Working as a first responder with an aortic root dilation?

Hello @bcbrian87,

I'd like to invite @bitsygirl, @pconkin1 and @scottbliz to this discussion as they have all discussed an aortic dilation and may be able to share some of the lifestyle changes or restrictions they have had to take.

@bcbrian87, it sounds like you have a job that is demanding and stressful - both physically and probably mentally as well. When your cardiologist informed you to not lift over 50 pounds and to monitor your blood pressure, were they aware of your work? Did they give any work restrictions considering your demanding career? If you don't mind me asking, did your cardiologist explain the difference between a dilation and aneurysm? From my limited research, it seems as though a dilation is a preliminary finding and an aneurysm is a more advanced (and more critical) stage of a dilation?

@JustinMcClanahan Thanks for moderating. The one of many adjustments I have made is my acute awareness of blood pressure and it's affect on my 4.3 CM anuerusym. More specifically, working with your medical team to fine tune your blood pressure meds and consistently monitor your blood pressure. Diet has been a major change for me as well; low sodium, low fat intake, lots of legumes, grains, vegetables and water have helped me reduce my weight and blood pressure. I still drink coffee in moderation but have eliminated alchohol (booze not good for vascular health) - alchohol was easier give up than my coffee! The toughest change for me was weight lifting. I was instructed by my cardiologist to avoid heavy lifting-holding your breath and straining with heavy weights wreak havoc on the aneurysm. I now walk 4+ miles a day (the gold standard for healthy aortic excercise) and lift light weights with high reps. Honestly, I was scared into this healthy lifestyle-I don't know that I would of done it without the anuerysm diagnosis. It wasn't easy but definitley worth it. Accepting the disease is challenging but crucial-this forum helps. The people on this forum are me in one way or another. It's hard for people not affected by aortic disease to relate and truly understand the emotional toll of it all. The people on this forum are relatable, and they are willing to share their insight with all members in a safe & welcoming enviroment. That's huge!

Hi, @bcbrian87

I was diagnosed with a 4.5cm ascending aortic aneurysm three years ago. Yours seems to be primarily at the root? I think that may be a slightly different situation than when it's in the ascending portion. Did the physician ask you about family history?

WRT exertion/exercise, I can give you my non-professional take. I think you will find there is not a well-defined prescription for the level of exertion. It's hard to measure anything to come up with concrete suggestions because when there is a problem, no measurements are being taken and in a lab, they don't want to push people until there is a problem. 🙂 I'm sure there's a ton of individual variation as well. Doctors seem to vary a lot in their level of conservatism. My aneurysm is being monitored by a cardiac/vascular surgeon that I have a lot of faith in, and his take on my situation was "No real restrictions. Don't become a powerlifter of course." What I do think there is some consensus on, is that it is bad to exert so hard it causes you to hold your breath because it raises your blood pressure significantly (which is what should be avoided). It's call the "valsalva maneuver".

There's a researcher Dr. Siddharth Prakash at UTHealth Houston (McGovern Medical School) that has done some Q&A sessions with Aortic Hope (https://www.aortichope.org). He's pretty good at explaining the situation and making recommendations. Here's a link to start your own research (https://www.youtube.com/watch). If the link is problematic, the title is "Dr. Siddharth Prakash: exercise and thoracic aortic disease". Also, he focuses on people that have survived a dissection. I'd guess this is a different group than those that haven't.

Another thing I've surmised is that you want to avoid abrupt changes. So warm up and cool down when you exercise. I do the Norwegian 4x4, but never without warming up well and cooling down after.

Frankly, in your place and imagining what you might be required to do, I'd try to contact someone with expertise on this. It sounds like you might be lifting very heavy weights and suddenly, without the opportunity to warm up. I'm not saying there's danger, only that based on what I've learned informally, I'd want to talk to someone that can give me an answer I can trust. (In fact, I am playing the Prakash video again in the background and he said "Dissection during exercise is very rare.") The recommendations from cardiologists seem to be all over the place. Maybe Dr. Prakash could be consulted remotely? I think he's the doctor for @houston13 who, if my memory is correct, had surgery for an aneurysm. He may have a suggestion for if/how to contact Prakash.

I am older than you (67) with a 4.7cm aneurysm in my sinus of Valsalva, like yours. One of the tougher things to manage is the variability among individuals. One person lifting 100 pounds might be easy, and super tough for someone else. I think that's why we have a hard time getting guidelines beyond no Valsalva maneuver and no straining. You might benefit from getting specific guidelines from your cardiologist or a physical therapist. I have personally gone to artificial intelligence tools for specifics, but I can't guarantee it's wise to do so. If you are looking for some real numbers, before my diagnosis I bench pressed my weight (160 lbs). Now I either work with 20 pound dumbbells or 90 pounds on the bar. No straining allowed when the reps get harder. The bar might be pushing it a bit but cripes, a guy's got to do something. I'm sorry to hear about your diagnosis. If there is one bright spot, while it stinks to find out you have a thoracic aneurysm it's a lot worse to have one and not know about it.

Hello bcbrian. It is wise that you are looking hard at your new diagnosis. You are very young. Your current job is very physically demanding with unpredictable and uncontrolled fluctuations in adrenaline surges and resistive force, both of which trigger sudden increases in blood pressure. As you research this, you will be able to weigh the pros and cons of how to move forward. Dr Prakash's program in Texas (See Bitsy girl's post and Houston 13) is extremely informative. The group also has a Facebook page Aortic Athletes. The Cleveland Clinic and the Mayo Clinic put out current guidelines regarding aortic dilations of all sizes. You might want to get at minimum a consultation (if you havent already) with a cardiologist who is an aortic specialist. Your age is critical. The choices you make now may prevent future growth. Good luck with this very difficult decision, and I thank you, from the bottom of my heart, for the work you do!
Respectfully,
UPArtist