@eldonjp — I’m really glad you posted, and I’m going to be direct with you because this is not something you should be left worrying about for 45 days without a clear plan.

First, I’m a survivor of a Type A aortic dissection (2015) and I had emergency open-heart surgery with a Dacron graft to replace part of my aorta. So I know exactly what it feels like when your body throws the words “dissection” and “aneurysm” at you. It is terrifying. But I also know this: knowing about it gives you power, because you can act, and this is very manageable when monitored correctly.

Now, here is the key point: a celiac artery dissection with a fusiform aneurysm is absolutely something a vascular team should triage, and in most cases it does not mean you are about to die today. But it does mean you need timely evaluation, blood pressure control, and a clear set of “go now” warning signs. Forty-five days may be acceptable in some cases, but no one should leave you in limbo without confirming you are stable.

Here is what I would do aggressively, starting now.
1. Do not sit and wait in silence
Call the vascular surgeon’s office back and tell them clearly:
I have a celiac artery dissection and a known aneurysm. The dissection is new. I am anxious and I need this triaged. Can the surgeon review my CTA now and advise whether I need to be seen sooner?

Ask to speak to the nurse or PA. Ask them to send a message to the surgeon the same day. Many cases get moved up simply because nobody has flagged them as urgent. You are not “bugging them.” You are advocating for yourself.
2. Ask your primary doctor to intervene
Call your primary care doctor today and ask them to contact vascular surgery directly and request expedited review. Doctors have back-channel ways to get urgency recognized. The exact words matter:
New arterial dissection. Known aneurysm. Needs vascular review and management plan now.
3. Make sure your blood pressure is aggressively controlled
The single most important thing you can do right now is reduce the pressure and force on that artery wall.
If your blood pressure is running above about 120/80, that is too high for this situation.
You should ask your doctor today about starting or tightening medication (often a beta blocker is used because it lowers both BP and the force of each heartbeat).
If you already take BP meds, this is the moment for fine-tuning.

Do not assume you’re fine because you feel okay. Dissections can be quiet. Prevention here is real medicine.
4. Get clarity on what imaging you have and what you need
You need to know:
What is the aneurysm size (in millimeters or centimeters)?
What is the length of the dissection?
Is the true lumen compromised?
Is there evidence of organ ischemia (liver, stomach, spleen)?

If you have a CTA report, read the “Impression” section and post the exact wording (remove your personal info). The impression usually contains everything that determines urgency.
5. Know the warning signs that mean ER now
You should go to the emergency room immediately if you develop any of the following:
Sudden, severe upper abdominal pain (especially epigastric or right upper quadrant)
Severe back pain
Pain that is escalating or not relieved
Fainting, near fainting, or profound weakness
New nausea/vomiting that feels “different” or severe
Signs of low blood flow to organs: persistent pain after eating, bloody stools, severe diarrhea, new jaundice, or severe tenderness

You are not “being dramatic.” You are acting correctly.
6. Activity restrictions right now
Until you’re evaluated, treat yourself like you have a fragile artery (because you do).
No heavy lifting.
No straining (no breath-holding / Valsalva).
No pushing, pulling, or intense exertion.
No deep twisting movements.
Stay hydrated and avoid constipation—straining on the toilet counts.

If you do anything, do gentle walking only.
7. If you feel dismissed, escalate
If the office says “45 days is the next available,” then you say:
I understand scheduling. But I need a triage decision from the physician based on my imaging. If the physician reviews it and says 45 days is safe, I can accept that. I cannot accept that no one has reviewed it.

This is not rude. This is correct.
8. What usually happens with these
Many spontaneous visceral artery dissections (including celiac) are treated medically at first: blood pressure control, sometimes antiplatelet therapy, repeat imaging, and close surveillance. Intervention (stent or surgery) is usually reserved for specific findings: expansion, persistent severe symptoms, organ ischemia, rupture risk, or significant aneurysm size.

That means you have a good chance of being stable — but you need to know that from a real vascular review, not from silence. Peace.