At age 45, Doug Gross wasn’t shocked to feel a bit of a pinch between his shoulder blades when he spit in the sink while brushing his teeth recently.
“It wasn’t anything that made me concerned because at my age I feel like I get a lot of those kinds of things,” he said.
The pain was sharp, but it soon eased and he went about his day. Looking back, Gross thinks that was likely a preview of things that were to come.
A week later, his life changed.
Pain on a Sunday morning spurs trip to Emergency Department
“That Sunday morning, I was standing in the kitchen and just felt this wave of pain go from my neck down to my toes,” said Gross, the K-12 principal at Oakwood Christian School. “My first thought was, ‘Am I having a heart attack?’ My left toes started tingling and going numb, and I thought this probably isn't good, but I live about five minutes away from our church. My family was already there. They left a little bit earlier than I did that morning.”
Making a choice that he now knows was not his best idea, Gross drove himself to church, though before he considered walking in he asked his wife to drive him to AnMed’s Emergency Department.
By the time they arrived, he could no longer stand, and he told the medical team that he thought he might be having a stroke.
The response was thorough and fast.
“I'm very grateful for that,” Gross said.
A complex vascular problem with complex treatment to match
Gross had experienced a life-threatening aortic dissection, and he had a blood clot in his left leg.
He was treated by Dr. John Muhonen, a board-certified general and vascular surgeon specializing in comprehensive vascular care at AnMed Vascular Surgery.
“Your aorta is the largest blood vessel in your body,” Dr. Muhonen said. “It comes off your heart and provides blood flow essentially throughout your abdomen and branches down your legs and arms.”
In a dissection, the aorta’s layers separate, and blood channels between the torn layers. That can compress the arteries to the bowel and organs, as well as the legs.
“It stopped blood flow going to his left leg,” Dr. Muhonen said. “When he came in, he was complaining of back pain — essentially numbness in the left leg.”
A blood clot had formed in the leg, and it required emergency surgery later that day.
Additional surgery was required two days later to repair the dissection, without which Gross risked having an aneurysm.
“The entire thing grows and becomes a risk of rupture,” Dr. Muhonen said.
Dr. Muhonen performed a minimally invasive Thoracic Endovascular Aortic Repair, otherwise called a TEVAR, and iliac stenting to restore blood flow to his aorta and legs.
Since then, Gross has made a remarkable recovery.
“He's walking. He's doing physical therapy. He's looking really good,” Dr. Muhonen said. “All in all, something that certainly could have taken his life at 45 years old didn't do that.”
High blood pressure likely contributed to aortic dissection
One likely cause for Gross’ dissection was untreated high blood pressure.
“Blood pressure can cause lots of problems,” Dr. Muhonen said. “It can cause worsening atherosclerosis or hardening of the arteries, but it can also cause major tears in arteries. They can occur essentially in any vessel. When it occurs in the very large blood vessel, then you talk about states of emergency, where that can cause a person to lose their life very rapidly. And the symptoms are very vague. It's usually back pain, maybe some chest pain — it may happen, and it kind of gets better, and you don't really know what it is. You just don't feel right.”
In fact, high blood pressure — if uncontrolled — can cause life-threatening dissection in patients even years younger than Gross.
Routine checkups and physicals help protect patients
Dr. Muhonen said hypertension, or high blood pressure, is important to address.
“You should get routine medical checkups, and then when you know you have high blood pressure, it definitely should be managed,” he said. “I think the most important thing is routine evaluation by your primary care provider — and then listening to your own body when something doesn't seem right. If it seems extremely abnormal, go to the emergency department and be evaluated, and when you do go, voice your concerns.”
Even complex vascular procedures like the one that saved Gross are available at AnMed. That means patients can get the care they need close to home.
A new, healthier future for a 45-year-old man
Six months after that fateful Sunday morning, Gross has a fresh start. After days in intensive care, followed by in-patient rehabilitation, Gross has worked hard with physical therapy. He has made lifestyle and nutrition changes, added exercise in addition to his therapy, and he is treating his high blood pressure.
And he is encouraging others to keep up with their preventive care.
“I think the tendency is that most people don't go unless there's a problem, but a doctor is somebody that can help you along on the journey of life,” Gross said. “When in doubt, get it checked. When it comes down to your life, it's worth it.”