Just an Average Fall Day of Commuting

As I got on my bicycle at 5:45 this morning to commute to the Wellness Center to teach cycling class, the weather for the day was typical for a South Dakota Fall.  The ground was wet.  There was still moisture in the air and still an occasional drop of rain falling, either from the sky or from the tree, desperately trying to hold on to the moisture on it leaves.  Temperatures in the high 40's and winds out of the north at a chilly 10-15mph.  Everything is in balance in the world as I commuted by bicycle for the 2,000th consecutive day.  Ride on.

In Search of Mister 19D

I went for a quick 30 mile ride this evening and I ran across a person that I just have to find.  I'm not sure if I will be able to sleep until I do -- I feel THAT bad about what happened.  Please allow me to explain and help me find this outstanding citizen of Clay County South Dakota.

Crossing the Hwy 19/50 interchange heading north of Polaris, I looked back in my mirror and noticed a truck crossing the intersection.  I first feel I must apologize to the driver as even though he was probably an 1/8 of a mile or more away, I was on his road.  Quickly I realized the error of my ways and I moved over onto the inside of the wide shoulder, on the other side of the white line and corresponding rumble strips.  Even though there was a little gravel where I was at, going over further would have proven more dangerous.

You came up slowly in my mirror, and even though there was nobody coming in the other direction, you chose to stay inside of your lane, seemingly as close to the white line as possible, maybe yourself worried that crossing that center line may be seen as suspicious behavior should an officer be anywhere near.  I must say you approached carefully and slowly.

As you pulled up next to me, I looked over and gave you a nod.  You passed me ever so slowly, which I have to tell you was a pleasant surprise as I rolled along around 20mph on a 65mph road.  Apparently it was at this point your foot must have accidentally slipped and stomped on the gas pedal causing your diesel truck to spew out a dark cloud of pollution in my face.  It was then I realized that something was wrong!  I don't think enough pollution was coming out of your truck!  I'm very worried for your health as I really believe that something is wrong with your exhaust.  Something must be clogging it up.

This clogging is potentially life threatening and I was trying immediately to figure out the best way to get your attention through the cloud you left behind.  As I raised my hand to get your attention, I thought at the same time that I should get your license plate number so I could trace you down, but I was only able to get the first three numbers of the plate:  19D.  Through the cloud of emissions and my sunglasses, I believe it was a maroon truck along with your extra wide mirrors which mean that you must pull something on occasion. 

It was then that I realized that my hand that was raised must have had a bad cramp as only my thumb and middle finger were extended.  I thought back to my childhood and remembered my parents telling me that combination of fingers meant something really bad.  You must have noticed that also as you slowed down again.  Finally all my fingers came up and I motioned for you to come on back so I could apologize for my completely legal and safe cycling that caused you to feel uncomfortable.

Apparently you misunderstood my attempts and you sped away.  I was hoping that you maybe lived on the Bluff Road as that is the way I was going to be going and I may be able to find you again, but alas, you went North on Hwy 19 past the turn.  Luckily for me, Clay County is fairly small so I hope that somebody out there may help me identify you so that I may sit down and apologize for all the things that I didn't do wrong.

I really feel that without sitting down and discussing this man to man, not only will this misunderstanding stand in the way of a potential beautiful friendship, but I will wonder if the potential blocked exhaust is slowly filling your truck, slowly killing your few precious brain cells.  So please, if you are reading this, or if a person who knows you is reading this, contact me soon so I can sleep without the guilt of wondering if you are okay.  Sleep will most certainly elude my guilty conscious until you do.

Mr 19D xxx, please allow me the opportunity to talk with you.  You seem like such an important man in your big diesel truck.  Surely you will give this puny bicyclist the opportunity to right this wrong face to face. 

Medically Speaking

Thanks to the blog-killing application known as Facebook, many of you know most of my medical story by now, but for the rest of you, and the Facebook averse, here within is going to be a rather long post that I will do my best to shorten up for the sake of losing those who might actually read, but not want to read too much.

It all started on July 27th, 2013.  It was my son Carson's 10th birthday and I had arose early and knocked out a quick 50 mile bike ride with a friend to Centerville and back, with the obligatory stop at the Royal Bake Shop for a Zebra Donut.  I had been home a while.  I had showered, powered down lots of liquids and Carson asked me if I could help him set up his XBox Live account that we had purchased for his birthday.

Needing a parental account due to his age, I went down and set up what I needed to.  I had been in a squatted position for quite some time and on the completion of the account set up, I grabbed my iced coffee and stood up to leave.  I took a few steps, and became dizzy with blurred vision.  I grabbed the wall to steady myself as this was not my first time that this had happened.  However, what happened next was a first.

All I remember was two sons standing over me with a rather panicked look on their face screaming "DAD! DAD" and me coming out of my stupor, not really too sure as to what had happened or what was going on.   It was a pretty terrifying experience, but I was most upset about the spilled iced coffee of course. 

Other than the initial panic by everybody in the family, it seemed to be a remote incident and nothing to get too worked up over.  Then it happened again, and again, and again.  Seven times in all between July 27th and Thanksgiving Day.  One time that was probably worth of a trip to the emergency room as I went backwards hard, using a nice concrete basement floor to soften the blow on my head. 

