Cancer survivor John Fuoco’s Calvins Challenge 2012

You may recall friend (and my 2003 PBP roommate) John Fuoco’s post about how he was forced to miss PBP because of a cancer diagnosis.

John has written a moving story about his difficult treatment and recovery in a new post that is one not to miss. He got back on the bike after months of chemotherapy and, in no surprise to anyone who knows him, got back into racing shape.

His goal was to ride this year’s Calvin’s Challenge ultrarace this year, which he accomplished with our mutual friends Andrea M. and Greg C.

John, Andrea and Greg, in their team gear. Kidding! Courtesy Greg Conderacci.

John was headed back for more surgery after the event. We’re hoping to see him out on the bike soon. Until then, MG and I send our best to John and his family. We’re pulling for you, John!

Calvin’s Challenge
by John Fuoco

July, 2012

It’s hard to say where this challenge began or to describe all that it entails. Let just start out heading south somewhere in Virginia on scenic rolling terrain on the DC Randonneurs 600K brevet last June. We had a big group together for most of the first day and I got to spend some time pedaling next to two folks whom it was my pleasure to get to know better, Greg Conderacci and Andrea Matney.

They were riding strongly and comfortably. I on the other hand felt just a little off my game. I told anyone who asked that “nothing is wrong; I just don’t feel that great”. At the overnight stop we dined on black beans and rice and made plans to sleep. Greg kindly let me share his room with him. But he and Andrea planned a longer sleep than I was comfortable with and so we parted ways at that point.

Within a few weeks I had to go see my doc. I’d had a lengthy series of chest colds and had a cough that just wouldn’t go away. Tests, tests, and more tests showed something rotten in my right lung. Biopsies did not show cancer but the right lower lobe had to come out. So on July 27th I underwent an open thoracotomy to remove that half of my lung.

To visualize an open thoracotomy think of a massive shark bite flipping open one half of your chest just under the armpit. It was ugly and nasty. I could not bring myself to look at that shark-bite incision for many days after. But what they found inside was worse than we thought. There was cancer, lung cancer.

I remember coming out of the fog of anesthesia, lying flat in the recovery room, and my surgeon delivering that news to me. One single tear wiggled out of my left eye and made its ways across my temple. This was bad news. Lung cancer is not a “good cancer” to get.

I spent 11 days in the hospital, longer than planned. Though my care was excellent I had side effects from the pain medicines used at first and was in pain and terribly nauseated most of the time. When released I still had a chest tube, which is nothing more than a garden hose pinched between the ribs, to drain leaking fluid and air. By that time my cancer had been staged and it was determined that I needed chemotherapy once I was over the surgery.

Diseases desperate grown
By desperate appliance are relieved
Or not at all

So home I went with my chest tube, big nasty incision, and bucketful of bad news. I’d get five weeks to recover from the surgery before having to start chemotherapy. A few days after the chest tube finally came out I got on the bike and didn’t feel half bad. My legs still seemed to have some strength, but oh my breathing was scary.

The first slow trip up the short steep hill to my house left me feeling like I was drowning. But I went out again the next day and it wasn’t near as frightening. That was only a few days before PBP was due to start and thinking to myself how my brother Art had ridden it in 07 with a broken wrist and banged up knee, that I could do that ride too! But that was only a daydream. I had to not only cancel PBP but the Michigan 24 hour race, the Colorado High Country 1200, and the Nightmare Double Century.

Instead I had a Power Port sewn under the skin of my chest wall with a tube running into my internal jugular vein. The chemo would be delivered directly into my internal jugular because it was so caustic that it would just tear up the smaller veins in my arms. I spent six hours in the chemo chair every Friday from early September to Thanksgiving, getting every third Friday off to let my body recuperate.

The very first treatment was the worst. Despite being in the medical field and being told about the effects of my particular chemo drugs I was just not prepared for what they did. Nausea does not describe the nausea. Sick does not describe the sick. It was a half metallic, poisoned sensation that crept immediately to the tips of my fingers and toes and into my saliva as the drugs were infused. For the couple of days after each treatment I had that poisoned taste and feeling.

I tried going for short walks with varying success. Once I had to phone my wife to pick me up two blocks from the house. I could not take one more step and would have been embarrassed to have the neighbors see me lying on the side of the road. I cried, out of desperation, in the shower after that, just not believing I could endure three more months of this.

