MY RATIONALE FOR WHY I DIDN’T CALL 911
I call Connie when all goes wrong on a ride. I've been in driving rain storms, pulled into a party store, called Connie, had her pick me up in the Outback, and all is right with the world. So when I had searing pain rocketing across my chest and driving down my left arm, I used my right arm to call Connie on the cell phone.
THE DIRT HAMMER
The Dirt Hammer is a special ride. It's a fast, hard thirty-five miles and there's always someone going off the front, trying to stir things up. I've always thought the hardest part was the first climb up Barton. It's steep, it keeps getting steeper, and it just hurts and my legs aren't ready for such exertion so early. But usually I give it a good effort and snarl through the pain. On Tuesday, 9/11, I found myself off the back immediately and not really able to hold on very well. I told myself that it was just fatigue. From what, I didn't know, but that's what I called it. After that hill I tend to get into the groove of the ride and enjoy everyone's attempts to put a burn into the pace.
That night, though, I felt like I was working awfully hard just to hang on. At one point on Jennings, Brian, who seemed to be particularly spunky, passed me, so I jumped on his wheel. He was pulling up the long gentle hill that ascends toward North Territorial. I was in his draft cranking away, then he just pulled right away from me. Man, I thought, I can't even hold on in the draft. I really am fatigued.
It was a cooler evening than usual. I thought maybe my muscles were in full rebellion. Rich passed and I hopped into his draft, but eventually he pulled away, too. I just pedaled easy from there. It wasn't worth wasting the energy. Way up ahead, Rodger and Brian duked it out at the stop ahead sign. From then on, whenever the speed went up I found myself at the back. Here I'd thought only a few days before that I was in good form and really ready for the cyclocross racing season and now I could hardly hang on.
Along Walsh I found myself at the front pulling through a strong head wind. I was only going about 16mph, but nobody was passing, so I thought maybe it was the wind that had held me back in the ride so far and everyone else was now fatigued from working too hard. We climbed the steep hill on Merkel and after that the pace picked up again and again I was huffing away near the rear. I was working too hard. Along Zeeb I just barely hung on. We crossed North Territorial and between there and Gregory Road the pace once again increased. I looked at my computer and the pace was fast, but not outrageous, about 21mph, but eventually I let the last wheel pull away and I waved goodbye. It wasn't my night. I was breathing awfully hard.
After Gregory Road, I felt a pain fill my chest and run down my left arm. I looked back, since I knew that Mark and Wendy would show up soon. It was all too weird, the labored breathing and the pain. Had I pulled some chest muscle that affected my lung capacity? Was it the cooler temperatures that my body had not adjusted to?
I looked ahead and there was the group turning up Farrell and climbing the first rise. That was my favorite place to attack on the whole ride. I love hills like that. Brian and I often fight it out there. But I wasn't there. Weird. I rolled along toward Farrell and the pain exploded across my upper body. I stopped at the turn and looked back. I wanted Mark and Wendy to show up. I leaned over the handlebars and waited for the pain to subside. It didn't. Mark pulled up. "You ok?" "No." That was about all I could say. I put the bike down and pulled off my helmet. Wendy pulled up. I was so glad they were there, but I didn't know what to say. I called Connie and told her to pick me up. I knew that I wasn't riding any farther with this pain. I felt faint and nauseous. I sat in the grass and put my head between my knees. I wanted to throw up, but couldn’t. Then I got up and wandered the road in circles. Mark and Wendy kept asking me questions to keep me talking. Wendy wanted to get Ben to come get me with the car, since they lived close and he'd be there soon. "No," I said, "I already called Connie."
Rodger called on the cell phone. "Everything ok?" I said Mark and Wendy were with me and Connie was going to pick me up. I couldn't talk any more than that. I circled on the road some more. Every time I circled past Mark and Wendy I said something like, "this is just too weird." I was in so much pain and it wasn't getting better. I looked at three sandhill cranes pass through the sky, an intensely blue sky with great graven white clouds carved into it. The cranes were so majestic. So big and prehistoric.
I kept looking up the road, hoping that every car was driven by Connie. A couple of cars approached. One was even an Outback, but it didn't have bike racks. One was an old woman in a Ford Explorer and she was going so slow and she looked lost, but she didn't stop to ask directions. I kept circling. I was getting cold. Wendy passed me her windbreaker. It felt good, but I wanted a warm room at this point. The cold wasn't helping my pain. I leaned over and picked up a small piece of metal, 4" of a chain link fence, and threw it over into the grass. It was important that that piece of metal be out of the road.
Wendy on the Dirthammer
I called Connie again. She was at Joy and Zeeb, but Zeeb didn't continue and she was confused. I told her about the jog left then right again onto the dirt section of Zeeb and verified it with Wendy. It seemed like forever after that, even though she was closer than ever. Then I saw the car and the rack and watched the car get bigger and then it was beside me and my daughter Lauren was in the passenger seat. Everyone mobilized and we got the bike in the car, and me in the car and Wendy said something to Connie about my heart and getting to emergency. I think Connie expected a stubborn argument from me about going to emergency, but I said that's where we needed to go. The warmth of the car was good, but the pain still ripped over my chest and down my arm.
Lauren's face was a good mirror on the situation. She looked worried. Why would her father look so screwed up? Rich called. "Everything ok?" I told him I was in the car with intense pain. "You're going to emergency, right?" It was less a question than a statement. "Yup."
THE HOSPITAL
At emergency there was a line-up of cars. Why now? A valet came up and assessed the situation. We got out, Connie gave him the keys and we walked into the emergency ward. We were at the desk behind a line. When Connie mentioned I had chest pain, the registrar's chair rolled directly to us, she ordered a wheelchair for me and I was pushed right back to the assessment room filled with the bustle of orderlies, technicians, nurses, and doctors. It looked like a busy night, but I was quickly the center of a lot of attention. I now know what to do to get good service in an emergency ward. Mention chest pain and you're the show until determined otherwise.
