Triathlete Battles Arthritis--Wins

Those who know George Yates say the contrast was unbelievable.

Yates at 28 was tanned and taut, his body conditioned for world-class competition. In fact, he ranked ninth that season among long- and ultra-distance triathletes--those super athletes who can swim 2.4 miles, bicycle 112 miles and then run a marathon--26.2 miles--all in a matter of hours. Yates at 29 was gray and shrunken, bound to a wheelchair. His skinny legs looked like they had swallowed grapefruit that got stuck at the knees. An unexpected and acute attack of arthritis had transformed him.

“When I first laid eyes on him, inside I was saying this guy is not going to make it,” said his running coach Ruben Chappins, a fellow triathlete. “All of his muscles had atrophied. . . . He looked like a cancer victim. It looked so hopeless.”

But Chappins said he also saw something else when he looked at Yates. “I saw desire in his eyes. In an athlete’s eyes is where you can tell everything about him. I saw that in George. His eyes told me he was going to come back or he was going to die trying. . . .”

This Saturday, Yates--who started running again only last March--is going to compete in another grueling triathlon. To the pride and amazement of his doctors, Yates will enter the Ironman Hawaii Triathlon--the world championship of one of the toughest endurance contests ever created.

During the year and a half Yates pulled himself through a self-designed, accelerated program of therapy and training, he said he used the 1985 Ironman as his goal. “It’s the Wimbledon or Super Bowl of the sport,” Yates explained. “I only want to prepare for one race, the Ironman. I don’t care about any other race.”

His racing bike against the wall, he sat on the edge of the couch in his Corona del Mar bungalow, rubbing a sore hip. It was 10 o’clock in the morning and he had just returned from a 45-mile bike ride to Huntington Beach.

‘Close to Remission’

Now 30, he is “as close to remission as you can be,” said one of his doctors, John Curd of Scripps Research Clinic in La Jolla.

Yates is bronzed, lean and muscular. At 160 pounds, he has regained the 35 pounds he lost. His manner is relaxed, his words casual and slow; but his ice blue eyes are fired with a single purpose. Coming back.

Something snapped inside him, he said, when the first doctor who diagnosed his illness told him he would never compete again. “That instilled a spark in me to go and fight this thing. I can honestly tell you I have fought it to the maximum of my ability.”

As a professional athlete, training and competing dominated his life. Starting 15 years ago with motocross racing, he turned to cycling, competing in national and international events. From 1976 to 1982 he was a nationally ranked Category I Bicycle Racer and in 1982 set a course record for the bike segment in the Hawaii Ironman triathlon. He finished seventh in the 1982 Ironman; but the following year, he placed a disappointing 48th.

For nearly a year, Yates said, he had been discounting a growing stiffness in his back and pains in his knees as part of training and racing fatigue. Then on April 17, 1984, two days after a 70-mile bike race from Orange County to La Jolla, Yates awoke and found he could not move.

He stayed in bed for five days, gradually getting worse. “I’d go to sleep at night, wake up in the morning and my ankle had turned like somebody popped it out. The next day it was my right ankle. The next day, my right knee. Next day, left knee. Then it was my back. You couldn’t touch me; I would scream bloody murder. It was like somebody was sticking a knife in my back and not pulling it out.”

Eventually, he said, he collapsed after an hour’s effort to make it from the bedroom to the bathroom. Fifteen minutes after he regained consciousness, a friend happened by and called the paramedics who rushed him to Hoag Memorial Hospital in Newport Beach. There, after more than a week of testing, it was learned he, like 8% of the population, had a genetic predisposition to arthritis.

The word frightened him. “Whenever I heard it, I thought of a cripple; you can’t move, you’re old and you’re on your way out.”

In fact, many arthritis victims are young. With at least 100 forms, the chronic crippler affects 37 million Americans of all ages, including children. The disease is so devastating many people give up and think their lives are through, a spokesman for the Arthritis Foundation said.

Negative Message

A few days later, Yates recalled, a doctor came in his room and sat on the bed. “The doctor said, ‘Forget it. You’ll never compete.’ I said, ‘Wow, this guy is giving me a bad dose of pessimism.’ I want to at least hear something like, ‘Hey, George, maybe we can get you therapy.’ ” Instead, Yates said the message was: “Go home. Here are some pills and try to live your life.” The doctor, Yates said, offered “no hope at all. No hope. Period. He left.”

By this time, Yates said his muscles had atrophied. “When I looked at myself in the mirror, I was scared. I couldn’t believe what had happened to me. I mean, years of work to build up your body to perform at a certain level . . . and it’s all gone in 10 days. It’s all wiped out. My legs just shrunk to nothing.”

When the doctor returned, Yates recalled telling him: “I want to get out of here tomorrow morning. I don’t like what was said to me about no hope. I think there’s more for me than to throw in the towel at this point.”

He insisted on leaving, he said, and with his parents’ help, checked into Scripps Research Clinic in La Jolla. John Curd, the rheumatologist who treated him, said he diagnosed Yates as having seronegative spondyloarthropathy--a group name for several types of arthritis. The group includes Reiter’s syndrome and ankylosing spondylitis. “For all practical purposes, he has acute severe Reiter’s syndrome of unknown cause and unknown course,” Curd said.

Ankylosing spondylitis, also known as spinal arthritis, generally occurs in men between 20 and 40, as does Reiter’s syndrome, a form of infectious arthritis.

