Monday, June 28, 2010

I am either a freak or a post-menopausal, overweight woman who smokes and just returned from Australia

There were moments when I feared for my life. That I wouldn't every see my kids again or live out all of my shared dreams with Christine.

So much has happened since my last post . At that point, I thought I would just live with the discomfort, see how things go, and gradually build up my training. But after this weekend, I'm grateful to be alive, see how things go, and look forward to taking a walk.

After encouraging training over the weekend, I took Monday off to go to Boston for work. On Tuesday I biked in the AM and swam at noon. Even did some good fly. On Wednesday morning, I went for an easy 6 mile run. The effort felt like a 7:15 pace, but Mr. Garmin said it was abut 8:40. I also had to walk three times. Walk. I walked not because of paid, but because I was gassed. [As a side story, near the end, I passed a guy who I see on the road many times a week. A little while ago we saw each other at an event, and realized we both know Angela. He was aware of her great achievements in triathlons. That morning, he said, "I saw you almost got Angela in that race (Pirate Tri). Nice work!" Sure, rub it in.] Wednesday noon brought a slow swim workout. All of these efforts made me feel like I was at altitude- I just couldn't get enough air in.

That afternoon, I had some sudden chest pain to the right of my sternum. Since it was to the right, I figured it wasn't a heart issue, so soldier on. I went out to dinner with my business partners. When I got home, it hurt too much to bend over to untie my shoes or even take a half breath. In addition, I have been spitting up more blood than last week. The next day I did a very easy bike on my trainer, being careful not to breathe so hard that I would cause pain in my chest. In the afternoon, Christine and I went to see our doctor, Jim. He was still thoroughly confused, but said he talked with a pulmonologist, who threw out the wild idea of a PE, or pulmonary embolism, or clot in my lungs. Jim said it didn't make sense, but was willing to try anything. He also said that in case it is, my exercise was now limited to tying my shoes until I got clearance to do more.

On Friday afternoon, we went to see the lung doc, who checked me out, performed some lung function tests, then sent me to another location for a contrast CT scan and more blood work. Last week's CT was to look for tumors. For this one, they injected a dye in my arm, at which point they had about 60 seconds to take pictures. It would allow them to see clots that wouldn't have shown up on last week's test. We did the test, and I returned to the waiting room. Minutes later, my world came crashing down.

The technician and radiologist came out and said they saw multiple clots in my lungs (I later learned 20+), and some were large. They had called an ambulance and were taking me to the Maine Medical Center ER. My brain immediately went to....clot, stroke, dead. My kids aren't with me, and I'll never see them again. This could be the end. I'll never be with Christine again. I can't be too dramatic here. Tears flowed.

There were times when I tried to stay calm. Panic wouldn't help anything. I remember the ambulance guy coming in and asking how I was doing. My response? "Other than that, how was the play, Mrs. Lincoln?"

As for the CT scan, both the lung doc and Jim were shocked by what they saw. It just doesn't fit. I have ZERO risk factors. The most common candidate for a PE? A post-menopausal, overweight woman who smokes and was just on a long flight. Yeah, that's me. I can't tell you how many times I was asked the same list of 20 questions in an attempt to find something that makes sense. Nothing fits. They drew a gallon of blood, some of which went to testing. We'll get results in a few days that might help figure this all out.

Back to the CT scan waiting room. They assured me that there was no risk of a clot going to my brain. You need a hole in your heart, between the left and right atriums for that to happen, and I had a clean echo last week. Fast forward to the ER. A very good friend, Ed, a cardiologist, was on site. It's normal for PE patients in the ER to get an echo, so the technician came in. As she was almost done, Ed arrived, and she pointed to one possible abnormality. He wasn't sure, but agreed to do a "bubble test" where they inject small bubbles in my IV. We watched on the screen as they filled one side of the heart, and sure enough, leaked through to the other side. A PFO is something that between 15 and 25% of the population has, most without every knowing it. When in utero, the lungs don't function, and there's a hole in the heart. That hole is closed by two overlapping flaps after birth, but not for me. PFOs are nothing to get worried about.....unless you have clots. Great. To make a long story short, it was another scare, makes me nervous, but intellectually is not a concern.

They moved me from the ER up to a room at 11PM. The next day, I saw Jim. He was incredibly relieved that we now know what's going on. I was, in turn, relieved to see his relief. I asked a bunch of questions and tried to remember the answers. The subject of Budapest came up. There are two primary risks with the trip. First is the flight- both the air pressure and the long inactivity. Second, a bike crash while on coumadin would not be good. Time has to go by for us to get a handle on this. At this point, I'd be thrilled to still go on the trip, put the uniform on, and just finish. It's funny to think I've had trouble coming up with a goal for this race. Now it's just to finish in one piece. As an aside, I dropped out of Urban Epic last week and Bethel last night. I'm leaving Fireman on the list in the event that we are able to go to Budapest.

