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Transplant Athlete
Tuesday, November 29, 2005
  Lessons

Every once in awhile I learn a really profound lesson. My freshman year at Stevens Tech was very difficult; I had a tough time maintaining discipline in my studies. I took a year off to work and that was really depressing. A couple of months before I was supposed to return to Stevens, I learned a lesson that changed the rest of my time at Stevens. I was visiting with a relative at the Jersey Shore and griping about just about everything. The difficulty of Mechanical Engineering classes, the dreary nature of Hoboken and New York City. A guest at the house, a chiropractor, said, “You’re stupid.”

“If you can’t see how great New York City is, you are stupid. There are amazing museums, restaurants, and…” I was taken aback and started to really hate him. The truth hurt and I gradually realized he was right and I hadn’t seen that side of New York. He also said I was stupid for wasting the opportunity at Stevens. Again, he was right. I spent the next three years at Stevens making the most of the opportunity.

Recently, I interviewed for a design engineering position at Zipp Speed Weaponry. My credentials were a bit weak for the position, but my zeal for the cycling got me an interview. Throughout the interview, Andy Ording, the President, kept asking questions like “Do you do work on your car?” He felt I didn’t have enough design experience and I didn’t have enough hands-on experience. He is right (which is probably why I haven’t heard back from him). So, I spent the weekend rebuilding the brakes and replacing lights on my Cavalier. It’s a start.

 
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Friday, November 25, 2005
  Its so hard to get out of bed...

It was so hard to get out of bed this morning. I knew the temperature would be in the teens and the high wouldn't get out of the 30's. Crista had planned "Unmarked and Unchained" for today, a nice little century that starts from Berryville, VA and meanders through West Virginia. My favorite part of the ride is a road (Butlers Chapel Rd) that overlooks the valley where you can find Hedgesville, WV.

I took some time of the bike, and last week was supposed to be a century, but I took the shortcut and it ended up as an 81 mile ride. Today I was feeling better, but I was really slow. Early in the ride, I got dropped by the group. They stopped at a Sheetz around the 20 mile mark. The Sheetz was just past my turn, so I missed the bikes out front, and Steve jumping around trying to get my attention. At the official rest stop at the 27 mile mark, I stopped just long enough to defrost my camelback hose, which had frozen solid. My waterbottles with Perpetuem were frozen solid and there was nothing I could do about that without a microwave or a longer stop. Ed Felker (sans tandem partner Mary) caught up with me on Arden Nollville rd, just a couple of miles from the lunch stop, and let me know what had happened. I had thought I was dead last, so I was planning on skipping lunch, which would give me about an hour jump on the group. Gradually, everyone caught and passed me, but we were like 2 miles from the lunch stop.

I ended up stopping briefly at lunch to defrost my waterbottle full of Perpetuem, then pressed on. The group eventually caught me again around the 80 mile mark, but I kept my stop short at 83 miles and was able to get nearly 5 miles down the road before getting caught again. I finished in a little over 8 hours.

We did this ride in February and I rode from home to the ride start, did the ride, and then rode home, totaling 187 miles.

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Monday, November 21, 2005
  I took the Shortcut

Saturday morning around 6am found me on my bike riding the W&OD trail to Ed Felker's house for the start of the "Alcova on the Rocks" century. The forecast was for 23 degrees at 6am warming up to a high of 51 degrees. When riding in weather that cold, my chief concern is that my waterbottles or my camelback hose might freeze. My waterbottle got a little slushy, but didn't freeze. My camelback hose did freeze up, but it was near Ed's house and I was able to use it after a couple of minutes inside. Other than the cold it was a beautiful, clear sunny day. I haven't ridden much in that area, so it was a good change of pace.

The ride headed into Georgetown up through the Capital Crescent trail and then up through Potomac to Poolesville. It was around 21 miles to Ed's house, then another 36 to the first rest stop. My legs were getting pretty fried by then and I had drifted to the back of the group. (Actually there were several groups and if history is any guide, the leaders were about an hour up the road from me at that point.) I decided to limp into Poolesville and take the Gen. Jubal A. Early Ferry to get across the Potomac. Then I took another stop in Leesburg, another stop at Partlow's Store on the trail, another stop at Smith's Switch in Ashburn, and then finally made it home. The shortcut brought the ride down to 81 miles and it took me 9 hours from start to finish. On the plus side, I was home by 3pm.

 
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Monday, November 14, 2005
  Procardia

I have a really odd body. Odd in the way that I always seem to get the least likely adverse reactions to medicine. For instance, I started taking Procardia a couple of weeks ago in addition to the Cozaar in an attempt to control my blood pressure. I knew that after the biopsy, I wouldn't be able to exercise and my doctor felt it would be prudent to be on both.

I got the headaches, 23% of the test population got them. But, the first night I took Procardia, I had the most realistic dream I have ever had. (Rough Outline of Dream: I went to a concert with my wife and kids, My sister Clair and her husband, and my cousin Matt. Afterwards, we spent the night in a Frat House.) When I woke up in my dream in the Frat House, it felt so real. When I actually woke up, I googled the drug to find out if that was a side effect This site had "Abnormal or Terrifying Dreams" listed as a rare side effect. The official Procardia page lists Abnormal dreams as occuring in 2% or less of the people in the test population.

I am thankful that its not some of the other "rare" side effects though, like "Transient blindness" or "sexual difficulties". That would suck. Another example? Prograf's rare side effects include: Alopecia (got it) and Hypertension (got it).

