Watch those NSAIDs

A little disclaimer: I don't mean to be an alarmist on this topic, but I'd like to get another story out there, in the hope that perhaps another cyclist or athlete doesn't go down the same rabbit hole I did when it comes to NSAIDs (ie anti-inflamatory meds like ibuprofen, naproxen, aleve, etc). That said, I'm sure that short term use to target temporary injury & inflamation, as recommended by any compentent Dr, poses reduced risk.  Oh yeah, sorry for the novel-like nature of the content below. If you finish reading this before you start contemplating questions about the value of the internet, who invented it, whether you'd rather be out riding a bike, or what's for dinner, I congratulate you.

So.....a few weeks ago on Saturday I put in 140 miles, 7000+ feet of elevation gain on my new Zanconato road bike. 4.5 hours of that ride had me in some unexpectedly foul weather, with windy pouring rain. (half of the route traced the same roads as the Tour of Utah queen stage where Horner and Danielsen had it out with each other). Needless to say it was a long, hard day in the saddle, but I still made it home in high spirits and an ok-for-me finish time. **I must say it was cool to look down and see one hell of a filthy bike as I rolled into my garage** But he point of this is not to cowbell what for me was a tough ride. The point is that exactly 7 days later I was in the hospital fighting for my life.

That was supposed to be a final training ride for one of the highlight events on my race calendar for this season, alongside some of my other good friends riding in black Zanconato team kit: the Tour of Park City, on Sat 8/3. By Thursday evening before the big event (the training ride mentioned above was the prior Saturday), I was starting to feel a little weak so I emailed my buddies that my participation was going to be a game-time decision. Friday, I felt a bit worse, but was still up and about, and spent the evening getting my bike ready for the race. Symptoms were mainly elevated HR, very tired, but no loss of appetite. Saturday morning I had a very dizzy spell after getting out of the shower and by that time I assumed the dizziness, cold sweats, etc, was an oncoming flu. So I took it easy the rest of the day and bagged the race. I continued to note that my HR would redline even if I took a few steps. My resting HR by that time was 120 and I would peak around 160-170 just by walking a few steps. So I did what most guys do when not feeling well: lounge around on the couch, watch some TV, and be super lazy. I still didn't miss the opportunity to enjoy a ginormous plate of Mexican food (I had some insane craving for salty/spicy food that day...for some reason). That should have struck me as odd at the time (I always lose my appetite with the flu), but it didn't. Then again, no one ever accused me of acting with complete intellectual clarity when presented with large portions of very good food.

By Sat eve, my wife notices the obvious and she says,'re white...what have you been up to today? Yup. Palms and face are very pale. Fingernails almost translucent. Whatever...stupid weird flu or stomach virus...I'll sleep it off and go see a doc on Monday. Gives me an excuse to be lazy on Sunday and watch more lame tv. She convinces me to at least call a nurse hotline. Turns out nurses are smarter than we are. The patient, smart, and most likely underpaid lady on the other end of the line had the presence of mind to walk me through the symptoms and also asked me about something my dumbass self chose to ignore...bowel movements. TMI I know, so I won't go there. But based on the answer to one question she had about that, she thought I might have an internal GI bleed and recommended I go to the ER. It was 1:30AM at that point, but I got my wife out of bed and we drove a short 5 miles to the local hospital, I got checked in and merrily let the poking and proding begin. First nurse was hard core - she had that perfect New Yawker attitude and balled me out for not coming in when I fainted in the morning. "Ummm...maybe THAT should have been your first clue to come in???". Funny how going to the ER involves equal amounts verbal abuse and equal amounts TLC at the same time... Anyway, she was nice enough, but made it clear that I was not operating with a full deck. They took various samples of my biology and finally I get to see a Doctor. He comes in and says, Wayne, your Hematocrit is 21%, your HR is off the charts, and I'm surprised you're even coherent right now...gotta get some blood in ya quick.

So I got checked into their hotel for sick people and got into one of those awful hospital gowns that make you feel like you're going to have some koolaid while you wait for a comet to come take you away while wearing old school Nike sneakers. After getting hooked up with IVs, ECG sensors, and the blood pressure arm strap which wakes you up every 10 minutes to take a blood pressure reading, coming just short of severing your arm (I swear the CNA had that thing on waaaaay too tight...she was otherwise pleasant though), they immediately started me on the blood transfusion 'program'. Yay. I am a cyclist and I am officially doping. I had no idea it takes so long to get a unit (bag) of blood inside you - it takes several hours per bag. They prescribed 3 units, so it took well into the next day to get all that blood in me. Luckily no bad reactions. Thank you to whoever donated that blood. But I hope you have good DNA, specifically the sort that leads to good cycling legs, as I am sorely lacking in that area.

