I’m in my 61 and living with the aftermath of a major sudden aortic dissection event. In 2015 I survived a Type A dissection that required emergency open-heart surgery and a Dacron graft to repair my ascending aorta. So I’ve had to learn the hard way what “living with an aorta problem” really means. The first thing I’d say is that it’s good you already know the measurements. Numbers matter—they tell your doctors when to act. But day-to-day life isn’t just about the centimeters; it’s about keeping blood pressure and stress under control so the aorta isn’t constantly pushed to its limits.

Being a firefighter makes that tricky. The sudden heavy lifting, adrenaline surges, and breath-holding that come with the job are all things that can spike pressure inside the chest. That’s exactly what you want to avoid. Even swinging an axe or wrestling equipment overhead can drive your pressure higher than you think, especially if you grunt or hold your breath doing it. Most of us with aneurysms end up adjusting rather than stopping everything. Hiking, fishing, and easy outdoor work are fine for many people—as long as the effort is steady and you can breathe normally while you do it. Avoid deep twists, straining, or any movement that makes your head pound or your chest feel tight. If your blood pressure is controlled and your cardiologist clears you, you can still have a good, active life. Just not the kind that tests the limits of your aorta.

Don’t take advice from anyone who isn’t either a thoracic surgeon or someone who has personally survived an aortic dissection. There’s a tremendous amount of misinformation and, frankly, medical ignorance about aortic disease—even within the medical community. You need to see a good thoracic surgeon in a major metropolitan center who has real experience repairing aortic dissections. At around 5.0 cm, you’re getting close to the size where surgery is seriously considered. If that hasn’t been made clear to you yet, you need to have a direct, honest conversation with that surgeon. The sooner you meet that person, the better. Surgeons who already know their patients before surgery tend to have better outcomes. Peace.