Every year like clockwork, Fritz Spence would get sick around New Year's. In December 2007, Spence and his wife Teri believed this time was no different.
But his cough had still not gone away by February, and Spence started waking up four to five times a night to change his sweat-drenched shirts.
Fed up with his inability to get a decent night's sleep, he went to the doctor, where he was diagnosed with nothing more than the common cold and given a Z-pack.
That same week, in his second year as the jumps and multi-events coach for Penn State's track and field program, Spence returned home from dinner with a recruit. Exhausted, he fell asleep on the couch, something his wife said almost never happened.
"When I went over to touch him on the couch, I realized his shirt was soaked through, and it felt as though he had a fever," Teri said. "I wanted him to go back to the doctor one more time just to be sure everything was all right."
After a second trip to the doctor that Monday, Spence's doctor received the tests the next day. The doctor saw his patient's white blood cell count was through the roof. He told Spence to go to Hershey Medical Center as soon as possible for further testing.
Spence and his wife drove to Hershey late that night and weren't seen until 7 a.m. the next morning. Teri said they didn't rush to be admitted, partly because both were unaware of the severity of what could possibly be wrong.
Diagnosis
The morning of Feb. 27, 2008, now lives on in Fritz Spence's memory as the day he was diagnosed with acute myelogenous leukemia.
"I first thought, 'Why me?' " Spence said. "Yet, then I kept telling myself, 'Everything happens for a reason, and this will make me better and stronger.'
"It then became a question of, 'How am I going to beat this?' "
Spence's body had begun to grow leukemic cells quickly, crowding out red blood cells, white blood cells and platelets.
What made the then-35-year-old Spence's case so interesting is that cancer does not run in his family, and his type of leukemia occurs mostly in young children or older adults.
"After getting the bad news, the doctor told us that if we would have not come in, Fritz didn't have more than a few weeks to live," Teri said.
"It was so surreal hearing it. It was like I wasn't even present."
Even though he realized the severity of the situation, Spence remained upbeat, realizing he had to focus on getting better.
"I put a lot of energy into overcoming it and doing whatever it takes," Spence said. "As much as it hurt, I tried to block it out."
One of the first players to find out about Spence's situation was Lena Bettis, then a senior long jumper.
She had the task of calling other jumpers on the team and letting them know of Spence's condition.
"We had to not be selfish," Bettis said. "We had to look beyond not having a coach and beyond athletics."
"At first, it was hard to believe," said Jay Pagana, a former jumper and now first-year medical student at Penn State's Hershey Medical Center. "And then it wasn't a reality until he wasn't there."
Many of the other athletes not specifically coached by Spence found out the next day when head coach Beth Alford-Sullivan held a team meeting.
"Many people left crying," Bettis said. "It was such a surreal moment for so many people."
Associate head coach Chris Johnson, who is one of Spence's closest friends, thought Spence may have pneumonia at worst. Johnson came down with a cold the same time as Spence, but doctors just diagnosed him with the flu.
"It is scary because you never think it would happen to someone that you know," Johnson said. "You do all of the right things, and for that still to happen, it makes you look at life a little differently."
Johnson knew that if nothing else, Spence would keep fighting until he got better.
"You just had a feeling that if anyone could get through it, it would be Fritz," Johnson said.
Treatment
After being admitted to the medical center, Spence immediately began a round of chemotherapy that lasted seven days.
"Those first 24 hours, we were in shock. We thought they had made a mistake," Teri said. "However, he still embraced the whole thing and kept going to get back to work and doing what he loved."
Two days after Spence was admitted to the hospital, the track and field program participated in the Big Ten Indoor Championships at Illinois. And even though he may not have been there, Spence could not be forgotten.
Before the weekend's events began, the complex held a moment of silence in honor of Spence and some people affiliated with the Iowa Hawkeyes who had also been diagnosed with cancer.
When Spence finished the weeklong treatment, test results came back showing the first round of treatment had not worked, something doctors said was unusual.
