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DEFINITION
Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood. When this happens, your bones increase in size, including those of your hands, feet and face. Acromegaly usually affects middle-aged adults.

In children who are still growing, too much growth hormone can cause a condition called gigantism. These children have exaggerated bone growth and an abnormal increase in height.

Because acromegaly is uncommon and physical changes occur gradually, the condition often isn't recognized immediately; sometimes not for years. If not treated promptly, acromegaly can lead to serious illness and even become life-threatening. However, available treatments for acromegaly can reduce your risk of complications and significantly improve your symptoms, including the enlargement of your features.

SYMPTOMS
One of the most common signs of acromegaly is enlarged hands and feet. People with this disorder often notice that they can no longer put on rings that used to fit and that their shoe size has progressively increased.

Acromegaly may also cause you to experience gradual changes in the shape of your face, such as a protruding lower jaw and brow, an enlarged nose, thickened lips, and wider spacing between your teeth.

Because acromegaly tends to progress slowly, early signs may not be readily apparent for several years. Sometimes, people notice the condition only by comparing old photographs.

Acromegaly may produce the following signs and symptoms, which can vary from one person to another:

Enlarged hands and feet
Coarsened, enlarged facial features
Coarse, oily, thickened skin
Excessive sweating and body odor
Small outgrowths of skin tissue (skin tags)
Fatigue and muscle weakness
A deepened, husky voice due to enlarged vocal cords and sinuses
Severe snoring due to obstruction of the upper airway
Impaired vision
Headaches
Enlarged tongue
Pain and limited joint mobility
Menstrual cycle irregularities in women
Erectile dysfunction in men
Enlarged liver, heart, kidneys, spleen and other organs
Increased chest size (barrel chest)
When to see a doctor
If you have signs and symptoms associated with acromegaly, contact your doctor for an evaluation.

Acromegaly usually develops slowly, and even your family members may not initially notice the gradual physical changes that occur with this disorder. Early diagnosis is important, however, so that you can receive proper care. Acromegaly can lead to serious complications if it's not treated.

CAUSES
Acromegaly is caused by the pituitary gland overproducing growth hormone (GH) over time. The pituitary, a small gland situated at the base of your brain behind the bridge of your nose, produces a number of hormones. GH plays an important role in managing your physical growth.

When GH is secreted into your bloodstream, it triggers your liver to produce a hormone called insulin-like growth factor-I (IGF-I). In turn, IGF-I stimulates the growth of bones and other tissues. If your pituitary gland makes too much GH, excessive amounts of IGF-I can result. Too much IGF-I can cause abnormal growth of your soft tissues and skeleton and other signs and symptoms characteristic of acromegaly and gigantism.

In adults, a tumor is the most common cause of too much GH production:

Pituitary tumors. Most cases of acromegaly are caused by a noncancerous (benign) tumor (adenoma) of the pituitary gland. The tumor secretes excessive amounts of growth hormone, causing many of the signs and symptoms of acromegaly. Some of the symptoms of acromegaly, such as headaches and impaired vision, are due to the tumor mass pressing on nearby brain tissues.
Nonpituitary tumors. In a few people with acromegaly, tumors in other parts of the body, such as the lungs, pancreas or adrenal glands, cause the disorder. Sometimes, these tumors actually secrete GH. In other cases, the tumors produce a hormone called growth hormone-releasing hormone (GH-RH), which stimulates the pituitary to make more GH.
COMPLICATIONS
Progression of acromegaly can result in major health problems. Complications may include:

High blood pressure (hypertension)
Cardiovascular disease, particularly enlargement of the heart (cardiomyopathy)
Osteoarthritis
Diabetes mellitus
Precancerous growths (polyps) on the lining of your colon
Sleep apnea, a condition in which breathing repeatedly stops and starts during sleep
Carpal tunnel syndrome
Reduced secretion of other pituitary hormones (hypopituitarism)
Uterine fibroids, benign tumors in the uterus
Spinal cord compression
Vision loss
Early treatment of acromegaly can prevent these complications from developing or becoming worse. If untreated, acromegaly and its complications can lead to premature death.

PREPARING FOR YOUR APPOINTMENT
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases, you may be referred immediately to a doctor who specializes in hormonal disorders (endocrinologist).

It's good to prepare for your appointment. Here's some information to help you get ready for your appointment and to know what to expect from your doctor.

