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Transplant Athlete
Saturday, April 30, 2005
  Man who sought new liver on billboards dies

Todd Krampitz, 32, died on Wednesday. Todd had advertised for a liver on a billboard alongside a highway in Houston, TX. Eight months ago he received a liver transplant from a family who had heard about him in the news.



Happy Trails Todd.

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Friday, April 29, 2005
  Clinic Visits and Blood Shortages

I had a visit yesterday with the clinic that performed my transplant operation. The bad news and I hope my mom isn't reading this...My hematocrit is low, it was either 35.2 or 36.2 and normal is between 41 and 50. This will be a definite disadvantage during RAAM. I can't quantify how much that will impair my performance, but it is big.

My creatinine I believe was 1.4, which has been a bit elevated since my transplant, but I'm not concerned. Apparently, the Doctors there are concerned and they think my medication may be nephrotoxic. I found this study. Researchers tested the Glomerular Filtration Rate (GFR) in healthy adult cyclists as they underwent a training program. They found that training intensity had a negative effect on GFR. I'm going to discuss this with my regular nephrologist on Monday.


I'm grateful for the Inova Fairfax Hospital for rebuilding my body, but I felt my visit was lacking in something. Dr. Alijani, inferred that I should be back on Prednisone, which is not something I want to go on for numerous reasons. 1) It can lead to diabetes. 2) It definitely makes me gain weight 3) It is banned by the UCI, which means its banned by RAAM. 4) Oh yeah, it F*&ks with my sleep. Keeping me up until all hours. 5) and, the one my wife hates - Mood Swings. So, No, I'm not going back on Prednisone. When I asked Dr. Alijani about the Hematocrit, he said my regular Nephrologist would watch it. When I mentioned that my blood pressure wasn't under control, he basically said, you guessed it, talk to your regular nephrologist.

I told my wife that I am not going back to the Transplant Center for any more checkups. She thought they told me I didn't have to go anymore, but I told her we are on the "Lou Plan" now. Yes I reminded her, the same plan that lead me to discontinue the prednisone and tell the Doctors afterwards. I'm taking my health care into my own hands.


PS While I was at the clinic I told them all about the Race Across America and that we were doing it to raise awareness for blood, organ, and tissue donation, she mentioned that the hospital was recently short of blood, so short, in fact, that they prayed that they didn't have to perform any liver transplants. I think we need to fix that.

 
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Wednesday, April 27, 2005
  Go 'Zo

Alonzo Mourning brought the "Heat" against the NJ Nets. He had 21 points and nine rebounds in 16 minutes.

Zo had this to say, "My game does not surprise me. I feel I'm a Hall of Fame player. I didn't forget how to play this game, I just had a kidney transplant."

You tell 'em Zo.

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Tuesday, April 26, 2005
  For Some Transplant Patients, Diseased Hearts Are Lifesavers

I'd like to thank Laura Johannes for writing this article in the Wall Street Journal (4/14/05). She lays out a couple of really important facts. The article is in the WSJ subscriber section, but you can see a copy here
  1. Transplant centers get paid based on their success rate. No surprise there. What is surprising is that they will often reject potential candidates because they are elderly or too sick to transplant. "Some 50,000 people die each year of congestive heart failure, a progressive worsening of pumping function. Many of those patients would have liked to get placed on the heart-transplant waiting list but couldn't do so, doctors say." That also means that the 5% that leave the list per year as being "too sick to transplant" might just be too sick to guarantee success.
  2. Doctors regularly reject life-saving organs for their patient because they are not "top quality." Last year 2058 hearts were transplanted, but 5,116 hearts were available. Those other 3058 hearts were wasted; burned or buried, instead of saving lives. We spend millions to educate the public on organ donation and doctors reject viable organs.
  3. "Doctors say that those who don't make it usually die from underlying health problems, not problems with the donated heart. "A lot of the hearts that we classified as marginal are working extremely well," says Donna M. Mancini, a cardiologist at Columbia University Medical Center."
  4. For most people, given the choice between death and a not quite perfect organ, I think its a no-brainer.

