Episode 35
“Even to this day, cycling is a huge passion of mine. I still love it.”
Have you ever crashed here at T-Town? Chances are this week’s guest was the one evaluating you on the sidelines or the one who put your collarbone back together. Join Joan this week as she sits down with Dr. Neal Stansbury of Lehigh Valley Health Network as they discuss everything from Neal’s racing days, heart transplants, sports medicine, and the Tour de France.
Dr. Neal A. Stansbury, Lehigh Valley Health Network: https://www.lvhn.org/doctors/neal-stansbury
Gift of Life Donor Program: donorsone.org
Thanks to B Braun Medical Inc. for sponsoring the Talk of the T-Town Podcast. BBraun is a global leader in infusion therapy and pain management, B Braun develops, manufactures and markets innovative medical products to the healthcare community. They are also strong believers in supporting the quality of life in the communities where their employees work and live.
Transcript
Joan Hanscom:
Welcome to The Talk of the T-Town podcast where we discuss all things track cycling, broadcasting live from The Valley Preferred Cycling Center. I’m your host and executive director, Joan Hanscom.
Joan Hanscom:
Welcome to The Talk of the T-Town podcast. I’m your host Joan Hanscom, executive director here at The Valley Preferred Cycling Center. This week I’m joined by our guest, Dr. Neil Stansbury from the Lehigh Valley Health Network. Any athlete who has raced bikes here on a Friday night will have seen Neil Stansbury as part of our medical team and many of our bike racers have in fact been patients of Dr. Stansbury, myself included.
Joan Hanscom:
So, welcome to the show, Neil. We’re delighted to have you here and delighted to get to pick your brain a little bit about why you come here, and why you love bikes, and how you ended up here.
Neil Stansbury:
Well, thanks. It’s great to be here, Joan, and thank you for asking me to come on board. So, my story is, is that I started out in California. I was a road racer for years. I started when I was 16, and started racing in Northern California. I got accepted to med school out in Philadelphia, and that’s what brought me out to the East Coast. Ended up doing both my medical school and residency and fellowship in Pennsylvania and ended up getting a sports medicine fellowship in orthopedic surgery.
Neil Stansbury:
My wife is from this area and that’s what basically planted me here for the most part. But I love this area. It’s one of the best areas in the country to ride a bike. I’m perfectly content, so I shouldn’t say that I’m here because of my wife. I’m here because of joint decision.
Joan Hanscom:
All good things.
Neil Stansbury:
All good things. Exactly.
Joan Hanscom:
All good things. But you glossed over, like it was very modest, right? “Oh, I started racing when I was 16,” but you were a state national champion. You’re record holder. You weren’t just a bike racer, you raced bikes for real. So, for everybody who’s been tended to by Dr. Stansbury, he wasn’t just junior in a crit down the road like he made it sound like, he actually really raced bikes, traveled all over the country racing bikes. You were actually doing the thing.
Neil Stansbury:
Yeah, I had a lot of fun with it. I did race around the country. I’ve won some national championships. I have multiple state championships. I went over to Europe and raced world championships on the track actually. And in my age group, set an hour record, world record. And also took third in the pursuit in Manchester.
Neil Stansbury:
And then I’ve also raced on the road in world championships, but didn’t see a hit coming. And in the sprint, got knocked off by an Italian into a ditch at 40 miles an hour, so I ended up not in the top 10.
Joan Hanscom:
Yeah, but you know. So, the very modest, oh, I started racing bikes when I was in my teens, yeah, it was a little bit more than that.
Neil Stansbury:
I’ve had a very good time. Actually, at the time I went to med school, I was contemplating whether I wanted to go pro or whether I wanted to go to med school and had a long talk with my parents and decided that going to med school and becoming a doctor was obviously economically more feasible than becoming a struggling bike racer and traveling around the country.
Joan Hanscom:
It has a bit more longevity as well.
Neil Stansbury:
Exactly, yeah.
Joan Hanscom:
A wise choice, I would say, for a career path.
Neil Stansbury:
In retrospect, yeah. I’m also very glad I did it just because the guys that I was riding with on my team that went pro, if you go pro, cycling becomes more of a job than a passion. And for me, even to this day, cycling is a huge passion of mine. I still love it. Every time I get on a bike, I’m just excited and happy that I’m there. And most of my friends that went into the pro ranks saw it as a job. And it does, it gets burned out.
Joan Hanscom:
For sure.
Neil Stansbury:
If I was racing, and I raced all through med school, and residency afterwards, and if it was a rainy day or is miserable, I don’t have to go to that race. I can just stay at home and work on my trainer or do something else. And these guys, if it was 41 degrees and raining and they were having hypothermia after 120 mile race, they had to do it. They didn’t have a choice.
Neil Stansbury:
So, I think, in retrospect, when I was in med school studying at 12:00 at night in the library and I’m getting calls from these guys, “Yeah. We’re in such and such, and doing this, and doing that, and we’re going on this race and wherever they were,” I was very jealous and very feeling sorry for myself. But at the same time, I still keep in contact with these guys, and when I talk to them now, it’s like they don’t even want to look at a bike or get on a bike. And I still, on the weekends, can’t wait to get out on a ride.
Neil Stansbury:
So, I’m very happy with my choices because cycling is still a major passion of mine where it might not have been if I had chosen the other road. Plus, I would have been broke at this point.
Joan Hanscom:
Yeah. Also that.
Neil Stansbury:
Also that.
Joan Hanscom:
Yeah, also that. So, which leads me to one of the things that I really wanted to talk to you about, because it’s a fascinating story, right? You’re a lifelong cyclist, you love cycling, you’re a very fit individual but you are a heart transplant recipient.
Neil Stansbury:
Correct.
Joan Hanscom:
And so, that’s got to be, heart disease unusual in a person who’s active, cyclist, fit. So, you had a diagnosis that was not promising and you are now the recipient of a new heart and you’re back on your bike, but for a while there you weren’t. Talk about that. I mean, that’s a huge part of your story at this point.
Neil Stansbury:
Well, it’s a very interesting story in that I started developing arrhythmias right about the time I was 40. I had won the National Crit Championship for my age group one year. I think I was 39 or something like that and I was just training the next year. And all of a sudden, I started on a regular basis when I would increase my, I would do anaerobic thresholds or do efforts.
