Out Of Shape and Wanting to ride the TransAm

[imaginarydave]

At 41 years old I've had two kidney tranplants. My last one was just over two years ago.

The last two years have been characterized by poor health and exercise intolerance.  I've grown exhausted by my doctors comparisons to 75 y.o. patients to make me feel better about "how you're actually doing quite well".  It took a year of pushing to finally get some tests done to confirm that my native kidneys are causing problems with my eleotrolytes (no they are not routinely removed when you have kidney failure).  I've gotten so out of shape and headed toward another surgery to remove them, but have been contemplating doing the Transamerica ride I've always wanted to do, if for nothing else than to prove to the doctors that younger active patients deserve a different expectation of quality of life. 

I'm guessing I would probably have to  start at like 20-30 miles a day.............. But since I am already unemployed and my wife was surprisingly supportive I am considering it.  I'm wondering if I anyone has ridden themselves into shape from that far out.

I live in Colorado, and would possibly just do half of it so as to not abandon the family for too long, but have heard the Missouri mountains are the worst of the whole trip and only a couple weeks in (intensity of effort seems to effect me more than duration), and heading west from here would involve immediate significant climbing so route advice would be appreciated as well.

[jamawani]

Dave -

I agree with your sentiments - and, yes, doctors can really talk down to you, at times.
Which hardly helps somebody to make changes and get better.

I've come back from a Stage IV condition, I'm pretty darn chunky, and I'm 20+ years older than you.
But, I've also ridden all my adult life and rode through my illness, too.

Here's what I did - starting small -
1. I rode a few humdred miles in a loop. 2014
2. Then I rode halfway across the country. 2015
3. Then I rode all the way across the USA. 2016

Remember, that 3# was, like, my 8th X-USA ride.
I don't know how much riding you have done over the years.
Also, riding a bike with gear is a totally different animal.

But you can do it - if you start with a reasonable goal.
I have found that if you pile too much on, too quickly, it all comes crashing down.

Nebraska might be a good place to start - - close to Colorado.
It's way more scenic than Kansas, light traffic, all the little towns have camping.
The towns are closer together in eastern Nebraska - western Nebraska has some big distances.
Also, there is weather - sometimes pretty serious weather.

If you haven't ridden a bike in a long time - I would suggest the Katy Trail.
It starts just outside St. Louis and crosses Missouri.
it is pretty level all the way and has no car traffic.
Plus, there are lots of camping lodging options along the trail.

https://bikekatytrail.com/

West to east might work better since there are fewer users in the western half.
Would your wife be willing to take you to trailhead in Clinton, Missouri?
Can you change a flat? Do you mind getting rained on? Being hot & sweaty?
I think you could do it, easily, in two weekends and the week between.

Of course, it sure wouldn't hurt to do some prep riding beforehand.
Plus, acclimate yourself to riding with panniers on the bike.
You don't have to be a pro to tour, many people learn along the way.
But, again, start moderately and then work up.

Best of luck - Jama

[John Nelson]

I agree with Jama. Start small. While the idea that some sort of grand gesture might give you the giant kick to get it done, I suspect that this approach  doesn’t work for most people. I’m reminded of Fat Guy Across America. It didn’t work for him.

You can probably find a few examples of people that it did work for. Maybe that’s you, but I think the odds are against it.

When you do work your way up to the TransAm, it’s going to be glorious. Set your goal now. A specific date to work towards. How about May 7, 2024?

[imaginarydave]

Thanks for the advice. And congrats on your remission and success.

I've been riding for close to 20 years.  I used to own a Koga Miyata purpose built tourer that I did some short tours on when I lived in Germany with the Airforce.  I'd had the intention of doing the Transam then but met my wife in 2008 and life took a different direction.  I still have my ortlieb panniers, though I might invest in a bikepacking setup if I go forward. My problem currently is muscle cramps and weakness secondary to some pretty serious electrolyte problems and nausea after moderately hard exertion. 

I am an experienced rider who used to do a lot more, but it has been a few years since I have been regularly on the bike doing any significant distance.  I mean I can ride comfortably for an hour and a half currently if it is not too intense.  Also I am SUPER slow.

honestly if I am going to do it I would probably just need to ride the whole distance I choose to do before I go back to work and it gets harder to accomplish logistically.

[imaginarydave]

Re: Healthcare.
When I was on dialysis and getting exhausted walking my daughter the 6 blocks to school  due to severe anemia I had three different doctors tell me that anemia doesnt effect quality of life in dialysis patients according to the studies. Of course the studies are made up of avg 68 y.o. individuals with >50% rates of diabetes, and >75% rates of obesity and chronic cardiac conditions.  Basically sedentary people.  they didnt want to treat my quality of life because a certain percentage of people have cardiac complications with the treatment for anemia but note these are people already with cardiac problems.

