22PlusY: Abdominal Aortic Aneurysm (AAA) Screening

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If you’re a 65 year old man, you can expect or would have received a letter from the NHS inviting you to what’s called an Abdominal Aortic Aneurysm Screening, an AAA scan screen. Most men, knowing what most men are like, will ignore it. They’ll say, A, I don’t want to make a fuss and B, I feel fine.
Well, you will feel fine because there are no symptoms, no indication, no warning, no nothing. It’s not a disease that you can feel coming on. You don’t get any indication at all.
It is a structural weakness in the body and it gets weaker with age, which is why at 65 we get a call to go and get a screen. Don’t be one of those guys who says, I feel fine or I don’t want to make a fuss. So what this video is going to do is it’s going to explain what the Aortic Aneurysm Screening is all about and why and why you need to do it.
Okay. So first of all, just put this number out there just before we talk about the rest of it, because you don’t want to make a fuss because you’re a bloke and you feel fine. 80% of men whose aneurysm ruptures will die within minutes.
Fact. None of them would have had an indication that they had a problem. None of them.
80% will die before they can get to hospital. Okay. So let’s look at the mechanics.
What is the aorta first of all? Okay. You hear doctors and people, I’m not a doctor. I used to be a motor mechanic.
The aorta is the largest blood vessel in the body. It comes from the heart and distributes oxygenated blood around the body. So the heart would draw in from the lungs, oxygenated blood, and then pump it through the aorta to the rest of the body.
The aorta comes out of the heart. It comes up through the thoracic region, which is inside your rib cage, loops over and then goes down through your abdomen, down to your lower abdomen, and it divides off and feeds the rest of the body. That’s what it does.
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The way it works is, if you imagine a balloon, okay, the sort of thing that the guys make sausage dogs with at kids’ parties. You get a cylinder and you’ve blown up this balloon, you’ve got a cylinder. It looks great.
This is your heart. This is your aorta. There we go like that.
When the heart pumps, the aorta stretches. When the heart relaxes, the aorta springs back. It does that the whole time, every time your heart beats, which is 65, 70, 80 times a minute at rest for most of us.
I’m slightly tachycardic, so my pulse rate tends to be a bit higher than most, but 60, 70, once every second, one in a bit times every second for your whole life. The reason they monitor us at 65 is because the aorta has been doing this throughout your life, and eventually it gets a bit tired. It’ll expand, but it doesn’t spring back quite as far.
The heart’s doing this to suck blood from the lungs into ready to pump again, and your aorta, instead of coming down to here, comes down to here. It’s just an age thing. It’s wearing out.
It’s becoming tough, and the fibres are becoming tough in the tissues, and it just doesn’t return as normal. The walls are becoming thinner because the aorta itself has stretched. It’s not returning, so it’s stretching, which means it’s getting thinner.
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You stretch a balloon, you squeeze one end of that balloon, it’ll go like that, but the walls of this part of the balloon have got thinner. It’s just physics. How big is this thing? Take a 50p.
That’s 27 millimetres. It’s about the size of a 50p. This is something that I made up on my 3D printer.
This is 29.9 millimetres. Okay, 2.99 centimetres. It’s that size for a reason, but that’s roughly the size of your aorta.
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The reason it’s 2.99, 29.9 millimetres, is because the threshold between normal and needing attention is 30. This is a tenth of a millimetre smaller than the threshold before you need regular attention. Before we come back to this little thing, what is the scan? You’ll get a letter.
Don’t ignore it. Follow up on it. I was 65 last June, and I was visiting somebody in hospital recently.
Not recently, back in December. I was visiting somebody in hospital, and on the way out, I spotted a notice board. I’m a nosy old so-and-so.
I saw a picture of Giles Brandreth on a poster, an A4 poster in this notice board. I like Giles Brandreth. I find him quite amusing.
I went over to see what he was saying. He was talking about the AAA scan, the abdominal aortic aneurysm screening programme. That’s the first time I’d heard of the screening programme.
On that poster was a QR code. I’m a nosy so-and-so. I scanned it.
It went to a 404. It was a bad QR code. It went to an old dead link.
But I took a photograph of the poster, and when I got home, I found out who to talk to. I said, look, I’m 65 in June. This is December.
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I haven’t received a letter. They said, that’s because our year goes from April to March, same as the tax year. I was on the list to receive a letter, and I would have received it by March.
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However, as I’m on the phone, did I want to get screened today? Yeah, okay, whatever that means. So they had an appointment that afternoon at my local health centre, Little Hampton Health Centre. So I said, yeah, okay.
I went along. I didn’t have to prepare. I didn’t have to do anything.
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I didn’t have to fast. I didn’t have to fill my stomach with water. I didn’t have to do anything.
