Getting some questions answered

A week after having a small stroke I was back in the hospital (this time a scheduled appointment versus an ER visit!) for a follow up test known as a Transesophogial Echocardiogram (aka TEE). The goal of the test is to get a better view of the Patent Formamen Ovale (PFO) in my heart and determine if

  • Should I have it closed – much of what I’ve been told is that the research doesn’t show a decreased chance of additional strokes whether a PFO is closed or not.
  • Is it something more than a PFO
  • The regular Echocardiogram showed the right side of my heart may be bigger than the left. The TEE would give a better look if this was actually the case, and if so, why.

The TEE is an outpatient procedure that involves putting a camera down your throat to get a picture from the back/side of your heart. I had a TEE done several years ago when my PFO was first diagnosed but I must have blocked from the experience from my memory because reading the authorization form and all of dangers was freaking me out a little. Just before the procedure was to begin the Tech came in and sprayed a numbing agent on my throat while we waited for the Cardiologist to arrive.

The Tech was a Colorado native so we had a short chat about some of his favorite hiking and mountain biking spots. Thankfully he did most of the talking because I was having a hard time swallowing, much less talking, as my throat started to numb. Thankfully my family had made the trip from NH because as much as I tried to remember what was going on around me, once the sedative was put into my IV, I was out. I needed my wife to fill me in with what the Doctor said after it was all over.

After the sedative started the procedure only took about 20 minutes. Once it was over I slept for about an hour after which I was finally allowed to eat. It was about 1:30 at this point and my last meal was 9:30 the previous evening. I couldn’t tell if the food was any good, just that I was finally able to eat.After eating and more sleeping the nurse took me on a couple of loops around the hospital ward to make sure the sedative had worn off, and I was released.

The results: it is a PFO, and the concern about the enlarged atrium size ended up being consistent with the PFO. The answer that I don’t have yet is whether or not to have the PFO closed. There are still more conversations to have and research to do before making that decision. Thankfully it is not an invasive procedure but it is not a decision I’m taking lightly.

In the meantime, other than no weights, there are no physical restrictions and I got out for a short run the next day. I plan on ramping back up slowly and if I decide to have it closed figure out what races to do based on how long the recovery time is. Lots to decide in the coming days….

Well That Was Unexpected

The Weekend started out normal

I spent Friday night at the gym doing a weight workout and then went to the grocery store to pick up some food for the weekend and following week. The workout consisted of a mix of upper and lower body sets, nothing too tough, but it was a challenging workout.

Which is why when I started to get a weak feeling in my left arm I didn’t think too much about it. Often after a weight workout my arms feel weak and fatigued for a little while. Though I thought it was a little weird that the weakness was just on my left side.

As I left the grocery store the left side of my face and tongue started to feel like they were coming off a shot of novacane. That is when I started to get a little worried. As I drove out of the grocery store parking lot I realized that some of the fingers on my left hand felt numb and I started to feel a little foggy.

At this point I was freaking out a little and decided to head to the hospital. Given that my family is 2,000 miles away, I was admittedly pretty nervous about being home if things kept moving the way the were. Thankfully the hospital is just a couple of miles away, and I remember as I explained to the recepeptionist why I was there, that I was having a hard time verbalizing what I was feeling.

Stroke Alert

I was shuffled into triage after which the true gravity of the situation set in when the doctor who examined me and asked a few questions said, “…We’re going to do a stroke alert…”. That sounded really bad to me.

For everyone else in the ER that statement triggered a very comprehensive set of events that filled up my room with more people than I can remember and led to lots poking, prodding, tests, and questions. All of this eventually led to being admitted to the hospital which entailed being woken up every few hours to check vital signs and an MRI of my neck and head at 6am the next morning (thankfully the MRI tech had a choice of music on the headphones and I was able to relax to some Dave Matthews).

The resulting diagnosis from all of this madness was a Transient Ischemic Attack possibly contributed to by a Patent Foramen Ovale. Or in plain English, stroke-like symptoms possibly caused by a small clot passing through a small flap in my heart that never properly closed at birth and going into my brain. YIKES!

By Saturday afternoon I was feeling good and was sent home with instructions to see a Neurologist in a week, take an aspirin every day, and call if there are any other symptoms. Unfortunately, I would be calling.

The Return

Saturday night was pretty typical outside of the challenging conversations with my wife and son who are 2,000 miles away. We obviously wanted to be together but flying on short notice is not cheap. On the one hand, I was feeling good and spending several hundred dollars wasn’t all that appealing. On the other hand, we learned that a TIA can be a pre-cursor to other TIA’s or something more serious in some cases.

Sunday morning came and soon after I got up the symptoms came back, though not as bad this time. I REALLY didn’t want to go back to the hospital. But, after calling the doctor he thought it would be best to move up the time table of seeing a Neurologist and also see a Cardiologist about the PFO. Not what I wanted to hear. So, I called my wife and headed back to the hospital.

The next two days consisted of two more days in the hospital in a department with people who probably averaged 2x my age (not very comforting!), meeting with a Neurologist and Cardiologist, my family flying to Colorado, getting my blood pressure taken every 3 hours and measuring my liquid input (and output via a plastic jug!)

The End Result

The resulting diagnosis is simlar to the first, except that technically a TIA doesn’t leave any damage, so because of the two small areas on my MRI indicating damage, the diagnosis is 2 small strokes, likely caused by the PFO. It was scary when they told me and it’s scary to write about now.

