Tag: DVT

The saga continues….

Today I cancelled Monday’s PT appointment. Yesterday I did a two-hour recumbent ride in the basement. My wonky left leg felt fine throughout. When I walked away from the bike, the ache in my leg returned.

I did a very abbreviated PT session, took two Tylenols, and chilled.

Today, my leg felt fine for a few hours after waking. Then, as I was telling Mrs. Rootchopper that my leg felt pretty good, the ache returned.

I went for a 30-mile ride to test out the repairs done on Little Nellie. The shifting works fine in the front. I still get some chain misbehavior in the rear but that’s the norm for this bike. I wonder if there isn’t some kind of flex in the frame caused by the folding mechanism.

In any case, my leg felt absolutely fine for the entire ride. The left knee hurt a little going up hills or grinding big gears. There’s a small painful spot on the outside of my hip, as well. I don’t know if the leg could handle a mountain out west but for present purposes it’s okay. I stopped to shop at a store and within a few minutes my leg was aching again. I think weight bearing is triggering the pain.

When I got home, instead of PT, I did a short version of my old yoga routine. There are over 30 poses involved. I spent about a minute on each. By the end, my leg was very achy.

It has been suggested by several people (my physical therapist and my brother, a retired nurse, who has similar back problems) that this ache is referred pain from a pinched nerve in my lower spine. My lower back doesn’t hurt any more than usual. It’s always stiff thanks to the family genome. I’ve had sciatica in the past as well as a herniated disk. My current symptoms don’t follow the classic knife pain from butt to calf of sciatica, nor do they follow the aching thigh numbness of my slipped disc. Still, some sort of nerve compression in my lower back is a pretty good candidate for the cause.

So I looked up yoga videos for lower back pain. The three that I found all include positions in my routine. Most include extending the leg away from the body, either while doing a standing yoga position or a kneeling one. (Some of them involve reaching back and pulling the foot back toward the body.  Ain’t gonna happen.) The level of difficulty of these is easy to moderate, for me anyway. If I had full blown sciatica, they’d be impossible.

Another candidate for the pain in my calf is repercussions from my blood clot episode of two years ago. It turns out that some people who have had a blood clot called a deep vein thrombosis (DVT) in their leg have residual pain that can show up much later and last a life time. The pain is caused by the body reacting to the DVT by redirecting blood flow around the DVT. After the DVT is gone, the blood flow gets discombobulated and pain and swelling results. (When I had the DVT,  I had no pain or swelling. It was a sneaky little bastard.) Depending on how my visit to the orthopedist goes on Monday, I may make a follow up appointment with my hematologist.

Digression: one way to tell that you are old is by the number of medical specialists you see. My specialty list includes ophthalmology, neurology, hematology, pulmonology, endocrinology, orthopaedics, and physical therapy. If this goes on much longer, I’m going to need a psychiatrist. As long as my list does not involve a mortician, I’ll consider myself ahead of the game.

A third possibility is acute Christmas cookie intoxification. ACCI is a bitch. The only known cure is January.

I happen to have a vibrating massage gizmo that I acquired during one of my many episodes of back pain many years ago. It’s basically been useless until now but it turns out to be surprisingly effective in calming my calf muscle down. This device can target the muscle tightness much better than a foam roller, massage stick, or a lacrosse ball.

So for the next several days it’s biking, yoga, massage gizmo, Netflix, and pills.

OOGA CHAKA

About ten months ago, my kids were coming home from overseas, Christmas was approaching, and I was about to hit 10,000 miles of bicycle riding for the year. I was really looking forward to a big finish to 2017.

Then I got my ass kicked by some invisible friends. Unbeknownst to me, I had been harboring a deep vein thrombosis, a big blood clot, in my left calf. On the night my kids came home, a week before Christmas, my DVT sent tiny bits of blood clots to my heart and my heart pumped them into my lungs. I’ll take pulmonary embolisms for 1,000, Alex.

Fug.

There I was in the ER hearing the diagnosis from a gaggle of doctors. It was literally unbelievable, and inane.

Me: You’re putting me on!

Doctor: No. We’re serious.

Me: I just rode a bicycle to Key West.

Doctor: Ever hear of a plane?

At some point that evening my right lung collapsed.

Fug.

