The Journal of the American Medical Association (JAMA) recently published a case about a 66 year-old man with heart disease and an enlarging abdominal aortic aneurysm (AAA). Once these aneurysms grow beyond a certain size, they may rupture and place one at the risk of bleeding to death. What I found unique about this case was not the story about the AAA but the patient’s own account of his situation, published in the same article. As the physicians taking care of this patient closely monitored the size of the AAA and aggressively managed his heart disease risk factors, the patient gradually came to accept his disease as a reality of life:
I was first diagnosed with my aneurysm about 4 or 5 years ago. My doctors found it accidentally when they were looking for problems with my esophagus. After the tests, my doctor called me and said, “I need to see you . . . now.” So I went in and she told me about the aneurysm and I went, “Oh,” feeling as if there wasn’t much else to say. I backed up, relaxed a little bit, and tried to grasp what was going on. She referred me to a cardiovascular specialist who follows me. We’ve been following the aneurysm now for about 4 years. I see my cardiovascular surgeon about every 6 months and so far it hasn’t gotten big enough for me to worry about.
I know the aneurysm can break or rupture and have dire consequences. It took about a year to let that information settle. But when it did, I realized that we have winter too, and I don’t like it either.
I came to terms with my aneurysm on an intellectual basis. There’s nothing I or anybody else can do. At some point I’m going to die, so all I can do is enjoy what I’ve got. I can’t spend my life worrying about an inevitability. That’s a waste of my time and a misdirection of my efforts.
