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During multiple tours in Afghanistan, Jeff Pharris conducted countless combat patrols and narrowly survived two bomb blasts. After 20 years of U.S. Army service as a communications specialist and combat advisor, he was honorably retired from active duty.

Soon after, he started substitute teaching at his local middle school and elementary school in Hope Mills, North Carolina. The job was great in many ways.

His wife, Jennifer Pharris, teaches fourth grade, so the couple often had lunch together. Plus, by working part time, Jeff was able to care for their kids, Tristan, 13, Isabelle, 15, and Madison, 17. This was especially fulfilling since he'd missed years of their childhood during deployments.

Jeff's students brightened his day, too. At 5-foot-10, with a full beard and bald head, middle schoolers fondly nicknamed him "the Viking sub."

Around two years after retiring, Jeff was home alone on a Thursday afternoon. As he tidied up in the 10 minutes before Tristan got home from school, Jeff noticed a slight, sharp pain in his chest.

Jeff figured it was from a workout. He lifted weights and did cardio six to seven days a week to stay in shape and help manage his stress and anxiety.

Then he became lightheaded. He lowered to the floor. A layer of sweat covered his body. He looked at the clock. Tristan would walk through the door any minute. Jeff didn't want him to worry, so he got up and wiped the sweat away.

"Hey, buddy," Jeff said, as Tristan walked in. "I'm not feeling good." It occurred to Jeff he might be coming down with COVID-19. "You might want to keep your distance."

Five minutes later, Jeff left to pick up Jennifer from school. When he told her about his symptoms and lingering, moderate chest pain, they went directly to the nearby Veterans Affairs hospital.

Jeff had blood work done and got an electrocardiogram, or EKG, to check his heart's electrical activity. All tests were normal. Next, he was told he'd need to have a CT scan so that doctors could take a closer look at his heart and blood vessels.

Soon after, doctors told Jeff his CT scan looked OK. But they did a second one, just to be sure. As Jeff waited for those results, his chest still hurt. Still, he was able to have some dinner.

Doctors recommended doing a stress test, which measures how well the heart works when pumping hard. They could do it the next day. Jeff decided to spend the night in the hospital to make it more convenient.

Well after midnight, Jennifer left to get home to the kids, knowing she still had to wake up at 4:45 a.m. to teach.

When the results of the second CT scan came back, a doctor called Jennifer to let her know that everything still looked good.

Not long after, the door to Jeff's room flew open.

"Don't move, don't do anything," the emergency room doctor treating him said. "You have an aortic dissection." It's a rare, life-threatening tear in the inner layer of the aorta, the body's main artery.

Although tests kept saying nothing was wrong, the ER doctor could see that something was causing Jeff's symptoms. The ER doctor consulted with his father, a thoracic surgeon, which led to the ER doctor and a radiologist making the diagnosis.

Now that they knew what they were dealing with, they faced a new challenge: The VA hospital wasn't equipped to handle it.

The best option was to transport Jeff via helicopter. But none were available. So paramedics drove him an hour and a half to a hospital in Raleigh.

Jennifer was at her desk at school that morning waiting for her fourth graders to arrive when her phone rang. It was the hospital. "Jeff needs open-heart surgery," the caller said.

"He needs what?" she said, her voice rising.

With tears in her eyes, she arranged for a substitute, readied her lesson plan and called her children. The family drove to Raleigh.

In the meantime, Jeff spoke with his surgeon. The doctor wanted to wait until Monday to operate. The first part of Jeff's aorta, where the aortic valve is located, was enlarged. If they waited, it might improve. Otherwise, Jeff would need a replacement valve and he'd have to take blood thinners for the rest of his life.

During surgery, fluid built up around Jeff's heart. His heart started beating irregularly, too, and doctors shocked his heart to restore a regular heartbeat.

The next day, when doctors removed a drainage tube, part of Jeff's lung collapsed. They had to reinflate his lung with another tube. Jeff stayed in the hospital for 12 days.

He went home with a walker two days before his 48th birthday with his aortic root still partially dilated. It wasn't clear if he'd need another surgery to replace the valve.

At home, he needed Jennifer's help to eat and bathe. Picking up a glass of water hurt. He could barely walk 10 feet.

When Jennifer went back to work, Jeff's two aunts from Nevada, as well as an Army buddy, were there to keep him company and assist with his recovery. Jeff also had the companionship of his loyal black Labrador, Murphy, who had his own medical issues. The dog was recovering from a torn cranial cruciate ligament, or CCL, similar to an ACL in humans.

"That bonded us even closer," Jeff said.

First, Jeff and Murphy walked to the mailbox together. Then, they made it to the end of the street. Jeff also did cardiac rehabilitation for two months. He was the youngest person by decades.

Because doctors weren't sure what caused Jeff's heart problems, they weren't sure how to plot his recovery.

One doctor said he couldn't work out anymore. Another thought it was fine. Jeff ended up going back to the gym two months after surgery, with an important concession: He lifts lighter weights.

In addition to the physical benefits of working out, the experience itself is important for his mental health. "The gym is kind of like my personal church," he said.

A similar mood-lifter was returning to substitute teaching.

"I love it," he said. "It's almost therapeutic. The kids are so excited to see me."

The surgery was in February. He still takes blood pressure medication to relieve pressure on the aortic root. He's getting genetic testing done to see if it offers any explanations.

During recovery, Jeff also contended with a new fear of death.

In the Army, he accepted dying as a possible part of the job. But after surgery, he worried that every twinge in his chest was a life-threatening problem.

Jeff's thoughts spiraled. He thought he could keep another dissection from happening by eating specific foods, exercising precise amounts of time and strictly monitoring his vital signs. He went to the ER five times after surgery.

"Some of the issues were just in my head," he said.

Not all, though. Over the summer, he learned the cause of severe abdominal pain was multiple stomach ulcers.

"It was almost like I stopped living my life," he said. "I was living to not die."

Jeff decided to see a therapist who specializes in veterans and post-traumatic stress disorder. He is actively participating in a treatment program for his mental health.

"Therapy has helped a lot," Jeff said. "I'm not afraid anymore. I don't check my blood pressure every 10 minutes."

He's also developed a bond with a fellow heart disease survivor.

Jennifer has noticed a change in Jeff over the past few months. "It is a journey, I'm always reminding him," she said. "But Jeff is in a much better place now."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.