What you can do
Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do to prepare for diagnostic tests.
Write down the symptoms you're experiencing. Your doctor will want to know about anything that is causing you discomfort or concern, such as headaches, vision changes or discomfort in your hands, even if those symptoms seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any changes in your s*x life or, if you're a woman, in your menstrual cycle.
Make a list of all medications, vitamins and supplements you're taking.
Take along old photographs that your doctor can use to compare against your appearance today. Your doctor will likely be interested in photos from 10 years ago through the present.
Take along a family member or friend, if possible. Someone who accompanies you may remember something that you miss or forget.
Write down questions to ask your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For acromegaly, some basic questions to ask your doctor include:

What is likely causing my symptoms or condition?
Other than the most likely cause, what are possible causes for my symptoms or condition?
What tests do I need?
What treatments are available for this condition? Which approach do you recommend?
How long will I need treatment before my symptoms improve?
With treatment, will I go back to looking and feeling as I did before I developed symptoms of acromegaly?
Will I have long-term complications from this condition?
I have these other health conditions. How can I best manage them together?
Are there any restrictions I need to follow?
Should I see a specialist?
Is there a generic alternative to the medicine you're prescribing?
Are there brochures or other printed material I can take with me? What websites do you recommend?
Don't hesitate to ask any other questions you have.

What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:

What symptoms are you experiencing, and when did they appear?
Have you noticed any changes in how you feel or how you look? Has your s*x life changed? How are you sleeping? Do you have headaches or joint pain, or has your vision changed? Have you noticed excessive sweating?
Does anything seem to improve or worsen your symptoms?
How much would you say your features have changed over time? Do you have old pictures I can use for comparison?
Do your old shoes and rings still fit? If not, how much has their fit changed over time?
Have you had colon cancer screening?
TESTS AND DIAGNOSIS
To begin the diagnostic process, your doctor will take a medical history and conduct a physical exam. Then he or she may recommend the following steps:

GH and IGF-I measurement. After you've fasted overnight, your doctor will take a blood sample to measure your levels of GH and IGF-I. Elevated levels of these hormones suggest acromegaly.
Growth hormone suppression test. This is the definitive method for verifying acromegaly. In this test, your blood levels of GH are measured before and after you drink a preparation of sugar (glucose). Normally, glucose ingestion depresses levels of GH. If you have acromegaly, your GH level will tend to stay high.
Imaging. Your doctor may recommend that you undergo an imaging procedure, such as magnetic resonance imaging (MRI), to help pinpoint the location and size of a tumor of your pituitary gland. If radiologists, who usually perform the procedures, see no tumor of your pituitary, they may look for nonpituitary tumors that might be responsible for high levels of GH.
TREATMENTS AND DRUGS
Treatment focuses on lowering your production of GH, as well as reducing the negative effects of the tumor on the pituitary and surrounding tissues. You may need more than one type of treatment.

Surgery
Doctors can remove most pituitary tumors using a method called transsphenoidal surgery. In this procedure, your surgeon works through your nose to extract the pituitary tumor.

Removing the tumor can normalize GH production and eliminate the pressure on the tissues surrounding your pituitary to relieve associated signs and symptoms. In some cases, your surgeon may not be able to remove the entire tumor. This may result in persistently elevated GH levels after surgery, requiring further medical or radiation treatments.

Because of the complex nature of the procedure, it's important to choose a surgeon experienced in performing this type of surgery. Usually, the more experienced the surgeon, the better the final outcome.

Medications
Drugs used to lower the production or block the action of GH include:

Somatostatin analogues. The drugs octreotide (Sandostatin) and lanreotide (Somatuline Depot) are synthetic versions of the brain hormone somatostatin. They can interfere with the excessive secretion of GH by the pituitary, and thus can produce rapid declines in GH levels. When starting octreotide treatment, you initially inject yourself with a short-acting preparation under your skin (subcutaneously) three times a day to determine if you have any side effects from the medication and if it's effective. Then, if it's tolerated and effective, you can take a long-acting form that requires an injection into the muscles of your buttocks (gluteal muscles) by a health care professional, administered once a month. Lanreotide is administered as a subcutaneous injection once a month.
Dopamine agonists. The medications cabergoline and bromocriptine (Parlodel) are taken as pills. In some people, these drugs can lower levels of GH and IGF-I. The tumor may decrease in size in some people taking a dopamine agonist or somatostatin analogues. Some people may develop compulsive behaviors, such as gambling, while taking these medications.
Growth hormone antagonist. The medication pegvisomant (Somavert), a growth hormone antagonist, acts to block the effect of GH on body tissues. Pegvisomant may be particularly helpful for people who haven't had good success with other forms of treatment. You administer this medication yourself daily by subcutaneous injection. This medication can normalize IGF-I levels and relieve symptoms in most people with acromegaly, but doesn't lower GH levels or reduce the tumor size.
Radiation
Your doctor may recommend radiation treatment when tumor cells remain after surgery. Radiation therapy destroys any lingering tumor cells and slowly reduces GH levels. It may take years for this treatment to noticeably improve acromegaly symptoms.

