2008 Rock Racing and More

You Be The Judge

I got a call from Mike Friedman the other day. He was pretty upset. He told me he wasn't going to be able to do any world cups. He wasn't going to go worlds, he wasn't going to ride Paris Roubaix. I asked him what was wrong. It turns out our boy is pretty sick right now. He wanted to let people know about this so rumors didn't start stirring. I asked him if we could do a quick interview on FGF and he quickly agreed!

I know I speak for all of us here at FixedGearFever when I say, get well soon buddy!


So you spent the weekend in the hospital, what is going on?

In my last blog posted on FGF I mention that I had recently undergone surgery in the perineum region of my body. To be blunt it was the area between the rear and the front of ones genital region. The day after the surgery I was intending on driving home to Pittsburgh for the off season. The surgery happened on a Monday and I drove pretty much straight through to Pittsburgh from Colorado Springs only stopping once to sleep for four hours in the car and numerous other times to fill my fuel tank and rejuvenate my coffee supply.

I drove 1630 miles arriving home the Wednesday night about 4 AM. There was a stop in there to see my x-girlfriend that added a few miles and a few hour layover, but ultimately added much unneeded stress to the trip. Big thanks goes to Brad Huff for talking me through that one. During this drive, and before I arrived at my x’s house I had fairly severe cramping in my right upper calf. It wasn’t horrendous yet, but was really painful when I would walk in to the gas stations.

Fast forward three weeks of a very sedentary lifestyle of watching movies, reading, cooking, visiting friends, family, and etc. and one finds three huge precursors to forming blood clots.

1. Surgery (near the pelvic region)

2. Travel in the same position for long periods of time with no movement

3. Healthy and Low athletic heart rate

The cramping had diminished in my calf, albeit taking almost two weeks after my arrival in the burgh to completely disappear only leaving me a phantom numbing feeling in my upper calf muscles through my hamstring region and all the way up into my glutes, especially when driving. I spoke with numerous people about this because for almost a week I could barely walk and considered going to a physical therapist to have it looked at, which I should have done... man I wish I did. I spoke to Allen Lim (Dear Friend, Coach, and Physiologist) about it, Lara Pate (Dear friend, Team Masseuse) amongst a lot of others in an effort to ease my mind about it. I was told it was probably from using the gas pedal so much since I don’t have cruise control and the fact that I hardly drive so I wasn’t used to it.

In and around the fourth week I began training with one of my best friends, Ryan Mele, here in Pittsburgh. I had to ride standing up the whole time because my “area” down below was far from healed. I started slow of course. I rode an hour the first day, and it was horrible! Everything ached from standing for an hour, only to discover that I covered twelve miles. However, and this is what caught my eye, I burned almost 1000 kilojoules in an hour. Impressive? Yes, but Pittsburgh is very rolling with steep little climbs. Average wattage was excessively higher than I had anticipated hence the higher energy output. For two weeks I rode out of the saddle working my way up to three and a half hour rides out of the saddle burning up to 2700 KJs, but only going roughly 60 miles.

Last Wednesday Ryan and I rode for four hours in the rain, and I was actually able to sit for a lot of the ride. Last Thursday I awoke with a hoarse sounding voice, back pains that I thought were muscular, and I felt ill. My step father and I went to the Pitt vs. WVU game that night because I had purchased tickets for the both of us on eBay. It was a gift to him that I’ve never been able to afford until this year and it was great because he’s a WVU alumni. I didn’t enjoy the game. I fell asleep on the way down to the game feeling ill, back in pain, and during the game I couldn’t stand without being in severe back pain, so I sat there eating peanuts and sipping a hot cocoa.

Friday morning: Same thing except worsened. I cancelled the rides again and felt sick. I decided I’d go for a massage. The massage therapist barely did anything for me. She didn’t flush my muscles in any fashion that I would have considered to be massage. She just touched my acupuncture points an proceeded to tell me how I should live agnostically vs. believing in any form of a God. It was really weird, but turns out that massage would have been bad at this point for possible further breaking apart of a sustained clot in my legs.

Friday night: I was visiting my friend Emily in her apartment downtown Pittsburgh. I told her I was feeling ill so she said she’d make dinner and we could just watch a movie. I was down for that and told her to rent “Cars”, as I liked that movie and it might put me in a better mood. I also told her to make a salad with the meal and suggested we eat straight spinach mixed with fruit. Turns out green leafy vegetables are high sources of vitamin K which serves as a precursor to “Blood Coagulation”. While she was prepping dinner I was stretching and doing some yoga breathing. My back hurt and I was convinced it was muscular so this is what I knew to do.

