I’m also taking the opportunity to update my blog/Twitter/Facebook interconnectivity…  Why post multiple times?

Check out the map log from Garmin Connect… I am slow!

37 miles of riding in 3 1/2 hours at an 11 mph average pace.

View Cleveland mini tour in a larger map

Click on the map markers for more information. Follow the link on the bottom to get a larger version of the map.

View Sunday Loop (2010-05-16) in a larger map

I’m trying out importing to Google Maps import from the GPS. It doesn’t have as much information from the ride but I’m more confident with the longevity of the data. Maybe I’ll do my own charting of the other ride data in the future.

We did a modified valley loop since we had a late start due to Shanna’s work schdule.

I would have suggested one of the shorter ride options, but they insisted we take the “long” route. When we started out there were about 15 riders together. At the end of the first hill, the last two riders in our group moved on. Though it was a social ride, we were just moving too slow. I stayed with them and we made it through the route. I was really happy with their performance. For not riding regularly and choosing the longer route, they performed well on the tandem.

It was just getting dark when we got back to the cars and headed out to meet the rest of the riders for dinner at Memories in Richfield. When we went in and sat down, everyone else was just finishing their meals! Everyone stayed for a while and talked while were waiting for our food.

We had a wonderful ride, beat the bad weather, and had good company afterward!

The Plesk control panel is connected to via SSL (https:// URL) on port 8443 by default.  This generally works out very well, except when I am on the road and find myself behind a restrictive firewall that only allows web connections on standard ports – port 80 for http and port 443 for https.  When this occurs, I need a way to access the server administration interface without resorting to using my 3G telephone connection.   This turns out to be a perfect opportunity for working with subdomains and Apache proxy support to transparently forward ports 80 and 443 to port 8443 on the same server.

After several hours searching with Google and reading many various proxy solutions and approaches, I discovered a posting on theBartels.de, Running Plesk on Port 443, that covered my requirements and almost worked for me.  I recommend reading the excellent information provided in the post to better understand what I have done.

Requirements:

1. Apache web server with mod_proxy support enabled
2. Virtual hosting system that uses Plesk and allows subdomain creation
3. Access to the subdomain configuration files
4. Command line access for Plesk and Apache configuration update

Note: In the configuration description, I use example.net to represent the domain to have control panel access configured and plesk.example.net to represent the new subdomain for accessing the control panel.  Use your own domain naming as appropriate and desired.

Configuration steps:

1. Create a subdomain (plesk.example.net) with SSL support using the Plesk control panel
2. Create a file called in/var/www/vhosts/example.net/subdomains/plesk/conf/ called vhost.conf with the following content

ProxyPass / https://localhost:8443/


<Location />
ProxyPassReverse /
</Location>


SSLProxyEngine On


<Proxy *>
Order deny,allow
Deny from all
Allow from all
</Proxy>

3. Login via SSH as an administrative user and reconfigure the domain from the command line using:
   /usr/local/psa/admin/sbin/websrvmng –reconfigure-vhost –vhost-name=example.net
   
   
4. From the command line, reload Apache configuration using the appropriate command depending on your Apache installation:

/etc/init.d/apache2 reload
or
/etc/init.d/httpd reload

5. Test your Plesk control panel access using the new subdomain you configured by opening your browser and connection to https://plesk.example.net/

Update: The video appears to no longer be available after a reorganization of the U.S. News & World Report web site.  I’m trying to locate a replacement link. – Bill

There is a whole series of health care videos available on the U.S. News and World Report web site.

At 30, I was diagnosed as having Mitral Valve Prolapse (MVP).  The mitral valve between the left atrium and left ventricle does not close properly and may “leak”.  This is a common cause for hearing a murmur when listing with a stethoscope.  At that time, I had several tests run and was told it was not an immediate concern and I should have periodic monitoring to see that it didn’t worsen.  Seeing as how I felt fine, I said “OK” and returned to my normal routine and didn’t really give it much additional thought.

