Aneurysm
Thread Starter
Aneurysm
The thread in the Medical forum on prostate cancer, and in particular,
Fortyodd's post regarding the risk of surgery, reminds me of what happened to a relative in November 2007.
Age 78, mentally & physically as fit as a fiddle, he had been diagnosed with abdominal aortic aneurysm through a population screening programme.
In deciding what course of action to take, his thoughts were that he would risk the surgery rather than risk a sudden collapse at perhaps an inopportune time.
So he tidied up his affairs, and in mid November 2007, surgery undertaken, only to be rushed back to the table from ITU due to blood loss. 28 units later, and after most of the night under anaesthetic, he is finally returned to ITU. Thanks are due to the National Blood Service.
It's now February, and he has only just left the HDU for a ward. He's still got a perforated small bowel from complications during the surgery, and has drains to alleiviate foul build-up. He is being fed through a tube.
Now the grafted plumbing is infected, and, in the opinion of the Consultant, is non-operable. His body is fighting the infection, but without a spleen (from an operation ten years ago), is not repairing the abdominal wound. To top it all, he's contracted MRSA.
So we're waiting for him to die. Palliative care, including anti-depressants, is being administered, but if (when) scepticemia or some other disaster befalls him, his wife and adult children have decided (in consultation with the various surgeons & doctors) to not administer recussitative care. We have decided not to tell him, in case he starts pulling tubes out, or something.
It's very strange going to visit him. We have to put on a smile and a brave face, especially since he is so mentally alert. He knows that he is very ill, but not the whole picture. He is making plans on what he is going to do when he gets out.
Should he have undergone the surgery in the first place? He thought so last November, and even now, we think so too. He would have for ever been worried about "when his time was up".
It's quite sad that he'll never experience flight again; one of the greatest pleasures in his life.
Fortyodd's post regarding the risk of surgery, reminds me of what happened to a relative in November 2007.
Age 78, mentally & physically as fit as a fiddle, he had been diagnosed with abdominal aortic aneurysm through a population screening programme.
In deciding what course of action to take, his thoughts were that he would risk the surgery rather than risk a sudden collapse at perhaps an inopportune time.
So he tidied up his affairs, and in mid November 2007, surgery undertaken, only to be rushed back to the table from ITU due to blood loss. 28 units later, and after most of the night under anaesthetic, he is finally returned to ITU. Thanks are due to the National Blood Service.
It's now February, and he has only just left the HDU for a ward. He's still got a perforated small bowel from complications during the surgery, and has drains to alleiviate foul build-up. He is being fed through a tube.
Now the grafted plumbing is infected, and, in the opinion of the Consultant, is non-operable. His body is fighting the infection, but without a spleen (from an operation ten years ago), is not repairing the abdominal wound. To top it all, he's contracted MRSA.
So we're waiting for him to die. Palliative care, including anti-depressants, is being administered, but if (when) scepticemia or some other disaster befalls him, his wife and adult children have decided (in consultation with the various surgeons & doctors) to not administer recussitative care. We have decided not to tell him, in case he starts pulling tubes out, or something.
It's very strange going to visit him. We have to put on a smile and a brave face, especially since he is so mentally alert. He knows that he is very ill, but not the whole picture. He is making plans on what he is going to do when he gets out.
Should he have undergone the surgery in the first place? He thought so last November, and even now, we think so too. He would have for ever been worried about "when his time was up".
It's quite sad that he'll never experience flight again; one of the greatest pleasures in his life.
Scalextric for Men
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The decision for surgery is in the majority of cases: one that is made by the patient.
The triple A operation, Abdominal Aortic Aneurysm, is like others, risk loaded.
We can survive with grade 4 arthritis of the knee. Many will be aware that the aneurysm is a big threat.
With Pprune you are not alone.
The triple A operation, Abdominal Aortic Aneurysm, is like others, risk loaded.
We can survive with grade 4 arthritis of the knee. Many will be aware that the aneurysm is a big threat.
With Pprune you are not alone.
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Dear friend of ours died of AAA, largely because the hospital failed to recognise his symptoms until it was too late. He died having the op. Later his daughter, a Consultant Heart Surgeon, said he presented the classic symptoms and she could have saved him had she been there.
My thoughts and prayers are with Russell's relative.
My thoughts and prayers are with Russell's relative.
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I've known of a number of patients with leaking AAA's who's diagnosis was clear only in hindsight.
The subject of the original post has had an unfortunate rocky course. Medicine is an imprecise science.
Best wishes to all concerned.
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obgraham is right.
Look the alternative of doing nothing with an aneurysm (AAA) is possible but the outcomes are dismal. If you aneurysm starts bleeding (leaking) one day, you have a 75 % death rate. Sobering eh?
Look the alternative of doing nothing with an aneurysm (AAA) is possible but the outcomes are dismal. If you aneurysm starts bleeding (leaking) one day, you have a 75 % death rate. Sobering eh?
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<<Well she was very helpful, wasn't she.>>
Well from 8000 miles away she couldn't quite reach. Point being, when the symptoms were described she knew what the problem was and, given quick treatment, survival was possible. Unfortunately, those who saw him didn't recognise the symptoms..
Well from 8000 miles away she couldn't quite reach. Point being, when the symptoms were described she knew what the problem was and, given quick treatment, survival was possible. Unfortunately, those who saw him didn't recognise the symptoms..
Plastic PPRuNer
Not really my field, but there are more or less recognised criteria for operating AAAs. Generally, smaller aneurysms, asymptomatic and non-progressive aneurysms are best left alone. I don't know where your relative fell in the risk profile.
There's a reasonable summary here: http://www.jr2.ox.ac.uk/bandolier/band27/b27-3.html
Just as in aviation, most of the time there's no absolutely right answer (except in retrospect!). SOPs will see you right most of the time, but occasionally one gets a gut-feel about things that I have learned to listen to.
And the most surprising people do survive catastrophes....
There's a reasonable summary here: http://www.jr2.ox.ac.uk/bandolier/band27/b27-3.html
Just as in aviation, most of the time there's no absolutely right answer (except in retrospect!). SOPs will see you right most of the time, but occasionally one gets a gut-feel about things that I have learned to listen to.
And the most surprising people do survive catastrophes....
