Endofibrosis stenosis diagnosis

That's a lot of sis's

Just one month ago I wouldn't have had any clue of their meaning. However, now I do because it's been a few weeks since medical professionals have put those names to the issues I have been having on the bike, especially in the last year. Bare with me as this is all stuff I learned just in the last few weeks but what this means is I have narrowing (stenosis) in my left iliac artery, likely caused by endofibrosis. Endofibrosis is basically a build up on the outside of the artery. It builds up this....stuff....to protect itself from the constant un-natural kinking that the iliac goes through when cycling. Particularly cycling in aggressive aero positions. This build up is good for protecting my artery, but bad for the blood headed to my poor left leg. The more build up, the more the artery is restricted from expanding to meet the blood flow needs of hungry muscles. This thing is actually fairly common in bike racers, yet somehow it flies under the radar. Someone threw out a figure that 20% of pro tour level cycling have or had this condition. I don't know that it's true, but now that I have had to do the research and pay attention, there is a decent sized list of domestic racers I race with or used to race with that have had the condition. Some of you may have heard of it as the "dead leg syndrome".

Now it seems there is some grey area. Determining how long this has been going on is one of those areas. I suspect it has been going on for a while. I recall back in 2008 people starting to see a noticable difference in the size of my legs. I didn't think much of it cause I was still doing ok on the bike. Also, it was a little hard for me to pinpoint the symptoms I think because the condition in my left leg has been degrading gradually over time and my body just came to recognize this as my limit. It took a while for the condition to get bad enough for me to notice what wasn't hurting. Last fall I felt like I just couldn't push the pedals. Something felt missing and when I really tuned in it felt is if there was something off balance. That's as far as I could nail things down at that time. Then this spring getting out for the first bit of hard riding with only fitness from indoor riding, things were very noticeable. It was as close as I have been to real "dead leg". I can only describe the feeling as suffocation. My left hip/groin area felt numb and tight and my left thigh would just burn. My left leg would be absolutely pinned and my right would be maybe at tempo. I'd have no choice but to slow down. But thing is, it felt normal. The body adapts to the conditions I guess, only I was just going slower and slower and slower as the condition worsened over the years. Now I can connect the dots and see back through the years and many un explained symptoms seem to be lining up with this. The size difference between legs is likely in part due to the lower leg just not getting blood. My lower back problems are focused on the right side (the side that works with the left leg) and that muscle is over sized and over worked from trying to make up for what the leg isn't doing. My left foot that goes numb is likely not because my shoe is strapped too tight as I usually determine. And there's the funny numb feeling in my left hip area that I have had for years and years.

Quantifying deficit is another grey area. I did an ABI test, which is where they measure blood pressure in all limbs at rest and exertion. This was significantly off. I wish I could remember the numbers. I then had an MRA that showed a pretty dim and narrow flow of blood down to my left leg as compared to a nice bright and thick flow down my right.

Naming the causes is a real big grey area it seems. In my case the concern is how much worse will it get if I were to never touch a bicycle again and remain naturally on foot for the rest of my days? How much worse if I take up RAAM? It is the acute kinking of the artery that causes this, but it seems some people are more prone to the problems than others. Some people can spend their whole lives riding in absurd time trial postions and be totally fine, while other people do a couple years of triathlon and the condition progresses to the point the walking up the stairs is a problem and then go back in for the other leg too.

For me the biggest grey area is with the solutions. This is not a health risk for me and surgery is the fix. I can be average joe just fine. I can even go on racing with the limitation that I currently have just fine. I managed ok last fall and during a period last summer even with the condition. Of course nobody can tell me if it will get worse and when. I could have surgery and return to my abilities from 6-7 years ago that are, at the worst, well beyond the best I have managed at any point in the last couple years. That would be nice. Or, I could have the surgery and, like many folks I talk to, return at about 75-80%. I attribute that to the body needing time to balance back out. Things adapt around this condition and they have to adapt back out of it. Or, I could have the surgery and also, like a few folks I've read about, have a re-occurrence of the condition and have surgery again. Of course, the worst case scenario, with any surgery, for anything, is major health risks from being cut open. These seem minimal in these days of modern medicine, but none-the-less a concern. People have died from all kinds of surgery, but many, many people die from crashing cars and I don't seem to mind hopping in the car to get to a bike race.

My thinking on the whole thing now is mostly concerned with post-cycling. I would really, really like to get back to previous levels on the bike and race the rest of my career, achieve my goals and all that. However, when I'm done with all that I would like to be a recreational athlete. Probably a runner. I can go out and enjoy running through the woods no matter how fast or slow I'm going, but I would like to be able to do so without a major hindrance. Especially a hindrance on one side only. I'm sure I will want to compete on some level also.

