What a long strange trip it's been

I rip that off directly from the great American poets the Grateful Dead, and use it because it is apropos of my summer. It has been a long and not so good summer, mostly because I was sick during most of it. I now know that I have bacterial endocarditis and that I got it when a tooth extraction back in May let loose bacteria into my bloodstream. Those bacteria found the defective aortic valve in my heart and set to work.

The first impact was a fever and fatigue about 5 days after the extraction. I got the tooth pulled on a Monday and Tuesday I went to Cartersville, GA to co-direct a dig on an interesting and large prehistoric feature located just west of the Etowah Indian Mounds site. I took my bike up there because one of the goals I set for myself at the beginning of the year was to ride in three states other than SC. It was hot and running a dig is always tiring and stressful. One morning I went for a 30-mile ride. It was a great ride, maybe one of the best I’d done. The countryside was beautiful, I saw a lot of wildlife and it just felt good to propel myself. A day later we ended the dig—without finding any conclusive answers—and the following day I got a fever, chills, headache, and fatigue. Thinking this was related to the tooth, I called my dentist and that Monday he gave me some antibiotics. I felt better in a couple of days.

Jump forward about 10 days. My wife was gone to Atlanta for a few weeks on a photo shoot. I took my kids to a local park, asked the moms to watch them and jumped on my bike for another ride. I only went 25 miles and really felt like crap—no juice. Two days later I got a new fever with chills, etc. I called my dentist—on his way to the beach—and he (somewhat reluctantly) called in a second prescription for antibiotics. In a few days I felt better…but I began to wonder if these problems weren’t related to the physical exertion of riding my bike.

A week or so later my wife came back home and I was ready to get back to training. I set up a very full schedule (5 nights in 6 days) of valet parking (one of my side occupations) and planned a ride in there, too. I took the ride on a Tuesday—after a couple of valet nights—and barely finished the ride. I was exhausted, no energy. It was such a terrible ride that I didn’t even want to think about riding again for days. A funny thing happened; a few days later I had the fever and all again. On July 5^th I went to a “real” doctor…OK a “doc-in-a-box.” He did some tests, confirmed I had an infection and prescribed me a long course of antibiotics. He didn’t have any answers, but suggested a variety of things. A few days later, I felt OK again, but I decided not to ride my bike until after I had finished this course of antibiotics. I was sure riding my bike was somehow triggering this.

Near the end of that two-week course, we went to visit my parents in southern VA. I brought my bike because I had been having troubles with the derailleur and wanted to work on it with my Dad. I also wanted to take it with us because from my parents’ house we were heading to the Shenandoah Valley to visit my sister-in-law. It sounded like a beautiful place to ride…and I was really jonesing to ride. The day after I finished my antibiotics I worked on my bike and then took it out for a measly 12-mile ride. There was a nasty hill in it and my shifting problems weren’t fixed, so the ride was a lot harder than it should have been. Two days later while in the Shenandoah Valley, the fever returned. We drove home the next day and the day after that I visited the “doc-in-the-box” again.  The PA I saw this time mentioned to me that I had a heart murmur. I asked if it was related to my fever and she said she didn’t know. She prescribed a course of antibiotics focused on tick-borne diseases like Lyme’s Disease or Rocky Mountain spotted fever and ordered some more tests. This time I did not feel better after a couple of days.

At this point I decided I needed to see a real doctor, so I tried to make an appointment with my wife’s internist. He was on vacation and wouldn’t be available for two weeks. I took the first available appointment in the practice for the following week. I saw the doctor and he puzzled over my case. He ordered some tests, including an echocardiogram. He suggested that my heart murmur might have something to do with my problems, but didn’t elaborate or commit. Then he said, I will see you in two weeks—he went on vacation. At this point, I had been through a week or so of daily fevers and chills and complete exhaustion. I suffered through another week of that and then got the echocardiogram done…the results wouldn’t be available for a week, just about the same time my doctor was coming back. I was pretty distressed at this point because I really didn’t want to face another full week of sweating, freezing, and feeling horrible and I was becoming increasingly scared that something very serious was wrong with me.

At the same time that this last fever started, while I was in Virginia, I also noticed a spot blocking my vision in my right eye…it didn’t go away. When we returned home in addition to seeing the doc-in-a-box I also saw an eye doctor. He said I ruptured a blood vessel in my eye and wanted me to see a retina specialist to make sure there was no permanent damage. A few days later I saw the retina doctor. He confirmed the ruptured vessel, said there would be no permanent damage, and scheduled a follow-up visit for about 10 days later. At my follow-up visit, the retina doc and his nurse started quizzing me about the persistent fevers. I told him my story. He looked at me and said, it sounds like you have endocarditis. He got a stethoscope—my eye doctor—and listened to my heart. He immediately called a cardiologist and two hours later I was in his office. Four hours later he admitted me to the hospital.

In the hospital it was confirmed that I have endocarditis, that my heart valve is damaged, and that I need surgery to replace it. Here I sit today talking iv antibiotics at home waiting to clear up the infection so I can have open heart surgery. Me, a healthy guy only 45 years old—heart surgery. Crazy! The fact that my eye doctor recognized my problem and got me on the path to treatment—crazy! The fact that I kept going on long bike rides and spending my evenings in 100 degree weather chasing cars while my heart was struggling to function—crazy and scary! I was actually beginning to wonder if my body just couldn’t handle the physical strain I was putting on it between my various jobs and bike riding. I was beginning to think I’d have to give up cycling before I really got to see what I could do. It was such a relief to finally know what was wrong with me that I was actually happy to hear I had a heart infection and needed surgery—crazy!

So, it’s been a long strange trip and I’ve got another one to take—recovery from heart surgery will take 2 months, maybe more. If I am lucky, I’ll get on my bike again in November and if I am lucky I might be able to do long, hard rides before the turn of the New Year. The upside? Well, my heart has enlarged so that it can keep pumping enough blood to my body despite the backwash across my leaky valve. When my new valve is in place and the backwash stops my heart will have an increased capacity. In cycling, more blood is more oxygen to the muscles and that means being able to ride longer and faster. My body will work better than it does now!

This whole experience has caused me to reflect …and I haven’t even gotten to the scary part yet (where they crack me open like a lobster, stop my heart, and tinker with it). I spend too much time and energy doing things because I feel like I have to (usually chasing the all-mighty dollar) instead of doing things that I want to do. When my life ends I want to think I’ve done the best I can for my family, but I want to feel like I allowed myself to live my life, too. I think of my friend Ed. He has a pretty demanding job and manages a pretty full family life, but he always makes time to take his kayak to the ocean, take his kids fishing, go for a run, paddle his wife or friends around to see dolphins swimming, etc. I need to get a little more living out of my life before I can’t anymore. Thanks for reminding me, Ed.

Another upside to this whole business? My course of antibiotics at home—when I am supposed to be recovering from the infection and getting strong enough for surgery—comes right during the final grand tour of the professional cycling season—Vuelta a Espana (Tour of Spain)—which also overlaps with the inaugural running of the USA Pro Cycling Challenge in Colorado. So I have every excuse and all the time in the world to sit on my ass and watch cycling for several hours a day for the next three weeks! Oh yeah, and finish that grant proposal, finish editing that book, and finish that paper I promised months ago.