Brian Goodwin didn’t know when he came to Montana more than a week ago to say one last goodbye to his dying mother that he would come close to death himself.
But a week after undergoing surgery to repair his torn aorta, Goodwin was getting ready Friday to return home to North Carolina. Goodwin, 57, still shakes his head about how everything came together for him to survive.
“We overuse the word ‘miracle’ sometimes, but it all had to fall into place, and it did,” he said, sitting in a chair in his room at Billings Clinic Friday morning.
His cardiac surgeon, Dr. Alexander “Sasha” Kraev agreed, letting statistics tell the story. About 20 percent of patients with aortic dissection die before they make it to surgery. And of those who do, only half make it through the operation, he said.
“Aortic dissection is one of the worst things you can have," he said.
The aorta, the main blood vessel in the heart, feeds blood to the whole body, Kraev explained. With the blood pressure so high in that part of the body, a tear anywhere along the aorta “sends blood everywhere.”
Goodwin, who hadn’t previously suffered any heart problems, had traveled to Livingston on Jan. 28 to visit his mother, Susan Wahl, who was at Livingston HealthCare with late-stage ovarian cancer. Her physician said she had only days to live.
Four days later, on Friday at about 6:30 p.m., he left the hospital to go get dinner. He went over to her house to sort through her belongings for family members who were coming to collect them.
“I felt a tearing, sharp pain,” Goodwin said. “I thought it was a panic attack, not a heart attack because I didn’t have any of the other symptoms, like shortness of breath or chest pain.”
He called his mother’s pastor, with whom he’d been making final arrangements, and told him he was having some kind of attack. The minister called 911 and 10 minutes later, emergency responders loaded Goodwin into an ambulance and took him to the hospital’s emergency room.
After undergoing a CT scan, an ER physician met with Goodwin and told him the scan indicated some kind of heart abnormality that would likely require emergency surgery. He was taken by helicopter to Billings Clinic.
Forty-five minutes later he was in surgery at the Billings hospital. In such a case, time is of the essence, said Kraev, Goodwin’s surgeon.
“Usually when you have something this catastrophic the clock starts ticking,” he said. “You can’t wait on these things. It’s not subtle. You’ve got to get in.”
Kraev explained that Goodwin’s aorta was thinner, more stretched out with an aneurysm, a balloon-like pouch. Kraev likened it to a bicycle tube that has a bulge in it.
“If you keep pumping more air, the tube will pop,” he said. “The same thing with the aorta, and what caused it to pop was high blood pressure.”
That’s not typical high blood pressure that requires medication to regulate it, Kraev said. It’s caused more by a highly charged emotional moment or physical exertion that causes the blood pressure to skyrocket.
In Goodwin’s case, Kraev said, the tear started in the root of the aorta, right over the main coronary artery, and went all the way to the chest and belly.
“It was a very big tear,” he said. “The whole main blood vessel was involved.”
The complex operation to repair the tear lasted more than five hours. Kraev had to replace the part of the aorta that was torn.
Through a technique called the Yacoub surgery, he replaced the aortic root, the section of the aortic closest to and attached to the heart, without having to replace the aortic valve.
“The advantage of saving the valve is an artificial valve is not as good as the one God made,” he said. “If the valve is structurally normal, you want to do that.”
The surgery tends to be performed at larger hospitals, Kraev said. A spokeswoman at St. Vincent Healthcare said the procedure is also done there.
Kraev said it was fortunate that all the damage done by the rip in Goodwin’s aorta was reversible.
When the surgery was over, Goodwin was grateful to be alive. A bit disoriented at first, not sure where he was, he began his recuperation that will continue for another four to six weeks.
His two daughters arrived Saturday night.
“Seeing them was fantastic,” he said. “Even if there had been some kind of medical glitch and I didn’t fully recover, I would have had the opportunity to be with them one more time.”
That’s especially poignant to Goodwin because his mother, Susan Wahl, 78, died in the Livingston hospital on Saturday, the day after he was flown to Billings Clinic.
“She was a wonderful woman and truly an inspiration to me,” he said.
Goodwin planned to fly home Friday with his two daughters. A capital accountant for a large food company who lives in Laurinburg, North Carolina, he acknowledged his life will never be the same.
An outdoor lover who enjoys hiking, swimming, scuba diving and white-water rafting, he may have to let go of some of those activities. He might have to change some of his eating habits.
But he said his oldest daughter, Brianna, 26, helped him to keep in mind what’s really important. In a lengthy Facebook post, she encouraged her readers to tell the people they care about that they can’t be replaced, to forgive hurts and “never let a conversation end on a note that you can’t bear to resonate through your mind if that person were to leave unexpectedly.”
“Life is fragile and we so often forget who and what matters and that each day is a gift," she wrote.
Goodwin said he will carry that message in his heart, thanks to the surgeon, his team and the others at the Billings and Livingston hospitals who helped him survive the unexpected crisis.