I’ve had some interesting
e-exchanges with Jeff Webster, a hard-riding cyclist living in Arkansas whose
own experience with arterial aneurysms has some parallels with my own.
Webster is mountain biker who
discovered in 2005 that he had four (count ‘em, folks, four) iliac arterial
aneurysms and one dissection. He was also the former CEO of Carmichael Training
Systems, which was the organization that trained endurance athletes such as
Lance Armstrong. A cyclist since childhood, Webster was a fan of century rides,
biathlons, 24-hour events and some serious mountain bike racing.
So, here’s a guy who, at 47 years of
age and recording up to 6,400 kilometres a year on his bike, gets blindsided by this bombshell found during a routine physical. Initially, he faced immediate emergency surgery, mostly because the medical team hadn’t seen
anything like this in their careers. Once the doctor and radiologist calmed
down a bit, Webster began a voyage that took him to the Mayo Clinic in
Jacksonville, Fla., then to the Mayo in Rochester, Minn. and then to vascular surgeon Dr.
Roy Greenberg at the Cleveland Clinic in Ohio.
After much talk about surgery,
stents and grafts, the experts have decided to monitor his condition. He has
undergone genetic testing for Marfan’s syndrome, Ehlers-Danlos and other
factors (all negative) to see if there are underlying conditions that might
have caused the problem or could contribute to complications during surgery. It
was suggested to him that perhaps he had had these aneurysms all his life. (I’ve
had various people wonder the same thing about me. It usually goes something
like, “If you had never had the CT scan, you would never have known about the
problem. It’s better not to know.” I, of course, disagree. I believe everyone
should have knowledge about their own bodies. The trick is controlling the
response to that knowledge. Don’t freak out … try to figure out how to manage
the problem.)
Anyway, for a couple of years, he
backed off the riding to about 2,400 km a year, and none of the aneurysms have
grown. He has resisted taking beta blockers to reduce his heart rate and blood
pressure.
Although my own vascular advisers
seem convinced that my iliac aneurysm is directly related to cycling, Webster’s
doctors aren’t so sure. But, he writes, “the more I read on this, the more I am
convinced it is.”
The big downside in all this is the
weight gain of his reduced exercise. After adding 10 pounds, he decided to
start some hard riding again: about 640 km per month, mostly on a trainer,
since January.
So, right now, it’s a wait-and-see
situation. If there is surgery, the stents will come from Australia, which is
at the leading edge of stent manufacture.
Webster hopes that sharing his story
will raise awareness about cycling and arterial anomalies: “I think the more
info there is out there, the more people are informed and the more experts may
be able to make linkages.”
As a part of that linkage, here’s a
link to the MRI images of Webster’s aneurysms. This shot shows the arteries in the context of the rest of the abdomen. Share this information with your hard-riding cycling friends, and with your doctor.
My own vascular surgeon, Dr. Thomas Lindsay,
was quoted last year on behalf of the Canadian Society for Vascular Surgery as
saying that every Canadian man and many high-risk women over the age of 65 should
be screened for abdominal aortic aneurysms. It’s a matter of saving lives, and
health-care dollars, he said. I wonder if the same consideration
should be extended to cyclists, who may be putting unusual stresses on their
lower abdominal arteries in a high-energy activity. A simple ultrasound screening
would cost the system less than $60, but might detect a problem before it turns
into a major medical issue.
Webster will keep me informed of developments, and I’ll
pass on what I learn.
