New and Experienced Climbers over 50 #31

wendy weisswrote:

Guy, that does look disturbingly (alarmingly) close. Are you on pre-evacuation? 

No, thank goodness…. The Santa Anna winds are blowing hard right now. North to South… the fire is about 5-6 miles west of me in the groves and fields.
Yesterday it did burn into a bunch of houses in Camarillo and destroyed about 35 of them, very sad.
For some reason there is almost zero air power fighting this.
Word on the street is California is too broke to pay for the planes- most are from Canada and are leased for the day.
Im in the second day of no power… going to start up the BBQ and grill up some ribs and chuck roast that thawed out.

The silver lining.

Carl- so sad to see great crags closed up. We have had a few closed in California. The access fund didn’t lift a finger to try and stop the closure's.
but there is a bright side… after all the hub bub dies down you can go back (low profile) to climbing there. Completely chalk free, it’s like doing FA’s.
Remember this- it’s your government discounting your right to enjoy the land we should all share. The government can’t understand that Rock Climbing is MY religion.

Later all 

OK, I'll see if I can shed some light on things- I don't have all the details I'd like, so if any of my assumptions are incorrect, just tell me.

It sounds like Tony had an abdominal aortic aneurysm (called an AAA). That is, an abnormal enlargement of the major artery in the abdomen.

Once these reach a certain size, they are very likely to rupture and thereby cause death. 

So he probably needed it fixed regardless of the pending surgery. On the other hand, if it hadn't reached the danger point yet it would still have needed frequent follow-up, but could have waited.

These used to be repaired by open surgery but now are usually fixed by inserting a stent (basically a tube) into the aneurysm, usually performed by starting a very large IV in the groin and threading the stent up to the aneurysm from there.

While usually uncomplicated, this procedure has definite non-zero serious risks, including bleeding, which can be caused by a couple of things- 1) free perforation of the blood vessel into the abdominal cavity, which I would expect to be extremely bad and probably fatal, or 2) dissection into the wall of the aorta or it's surrounding tissue in such a way that the bleeding is contained and directed along the path of the blood vessel. 

I suspect the latter is what happened. Alternatively there could have been a problem with the initial picture site where the IV/stent combination entered the artery in the groin (the femoral artery) and the excess bleeding may have come from there.

In either case you would expect pretty significant bruising and swelling in the leg.

I doubt that antibiotics are routinely given before this kind of procedure, but don't know. You'd need to ask the right specialist.

As for the blood transfused, they may have had units typed and crossed ahead of time or may have just had to use O neg. 

Regardless, their swift action after the complication occurred probably saved Tony's life.

As for discharging him after two days, this actually seems kind of a long stay to me. Again, you'd have to ask the right specialist about what's typical, but there's really not that much reason to keep somebody in the hospital once their risk of bleeding has diminished. Insurance companies have pretty strict guidelines about length of stay and nobody stays "just in case".

For his post-discharge course...

I don't know whether your series of pictures showed anything unusual or not, both because I haven't seen them and also because I don't know exactly what would be normal. Lots of bruising and swelling would be expected, Signs of infection, like redness or drainage, less so. Regardless, that you felt "blown off" is inexcusable.

Good for you, ultimately realizing something was wrong and taking him to the ER.

I'm guessing his infection is some kind of abscess near the groin picture site? If so, it's probably due to the frantic activity that must have been going on when his procedural complication occurred.

Unfortunate, but maybe not preventable.

As for malpractice...

From what little I know, I don't really see it, but without all the records, there's no way anyone can make a judgment that is worth anything.

Tbh, I'm disappointed that an ER doctor would make such an accusation without having all the data and would regard such an opinion as worthless.

Tony suffered a known complication of the procedure, which can occur even if everything is done perfectly. 

And not to exacerbate your anti-ageism beliefs, I doubt you could find a malpractice attorney to the the case. 

Maybe I'm wrong, but I'm guessing that Tony's future earning potential is a lot like mine, ie close to zero, so any payout isn't going to be much, and since  malpractice is a contingent fee sort of case, that means no potential big payout, no interest.

Finally, are you sure he can't get his hips fixed?

His aorta should be good now, and once he recovers from his infection, I just don't see any particularly good reason he couldn't proceed. 

Indeed, he's proven he's strong enough to take whatever surgery throws at him!

Hey Guy, hang in there . We spent almost the entire months of Sept. And Oct. on some kind of alert. Currently the winds have been blowing ferociously for the last several days. The pines and cedars are twisting and shouting.

Mark E Dixonwrote:

Mark, while we have your attention - do you have any opinion about Lifeline Screening, which claims it helps detect these conditions:

I get it done once in a while, every few years, mostly because it's not very expensive, and I think, why not.  I think it's just a handheld ultrasound device for the AAA..

Guy, I’m sorry to hear you’ve lost power. They warned us we would probably lose ours too but if we did, I didn’t notice because of our solar.  We got solar a few years ago, the Santa Anas and blackouts were one factor. installed by Freedom Forever and monitored by SunRun as our “power company”. We have a single Tesla battery as a backup, and I love it. On sunny days we are always sending energy to the grid. We still are connected to SoCal Ed and we get bills every month but they are always negative numbers.  

Trying Wagyu A5 beef, and themed snacks.

Aren’t those little Totoros cute?