"Hillel Laks, a transplant surgeon at the University of California at Los Angeles, contends that half the rejected hearts are suitable for transplanting. In his "alternate heart" program here, Dr. Laks refurbishes defective donor hearts, sometimes performing bypass surgery on their clogged arteries while the organs are on ice. He and his colleagues give infected donors heavy-duty antibiotics after brain death but before their hearts are removed. Sometimes, as in the case of Fred Austin, Dr. Laks simply puts an old heart in an old person."
"...Simply puts an old heart in an old person" - Makes sense doesn't it...
"...half the rejected hearts are suitable..." - The hard part here is seeing 1500 individuals. 1500 grandfathers or grandmothers. 1500 parents. The doctors only see 1500 less than perfect hearts, because they lack vision.
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Monday, April 25, 2005
  "What a baby"

Steven Cojocaru, suffering from Polycystic Kidney Disease, received a kidney transplant from his friend Abby Finer in January 2005. He then went on the Oprah Winfrey show last Thursday. My mom called me yesterday and this is how the conversation went:
Mom: Did you see Oprah on Thursday?
Me: Yes, Steven Cojocaru had a transplant.
Mom: What a baby.
Me: Yeah, that's his thing. It works for him.

Cojo repeatedly said that it was painful in different and dramatic ways. Oprah showed video of Cojo's mom waiting on him hand and foot "Where's my paper mom? Is the juice fresh squeezed mom?"

To be honest, I don't remember any pain from the transplant surgery, I remember some discomfort. The catheter was probably the most painful part.

Kudos to Abby for telling Oprah she would donate again in a heart beat.

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Thursday, April 21, 2005
  Katie Ride For Life

I flew down to Jacksonville, Fl this past weekend for the First Annual Katie Ride For Life. The Katie Caples Foundation was started in 1998 by the family of Katie Caples, a young high school student from Jacksonville who became an organ and tissue donor after not surviving the trauma of an automobile accident.

"We are hosting this event in memory of Katie and the wonderful legacy she left behind," says David Caples, Katie’s father and foundation chairman. "Katie was an athlete, and it is fitting to her memory to host a sporting event like this in her name. She was also a generous child who gave many others a chance to live through her gifts of organ and donor tissue." Funds rasied at this event will help provide materials for high school health classes to educate students on the need for and benefits of organ donation.

This event was amazing. There was an great turnout for the event and it was so organized that it seemed as if they had been putting this race on for years. It really means a lot to those of us who have received the gift of life that people are willing to come out and ride for the cause. There was a light breeze which provided a good tailwind in the morning, but turned into a stiff headwind on the way back. On the way to St. Augustine, we passed the "Fountain of Youth" supposedly discovered by Ponce de Leon and an old fort, which unfortunately, I was going a bit too fast to get many details. Here are some pictures from the event. Click on them for a larger version.






Chris Klug Chillin' out
after the ride

The Caples Family


Jakson Badenhoop,
Ride Director

JT Rhodes, President of TRIO,
Northeast Florida Chapter

Lou and Chris Klug

Chris and Beth Ann
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Thursday, April 14, 2005
  Its Official, too much water can kill, while dehydration is just bad.

The hyper-linked article cites a Harvard study of runners in the Boston Marathon who drank too much fluid. They say slower runners took more breaks and were more likely to suffer from hyponatremia.

"“Hyponatremia and, particularly, severe hyponatremia may be a greater problem than previously recognized,” said Dr Christopher Almond, the lead author of the study....Dr Marvin Adner, medical director, Boston Marathon, said, “Before this study we suspected there was a problem. But this proves it.” According to hyponatremia expert Dr Tim Noakes, both doctors as well as sports drink manufacturers push dehydration as a ‘medical illness that was to be feared’. “Everyone becomes dehydrated when they race. But I have not found one death in an athlete from dehydration in a competitive race in the whole history of running. Not one. Not even a case of illness,” he said."