But somehow endure I did. I had a lot of help from family and friends. I was on a lot of prayer lists and happy to be there. My fatigue grew worse as the weeks wore on but the sickness from each treatment never exceeded that of the first. Though most of my hair fell out and most of my muscle melted away, aside from one trip to the emergency room to rule out a blood clot when I became unusually short of breath (turned out it was just from severe anemia) I had no serious complications.

Before PBP I had sent a story into The Daily Randonneur (see it here) about my cancer and to encourage those going over the pond. So many of my rando friends knew what was happening with me and became vital sources of encouragement thru the fall.

During this time Greg began to email me with questions about RAAM qualifying. He was planning to do the Texas Time Trials and enlisted my help in preparing for the race. We had a lively exchange going as he asked multiple insightful questions about every facet of doing a 500 mile bike race that really made me think and draw on all of my experience in that realm. I was extremely grateful for this as it kept my mind and heart in the game while my body was somewhere else entirely. He did excellently in that event, achieving his goal of RAAM qualifying and did a nice write up that I honestly felt gave me too much credit for his success: See “The Fuoco 500”.

Andrea also jumped in. She’d been getting advice from other brevet riders to venture out into ultra races. She said with a sigh that maybe she needed to try one. Where should we start? I considered what was available and suggested Calvin’s Challenge as the best first race. It is a reasonable driving distance, drafting is allowed, there are a couple hundred racers unlike some events that may only get ten or twenty riders, and it is only 12 hours.

Through the winter we went over all facets of planning: training, course details, strategy, self crewing and the aspects of this particular race that make it differ from a brevet.

The plan all along was for the three of us, Andrea, Greg, and me, to go. Naturally I could not predict what my role would be at the race. I would prefer to ride it with them, but if I was only fit to ride part of it with them, or only just crew and lend moral support it didn’t matter because I was going with them one way or the other. For me life after cancer would still involve cycling even if it was just crewing and volunteering.

On Monday December 5th 2011, five months to the day before Calvin’s, I was two weeks past my last chemo treatment and went back to work and back to working out. I felt fine working that first four hour day but by the time I got home I was passed out exhausted and napped like I needed it. And so it went every day that week. I got on the bike for one or two hours most days. I drove to remote launch sites because I felt very skittish handling the bike and around traffic.

My leg strength was appalling but my breathing was even worse. My heart rate would shoot up just pedaling lazily on the flats. But I was in no hurry and I knew this would take time. The main thing was I was back to doing what I loved and was enthralled with the prospect of gaining some form back however long it took. After a few weeks of riding I sheepishly invited my good buddy Joe to ride with me. But my conditions were that I ride my cross bike with tires inflated to 70 lbs and that he ride his heavy mountain bike with tires at 20 pounds. It worked. It felt great to once more share the road with a friend.

When not cycling I was in the gym doing weights, or in the pool, or cross country skiing. At the end of January I cross country skied with my daughter Dani in Vermont who was amazed at my strength. I could tell it was coming back by then too. On my rides I was getting the feeling of being back on top of the pedals. Since my workouts were measured, and never too hard, I rarely took a day off. All the while May 5th, the day of Calvin’s Challenge, was on my mind.

By early March I had over a thousand miles of base training in so I started doing intervals. The first set hurt so good! I had almost forgotten that tired achy burn in the thighs after doing a set. My friend Jeff and I did our “easy century” in mid-March, only 5500 feet of climbing with no long or tough hills.

We’d done it many times before and this ride felt a lot like old times. I asked him the next day how he thought I did and he remarked that I seemed real good, about 90-95 percent. I had to agree with him.

At the end of March I did two 200k brevets. I was especially nervous at the first one which took place in Eastern PA. Though I knew my form was not bad I did not know how I’d do on a tough course over that distance. I rode within my comfort zone, which for me is still a hard effort, and sort of ran scared all day.

Though I was going well I kept expecting the bottom to drop out but it never did and I finished with a fast time. Maybe two full lungs are just excess baggage! I did well the following week as well. Though I was riding strongly, my recovery was way different. Whereas in the past I barely needed a day to recover from a 200, for these rides I was still drowsy tired three days later.

On Friday evening April 13th I met Greg and Andrea in Harrisonburg, Va. for the following days 300k through the Shenandoah Valley. Though we had emailed extensively it was the first time we’d seen each other since that 600k the previous June. At dinner that night we settled into some easy conversation and I began to truly appreciate what warm and friendly people I was dealing with.