Neil Stansbury:
I would go into ventricular fibrillations, which thankfully would last about 30 seconds or so, because the ones that lasts forever are the sudden death ones that you suddenly hear about athletes dying from. So, I went through a long period of time where I was misdiagnosed. And I remember asking doctors on multiple occasions, is it still okay if I go out and ride my bike and go hard? And the answer was, “Of course, yeah. That’s not a problem. You’re in shape. So, keep doing that.”
Neil Stansbury:
In retrospect, this is now 15 years later or so, we’re finding that long endurance athletes that have done this for a lifetime do actually damage their heart if they push it far enough. And if you think about cycling, it’s different than any other sport in that there’s no other sport out there where you can go out for four or five hours and push yourself and push yourself to your max and continue to do that day after day.
Neil Stansbury:
If you look at running, for example, first of all, you’re not out there for three or four hours. And if you are a marathon runner, most people that run a marathon have to rest for a couple of months afterwards before they do their next one. Swimming, same thing. Maybe an hour or two, but you’re done.
Neil Stansbury:
So, cycling is one of the few sports where you can push your heart and not damage your body because it’s a low impact sport. So, your muscles and your hips and your knees don’t get trashed like in other sports, but at the same time your heart does.
Joan Hanscom:
So, this is interesting though, because I’m curious about this. Because medical profession, medical industry, doesn’t do the same research on women athletes as they do on male athletes. Right? So, usually when you have these discussions, all the science and the research has been done on male athletes. And I wonder, do you know? Just out of curiosity. Does it have the same impact on female athletes?
Neil Stansbury:
That’s a very good question. And I don’t have the answer for that. And I agree with you that most of the studies I’ve seen are on male athletes. And the interesting thing is, is that 99.9% of the studies out there in the medical literature is not based on athletes, it’s based on sick people in the first place.
Neil Stansbury:
So, our cardiologists are really, really good at taking care of somebody that’s morbidly obese that smokes and drinks and doesn’t take care of himself, and they know how to try to help improve their lives. But when it comes to the athlete, that was my frustration.
Neil Stansbury:
When I first had this incident, I would walk in and I would just see this blank look on cardiologists faces. And they would be like, “Well, we don’t know why this is happening to you. We have no idea.” So, I had to do my own research. I actually came up with my own diagnosis and saved my own life, basically, because I kept being told that, “Don’t worry about it, just go and do whatever you want to do.” And I found myself getting sicker and sicker. I never forget that one season I won 50% of the races I entered. And two years later, I couldn’t climb a flight of stairs.
Joan Hanscom:
Wow.
Neil Stansbury:
My doctor, my cardiologist was telling me, “Well, you’re just getting old.” And I said, “Well, you don’t understand. The guys that I could beat without a problem two years ago, I can’t even go out on a casual ride with now. So this isn’t getting old. This is badness. This is something wrong.”
Joan Hanscom:
Yeah. And I think that that’s something that everybody who’s athletic or active faces, right? We know our bodies so well, right? We know there’s something wrong. We know when there’s a problem because we’re so used to using our bodies. And in my experience, a lot of times, unless you find the right doctor who understands that mentality and that just deep knowledge that we have of our own bodies, like you said, they’re used to treating seven-year-olds with heart disease, you don’t present that way.
Joan Hanscom:
So, it is really challenging when you say, “But no, I know there’s something wrong.” I mean, I obviously went through that with my iliac artery stuff. Right? Like, “You have the aorta of a 17 year old, you don’t have a problem.” I’m like, “But I do have a problem. I know I do.”
Joan Hanscom:
And so, it’s an interesting thing. And so, how did you research it? How did you figure it out? And how did you get then somebody to say, “Oh yeah, you do have this thing?”
Neil Stansbury:
Well, I was, again, I think you fast forward to 2021, it’s much more prevalent now. In medicine, it’s the old saying, I’ve never seen that before, but it’s probably seen me. And orthopedics is the same. There’s probably things where patients have come in and I’ve looked at it and I said, “I don’t really know what’s wrong with you.” And then five years later down the line, there’s some studies that come out and I think back to myself, I’m like, “Oh my God, that’s what that person had.”
Neil Stansbury:
And the same thing with heart. We’re getting more and more knowledge as time goes on. When I first had this problem, I believe in 19, I want to say 19, well, 2000. Right around 2000, I guess, is when I first developed this. They didn’t have any of these studies out. So nobody even diagnosed the diagnosis I have, which is ARVC, which stands for arrhythmogenic right ventricular cardiomyopathy.
Neil Stansbury:
The first papers came out on that in the late ’90s. So, most cardiologists, and even to this day, if I say I have ARVC, I’ve had several cardiologists look at me and go, “What is that?” And so, it’s not a well-known diagnosis. And if it’s something that has just come out recently, not every doctor on the block has seen it or read about it, especially if that’s not their particular area of specialty.
Neil Stansbury:
So, it’s getting more known, but if you’re an athlete, you need to go to a athlete-specific cardiologist. You can’t go to your general run-of-the-mill guy, because chances are they’re not going to have any idea what to treat you.
Neil Stansbury:
And the same with orthopedics. We have sports medicine guys just like we have guys that do total joints. I mean, if you send a sports medicine person to one of my partners that does total joints, he’s going to scratch his head and just look at him and say, “I have no idea what’s going on with you.” But of course they’re very, very good in their sub-specialties.
Joan Hanscom:
Yeah, absolutely.
Neil Stansbury:
So, I’m not trying to degrade them by any stretch, but at the same time, that’s not their area of expertise. So, you need to cherry pick and figure out the exact person that you need to go to.
Joan Hanscom:
Yeah. So, it’s cool that you went into sports medicine, right?
Neil Stansbury:
Right.
Joan Hanscom:
Because obviously you’re an athlete. The thing that I always love about going to sports medicine people as opposed to going to your regular doctor is they get you, right? Sports medicine doctors understand you want to be back in the game. They understand that you want to… What’s the best way, fastest way for me to get back in the game?
Joan Hanscom:
And I love going to medical professionals that understand that mindset instead of saying, “Well, just don’t do it anymore.” Well, no, that’s not an acceptable answer. I want to do the thing, so how do I get there? And so, that’s the coolest thing about sports med, right?