You receive radiation treatment in one of two ways:

Conventional radiation therapy. This type of radiation therapy is usually given every weekday over a period of four to six weeks. You may not realize the full effect of conventional radiation therapy for 10 or more years after treatment.
Stereotactic radiosurgery. Also known as Gamma Knife radiosurgery, stereotactic radiosurgery can deliver a high dose of radiation to the tumor cells in a single dose while limiting the amount of radiation to the normal surrounding tissues. This type of radiation may bring GH levels back to normal within three to five years.
Stereotactic radiosurgery is available at only a few U.S. medical centers and is not recommended for all people undergoing radiation for acromegaly. Your doctor will determine which type of radiation therapy is right for you based on:

The size and location of your remaining tumor cells
Your levels of insulin-like growth factor-I (IGF-I)
Even after initial treatment, acromegaly requires periodic monitoring by your doctor to make sure that your pituitary is functioning properly. This follow-up care may last for the rest of your life.

DEFINITION
Amnesia refers to the loss of memories, such as facts, information and experiences. Though having no sense of who you are is a common plot device in movies and television, real-life amnesia generally doesn't cause a loss of self-identity.

Instead, people with amnesia — also called amnestic syndrome — are usually lucid and know who they are, but may have trouble learning new information and forming new memories.

Amnesia can be caused by damage to areas of the brain that are vital for memory processing. Unlike a temporary episode of memory loss (transient global amnesia), amnesia can be permanent.

There's no specific treatment for amnesia, but techniques for enhancing memory and psychological support can help people with amnesia and their families cope.

SYMPTOMS
The two main features of amnesia are:

Impaired ability to learn new information following the onset of amnesia (anterograde amnesia)
Impaired ability to recall past events and previously familiar information (retrograde amnesia)
Most people with amnesia have problems with short-term memory — they can't retain new information. Recent memories are most likely to be lost, while more remote or deeply ingrained memories may be spared. Someone may recall experiences from childhood or know the names of past presidents, but not be able to name the current president or remember what month it is or what was for breakfast.

Isolated memory loss doesn't affect a person's intelligence, general knowledge, awareness, attention span, judgment, personality or identity. People with amnesia usually can understand written and spoken words and can learn skills such as bike riding or piano playing. They may understand they have a memory disorder.

Amnesia isn't the same as dementia. Dementia often includes memory loss, but it also involves other significant cognitive problems that lead to a decline in the ability to carry out daily activities.

A pattern of forgetfulness is also a common symptom of mild cognitive impairment (MCI), but the memory and other cognitive problems in MCI aren't as severe as those experienced in dementia.

Additional signs and symptoms
Depending on the cause of the amnesia, other signs and symptoms may include:

False recollections (confabulation), either completely invented or made up of genuine memories misplaced in time
Confusion or disorientation
When to see a doctor
Anyone who experiences unexplained memory loss, head injury, confusion or disorientation requires immediate medical attention.

A person with amnesia may not be able to identify his or her location or have the presence of mind to seek medical care. If someone you know has symptoms of amnesia, help the person get medical attention.

CAUSES
Normal memory function involves many parts of the brain, and any disease or injury that affects the brain can interfere with the intricacies of memory.

Amnesia can result from damage to brain structures that form the limbic system, which controls your emotions and memories. These structures include the thalamus, which lies deep within the center of your brain, and the hippocampal formations, which are situated within the temporal lobes of your brain.

