Jeff’s Story: Ruptured Aneurysm, Airway Reconstruction

Jeff’s remarkable story has two parts: recovery and reconstruction. He doesn’t remember the first part — the recovery from a ruptured aneurysm. But he vividly remembers the second part — the reconstruction of his airway.

He is living the followup to his story now: back to work full-time as an engineer, back to volunteering at his church, and back to spending time with his family. He owes his recovery and renewal to physicians, nurses, and technicians at the University of Cincinnati Neuroscience Institute. “The care I got was fantastic,” Jeff says.

Jeff was on his way home from work on March 6, 2008, when he stopped to help a motorist change a tire. That was hardly unusual for Jeff, a good Samaritan who has a habit of helping people in need. Jeff assists with the cooking at the men’s ministry at his church on Saturdays, and he’s quick to come forward when the youth pastor puts out a call for volunteers. Stopping to help an unknown motorist on a back road in Middletown, Ohio, was simply the neighborly thing to do.

What happened after that is not entirely clear. But sometime later, another good Samaritan – a nurse who chose to remain anonymous — came along and found Jeff by the side of the road, tools in hand. The nurse called 911, and Jeff, his condition critical, was whisked to Atrium Medical Center in Middletown.

Doctors at Atrium theorized that Jeff had suffered a ruptured brain aneurysm, a cataclysmic event in which a balloon-like bulge in an artery finally becomes so weak that it bursts. At the same time, Jeff’s heart was failing.

“Paddles were used on him three times,” Jeff’s wife, Jayna, recalls. “But Jeff survived, by the Grace of God.”

He was taken by ambulance to the University of Cincinnati Medical Center, which has the region’s only Level 1 trauma center, and was admitted to the hospital’s neuroscience intensive care unit (NSICU). In the NSICU Jeff received carefully monitored, round-the-clock care. Brain scans also confirmed initial suspicions that Jeff had suffered a ruptured aneurysm. In fact, Jeff had one of the most important risk factors for developing a brain aneurysm: he had smoked for more than 30 years.

Jeff’s aneurysm had caused a subarachnoid hemorrhage, a condition in which blood flows into a protective membrane surrounding the brain called the subarachnoid space. Jeff’s condition was sufficiently fragile that conventional surgery could not be risked. Andrew Ringer, M.D., a neurosurgeon with the Mayfield Clinic and Director of Endovascular Neurosurgery at the UC Neuroscience Institute, used an alternate approach to treating the aneurysm.

Dr. Ringer inserted a catheter; a long tube made of flexible plastic, into an artery in the groin and threaded it up through Jeff’s body to his brain and to the site of the aneurysm. A second, smaller catheter, about the size of a string of spaghetti, was then advanced through the first catheter. Dr. Ringer advanced small platinum coils through the microcatheter until they emerged inside the aneurysm. By packing the aneurysm with the tiny coils, Dr. Ringer effectively closed off the aneurysm while allowing blood to flow freely through Jeff’s normal arteries.

The treatment was successful, and two days later a Jeff began to gradually re-awaken. When Jayna asked him a question, he blinked his eyes twice to signal “yes.”

Jayna counts her blessings in every respect. “The road he stopped on to help the motorist was a back road, sort of a country road, behind factories,” she says. “There was nothing there. This person who came along was an angel. It was also a blessing that the aneurysm went when it did, because he could have been driving. He could have had an accident and killed himself or someone else.”

She also thanks her church and the prayer groups that prayed “from Alaska and Hawaii to Florida and Texas.” During the ordeal, she clung to her favorite scriptures: “I can do all things through Christ Jesus, who gives me strength.” (Philippians 4:13), and “Again I say to you, if two of you agree on earth about anything they ask, it will be done for them by my Father in heaven. For where two or three are gathered in my name, there am I among them.” (Matthew 18:19-20).

Twenty days after Jeff’s arrival at University Hospital, he was moved to Life Care Hospital, a rehabilitation hospital in Miamisburg, Ohio, near his home. Thirteen days later, he was continuing his recovery in the comfort of his home. Less than four months after the aneurysm rupture, Jeff’s life was almost completely back to normal.

But Jeff’s problems weren’t quite over. He had been intubated (a tube placed in his trachea) for a prolonged period during his early recovery, and scar tissue had built up around his airway. The constricted airway caused obstructive sleep apnea, a condition in which a person stops breathing for seconds at a time during the night. This in turn led to excessive sleepiness during the day. “The biggest problem I had was not being able to breathe correctly,” Jeff says. “My airway would close off with phlegm at night, and I’d wake up several times gasping for air and not being able to breathe.”

Jeff reached a turning point when he fell asleep at the wheel and caused an accident. He was diagnosed with narcolepsy, a sleeping disorder that results in daytime drowsiness, at Good Samaritan Hospital in Dayton.

For a second time, in July 2008, Jeff was referred to the UC Neuroscience Institute. Yash Patil, M.D., an otolaryngologist at the UC Neurosensory Disorders Center, stretched Jeff’s airway on two different occasions. But each time the airway closed back up after a few days. Dr. Patil then recommended airway reconstruction, a procedure in which he and a team of surgeons removed two damaged inches of Jeff’s windpipe.

“When they told me about the procedure, it wasn’t something I wanted to do,” Jeff says. “There was a chance they could damage the nerves around the voicebox, causing me to need a permanent tracheotomy (an airway opening in the neck). But with their skills, they were able to perform the procedure without any complications.”

Jeff credits the airway reconstruction with his ability to return a complex job that blends mechanical, electrical and hydraulic engineering.

“Without the reconstruction, my cardiologist wasn’t going to release me to go back to work,” he says. “The inability to breathe correctly and the lack of oxygen affect the heart. And if something had gone wrong during the operation, I could not have gone back to work because of the tracheotomy. The work I do wouldn’t permit that.”

In addition to returning to work, Jeff has returned to his quiet role as a good Samaritan, although he is the last to describe himself that way.

“I wouldn’t classify myself as being any different from any other person,” he says. “So often you reap what you sow. I try to sow good seeds so that I can reap something decent as well.”

* * *

Hope Story Disclaimer – This story describes an individual patient’s experience. Because every person is unique, individual patients may respond to treatment in different ways. Outcomes are influenced by many factors and may vary from patient to patient.

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