I have not been able to make a clear decision yet, but as you can probably see from the above text, subconsciously I have definitely been leaning toward having the treatment done. In the mean time I need to find the motivation to stay on the bike because I will be racing this fall either way and I am capable of doing ok even with the condition as long as I can keep it out of my head. I have been riding and racing the MTB a bit and I think that is the route I will go for the next few months. At least on the MTB I can have fun and make up in the techy stuff a little of what my legs won't do.

I wish I had better news, but hey at least it got me to write again.

I'm cold

I grabbed a win on day 1 of Supercross, and felt decent. Better than most of 2012, so I'll take it, but things cooled down pretty quick. Day 2 I felt pretty off and wasn't happy about it. NCGP was a complete disaster. Particularly Sunday. Embarrassing is the best word to describe my feelings from the day. I didn't even give my fitness the opportunity to fail because I was falling all over the place. Set the bike up all wrong with WAY too much psi. Just a complete mess.

On the bright side, there have definitely been times in my cycling career in which, under these circumstances, I woulld have just quit. Now-a-days I seem to be reasonably content with under-performing. Maybe "content" is the wrong word, but I feel like I can shrug it off and keep plugging away much better than I used to. That being said, I AM a realist. I've said before "you don't learn much when things come easy. You learn a ton when you make every mistake in the book". Well I'm going to add to that. You also don't learn a whole lot when you put the blinders on and deny the mistakes you made. I have to recognize how poorly I performed in order to see the mistakes I made and try to correct them. Things only get ugly when this creeps into you self esteem and you start to believe that you performed poorly because you ARE poor. I still go out to train and race with certain expectations. I have lofty dreams, but set reasonable expectations. The drawback that inevitably comes along with having expectations is the failure that you set yourself up for. I'll take the self-imposed failure every now and then, hell, I'll take a whole season worth, because I know I can work through them so I can have the expectations that provide me with the motivation and drive to become the bike racer that I used to be and the even better bike racer that I want to be in the future.

getting warmer

There is snow falling outside right now. Yesterday I was comfortable in short sleeves while inactive. What the heck? My neck of the woods is known for unpredictable weather. Great place to be a meteorologist. It might be actually, everyone knows nobody knows so if they are expected to be wrong, well that must really take alot of pressure off.....but this could also be looked at as an unatural swing due to climate change. A lot of people would be quick to jump to that conclusion, and they are right, but it just makes me think about how we really have no scope for the changes we are causing. Climatic changes over, say 100 years is a blink of an eye in human terms. A flash of lightning. Abrupt. Nothing can adapt. To us, well it's a lifetime. We have no personal gauge for what is happening. Not too long ago we had cultural knowledge. The collective mind of the people was one, so to speak and closely tied to the world around it. The feelings, memories, and skills from one generation were given to the next, so that any one generation had the memories of their ancestors. That is a wisdom unknown to the people of today.

The bike racing weekend was finally a pretty good one at the NBX shimano series finals. On day one sitting on the back of the lead group finally worked out in my favor, as I was able to avoid the puppy-monkey crash and follow Lindine up the road with Nick Keough. We got some space but Garrigan and Milne bridged up. I was not feeling great as usual and when it whittled down to Garrigan, Lindine and I chasing Milne, I got gapped off a little. The good from this day was that I was able to chase back on and squeeze into third at the expense of Justin. He bobbled the last corner, or else it may not have been so. On the second day things felt like they were finally coming together. I could push the pace, make the splits, and even cause the splits. I think it has taken me this whole season to just figure out my position on the bike. Sunday I finally felt like it was dialed. I was comfy all around. Pace and Position. Unfortunately my head might need to catch up. It is so used to not having the go that I found myself sitting on the back when Milne went away. Yesterday when he got the gap I saw it and was held up a little but in reality, probably didnt have the go to get across. Sunday I saw the gap and definitely had enough to go with but was poorlly positioned and had no way to follow. I came across second, feeling quite comfortable.

I am pretty happy to feel like things are coming together even though there are a limited number of races left. I need to get the confidence in the mind now that the legs are workin OK. Long Island, North Carolina, Arizona in-laws visit, and then on to Chicago and Nationals.

Part 2 of the bike racing post just without the bike racing

All this bike racing has really been getting in the way of life. I have been spending a very limited time in the woods. That is not only bad for the psyche, but didnt help my pursuit of the white tail during bow hunting season. This summer I acheived a goal of producing a bow from the landscape, but I just didnt have the time to practice enough to reliably make the clean shot. Actually making a shot on target is rare. So I stuck with my hand me down compound bow with sights. Not the end of the world. But lacking time in the woods, that was limited in productivity as well. Which is OK. Sitting in the woods is nice. It's not all about bringing home a deer. It's about connections to the real (natural) world. A connection to an activity that is fundamental to being human. Also eating good food and filling a predator void created by our imbalances. The unfortunate thing is I failed because I am lacking the connection to the real world and I miss out on the other three things because of it.