Amnesia caused by brain injury or damage is known as neurological amnesia. Possible causes of neurological amnesia include:

Stroke
Brain inflammation (encephalitis) as a result of infection with a virus such as herpes simplex virus, as an autoimmune reaction to cancer somewhere else in the body (paraneoplastic limbic encephalitis), or as an autoimmune reaction in the absence of cancer
Lack of adequate oxygen in the brain, for example, from heart attack, respiratory distress or carbon monoxide poisoning
Long-term alcohol abuse leading to thiamin (vitamin B-1) deficiency (Wernicke-Korsakoff syndrome)
Tumors in areas of the brain that control memory
Degenerative brain diseases, such as Alzheimer's disease and other forms of dementia
Seizures
Certain medications, such as benzodiazepines
Head injuries that cause a concussion, whether from a car accident or sports, can lead to confusion and problems remembering new information. This is especially common in the early stages of recovery. But head injuries usually don't cause severe amnesia.

Another rare type of amnesia, called dissociative (psychogenic) amnesia, stems from emotional shock or trauma, such as being the victim of a violent crime. In this disorder, a person may lose personal memories and autobiographical information, but usually only briefly.

RISK FACTORS
The chance of developing amnesia might increase if you've experienced:

Brain surgery, head injury or trauma
Stroke
Alcohol abuse
Seizures
COMPLICATIONS
Amnesia varies in severity and scope, but even mild amnesia takes a toll on daily activities and quality of life. The syndrome can cause problems at work, at school and in social settings.

It may not be possible to recover lost memories. Some people with severe memory problems need to live in a supervised situation or extended-care facility.

PREPARING FOR YOUR APPOINTMENT
You're likely to start by seeing your family doctor or a general practitioner. However, you may then be referred to a doctor who specializes in disorders of the brain and nervous system (neurologist).

It's a good idea to arrive at your appointment well-prepared. Here's some information to help you get ready for your appointment and to know what to expect from your doctor.

What you can do
Write down any unusual symptoms as you experience them, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life changes you can recall. Ask family members or friends to help you, to ensure your list is complete.
Make a list of all medications, vitamins or supplements you're taking.
Ask a family member or friend to come with you. Even in the best circumstances, it can be difficult to remember all of the information provided to you during an appointment. Someone with you can help you remember everything that was said.
Bring a notepad and pen or pencil to jot down the points you want to be sure to remember later.
Write down questions to ask your doctor.
Preparing a list of questions can help you make the most of your time with your doctor, as well as ensure that you cover everything you want to ask. For amnesia, some basic questions to ask your doctor include:

What's the most likely cause of my symptoms?
Are there other possible causes for my symptoms?
What kinds of tests do I need? Do these tests require any special preparation?
Will my memory ever come back?
What treatments are available, and which do you recommend?
I have other health conditions. How can I best manage them together?
Do I need to restrict any activities?
Are there any brochures or other printed material that I can take home? What websites do you recommend?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:

When did you first notice your memory loss?
Did you experience any other symptoms at that time?
Were you involved in any trauma? For example, a car accident, violent collision in sports or an assault?
Did an illness or another event seem to trigger the memory loss?
Does anything help improve your memory?
What, if anything, appears to worsen your memory loss?
Are the memory problems intermittent or constant?
Has the memory loss stayed the same or is it getting worse?
Did the memory loss come on suddenly or gradually?
TESTS AND DIAGNOSIS
To diagnose amnesia, a doctor will do a comprehensive evaluation to rule out other possible causes of memory loss, such as Alzheimer's disease, other forms of dementia, depression or brain tumor.

Medical history
The evaluation starts with a detailed medical history. Because the person with memory loss may not be able to provide thorough information, a family member, friend or another caregiver generally takes part in the interview as well.

The doctor will ask many questions to understand the memory loss. Issues that might be addressed include:

Type of memory loss — recent or long term
When the memory problems started and how they progressed
Triggering factors, such as head injury, stroke or surgery
Family history, especially of neurological disease
Drug and alcohol use
Other signs and symptoms, such as confusion, language problems, personality changes or impaired ability to care for self
History of seizures, headaches, depression or cancer
Physical exam
The physical examination may include a neurological exam to check reflexes, sensory function, balance, and other physiological aspects of the brain and nervous system.

Cognitive tests
The doctor will test the person's thinking, judgment, and recent and long-term memory. He or she will check the person's knowledge of general information — such as the name of the current president — as well as personal information and past events.

The memory evaluation can help determine the extent of memory loss and provide insights about what kind of help the person may need.

Diagnostic tests
Imaging tests — including MRI and CT scan — may be ordered to look for damage or abnormalities in the brain. Blood tests can check for infection, nutritional deficiencies or other issues. An electroencephalogram may be ordered to look for the presence of seizure activity.

