A rapid and team-oriented response: The stars aligned to save Gilbert’s life
Beyond the shadow of a doubt, the stars aligned for Gilbert Jorgensen: A prompt 911 call, swift communication of the emergency department’s health care team and the availability of a cardiothoracic surgeon. Each response, assessment, diagnosis and procedure was vital to his life.
Gilbert, 58, collapsed at his Pipersville workplace due to an aortic dissection, which claims the lives of 90% of those afflicted who don’t undergo surgery within 24 hours. Thankfully, Doylestown Health had the capabilities to repair his aortic tear in the main artery that carries blood from the heart to the rest of the body.
Diagnosing the cause of the collapse
Unconscious upon arrival, Gil quickly underwent tests and evaluation to determine an accurate diagnosis. “Within an hour, we were dealing with a life-or-death situation, and Gil had no prior symptoms,” said his wife, Lisa, a church secretary who was working when she got the startling news.
From X-ray technicians to nurses to the ED specialist, the healthcare team rapidly and methodically worked at the diagnosis. “At first, we suspected a stroke, but Gilbert had low blood pressure and no pulses in his wrists or groin — a scenario we realized could be a cardiovascular catastrophe including massive pulmonary embolism, ruptured abdominal aortic aneurysm, or aortic dissection,” said Dr. Charles Fasano, the emergency medicine specialist. “It was important to make the diagnosis and get Gilbert to the operating room quickly because the odds of survival with this condition drop with every passing hour.”
A CAT scan confirmed that Gilbert had a type A aortic dissection, a tear in his aorta that started in his aortic arch, where smaller blood vessels branch off to the brain. A tear like this can lead to problems including brain damage, lack of blood to the extremities, stroke and life-threatening internal bleeding, noted Fasano.
Repairing Gilbert’s tear, connecting with the family
With the clock ticking, cardiothoracic surgeon Richard Highbloom briefed Lisa.
“Dr. Highbloom gave me a good indication that this was serious, including statistics, without making me panic. They told me it was going to be a very long day,” she recalled.
Gilbert was about to endure a six- to seven-hour operation, his family facing an agonizing wait. “In the best hands and at the best institutions, this procedure still carries one of the highest mortality rates, along with a high risk for stroke or brain injury following the operation,” Highbloom explained.
Two of the couple’s adult children, a son and a daughter, joined Lisa at the hospital while their older son connected by phone from Texas. “We sat around the fireplace. The people at the welcome desk checked on us and shared updates from the operating room,” Lisa said. The hours dragged on, but the staff’s frequent visits and kindness carried them through.
Just rooms away, Highbloom and the team operated on Gilbert. To replace the damaged section of Gilbert’s aorta, Highbloom stitched in a synthetic tube (graft) and repaired blood vessels that run from the aortic arch to the brain. Working late into the night, the team employed a heart-lung bypass machine and cut off all blood flow to Gilbert’s brain so Highbloom could operate on nearby blood vessels, protecting the brain by keeping it very cold.
Recovering and reflecting
Walking into his room in the cardiovascular intensive care unit, Lisa was incredulous. “I can’t imagine what it must have been like for him to wake up and find out all these crazy things happened while he was unconscious,” she said.
Gilbert would stay in the hospital for most of the week with doctors and nurses closely monitoring his recovery and catching him up on what he missed.
“I don’t remember anything from the time I collapsed to when I woke up after a really long operation,” he said. “I was disoriented at first, but once I was alert, Dr. Highbloom stopped by with a physician assistant and spent an hour reviewing what happened and what to expect. He has a great bedside manner.”
The Jorgensens were deeply impressed and appreciative of the entire Doylestown Health staff.
“In the six days that Gil was in the hospital, it was clear that the doctors, physician assistants, X-ray technicians and nurses were a team. The communication at shift change was impressive, and anything we needed was there before we even thought about it,” Lisa said. “For major heart surgery, it could not have been a better experience.”
Fasano, the emergency medicine specialist, agreed. “It was great teamwork with continuity of care by EMS, the ED, nursing, radiology, cardiology, CT surgery, anesthesiology and critical care. Dr. Highbloom saved Gilbert’s life.”
Moving on with a grateful heart
Gilbert continued his recovery with outpatient cardiovascular rehabilitation. Moving forward, he will see a cardiologist for routine monitoring and follow-up care.
“I read that the actor John Ritter passed away from an aortic dissection,” Gilbert said. “People can die if they are misdiagnosed. I’m grateful that my co-workers called 911, and I recognize the importance of getting to the ED, getting the correct diagnosis and being at Doylestown Health, where a cardiothoracic surgeon was able to perform the emergency repair.”
Undoubtedly, the health care team’s collaboration and acceleration of Gil’s diagnosis amounted to his lifesaving care. “If any of those things had gone a different way, we might not be telling the same story,” Lisa said. “We feel blessed.”
The Jorgensens are ready to put Gilbert’s medical adversities behind them, with a summer vacation full of fresh mountain air, starry nights, and campfires with their family. Their children and grandchildren will join them at a mountain house that they rented before Gil’s emergency. “I’m looking forward to a great time,” Gilbert said.