Wednesday, October 8, 2008

Back on track

When Richard Horgan, age 72, was vacationing with the family at Disney World, he was not feeling well, “but nothing you could really pinpoint,” he said.

Upon their return to Westminster, MA , Marci (Richard’s wife) noticed that he began to speak haltingly - with a slight stutter. She became alarmed and drove him to the nearest hospital. Before the week was over, Richard would be diagnosed with stroke, serious kidney problems, and abdominal aortic aneurysm (abbreviated as AAA) – or ballooning out of the large vessel that supplies blood to the abdomen, pelvis and legs. As Marci said, “Any of these conditions could be potentially fatal, but Dick had all three at the same time.”

Richard returned to the regional hospital to have one of his kidneys removed. When the doctors determined that his carotid arteries were seriously occluded, the Horgans decided that a second opinion at Massachusetts General Hospital was imperative.

Seamless Care

Laurie Shea, Nurse Practitioner, answered the phone when the Horgans called the Vascular Center in Waltham. “She was so wonderful,” Richard said, “and gave me so much hope.” Michael R. Jaff, DO, Medical Director of the Mass General Vascular Center, evaluated Richard in November, 2006. “We knew we were in good hands immediately,” said Marci.

He referred Richard to several doctors. Raul Nogueira, MD, Mass General stroke specialist, met Richard to determine the extent of Richard’s neurological stroke damage; and Gardner Haupert, MD, nephrologist, intervened to make sure Richard’s solo kidney was healthy. “Once again, it was a really good experience,” Marci said. “The doctors and nurses really listened to what we were saying,” added Richard, “and we never felt rushed.”

Dr. Jaff convened a team meeting to discuss Richard’s AAA. Richard Cambria, MD, Vascular and Endovascular surgeon, was called in. Whatever stereotypes the Horgans previously had about surgeons’ bedside manners, were quickly dispelled the moment they met Dr. Cambria. “He was outgoing, reassuring, and exuded confidence,” Marci said. He repaired the AAA laparoscopically using a stent, and called from the OR to say that everything had gone well. When the Horgan family arrived in the recovery room, Richard was sitting up in bed.

Richard went home feeling well after the one-day procedure. Over the weekend, there was a flash flood, and the Horgan’s basement was engulfed in water. Richard spent the next two days monitoring the situation. By the end of the week, he was in trouble. Richard had begun stuttering again, so Marci drove him to the Mass General emergency room in Boston. Within minutes, the surgical team intervened. The site of his AAA was bleeding, and resulting drop in blood pressure had caused another stroke. This time Richard was hospitalized for a week. Following his discharge, visiting nurses came to the house to rehabilitate his speech and motor skills.

Feeling Good

Today Richard is doing remarkably well. He can drive a car (thanks to Dr. Nogueira’s encouragement to re-take his driver’s test), and perform daily functions. He played golf one day in late autumn and complained that his game was not up to par. And he’s not quite as strong as he used to be. But he feels self-sufficient and talks without any hesitation. His family - wife, four grown children, and 3 Basset hounds - have been a great support over the past year. Richard is eternally grateful that Mass General was there. “I don’t think we’ll never be able to express our gratitude enough,” Marci says. “We keep telling everyone,” adds Richard, “you have to go to Mass General if you have a serious problem. It is the place to get the help you need.”

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