Sunday, December 18, 2011

Riding Through Cancer...

In my previous posting today, I describe my new challenge with this damn heart of mine, that I try to keep big, open and happy... but my genes keep getting in the way. And in the posting I mention how important being in good physical health can be... especially when, invariably, we get sick. And I mention that in the past, I have posted regarding my challenges with oral/head and neck cancer.

I have also changed the goals of my life to reflect my aging and perhaps some wisdom that I can pass on regarding health, through my various physiological trials. I have decided to start writing a book about my cancer, using a bicycle trip I took in 2010 that started in Vancouver, British Columbia, Canada... and ended in Austin, Texas, America in an expansive metaphor for the experience. This 4,500 kilometer trip was one I took with about forty other riders and many support folks... it took a couple of weeks, and was the hardest thing I have ever done. It was also the easiest thing I have ever done!

It was especially hard on the road, when I was thinking I was doing it alone... as sometimes would happen when I wasn't feeling good on any particular day, or even just part a few moments of the day. When you are climbing a hill, starting from a couple of thousand feet, to a pass that is around 8,000 feet, there are some moments that the riding gets really, really, really hard... and lonely. Even if you really like yourself, if all you are hearing is your own voice or heart pounding, it can play tough games with your psyche.

But then someone comes along and gives you some encouragement as they go past... or maybe they slow down to ride along side and with you... maybe even put their hand on your saddle and give you a little push. Sometimes when these things happened I would get a little rush of adrenaline, and the strength would return, and my cadence would come back... it happened several times. On at least one occasion, it didn't!

( Photo Credit is to )

I was on Douglas Pass... it is just as you approach Utah in the Northwest corner of Colorado... our Team Five had ridden fifty-five or so kilometers that day when we approached the base of the mountain... I started up the mountain with the other four riders on our team... I had climbed poorly for about a mile and I could feel cramps in practically every muscle in my body... I got the message! It was about the hardest thing I had done on the trip so far... I got off my bike. It was so steep I had a hard time dismounting, and I was so cramped, I couldn't lift my 15 pound bike into the support van that was right there with me. My God it hurt... I had soooo wanted to climb that Pass.

In the van, we followed the riders up the pass to over 8,000 feet and at the top there was a spectacular view. I got out, it was just above freezing, but I was now rested and I didn't have any pain. I swallowed hard as the teams (a second team had done the ascent with us) prepared to descend... the whole reason in my psyche, for climbing a mountain is the thrill of the descent. Just as they were about to start off, one of the riders yelled to me... "Bruce, where's your bike?"

As I pulled it out of the van, raced to put the front wheel back on, checked the pressures, the chain, and my clips, I couldn't help think I didn't deserve to descend on my bike... I hadn't climbed it...

We crossed the cattle grate at the pass pinnacle, and the descent was on... I aimed the bike, down... the tears in my eyes were streaming, my ears were hearing an ethereal scream of delight, and when I looked at my speedometer it was at over 75km. I was wheel-to-wheel with the guy who got me there (my surgeon Chad Robertson), including up several earlier difficult climbs, and I could see the grin on his face... or was that the up-hill wind we were screaming into... a long sweeping turn to slow us down, passed, and then down again... then we looked at 80km...weeeeeeeha!

I realized that so many other people have so much to do with our big moments in life... but in the past I had, too often, not understood what was happening around me... this time, I got it!

The road flattened out after about an eight mile descent and we got to see tomorrow's mountains on the right side of the support van as we pulled away from the end of our section for the day. We had changed in a parking lot, not bothering with the other cars in the lot, with nothing but smiles pasted on our cheeks, hearts still flying... Now, we were in Utah's mountains where between us and the hot pink sunset, there were some snow crystals off in the distance... making it magical... but not so much as the descent!

( Photo Credit to )

So, I have decided to begin writing parts of the experience and post some of them here. In a way I want to see them in print, and share some of the experiences, maybe with the details of the ride profile, or the cancer oncology plans, or other questions that I had and have about how to get through challenges... I hope they will be useful, and perhaps allow covers to one day embody them in an useful way.

