Thursday, April 7, 2011

The Surgery

The surgery was done April 7th, at the University of Virginia Hospital in Charlottesvile, by Dr Ken Cherry, which is Chief of Surgery there and is the reason why I traveled there from Detroit.

Dr Cherry has operated around 20 cyclists suffering from external iliac artery endofibrosis in the last 16 years. He was recommended by another cyclist that also had eiae, as probably the best expert of that condition in the US, knowing that this is a recently disease and the number of reported cases is very small.

Dr Oppat, the vascular surgeon that took care of my here in Detroit and confirmed the diagnostic of eiae, was kind enough to consult with Dr Cherry and send him my arteriogram and other exams.

In another post i need to explain how eiae was diagnosed and the symptoms the couple of years leading to the operation.

So, Dr Cherry got me on his schedule really quickly (like 3 weeks after my phone call) and the only protocol he needed to do was an Ankle Brachial Index the day before. Results of the ABI was exactly the same as the one I did in November with Dr Oppat : 0.23 after less than 4 minutes of a hard workout (on the stationary bike this time).

Valerie and I met with Dr Cherry the day before the surgery and he was really straightforward.
He explained that until he was there and looked at the artery, he did not know if he was going to do a patch or a graft. He also said he was going to do a second small incision and release the inguinal ligament on the left side.
He gave us the stats : 85% success.

The surgery went well. Turned out that the artery condition was much worse than the arteriogram indicated and they elected to do a interposition graft with a 8 mm knitted Gelsoft Dacron graft. 5/6 of the external iliac artery was removed.
Here's the sketch that Dr Cherry did when I saw him the next day.

Post operation was OK, I had some strong pain killer (oxycodon) prescribed and that helped for the incision pain.
They had me raise and walk in the hallway the next day, Friday morning (really I could have waited another day ... the incision was really painful and I could not use my core muscles for any motion).

I saw Dr Cherry Friday evening and he said I was going to be discharged Saturday morning.
That was quick.
My first feeling was that was too quick and I was worried I was going to hurt a lot but in hindsight that was an excellent decision.
Saturday late morning, I was able to walk slowly to the car and we went back to the hotel.
We even had a nice meal at the Mediterranean restaurant in the mall by our hotel and I spend the rest of the Saturday resting in my bed.
Sunday was the return drive home. Valerie and my father took turns at the wheel. We stopped every couple hours and I walked 10 minutes every time. Not a problem. We left Charlottesville at 8 and arrived home at 9 pm.
Later, Dr Oppat told me it was risky to have driven that much only two days after this surgery.

Friday, April 1, 2011

First symptoms


The first time I reported on my training diary pain or weakness on my left leg was in the summer of 2007, July 22nd exactly. So merely 3 years after starting cycling.
June and July of 2007 had been extremely intense for me. I did my first long endurance races. First the 8 hours of Cannonsburg, MI in mountain bike, then in France l'Ariegeoise cyclosportive (160 km and 3 or 4 passes) and finally the insane Etape du Tour Foix-Loudenvielle with 200 km and 5 passes, the most difficult stage of the Tour that year and my first Etape.
Tough program. And in between I would ride in Catalunya and in the Pyrenees.
Pain under intensity started shortly after l'Etape and I noted this several times on my diary in France and then back in Michigan.
I attributed this weakness to fatigue and overuse, maybe muscle damage after the exhausting Etape where I had to stop every km on the last pass (Peyresourde) that I crossed in total agony.