TREATMENTS AND DRUGS
Treatment for amnesia focuses on techniques and strategies to help make up for the memory problem.

Occupational therapy
A person with amnesia may work with an occupational therapist to learn new information to replace what was lost, or to use intact memories as a basis for taking in new information.

Memory training may also include a variety of strategies for organizing information so that it's easier to remember and for improving understanding of extended conversation.

Technological assistance
Many people with amnesia find it helpful to use smart technology, such as a smartphone or a hand-held tablet device. With some training and practice, even people with severe amnesia can use these electronic organizers to help with day-to-day tasks. For example, smartphones can be programmed to remind them about important events or to take medications.

Low-tech memory aids include notebooks, wall calendars, pill minders, and photographs of people and places.

Medications or supplements
No medications are currently available for treating most types of amnesia.

Amnesia caused by Wernicke-Korsakoff syndrome involves a lack of thiamin. Treatment includes replacing this vitamin and providing proper nutrition. Although treatment, which also needs to include alcohol abstinence, can help prevent further damage, most people won't recover all of their lost memory.

Researchers are investigating several neurotransmitters involved in memory formation, which may one day lead to new treatments for memory disorders. But the complexity of the brain processes involved makes it unlikely that a single medication will be able to resolve memory problems.

LIFESTYLE AND HOME REMEDIES
Because damage to the brain can be a root cause of amnesia, it's important to take steps to minimize your chance of a brain injury. For example:

Avoid excessive alcohol use.
Wear a helmet when bicycling and a seat belt when driving.
Treat any infection quickly so that it doesn't have a chance to spread to the brain.
Seek immediate medical treatment if you have any symptoms that suggest a stroke or brain aneurysm, such as a severe headache or one-sided numbness or paralysis.
COPING AND SUPPORT
Living with amnesia can be frustrating for those with memory loss, and for their family and friends, too. People with more-severe forms of amnesia may require direct assistance from family, friends or professional caregivers.

It can be helpful to talk with others who understand what you're going through, and who may be able to provide advice or tips on living with amnesia. Ask your doctor if he or she knows of a support group in your area for people with amnesia and their loved ones.

If an underlying cause for the amnesia is identified, there are national organizations that can provide additional information or support for the individual and their families. Examples include:

The Alzheimer's Association (800-272-3900)
The Brain Injury Association of America (800-444-6443)

DEFINITION
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta, about the thickness of a garden hose, runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding.

Depending on the size and rate at which your abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Once an abdominal aortic aneurysm is found, doctors will closely monitor it so that surgery can be planned if it's necessary. Emergency surgery for a ruptured abdominal aortic aneurysm can be risky.

SYMPTOMS
Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Others expand quickly. Predicting how fast an abdominal aortic aneurysm may enlarge is difficult.

As an abdominal aortic aneurysm enlarges, some people may notice:

A pulsating feeling near the navel
Deep, constant pain in your abdomen or on the side of your abdomen
Back pain
When to see a doctor
You should see your doctor if you have any of the symptoms listed above.

Anyone age 60 and older who has risk factors for developing an abdominal aortic aneurysm, such as smoking or a family history of abdominal aortic aneurysm, should consider regular screening for the condition. Because being male and smoking significantly increase the risk of abdominal aortic aneurysm, men ages 65 to 75 who have ever smoked ci******es should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound.

If you have a family history of abdominal aortic aneurysm, your doctor may recommend an ultrasound exam to screen for the condition.

There are no specific screening recommendations for women. Ask your doctor if you need to have an ultrasound screening based on your risk factors.

CAUSES
Most aortic aneurysms occur in the part of your aorta that's in your abdomen. Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including:

To***co use. Cigarette smoking and other forms of to***co use appear to increase your risk of aortic aneurysms. In addition to the damaging effects that smoking causes directly to the arteries, smoking contributes to the buildup of fatty plaques in your arteries (atherosclerosis) and high blood pressure. Smoking can also cause your aneurysm to grow faster by further damaging your aorta.
Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat and other substances build up on the lining of a blood vessel, increasing your risk of an aneurysm.
Infection in the aorta (vasculitis). In rare cases, abdominal aortic aneurysm may be caused by an infection or inflammation that weakens a section of the aortic wall.
Aneurysms can develop anywhere along the aorta, but when they occur in the upper part of the aorta, they are called thoracic aortic aneurysms. More commonly, aneurysms form in the lower part of your aorta and are called abdominal aortic aneurysms. These aneurysms may also be referred to as AAA or triple A.

