Tuesday, January 7, 2020

Back From the Dead, Hopefully

I’m not sure who is still out there that cares enough to check into this dark corner internet but I figured I’d work on a post to see if I can kickstart some sort of motivation to ‘blog’. Blogs seem a little old school nowadays but that’s probably why I have always liked having this space to rant and rave about things that only I deem to be important.... place I can post what I want and not have to deal with making it into a discussion thread or a back and forth.  A place where I can put a bunch of thoughts all together separated by three 'dots'... like that... and think that's an acceptable way to write.

As far as 2019 went, it was a great year for my family life.  I had a great summer with the girls (all 3 of them). The two youngest ones are turning into fine young ladies. The third is my lovely wife of 9 + years and who I've been with now for half my life.  I’ve seen a lot of growth with the kids this year. We had a great summer at the beach (most days) and hitting up events and the kids’ favorite ‘theme parks’ from the seacoast to northern NH. As far as ‘running’ goes, I had an ‘OK’ Spring of just running volume with little to no workouts (my usual approach over the last 6 or 7 years). I started racing regularly for a month and a half or so and started progressing very slowly in the right direction but it ended up being more trouble than it was worth for me. As a wise man told me, with running it’s all about balance. I had no real balance with the running/racing and family/work, etc. ….aka real life. I was forcing the running and was stressing (for really no reason) when I couldn’t balance it with my real-life duties. I wasn’t enjoying myself as I used to, and trying to maintain a racing schedule became more of a hassle than something I really wanted to do. It all came to a head in May when I tried to go to the Concord Rock n’ Race 5k midweek and ended up not even making it to Rt. 93 because of traffic. I had to turn around after 90 minutes in the car and head home because I wouldn't have made it in time. That was kind of it. I stopped running for a while after that. It just came to the point where I’d almost rather be doing anything else…literally anything else.

I ran sporadically in June/July/August/September when the opportunity hit me.  I was meeting up with Darin Brown for runs here and there but never more than a few times a week and usually at the last minute if I saw him pull into the beach parking lot when we were there and I just happened to have my running shoes and shorts with me.

In late September/October I started to get the itch again to get out there. I ran some trails and roads more consistently as the girls went back to school. In late October on a run up in the higher parts of town, I had to stop for a bit.  It was weird.  I felt a bit off and things weren’t exactly right. I thought at first I was just tired that day or maybe still out of shape. But I had been running with some consistency by that time, and had some previous good hilly runs that weren’t as bad, so it was certainly concerning.  I cut the run short and turned for home. A day or two later (not sure as I wasn’t keeping track of runs that closely) I met up with Darin for some road miles and felt horrible right away. I remember apologizing to him for the pace during the first quarter mile. We hit trails and I was pretty quiet. I was struggling to keep my breathing under control at a pretty slow pace. I was also noticing that deep breaths were starting to really hurt. It wasn’t that cold out so I was a little unsure as to why I was having this problem. The next day, I met Darin again from my house and we hit an 8 mile loop (the previous day had been also about 8 miles) and we hit a 7 min mile in some flat trail sections in the middle. I was feeling like it was sub 6. I really had to focus on the pace to keep with Darin which usually I don’t have to do on normal runs like this. At this point my breathing was an issue even when I wasn’t running. Deep breaths (especially through my nose) were painful in my lungs.

The next 2 days I didn’t run. I also didn’t sleep….at all. I could no longer lay down. Even on my back, sitting up in a sitting position in bed was not doable. I started to have severe pain in my sides and chest. It was unbearable. When I got through the first of the two sleepless nights, I managed to get through the day at work. When I was sitting in a chair and up and awake, it was manageable but once I started to get tired, it was miserable. I couldn’t relax at all in any position. I couldn’t put any pressure on my chest, back, or sides.

That second day after 2 sleepless nights (it was a Thursday), I went into the ER. By this point, I was basically in tears sitting in the room waiting for the doctor. They took blood. They came back in and the first thing the doctor said is that he wanted to get me right into a CT scan and that it was a ‘good thing’ I came in today. When I was in the CT scan, I had to lay down. I was literally screaming n pain. I had to put my arms above my head while in the machine. I was crying like a baby while trying to stay on the table. The woman doing the CT scan was trying to calm me down the whole time but there really was nothing she could do. Once it was finished, I basically collapsed off the table and onto the floor. They scraped me up and wheeled me back to the room.