They were fully aware that I was damaged goods in terms of riding ability but seemed not only to not care about that but actually embrace me and my ordeals as a strengthening force for the team. Greg lauded me with Lance-like metaphors and Andrea had encouraged me with poetry: “We are talking about defiance.”!

The 300K was our only prep ride as a team before Calvin’s. The route was beautiful but challenging. Greg quickly assumed his favorite position drilling at the front. Andrea floated effortlessly up the hills. I hung on. After the first 90 miles my thighs were burning with any slight increase in effort and I was not hopeful that the day would end well for me. It was clear that my companion’s fitness exceeded my own. But I was able to stay with them and not slow them down too much.

We were able to finish together with a fast time, the tail wind at the end contributed greatly to my relief. And the knowledge that Calvin’s course is flat also provided some comfort because I knew our differences in fitness would be even less of a problem there. We were ready to rumble!

Though I dropped enough hints, I never came right out and said that many of my previous Calvin’s races were some of the hardest efforts I’d ever put forth. Only twelve hours, flat, drafting allowed: almost sounds easy. But those very same aspects conspire with the always present wind to make a good performance achievable only through an extreme effort.

One week after our 300k I had more tests and they found a stricture in my colon. It presented a danger. It could block off at any time which would be life threatening. I had to have surgery. My docs wanted it done right away but I said hold on, it hasn’t been bothering me that much and I have this race and my daughter’s college graduation to get through. Then you can operate.

I was admonished to keep well hydrated, avoid roughage in my diet, and hope I get lucky.

We assembled the eve of the race in Springfield Ohio. My wife Kim and Chuck Camp, a long time friend of Greg’s, joined in to cheer and crew for us. After our pre-race supper, Andrea and I had rough nights. I had a near miss with my bowel. I had several hours of pain and distention but whatever was hung up must have passed. By morning I was good to go. Andrea had a touchy stomach through the night but also lined up the next morning rarin’ to go.

We were blessed with excellent weather which for Calvin’s means little wind. Temps were in the 60s and 70s. No rain. This year there were a record number of participants with over 250 twelve hour racers. We queued up but not close enough to the front to suit me. I barely had time to reflect on the incredible journey taken to get here or whether any of the other starters were riding with a Power Port.

At the start we did a good job staying together. I moved us up as fast and as safely as I could but right away I could see too much separation as two separate groups went up the road without us. I’d never let that happen when I rode this race alone and here I was failing, I thought, at the get-go of our group adventure.

Losing the lead group however proved fortuitous for us. There were many strong racers this year and we settled in with a very fast group. We took our pulls when we had to but were largely able to sit in for the first 50 mile loop. And it was easier to stay together than I’d envisioned. We clearly had each other’s back.

We smoked through the first lap in 2:20, made a quick pit stop and were off again, this time alone. But we soon coalesced with other riders and again had good strong company for the second lap. Andrea remarked that she was had hardly been breathing hard. Greg was his metronomic self drilling at the front, head wind or no head wind.

I was feeling some strain in my legs but had not sold out completely and if my stamina held up like it had before my cancer, I’d be good till the end. We finished our second lap, pitted, and were back out for the third loop in 5:00. By six hours, halfway through the race, we had over 120 miles. Things were looking good.

But this is a true story and in real life real things happen. After about eight hours we had to slow down. Andrea had been feeling some nausea for a while but it progressed and we simply had to sit up. She tried sips of various liquids and gels but nothing would go down lest it came back up.

If you’re going through hell keep going.

So we stopped often and rode easily. Easy that is for Greg and I. Andrea was ashen and clearly suffering but would not quit. I tried to get her to sag in because I was worried about her but she’d hear none of that. She is tough as nails.

Though our mileage total at the finish was much less than we were capable of, Andrea was the one of us who fittingly got a medal. Happily she recovered quickly after a brief rest and quick shower: Shown here with her podium boys:

Andrea with her ‘podium boys.’ Courtesy Greg Conderacci.

After the race I felt very letdown. I missed my riding partners tremendously. This challenge was over, and all of the energy, love, and enthusiasm that went into it had been spent. We agreed we needed another goal to succeed this one. But I cannot commit. I have my last child’s graduation, then more surgery.

I don’t know what the future holds for me, but if my cycling life is to be at an end, I’ve crowned it with one last joyous achievement. And with that I feel satisfied.

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