It took me a year and a half to convince the doctors to even investigate my dangerously low potassium levels because they just kept saying they had "fixed It" with medications - a lot of them but whos counting. I Finally got an answer and am still fighting (but think I am finally going to win) getting them to treat the problem rather than medicate the crap out of me. 

Anyway.  I am ready to prove them all wrong. but I'm in such a hole and exercise has been so miserable for the last few years I am worried about actually crawling out.  wondering if I start slow enough I can ride myself into shape.

[imaginarydave]

I agree with Jama. Start small. While the idea that some sort of grand gesture might give you the giant kick to get it done, I suspect that this approach  doesn’t work for most people. I’m reminded of Fat Guy Across America. It didn’t work for him.

You can probably find a few examples of people that it did work for. Maybe that’s you, but I think the odds are against it.

When you do work your way up to the TransAm, it’s going to be glorious. Set your goal now. A specific date to work towards. How about May 7, 2024?

Honestly I'm afraid I will be back on dialysis by 2024.  It's a real risk with my autoimmune condition.

[John Nelson]

I'm guessing I would probably have to  start at like 20-30 miles a day

Is your wife going to accompany you in a vehicle? The problem with 20-30 miles a day is that in many places that is not far enough to get you to the next good place to spend the night. If you have a support vehicle, however, that problem goes away. If you can get up to 40-50 miles a day, with an occasionally 60-80 mile day in the West, then you can do it without support.

[staehpj1]

One problem with riding into shape on a coast to coast trip is that riding across the country is going to involve difficult terrain with widely spaced services too early in the trip with the possible exception of an east to west ride on the Southern Tier.  You don't want to ride it in the hot months though.  I did it in a mid Feb - mid Mar time frame and it was nice, but I like cool weather.

Jama makes a lot of sense as usual.  A good warm up trip might be some or all of the Pacific Coast.  Oregon is especially nice.  Washington less so.  N-S travel is preferred.

[HikeBikeCook]

You could consider East to West TransAm using the TransAm Eastern Express Route which keeps you on rail trails for the first 350 to 400 miles and also cuts out a lot of the tougher climbs in the East on the traditional TransAm route.

[John Nettles]

Dave,

I can somewhat relate.  I am a liver transplant recipient and was exhausted the first couple of years due to some post transplantation complications. 

That said, if your body is actually able to do it, i.e. no dialysis, then it is possible.  You just have to plan.  My first major post-transplant trip was 2 yeas afterwards from Tulsa (my home town) to Winnipeg.  Mostly tailwinds, relatively flat, and the bus transportation back to Tulsa was fairly well spaced out.  I had to carry a ton of meds due (29 pills a day, plus a really good water filter).  Took up about 1/3 a front pannier.  I buried the pills inside the sleeping bag so they would not melt in August.

To prepare for the trip, I rode for about a month before the start doing 30 mile days.  About 15 of those days I had loaded "gear" (water jugs) that equaled the weight of the gear I planned on taking.  I just put extra jugs in the panniers as the weight increased to my 25# estimate.  I started out easy and built up.  When I started on tour, I again started out easy (30 mile first day) and increased by 5-10 miles per day until I was doing about 55 in a week.  The tailwinds really helped as I now HATE headwinds since no longer have the torque I used to have.  One thing I noticed immediately post transplant and is still somewhat in place today is that I have very little "reserve", i.e., once my energy is gone, it takes at least overnight to recover so I careful not to go into the "red zone" too much when before it was just a long lunch break.  I used to climb hills with the best of them but now a centipede is faster than me. I takes lots of breaks, especially above 6k feet altitude. Above 10k, it is comical how slow I am.

I don't know much about kidney transplants and their idiosyncrasies but will start to learn as the drugs I take now are very hard on the kidneys.  If the electrolyte issue is non-medicine related, I would suggest you eat potato chips or something salty at every break.  Really helped me out as I was washing the electrolytes out due to drinking a lot of water which I needed for the all the drugs I was taking to ease the stress on the kidneys.

As suggested, if you do start in Colorado and head east, consider the Katy Trail and maybe continue into Illinois and Indiana instead of Kentucky.  Then the tough hills won't start until Kentucky/Virginia except for a few possible detours on the Katy due to washed out sections.  For a flat route, consider reversing the Eastern TransAm Express, a non-ACA route that is mostly well done.  It uses a lot of rail trails like the Katy, the GAP, C&O, etc. to Washington.  From there use the Potomoc Tidelands route to get to the coast or just take a train back to Colorado.  Download the maps this year as the website is stopping at the end of 2021.