Neil Stansbury:
And that’s exactly what makes my job fun and exciting is you want to push the edge so that you get people back as fast as possible, but the game is you can’t do harm. So, you want to make sure that they’re in good shape and they’re able to tolerate it, so you have to know which maladies can go back quickly and which ones can’t. And there’s many times that I’ll sit there and I’ll say, “I’m sorry, this is something we can’t push you back quickly because if we do, we’re going to hurt you.”
Joan Hanscom:
You did that this week. Right? So, for our listeners, we’re recording this right on the tail end of the USA Cycling National Track Championships here at T-Town. And Neil was our doctor most nights here. And as happens with bike racing, there were crashes. And that was your job that night to do the concussion protocol and tell a few little girls that their nationals were over.
Joan Hanscom:
And that’s a hard job, but we valued having you here doing that, but that’s got to be hard for you as an athlete to tell another athlete, “Sorry, your national championships are over,” but that’s the do no harm part of the program. Right?
Neil Stansbury:
Correct. And it’s something you have to decide very quickly because if there are nights going on and then a lot of these kids will jump right back up and say, “Well, I’ve got a couple of scrapes, but I want to do the next race in 10 minutes.” So, you have to look at these people, evaluate them quickly and say, “Okay. This one can go. This one’s got to sit.”
Neil Stansbury:
So, you have to do these quick evaluations on the sidelines, or on the side of the track, or take them back to their little tent and look at them there. So, it makes it fun. At the same time though, as you said, it’s heartbreaking to see these people wherever they’ve traveled from and come all the way out and do national championships and it’s like you have to tell them that if you go out with a bad concussion, you run the risk of the second impact syndrome type thing, which can cause serious, permanent damage. So, obviously it’s something you have to decide quickly and accurately. So, it makes it interesting.
Joan Hanscom:
So, you like spending your Friday nights with us then, which is cool. Neil, you’re also on our board. I neglected to mention that. So, Neil has been on our board for a long time, which is nice. You contribute to the sport you love. We appreciate having you as part of the board and sharing your perspective and wisdom with us as a board member. But how did you start coming here on Friday nights, I guess, is the real question? Because you’ve been coming here Friday nights far longer than I’ve been here.
Neil Stansbury:
Yeah, I think I’ve been coming here as a doctor Friday nights, probably since the early two thousands, if not late 1990s. That’s a good question. How did I come here? Let me think about that for a second. Well, I was very active in the cycling community around here, and I basically knew all the people.
Neil Stansbury:
I think at the time they were looking for somebody to fill the position of medical director. And the guy before was a guy named Tom Dickson and he was retiring and they said, “Hey, we need somebody to step up to the plate.” And for me, it was a perfect marriage because it’s a combination of orthopedics, which is a passion that I love or sports medicine, and also cycling. So I said, “Why not?” And I’ve been coming ever since.
Joan Hanscom:
Coming ever since. Yeah. We were laughing when we were walking around this past week and you’re like, “I think I’ve done his collarbone. And I think I’ve done his collarbone.” And I knew who you were before I even moved here and took this job because you had repaired the collarbone of my coach who was very anxious to race my National Cyclocross Series and he housed himself at a local cross race here and then he was planning to race my entire national series.
Joan Hanscom:
And I remember you put him back together and I remember him coming out and racing and being like, “Oh, not sure that that’s a good idea.” And he was like, “No, no. Dr. Stansbury said it’s fine.” And so, I knew who you were long ago just because he said Dr. Stansbury gave me the okay to race bikes.
Neil Stansbury:
That’s funny.
Joan Hanscom:
And I was like, “Okay.” But yeah, so you’ve put a lot of bike racers back together is the moral of the story.
Neil Stansbury:
Yeah. I’m rather busy during the summer with bike racer, so I probably see at least a couple of cyclists a week, if not more.
Joan Hanscom:
We have forbidden you to ride Hawk mountain on Saturdays. So, Hawk Mountain is a local climb for those of you listening from far away. And on Saturdays this year, we’ve had several incidents where we’ve needed Dr. Stansbury’s services. And both times, I think, that we’ve called you, you were either about to start climbing Hawk Mountain or descending Hawk Mountain. And so you’re not allowed on Saturdays. No more Hawk Mountain. It’s a bad thing now. We’ve got like, “Oh no, he’s got to be on Hawk Mountain. There’s another crash.” So, it’s our internal joke now that-
Neil Stansbury:
Yeah, that does seem to be a curse, doesn’t it?
Joan Hanscom:
No more of that. Find a new route. Only valley on Saturdays, Hawk mountain later.
Neil Stansbury:
That’s right, yeah. No, it’s funny because I’ll be going down Hawk Mountain, and it’s a rather steep climb at the top. I think it’s 13% or 14%. So, you can get going between 50 and 55 miles an hour down it. And obviously, you want to make sure you’re paying attention when you’re negotiating the corners at that speed.
Neil Stansbury:
I think twice now I’ve been going down the hill and on my cycle computer, it’s Bluetooth to my phone. And instead of looking down to see what speed I’m doing, instead I’ll see this message from-
Joan Hanscom:
The velodrome.
Neil Stansbury:
… the velodrome and it’s saying, “I need to talk to you.”
Joan Hanscom:
We promise we’ll try not to interrupt your rides anymore.
Neil Stansbury:
No problem.
Joan Hanscom:
So, tell us then about getting back on the bike now, after the heart transplant. We had a long conversation one Friday night. We were just watching racing and you were saying how great you’re finally feeling, and it’s great to be back on the bike. Talk about that because that’s cool.
Neil Stansbury:
That’s predicated by a lot of feeling sorry for myself. I guess I kept it to myself. For quite a few years, I wasn’t able to ride because when my heart went downhill, and once I finally had my diagnosis, one of the rules was you can’t do any kind of aerobic exercise because that will precipitate your problem further. I was already on a heart transplant list and I knew that I was going downhill rather quickly. So I wanted to try to do everything I could to preserve my heart as long as possible while I was waiting for another heart because basically 30% of people waiting for a heart transplant die. And with my size and with my blood type, they told me I had a 50/50 chance of getting one in the first place.
