Month: December 2017

Words from Christmas Past

Before the medical mayhem descended on me, I had planned on writing a post about Christmas. Here it is. A bit delayed.

One of my brothers is in the process of moving to a new, smaller home. In the process, he’s trying to get his pile o’stuff down to size. He came across something really interesting. When his eldest son was little, he had a holiday school project. It involved getting his grandparents to write a description of what Christmas was like when they were little. My brother found my parents’ Christmas recollection, written in cursive, of course. He sent me a copy.

My mother grew up in Freehold, New Jersey in the 1920s. She recalled that Christmas began:

“…at Thanksgiving time when my mother made fruit cake. Then, every once in a while, she poured a little brandy over it. That was served to our visitors at Christmas. My Dad went to the apple farms and got a bushel of Delicious, Golden Delicious, and McIntosh each. These he sent to my uncle and two cousins a basket full to each after he had mixed them…

“On Christmas eve, we went to bed early (at least I did). I guess that is when the rest of the family got ready for Christmas morning. I was the youngest of the family and even when I no longer believed in Santa I didn’t admit it. I wasn’t about to lose out on a good thing. It was at Thanksgiving that I started to look for hidden presents.

“Christmas morning we got up early, took a quick look at the tree, and unopened presents and went to seven o’clock mass. When we came home we ate breakfast and then opened our gifts. I guess we ate fast and I didn’t do much praying.

“When I was very young we had a tree [that] had metal holders for candles that were never lit. My parents were afraid of a fire because the tree never came down until the feast of the Epiphany… “

So it seems my mother was quite the scamp. And who knew that fruit cake was actually something people enjoyed. (I suppose the brandy helped.) And giving apples was very low tech.

My father was four years older. He was from Mechanicville, New York.  He recalled:

“On the day before Christmas we purchased a tree at the local grocery. We waited on Christmas eve until the smaller children were in bed. We then put the tree in the parlor and decorated it.

“Christmas morning we rose early and attended church. After church, we opened our presents and had our Christmas breakfast.

“There was a great assortment of presents. The older children received skis, sleds, skates, and other toys that older children enjoy. The younger children received dolls, books and clothing. As a rule the youngest would rather play with the empty boxes and wrappings than play with toys.

“Christmas afternoon we had dinner of turkey, cranberries, ice cream and pies. It was a very busy day for everyone.

“I hope you have a Happy Christmas in a tradition like ours.”

The summary of gifts makes me suspect that my father’s recollection compressed many Christmases into one. His was not a well to do family.

(The list of goodies made me recall the Flexible Flyer sled we had and our toboggan. The latter was the vehicle that nearly did my four brothers and me in on the scary descent from the first tee at Albany municipal golf course one winter. If you are ever in Albany when there is snow on the ground, go to Muni as it is called. The best sledding I’ve ever seen.)

Reading these letters, I could hear my parents’ voices in my head. That is a pretty cool Christmas gift indeed.

Old Man Drunk on Apple Fritters

Rachel and Katie – Part Deux

As it turns out Katie and Rachel are the Lennon and McCartney of get-well gifters. It was Katie’s idea to get me the t-shirt that gave me a dose of chronological reality with a side of laughter. Rachel’s part of the gift came in the mail today.

A couple of years ago Rachel did an internship at the Hammer Museum in Haines, Alaska. Food in Haines is expensive unless you want to eat salmon three times a day. In sympathy and in recognition of our mutual love for really unhealthy junk pastry, I mailed her a couple of apple fritters by surprise. She returned fire with a handmade postcard that really knocked me out (despite my rather grumpy appearance in the photos in the link).

I opened the box and pulled out a bag of a half dozen apple fritters. I can assure you that I am allowed to eat these because my blood thinner has virtually no dietary restrictions. It will take some time (mostly to avoid massive weight gain and pancreatic malfunction), but I will set my Old Man determination to the task.

