Wednesday, September 21, 2011

Update

Here's the short version:

1. I will be able to ride at normal "vigor" within a week or so.
2. I have to be a very careful rider.

The long version.

I'm going to leave out a ton of detail and technical terms, mostly because I'm lazy, but also, this *is* a bike blog.
Item 1: I will ride soon
My clot goes from my ankle up to my thigh.
The way these go away is to thin the blood so the clot stops growing. When the blood thins, the clot will sort of solidify along my vein and my vein and body will slowly absorb it over a few months. The whole "don't ride vigorously" advice refers to the chunk of time when your clot can still form. As it forms, bits can break off. Those bits can mess you up: think exploding brains, lungs, heart messy. So I'm taking blood thinners. Right now, I'm injecting myself twice a day to get my blood level to the right number. A couple times a week, I'll be going to the clinic to get a blood test to figure out the blood thinness number. Once I get to the right number (hopefully next week), I'll quit the daily shots and just take a pill to maintain the right blood thinness.
That's when I'll be able to ride with vim and vigor.
Note I also have some dietary restrictions and a requirement to drink 2 beers a day. Really. The blood thinning medication is sensitive to alcohol. So you have to commit: either no drinking or drink daily. But no in between. And no more than 2 drinks a day.
I'll be on blood thinner for 6 months.
Item 2: I need to be super careful
The whole blood-thinning thing is freaky. The concept is simple: it just means it will take longer for my blood to clot if I bleed. That's not a big deal when you cut yourself and the wound is external and easy to apply pressure to, stitch, or cauterize.
But it becomes a huge scary deal when you consider that your brain is just a big ball of fat floating in a delicate web of blood vessels. Apparently, folks on blood thinning drugs can knock their heads relatively not-hard and get internal bleeding up there. That's freaky. There's additional internal bleeding scenarios that are also freaky, but the brain one is the freakiest.
So, this is where the whole risk thing comes in.
I'm going to ride. From a risk perspective, I don't think it makes sense not to commute by bike, but then go and commute by car instead.
I'm not, however, going to ride a bike in the following scenarios for the next six months:
  • Trail riding/mountain biking. The fact is: the fun of mountain biking for me, is to push my technical limits. As a result, I wreck a lot. Mountain biking w/out going fast/pushing my comfort level, doesn't really appeal to me. This includes pump tracking and drop-bar-off-road-tom-foolery. But it does not include National Forest-type riding, which is really just long rides on dirt roads.
  • Drunk. On a two-day-a-beer diet, this is unlikely, but for the sake of completeness, it should be stated. To be clear, I don't ride around drunk. But one great benefit of being a bike-riding-beer-drinker is being able to occasionally have one too many at Benidittos and burning it off on the way up the hill. No more of that for the next six months.
  • Racing. Cross racing is out. That's a heart breaker. But each season I've raced (and I've only raced a few races a year), I've gone down at least once. I'd love to reason my way out of this, but it's not going to happen.
  • Fast descents. The idea of wrecking in this scenario is scary anyway, but even with a Nutcase dork helmet, going down at 30+ MPH would probably kill me.
So that's the deal. I'd rather not have this freaking clot, but it's not the end of the world. It's pretty painful at the moment, so I don't know how much riding I'll be able to do until blood flow improves a bit.

Also, there are 3 known causes (stasis, trauma, heredity) for blood clots and one unknown (shit happens/life is a mystery).  I can't find anyone in my family that's had a clot before, but the pending blood test will clear up the heredity issue. If it's the unknown kind (and about 20% of clot patients fall into this area), then is more likely than not to be a once-in-a-lifetime issue that will go away if I don't screw up the therapy.

2 final thoughts:
- Cars and driving still sucks. I've been driving all over the place for the last 4 days. It's no wonder our world is so mean and angry and stressed. I forget how much I rely on the bookend rides every day. No matter what kind of gooey shit I have to deal with at work or at home, there's always a bike ride around the corner. Not having it has been lame. And imagining it for months on end was making me pretty anxious.
- My friends and family are rad. Aside from the visible comments on the last post, I've gotten emails, FB posts, and calls from tons of people offering support, electric bikes, weekends of rack building, bourbon drinking, hangs, and just straight-up support and "dude that sucks, get better" notes. It's cool and it really mattered. Thanks.

13 comments:

JMH said...

Now that you have doctor's orders to drink two beers a day, you should get serious with what you drink. I'd start with a Ninkasi Tricerahops Double IPA or Hopworks Survival Stout. Seriously though, glad to hear that things are looking up, and that you are staying positive. Take care of yourself. You've got bike nerds all over the country cheering you on.

Apertome said...

Man, that sucks. I hope you heal quickly, and without incident. Take care!

Rachel said...

I'm glad to see your options look better than it seemed at first! And having doctor's orders to drink beer? How awesome is that?

I hear you on the driving thing. Every time I drive somewhere, it's stress. I suddenly become impatient and feel inconvenienced and hurried. Why would anyone want that upon themselves?
A bike ride, on the other hand, is relaxing, freeing, adventurous, and stress-killing. Even riding through light traffic isn't bad, and you can usually find a route to avoid heavier traffic so...

Hopefully your diet still has room for ice cream. See you tomorrow!

LukeB said...

Beer recommendations:

Three Philosophers
Old Rasputin
La Fin Du Monde

Anonymous said...

Drink beer. That's a care plan I can get behind. I wonder if you weren't drinking enough and that's what caused the clot? Oh well, glad to hear it's already looking better for you. Wade

zed said...

Ah, FINALLY a silver lining in all of this blot clot business! You now can be a cyclocross groupie for all of your cyclocross friends. This is a big job, it may include but is not limited to, driving the team bus, preparing drinks and lavish pre and post meals, ringing cow bells, providing general merriment, clothes holder, dog watcher, and last but not least, bike washer and maintenance dude. I can't wait for cross season...this is gonna be great!
Glad things are looking up and you'll be back on your bike soon and riding with caution probably isn't such a bad thing. Steph

Anonymous said...

This finally proves that my riding style is just what the doctor ordered.

Let me know when you're ready to accept a milkcrate, and I'll hook you up. There's nothing more useful!

Anyway, sounds hopeful...see you on the cross sidelines ringing a bell. They can always use more cowbell.

Nate

no headset said...

Same thing with me, my whole left leg. Spent a week in a Tucson hospital just after new years day. I'm still on warfrin. They actually threaded a catheter up my leg and soaked my vein with TDK, a clot dissolved. It dissolved about 80% of my clot.

I did invest in a portable INR machine; well worth the investment.

All the best and your fortunate they caught it early. Cheers, Al

Michael said...

Damn, I want a doctors order to drink two beers a day!

Sounds like you've got a reasonable plan.

John Speare said...

Hey no headset: can you contact me? john at phred dot org.
thanks.

Mark said...

What's the co-pay for two beers? Do you have to get generic or will they spring for name brand?

Anonymous said...

I had a patient last qtr in the hospital who was presrcibed a beer with each meal(not for blood clots). The pharmacy sent up 6 beers. 4 Busch Lights and 2 PBRs. Considering the costs/markup of drugs we were trying to figure out what the beers costs per unit and how you "waste" unused drugs. We didn't think they differented between PBR and say, Sierra Nevada or Deschutes brands. Wade

Dave S said...

John, so sorry we didn't get that Tower ride in before this. Let's be sure to do it in the spring if not sooner. You'll love it.
My beer recommendations: Dale's Pale Ale and 10-50 Stout.
May your blood thin rapidly.
Dave
ps still hoping to pick up a couple of those shirts if they're still around