Managing Stress, High BP & Aneurysms: What can we do & not do?

Posted by suz1950 @suz1950, May 30, 2022

Hi, I was recently diagnosed with aortic aneurism after a CT Cardiac Scoring test. Both my parents had premature CAD and died in their 50s. I had a DNA test provided through work that showed I was at greater risk, so I decided to see a cardiologist.
My arteries aren't bad (overall risk at 44th percentile) and my cholesterol and triglycerides are excellent. But, my aneurism is 4.5. My primary care dr. increased my BP meds and that is helping get it back into control. My cardiologist doubled my statin to 20 and will follow up with blood tests and possibly an echocardiogram, to decide next steps. Like @mustangsally67, I want to know what I can do/should not do.
I'd love to know your views and experience with stress management. I am hoping to start up a discussion about this topic 🙂

Interested in more discussions like this? Go to the Aortic Aneurysms Support Group.

I have been under watch of my AAA for 3 years 2019, it was discovered at 4.0 in Jan ‘22 it was 4.0 and 10 months later it was 4.5, (Sono) went to vasc surgeon 2 weeks later and he ordered Ct scan and even though it read 4.5 he said by my measurements it’s 5.1 (odd) he said we need to do elective EVAR surgery and I am currently scheduled but will probably get different opinion and other measurements, he also said I had the option of waiting 6 months and Ct scan again but according to his measurements it has gone from 4.0 to 5.1 in 11 months if rate of growth stays the same it’ll be around 5.8 by then trying to find ways to keep dormant , I’m on bp and chol meds , don’t know if I should begin a cardio exercise routine ( never have) only told not to lift heavy ???

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@lisabis68

Hello- I am wondering how your appointment went? I too am an emotional mess over my diagnosis, AAA about a year ago of 4.8- discovered accidentally on a breast MRI. It has grown twice in one year, is now 5.17 and I essentially had to tell my cardiothoracic surgeon I cannot live every day as I have been, in constant panic and anxiety that I have a ticking time bomb in my chest. I am 54, in good shape, used to work out 3-4 times a week, plus do a lot physically around the house. Now I an petrified to do anything, especially learning of the recent loss of the soccer reporter to AAA. I am having a hard time staying functional while waiting for surgery. I'm actually waiting on a surgery date, but it will be open chest. I'm reading on here how much riskier they are, I don't feel like there is a choice, I need it done and I cant live like this in a constant state of panic and worry over it. Anyone else out there feeling like this and if so what is helping?

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So sorry your diagnosis is creating so much havoc in your life. There is a new set of recommendations for aortic aneurysms from the AHA. You might find something helpful there or at least information you can take to a cardiologist or cardiac surgeon. The more information I've gathered over the past year since my diagnosis, the better my questions for my Dr. and the more specific, and helpful, the responses.
I also purchased a medical alert bracelet that specifies ascending aortic aneurysm, which makes me feel like there's a better chance of getting me into surgery should it ever dissect. I think about that pilot in FL that passed out and his passenger had to land the plane. They were able to get the pilot to a hospital and repair his AA so that he survived.
I know it is difficult, but I have made it a point of not focusing on my AA, but instead think about what I am doing to take care of my health. Maybe meditation or yoga would help you refocus so that you are 't thinking about it all the time.

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This site has given me hope for the future and the feeling of not being the only one. I am blessed to have a husband, family members, few friends I told who are supportive. However, all of your stories assist me on the right positive path.

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@lisabis68

Hello- I am wondering how your appointment went? I too am an emotional mess over my diagnosis, AAA about a year ago of 4.8- discovered accidentally on a breast MRI. It has grown twice in one year, is now 5.17 and I essentially had to tell my cardiothoracic surgeon I cannot live every day as I have been, in constant panic and anxiety that I have a ticking time bomb in my chest. I am 54, in good shape, used to work out 3-4 times a week, plus do a lot physically around the house. Now I an petrified to do anything, especially learning of the recent loss of the soccer reporter to AAA. I am having a hard time staying functional while waiting for surgery. I'm actually waiting on a surgery date, but it will be open chest. I'm reading on here how much riskier they are, I don't feel like there is a choice, I need it done and I cant live like this in a constant state of panic and worry over it. Anyone else out there feeling like this and if so what is helping?

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I agree, this is a stressful diagnosis. Hang on. The fact that you have a surgery planned has to be reassuring. You say you are reading on how much riskier the open chest is? That is confusing. Riskier than what? In order to repair the aneurysm, they use the heart/lung machine so your chest has to be open. The minimally invasive procedures are still open.
I just had mine repaired in August-- along with a new bovine valve. It was a much more complex procedure than I expected , since my aorta was in bad shape. I am 77 yrs old. The sternal wound is not as sore as I thought it would be. Getting used to the change in the cardiac output as it heals is the recovery issue. Weakness surprised me. I'm feeling better all the time.
I wish you the best. You will survive. There are always war stories about every diagnosis. The soccer player was that exception. Many people survive-- even with a dissection. Live your life, being grateful for each breath and that you live in the USA where surgery can be an option.