IMG_0767
Six Fritters – Each One the Size of a Saucer

Rachel and Katie kind of gave away the surprise by telling me to look out for a second package. I was half expecting salmon, to be honest. I am pretty sure my letter carrier was happy it wasn’t. (As am I.)

Thanks again you two.

But That’s Not All

When I went to pick up the fritter parcel at our front door, I found, not one, but two boxes. The second package was a complete surprise. It came from my sister-in-law Leah. My in-laws hail from southern West Virginia. I have heard so much oral history in the last three decades from them but it has lacked historical context. Leah’s gift fills the void; it is a book on Appalachian history called Ramp Hollow. (If you are from West Virginia, you know that the title is pretty much perfect.)

IMG_0768

Many thanks Leah. It sits on top of the formidable Rootchopper Tower of PE Recovery Reading on my nightstand. I can’t wait to read it.

A Note on My Health

It had snowed in the night. The light coating made for a pretty early morning. I am grateful that we didn’t get a significant accumulation.

IMG_0765
My Front Yard Early This Morning

I am in no condition to shovel or wovel, even. Mrs. Rootchopper reminded me that the doctors said no bicycling for three weeks. It is unclear whether that applies to geriatric basement riding on Big Nellie. So I will be a good boy and talk it over with my doctor next week. There is also the issue of doing exercises for my back. Most of these are yoga asanas. I seriously do not want to shuffle off this mortal coil while doing a shoulder stand. (I’d give money to see the face of a yoga-mad friend when she heard that I died of acute salamba sarvangasana.)

I have strength but no stamina. Each morning I get up feeling better than the day before but even minor exertion causes huffing and puffing.

I keep hitting the spirometer to increase my lung capacity. You suck on the tube and the blue thingie goes up the metered column. They should put a bell at the top. Not that I have gotten anywhere near the top, much less my supposed goal of 3,250 milliliters of air. Still, it probably warms the heat of many to say that I suck a little bit more every day. (Maybe I could write a book called Ten Percent Suckier.)

IMG_0771

My mental state remains upbeat, although as I get incrementally stronger I can sense some restlessness creeping in. It is already sufficiently annoying that Mrs. Rootchopper has asked me to back off on the caffeine.

I’d rather die.

Just kidding.

 

Old Man on a Bicycle

One of the things that riding a bicycle gives me is the happy delusion that I’m not nearly as old as the calendar says. The delusion is reinforced by the fact that the overwhelming majority of my friends from the DC cycling community and blogosphere are much younger than I am. There’s nothing like a pulmonary embolism to bring you back to reality. Last week I was 62 going on 42; this week I’m 62 going on 82.

This is really a slap in the ego. I could be getting down about it but not a day has passed that someone has not sent me well wishes. I’ve had reassuring phone calls, get well cards, emails, Facebook messages, Tweets, Instagram comments, texts, and comments on this blog. I can’t thank you all enough. Three years ago at this time I was mired in depression. Now, when I am faced with something that I can truly get depressed about, depression is nowhere to be found. (I keep on the look out for the bastard, though. Also, I have Klarence on the speed dial just in case.)

As most readers know, I came to know most of my BikeDC friends because Mary Gersema took a picture of me and Little Nellie at the start of the 2010 50 States Ride. A few months later, Mary invited me to come to a bike commuter get together called Friday Coffee Club. Not long after, I met Rachel Cannon and Katie Bolton over a cup of Joe and an apple fritter.  Although my memory is a bit vague about Katie. I may have met her when she volunteered at a rest stop on a local event ride. These two volunteer a lot.

In any case, you will never meet two harder-working, bright, multitalented, funny people in your life. Over the years I’ve watched and listened as they navigated the terrible 20s, the part in our lives when we think we’ll never get a decent career going or establish a firm adult identity. It’s as disorienting as being stuck in the middle of a half million people as I was at the Women’s March last year. How do I get my bearings? How can I move forward, or sideways or make any progress at all? Why am I freaking out? (The answer that I heard at the march from a short, elderly Buddhist woman is simple: Breathe.)

