Given your concerns regarding the medical care where you live, wouldn't it be advisable to follow a conservative approach to your activity level relative to your TAA diagnosis? 4.1cm is not large in the TAA spectrum, but deserves monitoring, self-care, and support. There are many here who have spent their lives being physically active, only to find themselves restricted now because of their condition. All seem to adapt, and remain mindful of their condition. The overriding sentiment seems to be avoid strenuous activity, keep BP at a proper level, and avoid straining during any physical effort. With those basic concepts applied, and continued education about your condition, you and your care team will create the appropriate guidelines for living with your aneurysm.