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Robert Ryan

Robert Ryan, Vascular Surgery

It had been a perfectly normal day.

Robert Ryan, 53, came home from his job as an account executive at Xerox, sat down in front of the computer with a beer and a cigarette, and logged in. He had a little lower back pain, “but hey, who doesn’t?” he thought. But the pain kept getting worse, and when he got up to stretch his back, he felt a whoosh of liquid move from the back of to the front of his lower torso. He started to shake and sweat, and he leaned on a chair for support. His sister walked in the room, took one look at him and shouted, “What’s wrong?” Next thing he knew, he was falling to the floor.

His sister called 911 and within two minutes, he was in the back of an ambulance headed to New York Methodist Hospital. “When he first arrived, his lips were dark blue,” remembers Nicholas Vaccari, M.D., attending physician in emergency medicine. Although Mr. Ryan doesn’t remember a thing after falling in his home, he apparently was able to tell the EMTs in the ambulance about his back pain. Dr. Vaccari remembers, “When Mr. Ryan got to the Emergency Department, we immediately performed a sonogram of his abdomen. We saw that he had a large abdominal aortic aneurysm that had ruptured. An abdominal aortic aneurysm occurs when the large blood vessel that supplies blood to the abdomen and legs becomes abnormally large or balloons. If the aneurysm ruptures, fewer than 40 percent of patients survive. Fewer than one-half percent of aneurysms are greater than three centimeters; Mr. Ryan’s was nine centimeters. It was critical that we get him into the operating room as soon as possible to give him the best chance of survival.”

Within minutes, Mr. Ryan was in the operating room surrounded by a surgical team headed by Elie Semaan, M.D., a vascular surgeon at NYM. “By the time we got him into the OR, he had bled internally to the extent that most of his blood volume was gone. His vital signs were crashing and his blood pressure was essentially absent. At that stage, CPR would have been of no benefit, since the internal bleeding was not controlled. The surgical team simultaneously intubated Mr. Ryan and opened his abdomen. We immediately clamped his aorta above the ruptured aneurysm and began aggressive resuscitation measures, including blood transfusions,” Dr. Semaan recalls.

“Mr. Ryan’s body responded immediately: his blood pressure began to build again and his brain, heart and lungs were now receiving the blood they needed. The vascular team quickly got to work reconstructing his aorta so that blood could reach the rest of his body. Within a couple of hours, he went from a condition that was incompatible with life to a condition that was near normal. The timing of his arrival in the Emergency Department and the speed with which we were able to open him up and control the bleeding truly saved him,” says Dr. Semaan.

The next day, Mr. Ryan woke up. “I opened my eyes and didn’t know where I was. My sister was there and told me everything that had happened to me. I was in shock. I appreciate how incredibly lucky and fortunate I was to have everyone— the EMTs, emergency room doctors, surgeons—work together so quickly and with such skill. Without them, I know I wouldn’t be alive.

“I was in the Hospital for three weeks. My body went through a major trauma and I needed to heal. Dr. Semaan came to check on me every day. He said I had two choices: I could keep on doing what I was doing—smoking and drinking, or I could overhaul my life. To me, the choice was clear. Never again will I take this this body for granted. I have New York Methodist to thank for that.”

Read more real life patient stories in the 2011 NYM Annual Report.