The first round of tests didn't show much. Then they did an EKG and there it was. A blip out of place. "It looks like you've had a heart attack," the doctor said. "We'll run some more tests to verify. But in the mean time, we'll call in the coronary surgeons."
Connie came back. She'd found a place for Lauren to spend the night. I'd wondered where she'd disappeared. My emotions were in check until that moment. The whole heart attack thing threw me off and I was in shock. Why would I get a heart attack? I'd worked so hard to stay healthy. Then I started thinking about all I loved about biking and that it was over. All the friends, the joking, the teasing and bravado, the times when my legs just soared, the ability to hold on and sometimes pick up the pace against all odds. The admiration I had for these crazy, competitive, fun-loving people. Young guys, older guys like me, powerhouses, and those who had to work their tails off week after week just to hold on, but they were always back for more. They were both competitive and supportive at the same time. And just good people.
The doctor asked what was wrong. Connie told her. "Oh, no," the doctor said, "you'll be racing again." She said it so casually, even with a small chuckle, like, what was my problem?
They gave me a nitroglycerin tab under my tongue. Then my blood pressure plummeted. Athletes often have low resting heart rates and their vessels are so dilated that any further opening can drop the blood pressure into the danger zone. The nitro was supposed to ease the pain by getting the blood to flow into my heart again, but any further tabs were out of the question. "Get the morphine." Option B. I was put on a morphine drip. It made me drowsy and it eased the pain somewhat, but it took a while. In the mean time I was wheeled to the cardiovascular building and into the operating room. Three nurses were prepping the area furiously. This was the first time I realized, through my dopey stupor, that time was important. Within minutes this amazing new room that looked like the Starship Enterprise control room was shifted into place for my operation.
They'd decided to put a catheter into an artery in my groin and work through it to access the left lower coronary artery where the blockage took place. Apparently I'd had a crack in my artery that was seeping blood and filling it with a clot. This cut off oxygen to that part of my heart. Once that happens and no oxygen is reaching the heart muscle, it begins to die. That's why getting to the hospital quickly is essential.
They did an angioplasty to open the vessel, then inserted a metal stent to keep it open. The stent is now a part of me and will be for the rest of my life. It is metal and I do need to lubricate it with WD-40 on occasion. I'm good for 5000 miles or six months, whichever comes first. Kidding.
The operation itself took just over an hour. Then I was taken to another part of the hospital and put in the cardiac ICU. There, a nurse named Andrea watched over me for the night. She took my pulse and blood pressure about three thousand times. Another fellow came in and removed the catheter, then stood over me for nearly an hour holding pressure on the area to prevent the artery from leeching blood and causing a hematoma, and waiting for it to clot enough to plug the hole on its own. He was a good natured, patient man and one time I fell asleep while he was doing this and he startled me awake, saying that I couldn't fall asleep because he needed my feedback. I thought he was doing a darned good job and I'd only mess him up, but it was obvious that I wasn't going to get to doze under his watch.
If you get a nurse for this kind of thing, try to get someone like Andrea. She was so darned patient, intelligent, friendly, and good humored that the experience was fun, minus the heart attack part. She helped me understand the specifics about what I was going through and reassured me that I was doing well throughout.
HEREDITY, MAYBE
We used to take the ferries to Door County in Wisconsin from Frankfort or Ludington. My dad sold farm equipment and the cherry industry was big in Door County and dad loved the people over there and they loved him. It was business and party time all in one. Beer sometimes foamed out of the bottles at breakfast. We used to transport the gangly red Friday cherry shakers on those big boats that swallowed up whole trains and parking lots full of cars and other odds and ends. We were the odds and ends. I once went over on a balmy summer night that felt like a Carribean cruise. It was beautiful with a sun line buzzing west across the water toward Wisconsin, a rich blue sky and breezes that made you inhale over and over to fill your lungs with memories for the upcoming bitter months.
Dad often went over on his own. It was little boy time for him and you could feel the energy when he headed out. On the evening of July 7th, 1977 he drove away in his green pickup truck and at about 7am on July 8th we got a knock on the door. It was a sheriff. Mom answered the door. I stood behind her as the officer told us that dad had died in a berth on the ferry. Massive heart attack. They'd gone to awaken him and he wasn't getting up. It was a beautiful blue sky day. I was way too young to lose a father and at 56 he was way too young to go. It certainly wasn't part of any plan I'd laid out. I'd always imagined him as a jovial grandfather to my future kids. He was a kid magnet. I had to go clean out his pickup truck. In the seat was a jumbo bag of jelly beans. It was nearly empty.
He was overweight, overworked, and out of shape, but so were many other men of his generation. I’m skinny and athletic. But even with our differences, my heart issues may be genetic. That’s one possible reason. The other is unknown. About 30% of all heart attacks occur in people with no risk factors. Those are basically lumped into the hereditary pile, since there’s no other known explanation at this point.
NOW
I feel good. After a week, my cardiologist let me go back out on the bike. In the mean time I did a lot of walking. He wants me to take it easy for a while, but by the end of a month he says I should be able to work at a level of fitness similar to the one I’d had before the heart attack. Apparently, recurrences are rare in cases such as mine. He says the rest of my heart looks pretty good. He doesn’t think cyclocross racing would be good this fall, but maybe next year. Fine. I can ride. That’s what’s important for now. I’ll take it.
I want to thank everyone who’s supported us through this interesting little exercise. There are few things in life as heartening or as humbling as the realization that there are a lot of good friends out there.