Yesterday I was surprised to hear a little bit on de-evolution in somewhat mainstream media. Well, on Wait wait don't tell me, which pulls it's humor from the media. They even used the term, which I don't totally embrace, but the theory was there. It's not surprising to me that it is so rare to hear it even mentioned. It has no easy solution. It might not even have a difficult one. Climate change? Cake. Stop burning fossil fuels, which are unnecessary for human life. Easy. So called de-evolution deals with a fundamental human trait. Our nasty little habit of controlling everything in our environment. What we control we remove from the great balance. What is removed is, well, off balance. The point of the skit on the radio was that human are getting dumber. That's a pretty broad generalization, but the point is without natural selection, there is no reason a smart person would be more successful at breeding than a dumb person. Just like a person predisposed for cancer, heart disease, poor eyesight, etc has no problem passing those genetics on to the next generation.

Now to tie these two topics together I'll talk about a recent event in the woods around my home. Opening day of gun season for white tail deer. De-evolution at work. These are not wise and capable hunters. Seriously, "hunting" with a gun is about as hard as going to the grocery store. It takes about the same effort and that is evident by the sight of some of these characters out there. It also takes about as much wisdom. The gun does all the work. Deer didn't evolve to avoid bullets sailing from a hundred yards away. All you do is sit and line up the sights. You dont even have to sit in the right spot really. Just a general vicinity, which is almost hard not to be if you are in the woods or field. They don't really need to aim that well either. Again general vicinity is good enough. Bullet goes through bone. With bow hunting at least you have to be sitting within like 20 yards of an unsuspecting deer that has to be facing a certain direction. Today this is considered "really hard". While yeah, I am unsuccessful so far, it really isn't so hard in the big picture. It's only hard because we are so far removed. Modern bows are really just quiet, short range guns. All the bells and whistles. If we think about how much time and experience we have with something like driving, and imagine if we spent that time learning to hunt from childhood......yeah, modern bow hunting is anything but difficult. All this being said, I guess I dont have any problem with gun hunting, other than the noise and the obnoxious people. If it's like going to the grocery store, well, at least it's fulfilling those two things mentioned above. They are eating good meat and filling that predator void. Now trophy hunting? No excuses. Trophy hunters are unskilled, misguided, meat heads. Humans used to be a component in natural selection. We culled the weak from the gene pool of our prey. Now these idiots go out and shoot the biggest and strongest with a rifle from a quarter mile away. I wonder what that's doing for the genetics of our prey?

where have I been?

been a lot of places. It's been long enough that I think I'll skim through the results and then summarize the big picture so far....and then get on with subjects of more substance.


I pulled off a 2nd place in Maine for the downeast UCI weekend. Felt OK, not super, but led alot of the race till Lindine caught me and I started to have lower back issues. Day two I flew through the air onto my face hard enough that I was a little dazed. Called it a day.

 I braved the coming of superstorm sandy and the prospect of being in New Jersey regardless of weather to race one day of HPCX. This was the first weekend that my current UCI points became effective. Front row! I was able to start with the front and let the race develope without going ballistic. Of course, presicely when the front was starting to throw a few punches a mechanical sent me right to the back again. Ahh, this again. I salvaged a 5th.

Alright the season starts. Front row again @ Cyclesmart Inernational. Lead got established and I was there.....barely.  So there was my answer to wear I would be if the bad start position was taken out of the equation. I was there, but I didnt have much to contribute to the racing at the front. Check this out. On day 2 I decided to test the bad start theory again by missing my call up to the front row and hanging back in the third row. I fought tooth and nail to that front group again but again I was just there, ready to be on the back at the finish line. Day one I was able to get in for 5th due to a bunch of crashing. Although its not really a gimme. I stayed upright and hence rolled in for 5th. Day 2 all those guys stayed upright, relegating me to 7th..

After a last minute decision Dan and I met up with the Jam fund van to get to the Louisville USGP. I soon remembered why I quit road racing. Well, one of the reasons. The team van. probably my least desirable method of doing something I dont desire. No offense to the Jam team cause it also was one of the most hilarious van rides I've been on. That is saying a lot. Anyway, my current UCI points were only good for 3rd row in this field. I killled the start on Saturday and snuck in the lead group. This course had some world class sand though and I guess I have some work in that department. I was flying right through in warm up, but in the race I was all off. That surprised me because skill is usually my fallback when fitness is lacking. Anyway that shot my right out of the lead group and left me fighting for 14th in the C1 event. Not bad. Not great. Story of my season. Day two I had a bad start and never got to the front. I finished 19th, but I crossed the line with a rubber chicken that I grabbed by the barriers from frame builder Don Walker who was screaming $20 to finish with the chicken. It had a dollar in its mouth and I had grabbed one earlier in the day too. So I was up to $22 dollars combined with my $28 prize for 19th and its still a crappy payday.