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I went along. Free parking, actually, at that health centre, which is good. Waited less than 10 minutes, went in, laid on the bench, lifted my shirt.
The sonographer put some gel on my stomach, and then she used the ultrasound, made all the measurements, and said, you’re done. And I think I came in at 27 millimetres. That’s it.
Easy. Done. 10 minutes.
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20 minutes, including the waiting room. Easy. Now, the reason I’ve got this thing I’ve printed up here at 29.9 is because at 30, the NICE, the N-I-C-E, National Institute for Clinical Health and Excellence, their criteria says that normal is under three centimetres.
And if you’re under three centimetres, you are discharged and you’re discharged for life. You won’t be scanned again. But it’s a binary decision.
It’s not a clinical decision. If you’re dehydrated, you might be smaller than you are normally if you’re normally hydrated. So just for giggles, that’s 29.9. That is 30.1, OK, over the three centimetre threshold.
Put that on there and look at the size difference. It’s next to nothing. You can hardly see it.
If you measure three, which is less than that, OK, 0.1 bigger than that, 0.1 smaller than that. If you measure three, NICE says you have a small aneurysm between three and 4.4 centimetres, 30 millimetres and 44 millimetres, and you will be placed on annual surveillance scanned every 12 months to monitor growth. OK, 0.1 of a millimetre.
And this is the flaw in the system. OK, because you might be measured on a day when it’s lower and if they’ve measured you the next day, it might be three millimetres, three centimetres. The margin is so, so fine.
If you measure three centimetres, the NICE website says you have a small aneurysm. I just read that. You’re placed on annual surveillance.
After that, it goes up in scale. So a medium aneurysm is 4.5 to 5.4 centimetres, and with that, you’re on quarterly scanning. Every three months, you’re scanned.
If you have an aneurysm that is 5.5 or larger, you have a large aneurysm and you get a referral within two weeks to a vascular consultant to discuss surgery. OK, so there’s not a lot of difference between the two. It’s an important thing, but that’s the flaw in the system.
If you measure 2.99, you’ll be discharged. If you measure three, you’ll be checked every year. Now, you can do some things about this.
First of all, first of all, you’ve got to go for the scan because without it, you don’t know. You could have a large aneurysm that should be surgically repaired by a vascular consultant, and if you’re measured large, you would have been seen within two weeks. You don’t know.
There is no way of knowing what’s going on in here. You don’t get any physical sensation. There’s no symptoms, no indications that you have a problem.
The first time you have a problem, the first time you know you have a problem, is probably about a minute before you’re dead because it’s burst. That’s the only way you would know. I have a friend who just literally dropped dead.
He was walking along the canal side with his son, and he literally dropped dead. He had no idea. So, if you measure close to three centimetres, go to your GP and say, I’d like to be referred for another scan in 12 months’ time, and put it in your diary.
If you haven’t had a referral letter within the year, phone up and self-refer. You can self-refer. You don’t even need your GP to refer you.
You can self-refer. On my website, this video channel is linked to 22plusy.com. Down below here, there’s a link, and it’s a link to a post that I’ve written. I’ve taken all the medical stuff out of that.
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The technical stuff, I’ve put it into plain English, and there’s a post on my site with links on there. One of the links is the link to the page where you type in your postcode, and it gives you a phone number to ring. You can self-refer.
If you go to my site, you can click on that link, enter your postcode, and it will give you the phone number. You phone them, and they will make an appointment for you. It’s that simple.
That simple. If you get your letter, then make the phone call and take the appointment. There are some things we can do about it.
First of all, there’s repairs. They can use a stent to repair it, or they can go in and make a physical patch. Remember, this is not a disease.
This is a mechanical structural weakness, and they can fix it in most cases. You’ve been nagged all your life if you’re a smoker, and I’m going to do it one more time, but not because I’m a Puritan. My dad died of lung cancer.
He had four years of finding out that he had some issues. He could feel something wasn’t right. They diagnosed a lump in his lung, and he had four years of living with this and treatment and everything else.
He died at 60 from smoking with lung cancer, but I’m not Puritan. People do what they want to do, but there are some facts to bear in mind, and one of them is concerning the aorta. Now, every single cigarette that you smoke is releasing enzymes into your blood.
Fact. Okay? Those enzymes are eating away at the lining of the aorta. Every time your heart beats and pushes blood through the aorta, it’s eating away.
The enzymes are eating away at the lining and making it thinner. Okay? It’s as if you’re going in there with some sandpaper and rubbing away the wall of the aorta. Every single cigarette is doing that.
If you know that and you still decide to smoke, that’s up to you. I’m just making you aware that there are facts behind all this. It’s not just about the normal stop smoking malarkey that people don’t really explain.