After it was apparent that is was more than just a remote incident, Laura was not about to let it slide and appointments were made with the VA to get in and see what was going on.  When I sent a message to my Primary Care Physician, an immediate appointment was set up to have an ECHO done to my heart.  Long story short, ECHO came back great.  No issues with the heart walls, etc.

Step 2: Wear a Holter Device for 21 days.  For those who don't know and don't want to Google it, it's a monitoring device that you put three sticky pads on your chest that connects to a device that you put on a lanyard around your neck, or some other creative place.  Another device that you put on your belt records "events" that happen and you are supposed to press when you are having an "event". 

I told them I work out pretty hard and was assured that I wouldn't break the device.  After my first day of wearing it in cycling class, it quit functioning.  My sweat was indeed mightier than the device.  Enter device number two which I put in side a Ziploc baggie while working out. It did fine but the recording device touch screen quit working.  I found this out when I actually DID pass out and then tried to hit "record" on the device.   Enter device number three to actually finish my 21 days.

The suffering of actually wearing the device was equal to the issues I had with it.  Not to mention, after all the waiting to find out results, it didn't show anything.  There were two events they discussed with me.  One was at 0640 on a Monday morning when my heart rate shot to 163.  Well, since I was in cycling class at that time, that would be a pretty normal heart rate to have.  The other event was that my heart rate went too low for their "normal" range a couple of times in the middle of the night.  Maybe something serious, maybe just because I still have a really good resting heart rate, but nothing seemed to alarm the cardiologist. 

Speaking of the cardiologist, we asked to have an EKG completed and he complied without questioning and that too came back without any issues.  Then came the Tilt Table Test the he ordered.  They did not have the setup at the VA to do this so the VA scheduled the test through Sanford.

What is a Tilt Table Test?  Evil.  Pure and simple.  It sounds simple enough however.  You lie on your back while they put an IV in you for fluids.  You stay there for a half hour or so and then they raise you up to a 70 degree angle and you are standing there, strapped in, with your feet on a foot board looking out.  The object:  you passing out.  If you don't, no worries, they'll give you medications to lower your heart rate so you DO pass out.  Awesome.

For the first 15 minutes of my test I was staring at the clock on the wall wondering why I was even there.  I felt great and nothing was wrong.  Then, slowly, my mid back started to hurt somewhat, which can be fairly normal for me.  Then at about 21 minutes, I started to perspire a little and I told the Nurse.  Then at 23 minutes I was beyond perspiring and now my pores were acting like individual spigots open wide.  I was begging the Nurse to put me back down as I was going to throw up.  With a look of "it sucks to be you", she said "Just hang in there for a bit longer" while handing me a barf bag.  Somewhere after 24 minutes, it was over:  I passed out and the next thing I knew they had lowered me back down and I was staring at the ceiling once again.

The Nurse Practitioner seemed fairly confident at that point that I have Vasovagal Syncope.  That has a wide range in the diagnosis world.  Mine would be a positional version of it.  However, it's the same thing that happens to people when they pass out at the sign of blood or pass out when bearing down to poop.  Yeah, I'm really not kidding with that either.

I finally had another appointment with my cardiologist thinking this was going to be the big break, the one we really needed to move forward with some sort of treatment plan.  A list of do's and don'ts with hopefully no medications.  Well, turns out that the results were nothing spectacular.  He said that he could take a good portion of healthy people and get the results he got with me.  Great.  Excitement drowned.

Laura brought up the fact that during times of stress that I can "zone out" and not be there for a few seconds as well.  When the cardiologist discussed this further, he seemed to know exactly what was going on as had a name for it, which escaped both Laura and myself after we left the appointment. He also stated that he didn't believe that my episodes had anything to do with my heart and that maybe I needed a neurology consult.  As much as that too didn't excite me, it was another option to try to get to the source of what's going on.

At this point he then stated that we should look at putting a "Reveal Device" in to monitor me for up to two years. He said that he would order the procedure and I'd be contacted soon.

This invasive device is about the size of a flash drive and is surgically put under your skin and monitors you constantly.  At first I had resigned myself that I would be getting this device.  After talking it over, praying about it, reading more about the device, and realizing the device would only catch MAJOR events (i.e. passing out), I decided against it.

It was also at this point that I came to a "I'm very worn out by all of this" conclusion that I had to approach Laura with.  I decided I was done for now.  I had been healthy for a couple of weeks at that point with not anything but the very lightest of dizzy spells when standing.  When I told Laura I expected to get a lecture, which would have been totally justified since she has the joy of seeing me pass out the most.  Instead she informed me that she was actually expecting I might say that I was done.

I struggled to want to go through with more tests when, at that point of having no spells, they would probably find nothing wrong as well.  I did make a deal that if they start up again, we are not going through the slow slow process that is the VA and we would go the Mayo Clinic route.  Go up, do everything at once, and see if there is anything that can actually be done.

Although this leaves out many of the details, you now all know what has been going on in my world.  99% of the time I feel great.  I'm healthier than most people half my age.  It's just the teensie weensie little issue of falling down and going boom that seems to be a small issue. 

Don't worry, I'll be back on the road biking with you all this Spring provided that the issues stay away!