What It Feels Like To Have Your Aorta Explode And Almost Die

Okay, I’ll come clean: that headline is not really medically accurate in any way, and yet, somehow that’s exactly what happened to me. Or at least that’s what it felt like. What technically happened is that a few weeks ago I was one of the unlucky 30-per-million people every year who decide to dramatically rend their aortas – the big main hose taking blood from the heart to feed all of your body’s equipment – in a process called an aortal dissection.

Of the many and wildly varied things I learned from this whole mess, one of them is that there don’t seem to be many first-hand accounts of aortal dissections online. So I’m going to tell you all about mine. Because I also learned that this peculiar relationship we have – between me and you, yes, you– is very important to me, and I want you to know the truth about as much as you can stand to hear. So, get ready to roll your eyes at my over-dramatizing and grimace at the sheer biological grossness of it all, because I’m not going to hold back.

What Happened

It was a pretty normal Monday night, before it became very abnormal. The kiddo was on his VR headset, hanging out with some friends in some virtual whatever and making noises that sounded like Tuvan throat singing, but that was normal. My wife was at a friend’s house, and I was wrapping up work, and just did un-shocking stuff like have a lovely phone call with a friend and walked the dogs, which included a bit of running, because we have a new puppy who is, of course, a loon. Again, normal stuff!

I was down in my basement lair, wrapping up work stuff and putting my computer to sleep, grabbing my iPad to do some member birthday drawings and about to head upstairs. Right as I put my system to sleep, I felt this strange bursting sensation in my chest. It rapidly changed from a peculiar burst to what I can only describe as a sphere of pain, fuzzy on the borders but rapidly expanding inside my chest.

The pain sphere, which I imagined as a deep red thing, blurry on the edges, sort of like how we often illustrate stars when they become red giants. This glowing, pulsating sphere of pain then dropped, rapidly and determinedly, into my abdomen. At that moment my jaw began to hurt.

Something was very wrong.

Somehow I made it upstairs, which wasn’t easy, because the pain was so intense that it was difficult to focus on things and, you know, walk. My body wasn’t working quite like it normally does, and in my mind I saw my body’s dashboard lighting up like the Vegas strip, every light coming on and the check engine light not just on, but blinking rapidly, demanding attention. My mind was all warning lights and needles firmly nestled in the red part of the gauge and buzzers and klaxons announcing that things were going very, very awry.

Like an idiot, I found myself Googling “chest pain abdominal pain and jaw pain meaning” and a lot of similar combinations to try and figure out what was going wrong, like I might be able to do something about it myself. I texted “I’m having a medical thing” to my wife, and based on how I normally treat medical things (specifically, I ignore them with the sort of idiotic unearned confidence of a true dipshit), she knew that this was A Big Deal.

I was also terrified, financially, of doing something like taking an ambulance, because, well, you know how America works. Here, people in medical peril actually consider waiting for a ride instead of taking an ambulance–unlike the rest of the world, where ambulance is the default first, best choice.

My wife, Sally, who was on her way back home, was thankfully less stupid than me, and insisted I call 911 and get an ambulance to the house, stat.

[Ed note: I have a really good friend who is an ER doctor and as soon as he saw the scar he was like “Thank God for Sally” because the type of aortic issue that Jason had doesn’t give you very much time – MH]

At this point, I was feeling deeply weird. The abdominal pain was intense, and it was getting difficult to focus on things, visually. My eyes felt like they were no longer under full control of my brain, and my limbs seemed to be enjoying some independence as well. Moving was difficult. My brain seemed to have entered some sort of Safe Mode, where I was processing actions one by one and only capable of doing things slowly, methodically. It was very strange.

Sally arrived home and found me on our son’s bed, (he was upstairs, still being a goofball in some virtual space, and that’s good – I did not want him to see me like this) confused and in a lot of pain. I was on the phone with 911, and they told me to chew an aspirin, in case this was a heart attack, which it, spoiler alert, wasn’t.

Help Arrives

Soon the paramedics arrived, dodging the Changli parked on the walkway in front of my house, carrying with them some genuinely impressive hardware that, were I in a different state, I’d have wanted to scrutinize until someone firmly reminded me that, hey, we have real work to do. But I wasn’t in anywhere near that state.

