Wednesday, April 26, 2006

Birthday Blahs



I've got a case of the Birthday Blahs... sitting in my office. Working. While my fiance is out skiing Pike's Peak. Here are the pics from last year when we did the same thing: Pike's Peak Pictures. And here are some videos:
Pike's Peak May of 05
Pike's Peak May of 05

Ahh that was a good day. Too bad I'm a gimp and can't ski... and have feelings of guilt that keep me here at work instead of out playing on my Birthday. I missed last Friday for a wedding and this Friday and coming Monday for my surgery - so I feel a bit obligated to get my work done. I have to remember that in about a month I'll be leaving all of this anyway.

I'll be leaving - but I won't be able to mtn bike - or wade in the rivers to fly fish - I hate the thought of this surgery. Living in the mtns but forced to lay on the couch... BLTHHH!

Ok enough ranting.

Tuesday, April 25, 2006

We're fine, we're all fine, here now, thank you. How are you?

Ah too bad Liz doesn't get the Star Wars reference... well - probably nobody got that except for Steve.

So yes - I had my nuclear stress test yesterday and just got off the phone with the cardiologist. It appears that "Everything's under control. Situation: normal." as Han would say... (I don't know why I'm in a Star Wars mood - maybe because I know that I'll be doing nothing but watching movies for a few days after my surgery??)

He says that I'm cleared for the surgery and that I should go about life as if everything is normal - he does want to see me in another year or so to make sure that the thickness in my heart is in fact caused by being athletic and in good shape. If it continues to thicken it would be cause for concern:
concentric hypertrophy
n.
Hypertrophic growth of a hollow organ without overall enlargement, in which the walls of the organ are thickened and its capacity or volume is diminished.


So, it appears that this round of trips to the cardiologist will be the Basis point from which all is measured in the future. Not a bad thing to have done.

The wedding this weekend was a blast. It was a beautiful service with much celebration. After this weekend I should probably be having my liver examined... sheesh.

Thursday, April 20, 2006

ECG and the cardiologist

Click to see the full version

My ECG - click to see a large version.

I went today to my first two Cardiologist appointments - seems I have both RBBB and LPFB - the formal can be considered normal - the latter can not... I had an echo cardiogram done today - seemed to be normal and strong. No holes. That's a good thing.

The Stress Test is on Monday.

We leave for Ross's wedding tonight!! It's gonna be a blast (except for the redeye flight....)

Tuesday, April 18, 2006

MRI images





Here are two images from my MRI readings. The Green arrow points to a healthy segment of meniscus which should appear like a dark solid triangle with no interuptions. The Red arrow points to the tear in my meniscus - showing a dark triangle with a light band running through it. The light band is a bit of fluid that has permeated the tear - thereby making it clear on the MRI.

The entire MRI series can be seen here.

2nd opinion is in...


2nd verse same as the first - except for a longer predicted recovery time. Awesome.
The attached image shows a little drawing of my knee... the crescent shape on the left is my meniscus viewed from above. The tear is not visible from the top view - but would be visible from the side. I'll post some images from my MRI later this afternoon.

The Cardiologist appointment is set for Tuesday the 25th - just prior to my pre-op appointment.

Sunday, April 16, 2006

This past weekend

We went to Body World 2 down in Denver this weekend. It was hard to make the connection that the "exhibit" was in fact real human bodies. We definitely recommend seeing it - but there was an interesting juxtaposition between art and science - the line was definitely blurred. Take, for instance, the fact that each "piece" was titled and signed by the Dr... or shall I say artist? We felt that the missing pieces that may have brought it all together were the brief bios of each person, their age, health condition, cause of death and anything else that may have brought some reminder that these sculpturesque figures were, at one point, living breathing people. There was only one body that still had a face with skin attached... and, in my opinion, it may have been the most effective.

I caught a fish on Friday! Liz got some bites and caught some rocks... and played catch and release with her fly collection. We're learning.