And so it became clear that my mileage for 2017 would fall 88 miles short of 10,000 miles. Which, at the time, wasn’t exactly at the top of my worry list.

I’ll take Please don’t let me die for $2,000, Alex.

About a week later, Katie B. and Rachel surprised me. Rachel sent the fritters. Katie sent the t-shirt..

Oldmantshirt

And I decided that I wasn’t done with 10,000 miles.

After a week or two, I gently began riding Big Nellie in the basement. Then, I ventured outside. Mile after mile. Day after day. I got a little bit stronger.

By February I was feeling pretty much like my old self. My lung had long since re-inflated and my pulmonary embolisms were gone. Still, I had to be careful; I was on Xarelto, a powerful blood thinner with no antidote. One blow to the head would cause me to bleed out in my skull. Can I have Dead as a door nail for $800, Alex?

And still I rode. And rode. And by the end of April my DVT was gone. My hematologist took me off Xarelto. And he and my pulmonologist gave me the green light to ride to the Pacific northwest. Their words of warning: stay hydrated and, if your symptoms return, get to a hospital.

All was well until my left calf became enlarged near Fargo. I felt fine. but by the time I got to Bismarck, I knew I had to go to an ER and get my leg checked out. A doppler ultrasound confirmed that I was fine and could continue to my tour. As it turned out, my December DVT made my left calf rather elastic, prone to swelling. Now all I had to do was wear a compression sleeve on my calf.

And I rode on. Through the plains, past the Painted Canyon, over the Judith Mountains, around Square Butte, to the Missouri Breaks, over Rogers Pass and Waconda Pass and Sherman Pass and Loup Loup Pass and Washington Pass and Rainy Pass, down to Anacortes, and, eventually, to the Pacific Ocean near Astoria, Oregon.

Dang.

But I wasn’t done.

For the next three months, day after day, I rode. And rode.

And today, just riding along the Mount Vernon Trail, I reached 10,000 miles.

In the immortal words of Blue Swede:

OOGA CHAKA, OOGA OOGA, OOGA CHAKA.

I think it’s time for some pizza and beer.

I’ll drive.

My car misses me.

 

 

Any Road Tour: Day 30 – Nothing up my sleeve

After last night’s dinner (I had the Fatty Burger), I slept like a rock. Except for waking up with s cramp in my swollen left calf that nearly sent me through the ceiling of my tent. Dang that hurt. Oh and there were the three other times that the compression sock on that leg caused my Morton’s neuroma to flare up. This feels like a nail is being shoved into your foot.

Nine hours of semi-restful sleep later I awoke to bid farewell to Peter and Gregg as they headed east. An hour later I was heading west after a healthy breakfast of two pop tarts. I had 45 miles to go until the next store st Bismarck so what could go wrong.

I munched in Gardettos snack mix from time to time as I negotiated the curving rolling hills.

More and more crops are giving way to cattle ranches. I looked forward to Twin Buttes that was indicated on my map. They weren’t twins (one was bald, the other covered in vegetation). And there was McMansion in between them. Location, location, location.

The picture makes it look like Uluru but it’s not a tenth they size.

My destination for the morning was the trauma center at Sanford Hospital in Bismarck. Before going in I stopped st s sun sandwich shop for second breakfast. I was handed s scratch off card and won a second sandwich.

I walked into the ER and there was no line. After getting a room a nurse told me that the place filled just after I came in.

I was given a Doppler ultrasound on both legs. The doctor poked and squeezed my calf trying to find some area of sensitivity. Nothing. The ultrasound showed no DVT. The doctor told me to wear a compression sleeve on my calf and sent me on my way.

I decided to press on to New Salem for the sole reason that it was only 23 miles away. A nurse said the area was part of the Badlands but I looked it up. This area is topographically similar but much too green. One massive cattle ranch after the next.

To get there I crossed the Missouri River. Woot!

The ride featured significant climbing but I kept at it and arrived in New Salem at 6:30.

Once in my tent I realized that I intended to ride only as far as Mandan which is across the river from Bismarck.

When I left camp this morning I expected to lose a day to my schedule. Instead I gained about a third of a day.

Miles today: 81.5

Total miles: 2,245.5

Any Road Tour: Day 29 – Recovery is for wimps

Martin woke me at 6. I suppose it was only fair since I woke him after midnight. He headed out before I got out of bed.