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Monday, April 11, 2005
  Sweet Dreams Are Made Of This

I rode a 200Km brevet out of Hyattstown, MD on Saturday. I rode to the ride start from Herndon by way of White's Ferry which added 36 miles to the ride's 125 "official" miles. I guess I should have known it was going to be a rough day when I leaned my bike against a trailer to sign in and my water bottle cage snapped. How often does that happen? I had left the house at 4 am and it was nice and warm out, but once I hit the ferry, it got noticeably colder all the way to Hyattstown. Standing around in Hyattstown it felt even colder. I had meant to do the ride in Zone 2, and I was able to do most of the ride in that zone, but there was a short steep climb on Mountville Rd, the climb over South Mountain, then the climb to get over the Catoctin Mountains into Thurmont with lots of rollers between. I hoped to stay in my aerobic zone to burn fat for fuel.

I was fueling and hydrating properly, but because I was going so slow, I ran out of Powerbars, and I ended up mixing my last two bottles of Perpetuem right before the climb over the Catoctin Mountains (about 47 miles to the finish).

I think most of the people I ride with know that I try to avoid "real" food on long rides. At the 68 mile mark, people were eating subs at All American Subs. I ate a small bag of chips there, but that was it. I ran out of food and Perpetuem with about 15 miles left in the ride. I stopped at a store and downed 2 packs of peanuts and a pack of granola bars. I spent about 20 or 30 minutes letting the food digest and then jumped on the bike. This section of the route was relatively flat, so I was able to make good time despite the fact that I felt like hurling at any moment. For the next hour and a half that it took me to get to the finish, I couldn't eat or drink because of the mess in my stomach. That's why I try to avoid "real" food. Powerbars and Perpetuem just seem to go down easier and they don't restrict my effort level.

Regardless, I was a lot slower than I felt I should have been and I was incredibly sore at the finish. This doesn't look good for somebody competing in Team RAAM. I guess its more recovery rides for me in the near future. It doesn't feel good to be the last person to show up at the end of the ride and have people ask me how the RAAM training is going.

 
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Friday, April 08, 2005
  Thank You Laura Dudes

Martin Phillips and I had VO2 Max tests administered by Coach Adam and Fitness Concepts. In a VO2 Max test, Coach Adam straps a mask over my face and a machine analyzes my breath as I pedal my bicycle in a stationary trainer. He started the resistance off at 100 watts and increased it at 20 or 30 watt intervals. From the air we breath out, the machine can determine how efficient we are at burning fat versus carbohydrates and what heart rate zone we are at our aerobic peak and at what point our body switches from Aerobic to Anaerobic. This helps us train much more efficiently.

On a side note, at Stevens Tech, we did the exact same thing, only we were analyzing the combustion in a furnace. We sampled the gases going up the chimney to determine the efficiency and the fuel mix(If I remember right we were using two fuels with different heating values). The teaching assistant was awe-inspiringly beautiful, she was much smarter than I was, and she treated me with the respect of a colleague. I had a minor crush on her. But I digress...

Here are the VO2Max Results with the % improvement over the 2003 results:



Anaerobic Threshold
Power%ImprHRVO2 (mL/kg/min)%Impr
Aerobic Threshold180 Watts29%16329.214%
270 Watts12.5%19443.911%
Max 330 Watts18%20560.130%

In addition, I became more efficient at burning fat as a fuel source which bodes well for RAAM as I have a nearly unlimited supply. For comparison, Lance Armstrong has a VO2 Max of 83.8 mL/kg/min and he puts out 600 watts at max(According to his site). I think the average VO2 Max for someone my age (and Lance's age) is around 40.
 
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Wednesday, April 06, 2005
  Don't Panic

Does anyone know the symptoms of over-training, over-reaching, and/or chronic fatigue? I've got these...
  • Mood disturbances, Anger, Depression
  • changes in blood chemistry
  • high resting heart rate
  • sleep disturbances, chronic fatigue, insomnia
  • reduction in performance
  • Lack of motivation
I know I'm over-training, I was pretty toasted after the Sebring 24 hour event, so I took two weeks off and then returned slowly. The first two weeks of my RAAM preparation were difficult, but I completed them. I was feeling much better after my recovery week, but I spent the next week trying to do Zone 5 intervals and I just couldn't do it. The week after that, I did one ride. I ran some errands on the bike and then rode in to DC for our team photo shoot. I was out for about 7 hours, but I was probably only pedaling for 6 hours, and some of that I was just noodling around DC site-seeing.