Just a quick aside: My kids came to visit me at some point and I had all these colorful electronic wires protruding from my chest for all the ECG sensors (which, upon their later removal, would later give me the added benefit of a chest wax - albeit in a slightly inconsistent pattern leaving nice circles of bare, pristine skin, surrounded by rugged un man-scaped wilderness). I had to pull the blanket up to my neck when my kids came in because I didn't want them to see all the wires and get too alarmed. It was quite tempting to let the wires show and tell my kids that the hospital was in the process of turning me into a robot...maybe throwing in a little Michael Scott lonely robot impression. I think that would have scarred them for life, so I withheld.

Blood samples taken all through the night by the vampires indicated no stabilizing of blood count; it had even gone down a tick or two by the next day. So clearly the internal bleed was bad and they needed to patch that up quick. Luckily, the GI (gastrointestinal) Doctor, known for his ability to serve up some of the most delectable endoscopies this side of Northern Utah, was able to make it over to the hospital pretty quick and the Surgeon was alerted to be on standby in case they had to open me up. I got wheeled down to the procedure room. It was supposed to be a quick 15 minute procedure; stick the scope down my throat, find the bleed, cauterize it with a freaking lazer beam (no killer sea bass involved), and out again.  Just before the procedure I was awake enough to make a few light jokes with the Doctor, his assistant and the anesthesiologist....'so a Dr, a Nurse, and an Anesthesiologist walk into a bar....har har har'   Afer the injection to put me out (I was out within seconds) it seemed like a blink of an eye and I was coming to again, just as they were pulling tubes out of my mouth.  Only now I noticed that there were 6-8 other people in the room, and the mood was a little more..shall we say "energetic".  Still a little groggy though & I got wheeled over to the ICU. 30 minutes later the GI Dr comes by and says (paraphrased) 'Wayne, I just want you to know what happened back there. I couldn't get that hole patched for the life of me. It was at the top of your stomach next to the opening of your esophagus and it was spraying blood everywhere....couldn't get the scope at the right angle to do anything about it. We had the surgeon preparing to operate but at such critical low levels of blood, you most likely would not have made it through surgery. After 45 minutes you were starting to come to again, so I said a prayer and did one last hail Mary: Twisted the scope in a very unusual direction and zapped the hole. It finally worked. You are one lucky (more appropriately 'Blessed', depending on your life philosphy) SOB.'   I owe that man my life.

Sorry for the loooooong-winded post here... Anyway, after the dust settled, it was time to run other tests, and try to find out why I got such a bad bleeding ulcer. Most causes were ruled out, including some kind of "H" bacteria that grows in the stomach lining, and no personal or family history of ulcers (spicy food and stress are old wives tales). Then we discuss meds. I had been nursing some chronic knee pain (old scar tissue from a past injury) and was taking Naproxen or Ibuprofen throughout the season to keep the inflammation down. I wasn't popping that stuff like candy, but I was taking it regularly, probably 6-8 pills a week for the past 6 months to assist with a high mileage training schedule.  Long story short, that stuff is baaad for your stomach and WILL eat away the lining eventually. The good doctor also mentioned there is a smaller % of the severe bleeding ulcer population that feel no sharp stomach pain as a warning sign - I was one of them apparently.  He did mention that, like any cyclist, runner, or other athlete with a strong heart, I was lucky due to the large "stroke volume" a good heart gives you in a situation like this. It was able to work overtime & pump vigorously to use what little blood was left to keep vital functions going.

So...  To my wife, all good doctors, nurses, medical staff, science, modern medicine, people who donate blood, my family, my friends, etc. I say thanks. And I also want to thank John...and Bill for always being there me. George, you know I couldn't have done this without you. And to all my fans....wait...where's the trophy? Seriously though, this blog is obviously not the place to wax religious, but thanks to that Higher Power for keeping me alive and kicking another day. And here's to a sport that gives us all strong hearts to keep us alive inspite of our mind blowing stupidity at times! (speaking for myself here) The rest of my season is hosed, but I can't wait to get back on my bike in a few weeks...It'll take another 2 months to get back to normal blood levels, but in the mean time I have been relishing what is most important in life but also looking fondly at my bike, dreaming of turning the pedals once again.

1 comment:

Anonymous said...

Very inspiring story, Wayne. Glad to hear your on the mend and I'm sure I'll meet you out on the road someday.