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Wednesday, November 09, 2005
  Post Transplant Kidney Biopsy

Yesterday, I arrived at the Inova Fairfax Hospital at 8am for my biopsy. While getting admitted, I was asked to sign a form that said if my insurance didn't pay, I would be liable for payment. Which seems a bit redundant to me. Who goes to the hospital and doesn't assume they'll be liable for the bill if the insurance company doesn't pick up the tab. Which brings me to my next point. If I'm supposed to be liable for the bill, shouldn't I be made aware of the costs? The largest cause of bankruptcies in the US is medical bills. Its a sad fact, but hospitals charge exorbitant amounts for operations. Insurance companies with lots of clout, then negotiate the rates down to a fraction of the cost, but people without insurance end up paying full price. Why don't hospitals post rates? Why aren't consumers allowed to comparison shop?

Anyway, back to the biopsy. The transplant surgeon, Dr. Jonsson, was supposed to bo my biopsy, but organs became available and obviously a transplant operation takes precedence. So, I was stuck in a bed in the short stay unit with my butt hanging out of one of those hospital gowns. The news ran a story about a car accident that had happened earlier in the morning, and I couldn't help but wonder if those were the organs that had become available.

I spent the next 8.5 hours waiting in the short stay unit, then I finally got moved down to ultrasound and discovered that due to communication errors, I was the last patient of the day and could have been seen hours earlier.

The biopsy is an interesting sensation. The lidocaine goes in first and that's what you'd expect, a needlestick, but it does its job and in my case, I didn't even feel the rest of the shots. Then, they use another instrument, and it feels like they are digging or scrapping around inside. Very interesting feeling. The nurse operating the ultrasound didn't have any experience with it, so the doctor performing the biopsy was juggling her tools, the ultrasound probe, and telling the nurse what buttons to push. When they get where they are going, there's a loud snap as they capture material. The first time didn't get them enough cortex marterial, so they did it again. The second time didn't yield enough cortex material so they did it again. The third time was the charm.

They cleaned me up and shipped me back upstairs. I was supposed to rest and let the incision heal, the major threat with a kidney biopsy is bleeding. Around 6pm, I asked a nurse for some water and never saw her again. I called the nurses station at 7pm to ask for water and received it about 15 minutes later. Also, the nurse came in and administered some Lasix (a diuretic). They were supposed to adminster that as soon as I came back up, and they were also supposed to be taking my blood pressure and temperature hourly, but apparently, they didn't know I was back from Ultrasound. This isn't a knock on the nurses, they are overworked and underpaid. I try not to bother them. I had seen their orders, so I was supposed to be restricted to the hospital bed for 3 hours. At 9pm, my wife called and I told her to come pick me up, it would take her about a half hour to get to the hospital. At 9:15, I got dressed and about ten minutes later, the nurse came in and said that she had my discharge paperwork. Which was fortunate, because I was leaving at 9:30 whether I was discharged or not. I did not want to spend the night.

 
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Friday, November 04, 2005
  Kidney Biopsy

Way Back in 1986, when I was first diagnosed with Glomerulonephritis, I had a biopsy done. My nephrologist performed it at the hospital in Dover, NJ. I spent at least one night in the hospital, maybe two (I can't remember, that was nearly 20 years ago). Then in 1999, I had another biopsy, which was performed by a technician at the Inova hospital in Alexandria. I was in and out inside of a day. The techniques for evaluating tissues had advanced, so by this time, the diagnosis was changed to Glomerulonephritis-"like", which is what they say when they have no clue what you have, but it looks like something they seen before.

Now, its come to a point where the nephrologists and transplant surgeons would like to know a little bit more about how my kidney is doing. They'd like to know if my Prograf (immunosuppressive medication) is at the right level and they want to make sure its not damaging the kidney. As I've found out, the drug that keeps my kidney from getting rejected also destroys the kidney (nephrotoxic). They think this may also answer some questions about why my blood pressure keeps going through the roof. So, I have a biopsy scheduled for Tuesday at 8am at Inova Fairfax hospital. Again, I'll be out in a couple of hours, and I'll have the results in about a week.

They say it will be two weeks before I can get back on the bike, so that sets my training back a few weeks, but I'll probably be on the bike sooner.
There was a question in one of the comments about how long it was before I was back on the bike after my transplant. I set my bike up on a trainer in the house and spun with light resistance a few weeks after the transplant. I had to wait until my wife went back to work, because she wouldn't let me ride. I was riding outdoors shortly after my 6 week appointment, when the doctors gave me the go-ahead to ride. The first ride was 40 miles out and back on the W & OD trail near my house. As a rail trail, there aren't any bad hills, so it was a nice easy ride. About 9 months later I was riding my bike across the country with Lon Haldeman and Susan Notorangelo.

 
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Tuesday, November 01, 2005
  2006 Training Plan

The first thing to do when working out a training plan is to schedule Races and any family commitments. In my case, RAAM is the biggie, but I'd like to complete the DC Randonneurs Brevet Series. These rides are timed, but are not races. They are ridden without a support vehicle and with strict time limits for the control points along the way. The 200km ride (127 miles) must be completed in 13.5 hours. The 300km (189 miles) must be completed in 20 hours. The 400km (249 miles) must be completed in 27 hours. The 600km (373 miles) must be completed in 40 hours. Arrive at a control point after it has closed and its, "Better luck next year." The other event on my calender is the Bike Sebring 24 Hour Time Trial in February.

Once, these events are on the schedule, its time to arrange the training cycles. Every cycle is 3 weeks and is followed by a recovery week. A training cycle will work on something specific (ie. Climbing, speedwork, etc). The earlier weeks will have more aerobic riding to rebuild my base. This year I'm going to add more strength training to my routine along with Compex workouts. I added the Compex Unit late in this year and mostly used it for recovery, but the few strength workouts I did use it for were really intense.

As soon as I get the specific workouts planned, I'll post the training plan online.

 
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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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