Laying on my stomach watching the movie half an hour later the pain in my back and now my chest began to grow. I changed positions, now sitting upright and the pain just continued to get worse. My right arm became heavy and numb, the right side of my back from bottom to top hurt terribly, the back of my neck began to spasm and hurt increasingly worse every time I tried to take a breath. I crawled to my knees and squeaked to her to grab her computer just so I could attempt to look up my symptoms, but as I kneeled there looking a the ground in wincing pain realizing I couldn’t breath and that my chest felt like it was going to burst I thought I was going to die of a heart attack, so we rushed to the hospital right up the road about four minutes away. I spoke with Allen Lim and he said it was smart for me to go, and I need to get an EKG right away even if it was for nothing. I called a doctor I trusted for advice, Dr. Prentice Stephen and left a message on his voicemail with what I was doing.

Checking in at the hospital I complained of heart attack symptoms. They checked me in quickly and during triage they asked me if I could walk to my check up room. I said, “I think I can”, and quickly found out to my devastating surprise and now almost crying that I couldn’t! I couldn’t walk with out gasping for air and clutching at my chest. I grabbed the wall and the wheeled me to my room. Upon a battery of tests, EKG’s, Blood Work, Chest X-ray, and CT Scan (another form of X-ray) the doctor who I found to be really quite cute came in and said well we have bad news and good news. She looked at me and said, “well, you have a blood clot in your lung”, and I sort of laughed because I didn’t think it was that serious besides the fact that I had been sitting there for almost four hours listening to a stupid machine alarming the whole facility that my heart rate was at “EXTREME BRADYCARDIA” or just really really really slow, 42, and they still put me on oxygen bringing it down further and even though my saturation was at 100%. So I meagerly asked this cute and younger looking female doctor what the good news was. She said, “I need to get to give you an anal exam to check for bloody stools”, and then she smiled. I sat there with an oxygen hose in my nose, an IV in my arm, the alarms still sounding, Rocky III on the tv giving her the most blank blinking eyed stare that I’ve ever given. It was at this very moment that I realized that the year 2006 would go down in history books as being the most awkward and amazing year all in one, that I’ve ever experienced.

I was then admitted to the hospital for treatment and care and spent Friday night, Saturday, Saturday night and Sunday in the hospital sharing a room with a crazed, suicidal crack addict who randomly woke during the night to kick over EKG monitors and then persist to rant and rave about crazy things that I couldn’t interpret. But it made the time go by quicker thinking about how I’d escape if the four millimeter thick curtain came crashing down between the two of us. Friday night my mother came down to the hospital around 2:30 AM and stayed with me until late the next day. She’s a trooper.

I have a Pulmonary Embolism (PE) involving the lateral basal and posterior basal segmental arteries of right lower lobe with associated parenchyma infarct within the lateral basal segment of the right lower lobe. Basically I have two blood clots and a severely damaged if not dead lower lobe of my right lung. The doctor said had I waited for half an hour more I probably wouldn’t be here today.

In a day where endurance athletes are using EPO to thicken up their blood, you have blood clots. Is this a condition caused by performance enhancing drugs? suppliments?

It is very easy to jump to that conclusion isn’t it. Especially in my case I suppose and I will try to be as modest as possible here, but I’ve had a season that some people think is too good to be true or too good to be done clean.

Here is what cause my PE or blood clots to form.

• Surgery

• Long drive home leaving the day after surgery

• Sedentary lifestyle for a few weeks after arriving home

Most causes of these and I will add that there are upwards or more than 600,000 cases of these a year leading to 60,000 deaths from PE. It’s a sudden blockage in a lung artery due to a blood clot that typically traveled from elsewhere in the body. Usually from the deep venous regions of the legs, IE the cramping I endured, or Pelvic venous regions, IE the surgery I endured. During surgery a few things happen.

1. There is vascular wall damage that stems from being cut open or cauterized as I was

2. Venostasis: stoppage of blood flow through a vein (surgery or driving cause this)

3. Hypercoagulability: which is a condition typically after surgery when the body senses a hole or wound needs to be closed that the blood will actually become abnormally thicker in order to increase the formation of fibrin complexes in the blood vessels. Fibrin mixed with Thrombin a protein used in blood coagulation eventually changes the balance of the blood to “Pro” clotting levels.

