Four weeks ago I had a bicycle crash that was obviously more severe than I had realized. A week later I experienced my first head tingling and dizzy spell, but it was not until this past weekend that the symptoms became problematic. After a 90-mile bike ride Saturday, symptoms grew noticeably worse and persistent so that on Sunday evening I went to urgent care, had an MRI that revealed blood had filled my cranium, was placed in intensive care, and on Monday morning had neurosurgery for a subdural hematoma. Here is the full story...
As many of you know, I have become an engaged cyclist. About 12 years ago I started to ride a few hundred miles per year, and recently ramped up. Last year I rode 3250 miles with weekend summer rides of 70 – 90 miles each. I read up on nutrition and training for cyclists and used that information to improve my endurance and conditioning. Also last year, I focused on eating ‘clean’ and lost a quarter of my weight, leading to an active and health lifestyle. I’ve never felt healthier.
This year I decided to focus on cycling ‘tours’ of 100+ km (62 miles), exploring new routes and small towns. Through last weekend, I completed 12 such tours. My main challenge of 2015 was to ride to my 40th class reunion in Iowa (three-days, 244 miles). I completed that challenged. A week later, or last Saturday, I rode 90 miles in northwestern Minnesota and into Grand Forks, North Dakota. At the midway point for this year I reached nearly 1800 miles (or near 3000 km). Now my touring will suddenly end for the summer…
On June 7 I set out for a 100 mile ride. I found a flat on my rear tire, so I changed the inner tube. But I didn’t get the tube seated correctly. Instead of removing the wheel and starting over, I loosened the wheel, deflated the tube, reset, and re-inflated. While I got the tire fixed on the second try, my repair sequence was out-of-sync and I forgot to secure the ‘quick release’ that grips the wheel in place. A half mile down the road I stood up, pumping my legs to accelerate. But with the quick release unsecured, apparently the wheel slipped out of its position. The chain came off and I could feel the whole rear of my bike being unresponsive. I do remember making the decision to guide the bike over the curb and so I could land on the grass. I do not remember the crash. As I know now, the ‘landing’ must have lead to a significant blow to my head. All I remember is pulling myself up from the ground as I gained my senses and composure. There was a family there who had stopped to help. But at that moment I didn’t realize that there was unaccounted time during which the family came to my aid.
I carefully rode home and cleaned up. I had been planning on a long ride, so I didn’t want to concede the day. I was concerned enough about my head so that I chose to ride locally on safe side trails and no roads. I ended the day with nearly 50 miles and no incidents.
For the record, I was wearing a helmet. I always wear a helmet. When I see someone biking without that protection, I silently disapprove. From what I know now, had I not been wearing a helmet that day, my fate would have been worse.
During the week I started to hear what I thought was some malfunctioning of our home ventilation system. At times I heard the air whirling with a rhythmic, pulsating ‘Doppler effect. ‘ I thought the house’s fan was going out or being stressed. Only later did I realize that the sound was coming from within my head and only I could hear it.
Still feeling relatively normal, a week later I rode 80 miles. Again, this distance is a typical Saturday tour for me. But on Sunday I had my first episode. I had been sitting for a while watching a Sunday morning talk show and I stood up to walk upstairs. The pulsating sound emerged. A strange tingling spread out over my brain, and I grabbed the stair railing as I started to feel that I might pass out. I never lost consciousness, but I knew something was wrong. So I scheduled a Monday morning appointment.
The doctor tested me for a concussion, and cleared me. He said if I had a concussion, I would not have been able to ride that far. He also tested my blood chemistry, gave me an EKG, and tested for thyroid issues. All came back with a clean bill of health. The EKG reported an athletic pulse of 51 beats per minute. The doctor said I could keep riding, and that my light-headedness probably stemmed from my conditioning which naturally produces low blood pressure and a low pulse.
In retrospect, I should have pushed for more answers. My symptoms were distinct, unusual, and not the typical light-headedness that I’ve felt from low blood pressure. Of course, I was happy to hear that I was clear for my planned bike ride to Iowa that was just ten days away. So I accepted that I was clear to keep riding, and I did.
So three weeks after the accident I rode three days to my home town – 107 miles to Rochester, 70 miles the Minnesota/Iowa border, and 67 miles to and around my home town. I had completed my main challenge of the year. I didn’t have any of these strange symptoms while riding. But hours after I finished riding and Deb and I drove to the evening event, I fought back another bout of the head tingling and light-headedness. Then, as before, after the episode passed I was feeling normal for the rest of the evening.