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oops, I need to correct myself. I was not thinking of the TEVAR procedures when I asked about riskier than what. Where is your aneurysm? Ascending or descending Aorta. TEVAR is especially suited to treat aneurysms in your descending aorta – the part that moves down through your chest toward your belly. These procedures are great. They are basically a splint across the defect. If the defect or ballooning out of the aneurysm needs a full repair- then that means an open procedure. TEVAR were traditionally / typically offered to older individuals who would not tolerate the bigger procedure. Science is getting better all the time, so now TEVAR is offered to younger people. Ultimately, the surgeon knows which procedure works best in his/her hands.

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Hi @lisabis68, @madscientist and all,
I've wanted to respond to the responses here since madscientist first posted but have not been ready until now--almost 7 months after being diagnosed. I thought I'd share what I've done since then, since I had the exact same feelings you're discussed
lisabis68 - I too, felt like I had a ticking time bomb in my chest after my TAA was discovered accidentally and being in a constant state of panic
madscientist - "I have always prided myself on being able to handle my stresses and stressors well; I don't believe that's true anymore. I'm not very good at all, but I don't know what to do to get better." That is a very tough place to be when you have been (interpreting your life here) very successful and feeling in control of your own destiny before.
tiger62 - "I’m still so anxious and constantly thinking about the unknown inevitable I have to pray and just keep praying to keep some type of sanity going on ..."
dewander501 - Like you, my root cause is hypertension, which was well-controlled by Lotrel 5/10 then suddenly wasn't. I also had (and still have) your focus on problem solving and being tough. Loved your story about Hurricane Ian and can relate to how life changing that was for you.
booklover - the importance of "having someone to talk with and help with solutions."
jeanrn01 - I agree 100@ with "speaking with my doctors seemed to help me a lot, and just having a plan in place"
So, what have I done in the past 7 months to deal with this better?
Basically I took the advice of the kind folks who initially responded at https://connect.mayoclinic.org/discussion/stress-management-high-blood-pressure-and-aortic-aneurisms/ and customized what they said to my needs. Knowing that I rely on problem-based coping, I reflected on what I saw as the main problems.
1. Blood pressure no longer well controlled - advocated for myself by talking to my cardiologist and PCP by emphasizing how big a problem I think that is and how I need their help managing it. While I really like both those providers, honestly they conveyed a more blase attitude that I felt was appropriate.
2. My biggest "self-management" issue was and continues to be anxiety. This is mostly produced by my job, which I love but which gets pretty intense at times. It also has roots in my exaggerated sense of always being able to create my own destiny.
I did 2 things about this: a) developed my own "protocol" consisting of prayer, meditation, journalling, making a serious effort to address the insomnia resulting from anxiety in the middle of the night, exercising (which is tough for me because I have a disability and have never been that active), and promoting relaxation in my daily life through apple-scented candles, periodic use of CBD oil, taking breaks during working hours by listening to music and doing things I enjoy).
I also worked on myself by cultivating more openness about talking with others about the aneurysm and practicing mindfulness by addressing things other than work (household stuff, always a low priority but remarkably helpful for learning to make mindfulness part of my day).
All of this has helped me a great deal--as a package, not any one thing. I can't emphasize that enough, it really is the little things that add up to gaining a better perspective. That said, I think communicating more and openly, assertively, and honestly with providers and family/friends have probably had the most impact. Most recently, I initiated a conversation with my cardiologist on "what do I do if I start having symptoms of aortic dissection (I imagine it would be too late with a rupture? Do I go to the nearest ER and trust they'll triage me appropriately? etc. He suggested I set up a consultation with a surgeon at the Aortic Center in our same health system, saying he'd referred others who reported they felt better after that. This was a game-changer, because the surgeon had "news I could use," specifically:
1. looking at the results of my CT scoring test and echo, he saw me as having a low risk of dissection BUT
2. ordered additional tests - CT scans of both thorax and abdomen, with and without contrast and a DNA test to see if I have any of the (very numerous) genetic markers that would put me at greater risk and potentially change my risk level.
3. I'm now enrolled in their aortic program with very specific directions on what to do if I have, specifically, severe chest pain radiating to my back.

I feel a lot better after this and very grateful for the milestones along my journey so far. [I've also continued the gratitude meditations I've done every day for ~ the past 5 years.] As soon as I heard about Grant Wahl's death, I had a hunch that the cause was an ascending aortic aneurysm! I feel that we can all have some measure of gratitude for finding out we have this condition, in spite of the anxiety it causes. And, I have to say I am very grateful for the support of this Mayo group and the opportunity to share hopes, fears, and triumphs with all of you.

