat keep him calm, his BP went up to 250/190 the morning of his surgery, which the thought his aorta was going to blow, they got it back down to a somewhat normal rate, but as those of you know who have had this, the pain is unbearable. His life expectancy was 2 years it has been a little over 2 years, the going time frame from what I understand is 5-10 years. However, ifyou made it through the surgery itself, as I say to my husband, well I guess the good Lord forgot ya and the devel dont wantcha" You are a walking miracle dont waste your time as my husband does, thinking about how long or worry about win, be happy you have the time with the ones you love now. You have already beaten the odds!
I recently studied intensively some relevant medical articles that had been dealing with survival prognosis of type-B patients (who all are heading to an inevitable aneurism, sooner or later):
see O. Dapunt et al. J.Thorac Cardiovasc Surg 1994;107:1323-1333 and T. Juvonen et al. J Thorac Cardiovasc Surg 1999;117:776-786
From their data I could estimate through an approximative model how the start and speed of growth of our aneurism relates to our BP.
We assume that right after the dissection there is no aneurism yet. But obviously the downward running dissected aorta has now an increased diameter caused by the weakend aorta wall, getting a diameter size around 3.5 cm at a 70 mmHg Diastolic BP, which is at least 1 cm more than the diameter of a healthy, non-dissected aorta.
Both articles report how at higher diastolic BP-levels the diameter is driven elastically above 4.5cm diameter, where lies about the point of expansion above which the aorta wall gradually starts building an aneurism (being a process taking years). I constructed an approximative model based on data from above articles to link the systolic/diastolic BP's to the elastic diameter expansion and also to the (inelastic) aneurism growth rate.
The latter is of interest in the topic at hand here. The data:
A patient having a BP of only 100/60 mmHg showed no long-term aneurismic growth whatsoever (!), while a patient group having a median BP of 140/80 mmHg showed a diameter growth rate of 0.09cm/yr. Finally, a patient group having a median BP of 170/90 mmHg had a growth rate of 0.16 cm/yr.
Starting from an elasticcally expanded diameter of 3.5 cm at a diastolic BP 70 mmHg, the elastic diameter of 4.5cm is reached at a diastolic BP 80mmHg, or at a syst/diast BP of 90/70 mmHg. So in practice almost every patient will have during each hart-pulse cycle the diameter above 4.5 cm for some part of the time, which causes then a slow inelastic aneurism growth.
And one has roughly about one inelastic cm more to grow until the diameter reaches 4.5 cm at 70 mmHg and aneurism surgery becomes advisable.
My aneurism growth model was closely linked to the data of the article of Juvonen et al., where we applied just interpolation.
Some examples of the outcome:
a. At a daily averaged BP of 110/73 the diameter grows inelastically by 0.04cm/year, so 25 years to go until aneurism surgery.
b. At a daily averaged BP of 130/75 the diameter growth rate gets 0.07 cm/yr, so 14 years to go.
c. At a daily averaged BP of 140/80 the growth rate gets 0.09 cm/yr, so 11 years to go.
d. At a daily averaged BP of 150/83 the growth rate gets 0.11 cm/yr, so 9 years to go.
c. At a daily averaged BP of 170/90 the growth rate gets 0.16cm/yr, so 6 years to go.
Please bear in mind that this is just the statistical story dealing with medians and averages and that the prognosis for any individual patient is dominated greatly by individual features (like the health condition, other deseases, specific aorta weaknesses).
Anyway, even taking in account all inaccuracy of the model, the message is clear: we better try to keep our BP's at any time down to the lowest possible minimum, this both through behaviour plus through medication!!
I was diagnosed with Aortic Dissection type B.
My blood pressure wasn't taken for 25 years or so. When they took it it was 180/110 but ofcourse I was in death-fear.
Stayed in hospital for almost 6 weeks. They did not operate me but gave me a lot of bp meds.
I was a chain smoker but stopped smoking once in hospital. I thought: "Now or never"
When I came out of hospital I was kept on medication and that first summer I remember having it always cold despite high temperatures outside.
They did not give me a life expectancy and I read some things that said 8 years but that's because most people get these dissections being older the 70 so 8 years is even normal then.
It's more then 5 years ago now.
I'm still not smoking (also no trouble with it) but I kept being a social drinker. Slowly diminished medication both on doctors advice and my own judgement. Still blood pressure is 120/80 despite little medication.
I must say I feel better then before the dissection occurred !
At this moment I see no reason why my life should be shorter then without dissection.
I get an MRI scan every year and it shows no changes till now so that's OK.
It's unlikely the aorta will expand and rupture unnoticed between scans.
So far my story
.At this time Mark has right side infarcted kidney with blood clot so half the r kidney is working ,labs are all good so no dialysis.We are now three months in the hospital and leaving Friday Mark is doing well slight concern over having to go back to surgery to repaire b disection ,has anybody else gone through this what is life exspectancy?The million dollar question ! What is common thread for the 40 year olds this has been awful