Brief summery: Kim had a major aortic dissection both (ascending and descending) This resulted in emergency surgery to save her life and her leg. Complications included patching her aorta, doing a femoral to femoral bypass, duel fasciotomies and other bumps in the road like pericardial and plural effusions. About one year later she had an aneurism which led to the replacement of a large section of her aorta. If you’re interested in more details feel free to read the following.
Wednesday, May 18, 2016 started out as a normal work day. Kim and I had eggs for breakfast with chocolate milk. We don’t usually have chocolate milk so that was a bit of treat. I walked Kim out to her truck, kissed her goodbye and closed the door. I can still picture her, as I’m writing this four months later, smiling and waving as she left. My truck was hooked up to a trailer and I went back in the house to finish my list before heading to town 30 miles away to pick up supplies for a house I’m remodeling. It was a long ride to town but not as long as the one that came next. There were flaggers on the road stopping traffic as the road crew worked on the road. It took me about two and a half hours to make the round trip. When I got back I went straight to my work site. I was just starting to unhook the trailer when the pastor’s wife Valerie drove in and said, “You need to call Jessica. Your wife is in an ambulance and on the way to the hospital.” For a moment I was dumb struck. Except for a slightly elevated blood pressure, Kim is a very healthy person and has even had life screenings where they check out all of your vitals. What was going on?
I left the trailer hooked to the truck and drove up to our house about a mile away. Running into the house I quickly called the number Valeri had given me. Jessica answered and said that Kim was on her way to the hospital and they thought it might be a stroke or a heart attack and that Carl and one of Kim’s students, Graden were following her in. After explaining to Kim’s mom Alberta who was living with us what was going on, I jumped in the van and took off. The tears came while trying to call our son Joshua and daughter Candace. I think I did get through to them but couldn’t say much and really didn’t know what was going on. I tried to tell myself it was just something minor.
That was a long 30 mile drive, especially when stopping for road workers. Carl and Graden were in the waiting room when I got there. They didn’t know much but filled me in as well as they could. I could not go back and see Kim for another long 15 to 20 minutes. Kim had been at work where she teaches at a boarding school when about an hour in she started feeling ill. Her legs started to go numb from the feet up and her stomach hurt. The students wanted to call 911 but Kim told them not to. One of the boys, Andrew, finally just went around her and called while another boy ran to a building next door to get Carl. Carl came and they decided to carry Kim down a long flight of stairs, put her in the back seat of his truck and go meet the ambulance. The ambulance was just on its way back from dropping off one of our next door neighbors so it was delayed. They met up with the ambulance halfway down the mountain and then had to stop at the local gas station to pick up the paramedic. Carl had tried to give Kim some aspirin and I think the paramedic did too but Kim threw it back up (bodily fluids were leaking everywhere). The last thing Kim remembers before she woke up after surgery was seeing Carl through the back window drive around the flaggers that were trying to stop him. There was no stopping Carl, bless his heart.
When I finally was allowed to see Kim they were just pushing her out on a gurney to go do a CT scan. She was in a lot of pain but was telling me to tell one of her students that he had to get his work done. No excuses, she smiled and was rolled away. The nurse gave me a bag with Kim’s soiled clothes that she had rinsed out. Then the neighbor whose mother was brought in just before Kim came over and asked what was going on and then I was alone. When they finally came back we were told that her condition was serious and she needed to be flown down to Kootenai medical center in Couerdalane. Less than 20 minutes later they were strapping her in a beautiful, shiny blue helicopter and I kissed her goodbye and she smiled, waved at me and said I love you. They gave her some Ativan for the trip to make her comfortable. Kim remembers nothing of here visit to Bonner General or the helicopter ride to Kootenai.
It’s a 20 minute flight to the Kootenai hospital from Bonner General. It’s at least twice that to drive, although I wasted no time getting there. When Kim arrived they took her straight to surgery and started prepping her. When I got there I was sent to the second floor surgery waiting room where there were still some people waiting for their loved ones that were having scheduled surgeries. The lady at the check in desk didn’t know anything about Kim being there and made some phone calls. She finally figured out the Kim really was there and in surgery. I think it was now about 3pm. I waited a while and finally a nurse from the surgery room came and got me. She took me to a private room where she gave me Kim’s wedding ring and told me about what they were about to do. Getting Kim’s ring was a real blow to me. My world was crashing down. The nurse said that they were going to ice Kim down and then stop her heart. They would call the waiting room when they stopped her heart and again after it was going. She asked me if I was okay. Yea right!