As I said earlier, this past Saturday I rode 90 miles to Grand Forks. Deb picked me up. On the way home, I became confused when trying to fill the tank and pay for gas. Then, as relatives and a friend watched, I stumbled to the car as if a drunk. I apologized. I finally admitted to others that I had been feeling strange and light-headed when standing after sitting for long times. I acknowledged that I needed to go back in for evaluation.
When we got home Sunday, the problem persisted and grew more intense. A significant headache began to task me, so I asked Deb to drive me to urgent care. The person who saw me there realized something serious was going on, so she referred me to a nearby hospital for an MRI. As I got up to walk to the car I had to grab the table and could not move on. They brought a wheel chair to get me to the car, and had a wheelchair reception waiting for me at the hospital. After a 40 minute MRI, they informed us that they saw blood in my cranium and that a neurosurgeon at St. Joseph’s (downtown St. Paul) knew what was wrong and recommended I come in for surgery. So an ambulance transported me via a stretcher – and I would remain lying down until Wednesday.
The problem was explained to us. Subdural hematoma. I had blood inside the skull pressuring the brain. The surgery would remove this blood and the pressure to the brain. The surgeon explained the risks of this surgery – stroke, or worse, allowing an infection to reach the brain. I later learned that without this surgery people have died.
Deb noted my calm acceptance of surgery and the seriousness of my condition. For one thing, although this is invasive surgery (next to the brain), it was not surgery on the brain itself. For another thing, as someone grounded in faith, I felt calm in the face of risk and the unknown.
It was early in the morning when I arrived at St. Joseph’s, and they had slotted me for a 10:30 surgery. After a brief conversation with the anesthesiologist, the next thing I knew, I was waking up in the recovery room. I heard that I was in surgery for about 90 minutes. They removed about 6 ounces of old and new blood, and the surgeon said that they were ‘shocked’ at how much pressure they removed from someone who was functioning so well up to that day. And the doctor did tell Deb that I had a healthy looking brain J. Most of the brain moved back into place immediately.
For the next 40 hours I was on bed rest – keep-your-head-down bed rest. That was hard, and I had several people ‘yell’ at me when I was inclined to lean up. Aside from having to lie horizontally, I found myself mostly free of pain and in good spirits. So for most of the time I was myself, having pleasant conversations with the hospital staff. I was compelled to be a positive energy for those around me and not a negative drain. That seemed to come easily.
Being in intensive care, we could watch my blood pressure, pulse, and other vitals. Commonly, my BP ran at or below 100/60 with a pulse generally in the 50s. It was not lost on me that numbers like these come from cycling and conditioning, and that ironically it was a cycling accident that led me to the hospital. As I said before, despite the blow to my head, I have never felt stronger or healthier.
As I finish writing my story, I am waiting to be discharged – just three days after brain surgery. My recovery is coming along rapidly. The staff here makes me feel like I’m doing exceptional and being released earlier than one would expect. (Don’t know if they say that to most patients, but I’ll accept it.)
I do have restrictions: Can’t drive for at least two weeks. Can’t lift more than 10 pounds over the next six weeks. (I expect my new grandson, due in four weeks, to weigh less than 10 pounds so I can hold him J.) Need to take anti-seizure medication until further notice. I'll need to return for at least one more CAT scan and multiple follow-ups. It will take many days (weeks?) to ramp back up to my normal living/work pace.
And I should not put myself at risk of a fall for at least three months. The neurosurgeon warned of the danger of having head injuries close to each other in time. No one is expecting me to avoid living and risks in the future, but I need to be extra safe in the near future.
In other words, I should not be riding a bike outside until October. However, I can transition my bike back to an indoor trainer and ride inside during that time. Well, once I’m cleared for such exercise. Riding stationery and inside is boring compared to riding outside and traveling through air and over roads. But because I can still ride, I don’t have to lose all my conditioning, I can look forward to the hope of some enjoyable fall tours or at least tours next year. I’m thankful for that.
And I’m very thankful that all my cognitive skills seem to be intact.
I’m thankful for Deb and having her by my side and now as my “nurse” to help me through recovery. And of course, I’m thankful for an authentic faith that allows me to be in good spirits while others might panic or fret and that keeps me level-headed and calm when faced with serious circumstances which I can’t control.
I love life, and I’m not done yet J