The right place, at the right time
Gil Nelson of Fargo has just one memory from Nov. 15, 2004: "All I can remember is the terrific pain – pain in the lower back and the abdomen," he says. His wife, Carolyn, fills in the rest: "He woke up that morning in terrible pain. He has arthritis of the spine, so I figured it might be related to that. But when I noticed his pajamas were wringing wet with sweat, I knew this was something more."
Carolyn called to make an appointment to see their family doctor, but after hearing they couldn't get in until later that day, she knew help was needed sooner. Gil continued to be in excruciating pain. With the aid of their building manager, Carolyn helped Gil into the car and planned to take him to MeritCare Walk-In Clinic. When she arrived at the Y in the road where she would have taken a left, she heard him say, "I'm going to pass out." She took a right instead and headed to MeritCare Emergency Center, just eight blocks north.
"Every light was green, no train was crossing the tracks and when we got to the Emergency Center there were no patients waiting. Right away they came out and got Gil and put him in a wheelchair and wheeled him in," says Carolyn. "In the time it took me to park the car and call our son, they already came and told me what is was."
Gil suffered a ruptured abdominal aortic aneurysm (AAA), a condition few people survive. As many as two out of three patients with ruptured AAA die before even arriving at the hospital. "It's just remarkable he made it here soon enough that we could help him – most people in his situation don't," says Dr. Stephen Stromstad, MeritCare vascular surgeon who performed emergency surgery on Gil shortly after he arrived at the Emergency Center. In his 25 years of being a surgeon, Dr. Stromstad can recall only two other patients who survived a ruptured AAA. The life-saving emergency surgery involved clamping the rupture to stop the rush of blood, then replacing the damaged portion of the aorta with a synthetic graft.
To put this in context, the abdominal aorta is a large artery that runs from the heart to the pelvis, supplying blood to all organs of the body. About 200,000 new cases of AAA – a painless bulge in the aorta – are diagnosed in the United States each year, typically in people (more men than women) over the age of 60. Many just require monitoring and will never need to be treated, but if they do need treatment, it's typically non-emergency and often can be performed using a minimally invasive approach. The most dangerous situation occurs when the aneurysm enlarges and – without warning – ruptures, causing sudden death in 80 percent of the cases.
"It just gives me goose bumps when I think about it now – all the 'what ifs,'" says Carolyn. "What if I had continued thinking it was back pain and hadn't done anything, what if we'd gone to the Walk-In Clinic rather than the Emergency Center, what if I hadn't had help getting Gil into the car, what if the Emergency Center had been busy, what if Dr. Stromstad hadn't been immediately available. Just so many 'what ifs.' It's miraculous how everything fell into place. To this day I swear the angels – or somebody – was looking over us the morning and making the right decisions."
Today, Gil is doing well. "It's almost as if nothing happened, except I'm a little weak," says the retired math professor who taught at North Dakota State University for 40 years. "The doctor says I'm just in fine shape. He said if I want to, I can even go elk hunting." Gils laughs, then Carolyn adds, "Except he doesn't own a gun." Among his activities this winter, Gil makes frequent trips to Bismarck to visit Carolyn, a District 21 Senator, who is there for the 2005 North Dakota Legislative Session.
For more information about how to handle emergency situations, visit meritcare.com.
Are you at risk for AAA?
Return to Front Page of Valley Health Journal.
Do you have comments or suggestions for Valley Health Journal? Email us.