Off Our Meds: Guest Post

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Affair of the Heart: I. A Brush with Death

This is the last post in the series, Off Our Meds, in which LWON examined some scary issues in medicine but didn’t resort to fear mongering because we didn’t have to, medicine being scary enough as it is.  

This is also the first post in Affair of the Heart, a series that takes place at the intersection of a highly-experienced science writer and the medical system.

B0005911 Mechanical heartBefore I retired as news editor of Science magazine last year, I promised myself I would never become one of those old men who go on and on about their ailments.  Yet here I am,  starting a series of posts on my unexpected journeys through the medical system.  My excuse?  At 68 I don’t consider myself an old man, and after more than 40 years in science journalism, I can’t resist the urge to tell a good science story.  Cutting-edge genetic research, pioneering surgery, the propensity of  high-resolution imaging to come up with troublesome “incidental” findings, family genetics, the cost of medical care, and a bit of negligence on my part—they all feature in this saga.

After a lifetime of good health, aside from old rugby injuries and wear and tear on the knees from a half-century of running, it was something of a shock to learn earlier this year that I have two scary medical “conditions,” as the doctors like to call them: an aortic aneurysm that requires some serious cardiovascular re-plumbing,  and a pancreatic cyst that has a potential to develop into an invasive cancer. Most people who have either of these silent lesions—and that turns out to be a surprisingly large number—are blissfully unaware of them until it’s too late.  I’m lucky:  It looks like I have a chance to deal with both of them before either deals with me.

Let’s start with the aortic aneurysm.  That’s the part of the story that involves some personal negligence.

B0005636 Enhanced image of a human heartIt shouldn’t have been a big surprise when I learned in January that a family history of burst and disintegrating aortas had caught up with me.  Twelve years ago, my brother, then 57 and living in Stockholm,  called an ambulance when he experienced dizziness, nausea, and the sense that he was on the verge of passing out.  An astute emergency room physician at the local hospital recognized the symptoms, put him back in the ambulance, and sent him to the renowned Karolinska Institute.

He was experiencing an aortic dissection. The hosepipe of an artery that carries oxygenated blood from the heart to the rest of the body was breaking down at the aortic root, the point at which it emerges from the left ventricle. Probably starting with a small tear, blood was being forced into the wall of the aorta, pushing the layers apart and narrowing the bore of the artery.  In his case, blood was also leaking into the pericardium, the sac-like membrane that surrounds the heart. His blood pressure was dangerously low.

A fit marathon runner, he had had no warning.

He was rushed into surgery, where a team of surgeons cut out the damaged stretch of aorta, including the aortic valve that prevents blood from flowing back into the heart, and replaced it with a length of Dacron tubing containing a mechanical valve, which consisted of carbon composite moving parts in a ring of stainless alloy.  To this day, when it is very quiet, he can hear the valve clicking away in his chest, a sound he says is reassuring and disconcerting at the same time.

My brother was lucky—lucky that he called an ambulance in time, lucky that the emergency room physician recognized what was happening even though my brother hadn’t had the excruciating chest pain that usually accompanies an aortic dissection, lucky that he was close to the Karolinska Institute where the technically difficult operation could be performed,  lucky that his aorta didn’t disintegrate in a catastrophic rupture, and fortunate that he was in good physical shape.

The actor John Ritter, Ambassador Richard Holbrooke, and many others struck down by an aortic dissection were not so lucky. Aortic dissection is the 13th leading cause of death in the United States, killing an estimated 17,000 – 20,000 people a year.  Like my brother, most victims never see it coming.  Most are unaware that they had a precipitating condition, an aortic aneurysm.

Fortunately, I’m not in that category. When I told my primary care doctor about my brother’s brush with death, he recommended a consultation with a cardiologist.

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This is the first in a series.  Next, coming on Monday, 10/13: Not So Benign Neglect.

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Colin Norman has been a science journalist for more than 40 years.  He is the former news editor for Science magazine and currently lives in Lewes, Delaware.

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Photos:  mechanical heart connected to the pipes and valves of brass musical intruments — Bill McConkey; digitally enhanced image of a human heart — Gordon Museum; both via the amazing collection at Wellcome Images.

4 thoughts on “Off Our Meds: Guest Post

  1. I only heard in a roundabout way about your problem, and did not quiteknow who to email, to say we are all thinking of you. I have learn t something about anatomy, reading your post, and am awestruck sat the wonders of modern science Rosamond

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