I waited in the second floor waiting room as the scheduled surgeries all completed and their families and friends slowly drifted out. Then I was alone. Pastor Scott showed up a while later and then after him our good friends Dave and Heidi came. They waited with me and we talked to take our minds off of what was happening. I had a cheap pay by the month flip phone with me that I couldn’t hear very well but I managed to make some calls and get people praying, and they sure did. The nurse called and said the surgery was going okay and they were stopping Kim’s heart and they would call back in about 20 minutes when they restarted it. I think Scott had to leave around that time. Dave and Heidi said that they would stay until Kim’s heart was pumping on its own again and they did. It was more like 45 minutes before the call came. That was a very long 45 minutes. But the surgery had gone well and Kim’s heart was pumping on its own so Bellville’s went home (Thank you so much Scott, Dave and Heidi).
The surgeon, Dr. Warall, stopped by later and talked with me. He said that the surgery went well and Kim would have died without it! He told me that she now had a 90% chance to live. My first thought was that there is a 10% chance she could still die. It’s hard for me to think positive at this point. It turns out that Dr. Warall is a renowned surgeon that just happened to be on hand filling in for someone else. He normally works out of Spokane, thank you Lord for sending the best. The nice receptionist had left me a pillow so I tried to lie down and rest. I was cold because all I had on were the work clothes I had on when I left home, Carhart pants and a t-shirt. So I waited there in the quiet dim-lit room alone for about another 2 hours. There was no resting. It was just after midnight before they let me in the Intensive Care Unit where Kim was.
The ICU is on the third floor and Kim was in room 333. Numbers have meaning and this gave me some comfort. When I walked in her room it was devastating because the last time I had seen Kim she looked fine. Now she was just barely hanging on to life. She was unconscious, she was so swollen that even her head was bigger. Her swollen tongue was hanging out and there were tubes everywhere. Two tubes were down her throat, one for breathing and another sucking out her stomach. There were several IV tubes stuck in her neck and the tape holding them there made her look like that side of her face was paralyzed. Then there were more I.V. tubes stuck in an incision by her right collar-bone. In total I think I counted 12- I.V. tubes running at one time plus the nurse kept injecting things into the I.V.s. Kim also had a wire up to her heart that was hooked to an external pace maker. Plus there were two tubes coming up from under her sternum that were draining the chest cavity. Doctors would pop in from time to time and they were able to adjust her heart rate, blood pressure and breathing. A nurse came in every hour and pricked her finger to check blood sugar levels. I sat by her side and talked softly and sang to her. The nurse started the process of waking her up and it took a grueling 4-5 hours and that time she never came completely back and she doesn’t remember it. The worst part is that the tubes in her throat made her very uncomfortable and she wanted to yank them out and tried her best to do it. I kept wiping out her mouth with a tiny sponge on a stick rinsed with water. She desperately wanted to drink but they wouldn’t let her.
What Kim had is called an ascending and descending aortic dissection. It was caused by a genetic defect that gave her a bicuspid aortic valve instead of a tricuspid valve. The dissection is a tear in the lining of the aorta which causes the aorta to separate down its length on the inside creating new channels called lumens. This shuts off blood flow to different areas of the body. Kim’s left leg had very low flow and she wasn’t getting enough blood to her kidneys and they weren’t sure what other internal organs were effected.
I hadn’t realized just how cold I was until I couldn’t stop shaking. The nurse finally asked me if I wanted a blanket. Yes, I did and when she brought it it had been heated. That was a wonderful sensation when she draped it over my shoulders. Another thing that I hadn’t realized was that I hadn’t eaten after breakfast the day before and all I’d had to drink was coffee. The dehydration started to catch up with me about halfway through the next day and I started drinking water, lots of water and felt much better. Sleep was not an issue because I wasn’t tired and didn’t sleep much if any the first 3 days or so.
Kim was struggling out of her first surgery. She was sort of with me but not really. One time she looked at me, tried to raise her hands, shook her head slightly and moved her lips to say, “What in the world is happening to me!” So I explained everything I knew but she remembers none of it. All through that five hour struggle I sat with her talked and sang quietly to her and now she was close to being back. That’s when Dr. Kladder the vascular surgeon came in and looked at her legs. The nurses had been concerned about the blood flow and tried getting pulses with a doppler device without much luck. When Kladder tried he was in an indecisive position, the Doppler device didn’t seem to work right and it upset him so the brought in a different one that didn’t work much better. The concern was the loss of or damage to Kim’s leg. He told me that he thought there might be enough blood flow to wait a few days before doing anything but I could tell he wasn’t sure. Then his partner Dr. Ward came in and looked at the left leg and said they needed to do surgery on the leg right now and it would probably take about two hours. So Kim was put totally back under again and we parted ways.