REPLY
@suz1950

Hi @lisabis68, @madscientist and all,
I've wanted to respond to the responses here since madscientist first posted but have not been ready until now--almost 7 months after being diagnosed. I thought I'd share what I've done since then, since I had the exact same feelings you're discussed
lisabis68 - I too, felt like I had a ticking time bomb in my chest after my TAA was discovered accidentally and being in a constant state of panic
madscientist - "I have always prided myself on being able to handle my stresses and stressors well; I don't believe that's true anymore. I'm not very good at all, but I don't know what to do to get better." That is a very tough place to be when you have been (interpreting your life here) very successful and feeling in control of your own destiny before.
tiger62 - "I’m still so anxious and constantly thinking about the unknown inevitable I have to pray and just keep praying to keep some type of sanity going on ..."
dewander501 - Like you, my root cause is hypertension, which was well-controlled by Lotrel 5/10 then suddenly wasn't. I also had (and still have) your focus on problem solving and being tough. Loved your story about Hurricane Ian and can relate to how life changing that was for you.
booklover - the importance of "having someone to talk with and help with solutions."
jeanrn01 - I agree 100@ with "speaking with my doctors seemed to help me a lot, and just having a plan in place"
So, what have I done in the past 7 months to deal with this better?
Basically I took the advice of the kind folks who initially responded at https://connect.mayoclinic.org/discussion/stress-management-high-blood-pressure-and-aortic-aneurisms/ and customized what they said to my needs. Knowing that I rely on problem-based coping, I reflected on what I saw as the main problems.
1. Blood pressure no longer well controlled - advocated for myself by talking to my cardiologist and PCP by emphasizing how big a problem I think that is and how I need their help managing it. While I really like both those providers, honestly they conveyed a more blase attitude that I felt was appropriate.
2. My biggest "self-management" issue was and continues to be anxiety. This is mostly produced by my job, which I love but which gets pretty intense at times. It also has roots in my exaggerated sense of always being able to create my own destiny.
I did 2 things about this: a) developed my own "protocol" consisting of prayer, meditation, journalling, making a serious effort to address the insomnia resulting from anxiety in the middle of the night, exercising (which is tough for me because I have a disability and have never been that active), and promoting relaxation in my daily life through apple-scented candles, periodic use of CBD oil, taking breaks during working hours by listening to music and doing things I enjoy).
I also worked on myself by cultivating more openness about talking with others about the aneurysm and practicing mindfulness by addressing things other than work (household stuff, always a low priority but remarkably helpful for learning to make mindfulness part of my day).
All of this has helped me a great deal--as a package, not any one thing. I can't emphasize that enough, it really is the little things that add up to gaining a better perspective. That said, I think communicating more and openly, assertively, and honestly with providers and family/friends have probably had the most impact. Most recently, I initiated a conversation with my cardiologist on "what do I do if I start having symptoms of aortic dissection (I imagine it would be too late with a rupture? Do I go to the nearest ER and trust they'll triage me appropriately? etc. He suggested I set up a consultation with a surgeon at the Aortic Center in our same health system, saying he'd referred others who reported they felt better after that. This was a game-changer, because the surgeon had "news I could use," specifically:
1. looking at the results of my CT scoring test and echo, he saw me as having a low risk of dissection BUT
2. ordered additional tests - CT scans of both thorax and abdomen, with and without contrast and a DNA test to see if I have any of the (very numerous) genetic markers that would put me at greater risk and potentially change my risk level.
3. I'm now enrolled in their aortic program with very specific directions on what to do if I have, specifically, severe chest pain radiating to my back.

I feel a lot better after this and very grateful for the milestones along my journey so far. [I've also continued the gratitude meditations I've done every day for ~ the past 5 years.] As soon as I heard about Grant Wahl's death, I had a hunch that the cause was an ascending aortic aneurysm! I feel that we can all have some measure of gratitude for finding out we have this condition, in spite of the anxiety it causes. And, I have to say I am very grateful for the support of this Mayo group and the opportunity to share hopes, fears, and triumphs with all of you.

Jump to this post

suz1950, I am joyful that many assisted you as you adjusted to this new health issue. Thank you for mentioning and including my name though I felt others gave so much more help. Sometimes when we share we have no idea if it will or will not help someone. I have not shared my TAA with anyone with the exception of my husband. my adult children, two neighbors, and three very close friends. Since finding out in October I decided to not say anything and let myself and others enjoy the holiday. This site has assisted me in learning more and reading the stories shared has given me a sense of a caring community. I was able to calmly access this surprise condition and have not yet needed professional mental health, but you can bet your boots I will seek it when and if the time comes. Happy holidays and a bright New Year to all.

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