I’m writing this blog entry 31 days after I had my second TEVAR procedure. I now have the TAMBE and my aneurysm is completely sealed off . I’m glad to have it all behind me now. Last Friday I had a follow up CT angiogram to check how everything is healing. Long story short, my aneurysm is 98% sealed off and my doctor said the overall procedure was a success. But was it the right decision to have a TEVAR repair instead of the open procedure? And was this procedure really a success?
How was the back pain this time?
For the second procedure, I took time off of work. This is because I remember the back pain I experienced from the first procedure. Fortunately, the pain was much less for the second procedure, even though I thought it would likely be worse. For my aneurysm which started high up in my descending thoracic aorta and ended before my leg arteries, Doctor Tran opted to do the repair in two stages. The first stage involved adding a 200+ millimeter stent graph to the top of my descending thoracic aorta. The entire device length ended up being about 310 millimeters, so the first part actually was two-thirds of the length.
This must have helped seal off more of the blood conduits to my spine than I originally thought, even though my aorta still had blood passing throught it. The difference is, there’s nowhere for the blood to go flowing upward. The blood at the top of my aorta between my aorta and stent tubes stays there. Since it’s under blood pressure, it starts clotting. I thought getting the second part done with the TAMBE and completely sealing off the conduits that provide blood to my spine would bring more pain, but in the end it didn’t. Getting the TAMBE was actually easier than the first procedure. Doing the procedure in two stages allows your body to adapt and send blood to your spine through other pathways. This significantly reduces the chances of spinal cord ischemia.
Feeling the pressure
One thing I did notice was feeling my high blood pressure during the 4 week healing process. My doctor advised I stop taking my blood pressure medicine Amlodipine for the 4 week healing period. That apparently allows the device to set up and heal better. During this time, my high blood pressure returned and now my entire descending aorta was bypassed with a non flexing stent graph. When my blood pressure went up, I could feel it significantly in my arms in even in my head. When my blood pressure was highest, I could see my heartbeat in my left arm near my elbow. It was a little uncomfortable and even worrisome. But now that I’m back on my normal dose of Amlodipine I am feeling much better and not feeling that intense pressure anymore. I noticed my blood pressure seems to be rather high first thing in the morning. As a result, I’m taking 5mg of Amlodipine before bed and 2.5mg of Amlodipine when I wake up. That seems to smooth out my blood pressure the best throughout the day, night and first thing in the morning.
Plavix, another medication I had to take
I was also prescribed Plavix (clopidogrel) post operatively to manage blood clots. Apparently once the entire stent graph is placed and during the integration period, it’s possible that blood clots can form. Resident Doctor Arash told me during the healing process, your body builds scar tissue around the stents, locking them into place. Your body also covers the stent graphs in cells so that the medical device literally becomes part of you. After that period, then you no longer need to worry about blood clots and after 4 weeks Doctor Tran allowed me to discontinue Plavix. I didn’t really like being on Plavix because you tend to bleed easier while doing daily activities like flossing. I was glad to be off it and it takes about seven days for it to completely leave your system.
Getting back to normal
After my scan on Friday and receiving a clear bill of health with no restrictions, I was back in the gym on Saturday. I was able to finish my Yoga class without any issues, but I was really careful not make any sudden movements. I also did some cardio and started lifting weights again. While I dialed it back, I still managed to get my pulse rate up into the 150s without much effort. No problems or complaints other than I’m sore today but that just means I’m closer to getting my muscle back.
One final note for now, I did tell Doctor Tran that I had some mild upper chest discomfort on the left and right side about a week before my check up scan. I think this is normal because today it’s a week later and I’m not feeling the discomfort now. It could be the workout that helped, or knowing post scan everything was OK. Maybe it was just part of the healing process because today I don’t have any pain and can’t tell I have a 310 millimeter medical device embedded in my aorta.
