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Transplant Athlete
Sunday, August 28, 2005
  Cramparama

When I completed the Race Across America, I weighed roughly the same as I did at the start. I thought I had done well, replacing lost calories along the route. I have been having trouble with my blood pressure and in searching for a solution, I read on the internet that excess fluid could cause High Blood Pressure. The recommended fluid intake is 8 glasses (8 ounces / glass) of water or juice per day. I had been pretty lax about monitoring my fluid intake, so I broke out the little measuring cups the hospital had given me to help with monitoring. After a day or so of the proper fluid intake, my blood pressure didn't drop, but my weight did, by 4 pounds. I was drinking and carrying around an extra half gallon of fluid inside me.


Did the lower fluid intake contribute to todays crampfest? I don't know. I rode the Reston Century today, its a fundraiser for the American Red Cross. I got about 30 miles into the ride and started cramping heavily. I took a couple of Endurolytes and would be cramp free for about 30 minutes. I went through a dozen Endurolytes in an 8 hour ride, I rarely used more than 6 on any century previously this year. The temperatures today were actually cooler than most of the riding I've been doing this summer. I was trying to keep up with Chuck and Crista on the tandem, but I've also been doing that on all the other rides. The rest stops today had the greenest bananas I've ever seen. I tried cracking one open and the outer layer of skin just peeled away from the inner layer. It was kind of like trying to peel celery. The banana itself was hard and chalky. I couldn't stomach it.

In the end, I logged 113 miles which included the 4 mile ride to the start and then 4 miles home afterwards.

 
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Tuesday, August 23, 2005
  Woah Nelly, Who Gave This Guy A Microphone?

Pat Robertson, a fanatical religious leader, told his tele-congregation that the US should assasinate Venezuelan President Hugo Chavez.

Eliminating Chavez would be "a whole lot cheaper than starting a war," said Robertson.
"We have the ability to take him out, and I think the time has come that we exercise that ability," said the Christian leader.
"We don't need another 200 billion dollar war to get rid of one, you know, strong-arm dictator. It's a whole lot easier to have some of the covert operatives do the job and then get it over with.


Does anybody else think this is funny? UM...THOU SHALT NOT KILL unless he's the president of a country that has a lot of oil? (Not Christian? how about the Muslim version: You Shall not take life - or the Jewish version: You shall not murder). I was going to say that Mr. Robertson should stick to preaching and leave the diplomacy to the professionals, but if he can't respect the Commandments, maybe the 75 year old televangelist should think about retiring. Hey Pat, I hear Jim Bakker's out of jail and he says he's rehabilitated, no more sex with secretaries or financial fraud for him. He's a changed man.
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Wednesday, August 17, 2005
  Steven Cojocaru Needs A New Kidney

Steven Cojocaru lost his new kidney to an infection in June. Presumably he is back on dialysis while he awaits a new kidney.

Cojocaru says he's "determined" to get another kidney and is trying to "help make donating kidneys the new, trendy, hot thing to do. Hotter than buying a house in Malibu."

"Kidneys are the new black!" he joked.


I wish him the best of luck finding a new kidney.
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Tuesday, August 16, 2005
  Non-Directed Donation

So...readers of this blog know that I am interested in recruiting non-directed donors (NDD) to wipe out the organ transplant waiting list and that at least one member of the National Kidney Foundation thought that was a bad idea. I recently talked with my local Organ Procurement Organization (OPO) and they are encouraging NDD. They have done a couple and are trying to increase the program. They even sent me brochures I can send out, so if you are curious and would like to learn more about Non-Directed donation send me an email with your address and I will mail it out to you, absolutely free. My email address is at the bottom of the page, just click on website administrator.
 
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Saturday, August 06, 2005
  UMCA Policy on Qualifying for RAAM

3) Team RAAM
Riders who officially finish 4-person, 2-person, or tandem RAAM will be qualified for solo RAAM.


So there...And don't think I'm not sticking my tongue out at you.

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Friday, August 05, 2005
  Medical Issues

The first question I asked my nephrologist, Dr. Goldberger of Metropolitan Nephrology, yesterday was, "Based on my bloodwork before RAAM and after, did I do any damage?"
He said, "No."
My next question, "Can I race next year?"
"Yes."