A few weeks ago, before my shit hit the fan, I saw Rachel and Katie at the WABA holiday party. Indefatigable Rachel was volunteering. Katie was beaming, soon to be married and a homeowner.

I got a text the other day from Rachel. She said to keep an eye out for a package. Today it came. I half expected it to contain some fritters. That would have been funny. But the actual content was both funny and buoyed my spirits. The perfect gift. I will wear it with pride and gratitude.

Oldmantshirt

The old man will be back. Take it to the bank.

Thanks Katie and Rachel for making my day.

One Week After

Well, it’s been a week since I experienced the wonderful effects of blood clots swimming upstream from my left calf to spawn in my lungs. It’s a beautiful thing, really. Not.

I’m coming around to accepting this recovery thing. I am a little stronger each day. My health was great then,out of the blue one week ago, it wasn’t.

Yesterday three good-ish things happened. I slept through the night. Basically, I sleep by sitting up against some pillows in bed. Lying on my side was causing some discomfort (not to mention more than a little suffocation anxiety).

Good thing number two, I think, was the fact that I coughed up blood. Eww. Sorry, but I am really surprised that this didn’t happen sooner. It was only a small amount, perhaps a quarter of a teaspoon. The sooner I can get this crap out of my lungs the better as far as I am concerned. (If it becomes a regular thing, or if the amount of blood becomes significantly greater, I have to call the doctors in, just to be safe.)

Good thing number three is my family and I went to another basketball game. I walked up two flights of stairs and was pretty winded. My heart rate went way up. The tachometer was briefly in the red zone. Danger Will Robinson. But after slowly walking a couple of blocks I felt fine. Thank you, bike riding. Inside the Phonebooth (what we call the downtown arena here in DC) I decided to look for my friend Jacques. I walked down the entire 100 level to courtside. There was no sign of Jacques so I walked right back up to the concourse. My heart went thumpity thump thump. Then I walked around the arena to our seats and my heart rate came back down to normal. I made it to my seat without being exhausted like Saturday night. No tears of frustration.

The game itself was a classic. Butler, my daughter’s alma mater, fell behind by 20 points to Georgetown. Then they came back. Bit by bit. The game went into two overtimes and Butler won. My son, who knows sports way better than I do, said that Georgetown has better players but the Butler coach outcoached Patrick Ewing, the Georgetown coach who is in the Basketball Hall of Fame for his stellar playing career. Both coaches are first year head coaches.

We walked back to the car with no ill effects for me. At 11 p.m. I was a little weak, but my spirits were high. It’s amazing what counts as a good day now.

My son leaves today.  He lives on the other side of the world. I am really going to miss him.

My daughter leaves on Friday. I get one more evening with my baby. Then she’s off to London town.

It is cold outside. From the basement I can hear something.

Big Nellie is calling my name.

 

Donate to the WABA PE Wing

Every year the Washington Area Bicyclist Association hosts event rides that are based on a gimmick. The March Vasa Ride, held in cooperation with the Swedish embassy,  commemorates Sweden’s Vasaloppet cross country ski event. The Cider Ride in November involves riding over 50 miles at the end of apple picking season. And, of course, the 50 States Ride presents participants with an 11-page cue sheet to more or less guide them all over the city to ride the avenues named for the 50 states.

So it occurred to me that WABA’s year end fund raising could use a little push from a gimmick. Here’s my idea.

I have ridden 9,911.5 miles this year. I thought the remaining 88.5 miles was a fait accompli, a tap in, a slam dunk. Unfortunately I was betrayed by pulmonary embolisms, pneumonia, and a partially collapsed lung. (It’s the trifecta I’ve always wanted, Santa!)

So I thought maybe I’d ask my friends to all go out and ride 88.5 miles on December 31. This would be fun (albeit flippin’ cold) for them but wouldn’t accomplish much.

Instead, I decided to invite my #bikedc friends (and any others who are feeling generous) to donate $88.50 to WABA. You money will be used to fund the new pulmonary embolism wing of the state-of-the art WABA Wellness Center.