Thursday, 5-19-2016 around 5am. I’m alone back in the second floor waiting room. I was able to phone out east because of the time difference. Joshua had taken the day off work and was making arraignments to fly out and he took over keeping friends and family informed about what was happening. I drank coffee and waited. Dr. Kladder said he wouldn’t know for sure what they would do until they had Kim cut open. Maybe a stint or something to get the blood flowing. He was right about the time and about 2 hours later I got the call that Kim was out of surgery and as soon as they had her settled back in ICU, I could come back up. The second floor receptionist came back to work and was surprised to find me there. I was already getting to know too many hospital workers.
Kim was back in room 333 and now she had two more tubes coming from her leg and one in her body. They had done a femoral to femoral (fem, fem) bypass and fasciotomies to both sides of her lower left leg. You can click here to see a picture of the fasciotomy and skin graft (caution graphic) The fasciotomies had sponges in them and then were wrapped in clear plastic and hooked up to a suction drain, in what they called a wound vac. Her leg was huge from swelling. Speaking of swelling at the end of the first week she hadn’t eaten anything but had gained about 30 pounds. Dr. Kladder and Dr. Ward saved Kim from losing her leg and we will be forever grateful.
Sometime in the afternoon the nurses started the long process of waking Kim back up. This was again a long grueling process. They had to restrain Kim’s arms this time to keep her from pulling the tubes out of her mouth. I had been trying to keep her from doing it but couldn’t swab her mouth at the same time. The restraints let her move some but not enough to pull out tubes or I.V.s. They run several test to make sure they can take the tubes out of her throat. Kim had to be able to breathe well on her own so we would shut off the breathing machine and watch the oxygen level on the screen. I got to know the numbers on the screen pretty well. It had body temperature, blood pressure, heart rate, oxygen level and the type of beat the heart was making. They would also take a blood sample and send it to the lab. Once everything looked okay they got the green light to pull the tubes. Common sense told me that it’s really not that far from a persons lips to their belly or lungs so the tubes should be pretty short. I was shocked when they finally started pulling these tubes out. They pulled and pulled these were some long tubes! But they got them out and Kim was breathing on her own and slowly starting to recognize her surrounding and me.
Kim and I talked a while although her brain fog was still pretty heavy. I again told her what she had just been through but she doesn’t remember any of this conversation. It was probably around 8pm by now. Things were settling in to a pretty good routine and the nurses had everything under control. I was alone with Kim and she was half setting up while I was giving her small pieces of ice. She said that she needed to go the bathroom and didn’t know what to do. I didn’t know either. It’s not like she could just get out of bed and walk to a toilet. I was turning to get a nurses attention when out of the corner of my eye I saw Kim go pale and slump back on her pillow. I glanced up at the screen and all of the numbers were going down! I’m not sure if I yelled or what, all I know is that the room filled with people impressively fast. Within less than 20 seconds there were at least 12 people in that small room and they all new exactly what to do. The head doctor came up from the second floor and was asking questions and giving orders. Kim’s main nurse was giving quick and precise answers. Another nurse had a breathing bag going. They ushered me out of the room while they got out the paddles. Kim had completely flat lined at this point and I was in some kind of a fog/shock. There were another 5 to 10 people outside the room watching and I fell in among them. I remember the quick calm decisiveness of all the professionals. They got the paddles ready, cleared the way and zapped her. She didn’t come off the bed like in the movies but she did jump a little. I was praying please Lord let her live and her heart started back up. Fortunately it only took one shock to get her going. The doctors and nurses kept working on her for a while. They put the dreaded tubes back down her throat and she was put under anesthesia again.
I don’t remember setting down on the floor but there I sat crying on the floor. One of the nurses was with me and asked if I would let her pray with me. You bet ya buddy. Her and one of the doctors knelt with me and prayed. Thank you. Kim was back under for the third time. I went and found an empty room out of the ICU and had a talk with God and basically broke down. I told Him that I understood that He could take her and that He knew what was best but to please let her live. I explained to Him that there were lots of people that needed her (especially me), as if He didn’t know this already.