Stressing speed as a key to keeping Spence alive, the medical center began a second round of treatment a few days later to stop growth of the specific leukemic cells.
After treatment ceased, the Spence's heard encouraging news -- the second treatment had stopped the spread of the cells.
"Through all the tests and procedures, I never heard him complain," Teri said. "For many of the treatments, they even had to drill into his hip bone."
During Spence's two rounds of chemotherapy, staying in such a confined hospital space became unbearable. Whenever the coach had the strength, he'd walk around the ward for a few minutes or write workouts to send to the players.
Pagana specifically remembered a time when Spence sent him a text message before a meet.
"I always had a problem fouling, and this one meet I get a text message from Coach Spence saying, 'Relax, don't foul today, dude,' " Pagana said. "We all laughed about it."
Many times, though, the recovering coach didn't have the energy to write an e-mail or text a player because of the strain the treatment was taking on him mentally and physically, Spence said.
Weighing around 190 pounds before treatment, Spence dropped to between 150 and 160 pounds during and after chemotherapy.
Spence also felt the affects of chemotherapy through his heightened sense of smell.
"The smells around me became so intense that paper towels had to be removed from my room because of the chemicals I could smell coming from them," Spence said. "They also had to let my food cool off in the hall before I ate it because the smell was too strong to me otherwise."
To this day, Spence still cannot eat broccoli or mashed potatoes because they remind him of that time.
That type of food became even harder for Spence to eat the longer he stayed in the hospital. He began to have severe nausea and ulcers in his mouth that made it harder for him to eat food.
But the battle for his long-term survival had only begun. For people suffering from AML, the best chance for long-term remission rests in having a bone marrow transplant.
Hoping for a match of proteins in the blood, Spence looked to his family, the majority of which still live in his home country of the Bahamas.
If Spence didn't get a match from his family, his next option would be to look on a bone marrow donor list, where only 3 percent of the people at that time were black. With those circumstances, a match was nearly impossible.
The most difficult part of finding out if his family could be a donor rested on the ability to get the blood from the Bahamas to Hershey in a specific amount of time. A doctor who could draw and ship the blood properly would have to be located.
"From the time the blood was drawn to the time it was tested, only 18 hours could pass," Teri said. "We had a huge concern about getting the blood through customs over the heightened restrictions on fluids post-9/11."
But the samples made it safely. Spence and family were ready to brace themselves for the worst if a match could not be found within his family.
"When we began talking about the tests results, they told us that something had gone wrong with the tests, which became very deflating," Teri said. "Then, all of a sudden, as we left, the transplant coordinator came running after us and said they had found two matches."
Spence's sister Karen and brother Wayde both turned out to be bone marrow matches. In the end, because he was two years younger than Spence and the same sex, doctors decided Wayde would be the better match.
After hearing the good news, Spence decided to make a visit to the Bucknell Team Challenge, where Penn State was competing April 19.
While Spence had a mask over his face the entire time and applied hand sanitizer liberally, players and coaches said he wore a wide-eyed grin the entire meet.
"It became our most important meet of the year. It was just great for him to be there and hear his voice," Bettis said.
While Spence may have lost a large amount of weight, players said he still acted like the old Fritz.
Many players and coaches went to visit him in groups while he stayed in the hospital, but for some players, it was the first time they got a glimpse of the coach they had not seen in more than a month.
After Spence visited the team and went back to Hershey, the transplant continued to be put on hold because of damage to his liver and a possibly cancerous growth on his thyroid.
Spence shuttled back and forth between Hershey Medical Center and the Hope Lodge, a facility he stayed at while recovering. After an operation to remove the tumor on his thyroid and with his liver healthy again, doctors performed the transplant on July 29, 2008, more than five months since his original diagnosis.
"We all missed his personality, jokes and his laugh and were eager for him to come back as soon as he was able," Bettis said.
Recovery
After the transplant, Spence fell into a state of total exhaustion.
