Thursday, April 30, 2009

small world

so today I was having procedure #5 (yes, that is 5 surgeries in 2 weeks) at the gynecologist's office. This was not exactly an elective procedure, but I did elect to have it when I was convalescing from my heart surgery as well as the incision on my saddle where, a pressure cyst that causes me pain at various times in a typical year where I ride 7000 miles directly on top of it, was removed.

So the progression of misery coalesced this way:

1. I decide to get the pacemaker, after having the EP study the week before

2. I was banned from bike/gym for a week so I decided to take care of that nagging little cyst mentioned above

3. once I am cleared to ride from #1 above I take a short ride and open up my stitches from step #2, ouch.

4. since I can't do anything anyway I decide to have pre-cancerous cells on my cervix lopped off with an electric wire loop, which they are doing today.

Basically since I am miserable from not exercising, trying to work, cook, clean, take care of dogs, etc in chronic pain, as well as having a deformed upper torso resulting from an elective procedure, I might as well check everything off my list that requires me to take it easy, and do it all in the same month. We will call that month April, 2009.

So I am in the waiting room and I hear my regular Gyno is late coming back from her C-section surgery. Great, now I have to sit in the waiting room, or Baby Central; aka today's Portrait of Hell. Crying babies, fat pregnant miserable-looking women, completely clueless fathers-to-be-looking like they would rather be ANYWHERE but here, a Stupid Box that spews out nothing except videos about what to do when your new baby cries at night blah blah blah. You get the picture. I have an ipod on and am glibly typing away. The nurse practically has to throw something at me to get my attention.

She calls me in and asks me if it is OK if another Dr. does the procedure. I say "no problem" since I was intending to drive to work after this. Which I did. They numbed me up nicely, even giving me a little shot of epi in the lydocaine, nice touch.

So I am there in the stirrups, propped up on two pillows so I can continue writing the poem I had been working on for the past week. Dr. B asks me who made the incision (still with little stitches sticking out) next to where she needs to "do her work". I tell her that my boyfriend did it; I asked him to slice me open since for the first time in 10 years I was off the bike, and he is a surgeon, after all. Might as well make himself useful! She asks me his name, and when I tell her, her eyes get wide and she starts laughing. "Wait--I know sent that funny party invitation! My husband and I are old friends of Mark's....we were so sorry we missed your party!"

So the two of us yammered on, and the procedure was done, and I was told not to exercise for a month. You have to be kidding me. There is no way; I am testing out this pacer in the lab at Cadence this wednesday so this thing better heal right quick.

It is a small world...and it does seem that doctors all know each other. Anyway, it was fun getting the dirt on your new boyfriend at the gynocologist's office. Kind of makes the whole business of having the tip of your hoo-haa cut off a bit less draconian.

despite what you might think after having read this I do love kids, even if they lack fur

Wednesday, April 22, 2009

4.21.09 the implantation

Today was the D-Day. I showed up at 7am , super-irritable because I had had nothing to eat or drink since 10pm yesterday, and I did not get home with my poor dog Madison until 8:30 pm, racing down from Skippack on the turnpike in the pouring rain. She was supposed to be in an Elizabethan collar for 3 days after emergency surgery for an absessed tooth (that cost her momma $1200) while she wore a Fentanyl patch for pain. I just could not leave her in the collar because not only could she not get out through the dog door with the collar on, but she looked so damn depressed in it; the collar dragging on the floor as she weakly stumbled into the furniture. So off it went, but I was worried she would chew off the patch. If either she or the other dogs ate it they could die. So needless to day there was not much time to calmly reflect on how my life was about to change.

At 6:58 am, Mark and I walked into the EP reception area there was an older couple checking in before me. They both were in their seventies, and the reception lady told them to have a seat. Mark whispered in my ear that he was pretty sure that that old guy was getting a pacemaker today, go figure. After the man was called up we could hear him answering the receptionists' questions.

She asked him his date of birth.

“November 11th, 1930.” Mark and I started hysterically giggling.
Like I needed one more reminder that I was too young for this shit.
There they are behind me: the surgery was supposed to take about an hour, but it takes about an hour just for them to prep you. First they take you to a bed and hook you all up with all the leads for the monitors and the blood pressure cup, and put you in a hospital gown ( I was able to keep on my boyshorts and smartwool socks, because last week I froze my toes off.)

I had done the entire EP test with no sedation at all I had toyed with the idea of doing that again this time. ....but after all they were making an incision in my shoulder. Dr. Mark used his surgical expertise to advise me to take as much sedation as they would legally allow.