I'm off to bed - the doc awaits tomorrow. I'm also planning a visit to a cardiologist just to be sure that everything is ok with the ticker.

Thursday, April 13, 2006

Second Opinion

I go in on Monday afternoon for a second opinion on my knee. I'll be meeting with Dr. Ferris who was the official Dr for the US Ski team for quite some time... apparently he is "the" guy to go to for knee injuries in Boulder.

I'll keep you updated. In the meantime - off to go fishing with Eric and Sarah. Figure that's a pretty low impact sport.

The results are in....

So the abnormal heartbeat detected by the Blood Pressure monitor also set off an abnormal ECG reading. Apparently I have Right Bundle Branch Blocking.

Right bundle branch block (RBBB) occurs when transmission of the electrical impulse is delayed or fails to conduct along the right bundle branch. Thus, the right ventricle depolarizes via cell-to-cell conduction spreading from the interventricular septum and left ventricle to the right ventricle.

RBBB commonly occurs in normal, healthy individuals, and the screening exam therefore often turns up no medical problems. In these cases, the RBBB has no apparent medical significance, and can be written off as a “normal variant,” and safely ignored.

Taken from a number of health websites - obviously I cut and pasted the best parts... choosing to ignore this one: Patients with RBBB from other causes may have diverse natural histories depending on the underlying disease; the outcome may be benign in some forms of familial RBBB, or sudden death may result if the RBBB pattern on ECG is due to Kearns-Sayre syndrome or Brugada syndrome.

Sweet.

Knee results

So the official diagnosis from Dr Halbrecht is that there ia an oblique tear extending to the inferior articular surface midway between the free edge and meniscocapsular junction beginning in the posterior body and extending throughout nearly the entire length of the posterior horn of the medial meniscus. (posted for Shawn and the 'rents who may actually understand all that).

Surgery date is set for 4/28/06 - they wanted to do it on the 26th - but I'd prefer to have a happy birthday instead! Prognosis looks like 3 months of rest and no high-impact sports (good thing the ski season is over - although ABasin remains open till June -sniff- no more summer skiing for me this year). She recommends a lot of biking... driving will be difficult for the first week or so (sniff - no hot rod WRX for a week... maybe it's time to sell it... either that or teach Liz how to drive stick and trade cars!)

I'm off to my physical... I'll post more later.

Tuesday, April 11, 2006

Possible Meniscus tear :(

After a visit to the specialist this morning and then an MRI this afternoon - it appears my long-awaited knee injury may finally have reared its ugly head. The injury was most likely caused by a combination of hyper-extension while kite-skiing and stress and fatigue from Ski Patrol tryouts - in addition to the years and years of mogul bashing and being a catcher for my highschool baseball team... I go in on Thursday to meet with the specialist again to read the MRI prints - we'll see what the word is. Her initial thoughts are that it is most likely a bucket handle tear:


From this website: www.kneeguru.co.uk

Circumferential or Longitudinal Tears

A circumferential tear extends along the length of the meniscus (along the circumference).

Such a tear renders the meniscus fairly incompetent, and the changed bio-mechanics of the knee may propagate the tear and prevent healing. These types of tear may not go through the full depth of the meniscus, but if they do, they are called 'bucket-handle- tears'.

The importance of the bucket-handle tear is that the 'handle' may flip over and be caught on the other side of the rounded condyle of the femur (rounded end of the thigh bone) and lock the joint, preventing full extension (straightening) and causing pain.

Each locking episode will stress the tear and cause it to get worse.

So - definitely some interesting developments as we prepare for a huge life change... YIKES.... oh and they also found an irregular heartbeat while taking my blood pressure. So I'm having a complete physical on Thursday to see what's going on with that.

Friday, April 07, 2006

Holding off?

So after some long chats last night - Liz and I are thinking that we may push the wedding back till next Spring. We're both going through a lot of changes right now - emotionally, financially, and geographically. With a move to the mtns in our near future, we're thinking that it may be hard to plan a wedding for the fall - especially when we have no idea where we will be come August. We're also waiting for some other things to smooth out so that we can really focus on our relationship and our lives together - feel free to call either of us to chat.

