By Graham Fogg
Sometimes health discoveries arise where you least expect them, and I never imagined that hill climbing on my bike would expose my most formidable health challenge. Worry not though, this story is ultimately not a downer.
First, some background: I turned 70 in Nov. 2023 and have been an avid recreational cyclist for many years, typically riding 70-120 miles/week on roads and trails of northern California. My main motivations for riding are the pure pleasure (fun and it’s the only activity that makes me feel 30 years younger), maintaining good health of my bad knee, relieving pressure on the pinched nerve in my back, and notably, maintaining good lung function. What’s not to like! About my lung function, I have COPD (no, I never smoked) due to a lifetime of asthma and bronchitis that led to six bouts of pneumonia, and in turn, scarring of my lungs and the COPD. Despite this, I have been able to cycle effectively enough to put up respectable numbers (without bronchodilators), with Strava segment times mostly in the middle of the pack for men my age, until recently.
After most rides I compare Strava segment times, power, and HR with previous rides on the same route and segments. For years I achieved gradual improvement, including some PRs most weeks. This all changed in January 2024, when I especially noticed more labored breathing on climbs along with marked reduction in power and speed for the same or greater HRs.
At first, I chalked it up to aging and perhaps recovery from some minor foot surgery done in December 2023. But week after week the numbers remained stubbornly inferior to my 2023 and earlier performance. So I decided I better have the pulmonologist take a close look at my lungs, especially since I had not had a lung checkup in over 12 years. This marked the beginning of my medical journey.
The initial hurdle was the impacted pulmonary medicine department and my lack of commonly recognized symptoms. In other words, pulmonary medicine had a long waiting list, and as a seemingly healthy 70-yr old with low blood pressure, low resting heart rate, and no typical symptoms, I was put on the lower priority list. (What? Your riding 100 miles per week and you’re trying to tell me you have some major health problem?)
During my 2+ months long wait, owing to the sage advice from my local bike club member, I got into Zone 2 training, which was likely most helpful as a bridge; but the climb difficulties and Strava numbers did not change appreciably, so I went back on the offensive with my medical provider to get an appointment with the pulmonologist, and finally got in.
Weeks later, after numerous tests and scans, I got the call from the doctor while driving — the kind of call where the doctor says, “You need to find a place to park before we talk….” Then came the first revelation: the scans (CT and others) detected a sizable, irregular mass behind my heart. And the breathing/climbing diagnosis: when I am exerting myself during my cycling climbs (>Zone 2), they believe this mass is compressing blood vessels between my heart and lungs, restricting blood supply to and/or from the lungs. The first phase of a hard reality lands with a thud!
That first revelation was followed by several more, including the subsequent biopsies and conclusion that I have lymphoma, and that the mass is a cancerous lymph node accompanied by 2 other, smaller lymph masses elsewhere in my upper body.
The incredibly good news that makes me so thankful to be a cyclist and data nerd: this cancer, which was caught at an early-enough stage to make it likely very treatable, would still be completely undetected had I not been cycling, climbing and perusing the data. Interestingly, this is because I had NONE of the usual symptoms on the lymphoma symptom list.
My only symptom was more difficulty on climbs, advertised in flashing red lights on my Strava segment numbers! I’m not saying one would need to be on Strava to detect something like this, but in my case, it certainly made the evidence impossible to ignore or rationalize as a ‘woe is me’ aging thing.
Earlier this month (July 2024), I started my first round of chemotherapy, and the oncologist has encouraged me to stay active up to a limit, with cycling and walking in this 6 month treatment journey. Stay tuned to my Strava feed as I embark on this next chapter of my cancer/cycling journey.
Graham Fogg started riding as a young kid on his single-speed, fat tire Schwinn, freely traversing the roads and trails of Concord, NH. Following knee surgery in his 20s, cycling became mainly a rehab activity, but in his 50s he discovered the joy of road-biking backroads and bike trails of the greater Sacramento area, California. Upon retiring from his day job as a Professor at University of California, Davis in 2020, Graham’s zeal for riding his road bike for pure pleasure and as a hedge against aging just grew and grew.
