However, its important to understand and appreciate that there is so much more going on in life than just what exists in our own “boxes”.

I like to think as a doctor that hopefully I’ve developed a little more sense or understanding of this. Patients come into my life for a variety of reasons, some self-limiting that will get better with just a little time and rest, others with a life-changing and perspection altering disease that not only changes their view of life, but that of the people around them. However, I think I’m just as guilty as most where I don’t always realize when someone like this walks into or past my own little “box” of life. Too busy, focused on other “things” in the box, I’m sure I don’t always bother to cast my gaze outward to notice when these events occur.

Fortunately, I was paying attention for some reason this past Tuesday at the Triathlon Club of San Diego meeting with Chris Carmichael. Otherwise I would have never met the “man with the mask.”

Don’t know if other people noticed the tall bald-headed newcomer (not to be confused with the recently golden locks-shorn Buck) at the meeting wearing the surgical mask. It was the first time I had seen him at a Tri Club event. I didn’t think much about him in the hectic controlled “chaos” I feel when we host one of these events. Maybe a “Hope he doesn’t have TB or H1N1″ though crossed my mind as I returned my focus back to my own little “box”…

Chris Carmichael with Clayton Treska

Clayton is battling stage 4 testicular cancer. If you’re not familar with cancer staging, the higher the number, the further the disease has spread. Stage 4 is not where you want to start your battle against cancer. It means the testicular cancer has spread to other parts of the body and makes the job of treating the testicular cancer a lot tougher.

Its kind of like starting a baseball game in the ninth inning with two outs, two strikes and down by two runs with nobody on base. Its not impossible, but its a hard road to come back from, but with enough belief, drive, perserverance and maybe just a little bit of luck, it can be done. Just ask Lance Armstrong.

Clayton has been undergoing chemotherapy which has supressed his immune system, hence the surgical mask, and as I watched him shake hands, the reason he pulls out hand sanitizer after he shakes somebody’s hand. But as I learned later, be careful shaking his hand – he was the Armed Forces “Fleet Week” arm wrestling champion one year (oh, and he won boh left and right handed divisions, so don’t fall for the old “I’ll arm wrestle you with my bad arm” ploy…). He’s getting ready to undergo another round of chemo followed by a bone marrow transplant later this month.

I’ve dealt with a lot of people that have battled serious medical problems and its interesting to observe what drives how some people respond to the challenge with a full-hearted, 100% never-quit effort. Clayton is surprisingly upbeat when he talked about his diagnosis and the long treatment road in front of him.

How upbeat?

He’s gone ahead and registered for the Honu Ironman 70.3 Triathlon next May and has been training as much as his treatment allows. You have to like the odds of someone who thinks like this… “Gee, I have cancer and it sounds pretty bad… hmm…guess I’ll whip it and then go race an Ironman to celebrate…”

Gotta love an attitude like that, and hopefully Clayton’s attitude reminds all of us of the importance of being more aware of the people outside of our “boxes”.

Welcome to the Tri Club, Clayton.

I have full confidence after meeting you that you’ll do exactly what you plan to do. Beat cancer and cross the finishline in Hawaii.

P.S.

Oh, and thanks for reminding me to look outside my “box”

The study, published in the July 2008 issue, by researchers at the University of Alberta looked at the difference in total body fat-free mass in obese cancer patients using a CT scanner. The interesting point not picked up in the NY Times article has to do with the toxicity of chemotherapy treatments since the total body fat-free mass is supposed to determine distribution at toxicity of the chemotherapy. However, many drugs are dosed using a body surface area (BSA) calculation that dates back to a 1916 medical study! Granted that there are variations of the body surface area formula that have been “improved” upon since then, but this study also suggests that there is not a good correlation in obese cancer patients between their body surface area and their fat-free mass due to the loss of muscle mass in some.

The number one food? Jack in the Box’s Junior Bacon Cheeseburger weighing in at 400 calories with  23 grams of fat and 860 milligram of sodium. Taco Bell, McDonalds, Burger King and Wendy’s round out the unhealthy top 5 value meal fast food offerings.

Read the entire report at The Cancer Project.

A big congratulations to Rick and George, their crew, family and sponsors for a job well done. George took a mighty last leg of over 200+ miles after Rick’s achilles finally got the best of him last night. A fair trade for some of the 100+ mile pulls that Rick took earlier in the race when George was also having problems. And folks, that’s what team RAAM is about – conquering the toughest bike race in the world – as a team!

Team Beat Cancer just rolled through Time Station #50 in La Vale, Maryland after completing the stage with the most climbing so far.That’s right, forget the climb over Monarch Pass in Colorado, don’t try to compare the ‘hills’ around Flagstaff, Arizona – its the hills in West Virginia, Maryland and Pennsylvania that offer the highest elevation gain per section in RAAM! George and Rick just came through 4,500+ feet of climbing to leave the country roads of West Virginia behind.

But like a bad Ginsu knife commercial – Wait! – There’s more! They still face sections with 3,000+, 4,300+ and 3,200+ across the next three time stations through Maryland and Pennsylvania. That’s enough for almost anyone to wish that they were back in Kansas – especially after 2,500+ miles of cycling.

BUT…They’re not done yet! Time Station #54 to Georgetown, PA features almost a vertical mile of climbing (4,910 feet if you’re scoring at home!) – The most climbing of any section of RAAM.

Want to be in on a secret? Rick’s wife, Terry, is on her way to Atlantic City, NJ to be at the finish line as a surprise for Rick. I figure Rick’s a little too busy to find time to read this blog in the next 48 hours to spoil it.
She’s been the support behind Rick the past twelve months and her successful battle with cancer over the several years has been one of the catalysts for Team Beat Cancer…

Rick just called in from the South Fork, CO time station and sounded in great spirits and had a lot of energy for a guy that is almost 1000 miles into an ultracycling race. Other than some fatigue, occasional cramping and a small saddle sore, he’s doing amazingly well – and getting ready to give George a bit of a rest by gearing up for a 100 mile pull!

The team competition started Tuesday. Team BeatCancer by www.coastalsportsmedicine.com seems to have found their cycling legs and have moved on up in the field according to the their last time station check.

Both riders are reported having problems adjusting their sleep schedules but may be on track after Rick Schulz took a 100 mile pull last night to give team mate George Vargas some well needed sleep and recovery.  Once both riders can get a little recovery, I believe we will continue to see Team BeatCancer move up through the field. Sleep and recovery off the bike will continue to become important factors for all racers as we get further into the race. Look for a shake-up in the team standings in the latter part of the races as competitors that went out too fast and didn’t plan for good recovery start to fall off their pace. Sometimes its better to be the tortoise than the hare.

Follow Team BeatCancer from their team blog