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Thoracic Aortic Aneurysm

  • 1.  Thoracic Aortic Aneurysm

    Posted 06-28-2021 15:30

    Greetings all. I tried to post this elsewhere so apologies for any duplicates.  Also, I had a great phone conversation with Vic from the AA Support Group.

    On May 25, 2021 I was diagnosed with an ascending Thoracic Aortic Aneurysm of about 4.4cm with no aortic dissection.  It was a complete shock as I am asymptomatic.  I was training for a marathon and someone suggested a calcium scoring test to be on the safe side as I am 56.  I thought I would pass with flying colors but I did not; instead finding this condition. I have 12 and 27 year old sons.  I live in Central Connecticut.

    I am a former power lifter and it's worth noting that I am a big guy 6'4", 240lbs now looking to get to 220 (currently around 230).  I have been an avid distance runner most of my life as well.   I have completely reconfigured and adjusted my exercise routine in preparation of future surgery.  In a sense I now feel like I am training for surgery.  I have dramatically cut my weights in the gym and have slowed my running pace – although I still run almost every day and plan to keep doing so.  I am very well controlled T2 Diabetic.

    Thus far I have gotten two opinions (Yale NH and Hartford Hospital) and have a third opinion at Mass General scheduled for later in July.  The first two opinions were inconsistent in regards to timing but both suggested valve sparing aortic root replacement (VSARR) option when the time comes because my valve is normal.  My younger brother had a genetic defect (a bicuspid valve - which I do not have) and had this type of surgery about 4 years ago.  He has a mechanical valve now.   I have also proceeded with a genetic test through Yale and am waiting for results.  I am not in a situation where I need immediate intervention but it is quite likely on the near-mid horizon.

    My anxiety has been through the roof at the outset of this news and is still considerable, but improving.   Daily meditation (not easy!) has helped. I have cleaned up all my life insurance policies and very clearly informed my wife about everything financial.   If something goes wrong my family will be financially ok.  I also ordered a LazyBoy chair -  although I was planning to get one of these anyway pre-diagnosis.

    This past weekend was the first weekend that I was not exclusively fixated on this.  I have learned a lot since my first diagnosis and opinion, and am learning more every day.  I find that there is a balance between constructive self-educating and over-educating.  That said, overall patient results and recent scholarly medical studies are very encouraging for this procedure.

    I have some experiential questions for the wonderful community here:

    • I have read frequent post op experiences describing profound fatigue, post op depression, lack of energy, exhaustion. Why does it happen?  Do Lungs get damaged on pump?  How is this treated other than walking?  
    • I am terrified of post op pain although I have read mixed experiences ranging from not too bad, to very uncomfortable.   How is post op pain managed?
    • I am also terrified of possible permanent surgical side effects but again I wonder if reading too much is bad. I tend to see that most people have done very well with near-normal life expectancies.  Any comments on this are welcome.    
    • I have not read many people factoring in ASI (Aortic Size index). Mine is 1.9.  I have been running and weight lifting most of my life.  Could my Aorta just be larger?  And of less risk? 
    Thanks in advance for any words of wisdom.  I am not happy to be here, but I am very happy to have found this community.

    Peter 


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    Peter Linn
    Watertown CT
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  • 2.  RE: Thoracic Aortic Aneurysm

    Posted 06-29-2021 22:51
    Peter,

    I'm a 71 year old current and lifelong weightlifter, and former gymnast, wrestler and competitive long distance runner who at age 67 had a heart attack and emergency quintuple coronary bypass open heart surgery, followed by a two week medically induced coma due to catching ventilator pneumonia.  I think I can answer some of your questions, even though I didn't have your specific condition:

     * The idea of "profound" post op fatigue, exhaustion, depression and lack of energy is not at all inevitable and, in my case, was virtually non-existent.  After I awakened from the coma, I could not stand, let alone walk, and could not feed myself.  Before I finished my three weeks in the rehab hospital, I horrified the staff when I threatened to press into a handstand (never could have done it, I was bluffing, but the key is the staff believed that I was capable of it).  I was never depressed.  To the contrary, I was filled with an immense gratitude that I was alive after my ordeal.! Within two months after I was discharged from rehab, I was running, lifting weights (baby weights at first) at my gym and back at work.  My exhaustion during 2 months post discharge consisted of taking a nap in the afternoons.  Bottom line is that everyone is different, so don't assume that you'll feel any particular way.  I hope you feel as well and recover as quickly as I did.