Neil Stansbury:
So, obviously I didn’t want to push the issue any more than I had to. So, it killed me to watch everybody else going out on rides and just having to sit there and do nothing. It was rather frustrating, so after I got my heart transplant, which is three years ago now, I started out almost like a new writer because I had lost so much muscle mass and everything else that I had to just basically start from the beginning and start out with real easy rise and then gradually work up and go from there.
Neil Stansbury:
And the interesting thing about riding with a heart transplant is they cannot hook the nerves up. So, any response that your heart get is very delayed. So, if you climb up a flight of stairs, for example, you’re going to get totally winded. However, if you do a lot of walking lunges or something like that, you wait a minute, then go climb a flight of stairs, you’re absolutely fine. And you’re not out of breath.
Joan Hanscom:
Oh, interesting.
Neil Stansbury:
So, cycling is the same way. That first summer, I had my heart transplant on July 18th, three years ago. And I remember going out for my first ride in about August or so. I don’t think my doctors really were thrilled with that idea. So I went out and I can remember going up somewhere just the local hills around my house. And literally I was in my smallest gear, standing up and trying to just go without falling over. I was going so slow. I was probably at two and a half, three miles an hour that I was climbing these hills on. And now I can jam up those hills that, 12, 14 miles an hour or so.
Neil Stansbury:
I’m not back to where I want to be yet, but it’s a process. So, my heart is becoming more and more responsive as time goes on, as are my legs and everything else. It’s exciting because I’m rebuilding. I spent years watching myself decline further and further, and just not being able to do anything. And now every few months I look back at my records and find that I’m a little bit faster. I’m putting out a little bit more average wattage on my bike and that kind of stuff.
Joan Hanscom:
Yeah. It’s so cool. I mean, it’s so cool that you can do that. You can remake yourself, right?
Neil Stansbury:
Yeah. I don’t know if I’ll be able to race again. I would like to, but just the fact that I can get out and go for-
Joan Hanscom:
Oh, yeah. That’s it. You can go do the thing you love.
Neil Stansbury:
Yeah, exactly.
Joan Hanscom:
You could ride your bike and can get out on a Saturday and get the wind in your hair. And that whole thing is like-
Neil Stansbury:
Absolutely, yeah.
Joan Hanscom:
Racing isn’t the only way to love a bike. Right?
Neil Stansbury:
Right. It is a fun way to love a bike though.
Joan Hanscom:
Absolutely. Absolutely. I know. I’m supposed to race my bike on Sunday and I’m just like, how am I going to race after the week we just had? I’m a glutton for punishment. That’s what it is.
Neil Stansbury:
We have to use savvy instead of strength.
Joan Hanscom:
Yeah. That’s savvy. Savvy doesn’t help you when you’re off the back, but we’ll see. We’ll see. When I first started here, you were very active with the transplant organization and educating about transplants and you had some plans to be involved with them. What are you doing with the transplant folks these days?
Neil Stansbury:
We’re starting back up again.
Joan Hanscom:
Nice. COVID of course.
Neil Stansbury:
Obviously with COVID, the last thing a heart transplant or a transplant person wants to do is get around a whole bunch of people and inside and talk about things. So, I think all those programs have been put on hold. I’ve done a couple Zoom-type presentations and things like that. But basically what we do is we just try to raise awareness for the importance of being a donor. Of people that die in the hospital, only 1% of those are capable of being donors. And so yeah, there’s-
Joan Hanscom:
Is that true?
Neil Stansbury:
Yeah.
Joan Hanscom:
That is a staggeringly low number.
Neil Stansbury:
It’s a very, very low number. And it’s basically people that have a traumatic brain injury is the most common type. So that’s either from trauma, like a car accident or something like that, or falling and hitting your head and having what they call an unsurvivable brain injury versus drug addicts or overdoses.
Neil Stansbury:
So, those are the two big groups right now. And so, it’s important that if there is somebody that is a potential for a donor, if we can get them to commit, then you save eight lives versus eight lives that would have been lost. Because if you count the two kidneys, and the lungs, and the liver, the heart, they can even use pancreas now, all sorts of things.
Joan Hanscom:
Really?
Neil Stansbury:
Yeah. So, it saves a lot of people.
Joan Hanscom:
I think that’s an amazing thing. I’ve never put it in that perspective. You think of a heart donor, you don’t think about that’s eight lives. Not just one.
Neil Stansbury:
Yeah. And every time somebody dies that could have been a donor, you’re probably going to lose those people because the list is long. If you ever look at, I think the stat is that if you look at the number of people in the United States waiting right now for organs, it would fill two football stadiums.
Joan Hanscom:
Holy moly.
Neil Stansbury:
And like I said, I’m not sure of the stats with the other groups, but I know that with heart, it’s 30% of people waiting don’t survive waiting for a heart. So, it’s rather sobering to be honest. There’s a lot of misconceptions out there about donors. They think, well, if I put that donor thing on my license, they’re not going to try to save me and that kind of stuff, which is actually completely reverse.
Neil Stansbury:
I mean, if you think that this person has a serious traumatic brain injury, and if you can keep them alive long enough to harvest the organs, then you’re actually going to be able to use them. If you just let somebody die, then you can’t use the organs because you’re taking them from a dead body type thing.
Neil Stansbury:
So, once they find out it’s a possible organ donor, they do everything they possibly can to keep them alive. And they don’t just go and jump in and take your organs. They talk with the family. Even if you have a organ donation thing on your license and the family says, “We don’t want that,” they’ll honor those wishes.
Neil Stansbury:
So, the whole conception that they’re out there trying to grab organs from peoples is just actually reverse. They want to make sure everybody’s very satisfied with the process before it happens. So, they have very, very well-trained people to come in and talk to these families in crisis. It’s not me. It’s not a nurse. They actually have people, God bless them, that are working 24 hours a day that if they hear that there’s somebody in a hospital, that’s a potential donor, they will go there at 2:30 in the morning and talk with them and just talk with the family and try to make sure that that’s the family’s wishes and that that’s okay-
Joan Hanscom:
Right. That they’re comfortable with what they do.
Neil Stansbury:
That they’re comfortable. Exactly.
Joan Hanscom:
Yeah.