With that out of the way, we moved on to the other important issues:

  • Hematocrit (HCRIT): My HCRIT was so low, that I was unable to donate blood. My bloodwork from Tuesday said that my HCRIT was 38.9%. He thinks that the ARBs (Angiotensin receptor blockers - blood pressure medication) that I'm taking may be having an effect on my HCRIT. He did say that he's never had a patient as obssesed with his hematocrit as me :) He's a cyclist also, so he understands why I'm obssesed. Just to be on the safe side, my next blood draw will check my EPO (Erythropoietin) level.
  • High Blood Pressure: I've been having side effects from the Diovan and it hasn't been working very well, so I'm going back to Cozaar. The Cozaar was a bit more effective for me, but may be damaging my liver. I'll get bloodwork done two weeks after switching and then monthly after that to keep track of my liver.
  • Creatinine: My creatinine was 1.4, which is normal for me.
  • Liver function: Results from AST, ALT, and Bilirubin, fluctuated a bit after RAAM, but would probably be considered normal for me.
  • Tacrolimus/FK506 levels: 6.7, which is within the normal range.

Dr. Goldberger will talk to my transplant surgeon, Dr. Jonsson to discuss whether they should biopsy my new kidney. From my last appointment with Dr. Howard at Metropolitan Nephrology, it sounds like a biopsy could answer some serious questions like is the medication that I take to prevent my kidney from being rejected actually damaging the kidney?

 
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Wednesday, August 03, 2005
  RAAM Redux

There are tons of articles on training for Team RAAM, there are tons of books (Complete Book of Long Distance Cycling, The Cyclist's Training Bible, etc.), and many good coaches that can get you to the fitness level required. The only thing keeping Team RAAM from exploding is the logistics involved. As you can see from my account of RAAM, and Martin's account of RAAM, logistics were the most difficult part. We both agree that the riding was probably the easiest part.

Before:

  1. Fundraising - In our case, we were raising money for a cause, so we had a committee in charge of raising funds. We also had a committee for publicity to raise awareness for our cause. We had a committee to plan and throw 3 fundraising events. This adds a whole other level to planning and organizing. We joined RAAM a bit late, so we had a limited time to plan and execute, but under the circumstances, our team did well.
  2. Transportation to the Race start - In our case the airfare was donated by Independence Air. For other teams, purchasing and coordinating flights and pickups at the San Diego airport is time consuming.
  3. Team Kit - Since we were trying to raise awareness for the Give Life Foundation we decided to get a Team Kit, which took several weeks to be made.
During

Once in San Diego, there is surprisingly little time before the race starts. And in that time, there are a million things that need to be organized.
  1. Vehicles and equipment - Renting an RV takes a lot of advance notice for an event like RAAM which depletes the inventory in the area. You can't just show up and rent one at the event. Picking it up generally requires several hours (getting to the RV center, learning how to use the equipment, driving it back). In our case, we rented a minivan and we had the Independence Air Jet Truck. All three vehicles needed signage, some needed bike racks, and others needed safety lights and other safety equipment. In our case, we had to track down the correct minivan, we had to get longer crossbars for the roof rack, and we needed to get the rear rack for the RV which had not arrived on time. Tick Tock.
  2. Bike Equipment - While putting the bikes together, the mechanic noted several problems with equipment and we spent a good part of a day going from bike shop to bike shop finding parts. My Zipps, with maybe a thousand miles on them, had wear and tear that prevented them from working properly and once opened up, looked like they had 20,000 miles on them. I brought 2 spare tubulars and purchased one more in San Diego, I ended up having about 5 flats on the trip.
  3. Groceries - Shopping and Storage - This takes time and scheduling to shop for food at the start and then arranging storage in the RV.
  4. Rider Swaps - This proved to be the hardest part for our team, especially in the large portions of the country without cell phone access. Were I to do Team RAAM again, the crew chiefs would be in charge of all decisions once the race started. I use the plural because Martin covered the need to have two crews, one to support each set of riders. A rider can get dehydrated, a rider can lose concetration, a rider could forget to tell the next team when their pull starts, but not a crew chief. Two crew chiefs can discuss how their 'team' of riders is doing and schedule them appropriately.
  5. Hotels - There are hotel rooms to be arranged (early) in San Diego and then at the finish line in Atlantic City. During the race, we had no problem getting hotels along the route all had vacancies, except for the expense which hadn't been budgeted.