While waiting in the room, tears streaming down my face and still unable to breathe without severe pain, Kristin came in. She knew I went to the ER but was trying to get ahold of me and couldn’t. I had my phone in my jacket and wasn’t able to get to it. She found me and came in right before the doctor came back. He came in and broke the news to me that my lungs were full of blood clots and I was extremely lucky I came in when I did. He gave me the rundown on what they were going to do but basically broke the news to me that this was life threatening and I had to be admitted. I had suffered a pulmonary embolism (or emboli because I had more clots than they could count). Once the dust cleared on that a bit, Kristin broke the news to me that at the exact time I went the ER, my brother had a heart attack and was awaiting transport to Mass General.  What a day.

 I was then taken down and admitted. I was hooked up to a blood thinner IV and placed in a room where all I could do is sit in a chair and take shallow breaths and focus on not stirring up the pain any more than it already was. They started giving me morphine and other pain killers. It was a mess. It didn’t seem like any of the pain medicines (even the morphine drip) was helping. It would take a small bit of the edge off, but that was it. I had moments sitting in that room on Thursday, where the pain would subside enough where I could talk to my parents and Kristin on the phone, etc. I would feel slightly better and then it would hit me like a truck again.

That first night, I had to ‘sleep’ (because I was exhausted by this point) sitting in a chair, hunched over, with my head on a small table (the wheeled table you eat off of). So I was sitting with my head almost in my lap but on a table…sort of how you’d sleep on an airplane sometimes. It sucked. I would drift off for a bit but wake up continuously throughout the night.  I had to keep getting serious pain killers regularly so I wasn't screaming in pain when I breathed.

In the morning, shortly after eating, it happened. Out of nowhere, I had the worst pains of my life start up in my left side next to my heart.  I stood up, still attached to the IV blood thinner, and couldn’t even communicate at this point because I couldn’t breathe.  I felt my eyes well up and I was frozen in the middle of the room.  Fortunately right at that point, the woman who was coming in to collect the food tray saw me and asked me if I was OK. All I could do was shake my head. She ran out and got the nurse.  The next thing I knew, there were no fewer than 7 or 8 people (nurses, doctors, etc) in the room. All gathered around me and all hands on deck. I was screaming in pain and couldn’t take any air in at this point. Every breath was excruciating. It literally felt like someone was taking a huge fork and jabbing me in my ribs as hard and as deep as they could stick it, and just tearing me open. I had people holding me down, while another nurse had a breathing device ready to put on me (it was right under my nose/mouth but I remember the doctor told her not to put it on me yet). I had another nurse with an O2 meeter in my face showing me the numbers. Usually I’m around 98-99 for oxygen saturation. I was in the 70s and it was dropping. They were basically screaming at me to focus on breathing and bring the numbers up. I got to the point where I couldn’t take even a sliver of air in my nose or mouth without the worst pain of my life. Breathing = excruciating pain. It was the scariest moment of my life to say the least. Not to be outdone I heard one of the nurses talking to the doctor about my ‘advanced directive’ and then I was asked about my ‘living will situation’. What a nightmare.  All I could do was look around the room and think about who was going to be the last person I was ever going to see. I wanted to talk but couldn’t. I wanted to tell someone to tell my kids I loved them. I wanted to say their names. I couldn’t. Being overexcited obviously wasn’t helping.

They finally picked me up and wheeled me, kicking and screaming, to the ICU. I was in critical condition for the next 3 days.  I had to do the same sleeping situation with my head on a table every night.  It was a nightmare.

I’m not exactly sure how, but slowly it started to get better (most likely due to the pain meds and blood thinners). My O2 got better and they pumped me full of morphine, oxycodone, and something else (at one point I heard it was the 'strongest stuff they had'). I was hooked up to that same IV and went through many bags of Heparin (funny enough the same blood thinner that my brother was hooked up to, 3 hours south in Boston). The next 3 nights I was in the ICU. In and out of it due to all the pain meds. My family came in to visit and I don’t remember much of it. Even on the morphine drip and pills, etc I was still doubling over in pain from time to time and it really took a toll on Kristin and my family who went in to see me during that time.