Neil Stansbury:
And if they’re not, and they walk away from it.
Joan Hanscom:
So if you had to tell our listeners something about becoming a donor, what would it be?
Neil Stansbury:
Please become one.
Joan Hanscom:
Yeah. Nothing to be afraid of. Do it on your license. It’s easy. Right? We can all do it on our driver’s license and it’s-
Neil Stansbury:
Yeah. You can even do it on, I actually tested it, there’s a number you can call is donor’s one. I tested it myself just to do it. And it takes literally about four and a half minutes to do it. So, if you go to donorsone.org and then /register, or just go to donorsone.org, and you can find it. And there’s a thing you can fill out. And it’ll automatically register you as an organ donor.
Neil Stansbury:
And it’s not absolutely necessary that you do that. I mean, if you are in an accident and you let your family members know that those are your wishes, that’s the other way to do it so that when the family comes in and says, “Well, we knew that this is what he wanted anyways. So, let’s go ahead and do it,” type thing.
Joan Hanscom:
Yeah. That’s one of those things where I think people, not just for organ donation, but in terms of their medical care in general, you need to let your family know what your wishes are and you need to communicate that.
Neil Stansbury:
It’s also very extremely important because if you make those wishes known prior, that’s one less thing your family has to think about.
Joan Hanscom:
Right. Well, that’s it.
Neil Stansbury:
At that point, I mean, this is…
Joan Hanscom:
And it’s easier for them.
Neil Stansbury:
They come into the hospital and suddenly they’re told, “Hey, I’m sorry, but he had a non survivable or she had a non survivable brain injury and we have them on life support right now, but they’re brain dead.” The last thing you want to do is start a conversation about organ donation. However, if you’ve already had that implanted in your family’s head that this is what I want if this ever happens-
Joan Hanscom:
Right. They’re clear.
Neil Stansbury:
… they don’t have to process that because they’re already processing the worst experience of their lives. So, that’s the last thing you want them to have to think about.
Joan Hanscom:
Yeah. And my mother was very clear on all of these things with us as kids, right? You just make everything known so that when it is hard, you don’t have to do hard things. That that decision has already been made for you if you understand it. Yeah. It’s an interesting and hard discussion to have with people at home, I think, but worth doing.
Joan Hanscom:
Yeah. So, we’ll let our listeners know. Make sure, we’ll put in the show notes, how to become a donor if you are not. Because we are happy to be talking to Dr. Stansbury here and he is here with us because somebody made that decision. And so, I would say this is a somber topic for our podcast.
Neil Stansbury:
A little bit yeah. By the time I got my heart, I was on the list for, I think two years or so, two and a half years. When I was getting sicker and sicker and they kept checking me every couple of weeks or so, and I finally got to the point that they said, “You’re not going to live if we let you go home.”
Joan Hanscom:
Were you still working through all of this?
Neil Stansbury:
Yeah.
Joan Hanscom:
Wow.
Neil Stansbury:
So, I was basically just trying to get through every day. My routine is I couldn’t eat any salt whatsoever. It threw me into cardiac failure. I had to sleep at least eight to nine hours a day. I could only eat about a 12 to 1500 calorie diet. So, I was extremely strict. I mean, it basically was a protein bar in the morning, protein bar in the afternoon, and a small piece of meat and a vegetable with no seasoning on it for about two years.
Joan Hanscom:
Wow.
Neil Stansbury:
Just to stay alive. So, it was very difficult. And by the time I got my heart, when they pulled out my old heart and they looked at it with pathology, they said I had at most two weeks to live.
Joan Hanscom:
Wow.
Neil Stansbury:
So I got it just in the nick of time. So, if that particular person had decided not to be a donor, I wouldn’t be here today.
Joan Hanscom:
Wow. That is astonishing. But let’s turn it to the positive, because yeah ooh, got dark place, but that’s because we’ve had a long week here of bike racing. Don’t you think that all of your discipline for training as a cyclist and all of your discipline as an athlete probably helped you survive those two years of really regimented food and control of your diet and discipline about sleep, your athletic ability and just how we all are? Right? We’re so-
Neil Stansbury:
Driven.
Joan Hanscom:
… driven. And that had to help you. Right? You have to fit.
Neil Stansbury:
It did and it didn’t.
Joan Hanscom:
Really?
Neil Stansbury:
The reason why it did was because it kept me alive. The reason why it didn’t is because, any cyclists out there, I’m sure they know this mantra is don’t show pain, don’t show weakness type thing. And so, I kept working, I kept doing all the normal things and the people down at Penn saw me working and they said, “Well, we were looking at these studies and we must be wrong because we don’t understand-“
Joan Hanscom:
How you’re still going.
Neil Stansbury:
“… how you can possibly be working because you should be laying in a bed someplace.” And my response was, “Well, if I have a 50/50 chance of living then I don’t want to spend it laying in a bed and feeling sorry for myself, I want to do what I love doing.” So, I kept working and I actually more or less got yelled at after they looked at my heart and said, “Why didn’t you tell us you were so bad?”
Neil Stansbury:
And I said, “Well, you had the studies. You knew what was going on.” But if I had played it up a little bit more, I probably would have gotten put up on the list a little higher and gotten the heart a little bit earlier.
Joan Hanscom:
Oh, that’s interesting. Yeah. That high pain threshold though. Right? You can push through a lot.
Neil Stansbury:
Yeah.
Joan Hanscom:
Interesting.
Neil Stansbury:
Yeah, because obviously with the heart transplant list, it goes by both seniority. Who’s been on it the longest, but also who is the sickest?
Joan Hanscom:
Need.
Neil Stansbury:
So, several times in the last six months before I got my heart, I was bumped three or four times because they looked at two candidates and they said, “Well, we have this heart, this guy looks sicker than this guy. So let’s pick him because he’s the one that’s going to die first.” And so, I was glossed over a couple of times. And I think if I had laid in bed at home and-
Joan Hanscom:
Been a little bit more ill.
Neil Stansbury:
… been a little bit more whiny, then maybe I would have gotten earlier.
Joan Hanscom:
Well, so you told me the other day that you’ve got a racing license now.