This is one of the mechanics of smoking, one of the things that causes problems, and we don’t yet know whether vapes do this as well, but certainly tobacco does this. The other thing is blood pressure. I said earlier, as your heart beats, your aorta does this, and then contracts and does this, and eventually, if your blood pressure’s high, it’s stretching this further, and when it relaxes, it’s not coming back as far.
Eventually, it stays stretched. That’s a side effect of high blood pressure. The two numbers that you get with your blood pressure are systolic and diastolic.
When the heart beats and this does this, that’s the systolic number, the high number on the top of the two, and then when the heart does this to draw new blood in from the lungs and the aorta does that, that’s the diastolic blood pressure, the bottom number. The other thing that can cause issues is salt. Now, I love salt, I love cooking, I’m a savoury person, I’m not a sweet tooth person particularly, and I was always taught to layer flavours and salt as you go through because you’re layering, you’re building layers of flavour.
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It’s absolute nonsense. What’s happening is you’re applying salt, and then you’re applying salt, and then you’re applying salt. However, if you put the salt on at the table, you’re still getting the salt in the flavour, you’re still getting the flavour of the food, but you’re using about 10% of the amount of salt.
Now, what’s the problem with salt? Salt changes obviously the salinity of the blood. By the blood becoming higher in salt, it draws in more water, so the blood pressure increases. It’s that simple.
If you’ve got a lot of salt in your blood, your blood needs to draw in more water because it thickens up, so it draws in more water, and by doing that, the blood pressure goes up and we have this whole systolic-diastolic issue where the blood vessels will stretch and stretch virtually permanently unless you do something about it. So, smoking is sandpapering the walls of your arteries away with enzymes. Blood pressure is weakening the arteries because they’re staying stretched, and salt is affecting the blood pressure.
Those three things. Now, obviously, smoking, if you decide to give up smoking, I’ll be really chuffed for you. It doesn’t affect my life, but I’ll be pleased for you if you do.
Blood pressure. Again, I’m not being a Puritan here. I’ve been a big bloke all my life, and since summer last year, I decided to do something about it and I’ve lost 27 kilos.
27 kilos is the same as 27 bags of sugar, and that’s 27 bags of sugar that I’m no longer carrying around with me 24-7. It’s quite significant. You put 27 bags of sugar in a shopping basket and walk around your local supermarket with 27 bags of sugar in there.
That’s the weight I was carrying around. Totally unnecessarily. Now, what has that done? It’s done a lot of things for me physically, but one of the things it’s done is allowed my blood pressure to drop.
I’ve been on blood pressure medication for years and they’ve reduced the medication I’m on now because my blood pressure has naturally started to drop. I will now put salt on the food when I’m at the table, rather than building layers of flavour, which is nonsense. So, that’s the nagging bit out of the way.
All I ask is if you get the letter, or if you’ve got the letter, or if you’ve had the letter and thrown it away, do something about it. Make the phone call, get the appointment, get the scan, at least know what’s going on. If you find out that you’re actually okay, it’s cost you 20 minutes of your life and you haven’t had to do anything special.
It’s a no-brainer. You don’t even have to tell anybody, to be perfectly honest. If you want to be manly, for want of a word, and don’t want to admit weaknesses, because we’re just organisms, but don’t want to admit to being weak, if that’s how you see it, phone up, make the appointment, go on your own, 20 minutes.
You can just say I’m done. Come back, you don’t have to tell anybody. But get it done, because you don’t know what’s going on in there.
And for sure, if you’re 65, your aorta has already started to expand, because that’s an age-related thing that we can do nothing about. It’s a mechanical, structural limitation of the tissues of the aorta. It’s not a weakness in the person, it’s a structural limitation.
Bearing in mind, if you think about it as we’ve evolved, I’m 65 now, 66 in June, go back several thousand years, I’d have been dead by now. Our bodies didn’t evolve to live as long as we do. So we’re going to start seeing failures, and this is one of the failures that we will see.
The link below takes you to the website. In fact, the link below that I’m going to put there will take you directly to the page to allow you to click on the link and type in your postcode, and get the phone number. You can do that any time, any day, Monday to Friday.
You can give them a call, make the appointment, go and get the scan. Anyway, 22plusy is a website for men. It’s written by men, principally me, but it’s there for your information.
It covers a whole bunch of subjects. I’m going to do a post on this microphone once I’ve got used to using it. So there’s tech stuff on there as well.
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The link below, like, share, subscribe, share. That’s important. If you’ve got a mate who’s the sort of person who says, I’m fine, but he needs to have the scan, share it with him.
Just say, look, it’s going to take 20 minutes. We’ll see if we can make appointments together. We’re both going along together, tell the wife we’re going down to the pub, and go along and get your scans done.
Share this with somebody. You could save their life. And if this video saves one life, then I’ll be happy.
Anyway, cheers, bye.

Transcribed by TurboScribe.ai. Go Unlimited to remove this message.