By late Monday afternoon I was feeling good enough (although my feet and legs were swollen pretty bad from having to sit in the same position every night) to come off of the IV and start what is now a lifetime on a pill-based blood thinner (Eliquis). I was so afraid of them pulling that IV off me because I know that is what saved my life. I was able to carefully shave (God forbid I cut myself) and wash and felt slightly human again. Kristin brought me home on Monday and my life changed dramatically at that point. But I need to keep reminding myself that I was extremely lucky.

The bad news is basically no one knows how I got to this point. I have seen multiple specialists, had scans, blood tests, etc. All genetic testing came back negative for a disorder. I had zero indication that I had a clot in my leg or lower abdomen short of one seemingly small calf pain I had in the weeks leading up to this (which seemed to come and go out of nowhere but it was very sore). Most doctors tell me that what I experienced in my calf most likely wasn’t the cause. The pulmonologist I see now  seems to think it could have been that.  But because we don’t know, they said that if I was to come off blood thinners its more risky than being on them. If it happens again, it could be it. The consensus is that I had one big clot, it went up through my heart and was soft enough where it shattered into many smaller clots and they all got lodged up in my lungs and grew.  The blood thinners helped stop new clots from forming and allowed the existing clots to dissolve on their own.  Needless to say, I blew through my 'out of pocket maximum' very quickly by being in the hospital for 4+ days.

The worse news is that I suffered a pulmonary infarction and had about 10% of lung tissue die due to the lack of blood flow to that area. The infarction is right next to my heart on the left side and is where most of the pain was. So now that will scar up over time and will be absorbed by the body apparently. The healing on these takes on average 3-6 months.

Even worse than that was that I had a small mass on my lung that was concerning to the radiologist. They suggested to have it followed up on in a few months. That was initially when I was in the hospital. Unexplained clots can be caused by lung cancer so that has not sat well with me.

About a week after I went home, I had a flare up of the same pain again. I was back in the hospital. I had more scans done and this time the radiologist was concerned enough about the mass to suggest I have a PET scan. The pain I was experiencing was just the infarct. I wasn’t having more clots.

Fast forward to the PET scan. I went over to Scarborough, Maine to Maine Med for a PET scan and the good news was that the mass they saw on the previous 2 CT scans didn’t light up. The bad news is that a few other things did, including two masses in the middle of my chest. They suggested from here that I have a biopsy done on them.

My doctor scheduled a biopsy to be done at Maine Med with a cardio-thoracic surgeon. But shortly after that, they reviewed it and thought it was best to wait a bit because it ‘could’ be inflammation which usually comes with a Pulmonary Embolism. So now I’m currently in waiting mode for that and have another CT scan set for February.

I have recurring appointments now with my Pulmonologist and have another echo cardiogram slated for this week. I had mild heart strain with the embolism and they want to keep an eye on it to see how much if any damage was done.

At this point, I am taking 2 pills a day (Eliquis). I cannot miss. My energy level is coming back slowly but I have no doubt that it's affected my energy. I’m not over the fear of ‘bleeding’ excessively quite yet. I am still very careful of what I do. I haven’t had a nosebleed yet but when I do, I’ll probably be a wreck emotionally.

I have run only a small handful of times. 3-5 miles at a time. I ran on the 2 month anniversary of my going into the hospital. I ran 3 days last week, all in a row, and took a few days off. I spun yesterday on the bike.  7:xx pace for a mile seems a bit hard at this point but I was able do a 5 mile run in under 8 min pace the other day. It felt a lot faster but it is what it is. I was able to finish a run on the Kanc last week with a sub 7 mile at the very end but  I was maxed out cardio-wise.  I gained about 15-20 pounds in the 2 + months I couldn’t do anything physically. The doctors stressed that I take it easy for a while and treat this very much like a ‘damaged organ’.  I still have uncomfortable feeling and pressure in my lungs and especially in the area where my infarction is. But that will slowly go over time. It takes a long time for these to 'heal'. I am hoping at this point to just be able to get back to running and activity as I normally did. I’m not looking to be able to do any PR-type of effort anymore (not that I physically could anyways) but I don’t want to give up. I'll already be now at a disadvantage 'lung-capacity-wise'.  This thing really knocked me on my butt hard. For some weeks afterwards, when I was still having to take strong pain medication at night so I wasn’t jumping out of bed with intense bursts of pain, I was pretty much convincing myself that I was permanently slowed down and that my days were numbered. I’m starting to think I have a chance again but this time I’m taking my time and balancing the important things in my life better.

