My name is Anne Linton and I am a retired physician as well as a safety rider for the Tour des Chutes. At the 2017 edition of the Tour, I came across my husband standing alongside his bike halfway up Johnson Rd hill and little did we know our lives were going to change once again. Tim, an avid cyclist for the past 30 years, thought he was just going out for an enjoyable day doing the 75 mile route but almost immediately he started feeling bad. As he describes it, almost everyone was passing him like he was standing still. I got some gels into him and some electrolytes and we limped back to the finish line.
The next morning he went in to see his Doc and the symptoms appeared to maybe be exercise induced asthma, but they also wanted to rule out things like a pulmonary embolism so some blood work was ordered. As he was driving back home he received a call asking him to immediately head to the hospital as emergency surgery was going to be needed to repair his aorta that had dissected again.
Some background: 17 years ago my husband Tim (35 years old at the time) had a life-threatening thoracic aortic dissection and spent 10 days in the ICU in a medically induced coma after undergoing over five hours of surgery to repair the dissection. If you don’t know what this is, it is something most people don’t recover from. In fact John Ritter (remember Three’s Company actor?) had the exact same thing happen about 3 weeks after Tim and he went into surgery but he never came out of it.
The recovery process was very slow and after six months, Tim was allowed to get back on the bike with the only restriction that he had to keep his heart rate below 140bpm. Soon, he was back to his 5 day-a-week cycling schedule just being mindful of his HR but at the same time disappointed that he couldn’t ride with his friends and cycling club teammates as he would slow them down. But, his heartrate limitations did not slow him down, as he would do the occasional cyclocross or mountain bike race and aim not to be dead last by letting his bike skills make up for the limitations. He even got back in good enough health and condition to head to Europe to participate in the Paris-Roubaix and Tour of Flanders Sportif rides and even portions of the Tour de France routes. But there was always the worry that it could happen again.
Fast forward to 2017, the second repair surgery went well and Tim was on his feet a day later and walking as many laps as the nurses would allow him in the CCMU. Unfortunately, the recovery was not perfect as he developed fluid around the heart that needed to be drained ten days later but he was lucky to be alive and once again on the road to recovery.
In a follow-up appointment with his doctor, they took a look at the recommended activities for someone like Tim and believe or not, the recommended cardio-vascular activities were bowling and curling. We both laughed and around that same time Trek had just released the Trek Domane e-bike, a pedal assist road bike with disc brakes and the ability to put wider tires on it. Since I was a Trek Women’s Advocate and worked at Sunnyside Sports they were able to get us one. Since his first surgery 17 years ago Tim was not comfortable riding with other people for fear he would slow them down. That bike was a game changer and I felt like I got my husband back. I didn’t realize how depressed he had been since his second surgery.
Since then Tim has also gotten a Trek Rail pedal assist mountain bike which he loves. He can go explore the gravel roads and some of the trails and doesn’t have to worry about getting too tired or not being able to ride long enough. The pedal assist bikes have different modes in them so when he gets tired he can give an extra boost. But he also still can get a good workout in all while keeping his heartrate low enough that he doesn’t stress his aorta and the repaired tissue.
This photo is of Tim and I at the top of McKenzie pass he on his ebike and me on my regular bike. Look at that smile! Prior to getting his pedal assist bike he was pretty depressed and bummed as he always felt like he could not ride with others because he had to go so slow. Now I can’t keep up with him and if I want a really good workout I try to keep up with him going up Skyliner Road. I have even had him moto pace some of my coaching clients.
After he got the Trek Domane + he continued to ride his mountain bike on the local trails but was finding that even difficult to keep his heartrate under control. So January of 2020 he got the Trek Rail Mountain bike, which is a pedal assist mountain bike with a good amount of travel, knobby tires and can go up to 20 mph. Again it is pedal assist so you can’t go without pedaling and putting in some power and work. He loves that in that he can explore the gravel roads and trails up high (off the traditional single track in Deschutes National Forest since it is not e-bike or pedal assist friendly at this point in time).
That brings me to another point. These types of e-bikes (called pedal assist Class 1 or Class 3) do not have a throttle so therefore they are not motorcycles and you can not go without working and pedaling. I think there is a big misconception about what is an e-bike and why people are so anti e-bikes thinking they will go super fast uphill and ruin the trails. Well most pedal assist mountain bikes max out at 20 mph so if you go faster than that it is your own human power causing it and you can’t do that uphill. And on the downhill they seem to just spin out if they go any faster. The road bikes come in two types some that go up to 28 mph max but are usually heavy (Tim’s weighs about 37 lb) or the lighter ones max out at 21 mph (and weight close to 23-25 lb).
Here is how ebikes are classified:
Class 1: eBikes that are pedal-assist only, with no throttle, and have a maximum assisted speed of 20 mph.
Class 2: eBikes that also have a maximum speed of 20 mph, but are throttle-assisted.
Class 3: eBikes that are pedal-assist only, with no throttle, and a maximum assisted speed of 28 mph.
All classes limit the motor’s power to 1 horsepower (750W).
There was a recent study that came out that showed the following: “Energy expenditure and ventilation rates (per minute) for all modes were not statistically diﬀerent. However, total EE and VO 2 for each bout (per mile) for e-bikes are 24% lower than that for conventional bicycles, and 64% lower than for walking. This reﬂects the shorter travel time. Diﬀerences between e-bikes and bicycles are most pronounced on the uphill segment. Still, e-bikes provide moderate physical activity (MET > 3) on ﬂat segments and downhill segments, and vigorous physical activity (MET > 6) on uphill segments. For e-bike trials, riders reported higher levels of enjoyment and lower need for a shower than walk or conventional bicycle trials. This paper adds to the expanding literature by comparing e-bike, bicycle and walk EE and VO2 . E-bikes can contribute as an active transportation mode to meet required physical activity guidelines.”
Journal of Transport and Health Vol 6, September 2017 pages 463-473
Comparing physical activity of pedal-assist electric bikes with walking and conventional bicycles.
This is a picture of Tim on his pedal assist Trek Rail Mountain bike. He loves that one even more than the other and can get out and explore all the dirt roads/trails and not worry that he can’t climb up that high for fear he has to keep his HR down.
Tim and I are forever grateful both for the miracle of modern medicine and now for the addition of pedal assist bikes which have allowed him to continue his passion of riding bikes while dealing with his medical limitations.
~ Anne Linton, Physician Turned Endurance Athlete and Coach, Trek Women’s Advocate, Sunnyside Sports Team Member