Then, during a routine physical in 2002, my doctor in Cleveland commented on the murmur and recommended a followup — it had been over 10 years since my original (and only) testing.  I still felt fine, but went ahead with the request.  The ultrasound showed “significant” regurgitation (leaking), but I was still feeling good and had no related problems.  It was decided to monitor for any changes.  Again,  I said “OK” and returned to my normal routine and was not concerned.

Things Change

This summer, things changed.  I had a heart attack that required intervention.  Two stents were placed and I was put on blood pressure medication – and it was suggested I reduce my weight.  I definitely needed to lose weight as I had allowed my self to gain 60-plus pounds in the last 10 years.  It was also noted that the MVP was present and I had significant regurgitation – 3-plus on a scale of 0-4.  This would now need frequent monitoring to avoid future complications.

Self portrait from my hospital bed

I was feeling good and looking forward to getting home when  my hospital stay was lengthened for a couple of days of monitoring due to a short episode of atrial fibrillation. Like the MVP, I was asymptomatic and unaware of the atrial fibrillation.

After I was back home, I began making necessary changes to my diet. No more “convenience” foods from the freezer section at the grocery store.  I enjoy cooking, so I started fixing all of my meals with consideration for heart health.  Low sodium does not have to be low flavor.  This part was actually easy.  I also started back with my bicycling.  10-20 miles to start and then up from there.  I was feeling great!

A few weeks after my discharge, I entered the cardiac rehabilitation program at Cleveland Clinic. As part of the process, they do a baseline stress test on a treadmill to determine your cardiac health and physical limits.  An exercise program is then designed around your individual needs.  This test did not go too well… before I was even tired, they made me stop.  Seems that I went into atrial fibrillation on the treadmill and did not even realize it.  After a short interval, my heart rhythm returned to normal.

The return to normal was good, but the episode itself was a cause for concern. My medications were adjusted and I was put on blood thinners – to lower the possibility of a clot forming due to the fibrillation.  OK.  I can deal with this also… Only problem is the medications are targeted at controlling my heart rate and this makes it more tiring to ride my bike.  I can deal with it, but it is not fun.

Rehab was going great and it was time for a followup with the cardiologist and another stress test.  Again, I went into atrial fibrillation, but was feeling fine and was completely asymptomatic.  This time, they let me continue on the treadmill to see if I developed additional symptoms.  No.  I continued without feeling there was a problem for another 2 stress levels.

After reviewing the test results, my cardiologist and I started discussing the future.  The MVP would cause progressive problems and eventual congestive heart failure (CHF).  The atrial fibrillation may be controlled by drugs and would require me to remain on blood thinners (warfarin) as long as it was present – and it would not  go away on its own. Of course the CHF was 5, 10, maybe 15 years in the future, but it was the definite outcome.

I had two options open to me.  Surgery to repair the mitral valve or continuing as I am and monitoring for changes.  While monitoring, I would continue on the same or more medications and the only outcome would be future surgery.  This translates to actually only have one decision to make.  When do I want to have surgery?

Decision Time

I decided to do some research of my own and it supported my cardiologist’s view.

• At some point I would need surgery.
• The earlier the surgery, the better the long term prognosis.
• Cleveland Clinic is the #1 ranked heart center.
• There are new minimally invasive and robotic assisted surgery options.
• Surgery could limit or eliminate the medications I take long term.

For me, it became an easy decision.  It only makes sense to have surgery now while I am relatively healthy.  Having the option for the robotically assisted heart surgery really won me over.  Lower hospital time and faster recovery is a definite plus.  By spring I will be finished with my rehabilitation and fully recovered.

Let’s Do It

Dr. Tomaslav Mihaljevic, M.D. will be performing my surgery on December 23.  Pre-operative tests and interviews have been finished.

Updated this entry to match my posting on theStatus.com.