Former construction site supervisor Lee Chai Hak, 54, tells Lee Hui Chieh about the day the wall of his heart artery split and changed his life forever.

Finding out

On our way back from a family holiday in Taiwan, our plane ran into turbulence.

We landed safely, but back home the same night – Sept 27 last year – I dreamt that our plane crashed.

I woke up around 1am, feeling very scared. My chest felt tight, my back became numb and I couldn’t move my right side.

I thought: Oh no, I can’t move, I must be having a stroke.

I remembered that my family doctor had said high blood pressure could lead to a stroke. I’ve been on medication since 1987 for high blood pressure, but I sometimes forget to take it. I forgot for a few days when we were in Taiwan.

I woke my wife, Mui Hiang, 55, a customer relations officer, and asked her to bring me some water.

I tried drinking, but threw up and didn’t feel any better, so I told her to call for an ambulance.

But she was worried it would take too long. So the eldest of our three children, Siang Hwee, 29, a manager, asked her friend who happened to be visiting, to drive us to Changi General Hospital.

We have another 27-year-old daughter and a 23-year-old son.

My wife said I was sweating so profusely that my T-shirt was soaked, and she had to help me remove it and put on a fresh shirt because I couldn’t move my right arm.

The doctor got me to go for a CT scan, and after seeing it, he told my wife and daughter that he was not optimistic.

He said my aorta had dissected. We had never heard of such a thing before.

Going for surgery

He told my family that I should undergo surgery, but warned that it was a dangerous operation – my chances of surviving were 50-50, and I was at risk of getting strokes after the operation.

My wife said I just kept repeating: “It’s very painful, please save me quickly.”

They transferred me to the National Heart Centre, where the doctor said I would need a heart bypass.

I asked if I could have it done two days later, because I needed to settle my work – I was a construction site supervisor.

But the doctor said I needed an operation immediately.

So I just agreed. I was in too much pain to worry about the surgery.

I don’t remember anything after that.

During the operation, I had a minor stroke, my daughter said, which made me lose about 25 per cent of the visual field in my left eye.

But it was one of the “least serious complications” that could have happened, she was told. I could have been paralysed, or my organs could have failed.

My daughter said that I regained consciousness only two days later. I spent a week in intensive care, and was fed through a nose tube.

She said that I was “emotionally unstable”. I was very thirsty and kept asking for water, she said, but I wasn’t supposed to have any, so they refused to give it to me, and I lost my temper.

My wife said I would get so agitated that I tried to pull out all the tubes, and had to be tied up.

I don’t remember anything at all.

It was one more week in a high dependency ward, and one more in a normal ward before I was discharged.

Carrying on

At first, I was weak, so I could walk only slowly. I was also very worried that I would trip and fall, and get another stroke.

But after doing daily exercises taught by the physiotherapist, I’m stronger.

After that day, I quit my job. My work kept me very busy, but now I just rest at home. It’s harder to pass the time now. I nap, read newspapers and watch TV.

Every evening, I go to Bedok Stadium, near my Bedok South flat, and stroll for half an hour.

I make sure I take my medication on time – three different types three times a day.

When I was working, I just ate anything in the coffee shops – char kway teow, chicken rice...

But now I eat homecooked food, usually fish, porridge and soup. My wife cooks with less oil and less salt.

When I read about others with the same condition, like Taiwanese singer Pan Anbang who collapsed suddenly when he was here, I get scared.

But I try not to think too much, just try to keep myself as healthy as I can.

Lifelong after-effects in a split-second

Former construction site supervisor Lee Chai Hak suffered an aortic dissection – meaning a tear had developed in his aorta.

The aorta, the main artery channelling blood from the heart, has many thin layers of tissue that form its walls. The inner wall can be ripped, often by blood hurtling past at high pressure, causing the blood to flow into the tear and between the inner and outer walls.

This disrupts blood flow to the rest of the body – in Mr Lee’s case, his right limbs – which then leads to numbness and temporary paralysis.

If the outer wall also tears, the patient will die, so an aortic dissection has to be operated on immediately, said Mr Lee’s doctor, Dr Lim Chong Hee, senior consultant at the National Heart Centre’s cardiothoracic surgery department.

One in about 10 patients dies before reaching hospital. The risk of death increases by 1 per cent for each hour that passes after the aorta has ruptured and is not treated, Dr Lim added. In two days, half of those not treated will die.

The operation, similar to a heart bypass, involves hooking the patient up to a heart-lung machine, which takes over the functions of those organs, and lowers the patient's temperature to 18 deg C.

At this temperature, the brain needs much less oxygen, and the patient can survive for about 45 minutes without blood flow.

The machine is stopped, leaving the patient in a state of “suspended animation”. The surgeon then replaces the torn portion of the aorta with an artificial graft.

Doctors told Mr Lee’s family that his tear was too long, so only the part nearest to the heart was repaired.

The body will have to repair the rest of the tear on its own, with medication.

The heart centre sees about eight patients whose aorta splits each year.

Those who are aged above 50, smoke, have high blood pressure, high cholesterol or abnormally thin artery walls are at risk.

The number of hours taken for the operation - 5

Actual number of minutes the surgeon had to operate on artery - 45

Temperature body was cooled to during operation - 18 deg C

Mr Lee Chai Hak’s actual hospital bill - $30,000

What Mr Lee eventually paid, minus subsidy - $4,800

Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction.