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Survivor Series Saturday Featuring Ryan Nitka

Hello. My name is Ryan Nitka, and my story is not limited to an aortic dissection. I have a history of other heart related issues and cancer which impacted my walk as an aortic dissection survivor.

In 2016 I was diagnosed with Congestive Heart Failure due to extreme and uncontrolled hypertension at the age of 28. In 2021, I was diagnosed with kidney cancer and had surgery in July to remove about 1/3 of my kidney that was affected. I’m thankful to say that I did not have to go through chemo or radiation and am still cancer free. Little did I know 2022 would be the biggest challenge yet.

On July 5th, 2022, my wife brought me in to the emergency room with some unexplained back pain and chest pressure. With my history of heart issues, we were concerned but not worried initially. The ER wasn’t too worried initially either, but after some interesting labs they sent me in for a CT scan.

Before I even got back to the room, the nurse and CNA came to collect my personal belongings and wife, as they were moving me to a higher level of care. My blood pressure was elevated (a bit high for my “normal” but extremely high for the doctor’s idea of “normal”) and they wanted to start IV medications immediately to bring it down. They were hesitant to tell us exactly what was going on at this point and reiterated I was in the best place possible.

After some time, an on-call doctor explained that I had a Type B dissection and would be admitted to ICU. At this point it was 2 am, and they sent my wife home due to COVID restrictions, not having an ICU bed for me, and lack of specialty support at the time.

By the next morning, I was on the maximum dose of IV Blood Pressure Medications (I believe it was two or three different types). Where my dissection is located, the vessel leading to my kidneys was being impacted. With all my other health risks and factors, the local hospital I was at felt my case would be better suited with specialty help from UW Health in Madison, WI.

As time passed, I continued to have ever growing side effects of the dissection and my kidneys starting shutting down. My creatinine level was just over 8, normal is around a 1.25. On July 7th, I underwent emergency surgery, to place two renal artery stents to restore the blood flow to the kidneys. Surgery went great, but I was struggling to wake up and breath on my own after surgery, so I remained intubated (for 36 hours) and in the critical care unit.

After being ex-tubated and regaining strength, I was moved to ICU where we continued to work on creating a manageable routine for blood pressure control. I had to remain in ICU due to the IV blood pressure medication and my body not responding well to only oral medications. At one point I was on 7-8 blood pressure medications, and the physician working with us stated she had been working in this specialty for 10+ years and had never seen such a stubborn blood pressure.

With the number of medications (and the side effects of them) I was on, I developed a bowel obstruction. Due to the obstruction, and at the time not knowing what could have been the cause, I had another CT scan done with contrast dye. For those that might not be aware, contract dye can make your kidneys really "angry". My creatine went from semi-normal to greatly elevated again in the matter of a few days. After several more days of observation to ensure the kidney's started functioning on their own and no other intervention was needed.

On July 28th I was finally discharged! After 24 long days, my wife and I were able to head home to surprise our family, friends, and puppy. (We didn’t tell anyone we were discharged until we walked through the door together!)

From my perspective, the hardest part of being in the hospital for 24 days was the distance. UW Health is 2.5 hours away from our hometown and with COVID restrictions still in place, it was hard for people to come visit. Thankfully, between my wife and my mom I never had to spend the days alone. I can also not forget the kindness of my good friends Catherine, Andy, Nicole, and my father-in-law Jeff, who all took the time to come see me at some point and more importantly check on my wife. While I was the patient and had to learn how to live with this new medical condition, it was a lot to process for everyone, and even more for my wife to try and manage.

The first few days home were difficult. We were trying to manage medications, a new way of eating, and just all around my strength and stamina. Due to the anxiety of being in the hospital my blood pressure was always a bit high. Once returning home and being able to relax (and have more family support), my blood pressure was much lower than what is healthy. When I would go from sitting to standing, I often was dizzy and passed out twice on my family. However, we had a fantastic care team that was willing to work with us over the phone, around the clock when my wife had any issues or concerns. I spent the next 4 months off work and recovering with light duty activities at home. Finally, in late October 2022 I as cleared to return to work.

As of today, I am more than 8 months post dissection, and am doing well. I have been cleared to resume my normal activities and I couldn't be more excited. But mostly I'm grateful to still be here.

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