My Dad, Archie Norval’s ordeal in 2003 when he had his Aorta Replacement Surgery. Below is an excerpt from the book he wrote about his life. The book is called “Lavron – A second chance”.
Archibald Joseph Norval (My Old Man) born 15 April 1936 – died 4 May 2015.
Early in December, 2003, I felt healthy, a “ young “ 69, and Susie and I was looking forward to Christmas, with all the children around us as was the tradition as far back as we could remember. We bought presents for everyone and when it came to wrapping, it was my job to write out the name tags. We stashed the parcels in the one corner of our bedroom and soon the others brought their presents to add to ours.
I went for brisk walks around the park in the mornings and, apart from an annoying cough, which was getting progressively worse, I felt good.
It was on such a morning; the 17th December; the sun was shining; the birds were singing and generally everything was beautiful. I went for my walk but the cough was getting really bad. When I came home, Susie insisted that I should go and see my doctor, “ to get something for the cough.” I made an appointment with Dr. Johannes Breedt and, after examining me, he sent me to have Xrays taken of my chest. He then diagnosed pneumonia and booked me into the Linmed Hospital in Benoni where I was placed under the care of Dr.H.D.Alexander, Specialist physician. Dr Breedt, when examining the Xrays again, noticed a white blob over the one lung. He telephoned Dr Alexander who immediately arranged a CT Scan. The scan showed up a mammoth aneurysm in the Aorta.; it had ballooned to 7.8cm and was about to burst; blood was already oozing through; the doctors told us that, had it burst, I would have died within a matter of minutes. The widened aorta compressed the left bronchus and this caused the irritating cough; it was not pneumonia as originally thought.
Where I was happily walking around the park that morning, I now found myself on my back, in bed, in the intensive care unit of the Linmed Hospital. I was not allowed to move or to go to the toilet. I was stabilized on beta blockers and Dr Alexander called Dr Steven Davis, Cardiothoracic Surgeon, to examine me in preparation for surgery. Susie and Henry were present when he explained to us that it would be a big operation and that it would be only the fifth time in his career that he would perform it. He would replace almost the entire Aorta with an artificial pipe and, for the purpose, he would have to open the chest and cut some ribs. He warned that there is a 5% possibility that I may not be able to walk after the operation. He told us that he would have to transfer me to the Glynwood Hospital as Linmed didn’t have the machines necessary for the operation. He would also have to borrow a certain machine from the Arwyp Hospital in Kempton Park.
I was transferred to the Glynwood Hospital on the 21st December and the operation was performed on Monday the 22nd. It lasted eight hours; they made an incision from under the left arm to high up in the back. The anaesthetist was Dr U. Mors, the two assistants were Dr. E.Abramor and Dr R . Kemper and the perfusionist was Mr. D van der Berg. The operation was a success but, from that point on, I was so drugged and mixed-up that I didn’t really know where I was or what was happening around me. My family told me later that, a few days after the operation, they found that the left arm had no pulse and the X-rays showed that there was an accumulation of blood within the chest cavity. They operated again on the 27th to rectify this and this operation took 5 hours. I experienced difficulty in breathing and, on the 28th, they did a tracheostomy to facilitate breathing through a ventilator. On the evening of the 29th, Dr Davis noticed that I had severe hypotention and a markedly distended abdomen. He contacted another Specialist, Dr T.B. Kourie, who, on the 30th, performed an emergency laparotomy where it was found that the colon was massively dilated. He also performed a tube caecostomy and removed part of the colon. He made an incision from the middle of my chest over the stomach. This operation took 5 hours. In 9 days, from the 22nd to the 30th, I had 4 major operations. To make matters worse, I had so much phlegm on my chest that I kept on coughing and this caused the cut across my stomach to pull open, leaving a gaping wound about 4 centimetres deep. They informed my family that, once a wound pulls open, they cannot stitch it up again as germs may then already have entered the wound. It would have to heal from the inside.