The paramedics were incredibly capable and competent, doing tests and taking what I think was a chest X-ray in a remarkably small unit, assessing what the hell was going on with me. I’m not certain if they decided then that what was happening was an Aortic Dissection, but whatever they figured was going on, they decided that I needed to get to the hospital as soon as possible, so I was loaded onto a stretcher, commemorated in this photo:

I’m amazed how, well, normal I look in this picture. I’m making a “jeez, what a lot of fuss” face there, but the truth is inside, I was barely hanging on. I felt like I was controlling my body from a distance, via remote control, having been ejected from my usual driver’s seat because the cabin was filling with smoke.

Also, RIP my Volkswagen Beetle shirt, which I think was about to be cut off me. I miss that shirt.

From this point on, things start to get really strange.

I remember being in the ambulance, and I recall thinking about how fascinating these vehicles are, but I couldn’t really focus on any details because my vision was behaving very oddly. My field of vision was getting dark at the edges, and it was hard to actually look at things. My ability to focus as I normally did was gone, and the pain was quite intense. I felt like I was on some sort of square platform, which makes no sense, and then, somehow, I think I was then in the emergency room, on another square platform, which still makes no sense, and I was writhing around, getting more and more confused, feeling more disconnected feeling from my body.

I don’t want to be too dramatic here, but at this moment I really felt like systems were shutting down. I felt like my body had thrown a rod, and the engine was still turning even though one of the pistons was poking through a hole in the block. Oil was leaking everywhere, every warning light is on, and now things are starting to really break.

Was this what dying feels like?

Let’s Talk Aortic Dissections

Let’s pause here for a moment to explain exactly what was going on inside my chest, this Aortic Dissection. This isn’t a heart attack, as it doesn’t really directly affect the heart: it’s affecting the big hose that carries blood from the heart to all the organs and other important bits. The word “dissection” here is a bit confusing because we normally associate it with the careful disassembly of a funny-smelling preserved frog or something like that but what it really refers to is what is going on inside the aorta.

What’s going on inside is a lot like what happens to that lousy German fuel line that’s rubber on the inside and braided fabric on the outside; the inner liner of the aorta separates, and that makes a gap between the inner part of the aorta and the outer, uh, skin, and then blood flows in there, where it’s not supposed to go, and eventually that causes swellings of blood that rupture and burst and then there’s a whole mess of blood not going where it needs to go and everything goes to shit. Here’s a video that shows the whole process:

In my case, I was told the aorta tear went all the way down to my kidneys, so the whole length of the aorta was dissected/torn. That’s why I felt the pain drop into my abdomen, I think. But let’s get back to my exciting evening!

Pants Shitting And Other Excitement

As I writhed on that table, my chest and abdominal pain continued, and, horrifyingly, my bowels decided that they were done holding anything inside, so as I squirmed there on the table, I shit myself. Lavishly. It just sort of happened, my intestines letting go and a remarkably generous amount of waste filled my poor pants, in such quantity and with such force that you’d think it was the finale for a Broadway show called Pantshitter! It was awful and embarrassing, and whatever dignity I had left was ejected into those pants along with all that rich, creamery feces.

Incredibly, it gets worse. There was a very cross EMT or perhaps nurse or doctor or someone there with me, who was yelling at me or about me, and she removed my waste-filled pants, an act that I’m certain that person was not paid nearly enough to do.

Once my pants were off, I instinctively moved my hands to cover my junk, because, you know, I have over 50 years of life experience that has trained me to not show my junk in public, but as I did so the nonplussed EMT or whomever yelled at me “TAKE YOUR HANDS OFF YOUR PENIS!”

I was confused. What? Then I heard it again: “HANDS OFF YOUR PENIS!”

I’m getting yelled at for having my hands on my junk? What is this, Trader Joe’s? No! Does this person think I’m going to have one last wank before dying on that table? It was bizarre, but I was in no position to argue, so I abandoned modesty and moved my hands.

The edges of my vision were a strange pattern of blackness, an unexpectedly pixellated sort of darkness, and what remained in the middle was getting increasingly fuzzy. I was laying there, mostly naked, having just shat myself with the ruthless abandon of an animal, and something was still going very wrong inside my chest and abdomen. If there’s any moment that sums up what an aortic dissection is like, this is perhaps it.