Just kidding.

Your money will help fund the many programs, events, and advocacy efforts that WABA conducts on your behalf.

And it will put a smile on my face.

So clink on this link to donate.

And if you can’t spare $88.50, you could always spring for some fashion fabulous WABA socks.

IMG_0730

All the cool kids are wearing them. All you have to do is go to the WABA store.

Cheers.

 

 

I’ll Take Medical Insanity for $2,000, Alex

  • On the way out of the hospital, one of my doctors mentioned doing an MRI to examine something as a follow up to a CT scan of my abdomen. I thought I heard her say “adrenal” and maybe “renal”. Well, I looked at the scan results. There are small abnormalities on my right adrenal gland (which sits on top of my right kidney) and my right kidney. Since cancers can be precursors to blood clots, the doctors want to investigate further. According to the interwebs, the vast majority of these sorts of abnormalities are benign cysts. It also turns out that one of my siblings has a similar anomaly on his kidney. It’s benign.
  • I didn’t sleep a wink last night. I don’t think it was my lungs. More likely my insomnia was caused by drinking a beer after dinner. This usually messes up my sleep cycle. Suffice it to say, today’s 4 hour afternoon nap was a winner.
  • I also learned that the blood thinning medication that I am on does not break up the blood clots in my lung or leg. The clots in my lung will be absorbed by my body over time. My doctors think this is what happened after the May 2016 episode. In any case, the anti-clotting medicine will keep my body from adding more clots. It took about a week to ten days for my 2016 problems to go away. It’s obvious by my relative lack of progress that the damage this time is far more severe and will take longer.
  • The results from my chest x-ray in May 2016 and the one last week are very different. In the former, my chest is clear; the x-ray shows no abnormality. In the latter there is pneumonia and a partially collapsed lung. This prompted a CT scan to follow up.  The CT scan found the clots that caused all this. Mostly the blockages are in my right lung but there is some blockage in my left.
  • As a practical matter, I feel like I have aged 25 years in less than a week. I have very low energy levels. My breathing is still very shallow. There is good news buried in this. I am not losing my mind from wanting to jump on my bike. Once my kids leave, I am going to start riding Big Nellie for a few minutes at a time in the basement. That will tell me how high I have to climb to get back to normal. And maybe help me defeat the evil Spiro, the Dark Lord of the Lung.
  • Speaking of Spiro, the spirometer, he’s winning so far. The force isn’t very strong in me. I haven’t been able to exceed 2,500 milliliters of air inhaled yet. My target is 3,250. This is for the typical 6 foot. 62 year old. I have no idea what a 9,000 mile bicyclist with asthma is supposed to use as a target so I’ll go with “normal” for now.
  • My mental game remains pretty strong. The first 24 hours were tough but going to see Star Wars and basketball games and hanging with my kids is really helping me stay away from the big red self-pity button.
  • If you talk to me, you’ll find my voice trailing off. I can’t sustain my voice for as long as I am used to. I need a few seconds to reload the air bags. Most people will count this as my personal gift to them.
  • Finally, if this had to happen it’s good that it happened in the dead of winter. When it’s cold and windy outside I enjoy curling up with a good book and a cup of tea. And I won’t lose any warm weather cycling days during my recovery.