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My Latest Challenge

Never a dull moment in life as we age... mine has been a roller-coaster of late... to say the least. About ten years ago I was lucky to have been able to have a diagnosis of a genetic heart defect; one that was getting to the stage that it could suddenly end my life. It was a bicuspid aortic valve... and it had a calcific stenosis that had become acute. Through persistence and the help of close colleagues in the cardiology business, I was able to have a heart catheterization when I thought I had symptoms of some sort of heart problem. This led to the diagnosis of a heart valve in crisis, even though the heart itself was otherwise in great condition.

My 2001 open heart surgery that followed was a sudden experience... one that I haven't shared on this blog. This, because it has always seemed that my subsequent and unrelated cancer was something I could share to the benefit of others, by exposing the issues associated with the epidemic of cancer. In comparison, cancer takes many more lives than my heart valve problem, so I have in the past highlighted the cancer issues.

However, by annually having an echo-cardiogram, we followed the performance of the prosthetic valve that was placed at the Arkansas Heart Hospital by a fabulous team of professionals. In July this year, I became aware that again, my aortic valve was developing problems. It wasn't enough to stop me from my cycling projects, but it did cause me to be much more aware of my sagging performance over the fall months. In an echo cardiogram follow-up this month, we found that the valve is approaching acute failure at an alarming rate of speed. It is again calcified, and has to be replaced.

I want to help people understand this little understood heart ailment. I will copy below the layman details of Aortic Valve Stenosis. This is from Wiki, but is quite accurate, so worth reading. It is a silent killer most of the time, although people who 'listen' to their bodies... and are aware of their exercise output capacities can in some instances catch things like I suffer from, before being killed by them. By my continuous effort to stay in shape, listening to my body, I have been lucky enough to twice now, catch this thing. Yes, I am lucky to have made a career choice that kept me in the medical device arena, therefore close to people who can help, but first, I have had to be in shape and listening, in order to question the things I occasionally feel, about my output.

So, what does this mean. Well, "its elementary", to quote Sherlock Holmes in "The Crooked Man"... replacement can happen in two ways... First, open heart surgery is the way I was treated ten years ago, and that remains the Gold Standard today. There is a new technique, still under clinical investigation/trial here in North America. It is called TAVI, but it is yet unproven to the standards here, and it is not at all approved for "re-do" situations, like mine.

After a good deal of consultation I have decided to have the Gold Standard procedure, open heart surgery... even though the recovery period is much longer. I had seriously considered the TAVI be done 'off-label', but there was in the end no reward for the risks involved in a procedure that does not have clinical efficacy, here in North America. I have a great level of respect for the clinical trial process that is utilized to 'prove' a new technique or device... and in our decision, Lynnda and I leaned on the experience we have had at the Arkansas Heart Hospital and our friends there, who have over the years been our great care-givers to both of us.

I will keep my blog updated as to the procedure, the outcome and so on. I am very confident in my physicians and in the outcome.

For the moment, my message is, again, that it is very important to understand that when one gets sick (and with time we all will), it is important to be in the best physical condition possible. Why? Simply because it opens doors to treatments that could otherwise be closed. When we battle cancer, or trauma, or congenital diseases, our chances of success are enhanced if you are starting out with good vascular and pulmonary function. These good conditions accumulate through cardiovascular and stretching exercise; healthy eating and weight management; great dental hygiene; non-smoking; avoiding environmental hazards; and so on.

Further, it is important to have regular check-ups and listen to your body when it is telling you things... don't hang up on your 'wake-up calls'.

Here is a pretty good description of my problems...just copy this and paste into your browser...

Below is a cool video of the procedure that I will have in January... since I have had it before, I know what to look forward to... great drugs, beer on the second evening, and lots of moderate exercise for six weeks or so... then, back in the saddle!


My photo

Grad. Saint Mary's University, 1975, got into the medical device business initially in sales, then various management positions up to president, all in Medical Devices. I prefer therapy products over diagnostic, but they are all fun, and in a way have defined my life. I have now evolved, with help from my 35 year partner Lynnda with whom I now share every hour. I am into staying healthy, photography, kayaking, bicycling, gardening and two books a week. I wish I had gotten to this stage earlier!