But as the days passed, he got stronger and stronger.
"Even to this day, he has given me the fight if anything like that should ever happen to me," Teri said. "I could never have imagined being so optimistic then about everything that was happening."
While doctors said it would be about 100 days before Spence left, his response to the transplant went so well that around Day 50, his doctor gave Spence news he had been waiting months to hear.
He could finally go home and sleep in his own bed.
Spence did come home a few times before his transplant, but this time he knew it was for good, and that meant all the difference.
Through it all, Teri created a scrapbook from all of the cards and e-mails the family received over the months of his diagnosis, treatment and recovery.
"The most exciting thing for me after I got home was just being able to take a shower without any tubes, cords or stickers on my body so I could actually move," Spence said. "I still love it to this day."
But Teri had mixed feelings about Spence living at home and going back to practice.
"I was so nervous and became obsessive about germs," Teri said.
"I knew it all was so liberating for him, yet I remained terrified and acted almost like a mother hen."
After coming home in September, Spence waited until late fall to get back to the track. But when he did, it was with a new mindset.
"I have really tried to show them how the decisions they have to make are not as serious," Spence said. "I am trying to guide them so they can see things from a different perspective."
Coming back so soon after recovering from such a debilitating disease has been an inspiration to the players he coaches. Bettis, who still trains with Spence, had food poisoning in January, but that didn't stop her from practicing.
Knowing what it was like not to have a shred of energy, Spence stressed that Bettis should stay strong and take advantage of being healthy even in a weakened state.
"It is really hard to feel sick when your coach had cancer," Bettis said. "It will always be my motivation in giving it all I have."
Teri became worried with Spence's energy level when he returned to the track and with the possibility that he might overexert himself.
In Spence's first week back at practice, he was advised to stand in the background and observe, but before the week ended, he took his place back on the track, talking, demonstrating and cracking jokes.
He once again became the coach that won the 2008 Mid-Atlantic Region Indoor Assistant Coach of the Year and Outdoor Assistant Coach of the Year awards.
But Teri had Alford-Sullivan in her corner, who made it a special priority to check up on Spence those first few months during practice.
"I gradually worked my way up and sometimes did press," Spence said. "Because of it, I would fatigue quickly and the muscles in my body would ache all of the time."
Spence said the biggest difference he noticed was in what his body allowed him to do and how active he could be. He could not stand as long or demonstrate, but Spence had no limitations from a coaching standpoint.
He said it wasn't until this past fall that he felt he could really get into coaching and do everything he once did.
However, Spence's eating habits changed drastically early in his recovery. Players said he could often be seen eating McDonald's or Burger King before practice.
After his transplant, Spence's wife said he started having a sweet tooth, something he never had before treatment. She had been told that patients often pick up characteristics of donors, and in this case, Spence began to love sweets just like his brother Wayde did.
Food aside, he is back to the Fritz everyone knows.
"I look back on certain days that were bad and instead I now look at the big picture and tell myself and even my players to really appreciate life and being healthy," Spence said.
With this newfound perspective, Spence and his wife have also begun to understand just how lucky they were to be covered by insurance during the entire process and how often many people are not as lucky.
Because of that, Teri recently created a non-profit organization to help with what she calls a "prescription alliance."
In conjunction with the Hope Lodge, Teri hopes to partner with local pharmacies to give gift cards for co-pays to patients in need.
As a precaution, Spence still takes bactrim, a pill to prevent bacterial infections and more severe illnesses such as pneumonia. He also continues to take anti-rejection medication daily, gets his blood drawn often and gets immunizations every three months, a process his wife said will probably continue for the rest of his life.
Teri admits to getting nervous any time Spence gets sick, feels fatigued or has night sweats, making her paranoid that the disease has come back. Yet almost two years after being diagnosed, Spence has no leukemic cells in his body.
"I always tell all of the athletes to appreciate life because it is short," Spence said. "You never know what tomorrow brings."