Pass the Cookies and Beer

  • I was being a good boy. Except for one holiday party, I had greatly curtailed my alcohol consumption since my bike tour. And I’ve stayed out of the junk food cabinet for two months. So I did the math: much less alcohol + no junk food + daily riding = pulmonary embolism.
  • Sooo, let’s reconsider. My recovery plan: more alcohol + junk food out the wazoo + daily sloth = bicycling fitness monster. What could go wrong?
  • In the hospital, my thinking was all about denial. I am going to get better in record time. No problem. My body, apparently, has other ideas. This is going to take a while. My body gets a little tiny bit stronger by the day. I am, however, a long, long way from being back to anything approaching normal.
  • Ever since the event rides I did in August and early September, I’ve been wondering if something was wrong with me. I went from a bad climber to a horrible climber this year. My 50 States team had to wait for me at the top of every hill. It was embarrassing. Whenever I started climbing, my speed dropped like a stone and I had no ability to get it back. Was I throwing clots into my lungs this summer? Was my strong heart kicking out unnoticed clots for weeks? Whatever the answer, I am betting that I have much more cardiopulmonary fitness than the average PE patient. My doctors were pretty funny remarking on it too. I look like the average man on the street until you measure my vital signs and take an EKG. (Better knock some wood, right?)
  • I’ve been reading, watching movies, watching sports, and hanging with my family. This has really lifted my spirits. If I stop and think about things, my brain goes into weepy mode. Thankfully, it’s nothing like true depression. A tear here and there actually kind of helps. Even having not meditated in several days, I am confident that I have the mental part of this sussed.  I need to be vigilant. Hearing words of support from friends and family and readers helps a ton. I am truly grateful.
  • Spiro, the spirometer, is not my friend. Spiro, you are dead meat. I am coming after you. I may be a wimp now but just you wait. I am going to kick your ass.
  • Since most of the clots and the pleural infarction are on my right side, I can sleep comfortably on my left side, which is how I prefer to sleep. If I turn over onto my left side, my breathing becomes shallow and labored.
  • My family gave me four books for Christmas. And cold weather cycling gear. I won’t make much use of the latter in the days ahead, but the books will come in handy. Once I get some strength back, I’ll be reading with Big Nellie.

    Big Nellie in the Basement
    Big Nellie, Locked and Loaded
  • Tomorrow we go for diner breakfast and the new Star Wars movie. Then I write some thank you cards. And we’ll see about some very light exercise too.

Well, on the Positive Side

I’m alive.

I was sprung from the hospital yesterday afternoon. My brain wanted to dance but the rest of me wanted nothing of it.

As I was about to leave, one of my cadres of doctors (I lost track at six), came into my room and told me I needed to have an MRI. “We can do it on an outpatient basis.” She explained what it was for, but my brain was already out the door. Apparently something on the last CT scan of my gut came back abnormal. My guess is they are looking for cancer. Twenty percent of blood clots are detected in people with cancer.

We’re having fun now!

I’ll blow the cancer bridge up if I come to it. For now I am focused on getting back to something approaching normality.

It was wonderful to see the house. It brought to mind the time my father, riddled with cancer, was driven to the emergency room over a decade ago. He looked out of the car window as it was backing out of the driveway. His face said, “this is the last time I’ll see my family and my house.”

He died a month later. In the house.

Once inside I played with my sprirometer. Basically, its a gauge that measures lung capacity in milliliters. I am supposed to be able to hit and hold the indicator at 3,250. I can barely sustain 2,000. I have a long, long way to go. My right lung is all effed up.

I took a shower. A glorious, long, hot shower. Before I got in, I took off the last of the gauze and tape from where blood was drawn on my arms. My right arm was one long, ugly series of bruises. The thinners are working, apparently. (The bruises don’t hurt at all, by the way.)

The doctors make its sound like this will happen.

Image result for dark knight monty python

Hasn’t happened. Yet anyway.

Last night my wife and kids and I went to see the Washington Wizards game. We slowly walked three blocks from the garage to the arena, then around the arena, and up a flight of stairs. By the time I was at my seat, I was huffing and puffing. Tears welled in my eyes. I still couldn’t believe this was happening to me. I felt like I was 85 years old.

The game was a welcome diversion. I forgot about my troubles for a few hours. The Wizards won in a romp.

The walk back to the car was much easier. I even drove home.

I slept in my own bed.

When I was in the hospital I was thinking that I’d be back on my feet in a matter of a few weeks, maybe 3 months. That’s probably really optimistic, even if the MRI comes back negative. And I think the prospect of getting off the blood thinners is out the window two. The doctors are assuming that I am a two time loser. That means I am at very high risk of recurrence if I don’t stay on the medication. There are worse fates.