I could get used to retirement…  
but I’ll probably run out of money if I eat like this all the time.   

Donald Thompsonwrote:

I'll be honest -- sometimes it's hard to believe some of the folks here are over 50.

Most over 60…

Any who , you'll need some religion over the next 4 years, courtesy of the peeps over at Babylon Bee-- once one o
f the more cancelled sites on the net.

Nah, just no sex until these stupid bans on safe medical procedures next 4 years is done.   

Mark, thank you so much! How very generous you are! It really does take a village.

I’m just leaving the hospital and your post helped a lot. It’s hard to know what I’m looking at so a little guidance helps. My understanding is it was a stent through the groin and the stent somehow didn’t retract properly, at any rate that artery was punctured. Tony lost somewhere between 2 1/2 to 3 L of blood and received five transfusions of O+.  

He was in a lot of pain when he was released, but very quickly he got in a whole lot more. There were large areas that were hard, raised, and red and oozing. But he never ran a fever and his blood pressure was fine.

So now he’s had that second surgery where the doctor said he “hoped he got it all”, he is on two different IV antibiotics and he has a vacuum tube in his groin wound which is suctioning out gunk.  It all looks better, but his left leg is still twice the size of his right leg. That “hope” part has me a little worried – – what if he doesn’t have it all?

I am especially heartened by your thoughts that he may still be able to get that hip surgery. I couldn’t believe that today, even laying there in that hospital bed with all this trauma, he said he just wished he could have that hip replacement.

In one way, I can kind of understand. At this age something things are now or never. Some things the ship has already sailed. I know he has regrets for maybe not taking better care when he was young and thought he was bulletproof. But there’s a wistfulness. I don’t think he knows how hard I am working to have my climbing days in the sun. But as I was leaving, I told him I would probably be climbing tomorrow and he said “have fun. Be careful. I guess if you are with Bob, everything will be OK “. Hard to leave him like that.

I’m going to bake this apple thing when I get home. If I could send it to you, I would. But consider it a virtual thank you pie. I will eat it on your behalf. 

phylp phylpwrote:

Mark, while we have your attention - do you have any opinion about Lifeline Screening, which claims it helps detect these conditions:

I get it done once in a while, every few years, mostly because it's not very expensive, and I think, why not.  I think it's just a handheld ultrasound device for the AAA..

You should probably ask your currently practicing Internist or FP, but my uninformed opinion is as follows-

Ultrasound itself is basically harmless, so your biggest 'risk' is a false positive result leading to unneeded medical intervention (which can be risky!)

I think screening for AAA is recommended at least once after the age of 50 or so. Might be 60. If that's normal you probably don't need to screen again for a good while.

I don't see the point in screening for peripheral vascular disease, as it wouldn't be treated unless you have symptoms, in which case it's not really screening, is it?

Carotid artery disease- I just don't know about this one.

Atrial fib- also usually will have symptoms, but they may be subtle. Maybe just check your pulse and see if it's irregular?

On the whole, this testing is unlikely to do you harm, and might help. It should detect the conditions it claims to.

Just don't spend more than you can afford.

phylp phylpwrote:

Mark, while we have your attention - do you have any opinion about Lifeline Screening, which claims it helps detect these conditions:

I get it done once in a while, every few years, mostly because it's not very expensive, and I think, why not.  I think it's just a handheld ultrasound device for the AAA..

PM. 

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/abdominal-aortic-aneurysm-screening.. 

WF WF51wrote:

PM. 

Got it - thanks!

Yesterday I woke up and unlike Donald I was neither happy or hopeful.  We went to the happy boulders & not only did I fail to complete my project I also came to the conclusion that I probably won’t and that’s ok. Today we went to the buttermilks and walked around trying what real boulderers call easy problems.  I call them v0 to v3 boulders most of which I did not find “easy”.  I did complete a couple v2s with the hard parts near the ground. My life is easy right now.  Best wishes to all.

Victor Creazziwrote:

I was going to ask you about this yesterday as I was surprised that I've seen nothing about it on MP.

There is a thread on here. Under General Climbing. Not too many replies.

https://www.mountainproject.com/forum/topic/127254723/further-climbing-bans-at-dyurritemt-arapiles-punks-in-the-gym-to-be-chopped-the-

The new inflatable crash pads work pretty well.  This is my friend Steve on a new V4 we did from the low sit yesterday.  Sunny but cold here in northern Arizona. 

Hey Ward, Sunny and cool here today as well. Happy birthday!!!! Hope you send your project and don't puncture the inflatable pads on a cactus!!!!

I don’t mean to beat this dead… Kangaroo… To death but it seems daily now I get pictures of kangaroos that do not look harmless and sweet as Carl would have us believe.  It’s just a little confusing is all.  Either Carl is telling us an Australian whopper or he’s a manlier man than I knew.

https://www.mountainproject.com/forum/topic/127268037/the-north-ridge-of-never#ForumMessage-127268474

Our old Supertaco member Edge has posted a wonderful trip report - take a look.

Of course his adventures can't compare to my travels though the wilds of the Las Vegas casinos, but at least he's getting out there.

Edge is one of the most impressive craftsmen out there.

Breakfast in Kyoto 

My son’s first course:

2kg of food with at least 150gm protein for his first course.   

He’s a big dude…