Imagine you are a five year old with a limited knowledge of things around you.
You have a nice toy on the table next to your bed, which you love dearly.
The toy keeps falling down occasionally, every time developing a crack or two but never breaking completely.
You desperately wish the toy would not break and try many ideas to stop its fall, but it falls down for a different, unforeseen reason every time.
I felt not very differently from the way the helpless child would have felt, in the context of amma’s hospitalizations.
Starting with her first hospitalization in 2011 for her original aortic dissection, by the end of 2017 she had survived ten emergency hospitalizations. The eleventh was her final one.
A review of the causes for her ten hospitalizations shows that they had been quite diverse – her aortic problems comprising only two of these ten.
She had been hospitalized for the following: aortic dissection on the ascending aorta, dissection on the descending aorta, iron-deficiency anemia due to internal bleeding, severe blood loss after a fall, hyperkalemia (high potassium), unstable angina (chest pain that can lead to heart attack), pulmonary embolism (blood clot in lungs), bibasilar atelectasis (lung collapse) 73, and twice for heart failures.
How best could I – with little knowledge of medicine – have prepared myself for her next emergency? Unless I had a cardiologist sitting at home with the necessary diagnostic equipment and medicines, there was little else to do but to watch out for an emergency and rush her to the hospital if there is one. 74
In the last five years, there had been at least a dozen times when she woke up in the middle of the night and complained about some unique pain or significant discomfort I had not observed in her earlier. Given that she almost never complained about her pain without adequate reason, I used to be really worried – was it anything to do with her aorta? After ascertaining that she did not have any of the symptoms that an aortic rupture or leak would present, 75 I would run a Google search to find out what indeed could be the problem, and most times end up completely confused, tired and falling asleep in the process, subconsciously hoping for the best. By the time I woke up in the morning, I would see her busy at work as usual.
None of her hospitalizations or these nightly readings made me any wiser – neither in terms of knowledge of what was going on inside her traumatized body nor how I could equip myself better to deal with the next such episode.
It is highly unlikely she survived ten emergency hospitalizations because of anything I did. Perhaps she (and I) was lucky, or the cardiology hospital quite likely did a great job, or it was perhaps her willpower that played a role in her successful escapades.
But during any of these incidents – be they the nights with chest pains or other trauma, or the emergency hospitalizations – do I ever recall her asking me in fear “Will I die?”.
No. I mostly recall her saying “If I die, I die”.
73. Bibasilar atelectasis is a condition when you have a partial collapse of lungs, caused when the small air sacs (alveoli) in lungs deflate. This condition specifically refers to the collapse of the lower sections of lungs
74. One way to be better prepared would be to take CT scans of the aorta every six months to review if there has been any further dilation in the arch or extension of the dissection in the descending aorta. I took these scans a few times in the last five years, but was not as regular in taking these as I would have liked to be. Another way is to have frequent blood tests and cardio tests done frequently – this is much easier said than done.
75. Depending on the location of the aneurysm or dissection, symptoms comprise some of the following: severe pain in the chest, in the back or abdomen, cough. shortness of breath and loss of consciousness.
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