That was alot of words on bike racing. I'm just going to do another post on important stuff.

racing update

Well, I made it through Gloucester and Providence. Thought I'd type an update. The two weekends were quite similar.

Day one Gloucester, a little wet, but plenty o' traction, lots of pedaling. I started somewhere just behind mid-pack. I didn't pass all that many people on the pavement like I had hoped. Everyone was going so damn fast. So I had to pass a bunch in the first bit of turns and just work through as many as I could, one by one for the whole race. I made it up into a group that was at the back end of the top 20. I kept pushing the pace in that group till it was down to just two and was out sprinted on the pavement. That meant I snuck in for 15th and the last UCI C2 points given out.

Day two started with morning rain that changed conditions significantly. I like that, but I didn't like my random draw start for the day. I don't remember what place it was but I was the second to last called to the line. Well, I couldn't see the line way up there, but I was called to the back of the people who were at the line. At least in the 90s. At this point I'm getting a little discouraged and I am sick of having to go so hard off the line. I knew it was going to be mayhem with the mud and all so I just started in my own row behind everyone and rode the pavement there, alone. Craziness ensued in the mud and I skirted around. Worked my way into 23rd by the end.

Day one Providence was dry and fast. Way too much pedaling. I had another mid-pack start draw, but I just suffered with the pedaling. That's bout all I remember. Suffering. I made it to 18th. No C1 points this time.

Day two, like Gloucester, changed significantly. Rain fell pretty much right before the start and made a layer of slime on top of solid earth. Also, like Gloucester I drew a start in the back of a 100 rider field. I think I drew 88, but missed my call. Didn't matter anyway. I'd rather be behind the last row on one side than in the middle of the second to last row. In the situation you have to work over to one side before you can move up much. From behind the back I have a straight shot up the side....usually. But anyway, I just didn't feel like fighting from the back, period. Like last Sunday I started slow and let the crashes happen and just skirt around. I didn't have a whole lot of motivation after that though and kind of just stayed upright, riding at a sub-race pace. I figured I was way back in the 50s-60s, but turned out I was inside the top twenty. Maybe 16th. Not knowing that I let anyone who was fighting go right around me. The end came and I was 24th.

Robbed in Baltimore

I don't like cities. No, I hate cities. They are the site of the human infection where the wound is gaping and the tissue is long dead and decaying. The long red streaks of the suburbs reach out into the living tissue of the planet. My experience with Baltimore went as usual. General disgust and overwhelming stress as I made my way to Druid Hill Park. Once inside I was able to block it out a bit, but only for a bit as we were surrounded. The city made it way to my car and my teamates car and decided to remove the contents of my wallet. This poor woodsman isn't used to having to worry about this sort of thing and of course had the thing stuffed with a significant portion of my worth....and when I say poor I also mean monetarily poor. My teamate Dan Chabanov is also poor and made a donation to the city by way of an expensive camera. Thing is though, he lives in these concrete jungles....he would argue that not all infections are the same....maybe not worded that way. Despite making sure I got a peek at my car every lap, the race went OK. Apparently the computer doesn't have much better luck than I. I've been pulling last row with the number out of the hat thing. The computer random kept me back there this weekend. 36th and 37th @ call up. Not dead last but close enough. I made my way through the pack on day one to make contact with the front of the race just as it was surging. A separation happened and I was behind it. I kept the pace and it split again. The end result was 2 leaders, 2 chasers, me and Ryan Dewald, and a large group behind. We worked together but couldn't make contact ahaead. I personally didn't have much to push with. Once we were certain to not make a catch or be caught I saved a little and took the sprint in for 5th. The next day I went about my business at the back of the pack and as usual when I reached the race at the front they were throwing down. This time I kept pace and made the split. It was me and the Euros from then on out. Bazin, Field, and the Frenchman's teamate Dassonville who started right in front of me. Nice to see someone else having to make it from the back. We cruzed around with a few surges happening, but when Bazin accelerated we all separated out to singles. The last 2 laps I was trying to close in on Dassonville in 3rd to make the podium, but just couldn't close the 5 second gap. We filed in with that order. Again another improvement. Things are alot farther behind than I thought they would be but at least they are headed in the right direction.