January 15
It is 3 am and I just arrived at the ICU waiting room here at Barnes Jewish Hospital in St Louis. John will be in surgery for about 12 hours...yes...12 HOURS for an extensive aortic dissecting aneurism.
It started about 5 pm when he had severe chest pain, called 911, then called me. I was home in less than 5 minutes and the ambulance was already there. He had vomited but was on the couch when I found him and they were trying to get an EKG. What they found didn't indicate heart but they knew from his cold and clammy symptoms and pain that they needed to take him in to the ED.
First diagnosis was pancreatitis. Then the CT scan showed what they called an aortic dissection (the term aneurism only came later) and they immediately started arrangements for him to be airflighted, and with some local counsel, we chose Barnes Jewish. (The drawing below was done for me at the Barnes Emergency Department by the Anesthesiologist). It shows the whole aorta and the dotted line shows the tear, clear from above the heart to the groin. The tear occurs when the middle layer of the aorta breaks away from the outer layer allowing blood to pool and clot. This causes a disruption of the blood flow to the major organs.)
The CT scan here showed the whole truth because the one in Rolla only scanned chest down. Here they did the full chest...it is amazingly awful.
Without surgery, he would no doubt be dead in a couple days because blood flow to vital organs is badly compromised. With surgery, an extensive "resection" will be done on the top part of the aneurism, like a graft. Basically, they give him about a 70% chance for survival, always with many possible complications. They are optimistic since many cases such as this don't make it to the ED alive. Regionals statistics vary from 5% to 30% who actually survive the dissection. He is healthy and strong with no co-morbidities like diabetes or COPD. But, heaven help us, this has been nothing but progressively worse news all day.
When John was told the first layer of bad news, he just smiled and said, "This is God's problem and He can fix it." He also said he is ready to go if that is what is to happen. He was smiling and calm despite nausea, vomiting, pain, and great discomfort, though toward the end he was drowsy.
Our good neighbors, Dom and Marilou are with me. Actually, Marilou was at the day care when I got the call and pretty nearly followed me home. She's a cardiac ICU nurse and just knew how necessary it was to be with me. I am so grateful. Dom drove their car and Marilou rode with me so I would have a car here.
Natasha and Jeremy are on their way and should arrive within an hour and Karissa is flying from Chattanooga at 5:30 am. I cannot tell you the comfort it was when Natasha and Jeremy decided to come immediately and when Karissa decided to come, too.
They just took John in and I won't even try to describe the horrors of what they will have to do to him but I know he will NEVER be the same again. So many possible complications...
Would rather have called you all but my cell phone was almost constantly busy during those four hours at our local ED, cell battery wore down, and now it is the middle of the night.
I praise God that our lives are in His hands...He is the great physician and HE IS IN CONTROL. You can understand that I am certainly in shock. Will try now to get some rest for the ordeal ahead. Already many prayers are going up in his behalf.
Love you all, talk to you soon...please understand that I will have to hire an answering machine person, a technical support director, a lawyer, and probably a host of others to handle all the details of this crisis...so if I can't talk to you, you will understand why. I'll need one of you to take on sharing details with the others, probably...
5pm
Us three girls are yawning here in the waiting room. The girls just went in to see John and he is slowly waking up, Karissa and I had seen him earlier and we were very pleasantly surprised at how well he looked. I just took my first nap and now I am groggy.
John's nurse is giving great care and shared some bright spots. For instance, the CT scan showed that John's left kidney is small, perhaps indicating that it has been minimally functional for a long time and has just decreased in size over time allowing the other kidney to compensate. This is another reason why the doctor thinks that John had some kind of previous dissection.
So, still lots of questions, but good reasons to hope.
Lovin' you....
Becki
Karissa 1/15
My precious dad is being life-flighted to St. Louis hospital right now. Thank you Jesus for having this under control. Please pray. I love you Daddy. — with John Knobloch.
Karissa 1/15
Dad is currently in surgery for an aortic dissection, a life threatening condition. All we can do is pray. The doctors told us most people do not make it to the hospital so we feel blessed.
Becki 7:30pm
This is a personal report to those of you who I am trying to keep informed. Please don't post it on face book or forward it to others, though you can share the jist of it with those who might inquire.
I am at Pear Tree Inn with Natasha and Jeremy while Karissa is staying with Dad at the hospital. His doctor encouraged us to rest now and to pace ourselves. Since he is not yet awake, he will need us more when he does awaken and can talk. It would not do for us all to have stayed there round the clock and be exhausted just at the longed-for moment.
So, his doctor has explained so much to us. Basically, in the 24 hours right after surgery they have three goals; no bleeding, stable heart, and responsive wakefulness. Both the first are well achieved while the third is just about to happen. We listened to the residents rounds and it was interesting. All of us being medical people, we are learning a lot. Jeremy even watched a video of the same surgery and Natasha and I may watch it too when we are not so tired, but not tonight.
Just talked to Karissa and she says John has made a bit more progress, maybe. It's very slow as they have told us it would be. We saw some encouraging signs just before we left. Several times we asked him to wiggle his right or left toe and he responded appropriately. Then twice, I saw him nod ever so slightly at our questions. The nurse saw these too and was glad.
We are all constantly receiving your texts, e-mails, and facebook messages of prayers and encouragment. Thank you for these. Every one of us feel as though we should be waking from this nightmare...but it has not happened. Tonight I just feel horribly tired and thus so fragile. Feel bad for leaving Karissa at the hospital alone because she has cried the most of all of us but she wanted to stay. She's getting a crash course in Coronarythoracic Intensive Care Nursing practices which will certainly only help her in her nursing experiences. I plan to go to bed pretty quick and head back to the hospital early in the morning so she can come and get some sleep. Both Natasha and Jeremy have been so fully supportive and helpful. Thankfully, they are also taking good chunks of time to keep up with their studies. So, I am praying I can sleep this evening.
All day long I have focused on that lovely modern picture of a smiling Christ in the OR with his hands on the doctors' soldiers, plus the images of angels hovering near. That helps me considerably.
love you all, dear and "present" friends,
Becki
Karissa 1/15
Update: transferred to ICU on a ventilator. Talked to doctor and he said the surgery went as all as it could have. We just got to spend some time with him and talk to him, even though he isn't conscious. I'm so glad he's made it this far and pretty soon they will try waking him up. Thanks for all your kind words.
Karissa 1/15
Definitely wasn't prepared for today.... Thank you to everyone for being so supportive. It's so hard to see my strong, healthy dad like this but with baby steps, I'm trusting and thankful that everything will be alright. — with John Knobloch.
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