RISK FACTORS
Abdominal aortic aneurysm risk factors include:

Age. Abdominal aortic aneurysms occur most often in people age 65 and older.
To***co use. To***co use is a strong risk factor for the development of an abdominal aortic aneurysm. The longer you've smoked or chewed to***co, the greater your risk.
Atherosclerosis. Atherosclerosis, the buildup of fat and other substances that can damage the lining of a blood vessel, increases your risk of an aneurysm.
Being male. Men develop abdominal aortic aneurysms much more often than women do.
Family history. People who have a family history of abdominal aortic aneurysm are at increased risk of having the condition. People who have a family history of aneurysms tend to develop aneurysms at a younger age and are at higher risk of rupture.
COMPLICATIONS
Tears in the wall of the aorta (dissection) are the main complications of abdominal aortic aneurysm. A ruptured aortic aneurysm can lead to life-threatening internal bleeding. In general, the larger the aneurysm, the greater the risk of rupture.

Signs and symptoms that your aortic aneurysm has burst include:

Sudden, intense and persistent abdominal or back pain
Pain that radiates to your back or legs
Sweatiness
Clamminess
Dizziness
Nausea
Vomiting
Low blood pressure
Fast pulse
Loss of consciousness
Shortness of breath
Another complication of aortic aneurysms is the risk of blood clots. Small blood clots can develop in the area of the aortic aneurysm. If a blood clot breaks loose from the inside wall of an aneurysm and blocks a blood vessel elsewhere in your body, it can cause pain or block the blood flow to the legs, toes, kidneys or abdominal organs.

PREPARING FOR YOUR APPOINTMENT
If you think you may have an abdominal aortic aneurysm, or are worried about your aneurysm risk because of a strong family history, make an appointment with your family doctor. If an aneurysm is found early, your treatment may be easier and more effective.

Since many abdominal aortic aneurysms are found during a routine physical exam, or while your doctor is looking for another condition, there are no special preparations necessary. If you're being screened for an aortic aneurysm, your doctor will likely ask if anyone in your family has ever had an aortic aneurysm, so have that information ready.

Because appointments can be brief and there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do
Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet. For an ultrasound or echocardiogram, for example, you may need to fast for a period of time beforehand.
Write down any symptoms you're experiencing, including any that may seem unrelated to an abdominal aortic aneurysm.
Write down key personal information, including a family history of heart disease or aneurysms.
Make a list of all medications, vitamins or supplements that you're taking.
Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
Be prepared to discuss your diet, exercise habits and to***co use. If you don't already follow a healthy diet or exercise routine, talk to your doctor about any challenges you might face in getting started. Be sure to tell your doctor if you're a current or former smoker.
Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For an abdominal aortic aneurysm, some basic questions to ask your doctor include:

What's the most likely cause of my symptoms?
What kinds of tests will I need?
What treatments are available, and which do you think would be the best treatment for me?
What's an appropriate level of physical activity?
How often do I need to be screened for this aneurysm?
Should I tell other family members to be screened for an aneurysm?
I have other health conditions. How can I best manage these conditions together?
Is there a generic alternative to the medicine you're prescribing me?
Are there any brochures or other printed material that I can take home with me?
What websites do you recommend visiting for more information?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

When did you first notice your symptoms?
Do your symptoms come and go, or do you always feel them?
How severe are your symptoms?
Do you have a family history of aneurysms?
Have you ever smoked?
Does anything seem to improve your symptoms?
What, if anything, appears to worsen your symptoms?
What you can do in the meantime
It's never too early to make healthy lifestyle changes, such as quitting smoking, eating healthy foods and becoming more physically active. These are primary lines of defense to keep your blood vessels healthy and prevent an abdominal aortic aneurysm from developing or worsening.

If you're diagnosed with an abdominal aortic aneurysm, you should ask about the size of your aneurysm, whether your doctor has noticed any changes, and how frequently you should visit your doctor for follow-up appointments.

TESTS AND DIAGNOSIS
Abdominal aortic aneurysms are often found during an examination for another reason. For example, during a routine exam, your doctor may feel a pulsating bulge in your abdomen, though it's unlikely your doctor will be able to hear signs of an aneurysm through a stethoscope. Aortic aneurysms are often found during routine medical tests, such as a chest X-ray or ultrasound of the heart or abdomen, sometimes ordered for a different reason.

