Tag: pulmonary embolism

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.

 

 

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.

It’s Hard to Like April

Mostly, April 2018 will fade from memory, because nobody wants to think about cold, wet, windy weather. April did have a few high points. For a start, my pulmonlogist was pleased with my recovery and backed off the prospect of leaving me on blood thinners for years or maybe even forever. She also lowered the dosage of my asthma medicine. And hopes to further lower it when I get back from my bike tour.

My bike tour planning is going along very well. I received several bike maps from the Adventure Cycling Association a few weeks ago. This allowed me to plan my trip as far as Missoula, Montana. There are numerous options for the rest of the trip to the coast. The southern route goes through central Oregon and follows the Adventure Cycling Transamerica Route. The middle route follows their Lewis and Clark route down the Columbia River gorge, through Portland, and on to the coast. Both these routes are encumbered 50 miles on road construction through the Lochsa River valley. In this corner, Felkerino, who is a man of many miles, advises that this road is awesome and contains a continuous downhill stretch of over 90 miles. In the opposite corner is Andrea, a woman of many miles too who rode the Northern Tier from Seattle east. She (and some commenters on this blog) both say the Cascades are awesome.

Two more maps arrived today from Adventure Cycling. One is for the missing segment from Missoula to the western edge of Oregon on the Lewis and Clark. The other is the segment of the Northern Tier that goes through the Cascades. To get to the start of that route, I’d need to ride a truck route along the Flathead River. I’ll plan both routes out and wait until I get out west before finalizing the way to the coast.

Getting back to my health, I did an acupuncture treatment last week that has done my left arm and shoulder a world of good. Yesterday I rode a 52-mile event ride called Breaking the Cycle. It was cold. The first 28 miles were uphill into a headwind. I rode The Mule as a test ride for the tour. It did fine except for some chain skipping on the cassette (which I had tended to today). At Friday Coffee Club last week, I bought a Brooks Flyer saddle from Felkerino. I mounted it too flat and spent much of the ride sliding my butt back to the rear of the saddle. This caused pain in my bad shoulder. Today I tipped the nose of the saddle up just a bit and my shoulder is happy again. So happy in fact that today’s visit to the gym involved two machines that I have avoided for over a month. So I cancelled tomorrow’s physical therapy session in a fit of optimism.

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The Mule at the Turn Around Point

A word of warning about acupuncture, if you don’t want to look like a junkie, you might want to avoid acupuncture if you are on blood thinners.

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The Golden Arm

Near the end of April, the sun came out. The trees and grass did their thing and we got to enjoy a shit ton of pollen. This is my car today.

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There was one excellent thing that happened in April, I went to three baseball games! On my bike, of course. I missed catching a home run at the first game. The Nats lost. At the second game I nearly killed my buddy Kevin with a nacho bomb. The Nats lost.

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At the third game, I avoided batted balls and gut bombs but the Nats still lost. I sense a disturbing pattern.

Despite its crummy weather, April did give me my biggest mileage month of the year. I rode 27 out of 30 days for a total of 789 miles during the month. For the year, I’ve ridden 2,743 miles. That’s a pretty decent foundation for what lies ahead.

 

Seven to Seven

I’ve don’t like being idle so today was my kind of day. I was running around and doing stuff from 7 am to 7 pm. After breakfast and reading the newspaper I did this:

  • 15 minutes of physical therapy exercises
  • A visit to the pulmonologist. She has pretty much decided to let the hematologist determine whether I should stay on blood thinners indefinitely. This was quite a surprise to me. This assumes that my lower leg is free of the deep vein thrombosis that dispatched the clots to my lungs. When I get back from my bike tour, she’s going to experiment with lowering the dosage of my asthma medicine.
  • Checked out patio furniture at Home Despot. It looked crappy.
  • Took my car to a state inspection station to find out if it would pass inspection with a ding in the windshield. He said “yes”.
  • Bought bird seed coated with hot pepper powder. (Alas the neighbor’s squirrel appears to be adapting to the stuff.)
  • Got my haircut so that I don’t look like I am undergoing electric shock therapy
  • Meditated for 30 minutes
  • Ate lunch
  • Rode Little Nellie to DC for one last look at the cherry blossoms. Okay, I might go tomorrow and Friday buy this is peak bloom and there’s no telling when it will end. The Tidal Basin was crowded so I skipped it and rode through the tunnel of blossoms in East Potomac Park instead. If you still plan to go this year, tomorrow or Friday before work would be best. Walk around the Tidal Basin and go snow blind. Then take a bikeshare bike (the dock was full when I was there) to ride the tunnel.