As Lon Haldeman points out in his article How to: Team RAAM , it doesn't take a lot of funds to do Team RAAM. Lon points to $4725 per rider, but I think it can be much much lower than that. Nearly $1300 of that is hotel rooms and another $1300 in food. Lon is saying that there would be $5200 for food, which seems high to me. Although, I would add in an RV which would bump the price up by $900/person. As an aside, its definitely cheaper to do a PACTour. For $3295, you can travel across the country in style over the course of 25 days.

I think more people should and could do Team RAAM. Any suggestions on how to get more people involved? Leave a comment.

 
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Tuesday, August 02, 2005
  Somebody's Been Naughty

Martin went to the Team Give Life Website to read my blog and found his blog had been deleted. Not only had the post been deleted, the blog itself moved to Atlanta. So, to give Martin his fair shake, here is his latest email to me, in its entirety, uncensored.

Lou,
First, I don't really know anything about hemocrit levels, but I hope that you are recovering well.
Also, congrats on your results at the world games. A huge accomplishment.
I'm realize that I'm a little more straightfoward than some people. I also know that tends to bother some people. It's how I am. I call them like I see them. Apparently, everyone doesn't agree with you about "free speech", at least as it pertains to MY free speech. I find it unfortunate that someone has felt it necessary to delete my blog while leaving incorrect information about me posted on the teamgivelife website. I guess my opinion STILL has no merit (I thought it was only a race thing). You are correct when you said that communication could have been much better on this team. It was a crucial failure. I honestly feel that no one other than Mike, Derek, Jacques, Bill and Scott ever really considered any input I had during the race.
The reason that I went to the website today was to take a look at your "Transplant athete" blog. I found some interesting misperceptions contained in it. Two that stood out are you thinking that I "decided" to ride to the parade route at the end. What actually happened is that I was told to ride to the parade route - twice. When I passed you guys when you were in the parking lot, I was told (by the Jet Truck) to continue, then to stop. When I stopped, you passed me sitting on the side of the road. I waited with the Jet Truck for anyone to tell us what to do. Finally, they called and said to ride back down the course to the parking lot where they were and have the Jet Truck follow you. I got on the radio and said I thought we'd be disqualified if anyone saw me riding backwards on the course (Though I didn't say it, I also thought riding on that road without a chase was crazy). They said, in that case, to continue to ride to the parade route. You didn't know that. An appropriate ending. "Miscommunication" should have been our team name.
The second was when you expressed an opinion that my heart was never in the race. Actually, if that were true, I wouldn't have thrown the helmet. Someone who doesn't care doesn't react that way. The REASON I threw my helmet was I was so frustrated with you and Bruce. Again, you and Bruce may have thought Bill and I riding for that long was the plan. That was not communicated to us or anyone in our support vehicles.
Again, communication was awful. As I was part of the team, part of that fault is mine. People seem to like to bring up my military experience. I'll leave you with this: in the military, morale is the responsibility of the commander. It can not be delegated. It is one of the commanders most important responsibilities. The commander influences morale by the command climate he creates. I know that may be an unfamiliar term, but basically it means how they their attitude influences other members of the unit, how approachable they are, if they listen, if they are perceived to care about the members of the team. Communication is key to all of these. We simply did not communicate. The morale was not good. We were not cohesive. Those factors are critical to the success of any military unit or any team. That is why I feel that the failure to handoff the "command responsibility" from Bruce to Mike was such a critical mistake. Bruce may feel that he handed it off, but I know for certain that Mike never felt like it was truly his.
Lou, I wish you luck if you do RAAM next year. As I said, I am considering doing it on a two man team next year. I thought your opinion on that was funny. I actually think it will be EASIER than this was. My experience is that from a logistical standpoint a 2 man, 24 hour race team is easier than a 4 man, a solo effort is easier than that. As I said in my (deleted) blog, I didn't find the riding difficult. I found the logistics difficult. I think with better planning, I'll actually get MORE sleep on a two man team than I did this year. I'm not certain I'll be there next year, but if you are, good luck.
Martin

 
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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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