Neil Stansbury:
Yes. So, I just want to see how I can do it. So I went from Cat 1 and now I’m a Cat 4 again, starting all over, so it’s kind of fun.
Joan Hanscom:
Yeah. It is fun.
Neil Stansbury:
Yeah.
Joan Hanscom:
New heart, new license category.
Neil Stansbury:
Yeah. So, I don’t know how I’ll do. I just literally just got it last week. So, I figured, it’s been three years, I’ve been training, so let me go out and see what happens. And I think I’ll just try to see if I can’t hang in the pack for a while and just be pack fill for a while and just see what happens.
Joan Hanscom:
So, you’re going to do road first or track first?
Neil Stansbury:
I may do track first and just do, because Saturday mornings are the masters and I won’t do the sprints obviously, but I’ll try to do some of the longer races and just see if I can just hang in the pack and hang there. And it’s just to give me a gauge on whether I’m anywhere close to where I need to be or whether I need to wait another year and just train harder.
Joan Hanscom:
So, you know that Chip’s doing his crit across the street on Thursdays now, crit across street back, and Sunday. He’s got a Sunday race.
Neil Stansbury:
Oh, is he? Okay. So, I’ll have to do the B race on Chips-
Joan Hanscom:
Yeah, there you go.
Neil Stansbury:
… and see how I do.
Joan Hanscom:
Oh, yeah. Because you’re Cat 4 now.
Neil Stansbury:
Yeah.
Joan Hanscom:
It’s going to be you out with the juniors.
Neil Stansbury:
I’ve been demoted.
Joan Hanscom:
I don’t think you’ll stay there long. I suspect. Because what we were saying before race, those use your savvy, not your strengths.
Neil Stansbury:
It’s combination of both obviously.
Joan Hanscom:
So, that’s fun. It’s fun that you’re going to come back to racing though.
Neil Stansbury:
Yeah, I’m excited. It’ll be a good time.
Joan Hanscom:
So, what else do you want to tell us? Anything else interesting happening here in your summer? What’s going on? You’re going to be back here Friday night with us in the trenches for UCI?
Neil Stansbury:
Oh, yeah. No, I love it. It’s a lot of fun for a couple of reasons. One is it’s, like I said, it’s a marriage of my two passions. The other thing I like about it is that it’s a great chance to catch up with old friends. You run into people all the time that you haven’t seen for quite a while and everything. Cycle racing and cycling is very much a fraternity, if you will.
Neil Stansbury:
When I stopped racing, I lost contact with a lot of my friends, and I think that was the worst part about it is that these guys that you see every single weekend and after the races, you sit around and have a beer and talk about things and get together and go for rides and stuff.
Neil Stansbury:
You don’t just lose the racing aspect, you lose the whole community. And cycling is, I think, a very tight-knit community. So, it’s for both good and bad. But it’s a lot of fun and I enjoy being part of that community.
Joan Hanscom:
Our international racing starts this weekend. Let’s see. We’ve got most of Canada here. No, I’m joking. We had a whole bunch of Canadians arrive today, which we are thrilled to have here. In COVID, it’s strange that we’re able to get the international athletes here. So, racing should be good this weekend for you. It’s going to be spicy on Friday.
Joan Hanscom:
We have some, let’s see, Guatemala, Mexico, we have Colombia, we have what else? Trinidad, we have Barbados. So, we’re going to have a good international contingent here starting right from U.S National Championships where it’s been from all over the U.S now we’re heading into our UCI dates and internationals, and the pace will get a little faster.
Neil Stansbury:
You only get good in racing by racing people that are better than you. So, I love to see the local guys go head to head with these guys. It’s a lot of fun and you see their game is raised significantly when these guys come as well.
Joan Hanscom:
A hundred percent.
Neil Stansbury:
Instead of just going against each other locally, it’s also, “Hm, I got to take on this guy from Canada or Mexico or wherever they’re from.”
Joan Hanscom:
And the speeds get higher.
Neil Stansbury:
Oh, yeah.
Joan Hanscom:
And what’s really exciting too is we have some real depth in the women’s fields here now. So the women’s racing has been terrific all summer, but now with the internationals coming in, the level’s going to go up even more. And so, we’re excited for the next three weeks of racing and hopefully a little less eventful on your side than this week was.
Neil Stansbury:
I think it’s funny. If you look at most of the races, the nationals was a little bit different for two reasons. One is people are going for gold instead of just, oh, if I don’t win this race, it’s another Friday night.
Joan Hanscom:
Yeah, there’s a lot on the line.
Neil Stansbury:
Instead of making 20 bucks tonight, I make 10 bucks tonight type thing. Whereas when you’re going for medals, it tends to be a lot more aggressive. And the other thing is we had a lot of juniors here, and I think most of the crashes were in the junior ranks because a lot of these kids, cycling is not a huge sport. So these kids come from other parts of the country where they’re racing against four or five, six kids. And then all of a sudden, they’re thrown into this big field with a whole bunch of kids. And you could tell there were kids that were very experienced and very comfortable and kids that were a little skid-ish because they-
Joan Hanscom:
Yeah, first time in a big field. Yeah.
Neil Stansbury:
They weren’t used to, yeah, being thrown into a situation like that. And so, you get somebody that’s not used to that situation and the speeds are obviously a lot more intense than they were before. They’re trying to race their game and maintain control, so it’s, I think, the combination led to more crashes than normal.
Joan Hanscom:
Yeah. The sprinting was good this week though, huh?
Neil Stansbury:
Oh, it was awesome.
Joan Hanscom:
The sprinting was on, it was great in the men’s elite in particular, the sprints were-
Neil Stansbury:
No crashes either, so that was good.
Joan Hanscom:
Yeah, no crashes either. That was great. We like that.
Neil Stansbury:
A couple of bumps, but nothing major.
Joan Hanscom:
That made the racing good though. It was super exciting racing. And I think yeah, we’re going to see some interesting speed this weekend. So, we’ll be happy to have you on the sidelines just in case, but I think the racing is going to be real good this weekend.
Neil Stansbury:
Yeah. I like being a spectator instead of working.
Joan Hanscom:
I will say, you went over the boards real quick though, with one of the crashes. You were over the boards fast. I was like, that’s a…
Neil Stansbury:
Well, when you watch, you know when somebody’s going to crash, because you see the way they’re going is like, “Yeah, I just better start moving now. [inaudible 00:36:29].”
