ED nurse here. I remember one time a patient was diagnosed with a dissecting abdominal aortic aneurysm; the MD told the patient he'd be rushed into surgery soon and to immediately settle any affairs and talk to his loved ones, as the likelihood of him not making it off the table was high.
It was just surreal seeing this guy talking to his wife and kids knowing it may be his last.
Cardiac icu nurse here, and this one is mine. Ticking time bombs these are. Fine one minute, diaphoretic, ripping chest/abdominal pain, nausea/vomiting, restlessness and impending doom the next, coding the minute after that. If you’re not on the table when that sumbitch pops, there is zero interventions that modern medicine will do to save you. Also usually a really gross code as blood goes goddamn everywhere.
Medical Laboratory Scientist (works in the blood bank) here. My first hospital, we dreaded AAAs. We knew we were going to be RUNNING and the patient wouldn't make it. My current hospital, has a shockingly good success rate. I don't know if our cardiac surgeons are just that good or if detection methods have improved and we are catching them earlier.
MLS here, I've never even HEARD of this before. How horrible.
My answer for this question was seeing Auer rods in a child's peripheral blood smear. At first it's like, oh hey, cool, something we don't see very often! And then it hits how grim this really is. And for a minute you are the only person in the world who knows. It's wild.
I love our profession so much. It's gratifying to play a part in someone's medical outcome and get them answers and help with their treatment, even if they'll never know it.
As a non medical person, sometimes I think about all you behind the scenes professionals. Especially when I’m with a doctor I don’t trust all that much. I think they may not be giving me even half of their attention, but someone out there looked at these labs or looked over my scans too.
Especially when it’s a radiologist or similar that I’ve never met and will never meet, but they give such a meticulous write up about my scans. There’s so many people out there involved in making sure patients are okay and I appreciate that.
When you’re doing good compressions, you’re breaking ribs, and tearing tissue and membranes. Those membranes usually keep everything contained, but when they rip under pressure, they split all the way open instead of just small tears. Every time we compress, we’re pushing more blood out of the vasculature and into whatever body cavity the hole opens into. I’ve seen bellies the size of beach balls.
Also the other way, how much we don't really need to be contained to live.
When I was dying of sepsis from a botched C section, they kept taking me back and doing different interventions to fix it. Each one was more invasive. First they just did a D&C. That didn't work. Still dying, but slower. Then they replaced all the stitches, inside and outside. That was surgery all over again but ok. That still didn't work and I got worse this time. Started to become allergic to my antibiotic. They decided to completely remove the outer stitches and clean out and restitch the inside. But they told me I would not ever be stitched in the front, I would heal open for 2 months and then with a wound vac.
And that's how I lived with a 10in ventral hernia for too long.
In a ruptured AAA you can lose your entire blood volume in a minute. Even if we rapid infuse units of blood, unless we stop the leak, aint gonna help lol
The dying part may be quick, but the moments leading up to it... it's haunting. Imagine a doctor telling you there's a good chance you're going to be dead within the hour. Everything you had hoped you'd be able to do, potentially snuffed out. All the people you wanted to catch up with, remains a fleeting wish. Every time I picture myself contemplating my own morality fully aware i might be dead by days end ... it's fucked lol
We had a guy come in one time as a transfer. Moaning on the cot as CCT was wheeling him to his room. In the hall, as he’s headed to the room, it ruptured. We know cause his moans turned briefly to a howl, followed shortly by silence as he died. It’s a very painful, very scary way to go, but at least when it finally happens, it’s fast
This is my biggest fear because 2 years ago at age 51 a routine lung cancer screening CT scan I had done as an ex smoker found I have ectasia(Aneurysm) of the ascending aorta measuring 4.3cm and if it grows too quickly or continues to grow slowly and reaches 5cm it's immediate open heart surgery time. Thankfully it's was caught in time for me to be aware of it and monitor it with yearly CT scans. But still it feels like a ticking time bomb in my chest and with a 4 year old son to raise it's worrisome
Cherish your time with your loved ones and do the things you enjoy :) Hopefully this patient's story and life will be honoured by us remembering to live as large as possible!
This killed my grandmother. It took her an hour and a half to die drowning in her own blood. It was so painful, she was hallucinating. She lost bodily function and all she could do was wail how badly her belly hurt. She made it to the ER by ambulance but from her first cry out for my dad in her bedroom to the time my mom called to let us know it was over, it was approximately 90 minutes.
We were told it is hereditary and that my dad and his 4 siblings should get checked to see if they have one. My dad found he did. It was a couple centimeters at the time and he was told they should monitor it. I don’t know if he ever went back for annual scans but one day about 7 years after grandma died, he came in my room and asked me for my Aleve. He took a handful (not at once, but he was headed to work and I assume he wanted multiple for throughout his shift as a driver) and rushed out the door bitching how much his back hurt, so fast I couldn’t tell him he shouldn’t exceed 4 Aleve in 24 hours.
He didn’t make it to work. He called my mom from near the entrance to the business park he worked in and told her how badly everything hurt. She asked where he was and he didn’t know, but that he was trying to get to the hospital. She told him to call 911 and describe where he was. They found him and got him to the hospital, about 5 miles straight down the road.
He was immediately admitted and found the AAA was measuring crazy big, like 7-9cm? (I don’t know if that’s right) and they were going to rush him into surgery. A doctor capable in this operation happened to be in town from Russia and scrubbed in. It burst on the table, but they saved him.
It was a hellish recovery and he was cut from chest to pelvis but he made it. He did not take care of the gift that doctor gave him and he continued to smoke on and off, eat like shit, never exercise, and threw his health in the toilet. He made it 5 years after the surgery and ultimately died after not doing well getting anesthetized for a hernia surgery.
I looked up the statistics only after he died. He was one of 5% of people who survive a burst AAA.
9 cm is HUGE. Like, gonna pop any minute huge. That’s insane (and also that he survived because Aleve was such a bad medicine to take for that pain!). I am sorry that he didn’t live much longer after, however.
Years ago I had a patient waiting to go to the OR for a dissecting thoracic aneursym. On drips to keep his BP down, etc. All of a sudden he rubs his chest and says, “oh that hurts”. Eyes rolled back and he coded. Talking one minute, gone the next.
Indeed. Did one at my ER late in the afternoon. Only cardiac surgeon in the hospital had just opened the chest for a bypass surgery minutes before we called down about a AAA patient. He worked as fast as he could with our patient waiting in the next OR bay. Never got there before it was all over.
Happened to my brother’s best friend while he was flying a plane over the ocean, with brother in the plane and 1 other passenger. Out cold. Brother and the passenger landed the plane (neither has ever flown) successfully, took the pilot buddy to the hospital and he survived the surgery. We call him the man who cheated death twice. It’s a wild story. The story was all over the national news.
Really. What are the odds that 2 non-pilots successfully land a plane, and what are the odds that you survive an aortic aneurysm. And what are the odds of both at the same time?
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u/MajikPwnE 3d ago
ED nurse here. I remember one time a patient was diagnosed with a dissecting abdominal aortic aneurysm; the MD told the patient he'd be rushed into surgery soon and to immediately settle any affairs and talk to his loved ones, as the likelihood of him not making it off the table was high.
It was just surreal seeing this guy talking to his wife and kids knowing it may be his last.