Back in room 333 Kim was stable and from watching everything the last two times I figured that as long as she was under she was fine. Hey, they can control everything, heart rate, blood pressure, oxygen levels… Our son Joshua had made arraignments to fly in from Michigan and I was to pick him up at the airport at 11pm. It’s about a half hour drive to the airport. I told the nurses that I had to leave to get Josh and they were skeptical of my ability to drive. I knew I could and needed to get away for a minute anyway. As I was leaving they tried to have me get a taxi to pick Joshua up but I had it in my head that I needed to do it. They had my cell phone number but I told them that if Kim died not to call me as I wouldn’t be able to handle it and would know soon enough. Looking back I should have just called the taxi.
11pm, 05-19-16. I met Joshua at the airport and let him know that his mother had just flat lined but was back and okay for now. I prayed with him and told him he was going to have to drive back to the hospital and he did. At the ICU you have to use the phone to get into the unit if you’re not an employee. Before too long they all new me so well that all I had to do was wave at the camera or wait for someone with a key card going in or out and just go on in.
Friday 5-20-2016. With Joshua there helping, I was able to rest on a bench that was along the back of Kim’s room and we took turns swabbing Kim’s mouth as the nurses started the long grueling process of waking her up for the third time. I was pretty nervous about pulling the tubes out this time because she had flat lined last time. The doctors assured me that last time it was due to a reaction she had to some anti-nausea medication they had given her. But still I had a vivid memory of the last time. Having Joshua there was a big help and it gave me some peace. Sometime on Friday morning they pulled out the two tubes down her throat and she was breathing on her own again. All of her vital signs looked good but the blood tests were showing that her kidneys were not working. They kept her blood pressure and pulse a little high in hopes that would help. As Kim came back to our world, I kept nervously looking for signs that she was really going to be okay. As I said before the tape holding the I.V.s in her juggler vein made her mouth droop like she had a stroke but at the time I didn’t realize it was the tape doing that. She was pretty groggy and I think Josh may have been the first person she recognized. I was close to her face and asking if she knew who I was. About the third time I did this she looked right at me and shook her head no!! Then she started smiling ever so slightly. She got me good!! Then she said groggily of course I know who you are. What a relief. I still owe her for that one!
I’m not sure when but Joshua went and picked up our daughter Candace at the airport. She had flown in from Alaska. With both kids there helping my job got easier. Thank you Kids. With Kim stable I drove over to Costco and bought a shirt and jacket. We got a room for Joshua and Candace at the Walden house which is like a bed and breakfast for people staying at the hospital. It was not too expensive and gave us a place to shower and the kids had a place to sleep. I was allowed to stay 24/7 in Kim’s room which was a big relief to me because I didn’t want to be anywhere else. The days started to get into a routine. Every day there were tests like x-rays, dopplers and echo cardio. It’s amazing the machines that can be brought right to the room now. One of Kim’s kidneys started working but not great and she was still very swollen everywhere. We got to know the doctors and nurses. Every day we saw some improvement and little by little the tubes started to come out. Two of the tubes they took out were the two large ones that drained fluid from her chest cavity. Again you would think that these tubes should be pretty short but they must wind around inside the body because they were anything but short. Candace was there for that and she didn’t flinch. With Josh and Candace there was even stories and laughter. Candace commented that the nurses had probably never heard that much noise and laughter from one of their ICU rooms (it’s the Ruge side) Kim barely remembers any of this.
Kim was in the ICU about a week. It was kind of disheartening to see the other patients, usually older over weight men, have their heart surgeries and be up walking the next day while normally healthy Kim was still in real rough shape. They finally were able to move her to Critical Care Unit, CCU, in 3 south. She still had plenty of tubes in her. The worst one might have been the wound vac that she had to drag around. Not that she was moving much though. Joshua and Candace had to leave to fly back at 3 am I think it was Tuesday morning. A friend a pastor Nick paid for a taxi to pick them up and drive them to the airport so I didn’t have to. Thank you Nick.
Kim’s leg was still real swollen so they left the wound vac on. Dr. Kladder was going to try to sew it up once the swelling went down. Almost a week later we were still in 3south and the swelling only went down enough to sew up one side. The other side needed a skin graft. So they took a big layer of skin off Kim’s thigh and put it on the lower leg. She has a beautiful scar. They took her down to the second floor operating room and put her under. I had to wait in another room nearby all alone again but pretty confident she would be okay.
Kim was still struggling in 3south. Her kidneys were not working well, she was anemic and she could hardly breathe. Every morning around 4 or 5 am (you never really get to sleep in a hospital) they took her down for chest x-rays. It turns out that she had pericardial and plural effusions (fluid around the heart and lungs) so the surgeon came in and told us they were going to go in, suck some of the fluid off and put a tube up by the heart to drain it. I was nervous but the surgery didn’t last long and Kim came right back out of it. They had drained about 12 oz. of fluid from around her heart and she now had bag by her side sucking out more. This did help her breath better.
