I recently had an incident of having Pulmonary Embolism aka blood clots in my lungs. It was quite a surprise. Of course any health issue would be since I rarely have any! All my cycling peers wondered, “how can it be, you ride tons of miles for years?” You would think, huh?
Nope. Clots may be much more prevalent than we should assume. They may typically form in our calves (some call our second heart) over time and “float” up into our heart, brain or lungs as they break apart or if they break apart. They come in all sizes. As cyclists, we can ignore the early stages if they begin in the calves. We would think of them as sore muscle or cramps due to fatigue and dehydration. When clots form in the calves, it is diagnosed as Deep Vein Thrombosis. Serious. For me, I had a new hurt, not while riding. Mine was like a running “stitch” in my lower right chest that became increasingly worse like a case of indigestion and then like I was punched in the ribs, just over a few hours. I tried all my old tricks, drinking lots of water, breathing deeply and lying down. Nothing worked. Pain became unbearable. Time for the pros.
So, Andrea and I went to the hospital and I was tested with CAT scans, ultrasound and X-rays. The fine folks at the hospital discovered the clots, all in my lungs. I am glad Andrea was with me who could explain to the doctors, “Do you understand what he does for fun?” I am very fortunate it was caught early and the doctors understood my riding lifestyle. I am not such an oddball here since the small community where I live is full of sports intense individuals. We live in the heart of the Rockies at high altitude, perfect conditions for the athlete.
I was treated with blood thinners to begin the process to dissolve the clots and meds for the pain. I was lucky. I went to the hospital and needed no surgery!
The doc said I could start riding the week after the pain ceased. I should monitor myself with a Pulse Oximeter and use the Incentive Spirometer. Great news! But how much riding? I was into my season of brevets starting with lots of 100+ mile rides. She said hydrate more, check your blood oxygen amounts and stop if it goes in to the 80s. Does she really know me? I choose to side with caution and actually heed the advice of others this time and the HTFU mentality will have to take a back seat for a bit. I just got a little shit scared. Cycling friends came out of the woodwork sharing their experiences, all with much worse situations than mine, one a world champion nonetheless. All are back on their bikes and competing!
However, what to do next from such limited guidance was not enough for me and their riding was not quite like mine. Could I just resume my schedule? I have 300k brevet the next week. No. This new incident and my riding goals conflicted with my friends, family as well as me! I was not sure what to do! The best tips I received so far was from others with Pulmonary Embolism (PE) and Deep Vein Thrombosis (DVT) is to do your own research and hydrate! Thank God for water and Google!
I began researching topics of athletes with PE, endurance athletes with PE, low heart rate and PE, bicyclists with PE, and recovering from PE, etc. I found the best source was LiveStrong.com. I learned all about PE, DVT, hydrating, signs to look out for, compression stockings and socks, what to avoid, exercises, stretches and so on. All very helpful but a lot of gaps in my situation, riding alone for long periods of time. So, I have had to piece together items I need to add to my riding gear beyond what most of you take like your spare tire kit, pump and water bottles.
Now I have to take this speck of a pill daily. Little sucker costs over $12 each! It’s called Xarelto. My fellow PEers call it rat poison. I’m okay with it. It works however there is one side affect that worries me. It’s a blood thinner. I already have thin skin. So if I cut, scrape or knock into something, I bleed easily. Xarelto compounds the issue. So, I worry of external bleeding as well as internal. I have been making changes, such as exchanging razor for electric shaving, wearing a cowboy hat so I don’t bonk my head and always carry a bandana and wear a RoadID.