A number of people came down and talked to me about the procedure and made me sign a bunch of forms. They told me I would have light sedation, or "twilight" but would be awake the whole time. Then the Head Nurse, an Asian woman whose name I cannot remember, marched in. She stuck my IV in and this time it hurt, even with my large easy-to-navigate veins. I found out later that she stuck me with an 18 guage needle, probably because she was in such a damn hurry she did not want to wait for the IV to drain. I was brought on a stretcher to the OR.

(They take latex allergies seriously here)

Then I climbed off the stretcher and into the bathroom, where I peed into a cup so they could see if I was pregnant. I'm not. They lifted me on the operating table where 5 nurses immediately started to work on me, with the asian Head Nurse cracking the whip. She told them, “we have to move fast today because we have two cases.” I mumbled that they did not need to move toooo fast....

They hooked up the IV, put all of my monitor leads and blood pressure cups on (yes, again) then proceeded to scrub my left breast and shoulder with this green cold liquid that felt great running down my back. The OR is kept very cold and I swear they store those plastic patches they use to hook you to the monitors in the refrigerator. Finally I was hooked up and Monique my nurse adjusted some blankets over me. My wool socks kept my feet nice and warm and this was good.

checking the equipment as I was wheeled in

I squinted to look at the monitor and asked the nurse what my heart rate was since they had taken my glasses. My blood pressure was about 110 over 69 or something. My heart rate was 43. Keep in mind that I had no coffee or food this morning; if I had had a cup of coffee it would be 55 or so. I explained to them that if I fell asleep it might drop into the 30s and they should not worry, that was my normal rate. Then they took my glasses away and covered my upper torso with a surgical drape so I could not see anything anyway. Soon Dr. Callans came in and said hello and they told me they were going to add some sedation to the IV since they were "ready to rock and roll." It felt cold going into my arm. Then it felt really nice.

Then Dr. Scollan, the Fellow who works with Dr. Callans, started injecting the site of the pacemaker insertion with lidocaine, "big stick and some burning." They got it all numbed up, then they opened up the site, which was in my delto-pectoral groove my just above my left breast below my shoulder. I was awake the whole time, and could feel the pressure of the incision but not the cut. Monique, my nurse, asked me if I was OK and did I feel any pain. I said I was fine.

We were going to insert the pacer under the muscle, so this was a little more involved surgery than the typical beneath the skin type, but if I did it that usual way you would be able to see the pacer sticking up right underneath my skin since I have very little subcutaneous fat in this area. So to place it beneath the muscle they make the incision, part the pectoralis major muscles, and slide the pacer in between. Needless to say it was not so easy with my anatomy.

The first thing they do once they have you opened up is to lacerate the cephalic vein and thread the 2 leads down into my heart, one in the atrium and one in the ventricle, as in the pic above. The leads are actually about 15 inches long as it is a circuitous route. As this was happening, Monique would monitor my stats and ask me how much pain I was feeling. I was fine for the most part, I would occasionally twitch when the leads hit a part of the vein which brushed against a nerve. They had some difficulty getting the leads where they needed to go. Then the leads needed to be screwed into the pacemaker, which is pictured here
just about actual size, although mine is slightly larger since they wanted to add an extra couple of years of battery. Then the pacemaker needed to be shoved into that little space that they opened up in my delto-pectoral groove. I think is was during this prcess that they hit the nerve that goes down into the funny bone in my arm and from then on I was uncomfortable.

They had some trouble getting it into place. Perhaps they cut the incision too small in an attempt to keep my scar as unnoticeable as possible. It seemed like they were shoving the pacemaker into that hole, tugging and pushing on my flesh. I imagined them grabbing onto my pec muscle with both arms and tugging, stamping on the pacemaker with their feet in an attempt to fit it in, but then they were flushing narcotics into my veins so I was sometimes in a quasi-dreamlike state. Then Dr. Scollan sewed me up, and Dr. Callans made a joke that even Mark would approve of the beautiful job he did. The surgery had already taken longer than expected. I could feel what seemed like dull needles pierce my skin as the lidocaine was starting to wear off. They tested the pacer, I did briefly lose consciousness at this point, and came around to the sounds of strange numbers being called out by a female voice, an exchange of digits that I did not understand, as they did not correspond to heart rate or blood pressure or oxygen. Valerie, the Medtronic rep, was testing the pacer with Dr. Callans. I guess it was the frequency corresponding to voltage readings or something. A this point I was feeling more discomfort. Monique leaned down and asked me if I needed anything. I was picking up on some negative energy in the room, frustration or irritation or something. I heard the doctors speaking in hushed tones to each other.

