Case #35: Len (Pt. 2)

Len Geiger (0:06)

I wanted to train my body again, and Idiot Me said, what about mountain biking? If you've ever been on a bike and locked down the front wheel, you know what happens. The rear wheel comes off of the ground and throws you out into the air.

And so I'm doing a Superman, flying without a cape. It's only been three months since my transplant, and I literally had enough time to think to myself, don't land on your chest.

Lauren Bright Pacheco (0:35)

Imagine your body being hijacked from within by an unseen assailant, determined to inflict pain, steal your independence, and slowly unravel your life. Even your doctors can't tell you why. You're trapped in a diagnostic maze, searching for answers while fighting to be believed. For millions living with chronic illness, this is reality. And this is the Medical Mystery Podcast, where patients become investigators, survivors become advocates, extraordinary doctors become heroes, and every story has the power to help someone else find answers.

I'm Lauren Bright Pacheco, and this is Symptomatic.

The last we heard from Len, he was flying over the handlebars of his mountain bike three months after receiving a miraculous lung transplant that saved his life. After having suffered for two decades with a rare genetic disorder called Alpha-1 antitrypsin deficiency, also known as genetic infecima, he had been given a new lease on life. He could finally breathe again. Len, who has always been someone to sprint out of the gate, had jumped back into active living with veracity, using his new lungs to their fullest extent. Mountain biking became his new obsession, and though he had already been through so much in his short life, Len was handed another tragic twist of fate when a vine locked up his front wheel while traveling at high speed down a hill, and he was catapulted through the air.

Len Geiger (2:25)

I was able to twist enough to instead land on my left side. I hit my shoulder and my hip and my entire upper leg on my left side.

Lauren Bright Pacheco (2:37)

Good Lord.

Len Geiger (2:39)

I shattered my femur.

It was broken into five pieces. It was an absolute mess.

Lauren Bright Pacheco (2:46)

Here is Dr. Mark Brantley, expert on pulmonary diseases and, in particular, Alpha-1 antitrypsin deficiency. He was one of Len's doctors for many years.

Mark Brantley (2:58)

If I was his transplant surgeon, I would have killed him.

Lauren Bright Pacheco (3:02)

I told him to stay away from bikes. Why do you think he would take the risk of doing such a potentially dangerous activity so soon after his transplant surgery?

Mark Brantley (3:14)

When he developed his devastating disease, he was a young man, very vigorous, athletic, and doing many different things. When he got that new set of lungs, he went wild.

Lauren Bright Pacheco (3:25)

Here's Beth, Len's sister.

Beth (3:28)

For years, he had not been able to do what he'd always been able to do. And I'm sure he was just feeling the pure joy of his body working, his ability to go out there and do these things again.

So I can't blame him for that.

Lauren Bright Pacheco (3:43)

Len was rushed to the hospital. Even he admits he was in rough shape.

Len Geiger (3:48)

It was about five and a half hours of surgery to put my leg back together. I've got two full-length steel plates that run from my knee up to my hip, one on the front, one on the side. Got a bunch of screws in the bottom half holding everything together. And then on the top half, they had to put five steel cables wrapping around everything. Because at that point, I've got my artificial hip, and they can't drill through the titanium rod that's already in there.

And the surgery went well.

Lauren Bright Pacheco (4:14)

But Len wasn't out of the woods yet.

Len Geiger (4:16)

About two hours after the surgery, I threw a fat pulmonary embolism, and I stopped breathing.

And they came running into the room, and they found me unconscious and not breathing. And they didn't know how long I had not been breathing.

Lauren Bright Pacheco (4:31)

Len was in such a fragile place medically that his doctors were left with only one option.

Len Geiger (4:38)

They induced a coma, and they had me on a ventilator so I could breathe. And as quickly as they could, they airlifted me back to the University of Virginia because they needed me to be in a transplant center.

The doctors at UVA told my mother and father, we want to make sure that we're all on the same page. We do not expect them to survive this, because you don't do crap like this, you know, three months after a double lung transplant and expect to live.