If your doctor suspects that you have an aortic aneurysm, specialized tests can confirm it. These tests might include:

Abdominal ultrasound. This exam can help diagnose an abdominal aortic aneurysm. During this painless exam, you lie on your back on an examination table and a small amount of warm gel is applied to your abdomen. The gel helps eliminate the formation of air pockets between your body and the instrument the technician uses to see your aorta, called a transducer. The technician presses the transducer against your skin over your abdomen, moving from one area to another. The transducer sends images to a computer screen that the technician monitors to check for a potential aneurysm.
Computerized tomography (CT) scan. This painless test can provide your doctor with clear images of your aorta. During a CT scan, you lie on a table inside a doughnut-shaped machine called a gantry. Detectors inside the gantry measure the radiation that has passed through your body and converts it into electrical signals. A computer gathers these signals and assigns them a color ranging from black to white, depending on signal intensity. The computer then assembles the images and displays them on a computer monitor.
Magnetic resonance imaging (MRI). MRI is another painless imaging test. Most MRI machines contain a large magnet shaped like a doughnut or tunnel. You lie on a movable table that slides into the tunnel. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. Your doctor can use the images produced by the signals to see if you have an aneurysm.
Regular screening for people at risk of abdominal aortic aneurysms
The U.S. Preventive Services Task Force recommends that men ages 65 to 75 who have ever smoked should have a one-time screening for abdominal aortic aneurysm using abdominal ultrasound. People older than age 60 with a family history of abdominal aortic aneurysm or other risk factors should talk with their doctors about whether to have a screening ultrasound.

TREATMENTS AND DRUGS
Here are the general guidelines for treating abdominal aortic aneurysms.

Small aneurysm
If you have a small abdominal aortic aneurysm — about 1.6 inches, or 4 centimeters (cm), in diameter or smaller — and you have no symptoms, your doctor may suggest a watch-and-wait (observation) approach, rather than surgery. In general, surgery isn't needed for small aneurysms because the risk of surgery likely outweighs the risk of rupture.

If you choose this approach, your doctor will monitor your aneurysm with periodic ultrasounds, usually every six to 12 months and encourage you to report immediately if you start having abdominal tenderness or back pain — potential signs of a dissection.

Medium aneurysm
A medium aneurysm measures between 1.6 and 2.1 inches (4 and 5.3 cm). It's less clear how the risks of surgery versus waiting stack up in the case of a medium-size abdominal aortic aneurysm. You'll need to discuss the benefits and risks of waiting versus surgery and make a decision with your doctor. If you choose watchful waiting, you'll need to have an ultrasound every six to 12 months to monitor your aneurysm.

Large, fast-growing or leaking aneurysm
If you have an aneurysm that is large (larger than 2.2 inches, or 5.6 cm) or growing rapidly (grows more than 0.5 cm in six months), you'll probably need surgery. In addition, a leaking, tender or painful aneurysm requires treatment. There are two types of surgery for abdominal aortic aneurysms.

Open-abdominal surgery to repair an abdominal aortic aneurysm involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place, through an open-abdominal approach. With this type of surgery, it will likely take you a month or more to fully recover.
Endovascular surgery is a less invasive procedure sometimes used to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded up into your aorta. The graft — a woven tube covered by a metal mesh support — is placed at the site of the aneurysm and fastened in place with small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.

Recovery time for people who have endovascular surgery is shorter than for people who have open-abdominal surgery. However, follow-up appointments are more frequent because endovascular grafts can leak. Follow-up ultrasounds are generally done every six months for the first year, and then once a year after that. Long-term survival rates are similar for both endovascular surgery and open surgery.

The options for treatment of your aneurysm will depend on a variety of factors, including location of the aneurysm, your age, kidney function and other conditions that may increase your risk of surgery or endovascular repair.

LIFESTYLE AND HOME REMEDIES
The best approach to prevent an aortic aneurysm is to keep your blood vessels as healthy as possible. That means taking these steps:

Quit smoking or chewing to***co.
Keep your blood pressure under control.
Get regular exercise.
Reduce cholesterol and fat in your diet.
If you have some risk factors for aortic aneurysm, talk to your doctor. If you are at risk, your doctor may recommend additional measures, including medications to lower your blood pressure and relieve stress on weakened arteries.