4. Slow heart beat: allows more time for the now imbalanced blood clotting factors to flow near each other.

In any case for any doubters, as to whether or not this was drug related you can assume the worse OR you can assume the best. If you don’t know me it should be no doubt 50/50 except for the fact that I swear an oath to God on my life and cycling career that I have not taken any performance enhancing products that would have caused this condition. If you know me and for what I stand for and how I live my life you all know in your hearts that I have not nor would I have taken any performance enhancing drugs.

While there is evidence to suggest that EPO and other drug use could cause this condition I have two blood tests before it happened and a battery of blood tests right now after the fact that I’d be willing post for everyone to see showing my hematocrit and hemoglobin levels in the range the should be living at altitude or sea level for a healthy athletic male. For the records my crit during my PE was 40.5. I read on multiple sights and in a few journals that in order for EPO or whatever to cause this my blood would have to be a sludge around a crit of 60 or 65.

Have you talked to the TIAA-Cref folks about this? Are they supporting you?

As I’ve said before, and I’ll say it again, riding with Tiaa Cref has been riding with my best friends and being treated as if I were their own brother. Many of the riders called, and I shared many tears with Brad H. and Danny P. over the phone. Jonathan called right away as did the team’s owner all inquiring how I was, what was happening, and offering support. Allen Lim and Prentice Stephen were with me right along giving me advice and keeping my morals high.

They believe in me, and I believe in all of them, and that will draw us all even closer than we already are. We are all like War buddies in a way, especially Huff and I.

It's been a few days, you are at home with your family. How are you feeling?

I’m feeling better, but still have a sore back. My back was sore for a few days because of the infracted or dead lung tissue. There are no nerve endings within the lung to suggest pain, but the outside layer of lung tissue is loaded with them and since the part of infracted lung tissue breached the outside portion I really felt and still feel a little of it. The word from the doctors is that because I’m an athlete and at very low risk for this ever happening and for the fact that we know what caused the clots and that those situations can be prevented from now on…I’m needless to say in a much better place. Not to mention that it cuts my recovery down from 6 months to possibly 3 months or less.

I’ve been put on Coumadin for a period of 6 months just to be safe, but that doesn’t mean I will be on it that long. While it takes a few day for the coumadin to regulate itself against my diet and body's formation or various proteins used in the production of clotting and the effect of vitamin K I have to give myself shots of Lovenox into my stomach. That’s scary and hard to do because it’s not small, and the blood is already thinner so it pools in my abdomen now after each injection making a discolored blue lump of blood.

Family has been good and supportive. I’ve been keeping myself busy by researching this topic and baking a lot of things I shouldn’t be eating haha but it’s for thanksgiving.

Are you able to work out at all? What are the risks associated with working out?

After about a week I will be able to begin a regiment of walking and light riding indoors. I’ll be able to pick it up and train quite a bit, but it will most likely remain indoors on a trainer because of the risk of falling and hitting my head or internal/external bleeding. The blood will be so thin that I may not be able to stop it if I get wounded nor not even no about it if it’s internal.

I thought about training for the individual pursuit still, because I don’t think I’d crash during that, but Allen Lim said that I’m probably reach a state of pursuiters cough that would emulate a horse being run to hard and drowning in it’s own blood. What his point is, is that as an athlete it’s likely that our hearts can pump more blood through our lungs than the lungs can handle similar to what a race horse could do. If this were to happen and I couldn’t stop the bleeding, I’d internally drown myself.

When do you see yourself back on the bike? Training full time?

I see myself back on the bike doing gentle training in about two weeks simply because I have the time to rest and should, and I should also let my perineum / taint heal all the way. From there I’d say it will be full time from there on in. Depending on what the team says I’ll go to team camp, and even the world cup to support Brad and my teammates racing there.

Will we see Mike Friedman back on top of the podium?

While I will be most definitely missing the world cup season and world track championships and maybe even Paris Roubaix, this time period is a short time in the realm of my cycling career. I will be allowed to race free and clear about a week after I come off the anticoagulants once my “D-dimer” tests come back. It’s a test to measure thrombotic evidence. I intend to learn from this experience grow stronger and use it to my advantage. Plus, for a bonus, I might have just found what I want to specialize in after cycling…Pulmonology? I’ve been looking to specialize in something other than Biology at Penn State.

I will be back though, because I live for this sport and it’s my dream to go to the Olympics and be the best I can be.