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Need some guidance

  • 1.  Need some guidance

    Posted 10-05-2020 14:18
    Gd afternoon everyone, 1st time posting, in 2009, me echo showed 4.1 cm thoracic aeorta, aug of 2019 grew to 5.0 cm and sept 2020 stayed at 5cm. both CT imaging and eco showed the same.I have visited the Cleveland clinic in Weston, Florida last Friday and spoke to one of the top thoracic surgeons, he told me he wanted to give me another ecogram in 3mos to keep close tabs on it and also said that I was a candidate e for surgery, at 51 the word aneurysm scared the living hell out of me. I am in the best shape of my life 6'0 200lbs always have been a workout guy, haven't touched any heavy weights in a long time, lots of cardio and resistance training. my cardiologist put me on 50mg metoprolol (bp med) 110/70 range right now and 20mg of rosuvastatin for cholesterol. I'm married 22 years with a 19 and 16 year old. I live a very active lifestyle and now I have to really take it down a bunch of notches. i'm concerned that mentally the thought of a possible rupture or tear will lie heavily on my mind and cause a great deal of anxiety. if anyone has any advice here, it would be greatly appreciated. I want to get in front of this, I understand it will not get smaller, so inevitably surgery will have to happen. So now I am processing. The thought of open heart surgery is not an eay pill to swallow, but neither is the alternative, so if anyone has a similar sitch and how they dealt with it, I wd greatly appreciate to hear from you. I am visting another surgeon in broward county at holy cross hospital this Thursday. Thanks for everyones time Hank

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    hank Lanzo
    boca raton FL
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  • 2.  RE: Need some guidance

    Posted 10-05-2020 19:13
    Hello Hank,
    You are doing the right things to stay ahead of this thing. Putting off the surgery too long will not do any good and may make things worse. Also having it too soon also has it's risks.
    My gut advice is to have the surgery as soon as the doctors say it should be doon. The sooner it is done the better your recovery will be. Since you are in good shape it will be easier for your body to heal. 
    Do not dread the surgery. It will be the beginning of the second half of your life. The hard part is waiting for the doctors to get it done. Keep a positive attitude and a sense of humor and believe it or not things will get easier.

    Take Care
    Richard 





  • 3.  RE: Need some guidance

    Posted 10-05-2020 19:26
    Thanks Richard, I appreciate you taking the tone. I'm an active guy, and working out is a therapy u use in my life, the thought of having to almost completely shut that down, is depressing in itself. The doctor said this procedure is a 95% success rate. I'm a numbers guy, they r def in my favor. The amount of anxiety I believe I'll have waiting will drain me, as well as my family. I know this isn't gonna get better. The fear of a rupture or dissection really frightens me.

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    hank Lanzo
    boca raton FL
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  • 4.  RE: Need some guidance

    Posted 10-06-2020 05:26
    Hank,

    I agree with Richard 100%.  I never had your issue but I did have quintuple bypass surgery almost three years ago after having been a gymnast, wrestler, weightlifter and runner my whole life (I'm 70 years old now and I've been working out continuously since I was 12).  The open heart surgery recovery will take you out of commission as a resistance training workout warrior for the 12 weeks or so that your thoracic surgeon puts you on sternal restrictions, but I can tell you that I came back really fast once I hit the gym again.  And if an old guy like me can do it, a guy 20 years younger like you can bounce back too.

    Good luck, friend.  Get that surgery and we'll be here to talk you through both the presurgery jitters and the postsurgery recovery.  Before you know it, you'll be embarrassing your kids by doing one armed pushups at their weddings.

    Ira

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    Ira Reid
    Hoboken NJ
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  • 5.  RE: Need some guidance

    Posted 10-06-2020 06:53
    Thanks Ira, appreciate your perspective 💪🏻

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    hank Lanzo
    boca raton FL
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  • 6.  RE: Need some guidance

    Posted 10-06-2020 13:43
    Your concerns are valid. Never let anyone tell you they are not. However, as the doctor said the numbers are on your side. The bad thing about fear is that it can spread. Your family will feed off you. The more you fear the more they will. 
    There will always be a small percentage of things going south, but the better you feel about going forward the better your odds are. It is a fact that attitude and faith are key factors ion getting better faster. This has been proven time and time again. There have been many studies that show that. 
    Keep your faith, whatever yours is, and a positive sense of humor and tell yourself you are going to get through this better than when you went in and it will all go easier.
    When I had my 4XCABG there was another fellow that had a 2xGABG the same day. He was 10 years my junior, in better condition than me, and should have healed better and quicker than me. 
    I was out of the hospital 8 days after my surgery. He did not get out of ICU until 7 days after his. We had the same surgeon as well. But he was a grumpy Gus! His family was grumpy as well and nothing the nurses or staff did could make him feel better. He did not try to get out of bed, he did not try to eat, he just complained about the pain and about everything. He made himself sicker than he was. 
    You can handle this and you will be an example for the next person that comes along after you. You will be able to show others your scar and tell them your story and you will be able to assist them with their recovery.
    Take care and God Bless.
    Richard Short
    Chapter 395