Apparently the lead in my atrium was not reading.

This means they had to rip open the sutures and basically start over again. They should have injected more lidocaine at this point, because Mark told me later that it only lasts about an hour. Monique asked me if I needed anything for pain. I am not sure why I kept saying, “I’m OK.” I think part of it was I wanted to see if I could get through this procedure with minimal sedation, I had my camera with me and I whispered to Monique that she should take a picture while I was still all bloody and cut open. She whispered back that she did not think she could legally do that. The other reason was it had been my experience that the medicine they used to block pain receptors always make me nauseous. So I said I was fine.

They pulled out the pacer and threaded a new lead into my atrium. Then they screwed it back on the pacer and there was what seemed like a tremendous amount of pushing and pulling to get the pacer back into the pocket. They apologized to me for all of the manhandling. I mumbled cheerily that it was OK, but the combination of the pain and my squeamousness was starting to get me agitated. I believe that at this point the HN realized that they were going to be very late for the second case. I never saw her again.

Then Dr. Scollans sewed me up again, and this time I felt every needle prick. Ouch. I decided I needed to tell Monique they needed to put something in the IV for pain, although at this point the surgery was essentially over. Monique responded and announced that she was giving me x grams of Fentanyl. (yes, the same med that Madison the dog was on)

Valerie called out her numbers again, as this metal mouse-shaped piece of metal was placed over the incision, I felt an electrical current and my heart responded with a flutter, and the voltage was tested, frequencies were adjusted. I guess this time everything came out ok. I barely remember that part, because all of a sudden I was incredibly nauseous. I told them I was feeling really sick, and they looked up at the monitor and said they were going to give me something for the nausea. I found out later that I had gone vagal and my blood pressure had dropped to 60/40 or something, and my heart rate dove well into the 30s. Dr. Callans said to give me Atropine.

Which they did, and whatever else, and the nausea subsided. I was getting very strong hiccups in my diaphragm from the electrical current of the pacer stiumulating my phrenic nerve. This was really annoying. The doctors had left the OR and many of the nurses as well but Monique had to call Dr. Callans back to make another adjustment. Finally they were able to wheel me out of there….around noon.

As I was wheeled out of the OR onto the stretcher the nausea hit me again like a wave. Steve, my nurse from the EP test last week, came over and asked how I was doing. I was sweating profusely, drenched all of a sudden. I mumbled "OK", staring weakly at him. I was sure I was going to throw up. I had turned a ghostly shade of green, my pressure had dropped again and my heart rate monitor was screeching it's alarm. Someone grabbed a plastic hat-shaped thing that you would use to collect a urine sample from someone who had no aim. Suddenly there were 4 nurses hovering around me, and one of them set one of those portable defibrillator units down on the end of the stretcher. I clutched at the plastic dish, and someone injected something else into my IV to bring my pressure up as they wheeled me into recovery. The nausea subsided, I was put into a bed and hooked to everything again, and my mom was called in.

Finally at 12:30, the procedure was over. I was very sore and stiff, but happy to not be throwing up.

I did doze for few minutes, and when I opened my eyes Mark was at my side. He gave me a hug and I asked him if he was between surgeries. He was. He had talked to Dr. Callans and had gotten the scoop about the dead lead. He stayed for about 20 minutes and then had to go back to save someone’s life.

For the next several hours my mother stayed at my side, and we chatted. People would call and I was able to hand her the phone, I did not feel like talking to anyone. About an hour later a nurse wheeled a portable x-ray machine over to me to check to see if during the surgery they had punctured either my heart or my lungs. They had not. Awesome.

I was still getting strong hiccups in my diaphragm so Valerie came back a few hours later and performed some adjustments to the pacer.

Basically the unit was pacing me when it should not be:

As you could see here was I was lying in bed and being paced artificially. It is important that we adjust the pacer so it does not pace me unnecessarily; since 1. it feels weird and 2. it will prematurely wear out my battery. A battery change means more of this stuff that I went thought today; I am in no rush to repeat this drill again.

the view from Valerie's strange suitcase

So finally at 5pm they discharged me, and I was sent home with a prescription of Darvocet. I thought I would only need a couple of days of pills. ha. that's a whole other story.

Anyway, Mark made me fried skate with capers and leek and shiitake mushroom risotto, and then Colin and Michelle came over and there was more food and many laughs. I convinced Michelle to help me make chocolate chip cookies, which we did. I ate 4.

