Norma Cool and her son Ron pose for a photo.
Norma Cool, her son Ron, right, and three other sons have been confirmed to have abdominal aortic aneurysms. (Chris Clark | Spectrum Health Beat)

For all the fun, love and exuberance that flows in the Cool family, there’s something unseen, lurking beneath the surface.

Norma Cool and four of her sons have been confirmed to have abdominal aortic aneurysms. The aorta is the main vessel that supplies blood to the abdomen, pelvis and legs. An aneurysm occurs when an area of the aorta balloons out.

The exact cause is unknown, but what is known is that the Cool family has an abundance of them.

It all started when one of Norma’s sons fell off a horse and broke his ribs about a decade ago.

During X-rays and scans, doctors discovered an aneurysm and repaired it, after his ribs healed.

Years ago, doctors noticed a small abdominal aneurysm in Norma’s aorta.

“Nobody said anything at all after that,” said Norma, 84. “I didn’t know they were dangerous.”

‘You … told us all goodbye’

On a warm day in August three years ago, she bustled about in her Leroy home getting ready for church.

“My son was already in the car and my daughter-in-law was still in the house with me,” Norma said. “I was walking across the living room and I felt a terrible pain. I called out to Arlene and told her something was terribly wrong. She got me to sit down then called out to Dan. That’s the last I remember until I was going up in the helicopter.”

Norma was rushed to Spectrum Health Reed City Hospital then transported by Aero Med to Spectrum Health Butterworth Hospital.

“I later learned that my kids came down to the hospital,” she said. “My granddaughter, Christina, said, ‘Grandma, don’t you remember talking to any of us?’ I said, ‘No, honey, I don’t.’ She said, ‘Grandma, you prayed for every one of us and told us all goodbye. You said, ‘I’m going to die now, but I’m going to be in heaven with Jesus and Grandpa.’”

Norma said she had no warning symptoms prior to the 10.1-centimeter aneurysm bursting. After a brief evaluation in the emergency room, surgeons rushed her to the operating room.

She couldn’t walk for several months after surgery, but she said with God by her side, and inside, she slowly healed.

But it wasn’t the end of the aneurysm activity for the Cool family.

‘You get used to rough things’

Rob later developed stomach pains. Doctors discovered he also had an aneurysm. So did his twin brother, Ron. And their younger brother.

“It’s scary,” Norma said. “But when you have eight children and seven of them are boys, you get used to rough things. Half of them are skiers, which isn’t exactly the safest thing. But yes, it’s scary. I do a lot of worrying about it.”

Ron, 63, of Grand Rapids, said having his 6.8-centimeter abdominal aortic aneurysm repaired last August has given him peace of mind.

“I had no symptoms going in other than the history in the family,” Ron said. “But the thing I noticed that doesn’t happen anymore that happened before the surgery was when I would bend over or squat down, I would get dizzy.”

Despite the dizzying number of aneurysms in the Cool family, Robert Cuff, MD, said it’s not that rare.

Dr. Cuff, who operated on Ron, said the risk of developing an abdominal aortic aneurysm is 15 to 18 percent in people over the age of 60 who have a sibling with a similar aneurysm.

“Patients with family members who have abdominal aortic aneurysms tend to develop them at a younger age than those without a family history,” Dr. Cuff said. “It is unlikely he had this at birth, but rather developed it over the last 10 to 15 years.”

Know your risk

Dr. Cuff said abdominal aortic aneurysms are the most common type of aneurysm. Men are nearly five times more likely to develop them than women.

Ron continues to get checked frequently.

“He could develop other aneurysms in the abdomen or other areas,” Dr. Cuff said.

Norma did.

During one of her six-month checkups, doctors discovered two more aneurysms, which she had surgically repaired several months ago.

“That wasn’t real good news,” she said. “They showed up when they did the X-ray for the other one to see how it was coming along. When you get to be this old, it’s not scary. It’s not scary at all. What’s going to happen? You die, you go up to heaven and I’ll see my husband and Jesus.”

But Norma isn’t checking out quite yet. She’s treasuring her second chance.

“I’m awfully glad that we had such good doctors to take care of us,” she said. “When you’re given the gift of life, you ought to take care of it.”

Dr. Cuff agreed. He encourages everyone to get a screening ultrasound if there is an aneurysm in the family.

“Since most patients never know they have them, it can be difficult to know if there truly is a family history of them as older generations may have died with undiagnosed AAAs,” Dr. Cuff said. “We encourage all siblings and children of patients diagnosed to be tested with a screening ultrasound.”