I spent 5 weeks in the I.C.U., a very long 5 weeks……………most of the time I was not aware of whether I was still alive or whether I had passed on, and the pain, Oh man!!! There were needles stuck into my neck and pipes into my throat, my stomach, and all over. I lost my voice altogether and I became completely deaf, I couldn’t hear anything or speak to anybody. It was awful seeing the doctors and the nursing staff talking about me and not hearing anything they say. When my family visited I couldn’t hear them or speak to them. When I needed anything I had to point or try and make signs to the nursing Staff. Later on they gave me a writing pad with a pen to use as a means of communication. My body was so sore and, when they turned me over to wash me, I nearly cried of pain. Every morning when they wheeled the Xray machine in to take Xrays of my chest and stomach, they lifted me to insert an Xray plate under me, and the pain was almost unbearable. For the first 3 weeks or so, I was not allowed to drink anything and my mouth became so dry. When I indicated that I was thirsty, they wiped my lips with what looked like a cotton bud, with a bit of moisture in it. Later on I was given a glass with ice blocks which I could suck. Being December it was very hot and after I indicated that I was hot, they brought me an electric fan which they set to blow onto me.
My bed was in a separate glass enclosure in the I.C.U and the bed vibrated softly all the time. In the I.C.U one didn’t have a buzzer or bell to call the nursing staff when you needed something, because a sister or a nurse was allocated to each patient each day and each night, and they were supposed to stay with you throughout their shift to care for your needs. I remember many a night when the night staff assembled together in a corner to chat or read etc. and when I needed someone to help me when I was just about choking in the phlegm on my chest, I lifted my arm and held it up in the hope that someone would notice it and come to my aid. I couldn’t sleep at night and just lay there, staring at the wall in front of me; the nights were so long; I just waited for 3 0’clock in the morning when the nursing staff would start washing the patients and preparing them for the doctors doing their rounds any time from 6 onwards. I communicated with Susie and she arranged for a wallclock to be hung from the wall where I could see the time. I never realised that time could pass so slowly; it seemed , at times, that the clock had stopped completely.. When washing me they had to turn me first onto the one side and then onto the other. Sometimes the one attending to me would call someone else to help but sometimes she or he would attempt it alone and then I would hurt unbearably. I knew I had wounds all over but I didn’t know how and where; all I knew was that I had insufferable pain. Initially they injected painkillers and other drugs into me via the drips and when I could eventually drink water, they gave me numerous pills and capsules to take.
Eventually they brought a large easychair which they placed next to my bed. Every morning two of them helped me out of the bed onto the chair and in the late afternoon back to bed. It was quite a task sorting out all the pipes and bags/ bottles tied to me. My left leg swelled to nearly double its normal size and they fitted one of those white medical sox which stretched to well above the knee.
Throughout the period, most of the time, I was not sure of what was happening around me; whether I was dying or whether I was going to make it. Sometimes, during the operations, I was aware of the anaesthetist making jokes; he always wore a sweatband around his head during operations. I was aware of the long passages they were wheeling me through, and the bright lights. On one occasion, I had the distinct sensation that I was rising from my bed and when I looked down, I could see myself lying on the bed; I wondered whether they would, in fact, operate on the correct me. Then, one day, I was lying on the bed on my stomach with my arms outstretched above my head; people were walking past my bed; doctors, sisters, my family, all people I knew; I kept trying to grab onto them, onto their clothes, but they kept on pulling away; I felt that I just had to get hold of somebody but in vain. Eventually I gave up and felt myself drifting away. I felt as though God had forsaken me; lost and without any hope. I battled to breathe, I couldn’t talk, I couldn’t hear, people came and people went, but I seldom knew what was going on around me. The one thing I remember clearly, it stuck in my mind, was when Dino, the medic in charge of the I.C.U, asked me whether I knew what day it was. When I replied,” no I don’t.” He said, “ Today is Christmas.” I felt as though a blanket of calmness and peace was descending on me. Many a time I tried to pray to my Lord, but I couldn’t. My mind was completely mixed up. I couldn’t read or think logically. Once I was under the impression that my bed was at the reception desk of the hospital, and that I was demanding to be booked out. They calmed me by saying that they would have to get hold of the doctor first as he was the only one authorised to book me out. Then it petered out. I had so many hallucinations, so many times when I thought something was happening, just to realise later that it wasn’t.
