How long will it last? Maybe not much longer.

26 blood studies from 5/5/2017 to last week. That’s probably 20 more than I had my entire life up to that point! And it’s in these tests that I search for answers, not just for my health but my performance on a bike as well.

Pretty crazy how these last few months have seen ever-improving climbing speeds on my bike. You would have thought that the time off when I broke my pelvis (Feb-March-early April) would have held me back, but instead I am now within 5% of the power I was pushing over 3 years ago. That’s a pretty big deal for me, as turning 60 saw things really take a nosedive on the hills. And at 60, you’re really not thinking you’ve got better days ahead! More likely you’re going to be writing about a (hopefully) gradual decline, with it being increasingly obvious just how much your best days are behind you.

Of course, it was shortly after turning 61 that I was diagnosed with Essential Thrombocythemia, a mild bone marrow cancer that certainly wasn’t going to help me on a bike. In fact, the med that I take for it, Hydroxyurea, is the opposite of Lance Armstrong’s EPO. Curiously, a good share of my decline happened during the time between turning 60 and beginning Hydroxyurea. Even though there is no evidence that excessive platelets and an enlarged spleen hamper athletic performance, the 2016-2017 period was not kind to me. 2018 saw no change in cycling performance, even as my Hydroxyurea dosage was kicked up to better-control my platelets, resulting in a decreasing Hematocrit level. Hematocrit, for those unfamiliar with the world of doping cyclists, is basically your blood’s ability to carry oxygen throughout the body. There’s no evidence my hematocrit was ever very high (how would I know, since I had such a fear of having needles stuck in my arm since I was a kid?), but what little data I have suggests it was around 44. Pretty average.

Hydroxyurea brought that down below 40 a few times, most recently in February, about the time of my black-ice crash. Curiously, my Hematocrit has bottomed out in each of the past two winters. But it’s been climbing again, and my last test, last week, it hit 45. Likely no coincidence at all that the higher hematocrit readings have corresponded to my best climbing times in three years. But… this too, shall likely pass. Why? Because the dose of Hydroxyurea I’ve been on is beginning to lose effectiveness at controlling my platelets, and with the disease I’ve got, platelet control is the name of the game. Too many platelets and I’m at risk of stroke or heart attack. I’m fortunate to have a genetic mutation that generally has the lowest risk of such things, but still, a good idea to keep my platelet count below 700, and this last test it went to 799. Which means more Hydroxyurea and likely lower hematocrit.

I spoke with my doctor the day after my tests came back, and suggested a specific increase in dosage, with a re-test in 30 days. I wasn’t surprised that he was on exactly the same page. It will be interesting to see how my riding goes between now and then, and track my hematocrit against it. It’s strange, given my fear of needles, that I find myself wishing I had more-frequent blood tests.

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