Ron Savage

Part 1.

On Match 20th I had keyhole surgery to repair the aortic arch.

The lining had peeled off the wall. This happens when the lining develops a tear due to (in my case) childhood and later stress. Then, blood is pumped thru the tear and thus between the lining and the wall. Where the blood ought to go is called the 'true lumen' and when it's behind the lining and thus where is should not be - which is the bad news - , is called the 'false lumen'. So it's blood pressure in the false lumen which splits the lining off the wall. I just checked that original post and now realise I did not explain that at all.

So, the keyhole surgery involves 2 incisions in the groin, with a stent in 2 pieces being pushed up thru one and a wire used thru the other to both manipulate the 2 pieces into place and to lock them together. All this of course because the stent ends up inside the aortic arch, and a bent stent can't be inserted as one piece.

The danger is that when the stent pushes the lining back against the wall, the 3 holes in the lining in this vicinity do not end up precisely aligned with the 3 orifices in the wall where 3 major arteries branch out from the aorta.

Blocking 1 artery can block blood to the spine causing paraplegia, blocking the 2nd can block blood to the right kidney (also bad news but not quite as bad because we have 2 kidneys), and blocking the 3rd can block blood to the intestines (another disaster since they need a blood supply to digest food).

So while discussing the op with the vascular surgeon I asked what was the probability of failure, and he cheerfully told me 10-20%! I felt sick, and said that seem terribly high to me, and he relied: Oh, no. We regard that as low!

As we watched the CT scan of the aorta responding to my heartbeat, and the lining literally flapping like a flag in the breeze, he said one reason they sometimes refuse to operate is that that particular person's lining is too rigid. But mine was just fine. Phew.

So I agreed to take the risk, and eventually the op took place.

And I survived. Though, I must say, the resultant bruising covers so much of an area in the groin, across the tops of my legs, down the legs and down my penis, that I can't cover it all with an A4 page.

I left hospital 5 days later, when I was deemed to be well enough to manage. Just don't ask about the bruises on my arms where I had at least 4 cannulas inserted for various purpose. And yes, for 4 days I had a catheter up the penis, to check I was excreting as much fluid as would indicate my right kidney was still ok.

So now I'm dealing with github pull requests, and going back to bed 4 times a day because I still feel so tired. But no matter, for as that old scribbler Shakespeare said: All's well that ends well.