The Cooling Down And Surgery

After this point, there’s not much I remember, as I was anesthetized in preparation for surgery, which included cooling my body temperature down to something in the 70s, a process I’m very happy to not have been awake for (it’s known as hypothermic circulatory arrest, and lets the heart stop pumping without cellular damage). I was told this process took longer than usual, something I like to attribute to either my warm heart or hot, humid sexuality, perhaps a combination of both. Or, it could be some metabolic weirdness caused by my near-constant intake of Diet Cokes.

I went into a three-hour-long surgery where a Gore-Tex and Dacron sleeve was used to replace the damaged part of my aorta – thankfully my valves were okay, which I’m told is good because the artificial ones just aren’t as good as the OEM ones.

After surgery came a full week in the ICU, where I was barely awake and an absolute octopus of tubes and wires. As I gradually was able to be more alert and active, I remember drinking some cold apple juice and every sense I had going into overload with the achingly intense pleasure of it all, the sweetness, the coolness, the wetness, the everything. If there’s more of this in life, then I want to live, dammit! Being in ICU gives you an ability to appreciate little things more than countless self-help books about mindfulness or whatever.

I also had intense hiccups for days straight, and they were so persistent and violent they made breathing incredibly laborious. The doctors thought the tubes draining fluid from my body were irritating my diaphragm, and let me tell you, those hiccups were terrible. For several nights I had to work to take each breath, and that’s no fun. Hiccups aren’t the innocent, good-time brother of the burp they like to let on to be. They can be evil, breath-stealing monsters if they choose to be.

Post-Heart Explosion Thoughts

If I took any one thing away from this whole experience, which may have included a near-death component, it’s that people are wonderful. Not all people, I suppose, but the people who seem to be in my life, the ones who reached out, the ones who set up that GoFundMe to help with the medical expenses, the ones who sent recovery stuff, like potent yet gentle packs of ass-wipes, the ones who texted and called and made me feel cared about and loved, even though for most of these people we’d only interacted online, and only talked about cars.

If more proof was needed that car people are, somehow, the kindest and most welcoming and supportive group of people joined by a common interest, then I think we settled that here. I’m humbled by the vast amount of kindness shown to me, a karmic debt I likely can never repay. It’s beautiful and something I’m never going to forget. It’s also a wonderful motivation for me to heal, so I can get back to writing ridiculous things about cars and deep, important works about taillights, the most significant of human endeavors.

The suddenness and unexpectedness of this whole nightmare isn’t lost on me. Everything could have just ended, right then and there, with no warning, no hints, no nothing. And there’s so much more I want to do in life! Life, for all its difficulties, most of which I feel like I’ve created for myself, is such a rich and dazzling and wonderful thing, complicated and beautiful and chaotic and rewarding and so full of messy, confusing love, in so many ways, reaching out to so many things, people and animals and concepts and, yes, cars, ridiculous wonderful cars that we write about here, that peculiar wheeled thing that has brought so many of us together in the first place.

It all has value and merit and is all capable of inspiring feelings of joy, and I love this absurd business of living, interacting with all the people I do every day, all of whom I think I love more than I even realize, and I am not remotely ready to give it up.

I’m not exactly an observant Jew, really, but one thing I’ve always liked about Judiasm is the strangely pragmatic approach to the afterlife. Judiac eschatology as I grew up understanding it was that after you die, you rot in the ground. It’s hardly a romantic or inspiring notion, but it sure does make this life we know we have more important.

This is it! This is all we get! There’s no point in planning for some afterlife because who the hell knows if there’s anything there? And that’s okay, because what we have here has so much potential, is such a rich and wildly varied array of experiences, and it’s worth cherishing. I’m so happy I get to keep going, experiencing this life.

My meds are kicking in and making it tricky to string together thoughts, but I think you get the idea. Aortic dissections, in case I wasn’t clear, suck, deeply and powerfully, and I hope no one reading these words gets within miles of one. I hope my likely inadequate description gives enough of an idea to sate your curiosity, and that is as close as you ever get to having your heart’s main hose explode.