One day at a time.

For now, I am super grateful to be at home for Christmas with my wife and kids.

Thanks again for all the well wishes.

Final note: Very, very big thanks to Chris Markiewitz, a friend from my Boston days who called me to tell me about his experience with pulmonary embolism. He said my experience is uncannily like his. “Give it time. It will get better. The blood thinner you are on does a great job of letting you get back to normal activity.” I can’t thank you enough for your call, Chris.

 

 

 

Hoping for a Jailbreak

Last night was rough. I tried to go to sleep at 11:30. There was good news; for the first time in days I could lie on my side without pain or labored breathing. After about 20 minutes I started drifting off to sleep. Then there were voices in the hall. Doors opening and shutting. My room is across the hall from the staff lounge. The staff was having its holiday party. At midnight. In a hospital. Are you fucking kidding me!!??

They weren’t all that loud but I could not get to sleep with the on and off voices and door opening and closing. After 20 minutes I was going to get up and walk the half mile home. Then a nurse came and closed my door. I was asleep in another 20 minutes.

Long story short, I want out of here. Now!

My new nurse this morning asserted without my asking that I’d be on blood thinners for the rest of my life. What happens with the rest of my life is none of your goddamn business, bucko.

The doctors think I may have a genetic mutation that caused this episode. Here’s why: when I checked in they asked about family history of clots. I said I don’t have any. Then they asked me if I had been on any long flights recently. Nope.

The next day they told me that my May 2016 visit to the ER was probably caused not by a respiratory infection but by another pulmonary embolism. The pain cleared up in a week and I flew to Scandinavia. Derp.

So their treatment plan is based on the assumption that both PE episodes were “unprovoked.”

They never asked me if I had taken a long flight before the May 2016 lung troubles. In fact in September 2015 I flew around the world, 60 hours of flying in 19 days. This included flights of 9, 14, and 16 hours. As the Dixie Chicks say, there’s your trouble.

I need to talk to the doctors today and clue them in. I think I’ve had a clot in my leg for over 2 years.

In any case there is no reason for me to stay in the hospital at this point. It’s just pissing me off.

Just give me the drug you want me to take. I already have the spirometer (a gizmo to help me bring my lung capacity back to normal).

We can deal with the issue of taking me off blood thinners in 3 to 6 months in 3 to 6 months.

I want out of here.

Update on the Clotting Bicyclist

I’ve been in the hospital for 41 hours and have turned the corner. I still have trouble breathing but it looks like the worst of this insanity is behind me.

As a result of yesterday’s echocardiogram the doctors decided that I can use conventional therapy, rather than surgery, to fully recover. Basically that means I take blood thinners and do respiratory therapy for a few months.

I was given the okay to get out of bed this morning. Yes! When I did I had a massive stabbing pain in my back. No! But it went away quickly. I stood up after a few minutes and the pain didn’t return.

They took me off the IV blood thinners and put me on a 2x per day pill.

I feel one hell of a lot better but my breathing is shallow still and aches still hit my back and shoulder from time to time.

I feel like two big hands are pushing against my lungs when I breathe. It’s uncomfortable but tolerable.

Since they monitored my progress with blood tests my right arm is one long bruise

The attending physician told me again that I am pretty lucky. This could have been much worse. All the doctors said all my bicycling gave me an edge. My respiratory fitness may have been masking this problem for quite a while.

I’m not well by any means. I’ll be taking blood thinners got a few months and doing respiratory therapy to open the breathing passages in my lungs.

And don’t you dare make me laugh. My son was visiting today and had me in stitches. It hurt so much. And felt so good.

My son is going to set up a bike in my basement so I can “ride” while on the medications. Riding outside is not a problem. Falling outside, especially if I hit my head, would be a catastrophe.

This whole episode has been a shock and very depressing. Thanks to all of you for your kind words of love and support. They mean a lot.