This week has been a rest week, but I got a message on Monday night that my blood work was "irregular". My AST and ALT were elevated. These are tests to check liver function. As a precaution, my doctors decided to discontinue my anti-hypertension medication - Cozaar. I've dropped my dosage from 50 mg/day to 25mg/day in the process of tapering the medication. My blood pressure has shot up (159/99) and now I feel like killing myself. I cannot escape the pain. Tylenol doesn't work, nothing works. It used to be I could jump on the bike for an hour and I would feel great. I haven't been sleeping well to begin with and I'll likely be up all night because of this.

I have this fear that maybe my original kidneys are causing the problem and maybe they will have to be removed. If I had to have surgery before RAAM, I've thought about how I would get back into shape for RAAM, I will not let the team down. I've done some research on the Internet and it doesn't look like the kidneys could be causing the problem, but hey, I'm sleep deprived and in pain, I'm not thinking clearly.

Then out of the blue I see an ad for "The Hitchhikers Guide To The Galaxy" and I think - "Don't Panic" So, later today, I'll call the doctor and beg for a new anti-hypertension medication.

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Sunday, April 03, 2005
  Half of cancer deaths preventable

The American Cancer Society says that cancer deaths can be cut by 60% IF:
  • Amercians stopped smoking
  • Exercised more
  • Ate healthier foods
  • Got recommended cancer screenings

Dr. Michael Thun, head of epidemiology for the non-profit group, said in an interview, "In designing our communities and our lives, we inadvertently have made a lot of choices that work against health."
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Friday, April 01, 2005
  Solutions

I was watching a program "Weight of the World" on Free Speech TV (channel 9415 on Dish Network) and like "Super Size Me", it places the blame for our growing weight epidemic on fast food and a lack of exercise. It also makes the link between diabetes, heart disease, and all the other diseases that are threatening to start decreasing the life expectancy of Americans.

What I found really interesting is the scope of the solution the producers of the show recommend. Part of the problem is the lack of exercise due to the labor saving devices, but primary blame is placed on the automobile and the way our neighborhoods and cities are designed. The Indian Tribe featured in the program had built walking paths all over town and used different "games" and events to get people to exercise. The problem with that situation is that it depends on one or maybe two people to force it. It could easily revert back to where it was before. A new housing development was being designed from the ground up to encourage exercise which makes a lot of sense.

If, by design, people are forced to exercise, they will. In the new housing development on the show, houses were placed uphill from the street, so people would be forced to walk up and down stairs. Stores, walking paths, and parking lots would be situated such that it would be quicker to walk, rollerblade, or bike to the store versus a car. The problem there is people don't like to be forced into anything and they may just find someplace else to live.

I can get around most of the DC area by bicycle, but sometimes, just going two miles to the store can seem like a nightmare. I want to take the bike, but its raining and cold and the car seems so much faster. If I can't get on the bike for a short trip like that, how do I get others to get out of their cars for a trip to the grocery store that might seem like a hundred miles away to them?

The stakes are high. Obesity leads to diabetes, hypertension, and other diseases that have side effects like kidney failure, blindness, heart attacks, etc. Diabetes alone accounts for 43% of new cases of ESRD(kidney failure). Diabetes CAN be controlled with diet, exercise, medication/insulin.
 
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I've gone through kidney failure twice. The first time in 2000, my mother donated a kidney; and again in 2008, I'm on dialysis waiting for a breakthrough in immuno-suppression medicines before seeking a new kidney.

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Warning Signs for Kidney Disease:

  • High Blood Pressure
  • Burning or Difficulty when Urinating
  • Frequent Urination at Night
  • Blood in your urine
  • Cola or tea colored urine
  • Swellig of the eyes, ankles, or feet
  • Lower back pain unrelated to physical activity


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