Bill Bean: I'm a 50-year-old partner of one, father of two, who lives in Kitchener, Ont., Canada. I'm an editor and columnist for the daily newspaper here. I'm a longtime bicycle commuter and tourist, enjoy the great outdoors and read military histories by the boxful, especially the War of 1812 in North America.
19 September 2002
After reading some of your stories, I feel like mine will sound like whining. I'm a 50-year-old male with a dissected aorta and iliac artery, from just below my kidneys into the iliac artery near the top of my right leg. My dissection is relatively small, at 3.5 centimetres at its largest. It may be stable, since there has been no change since the diagnosis CT scan in April of this year and the first follow up scan results this week (Sept. 9).
My blood pressure is controlled with Metoprolol (resting heart rate of 54 and bp of 100 to 110 over 70). I don't feel tired, particularly, and walk my dog every day and still ride my bicycle about 10 to 20 km a day. (I will admit that I ignored the doctors' orders and rode 80 km one day, and was pretty pooped by the end)
But here I am, with this thing in me, the enemy within, that has put limits on me that I did not expect to have, and I'm having a heck of a time coming to grips with it. No heavy lifting, so when my daughter, my son and his new wife and my sister-in-law and her kids all moved to new places over this past summer, I was relegated to carrying the lightest boxes. No long distance cycling, so I haven't been able to participate in the charity fund raising rides I usually do (I raised $5,000 last year riding nearly 700 km for MS and heart and stroke) or the recreational riding I do (cycling holidays, challenging hills). No more blood donation, so I will never reach that goal of 100 units. I feel that many of the things that have defined me as a person have been ripped away, and I am struggling to find out who the new person is and what that new person does.
So what am I looking for?
Well, exercise advice, for one. I've been told to stay away from exercise that involves torsion. My neighbour teaches Pilates, but the vascular surgeon was not particularly happy with Pilates. Some moves, yes, he said. Anyone have any experience with this? Suggested exercise options are appreciated. The same for weights. Heavy weightlifting is out, but I never did that anyway. I did play around with dumbbells, and wonder about any programs that avoid torsion.
I live in Kitchener, Ontario, Canada, by the way. Anyone have any cardiovascular contacts in Southern Ontario, Detroit or New York State who they would recommend? This has been hard on my partner, something I lost sight of in my own self-examination. Any comments from the spouses of dissection survivors are welcome.
I just recently found this site, part of my ongoing combing of the Web for contacts and support, and am looking forward to feedback from members.
Update: 3 Oct 2002
Today (October 2) was a rough day. Yesterday I had seen a highly recommended vascular specialist in Toronto, who I had hoped would cut me some slack on the restrictions on cycling. He was pretty firm about it: no more "industrial" cycling (by which he meant, I believe, long distance, fast or vigorous uphill-type cycling). The doctor was pretty firm about not doing activities that pound the blood to the legs and through the aneurysm and dissection, so even my bicycle commuting to work might be off the agenda. I'm going to try walking to work (7 km round trip) for the next couple of weeks. I need the variety, anyway. He's scheduled me for another CT scan in a few weeks. I'll know more by the end of October. He also said that he expects I may never need surgery... this can be managed medically. And that's positive news.
The same day, I did a stationary bicycle blood pressure test at my hometown hospital, riding for an hour at various "loads" to simulate changing road conditions. The equivalent of a reasonable grade or stiff headwind was enough to send my BP too high, so it appears that the arbitrary "speed limit" of 100 beats per minute will become the firm limit. In cycling terms, this means I'll be OK on flats, downhills and with tail winds, but will have to stop occasionally in other conditions to bring my heart rate and blood pressure down.
I put two and two together today, and realized that my days of bicycle touring are over, as are my dreams of cycling across Canada and in Europe. No one would cycle across Canada in 20-km increments. Last year, I had participated in a week-long 600-kilometre bicycle tour, where the oldest rider was 75 years. I held that up as a model for my own future, riding on long tours into my 70s.
I was splashed with the cold water of reality today, and was ready to sell my bike panniers (and my road bike). My supportive partner said we can use the bags for picnics and won't let me sell the bike. I am reminded why I love her so much.
Update: 14 Nov 2002
According to the visit with the vascular surgeon in Toronto last month, I have neither an aortic dissection, nor an aortic aneurysm. The doctor advised that he would not call the enlargement of the descending aorta an aneurysm. He said that it was enlarged due to the heavy demand for blood that I put on my legs while cycling, and that the diameter was not out of line for someone who rides as much as I do (or rather, did). In other words, it was just big.
The dissection of the iliac artery is clearly a dissection, and, in his opinion, the result of the bicycling. All the restrictions that were applied earlier still apply: take my medication, no lifting of more than 40 pounds, no activities that raise blood pressure, etc. He said that by following this advice, I "will live forever and a day" without needing surgery.
He also looked at the blood pressure readings that had been taken earlier in the month on the stationary bicycle, and agreed that the higher BPs were undesirable, but that the BPs associated with a heart rate of about 100 beats per minute were within acceptable limits. So, limited recreational riding is still OK.
So, I am emerging from the dark cloud. It is odd how, outwardly, nothing about me has changed, but the interpretation by others of my insides has had a tremendous effect on my mental state.
© Copyright 2002 Bill Bean
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