Cycling became a part of my life shortly after I turned 32 years of age in January of 2001. Suddenly aware of my mortality, I quit smoking, joined a gym and bought a cheap mountain bike. I quickly discovered that mountain trails and me were not a good match. There happen to be big Alex eating boulders and trees on the trails around here. So road cycling got my attention. I did not have a road bike yet but figured I would save for a few months and go for it.
Then I went to the Doctor. I had a cyst on very front of my left shin that had been there for a couple of years. Docs had, in the past, told me not to worry about it because they are common. But mine had started to hurt. So my Internist decided to send me to an Orthopedic Surgeon to remove it. The procedure was on October 8, 2001. Two days later I came home from dinner with the guys about 10:15 PM and saw on the caller-id that the surgeon had called three times?the last time about 5 minutes before I got home. HINT ? That was a bad sign. So I called him back and found out I had cancer.
General Cancer Type: Sarcoma
Specific Cancer Type: Soft-Tissue - Malignant Fibrous Histiocytoma (MFH)
I was Stage II-B. The tumor was 2 cm in diameter, non-encapsulated (it had invaded the surrounding tissue) and was very close to invading the bone in my left leg. So it was decided that surgery to remove the cancer, followed by radiation, would be our best course of action. There is not a chemo treatment that has been proven effective in treating MFH.
Since this is an aggressive cancer the surgical standard is to cut out 2-3 cm of healthy tissue in all directions from the cancer. This is called a wide excision and in my case meant removing a piece of my leg roughly the size of a tennis ball. Now you might have guessed that a procedure like that leaves a mighty big hole. But wait?there is a way they can fix that. It is called a muscle flap. The soleus muscle (it lives deep in the calf) is cut loose and wrapped around the front of the leg to cover the bone. Then they cut a strip of skin from my thigh about a foot long to do a skin graft to cover the whole mess. My thigh still looks like it has a landing strip on the front of it. Finally, they dosed me with radiation for six weeks. I should glow in the dark for at least a decade.
That was the easy part. Next came the failure of part of the muscle flap, part of it was cut off and part of it fell off. That brought about several post-surgical infections, and a bone infection. We treated these by inserting a Hickman catheter in my chest (another surgery) and taking IV antibiotics for five weeks. Three antibiotics were used and I had allergic reactions to all three (welts, hives and drug fever). I turned purple from neck to ankle when I had the hives. I looked like Barney the dinosaur.
The wound would not heal so we tried five weeks of Vacuum Assisted Closure. A little vacuum cleaner that sucks on the wound 24 hours a day, seven days a week. It is supposed to increase blood supply to the wound to stimulate healing. But I had so much damage to the area from surgery and radiation that it didn?t work.
Next we tried three surgical applications of Apligraf. This is a skin substitute that is part synthetic, part foreskins. Yes, now you know what they do with them. Now every time I see a pretty girl I get taller. Other than that, it did not work. Again, there was just too much damage for the blood to get to the wound. During this time the wound opened up wider and the bone was exposed. THAT is a weird sensation to look down and see your bone. ?Is that the bone Doc?? Tap tap tap??Yep that?s bone alright.?
Finally, we tried Hyperbaric Therapy. Imagine a cigar tube big enough to hold a person. They put you inside and seal you in. Then the pressure is increased to two atmospheres. That is roughly equivalent to being sixty feet underwater. The air inside the tube is oxygen rich. That means it has more oxygen than normal air. The higher pressure pushes more blood through the damaged blood vessels and the blood it carries has more oxygen?so you heal better. This one worked. I spent two hours a day in the chamber for sixty days. At the end of it the 6cm hole in my leg was less than 1 cm and the bone was almost covered. Enough blood supply had been created that four weeks after treatment stopped the wound was almost totally healed over and the bone was no longer exposed.
I had a goal throughout my treatment. I would live. I would buy a really good road bike. I would ride in the Ride for the Roses in Austin. I would finish that ride. That was it. I like the K.I.S.S. strategy (Keep It Simple Stupid).
I am alive. I bought the bike (a Trek 5200) before I could even ride. It sat in my guest room where I could see it every day when I walked down the hall. I am riding in the 2003 Ride for the Roses in October. I will finish it.
I think it turned out ok.
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