And so ended a very long and life-changing day for me. I slept well that night. I was still under the effects of the sedation (what little there was) and looking forward to mending up and being able to test this new little device of mine on the bike, cauz God knows I am not going to win any beauty contests now with this thing:

before.......and after......

Tuesday, April 7, 2009

6.28.08 ground zero

I’m actually not sure where to start, so I think I am going to have to try and start at the beginning. It was June of 2008, and I had broken my clavicle about 6 weeks earlier. I was training hard for a race season that never materialized, and riding outdoors with my broken collarbone about a month too soon. I had taken Cadence Class on Thursday night, did a heavy leg workout in the gym the day before, and I was enjoying a beautiful June ride by myself when something weird happened. I was pushing, as I always did, at the end of a 3 hour ride back to Philadelphia on the bike path. My heart rate had been averaging about 145 and my power was in the endurance zone, but for about a minute and a half both had climbed as I made an effort. All of a sudden a felt this flutter in my heart and I felt overwhelmingly weak. What had just happened? This weakened state lasted for over 5 minutes while I struggled to maintain my power output, and by the time it was over I was in Manayunk eating an Italian water ice. It was unsettling. But I was eating my favorite: watermelon-- and I soon forgot about it.

Later as I was downloading the ride from the Power Tap, I looked at my power graph after the ride this is what I saw:

note the red line which is heart rate dropping like a stone from 164 to 82
I did not think too much of it, but then a week later I was riding again on the bike path by myself and I passed a female recreational cyclist who was determined to keep up with me. I noticed she was on my wheel and crept up the pace a little, but suddenly I felt that flutter in my heart an I looked down and suddenly my heart rate had gone from 165 to 82. I felt like crap. It was everything I could do to keep going, but by this time I had already run her off my wheel anyway so it did not really matter if I slowed up a bit. I know, lame.

And so it started. I inquired around to a few coaches who told me perhaps there was something wrong with the Power Tap heart rate monitor, that sometime the power lines can make them act screwy. But I knew there was nothing wrong with my heart rate monitor, I had felt that flutter in my heart and had felt incredibly weak and had to curtail my effort. I had ridden next to Donald Yih, MD on many a cold long winter Pretzel ride, so I told him what was happening and I made an appointment to see him over at Lankenau. He said that he noticed that if your heart goes into any kind of arrhythmia the power taps do not record it properly. He said what was likely happening was that I was gong into tachycardia, or fast heart rate. He suggested that the next time it happened I got off the bike and took my pulse.

It happened once at the end of a group ride when everyone was pushing up the last hill into manayunk on Umbria. I was in a paceline and I felt really strong and I pushed hard up the hill in my big ring, trying to make everyone suffer a bit….and then it happened, I motioned that I was pulling off and I cruised onto the sidewalk and jumped off my bike and took my pulse. My heart rate monitor said was beating at 79 beats….and so was my pulse. WTF?

Wednesday, April 1, 2009

what to do when your domain is poached

At 10 am yesterday I got a email from my boss: "email is down...should I call IT?"

“IT” being IT Solutions, our outside IT company that handles all of the computer stuff that is above my head or that I am too busy to deal with, which seems like everything these days. After the obligatory 3-4 emails back and forth that it always takes for me to get relevant information from any of my co-workers so I can actually begin to solve the problem *more on this later*, I send an email to IT from my blackberry while performing a turtle pose on the gym floor after my 65 minute humiliating plyometrics bashfest. See, I had to procure my own agility ladder after being kicked out of X’s gym, so I had not done ladder drills since early January. They get much harder after you don't do them for 3 months; and furthermore my synapses were still in Miami or something, and even furthermore I am always sluggish on Wednesday mornings after the mountain bike ride on Tuesday nights. 10 minutes later I called IT and they were on it.

On my way to work I called them again. Our liason patched me through to a tech, apparently because he did not want to be the one to face my anticipated disgust. The tech hesitated, “I have bad news for you. It looks like your domain has been poached.”

It turns out that our domain expired back on February 18th and was in limbo for 43 days, at the end of which it was released for purchase to the general public. That happened Wednesday morning at 10 am. At that point, a very savvy person in India by the name of Karan Goyal (no idea if male or female, but I prefer to think of this person as a bi$%ch) poached our domain name. We never received the notifications that our domain was going to expire because they were sent to the email address that IT Solutions disabled when they moved us from NJ to our current locale down by the airport. So needless to say, we were screwed.