I realise today that the only thing that pulled me through, was Susie’s smile and the love and affection of Henry and my other family who visited me so regularly. Shaun brought me drawings of a smiling face, which he stuck onto the wall in front of me. The nursing staff didn’t object; I’m sure they would allow anything to cheer me up a little. I looked forward, desperately, to Susie’s smile when visiting hours were near, and to Henry’s strength and patience when I needed to be lifted or turned onto my side a little. Sometimes, when they visited, I was not aware of their presence and they left with the feeling that they may not see me again. Henry told me later that they left sometimes with tears flowing freely. He also told me that, although Susie was always smiling, there were times that she had a terrible cough but on her way to visit me, she would suck as many Medikeel drops as possible to stop the cough when she reached the hospital. When they removed the pipe from my throat and put a plaster over the hole, I gradually started talking again and I also started hearing.
Time marched on, albeit through Hell, and then, one day, they moved me out of the I.C.U into a private ward. There I had a T.V above my bed and my family could visit me more often. It was wonderful to be able to drink tea and to eat proper food. I still could not sleep and, after 5 weeks in I.C.U my stomach had, for all practical purposes, died on me. My head was itching and, when Susie called, I asked her to persuade the nursing staff to wash my hair. The response was,” we cannot wash his hair in this weather.” ( it was raining at the time). At this stage, I still had no idea what wounds I had, all I knew was that there were many plasters and that I had a lot of pain.
One morning, the doctors were deliberating and Dr Kourie told me, afterwards, that I could go home. He said that he would arrange for a sister to come to the house every morning to dress the wounds until they were properly healed. He also arranged for the sister to use honey in the wounds because, according to him, there was no better cure. Knowing what was involved in the nursing, I asked the nursing staff to contact Susie and Henry to call beforehand so that I could ask them whether it would not be too much for them to nurse me at home. They were adamant that they would manage.
They took me home and I felt like a stranger when I arrived there. After more than 6 weeks everything seemed different but it was like heaven getting into my own bed. I was treated like a king. I brought with me a plastic bag full of pills and capsules – heaven knew what they were and what they had to be used for. After talking to our doctor, Susie threw the pills in the ash bin. Our doctor discussed the issue with the specialists, who performed the operations, and prescribed fresh pills/ capsules. Today, 10 years and 5 months later, I still take 25 pills/capsules daily. Susie is my Pill Manager; every night, before we go to bed, she sorts out the pills for the night and the next day; I would be lost without her. I always tell people that, if ever she wanted to get rid of me, it would be the easiest thing in the world for her to wangle my medication; there wouldn’t even be an autopsy because everyone will assume that I died as a result of my medical condition. In the circumstances, I treat her with care and devotion……………..
The first few days at home, Susie and Henry, when preparing me for a shower, cut a hole in a black dust bag and pulled it over me to keep the bandages and plasters dry. Then the sister, who called daily, told Susie to remove the plasters every morning, to let the water run over the wounds, to dry them lightly with a sterilised cloth, to let me lie on my back on the bed and to cover the wounds until she could get here to apply fresh dressings and honey.
To shower me, Susie and Henry placed a little plastic chair in the shower cubicle for me to sit on. Then they washed me and rinsed me whereafter Henry lifted me up, ( thank God, he is a tall and very strong man). They dried me and then Henry helped me back to bed. He always held a towel in front of me, “ so that the ladies in the house couldn’t see me naked”. I realised later what the true reason was. The entire one wall of our bedroom had sliding mirrors covering the built-in cupboards. They covered me in front to hide the gaping wound in my stomach so that I couldn’t see it in the mirrors. . Had I known of the wound, I would probably, never have moved from the bed.
The sister called every morning for three months before she felt that the wounds have healed sufficiently. We noticed that, each morning, after I showered and while we were waiting for the sister, I started coughing. The family joked, saying that it looks as though I was developing an allergy for the sister. When Susie mentioned the coughing to the sister, she said that, when they showered me, they should apply a plaster over the hole in my throat, because they were obviously spraying water through the hole, onto my lungs which caused the cough.
Susie told me later, that when they first started showering me, she nearly passed out. She was kneeling in front of me where I was sitting on the plastic chair, and, as she washed me, she was looking directly at the gaping wound stretching open; the red flesh, the yellow fatty tissue and the bloody water running through it. She said that she must have received power from above because she wouldn’t have managed on her own.
I still couldn’t sleep; it felt as though my eyes were permanently open. Many nights, Susie stayed awake with me and this was slowly draining all energy from us. We became very tired and we realised that we had to do something to rest and build up our energy. Henry explained the situation to Dr Breedt and he prescribed some strong sleeping tablets. They gave me the tablets together with all the others I was taking. Nobody expected the results; for a whole day I became what they described as “Fruitcake “. I didn’t know who I was or where I was. Someone had to watch me the whole day long. I tried to pull off the plasters over my wounds, I started chewing the sheets covering me, saying, “This roast needs salt,” I said to Mandine, Shaun’s Fiance, “ Thank you for looking after my car, here is your money,” I later said to Shaun and Mandine, “ Here is the key to your hotel room,” I said to everyone around me, “ Please help me, the blood pressure machine is raping me!” ( In the hospital I constantly had a band around my leg which was connected to a machine which measured my blood pressure automatically every 30 minutes.) Susie and Henry became worried and telephoned Dr. Breedt. He called later in the afternoon and told them not to give me any more of those pills. The next day I seemed fine, under the prevailing circumstances.
The wound over my stomach healed slowly from the inside and, one day, Henry took me in to Dr Davis to remove the stitches on my back and under my shoulder.
Susie later told me that, on Christmas Day, while I was in hospital and they didn’t know whether I was going to make it, no one was interested in dishing out or opening any presents. Henry said that, if something happened to me, he would never be able to open presents with the tags which I wrote out before I went into hospital. Apparently, Christmas Day and also New Years Day, were very dull and certainly not like the festive occasions they traditionally were in our house. Nobody felt like eating or partying.
I was in a wheelchair for many months and, one day, Henry pushed me to where he was working to chat to them. At that stage I couldn’t wear shoes and went everywhere in my socks. Eventually, when he pushed me back, he cut the corner around one of the desks, too short and one of my big toes caught the corner of the desk. It was very painful and gradually turned black. We realised that it must have broken and for a long time the pain diverted my attention from the pain I was suffering inside.
One of the main things I had to battle with after the operations, was depression. Many nights I would wake Susie just to talk to me as the dark of the night became too much for me. In the late afternoon at dusk, somebody had to be with me because the, “Black Dog,” was getting to me. The lights had to be on, I just couldn’t stand the dark. This, once again, is where Susie and Henry came to my aid, They made sure that there was always somebody with me to talk to me and to cheer me up.
In the first 2 years after the operations, I couldn’t do any work. I couldn’t even hold up a newspaper to read. After cutting and putting butter on four slices of bread, my back was aching so much that I had to sit down in my recliner which was bought for this purpose. I had no strength in my arms at all and I had to be careful not to pick up heavy items. When I started walking, I could only walk for short distances with the aid of crutches, before my back forced me to sit down. I went back to my specialist physician to seek help with the back pains which were driving me crazy. He referred me to Dr Francois Swart, a Neurosurgeon, who studied the plates of the scans they had done. He found that, whilst during the operations the doctors had to maintain a steady flow of blood through my spine, there was a short piece of the spine which didn’t receive blood and it caused a thrombosis in the spine. He explained that, apart from another major operation, I would just have to live with it. He prescribed morphine pain killers which I had to take regularly three times a day. They helped, but I can still only walk short distances even today. He also found that, when they severed the ribs during the operations, many nerves were also cut off. In the healing process, these nerves were trying to bond somewhere and they were sending weird messages to the brain. He prescribed “Eplentin” of which I had to take 900grams a day. If this didn’t help, he was going to implant a little machine into me, which he would connect to the nerves to send proper messages to the brain. Thank God, the “Eplentin” worked and today I feel much better although, when I scratch the left side of my chest, I feel it in my back.
On Saturday the 1st of February,2004, we dished out our Christmas presents and on the Sunday, we had our Christmas Lunch.