I lingered to recharge my electronics. Then hit the road. There was no breakfast to be found in Gackle so I rode 12 miles, including 5 miles off route, to Streeter. They had no cafe and only a poorly stocked market. I bought two apples and a chocolate chip cookie ice cream sandwich. Bike touring diets are strange, what can I say?

The road was actually quite hilly in sections, not exactly what my dead legs needed. In one marshy area the bird life was going nuts. I slowed to listen to their little symphony.

It seems like every day I see a new animal. Today was pelicans.

I rode by many herds of cattle. If you call out to them and say “Let’s go!” they’ll start running along side you. One herd got rambunctious and practically stampeded. Layer in the day I had horses galloping with me. They must have recognized The Mule.

And there were crops. So many. Most fields around here have rocks in them. Some farmers make stacks of rocks. This farm had just cut its hay (I think).

The uphills finally ended and I was given the benefit of a few miles of downhill.

At Hazelton, I grabbed a campsite next to Peter (from Maine) and Gregg (from Boise, Idaho). They met on the road and seem to be well matched by the bike tour gods. We all went out for dinner and ate way too much.

Miles: 71.5

Tour miles: 2,164

Medical note: My left calf ballooned today. It doesn’t hurt and I am breathing normally but it does not look good. Bismarck is about 40 miles away. If it looks like this tomorrow, I think I’ll swing by an ER.

Recovery – Done

I let the cat out of the bag earlier today on Twitter and Facebook, but, in case you didn’t hear the news,  I went to my hematologist today. Based on the scans of my lungs, heart, and left leg, I am totally clear of blood clots. My blood work looked totally normal.

So he took me off Xarelto, the blood thinning medication I have been on for nearly five months. He told me to take a small dose of aspirin every day and to wear compression socks if I fly. I can now drink alcohol again, too.

He wished me well on my bike trip.

Lift off in two weeks.

Recovery Update

To recap, on December 20 of last year, I had a backache while having dinner with my family. The pain increased so we went to the emergency room the next night. The doctors discovered that my back pain was caused by blood clots in my lungs, pulmonary embolisms. These clots had come from a larger clot that had formed in my lower left calf. This larger clot is called a deep vain thrombosis.

The clots blocked blood flow to my lungs. My right lung collapsed.

To keep additional clots from forming I was prescribed Xarelto, a powerful blood thinner.

In early February, about six weeks after my trip to the ER, I had a CT scan of my chest. My lungs were free of clots.

Today, I went to have an ultrasound examination of my left leg. The scan showed that the DVT was dissolved and there is no apparent residual damage to the veins in my legs.

Next week I go back to the hematologist to discuss next steps.

From where I sit, I am now back to normal health. My bike tour starts in 20 days.

Recovery Update – Normal

About a month ago I had a bunch of tests done to determine if I had some blood or DNA abnormality that caused my body to form a deep vein thrombosis (i.e., big blood clot) in my left calf. This DVT at some point became disrupted and send blot clots to my heart which sent them into my lungs where they stuck. Had they continued on into my brain, I might not be pushing up daisies.

I went to the hematologist today for the results.

“You are normal.”

In truth, the tests revealed a couple of genetic mutations, but nothing that could have caused the pulmonary embolisms last December.

So after hundreds of $$$ we have a definitive answer to the question: “What caused these PEs?)” Answer: “Dunno.”

My hematologist says that unless he finds a specific cause for my illness he is inclined to discontinue the blood thinners and put me on an daily aspirin instead.

I go to see my pulmonologist in mid-April. She’s probably going to vote to keep me on the thinners.

In early May I have an ultrasound scheduled to see if I my DVT is gone (the body absorbs DVTs). Then another hematologist visit to discuss the findings. With any kind of luck, this entire medical mess will be in my rear view mirror by the time I pedal out of DC for the west coast in late May.

One other interesting thing happened since my last update. Yesterday, I was riding my bike with my head down and a tree branch whacked my helmet. A blow to the head while on blood thinners can cause run away bleeding in my skull. This would cause my brain to get compressed and displaced. The chances of dying from this are high.

I described the incident to my hematologist. He told me that since the branch deflected off my helmet and didn’t cause so much as a bruise, I should be fine.

And so it goes.