  • 7.  RE: Need some guidance

    Posted 10-06-2020 07:39
    Hank,
    As a former gym guy myself, I understand the impact of reducing your cardio exercise. You said you haven't touched any heavy weights in a long time but you engage in "lots of cardio and resistance training". Cardio exercise, including jogging, speed walking and biking is excellent but resistance training sounds like weight machines. You should discuss your workout routine with your cardiologist and get their approval.  Since the aneurysm will not get smaller and inevitably you will need surgery, begin planning when, where and who will preform the procedure. The Cleveland Clinic is world recognized leader in heart surgery but you should talk to other patients who have had surgery at their Weston Medical Center.

    The recovery from an ascending aortic aneurysm procedure is somewhat longer than bypass surgery but you should be able to begin cardiac rehab about six weeks after your surgery.  The Cardio Rehab is a program of monitored activities; three times a week, one hour per visit of treadmill, stationary bike, rowing machine and very light weights.  After three months of Cardiac Rehab you should be ready to return to a gym - but no one arm push-ups.
    Email me if you have additional questions,
    Best of Luck,
    Vic



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    Victor Fabry, CEO
    Greylock Advisors, LLC
    Short Hills, New Jersey
    fvfabry@gmail.com
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  • 8.  RE: Need some guidance

    Posted 10-06-2020 11:32
    Thank u Victor, this is very helpfu.

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    hank Lanzo
    boca raton FL
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  • 9.  RE: Need some guidance

    Posted 10-06-2020 09:43
    Hi Hank,

    Here's the deal. Surgery is surgery - nothing to scoff at or minimize. Heart surgery is scary. Things can happen. However....

    As you will see from many people here, its bark is worse than its bite. Many of us will tell you that we were stunned at doable it was. You are WAY ahead of the curve because you are in GREAT shape. That alone puts you in a great position. Plus you're young (relatively speaking!). Check! Then you need a really great mental attitude. Oh, a make sure you have a surgeon who does this type of surgery in his or her sleep - in other words, LOTS of ascending aorta repairs. Some surgeons specialize in the aorta and even if you go with one that doesn't, remember: This is their day job.

    For perspective: My surgery was seven months ago. I had my ascending aorta repaired, plus my aortic root and valve replaced with a single bypass thrown in as a bonus. I was then 67. I was in good shape but nowhere as good a shape as you are. Even with a minor complication that was more of an annoyance than anything, I pretty much sailed through it. Recovery was unremarkable (or remarkable in the sense that it was pretty straightforward.) I followed all of the lung-breathing/walking instructions I was given and started working my day job the day after I got home from the hospital (Day 11 - surgery was in Cleveland; I live in San Diego.) As expected, I was slower-than-usual, rested generally for 15-30 mins when I got tired (as in feeling that I could fall asleep sitting up at my desk) and was foggy at times. But I kept pushing my brain. (I work from home and research/write.)

    I now have a 9" souvenir on my chest that is fading. If it wasn't here I wouldn't know anything had been done. It's crazy!!!! 

    The first few days are not a party, but just keep hitting that fentanyl button (don't be a hero - the goal is to get ahead of the pain) and I promise that you probably will forget most of it. My guess is that you will to exceedingly well. Yes, there are risks, as there are every day we step foot out of bed. Whatever you do keep yourself in shape pre-surgery. You might not be able to do resistance, but if your doctor says walking/running is ok, do it until the day they wheel you in. 

    The good news about engaging on this forum and/or others is that you will get plenty of opinions with differing outcomes, including complications. My approach was to over-research, including any/every study I could get my hands on. Every video I could watch. (Keith posted several exceptional ones here a few days ago.) I'm a former journalist, so I wanted to know everything - what could go wrong and right and what the range was. I did not want any surprises. In general, there were none.

    If you ever want to chat, feel free to reach out and we can set up a call. Others here made the offer to me and it was greatly helpful. My turn to pay it forward.

    Cheers!
    Herb

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    Herb Greenberg
    San Diego CA
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  • 10.  RE: Need some guidance

    Posted 10-06-2020 11:31
    That was great Herb, thanks for taking the time, I greatly appreciate your perspective. Very helpful.

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    hank Lanzo
    boca raton FL
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  • 11.  RE: Need some guidance
    Best Answer

    Posted 10-06-2020 16:47
    I had my a quintuple emergency by-pass at 52.  I was in and out of shape my whole life from athletics to gym rat to traveling to much for work to have time.  After my surgery I began a steady cardio workout and 3 years later went snow skiing and was hardly tired or sore.  Felt like I was in my 20s again.  Your call on the surgery, just know that with time and effort you will get back to having the active life that you had before and possibly even better.

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    Randy Waclawczyk
    Round Rock TX
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