Which brings me back to my family. My wife and kids and parents and everyone else who came to me when I needed them. Kristin has a sign hanging on the wall in our downstairs bathroom that I have to look at every time I take a wee.  It says simply ‘Enjoy the little things in life for some day you will realize they were the big things’. As I’ve had to think about my own mortality up close, the only thing in the forefront of my mind is my kids and my wife and their wellbeing. And how they’d get on without me. That was the scariest thing of all to me. Thinking of my kids growing up without their dad…maybe not even really remembering me all that well when they got older (they are still only 5 and 7). I’ve always realized my kids were my world. I feel like I’ve always prioritized their health and happiness. But after the last few months, I am more in tune with how every waking minute and every experience with them, no matter how small and seemingly ordinary, is priceless. Being able to take the first couple walks around the yard when I got home from the hospital was overwhelming for me. I realize how lucky I am to have a second chance and to have my family around me who loves and supports me unconditionally. I’ve certainly had my ups and downs. I had very dark days sitting here the last couple months, thinking about what these tests are going to reveal in the upcoming month or so. I guess I won’t completely move on from that until it’s all said and done and I get an all clear. If I don’t get an all clear, I’ll have to start making the appropriate plans and do what I need to do. For now, I’m going to try to get back into the normal routine as much as I can. Kristin has been incredibly loving and supportive and I cannot think of where I would be without her.  I love her and the girls more than ever and I’m more motivated now than ever to be around for them as long as possible.  I may be a grouch here and there, but they’ve learned by now to deal with that pretty well :).

Oh…and my brother is doing great now…he’s on some lifetime meds now and had a procedure (stint) and is back to his old self again. I always joked up until this year that he was my ‘canary in the coal mine’ because he’s 10 years older than I am. I figured when/if he had an issue, that would be a good indictor for me.  Our father had his first heart attack at 42. I’m almost 43. My brother is 52. Things are getting real now to say the least.

Anyways, for now, I look forward.  I have been blessed with a great Christmas with the girls and we're getting on with the  winter months now here in the Mount Washington Valley.  Here’s to a wonderful new year for everyone. I hope everyone is happy and healthy as we begin a new decade.

Some January fun...so far....


Probably shouldn't be doing this but.....



30 comments:

  1. Holy shit, man! This scared (scares?) the sh*t outta me. I don't know you at all except via the blog world but I'll be thinking of you. Best of luck.

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  2. Holy crap, that's scary stuff! Didn't expect the title of this blog post to be so literal. A very sobering read - I'm glad you're still with us!

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    1. I stole the title :). But I appreciate the visit to this ghost-town of a blog Seth. Hope all is well with you !

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  3. So sorry you are going through this; thank you for sharing in such detail- runners KNOW when things are 'off' and it can be difficult to get a doctor to take that seriously before something big happens. Am so glad you are here, will be sending good energy into your next scan.

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    1. Thanks. I appreciate it. Hard to put in words but I got through it better after a few attempts.

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  4. Damn dude. Was really not expecting this sort of post. I am glad to hear you have come through. Appreciate the perspective you have from it. Best and hope I get to cross paths with you again someday.

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    1. Thanks GZ. Do I still have your shoes in my attic?

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  5. Jim,
    So glad you're pulling through this. Sending positive thoughts to you and your family for a healthy 2020. Thank you for sharing, I very much appreciate the perspective and reflection on what really matters.

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    1. Thanks Scotty. I appreciate it. Hope all is well w/ you and the family.

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  6. I found your blog through another running site (as in, I don't know you irl!), but wanted to comment because I had a very similar experience with a PE 5 years ago (at the age of 35.) I had symptoms for a month before landing in the hospital. Didn't quite make it to the ICU but they kept me for a week. Took close to a year off running out of paranoia but I'm now back to doing ultras. The doctors kept commenting that if I wasn't in as good shape, it could have been a very different outcome and that stuck with me... Best wishes for a full recovery in every sense; give yourself the time and space you need!