We’re having fun now.

Getting Off the Hamster Wheel

Today was my second trip to my lung doctor. After a scheduling snafu, I managed to get in to see her. She confirmed that my lungs are clear and sound great, as does my heart. There is some residual damage to my right lung but it’s nothing to worry about.

We discussed my outlook. She thinks that my complaints about breathing problems while bike riding last year may be indicative of blood clots in my lungs long before my December ER visit. I recall complaining during rides back in August. I told her I had no strength in my legs.

She’s inclined to keep me on thinners for at least a year. No news there. She also said that while I am on anti-coagulants we can try lowering the dose of my asthma medication. And if that works, lowering it further still.

I told her about my plans for a big bike tour to the Pacific and she moved up our follow-up appointment to make sure we had my medication situation squared away.

After tomorrow’s lab tests and a trip to the pharmacy I am off the medical hamster wheel until mid-March. Finally!

Grocery List: Coffee, Cucumbers, Lab Tests,…

On we go with the never ending parade of doctors and tests. During my hospital stay, a CT scan showed an abnormality on my adrenal gland. About six weeks later I had a slightly different, but more focused CT scan done of the area. This scan showed an adenoma, a small growth almost certainly benign. I know this because the interwebs told me so. But the interwebs are not enough and today I went to the endocrinologist.

She told me essentially what the interwebs told me. When CT scans are done, anomalies are often found. Most of them are utterly innocuous. This adenoma has all the signs of being a nothing burger. However, just to be sure, in case I am the unluckiest man on the planet, I need to have blood and saliva tests.

The tests will be done at a blood lab in the local Safeway. Right next to the condiments section, no doubt.

The doctor said the adenoma had nothing to do with my blood clots.

I really need to get off this hamster wheel soon or they’ll be sending me to McDonalds for x-rays.

Tomorrow I go to the pulmonologist. I’m going to see if I can order a shake while I’m there.

Right now I am going for a bike ride. I need one.

Recovery – Seven Weeks In

Here’s an update on my recovery.

It’s been seven weeks since my pulmonary embolisms came for a visit. I feel perfectly fine. Normal. No pain. No breathing problems. No swelling in my leg. Just the usual insufferable me.

On Monday I had an echocardiogram – an ultrasound examination of my heart – and a computed tomography (CT of CAT) scan of my lungs. Both came back normal. No heart damage. No clots in my lungs. My lungs have some residual tissue damage from the clotting episode. Despite the damage, my lungs seem to be functioning normally.

I went for my first visit to the hematologist today. His job is to determine the status of my blood, my blood’s clotting function, and whatever clots remain. He had already seen my recent medical history. He was very upbeat. Unless we find something seriously wrong with my clotting mechanics or my deep vein thrombosis doesn’t resolve itself, he’s inclined to take me off blood thinners in six to twelve months. If things don’t pan out, he’ll recommend I stay on them indefinitely.

The plan of attack is pretty straightforward. First, we do what we can to find out why this happened to an otherwise healthy person who does all the right things. I exercise regularly. I am not obese. I don’t smoke. I am handsome. (Okay, that last one’s both irrelevant and dubious).

He had beaucoup vials of blood drawn to for tests. Some of these are genetic tests. Unfortunately, the tests are not covered by insurance so I will be out well over $1,000. I wasn’t thrilled with that aspect but I really want to know as much as I can about what happened to me so I can make informed decisions.

Next month, I go back for the results. The following month, assuming all is going well, I go for a sonogram of my calf to find out if my DVT is cleared up and if there is any related damage to the vein in my leg that we need to worry about. And if everything is fine, I go back in May to get his recommendations for on-going treatment.

My pulmonologists warned me that hematologists tend to be more optimistic about on-going treatment. She predicted he’ll want to take me off blood thinners in six months or a year. She was right. I go back to her next week to see what she has to say about my lung function.

I also go to the endocrinologist next week, likely to have more blood drawn for tests on the little abnormality on my adrenal gland. As I understand it, we are trying to rule out cancer. According to what I read on the interwebs, the probability of my abnormality being cancer is very, very small.

Seven weeks ago I was scared to death. Today, I am wishing it were warmer out so I could go for wicked long bike ride.

Fingers crossed. Knock wood. Hope the creek don’t rise.