Get started early in the day and/or season so the heat doesn't sap your strength.

Regardless, your body will adjust, if the ride doesn't kill you  .

Tailwinds, John

[ray b]

A lot of us can identify with your frustration and sense of urgency, but the advice above on not starting out unless you can handle a 40 mile day seems sound..., though you might be able to pull off somewhat lower mileage for the first week or so running west from Norfolk. To answer your question, yes, one can ride themselves into good shape in the course of riding the Trans Am, but the first 3-6 weeks would require a lot of planning and include a lot of recovery days with no travel. One of your comments suggested you did not want to take too much time away from home. If you plan on riding into shape, you will not want to feel hurried; 120 days would not be an inreasonable time frame.

I'll second the suggestion for a shakedown on the KATY-Rock Island rail-trail from St.Charles to south of KC. Your first day could be a simple out and back from the hotel in St. Charles to the official but remote starting point of Clinton. There are a couple of pretty boring stretches, but you could use those to test your mental fitness.

I'm assuming you're getting some of your renal consultations in Aurura. U.C has had a long tradition of top notch physician-scientists in nephrology.  The condition you describe is quite rare, so I encourage patience. Low potassium will make you feel weak as a kitten, and effects of stress and adrenaline of exercise on the kidneys can further lower potassium. If you ask around, I suspect you'll find a couple of the nephrologists are avid cyclists. Although for legal reasons, their enthusiasm for an immediate adventure might be somewhat blunted, they might still be a source of encouragement and good advice.

Those of us who have more than a couple of decades on you will do the dad thing - which might seem frustrating - but be patient, plan ahead, and work your way up to this. Your instincts are good; a long tour on a bicycle is a great way to recover one's health and fitness. You might enjoy it more if the first few weeks are not spent lying around hotel rooms by yourself, wondering how long it's going to take for your recovery times to improve, so you can ride daily.

The comments about the 75 y-old body hit home; most of what we call aging is just decreased fitness....

Safe travels.

[Inge]

John - would you happen to know if there is a full gps set of this track (Eastern TransAm Express) somewehere? I have not bene able to find it yet.

[HikeBikeCook]

TransAm Eastern Express Site - not currently an ACA Route but they do lead trips along this route I believe.
https://www.easternexpressroute.com/

[staehpj1]

I don't know much about the Eastern Express other than what I know about the areas it goes through and some of it's route choices that I am familiar with, but it sounds like a good option if you do decide to try to ride into shape on tour.

I have seen folks take off on long tours in very poor condition and successfully ride themselves into shape.  Do pace yourself though.  Life on the road is a grind.  It can build you up and it can also break you down if you don't properly take care of yourself and manage your efforts.  Eat properly, hydrate, and work your way into the effort building up to the mileage.

Take it easy in the beginning, especially the first 10 days or so.  Don't push to the point of needing rest days.  If you like to take rest days taking them is fine, but don't ride to the point of needing them.  I figure that if you get up in the morning and need a day off it means you pushed too hard the day(s) before.  Personally I find it better to ride at least a little every day and I tend to take what I like to call half days here and there rather than rest days.  I might take a day off to do some active fun like hiking or whitewater rafting or something.  I might very rarely even take a week off some place that warrants it, but I have only ever done that once (Yosemite Valley).

Even for folks in good health and generally fit I'd say the same stuff. 

[imaginarydave]

Wow,  thanks for all the advice folks.  I am really intrigued by the eastern express option that could really work for me. I'm going to guess that by the average persons definition of fitness I am not as out of shape as most might think.  My health has just made for ongoing significant setbacks but with the problems hopefully identified I am optimistic about my abilities to start making progress again. I wouldn't show up without any training.  After my first transplant I was doing 50 mile rides in the Colorado front range within a year, and even last summer I had a stretch were I was doing ok and I managed to do some pretty long rides,  so I think I could get back there.

On a philosophical note I am very grateful for the perspective my illness has given me.  Permissions to step of the American hedonic treadmill is a wonderful thing, and aside from the challenges covid has handed a severely immunocompromised person I continue to embrace the idea of living for today.

There is also the chance I could convince the wife to drive our cargo trailer conversion camper as a sag wagon with my daughter, but at least out west here finding a place to camp without a plan months in advance is getting really hard since covid hit - even in dispersed camping areas for half the week. I'd always wanted to do it self supported, but I could accept that change.