Joan Hanscom:
Yeah. I was like, “You went over those boards faster than I was.” I was like, “Wow, damn. He was moving.” So, I think you had some new colleagues here, so we were very lucky that we had LVHN on-site all week. And we had your sports trainers in, in addition to the doctors on site.
Neil Stansbury:
Yeah, that was neat for us because a lot of the trainers at Lehigh Valley Hospital had never seen a bike race. So, it was, they came in and they were able to experience it for the first time. So it was kind of a teaching. And it’s like, “What am I going to expect here? There are a lot of trainers.”
Joan Hanscom:
You had not just a trainer, you had a fellow with you this week.
Neil Stansbury:
Yeah. So, Lehigh Valley Hospital also has non-operative sports medicine fellows. So, it’s basically people that have done three years in a family practice residency, and then they want to specialize in sports medicine. So, they spend a year with us and they spend part of the year with the family practice, sports medicine doctors at Lehigh Valley, and they also spend time with the orthopedic surgeons so they can get a flavor of both perspectives.
Neil Stansbury:
And so, it was a lot of fun because every year we have two guys. So, I have two guys with me on Friday nights and during the nationals. So, one of them is a cycling enthusiast that rides all the time as well.
Joan Hanscom:
Oh, that was cool. I didn’t know that.
Neil Stansbury:
Yeah. So he was really excited about this. He said, “This is really cool. I need to do this.”
Joan Hanscom:
Oh, that’s awesome.
Neil Stansbury:
I think then he went home and told his wife that and had other ideas after that.
Joan Hanscom:
Perhaps not. And then the other fellow, was he also-
Neil Stansbury:
He was very intrigued by it.
Joan Hanscom:
Yeah. I can’t remember his name, but he seemed like, “Huh, this is interesting.” Not like I want to do this thing, but I find myself in an interesting place.
Neil Stansbury:
Well, I think everybody, the trainers, the sports medicine fellows, and even there were a couple of other doctors that have not been that were here helping cover and spending time with them. And they, all of them just had the same comment was, is, “I’ve always thought of cycling is just this easy, leisurely, let’s go out and ride.”
Neil Stansbury:
And he goes, “This is hard. This is really hard. These people are really pushing it.” Because they would see the exhaustion on their faces and they would see the aftermath as they were coming off the track of these guys, just basically rolling over and just, oh my God, just trying to get their breath back and trying to stop their legs from burning. So, it was a fun experience for them for multiple reasons of both from a medical side as well as just the intensity of the sport as well.
Joan Hanscom:
Yeah, it goes back to that piece, having a doctor that appreciates what you do. And so, they understand why you want to go back and do the thing or what you need to be to do the thing. I think to me, that’s the most important thing as a patient. I want a doctor that understands that it isn’t just I need to be able to walk to the mailbox, I need to be able to do more than that. Right?
Joan Hanscom:
And having doctors like the doctors LVHN that were here this week who were like, “Oh, now I get it. It isn’t just the ride down the bike path.
Neil Stansbury:
And injuries are very sports-specific. So, cycling is no exclusion to that obviously. You have overuse injuries and you have traumatic injuries and the overuse injuries in cycling are going to be a little bit different than your overuse injuries in football, or baseball, or basketball, or things like that. So, you have to understand why those overuse injuries occur and be able to treat them.
Neil Stansbury:
Whether it’s bike fit or whether it’s over-training or whatever you have. As well as the traumatic injuries. When you break a collarbone, how quick can you get him back on the bike type thing? Because cycling is mainly a lower extremity sport, but you do need some arms to do different things. So, my comment with them is, “Well, you can go back and go for a ride, but don’t try to practice your starts on the track where you’re pulling up as hard as you possibly can on your arms because you’re going to not let that then heal.”
Joan Hanscom:
Pop that thing.
Neil Stansbury:
“You’re going to pop that thing wide open.”
Joan Hanscom:
Yeah, that’s where having the doctor that understands your sport is so important. When I did my collarbone, my doctor was like, “What do you mean you want to get back on your bike?” I’m like, “Well, because I want to get back on my bike.” And he’s like, “Gee, I don’t know if that’s a good idea.”
Joan Hanscom:
And I’m like, “Well, I’m going to do it. Am I ready?” He was a football guy and he had been a water polo player, so he was athletic. He understood the sports, but he was like, “Are you sure you want to get back in the bike?” I’m like, “Well, my legs aren’t broken. My legs work.”
Neil Stansbury:
I had a discussion with our non-operative sports medicine doctor that I work with at the office, I think it was six or eight weeks ago now I was mountain biking. I lost it on the trail and came down with my chest right on the edge on the end of the bar and it broke a couple of ribs and it was actually a little bit displaced and everything. And so, I gave it a little bit. I was back on the bike the next day, actually. It hurt, but I was back on the bike.
Joan Hanscom:
Well, you said you did an experiment on-
Neil Stansbury:
Yeah, I wanted to see if I could do it. So, the bottom line is that the whole reason I’m finding this-
Joan Hanscom:
Did our listeners just hear this, he broke his ribs and the next day he’s back on the bike because he wanted to see if he could do it? I want them to make sure we made that point loud and clear on the pod because that’s awesome. Because I wanted to see if I could.
Neil Stansbury:
Yeah. Well, it’s because you always hear about these guys in the Tour de France and they’re trying to ride with broken ribs and everything. I’m like, “Well, how painful is that?” So I said, “Well, let me try it out.”
Joan Hanscom:
Pretty painful.
Neil Stansbury:
So, first 10 miles hurt like hell, but I ended up doing 80 miles that by the 30 or 40th mile, it was like, it hurt, but I could hold onto the bar finally and I could jam on it, but I could do it. And I think the point to that is that I realized that going out and riding a bike, as long as I wasn’t using my upper body extremely, that’s something you can probably get by with. As long as you didn’t puncture your lung.
Joan Hanscom:
As long as you have the right pain threshold.
Neil Stansbury:
But the point of that is that I wanted to do it so the next time a cyclist comes in and says, “Hey, I broke my rib. When can I get back and ride?” And so my answer will be, “When you can tolerate it, basically, because you’re not… If it’s a broken leg and the bone is shifting in and out of place every time you take a pedal, obviously you can’t do that.
