When should I start being more careful or cautious

It's really good that you are being proactive about your health and seeking regular check-ups. It’s essential to stay informed about your condition and how it affects your life. You mentioned that your thoracic aortic aneurysm has grown slightly from 4.0 to 4.2 cm over the past year, which your cardiologist has noted isn’t a significant change. However, it's understandable that this progression, even if minor, could cause some worry. In addition to the aneurysm, you are managing other significant health issues like Wenckebach AV block, a myocardial bridge, and sleep apnea. The chest pains, light-headedness, and shortness of breath you've experienced, combined with the physical demands of your job, certainly warrant a thoughtful discussion about your future work.

Given your current health status and the physically strenuous nature of your job—which involves heavy lifting and exposure to extreme heat—you should start considering a transition to a less physically demanding job. Your body is sending signals that the current workload might be too taxing, and it’s crucial to listen to those signals to prevent any further complications with your aorta.

The primary concern is ensuring your well-being. Heavy lifting and extreme temperatures can exacerbate your symptoms and potentially lead to more serious health issues. Transitioning to a less strenuous job can help mitigate these risks. In addition, a less demanding job could help reduce your symptoms and improve your overall quality of life. This change could also give you more energy to enjoy your personal life and activities outside of work. I know for myself that I feel much healthier 9 years after I had emergency open heart surgery to repair my fully dissected aorta. I was 50 years old. You do not want that scenario for yourself, trust me. Managing your aneurysm, heart condition, and sleep apnea now effectively involves reducing stress and physical strain. A different line of work could support these health goals. You should discuss potential job modifications or new roles with your employer that accommodate your health needs. Find a vocational counselor who can assist in finding a position that aligns better with your health requirements.

You have got this. You know you have a problem. I wish I had the insight then, that you have now. I never imagined what could happen to me until my aortic dissection had already happened. Your thoracic surgeon will tell you that the survival rates for a sudden aortic dissection drop like a rock, so the time to deal with it is now. Reduce stress. No heavy lifting. No planking. No valsalva maneuvers when working out.

Part of the reason you are where you are is the work that you do. If you had a bulging tire on your vehicle, you would drive cautiously, never go 75-MPH on the freeway with it, and get it fixed the first chance you got. That's what a sudden aortic aneurysm is like. Think of it like a blown heater hose that has to be fixed while the vehicle is moving, the engine is still running, and the repair has to be made before all the coolant runs out. You're going to be fine but you have to recognize that you have been given a gift: you know you have a problem. That puts you ahead of 100% of the people, like me, who first learned they had an aneurysm after it burst. Reduce your stress, take your meds, listen to your docs, and take it seriously. You'll be alright. Peace.

I'm not a doctor, but if I were your wife, I'd want you to find another job. Your current job would stress someone in perfect health and you've got a lot going on. Take care of yourself. Is disability an option?

I’m no doctor or financial adviser so the following diatribe is purely off the “top of my head.”

As a wise thing to do, ensure that you maintain an adequately funded life insurance policy to provide for your family if it all goes pear-shaped. Sounds morbid but it’s only common sense; something I’ve done since my early 40’s ( now 65).

Your personal health is your very very top priority and I’m thinking you must move to a job that’s way less anaerobic in nature. (Although easy to say but difficult to do 😫). Aerobics is fine - walking cycling swimming etc based more on volume not too much high intensity stuff.. The heavy lifting in your job spikes the blood pressure which puts pressure onto the aorta (repeatedly lifting 50+ lbs thru the day is way above anybody’s limit let alone somebody diagnosed with heart health issues.) FYI I’ve got a TAA of 4.4 at age 65 - been put on a bp med and stopped lifting weights.

I was also diagnosed with apnea 20 years ago and had a full on nose job (to fix a deviated septum and do a turbinate reduction) which appears to have worked as I no longer nearly drift off whilst driving or take a daily “nana nap” every afternoon like I used to. Also lost a lot of weight (40-50lbs). Also look at potentially using a CPAP device.

You must be your own very best friend and that you go out of your way to take all the necessary actions to ensure your optimal health.

Best of luck with your journey.

If it were me I would be actively looking for something less physically demanding on your body. Good luck.