No, this was not a joke. Something was terribly wrong, and Brian's finger was pressing 9-1-1 on his cell. At that moment, neither of them knew that Richard had an aortic aneurysm tearing in his chest. And neither of them knew that as Brian made that call, there was an aneurysm in his own chest as well.
|Brian Cleary (left) and Richard Houchin|
September Awareness 2006, Marina del Rey, California
It wasn't until months later that the topic came up again, when Richard and Brian were again having lunch one day. This time, Brian gave Richard the shock of his life. He just casually brought up his own heart surgery, saying that his bicuspid aortic valve had been taken out over 10 years before. Unlike Richard, who never knew he had a bicuspid aortic valve, Brian had known about his BAV since he was about 30. When it began to fail, Brian's aortic valve was replaced with a human donor valve, a homograft.
You can imagine their conversations . . . talking through what is just beginning to be appreciated by physicians - that bicuspid aortic valves may be associated with abnormal tissue leading to aneurysms, especially of the ascending aorta. Brian knew that his donor valve was leaking and might need to be addressed at some point. But the idea that he might have an aneurysm too just seemed hard to believe. Could Richard possibly be right?
If you have seen someone collapse and then fight to recover from both aortic dissection and stroke, you have a pretty good idea what you could be facing if it happens to you. You also know you might not make it at all. So Brian had an MRI, and there it was - an aneurysm. Brian's ascending aorta was bulging to just over 5 cm, roughly the same size as Richard's had been when it dissected.
Brian's Surgery - March 2005
Brian and Richard in 2006
How do you thank someone for insisting you have your chest scanned for an aneurysm when your doctors had never suggested it? Brian Cleary probably thinks about that when he thinks about Richard Houchin.
So, how do you thank someone? Well, you might take them to lunch, but if Brian and Richard do that, they joke that they might as well split the tab. Despite the fact that their most dramatic moments seem to happen around lunch time, Brian and Richard still get together often at local restaurants. And when they do, beneath their banter and laughter is an indescribable bond. Listening to them talk is like being with those who have gone through war together. There is a sense of something that only they have lived through, something only they know. They both have scars on their chests and Dacron inside, evidence of winning their fight to live.
Brian and Richard are grateful to many people who played such important parts in their experience - paramedics, their surgeon, their families. . . . But they both know that the reason they are still here begins with the two of them.
"It could be the guy standing next to you."
And that is their message, for September Awareness and for every day of the year: it is much more common than we think.
Bicuspid aortic valves are estimated to exist in up to 2% of the population, more frequently found in men than women. Along with the bicuspid aortic valve may be abnormal aortic tissue, which can result in thoracic aortic aneurysm and dissection or rupture.
So go ahead, talk to the guy standing next to you about BAV and TAD. Sometimes, two lives may be saved.