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    To be honest, this picture doesn’t do the road to Hains Point in East Potomac Park justice.
  • Rode to the gym to lift weights lamely. I tried some free weights today.
  • Rode home feeling tired.
  • Ate dinner
  • Turned on the Nats game right about now

 

 

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.

A Winter Retirement Day by the Book

My schedule for a winter retirement day is pretty simple. In no particular order: eat breakfast, read the paper, ride my bike (or go for a hike), do either physical therapy (a.k.a. yoga) or go to the gym to lift weights, read a book or magazine, meditate, and do one adult thing.

So today I began with a half mile walk to the hospital where I had a CT scan on my lungs and an echocardiogram. I’ll count these as one adult thing. After an administrative snafu I got signed in and escorted to the CT scan room. There I was passed under the machine once. Then I was injected with a dye and passed through again as the dye sent eerie warmth through my chest and head. (I really should do this stoned at least once.) Done. It only took five minutes.

The CT tech took me to ultrasound where I was given my echocardiogram. I was positioned on my left side allowing me to watch the screen as the exam took place. The tech told me my blood pressure which was well within the normal range (as usual). She also told me my resting heart rate was 45. This is the first time since my DVT/pulmonary embolism crisis that it has been below 65. To me this is great news because my pulse is normally in the 40s. As I watched I could see the line for my heart going boing…thud……..boing…thud and so on. At one point there was audio. My heart sounds pretty cool. DOO…duh…..DOO…duh. I am pretty sure that my former co-worker Kelly would confirm that this is the only part of my body that has good rhythm.

The tech cheated a bit and told me that  my heart looked and functioned normally during my December echocardiogram. She was not surprised that it still did. That’s one organ less to worry about as far as I am concerned.

I walked home in a cold wind and ate breakfast and read the paper. There was ample coverage of the Super Bowl which I thought was great even though my team lost. We can now move on to the winter Olympics and make a smooth seque into Spring Training. Yes, yes, yesyesyes.

After my repast, I headed back out into the cold wind for a bike ride. I had on my normal winter bike commuting stuff: skating cap, heavy-weight neck gaiter, base layer, holey sweater, rain pants, and neoprene overboots. I was comfortable within a mile.

I headed south past Mount Vernon and Fort Belvoir. I used the bike lane on US 1, a busy four-lane highway. I wanted to see how my mirror would work. It did fine. There were literally no surprises in that I saw every car, truck, and bus well before it was close to me. I turned north on Telegraph Road, the kind of totally inane roadway that Fairfax County is known for. Lanes come and go seemingly without rhyme or reason. Bike lanes also come and go. I came flying down a hill at 35 miles per hour in a bike lane. It was a good thing I came to a red light because 100 yards beyond the light, the bike lane disappeared.

I rode all the way to the Beltway, took a right to go east on Huntington Avenue, and headed south on Fort Hunt Road where I stopped after 25 miles to go to the gym. For some reason my left arm is unhappy. It shoots sharp pains whenever I lift a weight above my head or push one away from me. Even though I use very light weight on two machines that move in this manner, my arm still hurts. I’ll bring this up with my doctor during my physical later this week.

Finally, I rode 4 miles home into the cold wind. It was nearing 4 p.m. but the sun was still well above the horizon. We are now getting about the same amount of daylight as in early November. Works for me.

When I arrived home, I had a snack and a shower. Then I sat down to meditate. And the phone rang again and again. It was Verizon calling with an offer for its mindfulness long distance plan. (I made that up.)

All that’s left is some filing of medical stuff including beaucoup CDs and DVDs of my scans. Then I can read and eat dinner and call it a successful retirement day.

And one more thing. My wife told me about this really cool National Geographic travel package. It takes you all around the world to Machu Pichu and the Holy Land and Burma and Paris and everywhere in between. On a private jet. Just $99,000 per person.

Spit take.