    *  I never had any post op pain other than if I sneezed but, then again, I was unconscious for the first two weeks post-surgery, with nearly all the tubs removed before I awakened, so perhaps you should discount this experience of mine.  I did not have any other post-surgical side effects and certainly no permanent side effects.  The biggest post-surgical issue everyone has is being patient while your sternum heals over the 8-12 weeks post surgery (assuming you even need full open heart surgery).  At around 8 weeks, I cheated by doing some pushups against a wall and, while I suffered mo ill effects, I highly recommend that you not be as stupid as I was.  (I also pulled myself up from my hospital bed from a prone position to a seated position using a set of cart handles as pullup bars, which really infuriated my nurse but pleased me to no end-I also discovered that, although I generally was weak as a baby, my grip strength was surprisingly intact).

    Best of luck and stay positive.  Follow your doctor's orders and get done whatever medical work needs to get done.  As we say in the Iron Game, that weight won't lift itself.

    Good luck and strength,

    Ira

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    Ira Reid
    Hoboken NJ
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  • 3.  RE: Thoracic Aortic Aneurysm

    Posted 3 days ago

    Hi Peter,
          Like yourself, I was diagnosed with a thoracic aortic aneurysm. Mine was discovered at 4.2 cm. 6 months later 4.6 cm. After that, it was stable for 2 years. The last test was about a month ago, and was 3.0 cm. 

     I'm an active 56 year old male, although I'm light on the weights and run on a treadmill only at home.



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    jim kelly
    jimjim
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  • 4.  RE: Thoracic Aortic Aneurysm

    Posted 2 days ago
    Hi Peter,

    Let me relieve you of some concerns.  First, although I never had your condition, I did have a heart attack and emergency quintuple bypass surgery at the age of 67 (nearly 4 years ago), immediately followed by a 2 week medically induced coma when I contracted pneumonia from the ventilator.  The good news is that when they woke me up, I had zero pain from the surgery unless I sneezed or coughed.  Nevertheless, I don't recommend contracting pneumonia as a means of avoiding post-surgical pain.

    As to fatigue, you will certainly experience that.  OHS is a tremendous physical trauma and your body needs time to recover.  When I first was relieved from the hospital and inpatient rehab 6 weeks post surgery due to the pneumonia, it was all I could do to walk a 1/4 mile, and then take a nap, although I did rapidly progress both in distance and time.

    Let me digress a bit.  Like you, I have been a serious weightlifter and distance runner most of my adult life including up to and after the heart attack and bypass surgery.  I'm a shrimp compared to you but, when I was 50 years old, I was push pressing 220 pounds for reps deadlifting over 315 pounds at a body weight of 185.  I am 5'7".  In my peak distance running days, I was a 6-7 minute miler in races from 5k to half marathon, including a lot of cross country.  I usually would cut weight to the 150's when I was seriously running.

    Bottom line is that I'm still doing most of that now (except for the running since a sciatica injury from a sloppy deadlift killed my running career, although it has not had any major impact on my lifting, strangely enough.  I cannot currently lift anywhere near what I lifted when I was 50 (and younger(, but it has zero to do with my heart history and everything to do with the fact that I am now a 71 year old fart and am experiencing the joys of being elderly.  I did recently check the weightlifting age/poundage charts, however, and my now puny lifts (compared to the good old days) actually are considered better than my earlier lifts 20 years ago!

    So there is nothing that will stop you.  It will take a while for you to recover, maybe a couple of months to become like a normal person, and maybe a year or a year and a half to become the same strength and endurance athlete you are currently.

    Best of luck to you and keep us posted.

    Ira

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    Ira Reid
    Hoboken NJ
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