Just as I’m beginning to see results with my gym workouts ( I actually have visible biceps now:-), I’ve also been trying to solve the mystery of this new, and very nagging neck and shoulder muscle pain Ive been experiencing ever since I began those workouts.

At first I thought maybe I was just over-doing it with the weights, but I only go to the gym 2-3 times a week and I spend less than 30 minutes on the actual weight machines, so I figure it can’t be that. I can understand being a little sore after beginning a new exercise routine, but Ive been in pain since the very first day ( 4 months now) . The pain and stiffness is persistent and tends to get really bad in the middle of the night. Sometimes it gets so intense, that I actually have to get out of bed to get any relief. Between my breathing problems and this new muscle pain, its getting to the point where I’m unable to get very much restful sleep.

I discussed this with my primary care doc, and thinks it could be from not stretching the opposing muscles groups properly. She also thinks that I don’t drink enough water during the day to flush out the accumulated lactic acid that builds up in my muscles. Then there’s also the question of whether some of medications I take have anything to do with this ….All these things sound logical I guess.

I don’t know if you remember, but I also had a problem with my calve muscles cramping up all the time. I think we concluded that the cramping was caused by too much walking, improper hydration and steroids. Maybe the same is true for this new problem?

If any of you fitness people have any advice on what might be causing this problem or how I can treat it , Id certainly appreciate hearing from you. I’ll probably start going to Physical Therapy once a week and sign up for a yoga class at the gym, to see if that helps.

The main reason I started going to the gym in the first place was because I wanted to add weight training to my walking regimen and tone up a little bit. I’m very interested to see if this type of cross- training will make a difference at the Rome marathon next year.

Thanks !

The bills have been tallied.  During these past 12 months,  I’ve managed to rack-up an astounding $492,338.53 in hospital bills. Add to that, all the outpatient clinic charges, prescription costs and so on, and we”re easily over the half million dollar mark.  That’’s pretty scary.

Did you know , that a single day in the Intensive Care Unit at UCSF medical center in San Francisco, now runs almost $16,000. For that price you get the Nurses, Physicians and a monitored bed.  Everything else is charged separately! Even If you’re lucky enough not to need the ICU, a bed in the step down unit will still cost you $5,000 a day.  I think a regular semi-private room on the medical ward goes for around $2000. I’m not sure , because Ive never actually stayed in a regular hospital room. They always put me in ICU or TCU (whether I think I need it or not.)

I’m extremely fortunate (at least for the time being), that I have good medical insurance and don’t have to pay the bill, but looking though the itemized charges, I quickly found over $50,000 in billing errors and/or charges for stuff I never received!   For example…$150 for a pediatric airway adapter?? ( I don”t even know what that is) How about $600.00 for Bipap masks when I wasn’t even on Bipap? One of my favorites though , is $ 900.00 for a bottle of Flonase. You know…nasal spray? And how about the legitimate charges; $190.00 for a single nebulizer treatment. $500 per day for Oxygen, $200 for a single blood gas, or how about $3000 per day if you need a ventilator? I wonder if the insurance companies ever bother to scrutinize these line- by- line charges? I know they have contracted rates with the hospital and end up paying less than 10 cents on the dollar anyway, so maybe it doesn’t matter to them. I’m just floored every time I receive a hospital bill. How on earth do people with serious health problems survive without insurance?

Today I received my entry confirmation for the 2009 Maratona Di Roma in Rome Italy next March. I know it’’s still 5 months away, but I”m very psyched! This to me, is the marathon of all marathons. And new for 2009, they’ve incorporated St Peters Square into the Marathon course. How cool is that?

Seriously, if you ever get the opportunity…. Do the Rome marathon! — It’s a life changer! And if you need help registering (which can be a daunting task if you”re in the United States) , contact me and I’ll show you how to cut through some of the red-tape.

Back in the old days when you got sick and ended up in the hospital, it was probably because your primary care doctor put you there in the first place. Boy, have things changed.

Nowadays you have one set of doctors who see you in the clinic when you”re doing well, another set of doctors who see if you need emergency care, and yet another set of doctors who take care of you if you become hospitalized . Many times, these “hospital” doctors know little, if anything, about you except what they observe right there on the spot and /or what they can read about you from prior admissions. If you receive your medical care at a huge teaching institution like I do, it gets even more impersonal, because you have multiple teams of student doctors and residents that rotate through the system a every 3 or 4 months. Chances are, you’re gonna see a different doctor every time.

This system seems to work fine if you”re generally healthy and don’t need frequent medical care, but if you have a complicated medical history and don”t fit the mold ( like yours truly), then things can get a little frustrating…especially in the Emergency room.

That’s where the patient “intro letter” comes in. More and more Physicians are writing these kinds of letters for their medically complex patients (not just severe asthmatics) to carry with them. If you ever end up having to go to an Emergency room ,the letter basically introduces you to the staff and provides the physician with some basic information about current health problems. It can save you from having to recite your entire medical history over and over again to people who don’t know you ( this is especially helpful, when you can”t breath). It can include valuable information on what seems to work best in treating your condition.

The letter below was just updated a few days ago by my Pulmonologist, and is the actual letter I sometimes bring with me to the ER . Yes…sometimes being in a place I don’t want to be when I’m having a hard time breathing , can make me a little anxious. But c”mon…. when you”re struggling to breath and they”re threatening to shove a tube down your throat, you”re bound to get a little antsy!

IV Fentanyl in small doses sometimes works for me in helping blunt the feeling of suffocation. The only problem is, most opiates can also suppress your breathing , so most physicians are reluctant to give then unless they know you will react to it.

First of all , thank you everyone! for all the nice comments. They mean a lot to me. My apologizes for the self pity thing in the previous post. I guess even us butch super hero types carry a bit of drama queen gene. I don’t care how many times I go through this, I always feel worse during the first 5 days following a hospital discharge. The medical establishment tends to release you as soon as there is clinical evidence that you’ve “turned the corner” , but not necessarily when you’ve started to feel better. There’s a huge difference.

Anyways, this time is no exception. Two days out of prison and I feel like hell. On top of steroid withdrawals, I picked up an horrendous cold/and or allergies ( I”m not sure which) , my lungs are still tight , and all those needle pokes I received in the hospital are finally starting to ache. Believe it or not they put IVs in my knuckles ! I have no decent veins left, so they had to use the tiny ones in my thumb and first finger knuckles. Ouch! That bit about trying to convince some of the doctors that I wasn’t faking my asthma , was probably a result of mild hypoxia , mixed with a little hypercapnia, and some steroid induced psychosis sprinkled in. Geese, they must have thought I was a lunatic. Last time I was in the hospital , I felt the need to convince everyone , that I was indeed a 4 time marathon finisher (that probably got a lot of laughs too). It’s amazing how a combination of IV steroids and heart -pounding, sleep depriving drugs can change can make you paranoid.

Each severe flare-up and subsequent hospitalization, takes a little bit more of the fight out of me. And though I sometimes complain that I will never put myself through it again, the reality is , when you can’t breath , you’ll grasp at anything you think might help. It’s probably because of my high level of physical conditioning, that I’ve been able to endure so many of these severe exacerbations. Sometimes I wonder if everything I do to try to fight this disease is really worth the hassle. But I suppose as long as the good days out number the bad, it is.

OK time to put this episode to rest. All I wanna do now is get well, so I can plan my next adventure. I haven”t been outdoors in almost 2 weeks, and it’’s driving me batty.

Here are a few grainy pictures I captured with my phone while in the ICU. I don”t think they’re worthy enough for a slot in my “Gross Hospital pictures ” album , but they capture the moment.