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  7. Thanks Megan. I appreciate the comments. So I went back and looked at my GPS data and it looks like on 10/15 I had no issue. On 10/16 was that run in which I ran out of gas in a strange way and had to stop and turn around when on a pretty long climb. It looks like I ran the next 2 days but very easy and short. I made no notes on those days but I want to say I just didn't really feel much different but I didn't push it enough to notice. Then I took 2 days off. Then I ran those back to back days with my buddy, where I really noticed that I was gassed right away. So from 10/16 - 10/24 when I went into the hospital, that week+ was probably where it was really ramping up. I have another teammate who went through this last March, kind of out of nowhere. He was also in the hospital for about the same amount of time as us. I've heard usually 4-5 days or so is average for the hospital stay. I'm glad to hear you are back to ultras. Wow. That's good to hear and motivating for me. The doctors have been telling me to get back to activity and running. The pulmonologist has been telling me to get back to it so I'll start ramping it up a bit and see. I ran 5 today and had an actual pain where I have the infarction, on a very deep breath. That was a little concerning. But it's been fine since. Best of luck to you and thanks for sharing your story with me. I appreciate it.

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    1. I had an infarction as well, the pain just gradually dissipated. My heart was under a lot of strain initially and that was really what held me back for so long from running. Anyway, happy to be able to offer any kind of encouragement; I spent my fair share of time reading other people's stories and reaching out to friends afterwards. This is a more common experience than most of us realize!

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    2. Thanks Megan. I forgot to ask you if you had an infarction. I was curious as to how you dealt with the healing and pain. My friend also had a small infarct as well. I also found out my neighbor had this a few years back but then got pneumonia quickly afterward and really struggled. I do keep reminding myself that I'm lucky I was in as good shape as I was because a lot of people don't make it through it.

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  8. Thank you for sharing. My girls are 9 & 6 and basically my world outside of running as well. You have the right perspective. I hope you continue to heal and enjoy those "small moments."

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    1. Thanks I appreciate it Eric. Wishing you and your family a happy new year!

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  9. Wow just wow. We all need reminders like this to enjoy the little things in life. So glad you are still able to run.

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    1. Yes we do. Thanks for the comments. Hopefully 2020 brings better luck for all of us.

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  10. Holy Moly, Jim, that was terrifying to read. Hopefully we can look forward to many years of posts about your continued health and happiness

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    1. Thanks John. I heard today that you won Whitaker! Great work out there. Keep it going man.

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  11. Wow that is scary...and a frightening read. I had to jump to the end to make sure you made it through. I'm glad you are on the other side of it.

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  12. "....I had to jump to the end"... haha..I know it was long winded. Thanks for the kind words...

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  13. Terrifying ordeal. So sorry you and your family had to go through that! We've sincerely missed having you on some of the long runs around the seacoast over the last several months. Your post is an excellent reminder to never take anything for granted. Hope to see you this Spring or sooner (you still owe me a Pemi Loop)

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    1. Thanks Matt. I appreciate it. I'd love to try a pemi loop again at some point. I have a long way to go before I can get up those mountains again.

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  14. Jim, Continue to heal and enjoy your family. I've only met you once (Market Sq 10K), but have been following your blog for years. Such a scary experience, but you made it through. Be well.

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  15. Thanks Don. I appreciate you reaching out. Hope all is well with you these days. Thanks for reading.

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  16. I had assumed your absence was attributable to something far more benign and less unpleasant, like rereading all of my exhortations to quit racing while you still have the vestiges of a brain left or else invite tragicomic results before too long. I wish I had been right. I guess if there is a positive angle to this, it's that a recurrence seems extremely unlikely now that you know you need anticoagulant meds, maybe for life? I guess I'm saying it probably beats a TIA or MI that could come out of nowhere regardless of your own diligence.

    Glad you made it, no matter what.

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  17. JJ, Holy SHART! I'm glad to hear that things are getting better. You are right about the little things in life for sure. Take your time coming back and you'll be kicking all of our arses once again!

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