Neil Stansbury:
But with ribs, ribs is what’s called a stable fracture, which means they’re not going anywhere. It’s not like you’re moving it all over the place. So, it’s something that will heal whether you move or not. And that was the same as after I had my heart transplant, obviously they split your sternum over.
Neil Stansbury:
I could only walk at that point, but I started walking and I got up to 15 miles within three or four weeks, after my heart transplant, per day. And it hurt, but it’s more or less stable and I wasn’t trying to do pushups. So, that’s something I could get away with and still exercise to try to recover.
Joan Hanscom:
So, this Tour de France, poor Grant Thomas, my favorite grade crashed on day one. Right?
Neil Stansbury:
Yeah.
Joan Hanscom:
Dislocated the shoulder. In your opinion, how painful was that for the rest of the, I mean, that guy’s hard as nails, right? He’s ridden a tour with a broken pelvis. Clearly he’s got the pain threshold that we all wish we had.
Neil Stansbury:
When your shoulder is out, it hurts, like all get out. I mean, it’s a very, very painful thing. When you reduce it, the pain goes down dramatically, but you’ve still dislocated, you still stretched out all those muscles and you still have some damage to your joint.
Neil Stansbury:
So, bottom line is it’s going to hurt. And the nice thing about cycling is you’re in one place, so you’re not putting as much strain on it as if you were doing something else. Having said that, the Tour de France is a whole different animal. You have to get up and just to finish every single day is extremely difficult.
Neil Stansbury:
So, to add on to that, my shoulder’s killing me and throbbing me and I can feel my heartbeat in my shoulder every time I try to go to bed at night and I can’t roll over on that side and I can’t sleep right. And I’ve got to sleep in this one position all night long just to be able to get some sleep.
Neil Stansbury:
So, you’ve got this guy that’s trying to go really, really hard six hours a day that has this problem that’s keeping him exhausted and not allowing him to sleep and hurts on the bike. So, something like the Tour de France and having an injury like that, it’s amazing that he could keep going as long that he was able to keep going.
Joan Hanscom:
Yeah. He said it was the hardest tour he’s ever done.
Neil Stansbury:
Oh, I’m sure.
Joan Hanscom:
And, again, this is a guy that did the tour with a broken pelvis, and he said this one was the hardest. And I was just thinking, I don’t know how you do it, right?
Neil Stansbury:
Think about it. Every time he went over a bump on the road-
Joan Hanscom:
Every time.
Neil Stansbury:
… he’s got that jump and that hurts like crazy type thing and can you imagine doing that-
Joan Hanscom:
Yeah. And trying to stand up in the Alps and pull on the bars.
Neil Stansbury:
Yeah, that’s ridiculous.
Joan Hanscom:
Yeah. The whole time of the tour I thought, “Oh boy, I don’t know how you’re doing that.”
Neil Stansbury:
Yeah. I was watching him very closely and I was like, “Man, this guy is tough as nails even to be able to stay with it.”
Joan Hanscom:
Yeah. He’s my favorite, but what a disappointment for that poor guy who-
Neil Stansbury:
But he helped. He helped a [inaudible 00:45:08] he like was already dead and stuff like that. I mean, some of his climbs, he was-
Joan Hanscom:
Yeah, he was coming back to life at the end. For sure.
Neil Stansbury:
Yeah. He was climbing up the hills and getting in front and helping with the pace.
Joan Hanscom:
The poor guy can’t catch a break. Right?
Neil Stansbury:
Yeah.
Joan Hanscom:
The Giro last year hit the bottle out, broken pelvis.
Neil Stansbury:
Was the same as [crosstalk 00:45:24].
Joan Hanscom:
Yeah. Oh, [inaudible 00:45:24] was sad this year.
Neil Stansbury:
Yeah. He got just tortured.
Joan Hanscom:
You got to wonder, that much road rash. How long does it take to heal from that?
Neil Stansbury:
And the same thing is it’s not even so much when you’re on the bike, road rash doesn’t hurt that much.
Joan Hanscom:
No, it’s sleeping.
Neil Stansbury:
It’s the trying to sleep and things like that. So, if you’re up all night tossing and turning because every time you move something wakes you up, can you imagine trying to get up and race 120 miles the next day?
Joan Hanscom:
At the speeds they race-
Neil Stansbury:
Yeah, it’s crazy.
Joan Hanscom:
… and compete no less. Yeah. It was a tough tour to watch this year. It was fun, but it’s tough.
Neil Stansbury:
It was frustrating, especially when that fan jumped out in front of him and took 50 of them down.
Joan Hanscom:
Yeah, that’s was awful. And then you see somebody like Chris Froome who could have died in his crash couple of years ago and see what the toll of those injuries took on him as a professional is super… Our sport’s brutal.
Neil Stansbury:
Yeah.
Joan Hanscom:
I think I say it all the time that this sport will break your heart 10 different ways every day. And it’s true, but yet we-
Neil Stansbury:
That’s what makes it fun.
Joan Hanscom:
Yeah, exactly. That’s what we love about it, exactly, is that whole thing. Well, Neil, it’s been delightful to have you on the pod. I just want people to know this doctor that’s standing on the sidelines is one of us, and understands us, and wants to do the best for us, get us back on our bikes.
Joan Hanscom:
And so, I just wanted to take this opportunity to get people get to know you who don’t know you and who know that if you crash and the doctor runs over to you, this is who’s helping you. And he’s one of us and he understands you, which is cool.
Neil Stansbury:
Thanks. I really appreciate you having me on the show.
Joan Hanscom:
Yeah. Right on. All right. Well, this has been The Talk of the T-Town podcast with Dr. Neil Stansbury from the LVHN sports medicine department orthopedics. And we hope you liked the show and we hope you tune in again. Find us on Spotify or iTunes and give us a listen to the past pods. Thanks so much.
Joan Hanscom:
Thank you for listening. This has been The Talk of the T-Town podcast. I’m your host, Joan Hanscom. Thank you for joining us for this week’s episode. Head over to our website at thevelodrome.com where you can check out the show notes and subscribe so you’ll never miss an episode.