Now the decision is whether or not to close the PFO. Further heart tests will provide more information on how to proceed with that decision.

Some things I learned (which I already knew, but this situation highlighted) are I have an incredible network of family and friends, a very thoughful and understanding group of co-workers, great cholesterol levels, and a resting heart rate of about 50.

All in all, I’m a pretty lucky guy.

How We Stay Connected

After two weeks living apart from my family we’ve had the chance to test out different ways of staying connected before they make the move out to Colorado.


This is the obvious one but we actually haven’t used Skype since the westward move. We did use it during a trip to Germany last fall when I went to Eurobike and it did the job, though my internet connection in Germany made the video quality poor at times. We haven’t used it recently only because video chat is available in platforms that we are already in – primarily Gmail and XBox.

Google Video Chat

We are definitely a Google household and regularly use Docs, Calendar, Reader, Photos, Videos, Maps, Gmail and Chat (it’s actually a little scary to think about how much information we have on Google servers!). Since we have video capability in both Colorado and New Hampshire, and we are in Gmail so much, its just easier to request a video chat right from Gmail rather than open up Skype.

XBox Kinect Video Chat

Not only is XBox Kinect a blast to play games on, it also has the ability to do video chat. There is a cool feature that automatically follows you around the room. However, we’ve found that the auto feature is tough to manage when there are two or more people in the room.  Still, the video and audio quality are great and the larger coverage area (vs a web cam) has allowed me to do some great things like see my son’s school projects when he holds them up to the Kinect unit.

XBox Live Gaming

I’ve been able to play NBA Live 2010 against my Son from 2,000 miles away and talk over our headsets at the same time. Of course he kicks my butt every time but I’m slowly getting better. Next on the game list is Call of Duty so I can be further humiliated by him!

Smart Phone

Colorado is an incredibly beautiful place and as I explore new places we are able to easily share pictures and video in real-time.

Social Networks

My friends and family are able to see what I’m doing on a regular basis through the sharing I do on Facebook and Twitter.  Whether it is my Foursquare check-ins or cool stuff going on at Peaksware, the information i share frequently becomes the topic of conversation on phone and video calls.

Being apart from my family is no fun – but the technology we are leveraging is making 2,000 miles seem a little bit closer.

Any other ideas for tools to use?

One Week Down, A Lifetime To Go

It’s been a little more than a week since I moved to Colorado and I’ve thoroughly wiped myself out.  After not having the time to get regular workouts because of work and commuting I’ve been making up for lost time. In the past week I’ve done 3 runs, 2 bike rides and 1 swim. I even shot some hoops (which I also haven’t done in a long time!) I’m now thoroughly wiped out and it feels great! Unfortunately I had forgotten the fulfillment I get from regular training and ending the weekend completely spent.

The first week of work was spectacular! Peaksware is filled with an incredibly passionate and authentic group of people who all seem to thrive as much as I do on either swimming, biking, running or all three! It’s no wonder TrainingPeaks is so successful – I guess that is what happens when you put a bunch of passionate and driven athletes together and get them working on products that help other athletes be their best!

Colorado is everything I thought it might be. It is a beautiful part of the country filled with people who love the outdoors. During a two hour ride on Saturday I must have seen 150 other cyclists, and even more throughout the rest of the day while I was getting errands done throughout the day.

As week 2 starts the lesson I’ve learned is that I don’t need to catch up on my training all in one week! Besides, going from living at sea level to living at 5,400 ft above sea level necessitates that I take several weeks to acclimate!

Stay tuned!

The New Year’s Day Run

I don’t remember exactly when it started.

On some New Year’s Day morning several years ago I woke up and decided to run. The distance happened to be 10 miles, which at the time was a stretch for my athletic endurance.  Since that day, every year, on New Year’s Day I’m compelled to run 10 miles.

Some years the 10 miles has felt like 20 while other years (typically when I’m in the midst of training for a marathon or Ironman) the 10 miles was a cakewalk. I tend do some pretty deep thinking when I run (like most runners I suspect), so combining the stillness of a holiday morning plus the mindset of starting a new year – the contemplative thoughts get pretty active.

I’ve tried to figure out why I’m so compelled to run on New Year’s Day, even more than my normal desire to run. I think the reasons have changed over the years as my age brings new perspective and depending on what happens to be going on in my life. However, I think the underlying drive though is a desire to shock the system on a day that has such symbolic meaning for new beginnings.

Even if I’m not in a place where I feel like I need to have a “new beginning”, I find value in pushing my body out of it’s comfort zone for a while. Over the year’s I’ve had moments of such clarity while running that I’ve come to expect that if I head out for a run with some problem or challenge on my mind, that by the end of the run a solution will have made itself clear to me.

I’ve read or heard two people I admire very much tell stories of how a run, outside of their comfort zone, brought clarity to their lives in an otherwise challenging time. One was Tony Robbins at an event I heard him speak at, and the other was Dean Karnazes in his book Ultramarathon Man. Early on, this brought some validation to pushing myself on a New Year’s Day run. Now, it’s so ingrained in my annual routine that I don’t give it a second thought no matter what shape I’m in.

By running on New Year’s Day, maybe I’m expecting (or hoping) for that clarity of thought that Tony and Dean experienced as I contemplate how I want to craft the upcoming year of my life. Whatever the reason, I always feel better when I get back versus when I left; I’ve run off any extra calories I might have consumed the night before; and I feel ready to face the new year with optimism.

By the way, this year’s run will feel more like 20 miles than a cakewalk.