While all of this was going on, I had another problem. Kim’s mom, Alberta, had just gotten off hospice care and was living with us. We had friends and volunteers from church coming in but I knew that could only go on for so long and mom couldn’t be much on her own. I figured that some of Kim’s 8 siblings could help out but they didn’t understand the depth of the problem. Josh and Candace had been communicating with them but for some reason it wasn’t sinking in. Finally I let the siblings know that I had volunteers until Tuesday but needed them to step up after that. So arrangement were made for Kim’s sister Tammy to fly up on Sunday rent a van and move mom to Nebraska to live with her sister Carol. I told mom to have people start helping her pack. Tammy stopped by on Sunday on her way to our house. She brought mom back with her to the hospital on Monday to see Kim before she left.
Alberta wanted to stay here. She had lived with us for 20 years. I drove home on Monday while Tammy and mom were with Kim. Zero packing had taken place and they had to leave the next day. I felt bad because I didn’t want to kick mom out and I felt even worse packing her things. They left on Tuesday with the van packed with mom’s stuff. Mom was on her way to Nebraska a burden lifted from me but there was also sadness for having to move her out. We never saw mom again, she died of old age about a month later. She was 89 years old.
After nearly a week in ICU we spent another week in 3 South. There were ups and downs. At one point we talked about the possibility of Kim dying and maybe this was a time for some last words. Kim’s concern was mostly for our kids and grandkids. “You be there for those grandkids”, she said. “You stay alive to help them too,” was my reply.
Kim was still in pretty rough shape when they were ready to discharge her. The insurance company wanted to send her to a nursing home. We wanted the Rehab Hospital of Northwest in Post Falls, Idaho. Miraculously we won and Kim was sent to a decent place. It was a good move because Kim ended up needing a blood transfusion while she was there and other help. It was also a place that I could stay with her (they had a big, stuffed chair that folded flat so I could sleep on it). The nursing homes weren’t going to let me stay. It was a rough week there but it helped Kim adjust to coming home. The nurses had a real hard time finding a vein for the blood transfusion. The flow kept being cut off and the nurse kept coming in adjusting the needle etc. I think it ended up taking about six hours and Kim did not want to have to go through that again. Fortunately her blood count came up just enough that she didn’t need a second bag of blood. We stayed there about a week.
So after one week in intensive care, one week of critical care and one week of rehab we came home. That was a happy day!! Kim started making big gains and could even walk out on the deck. Slowly things got better and now we are a month out. She can walk a mile, ride a bike and swim as long as she does it real slow. Her blood pressure won’t come down and she is on 5 different medications for it. There are still complications with the aorta. Now she has a descending aortal dissection which they don’t want to do surgery on. We are very happy to have each day above ground. Thank you to everyone that prayed or helped in some way.
Update 3-27-17
Kim now has an aneurism and the surgeons said they can’t put in a stent to fix it so it looks like more surgery. Kim is in pain and is fatigued. Two doctors have told her no exercise and she tires quickly. We are waiting for the surgeon to call for more information.
5/18/17 Kim is now recovering from the second of the three most difficult surgeries that they do (Dr. Burnett called them the mac daddies of surgeries). We don’t even want to know what the other one is. This time the surgeons went in through her left side and back. If both surgeries would have been done at the same time you could have seen straight through her chest. During the 5 hours of surgery they replaced a large section of her aorta with a Dacron tube. They cooled Kim’s body down again to 65F degrees for an hour and a half. For one half of an hour there was no blood flowing to her brain. The main part of the surgery went very well and the surgeon said that the aneurism was much closer to bursting than he thought. They did cut a nerve to Kim’s vocal cord so now she can only whisper. They say that can be fixed. Kim also had a lot of drainage from her chest tubes (left thoracic duct in the lymphatic system) and had to have another procedure that lasted several hours. That procedure was unsuccessful but the drainage finally stopped on its own. We had to stay at the hospital longer (we were there for 12 days).
Now we are home and Kim is very uncomfortable, weak and tired. But we are very grateful for her to be alive and for all of you that have prayed for her and me. Sacred Heart of Spokane has a nice lobby/waiting area with a grand piano and volunteers come in and play on it. One day shortly before we were to leave I sat down and listened. The lady was playing My Tribute (How Can I Say Thanks). I started to cry. How indeed. To God be the glory, great things He has done.