I often ride alone on roads that see very little traffic. How nice, yes? Unless there is an emergency. Cell phones do not work very well. Reception is sketchy to non existent here and who I may be calling is not close by or understand exactly my location or not have their phone with them. Voice mails are not always quick on delivery and texts as well may be overlooked. It happens. However, this shit doesn’t fly when there is an emergency. Therefore, I ride with a Spotfinder. I hope I never have to use it for an emergency. I do use it often because there are features to communicate. My wife, Andrea can track my progress. I can tell her that I am okay. I can tell her a simple message which is usually prearranged of a brevet control station or a turnaround or destination. I can hit the black button that can tell her to come and get me. Finally, there is the red button. I depress that one, I am telling her and the 911 folks I am in dire need of help! The folks at Spot claim that they have helped save over 5000 lives. I do not ride without it. It might help me, but it may help someone riding with me that is having an emergency or someone else on the road I encounter. The Spot has become my primary tool of outreach and then my phone. It uses GPS, not cell towers.
Speaking of communicating, before I leave for a ride. I provide Andrea with all the details and time estimates of my stops. I furnish her with a map of my route with all the controls or stops with which I will “spot” her so she can be notified of my progress. I will use my phone if there is cellular reception or later when I find coverage. COMMUNICATE!
I am not much of a drinker on rides. I can go thirty miles without taking a sip. I know, I know. I’ve read all about drinking. Ya da Yadda! I hydrated before rides and when the temps get hot. I’ve finally seen the light! Halleyfreakinlouya! By not hydrating, my blood was turning to “syrup” trying to flow through my veins, arteries and heart at 125-190 bpm. A curdling thought, eh? Post clot mentality is to take a minimum of two bottles and take a drink every 5 minutes and replenish with much more at stops. On rides that are super long with stretches of no available water, I will pack the Platypus liter bottles filled. I will also use them if I go overnight and poach a sleep/nap and I can have plenty of water to refuel and recover. I love coffee and now I supplement it with water afterwards. Some of my peers shared with me that they hydrate with electrolytes. I’m not a fan of those drinks. I prefer a mineral water instead if I can get it. HYDRATE!
So, now I’m an easy bleeder on blood thinner medicine. If I have an accident, chances are I may need medical help. I had my RoadID updated. I have been wearing medical IDs for a long time. I am on the road quite a bit and alone and if I have a health issue and I am unable to speak for myself, I hope this will help. When I was in the hospital recently, the EMT’s did not see it because it was a black wrist band. I think the red will be more noticeable. Please do not put one on your shoe or on your bike. Who is going to look there while there is an emergency tending to you? Give them something to work with. Time is of the essence. IDENTIFICATION!
In addition, I carry a first aid kit for me and for anyone else in distress! I always had some first aid when I began randonneuring, but it was entirely insufficient. So, I found a wonderful backpacking medical kit and I included a clotting sponge. I also ride with a bandana and I can use my tire pump as a tourniquet. You never know, I might be snake bait! All I hope I never have to use. PREPAREDNESS!
Finally, when I am not riding, I make an effort to take better care of my lungs and legs. I will no longer ignore the soreness or cramps from leg pain. I feel my calves for specific sore spots and gently rub them with my hands or a massage stick. I foam roller will do the job too. I hydrate before I go to bed so I hope not to have night cramps. I also tend to my lungs now. I am much more sensitive to aches and pains around my chest. I use the Incentive Spirometer to exercise my lungs. At rest I typically blow only 500ml of air. The doc told me to pick it up. So I practice my breathing technique fully using all my lungs. Look up LiveStrong.com on deep breathing technique for cyclists. I practice breathing at 1500ml and push to 3000ml for full capacity. This practice helps enrich my blood oxygen levels which I monitor with the pulse oximeter. I cannot get 100% living here at 7500+ elevation, but pretty close. Doc sez stop riding if I drop into the 80s. Damn right! I have begun a practice checking my levels at stops. BREATHE!
So, I am a work in progress trying to figure this all out. My goal is to bounce back and resume riding forever. Getting PE was a surprise for me as it was to other riders who shared their story with me. Equally surprising was the little specific information as to what I can do next after I left the hospital and “recovered”. I hope this helps. PE can happen to anyone. Sharing is caring. RIDE!