It's Always Something

I had my annual ultra-sound and follow up for my triple A (Abdominal Aortic Aneurysm) at Umass Medical in Worcester.

I got an early start and join the throngs headed off to their work.  I'm happy that traffic cooperated and I made it to my appointment with a few minutes to spare despite my spacing out and missing my exit.  The detour didn't take me too far off course.  I attribute this navigation error to my lack of caffeine since I had been fasting since 11PM last night.  So I had a serious case of brain fog.

My appointment is a two-parter: Ultra Sound then review/follow up with the doctor (or his associate).

I was called in for my ultra sound and I had someone in training observing and talking medical jargon.  Like most of my ultra-sounds, the attendant had a tough time due to bowel gas.  She had me take deep breaths and exhale a number of times in hopes that the gas would 'move along'.  I was hoping it didn't move further south and escape.  This could have been quite embarrassing if flatulence permeated the confines of the exam room.  I guess it was lucky for them that we had no disturbance, but the trapped gas made their job a bit harder.  I did notice there was some 'hubbub' as the were quickly riffing into medical-speak.  To me, this is generally alarming and makes the mind reel when no explanation is provided.  Eventually the hard pressing was done and I was dismissed.

I returned to the waiting room and was almost immediately called in. I was weighed and had my vitals checked and recorded.  I was told that the Nurse Practitioner will be with me shortly.  Since 2017, I've seen both a NP/AP and Dr. Schanzer. 

Nurse Practitioner, Shauneen arrived and initially said all my tests looked good.  I had no endo leak and my sac is continuing to shrink.  She said it was 3.4cm versus 3.8 last year.  She checked the pulse in my lower extremities and indicated that I had a strong pulse.  She added that I'll be returning in a year.

I got home and had a message indicating my visit notes were available in my portal. I think I found what the hubbub was about, but apparently it's not a concern.  But of course I had to look it up to see what it was.  Of course the results are varied and may or may not indicate a cancer. But since it doesn't seem to be a concern for the doctor and staff, I'm going with that.

Basically the findings were:

 

•  Duplex ultrasonography of the endovascular stent graft appeared patent.

•  No flow was seen in the residual aortic aneurysm sac by duplex ultrasonography.  The residual aneurysm measured 3.4 cm.

•  A linear hyperechoic structure was noted along the vessel wall at the level of the distal fixation. It was not possible to distinguish dissection versus plaque. This appeared to be consistent with CTA findings from 3/20/2023. The distal stent edge appeared to be poorly adhered to the vessel wall. This did not appear to be of hemodynamic significance.

 

ASSESSMENT: Satisfactory progress 7 years following endovascular repair of a an infra renal aneurysm

 

PLAN: We will plan to see him back in 1 year with a repeat EVAR duplex. He should continue on his aspirin and statin indefinitely.

 

Next appointment will be March 24, 2025.

 

More to come!