Harold Ward survives a Triple A, in the right place at the right time.
By Elise Sims
Harold Ward of Gary worked for 39 years with the Department of Child and Family Services in and around hospitals helping plan care for kids with special medical needs. In relatively good health himself, he had never been hospitalized. Suddenly last July, he found himself on the receiving end of care at the Emergency Department of St. Catherine Hospital, suffering from severe back pain that couldn’t be relieved with over-the-counter medications.
“The pain was terrible,” recalls the 70-year old retiree. “It was on my left side and radiated from my lower back down my leg. They were still running some tests when my sister, who is a nurse practitioner in Dallas, Texas, called the hospital to speak with the healthcare team. That phone call saved my life.”
Ward’s sister Tamara McCrary, NP, told Nurse Annette Henderson that Harold’s father and grandfather had both died of abdominal aortic aneurysm rupture when they were in their early 70s. She told her, “I can’t afford to lose my brother; please check it out.”
The healthcare team had been monitoring Ward, who told them that he didn’t have any major medical issues and didn’t drink, but was a smoker. However, with this new key piece of family history, they immediately sent him for a MRI and CT scan. The MRI revealed a mass in his stomach and the CT scan distinctly showed the aneurysm.
Cardiologist Pastor Llobet, MD, reassured Harold that he would be able to repair the life-threatening aneurysm.
“Dr. Llobet did not let me down,” Ward says. “I’ve been blessed. It is a miracle. When I go to church – the Pilgrim Baptist Church in Gary – I’ve got testimony. The care at St. Catherine Hospital is very good. You couldn’t find a better team of doctors, nurses, aids, caring people who go above and beyond the call of duty.”
Abdominal aortic aneurysm (AAA), also known as a triple-a, is a bulge in the aorta, the main artery that carries blood away from your heart. If the bulge – caused by a weakened vessel – ruptures, the results can be deadly.
Typically, an AAA has no symptoms, but if it expands rapidly, leaks blood along the aortic wall or ruptures, there can be severe and persistent pain in the abdomen or lower back. Occasionally there can be leg pain. An AAA most commonly occurs in men over 50 years old and among those with a family history. The most common cause of an aneurysm is arteriosclerosis. Smoking dramatically increases the risk for arteriosclerosis or hardening of the arteries. Not smoking is the single best way to prevent the disease.
“Mr. Ward had both major risk factors – he had two family members who had aortic aneurysms and he is a smoker,” says Llobet.
“Previously we fixed an aortic aneurysm with a major surgery,” explains Llobet. “Traditional open aortic surgery is a big complex surgery with a higher morbidity rate, the patient usually needs to be intubated almost 24 hours, has an eating tube for five or six days, has more pain because of the large incision in the midsection and a lengthy recovery.”
Luckily for Mr. Ward, we were able to do a minimally-invasive endograft repair in the cath lab, he says. Endovascular aneurysm repair (EVAR) is an alternative to open surgery for the treatment of AAAs. In 2003, EVAR surpassed open aortic surgery as the most common technique for repair of AAA, and in 2010, EVAR accounted for 78% of all intact AAA repair in the United States.
“Endograft repair has a lot lower morbidity; it has a shorter hospital stay and fewer complications for the patient,” Llobet says.
Using special endovascular instruments and x-ray images, a stent-graft is inserted through the femoral artery and advanced into the aorta and placed at the site of the aneurysm. The surgeon checks for leakage of the stent-graft. Incisions are closed and sterile dressings are applied.
“If you catch the aneurysm in time, it is easier to do the endograft,” says Llobet. “This particular procedure was more difficult than it needed to be because Mr. Ward wasn’t screened and his aneurysm was almost at the point of rupture.”
Llobet recommends regular screenings which are available at St. Catherine Hospital. “Medicare pays for an abdominal aortic ultrasound once a year if you are 60 years of age or older and smoke.”
“You should have it checked out on a yearly basis,” Llobet says. “If you have an aneurysm, sometimes you have to have it checked initially every six months. If it is stable and it is not growing, then you don’t worry too much about it then you can check it every year. But if it is growing a little bit then it’s time to go ahead and start checking it more frequently or even have it repaired.”
