Serious Circulation Problems



dymaxion

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Oct 12, 2012
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I am just home from 3 days in the intensive care unit at the hospital where I unfortunately met my new cardiovascular surgeon. I was diagnosed with [COLOR= rgb(51, 51, 51)]Spontaneous Iliac Artery Dissection After Exercise. Apparently I am the 13th reported case in the world and looking for information on what might be going on as it appears that it may be related to cycling. I am wondering if anyone has information or thoughts that this may indeed be from cycling or not.[/COLOR]

I am a 43 year old man training for triathlons. I trained competitively for distance and middle distance track since I was 9 years old. As an adult I ran track in college so my circulatory system has had some experience with high performance training. I started training and competing in triathlons about 11 years ago. Since then my training has been sporadic with many months and recently a couple years between training and competing.

9 weeks ago I started training for an olympic distance triathlon - the trinewbies training program as I have many times - working up slowly. As part of my training I commute to work daily on my traithlon bike - about 15 miles round trip. 5 weeks into the training I had an intense pain to my groin area that lasted for a few areas. It was not just on the surface but felt more like where your prostate is located. I could not figure out what it was. I took ibuprofen, finally fell asleep with the pain and woke up in the morning with the pain gone. I rode to work on my bike and the pain did not occur again. I thought it must have severe inflammation due to just getting into riding again.

A few weeks later I did an 85 mile bike ride. I started very slow pace, felt great and ended at a must faster and personally intense pace. I did not have any pain in my pelvis area other than mild discomfort that comes along normally with cycling.

Two weeks later, while continuing my training and commuting, I woke in the morning. Had my cup of coffee. Went to the bathroom. And realized I was in severe pain. Much like the pain I had previously only this was right in the location of the appendix. After an hour or so I decided to go to the emergency room, was emitted to the hospital where it was thought that I either had an appendicitis or a kidney stone. After the CT scan it was obvious that I had a dissection in my iliac artery. This is very rare with 12 prior reported cases. Of these rare cases it is commonly occurring in older high performance athletes. Little is known but this may be due to repetitive motion. The published case describes an older cyclist that this occurred to while riding up a hill.

To complicate issues my mother had a dissection of her aorta at 57 years old. She was never athletic and smoked for years. I do not smoke but there is some thought that there may be a genetic disposition contributing.

A CT scan did show that the dissection was going into the artery that goes into the pelvis. This explained the incident that occurred at week 5.

Has anyone heard of something similar happening to other cyclist? I also wondered if cycling on a tri bike with aerobars and a more forward angle may have contributed.

Thanks for any input.
 
I'm not sure that posting on an internet forum to seek medical advice is the way to go.

If there are only 13 cases in the world of Spontaneous Iliac Artery Dissection After Exercise then you might get lucky here and make contact with someone who has that condition however.

Surely your doctor can consult a specialist on your behalf?
 
There have been a few pro cyclists who've had iliac artery issues, but I don't remember them being dissections of the iliac artery. I think they were blockages--like maybe a clot or summat--or poor blood flow through the iliac artery do to things like a stenosis or summat. At any rate, I've uploaded a pdf of an article in a medical publication: "External iliac artery dissection secondary to endofibrosis in a cyclist". You might find more articles available through Google Scholar. [ATTACHMENT=343]External iliac artery dissection secondary to endofibrosis in a cyclist.pdf (800k. pdf file)[/ATTACHMENT] FWIW, make sure that you ask your doctors about whatever concerns you, and make sure they give you answers. Unfortunately, on the internet you can't know if people are telling you the truth or messing with you. Given that, internet forums are really bad places to go for medical advice. Hopefully you will have or have had an appointment with a vascular surgeon. Good luck.
 
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Thanks for the post. I am getting the necessary medical attention and have a respected cardiovascular surgeon and other doctors now working with me. I am really just trying to gain some understanding of this and think that the cycling community may be another place to get informed from the ground up. My understanding is that doctors often base decisions on statistical data gained through precedent cases studies. As this is very rare, there is little information available even to doctors. And as you suggest, I am also just fishing to see if I might get lucky and hear of a similar case from cyclist and how they have managed it.
 
Thank you Alienator! I am reading the article now and am finding more.

http://www.bmj.sk/2011/11207-09.pdf
 
HI Dymexion,

I hope that your circulation problem has been resolved.Today as a new user I read your comments which chimed with me. Earlier this year a stent graft was inserted to repair an Abdominal Aortic Aneurysm. All went well for a few months then Pow! 16Km into a ride my left leg lost complete power and I was hauled home by car. For the past two months the outcome has left me with intermittent claudication, unable to ride my bike or walk more than 150m without severe pain in the calf. While waiting to see my surgeon, my online reading indicates that there is perhaps a kink in the iliac artery severely reducing blood supply to the affected leg. I have read that this condition is by no means uncommon in endurance cycling but I hasten to add that I am not in that category, perhaps 60km three times weekly. Meanwhile I await a CT scan and Angiogram 16 December 2013 in the fervent hope that whatever is found troubling can be rectified with minimally invasive surgery.