I found Ms. Karan's email from the WHOIS database and sent her an email inquiring about buying back our domain:

Karan, our domain name expired and the hosting company had expired contact info for us so we did not receive notification until today. I would like to inquire about purchasing our domain back from you as soon as possible. Could you please let me know how much it would cost to for you to release the domain back to us? Thank you. Andrea Walheim Liberty Flooring

I tried not to sound too desperate. However, at this moment in time no one in our organization is able to send and receive email, no one can log in to the remote network, the 4 employees with blackberries are unable to receive email, and if we can’t get the domain back I have to reprint thousands of business cards, repaint the three trucks, and who can quantify the cost of inconveniencing all our customers and suppliers who currently cannot contact us by email and cannot send us documents/plans/etc.

This is the lame-ass email I got back:

Hi, Actually I am really sorry to say but there's a project in my mind which I already have started. Anyways if you want to have it back I can give it to you for $500 via paypal @ Thanks

$500. Ouch. Well, it could have been worse I guess.

Now we all know this was a planned extortion. Congratulations Karan, you capitalized on our mistake and now you hold the cards, but please spare me the bullshit that you have a project in India which requires the use of Give me a break.

I guess her first attempt was to see if I would be stupid enough to just pay her the cash without her releasing the domain. I’m not quite that stupid. I emailed back that we needed to use an escrow account.

She agrees to escrow because, of course being the pro that she is, she already has an account setup at Then I had to call Godaddy, who had hosted the domain, and find out how long it would take to transfer it back. I was able to coerce the rep on the phone to reveal that Ms. Karan was a account holder at Godaddy and if she changed the domain through her control panel we could use our domain in 5 minutes. I sent Karan an email asking if she would agree to release the domain to us in this manner. It got lost in translation a bit, but then she replied, “OK. Yes.”

…..and then I did not hear from her anymore.

She sent me an escrow link that did not work after I opened an account. I wanted to be careful not to send too many emails to her; not to sound too desperate. I knew she was playing me for more money. I had agreed to the $500 too quickly perhaps. Our website (had) boasted that we had become an 11 million dollar company, and perhaps she had used the google money converter and decided that $500 was too paltry a sum to ask of the goliath Liberty Flooring. Perhaps they had not heard about the recession yet in India, especially in the construction industry. We don't use call centers in construction much.

I decided to initiate my own transaction on as the buyer and I sent her the escrow request for her to accept.

Still nothing.

It was now 5pm EST and we had been offline to the outside world for 7 hours. I had no idea if this bitch was going to release my domain or not. It was 5 hours ahead in New Delhi, but I doubted that the reason for the non response was because Karan decided she had more important things to do this evening than extort $500 from an American company. The escrow link had not worked because she decided to hold out for more cash.

The next morning I checked my email for the 100th time, still nothing. She was seeing how desperate I would get. This is bullshit. Nobody does this to me. I decided it was time I played a card and see if I could turn this whole thing around. I sent the following:

Karan, if I don’t hear from you in the next three hours I have no choice but to purchase another domain. Once I do that I will have no use for so you can keep it. Otherwise please respond to my escrow request immediately so we can finish the transaction. I would rather not have to change domains but at this point the delay is costing me too much money. It’s your choice. Andrea

You could hear crickets chirping across the Internet. chirp. chirp.

. . .still nothing.

and hour later, I received an email notification from that she had accepted and I need to ante up and pay. Whoo hoo!

So I paid with a personal credit card, which involved faxing them a copy of both sides of my credit card(!) and said it would take a day to process. I called the IT company and they said they would be on call in case the domain would be able to be released that evening.

At 6pm I got a notice that the CC payment had been verified and to let escrow know when I had received the domain back. I emailed my Indian friend:

If you go into and hit "account change" you can enter my account number which is 465XXXX and my email address is xxxxx. We should then be able to get our domain within 5 minutes and I will release the fund to you.

Ha! Like I needed how to tell her how to do her job.

On Thu, Apr 2, 2009 at 6:29 PM, Karan Goyal <> wrote:

its done Thanks

yeah thanks to you too sweetheart. FYI that would be "it's" in English.

I got the notification, made the switch in the control panel (if we had not both been account holders at Godaddy this could have taken months) and called the IT company so they could re-attach our Exchange Server to the domain.

An hour later we were up.

And there you have it. A perfectly legal and profitable extortion scheme that you don't even need to be that tech-savvy to pull off. Just a little patience, a pc, a few dollars, and a little luck.

Do you know when your domain expires?

Want to check? Click here. Good luck.

I am so glad I don't have to put duck tape over the ".net" .....