I am 82. While riding my bike after some time off the bike in 2019, I started having chest pains at 13mph. Formerly I was able to get up to 25 but not for long. I went to a cardiologist (not a very good one I found out) and after 5 tests including a cardiac MRI and wearing a heart monitor for a month, he said if it got worse we would have to do something which he described as open heart surgery. I got a second opinion. I had an enlarged septum, the central muscle down the center of the heart which carries the nerves to signal timing to the heart. The enlargement was muffling the signals and causing constriction of blood flowing out of the heart. The second cardiologist had me talk to an electrophysiologist who said my heart was out of sync up to 18 seconds. Blood standing still can clot and a clot in the heart is fatal. I got a pacemaker/defibrillator and then had an alcohol septal ablation (not open heart, but via catheter). I walked out of the hospital the next day feeling 10 years younger. I could run up the steps at home rather than getting light-headed. I ride about 100 miles per week, all solo, because I can no longer sustain 19-20 mph in a group. I plan to continue riding.
Wow, great story! Congrats to you for catching it early. Thanks for sharing and best of luck to you for a full recovery and much more time on your bike.
Cheers,
Harth
Wow, what a story. I’m so glad you listened to your body and pursued testing. Wishing you all the best in dealing with this disease and continuing to stay active. Cycling really can help save a life!
Hi
Fantastic, I’m so pleased you were diagnosed early and are being treated successfully. I defintely agree with your process of discovery as I had a similar experience that I put down to being an active cyclist.
Aged 71, just finished a 2017 winter cycling workout in the garage with a few floor exercises including the ‘Mountain Climber (https://www.youtube.com/watch?v=T_BvreyYL0w).
Lon story short, following my shower I ended up passing blood in my pee, probably as a result of the Mountain climber routine! Tests, scans and MRI resulted in finding cancer in my right kidney (renal pelvis).
March 2018 operation to removed the affected kidney, ureter and small portion where it joined the bladder. All successful, no chemo required back on the bike in summer 2018 and all ok since.
Best wishes, keep riding.
Brian Peto
What a wonderful story! Congrats to you on staying fit and nerding out on the numbers! I’ll be 69 this month. I just completed Roswell Park Cancer Center’s Empire State ride; a week long 560 ride across New York State. We raised $2.2 million for cancer research.
In September, I’ll be cancer free for 5 years (prostate cancer).
Great story Graham, so glad you identified the issue and are addressing it and on the road to recovery. Also, if you attended Concord High School we might have been classmates!
Best wishes for a complete recovery!
Jim Langley
Thanks Jim! I did attend CHS, class of 1971.
Thanks for sharing, Graham, and best wishes for a full recovery.
While not anywhere as serious as a cancer diagnosis, I discovered my borderline anemia the same way. I was just slower on a weekly time trial where I had years of data. My diet was plenty high in iron, but talking to my “on-like bike buddies” revealed that others had the same experience. Blood tests showed low numbers, and iron supplements fixed it. Knowing your body is a key in maintaining your health. When something goes off, dig into it and get it fixed!
Get yourself tested for celiac disease, which can limit iron and calcium absorption.
I had borderline anemia, and my (very wise) doctor checked me for celiac. Going gluten free resolved the anemia and an intestinal problem that I had had for years….
In 2023, I noticed some unusual chest tightness when climbing hills, which caused a notable drop in speed.. That was the only symptom that I noticed, which was soon determined to be atrial fibrillation. Some months later, an atrial ablation has “cured” the condition for now, and maybe for some years. Had I not had that experience, I’d probably be walking around with a silent problem.
Please keep us in touch as to how things go!
Great story where cycling helped.. I have a similar story. In 2008 while commuting to work by bike in February, I noticed I was going slower and had heartburn while riding. The heartburn went away as soon as I stopped riding. I read a story in RBR about someone with a heart problem having “heartburn”. I made an appointment with my cardiologist in my bike club. After having a couple of stents put in that were ineffective, I had a double bypass in August 2008. My grandfather died from a heart attack and my dad also had heart problems. I credit riding with giving me an early warning.