Paying the Price

Many people feel that big rewards come with a hefty price tag.  When it comes to the 24 Hours of Sunlight event held last weekend, my wife, Dina's, reward was pretty big.  She succeeded in setting the women's record for skiing the most vertical, up and down, in 24 hours (34,500 feet one way).  The price?  Well, initially, what you'd expect...exhaustion.  Not too expensive, really.  The next morning, however, the ante went up with some coffee ground emesis.  That's the technical term for barfing up blood that's been sitting in your stomach juices long enough to change from bright red to black and coagulated.  Hmmmm, not good.  Next up was, pardon the graphic description, black shit.  Now, from a medical standpoint, there are only a couple of common things that give humans black stools.  Pepto Bismol will do it.  Blueberries, a lot of them, will get close.  But the most likely culprit in a healthy person who knows what they've been stuffing down their pie hole recently is upper gastrointestinal bleeding.  By the time blood from, say, a bleeding ulcer gets to the exit, it turns your shit black.  Lovely.  Now things are getting expensive.  Certainly figuratively and, perhaps, literally.

Being the medical dork, I cruised over to the local ER after the second such episode and acquired the handy quickie test to check for blood in shit.  Not too many secrets left in our relationship.  Sure enough, it was positive.  The next day, a trip to a doctor bought her a round of blood tests.  She was a little anemic and one of her liver function tests was elevated.  These results generated a recommendation to go to Idaho Falls to see a specialist and spend two days consulting and getting an endoscopy.  Whoa!!

Now, I don't want to go off on a rant here but I've been in the medical business for over 15 years now.  I have come to feel that many people are victimized by our health care system rather than helped by it.  Too many fucking tests, too many fucking pills, too much cover-your-ass medicine and not enough patience to simply let things run their course.  A quick check of the medical literature dealing with ultra endurance athletes yielded many observational studies where athletes experienced transient signs and symptoms just like Dina's.  I queried a few other clinicians much smarter than me and they felt that waiting a few days to see if the "stress gastritis" and elevated LFTs clear spontaneously was reasonable. 

There was also a recommendation to treat the stomach issues with a prescription antacid, omeprazole.  The first prescription priced out at $360!!!  WTF!!  How 'bout a generic?  Sure, that one's $180!  Double WTF!!  Oh, wait a minute.  Mean she can buy the exact same stuff over the counter for $28?  Now, that's more like it.  Sure, she'll have to take more of it but it still prices out waaaaay less.  I can't help but wonder how many people go blindly down the first path, going broke as they go.  Clinicians don't usually intentionally prescribe the most expensive drugs.  Most simply don't have time to find out the costs of what they prescribe.

Now, I don't want to seem so arogant as to suggest that Dina may not eventually need a scope of her belly.  People do get sick for real sometimes and need all our health care system offers.  But most can get away with less.  Case in point, the black shit stopped today and her stomach felt better.  Of course, that got her out on a snowbike this afternoon and her belly got sour again.  Black shit in the a.m.?  Stay tuned.  We'll check the liver function tests next week and I would not be surprised to see them back to normal.  If she is smart about it, she will chill, ease back into very light exercise and all will be as it was.  Hopefully. 

All this "cost" reminds me of one of my earlier articles where I pointed out that some folks in the fitness industry would shake their heads at this crazy pursuit of endurance records.  The physical cost of Dina's effort certainly could turn out to be pricey.  Gastritis?  Blood in your shit?  How stupid can we be???  A 20 minute hyperintense barbell workout in the gym would not lead to such grief.  Of course, none of those hybrid gym rats could set a world record, nor, perhaps, would they want to.  Like I said previously, we do this crazy shit for something more than health and fitness.  Keep your eyes open, do what you need to do, but be prepared to pay the consequences. - Brian

Comments

[Ralph S.]

I hope all is well with her. I had a similar thing happen last year and I have never been more scared. I found your blog through the Mountain Athlete site, in case you were wondering. Good points about the Med industry. A technician fucked up my wife's blood test a few years ago and called us at home to say that she had leukemia only later the next day we were told the tech had performed the test incorrectly. I wanted to meet the guy, personally. Anyways, good thoughts from over here on the west side of Idaho.

[Ralph S.]

Hey Brian,
You are correct on both, with regards to the pics on my blog. I am thinking of heading up to Cobb to check the ice and possibly ski it. Maybe it's got more snow and ice than last year! Jump creek was pretty fat for about a week! Hidden Falls is still really nice, but Yellow Pine still takes the prize.

Hope everything is going good.