On Saturday night, I had an echo on my legs. It was around 9PM, and my family had all gone home. As I lay there, she seemed to keep working on certain areas, pushing lots of buttons, etc. Given my recent track record, I was sure there was more bad news on its way. Fortunately, I tested negative for Deep Vein Thrombosis, or clots in the legs. While that's good, we're left wondering where they came from since 85% of clots come from the legs.

Most of my time in the hospital was spent in the waiting room or walking the loop around the floor. It was kind of funny how the nurses and doctors had to keep chasing me down to draw blood, take vitals, whatever. The whole time I had five leads taped to my front and a bulky wireless transmitter. This made sleeping rather difficult, in addition to the "just in case" IV sticking in my arm. At one point I was walking circles, carrying my transmitter and iPhone in the same hand. That caused some panic with my nurse as the phone caused my HR to read too high, setting off alarms.

Which reminds me of another funny story. While in the ER, I had all sorts of wires attached, and a monitor above my head that I could read. One of the numbers and graphs showed my respiratory rate. I found I could control the shape of the white line with my breath. So I slowed my breathing to 7 (per minute?), which would set off an alarm. I got a kick out of it during a pretty stressful time. Whatever works.

On Sunday morning, I learned I would go home that day. While talking with the doctor, I asked to see the CT scan from Friday. I wanted to visualize what was going on. Most of us have two lungs, and each has a pulmonary artery feeding it blood. My guess is they are about 2 cm. wide. Both of mine were/are about 85% blocked. Holy shit. That isn't far from 100% (not good). That visual will stick with me for a long time. So why was I able to function so well before, even on the day they took me to the ER? It's all about my training. To over-simplify, a "normal" person might use 30% of their lung capacity to walk down the road. If you take away 85%, they're in a deficit. I might need 10% to do the same. Take away 85%, and I still have room to operate. Training, however, also made things worse. We train ourselves to push beyond discomfort and previous limits. If we don't hurt, we aren't working hard enough. We feel something, and assume it will pass or we need to work though it. As a result, I didn't take all of this seriously enough. Now I know what it feels like, and I will not make that same mistake again.

Walking out of the hospital was tough. I felt incredibly vulnerable. The cord was being cut. What if? What if? Apparently, these feelings are very normal, and subside with time and as confidence rebuilds. I already feel better today. I can take a huge breath without pain, the first time in over two weeks. Physically, I know things will get better. Mentally, this is all pretty heavy now. It's life changing, but I realize it's too soon to know exactly how.

One final thing. Through the iPhone and Facebook, many good wishes were received. They were not only a great distraction, but also very comforting and greatly appreciated. Thank you all.


  1. Thanks for taking the time to fill in the blanks for us Steve. I'm so happy that you are on the mend!

  2. wow. Budapest, schmudapest. go hug those kids and relax a bit.

    look forward to getting you back to full health amigo. I age up next year and need some one to race!:-)

  3. Wow Steve, so much to take in. I'm with Kurt, hug those kids of yours and relax the best you can!

  4. [Sigh] ... oh my Steve. I am so glad you got in there and know what is going on. Also know you are not a alone, freaky life threatening heart issues happened with my 2 immediate 40-year old male neighbors. Be grateful you put your body in such great shape. Now... Enjoy summer, the way life should be, with your family kicking back.

  5. phew...oh gosh Steve. I just can't even imagine how you have been feeling. I am so incredibly relieved that you are ok. I agree with those guys... hug your kids and wife and just savor things. THe other stuff will be there when you're ready. You're in my thoughts!!

  6. Yikes! I'm so glad that you're okay and that all those hours of training paid off in more ways than one. Nice to see you kept your sense of humor through everything by setting off the alarms on the breath meter too.

  7. Okay - I am SO SORRY this happened to you! THANKS for the comment on my blog - I will definitely be getting in touch with you and comparing notes. I have yet to write a blog - but rest assured, I'm in the middle of one right now. I'm at: - send me your email and I'd love to get some feedback from you. My clot DID stem from DVT - and I'm now awaiting an ultrasound on my heart. But it's a long story. I'm still learning more about what happened... I'll be in the hospital for another few days until they figure out the appropriate amount of cumadin and lovenox for me.... but yeah... FEEL BETTER! And let's get through this thing!

  8. Oh my gosh! After your email, I had to read your blog (Marit told me your blog) - so here I am...and I also JUST SO grateful you are ok. I hope you know you have a ton of cheerleaders in the TRI world for you - Any friend of Ange's is a friend of mine.