Appointment with Dr. Pochettino

Very helpful as I am also in Florida and was considering traveling to Rochester for surgery. I am currently at 4.9 and a patient at Mayo in Jacksonville. Did you have any issues with the distance and travel afterwards?

Mayo is awesome! But... it can be hard to get an appointment. If you can't get one, google Cleveland Clinic 2nd Opinion. It looks like they have much broader access. Though I don't believe it will be covered by insurance.

Question… When you say trouble swallowing, do you mean that you literally can’t make your muscles constrict to swallow or do you mean that something gets stuck in your chest after you swallow I’m having trouble sometimes actually feeling like I can’t get the actual apparatus to work( my swallowing muscles). I have an ascending aortic aneurysm diagnosed last year that hasn’t expanded as far as I know. my last CT was in April and it ranges (depending on whether it’s a CT or an echocardiogram) between 4.0 and 4.2 recently measured 4.0 and since I know they don’t shrink or least, that’s what I understand, then it must’ve been the angle that they measured it. I’m really interested in a more detailed description of what you mean by difficulty swallowing

Regarding the difficulty swallowing, my trouble lays in when the food enters the esophagus and results in feeling something is stuck.

There are three phases of swallowing that occur beginning with food entering the mouth and the final phase of it leaving the esophagus into the stomach.

Often I have to drink a cup or two of warm water to relax the esophagus and allow food to enter the stomach.

I suspect this is from the pressure of the aneurysm on the mediastinum which houses the esophagus.

If you have had imaging see if they comment on the mediastinum and whether it has shifted.

Hope things turn out well. I understand the fear and uncertainty.

Wish I could answer your questions but my surgery was scheduled so quickly, I never had time to think about it. Talked with Dr Pochettino while at Mayo along with Dr Oderich. Think you should start trying now to get an appointment. Mayo will want CT scans plus lots of other health measures. Aneurysms can burst and that’s serious, if not life threatening. Good luck to you!

Thank you for your advice.

You indicated that you are trying to learn more. You might be interested to read the information at this link: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001106 and the information here: https://consultqd.clevelandclinic.org/thoracic-aortic-aneurysm-how-to-counsel-when-to-refer. These are links to information for doctors, but I have found them useful to try to educate myself before meeting with my doctor.

There’s an app you can input your relevant information in and it will let you know the recommendations from various organizations regarding surgery. It’s called “Aortic Surgery Guidelines”. It doesn’t seem to include symptoms and, as you note, that should change the “equation”.

Good luck!

Bitsygirl thank you so much for the very informative articles. The links provided contained exactly the type of information I was seeking.

I believe in being as educated as possible on the subject matter.

Thank you for taking the time to share the research. It is most appreciated.

Thank you Bitsy Girl! Very helpful!!!

Dr. Pochettino is fabulous. We sought a second opinion with him and decided to stay with him until and if aneurysm surgery is necessary.
He is not only a kind and smart man but we were very interested in his research on antegrade cerebral perfusion, which keeps blood flowing to the brain during open heart surgery - which, of course, is what an aneurysm involves.
While a previous surgeon had said that he would just work quickly to get the repair done within the requisite 20 minutes cooling time, we were interested in someone that would and could use other methods. What if the surgery could not be done within 20 minutes? We were very concerned about cognitive deficits resulting from surgery.
I work with patients anticipating surgery. There is growing realization, especially for older patients, that general anesthesia, anesthesia overall, and just the surgical process produces inflammation. UCSF researchers recently published work stating they may have identified a brain element that produces the immune reaction that possibly is responsible for damage in the brain stemming from surgery. This was denied for years but more and more research indicates that this is something to be concerned about.
Usually you must schedule at least three months ahead of time to see almost any physician at Mayo. Mayo may not have relationships with all insurers and it may be difficult to schedule if you have some Medicare Advantage products; this is true for many, if not most, big medical centers. You need to talk to the insurance people.