We looked at a few places for the ceremony and reception this week - and left them all without finding what we're looking for. The search for a location has really just begun - but it's a bit overwhelming - and we're unsure of how many people will actually be able to commit to flying out for the event.

We're starting the sell off - couches, plants, everything must go!

Monday, April 03, 2006

Top ten!

I just heard back from Steamboat Ski Patrol - I placed in the top 10! 6th... not too shabby. So hopefully that means a position with them for next season either in Courtesy Patrol or with the Pro Patrol!

I'm excited!

Sunday, April 02, 2006

Steamboat - Round 3: Ski Patrol Tryouts

Liz and I just returned from a long, grueling, nerve-wracking, and incredibly fun weekend trying out for the Steamboat Ski Patrol. We both are applying for "Pro-Patrol" as the paid patrol positions are called... though we'd be happy with Courtesy Patrol as well - which entails all the same responsibilities minus some of the medical first response and adding more snowmobile work.

There were 22 hopefuls in our clinic - which meant that we split into two groups. I was in group 1 and Liz - 2. It definitely worked out to not be in the same group together - being that we were all vying for the few open positions and it was nerve-wracking as it was without adding the stress of competing with your loved one. Plus we ended up meeting more people and socializing much more that way as well.

The tryouts consisted of two days.

Day 1 consisted of practice runs for everything that we would be doing on Day 2. The activities were this:
A ski test consisting of each group member skiing one at a time down various types of terrain while everyone else watched and the Patrollers assessed and "graded" our skills. We started the day with short radius turns down a groomed run. Moving on to fall-line skiing down "The Upper Triangle" - which is a short steep run that funnels into a small chute between a few pine trees. Off to long GS turns - followed by a cruddy bump run on which we had to carry our poles and a stick of bamboo down - to simulate carrying equipment and not using our poles in adverse terrain. We then went to Chute 1 which was steep skiing with soft snow. Finally, we had the bump run (I love bumps). The skiing portion of day one was in the morning for me which meant rock hard icy conditions with frozen lumps of snow from the previous afternoon's slushy conditions (aka frozen chicken heads - which is exactly what they look and feel like) however, the chutes were both still nice and soft as they're on the upper portions of the mountain. Day two skiing was also in the morning for me which meant 7 inches of fresh powder!! So all those same runs we did on day one were made much easier and nicer with a fresh coat of goodness.

The second half of each day was Tobaggon training which entailed running the tobaggons down both groomed and bumped runs unloaded and loaded. Skiing with a 65 pound sled behind you is interesting to say the least - now try to imagine that in bumps - and then - try stretching your imagination and add a person to that sled. Bumps with 225+ pounds behind you are not such an easy task... gravity and momentum are and are not your friends. It took the majority of the first afternoon to learn the ropes of how not to dig your tobaggon into the next mogul while not tipping it or making it an uncomfortable ride for your injured passenger. A subtle art of pushing, pulling and lifting makes the world go around.

Now try all of these tasks while being graded for your communication skills, line choice, placement, stability and smoothness of the tobaggon, and just your plain ol' ability to ski. Not easy. Mildy stressful. Hugely entertaining.

Liz and I both feel that we did well - they are posting the top 10 candidates tomorrow on the locker room door... assuming we both make it in the top 10 - the next step will be to wait and see how many positions they have available for next season... and they won't know that officially till late fall. Let the waiting begin.

Meanwhile - we are officially registered for our EMT/WEMT course given by www.medicalofficer.net in Crested Butte.

It was a great weekend - we're both exhausted. Oh, and did I mention, during my lunch break today I skied Fish Creek Falls with a few other Steamboat locals... mmmm knee deep fresh powder - 20 foot cliff drops - 2 ski length-wide chutes.... ahhh so nice. It's good to be in love, in the mountains, and in deep deep snow.

Let me also tell you - it's fun to introduce Liz as my fiance!