The causes of Reiter’s are varied, Curd said. Some believe Reiter’s syndrome to be a sexually transmitted disease, he said. Also evidence has shown food poisoning (salmonella) can cause Reiter’s syndrome in people who are already genetically predisposed, he said. In Yates’ case, Curd said he suspects Yates’ arthritis may have been caused by his tendency to drink nonpasturized milk which has produced salmonella in some patients.

While many people spontaneously recover from Reiter’s syndrome in less than a year, Curd said Yates had one of the worst cases he had ever seen.

“I have lots of people with his illness and they don’t go back to playing golf. He was down in the bottom.

“George was so sick, he couldn’t stand up,” said Curd, who removed a half pint of fluid from each of Yates’ knees. An intensive drug therapy produced only minor improvement. Then Curd tried a medication he declined to name, but which he said has been used with success in Belgium. He does not credit the drug with Yates’ improvement. But, after taking it, Yates “dramatically changed” and then started to improve slowly, he said.

According to Yates, Curd’s contribution to his recovery was crucial--mostly because he left the idea of his future open. “He asked me, ‘What do you want to be?’ I said, ‘I want to come back.’ He said, ‘That’s a tall order, but you can do it and I’ll help you in whatever ways you want to come back.’ That cemented the process of wanting to come back.”

Curd said he figured it would take Yates at least a year to return to competition. But he did not think he could continue his career as a triathlete. Indeed, Curd sent him to a psychologist to help him cope with depression, withdrawal and anger which he thought would accompany the end of his career. But according to Curd, Yates told the psychologist: “I’m fine. I think I have a good chance to get better. If not, I’ll find something else to do and thank you very much.”

Positive Attitude

Recalled Curd: “George believed he would get better from the day he hit the hospital. His attitude was such that he would not be denied. His attitude was, ‘If I can, I will.”’

Curd was impressed with Yates’ “hard as nails” determination. He once considered injecting Yates’ knees with a drug that would ease the pain but soften the cartilage, but Curd said he decided against it. “He was going to use them to run, to bicycle and to swim.”

“I’m not in a position to tell him what he can and can’t do,” said Curd. “He’s doing more than what I think is possible.”

In June, Yates left the clinic and started swimming on his own at the YMCA.

In July, three months after his attack, Yates, though still sickly, started a gradually accelerated program of physical therapy with Dr. Kenneth Forsythe, a sports medicine specialist in Santa Monica. Forsythe had trained insulin diabetic Bill Carlson, who finished the Ironman in 1983.

Unlike heart attack victims, it is uncertain what the benefits of exercise are for arthritics, Forsythe said. There’s a risk that overexertion could precipitate a new flare-up of the disease. “The traditional medical approach is to do nothing. That’s of course unacceptable to an athlete. My approach is, well, let’s push as far as we reasonably can and keep close tabs on everything and see what happens.”

Yates worked out three days a week, three hours each day. The workouts focused on computer-controlled weight resistance to rebuild his muscles as well as swimming and cycling to improve his cardiopulmonary system. By August he could walk unassisted. By October, he said, he started to feel he would recover.

After about six months, jogging was added to the workouts. Yates was anxious, recalled Forsythe. “He remembered all too well what it was like to be incapacitated. He expressed the fear openly to me. It was a good sign that he showed a realistic approach, not just cavalierly saying, ‘Now I’m going to start running.’ ” Realistic athletes are typically more successful, he added.

“I realized a long time ago when all this first happened, I would be facing a big obstacle,” Yates said. “I knew I was written off; I knew what people thought about me.” Some sponsors dropped him. A girlfriend thought he was faking the illness for attention. And his parents, while concerned, have never understood his devotion to sports, he said.

Worked Alone

Basically, he said he pushed through his rehabilitation workouts alone. “In most cases like this, you have to keep (your goals) to yourself or be laughed at and ridiculed. . . . I drew upon what’s inside of me mostly. It’s hard to tell people what you’re going to do when it’s way out. I’m basically doing an extreme to make a statement about something.”

In addition to proving to himself he could come back, Yates said he was driven by the thought of serving as an example to others among the nation’s millions of arthritics who may feel there is no hope in their lives.

By March he was running again, though his knees were still swollen and had to be packed in ice to reduce the pain. Since then, he has trained “like a machine” for the Ironman, incrementally increasing his mileage and bettering his times. Yates said an average week now involves 50 miles of running, 350 miles cycling and 16,000 yards pool and ocean swimming.

In May, he ran in the Los Angeles Triathlon Championship Series (a minitriathlon with a .6 mile swim, a 25-mile bike ride and a five-mile run) in Pomona and placed 48th in a field of 500.

Yates is typically optimistic about his chances in this Saturday’s triathlon. “It could be my best one I’ve ever done.”

His doctors, however, worry. Said Curd: “The concern I have is that he had a dramatic illness and he was very sick. You wonder, given that, can he compete at such a high level? His answer is yes. As a doctor, I wonder whether he should be doing that.” But then, he added: “I’m not going to tell him how to live his life.”

After the race, Yates said he’ll continue to compete but will no longer dedicate his life to racing triathlons.

He plans to continue his small business selling cycling products through bike shops. He also hopes to become a spokesman for the Arthritis Foundation. He has already helped the Coachella Valley branch of the Arthritis Foundation set up a biathlon fund-raiser and has also spoken before groups. “He is so inspirational,” said executive director Bebe Green. “He runs on the theory that it’s not so much what happens to you in life, but what you do with it.”

“What the public at large can learn from George’s story is what George did with opportunity,” said Curd. “It’s not what Scripps Clinic did for his arthritis, or whether this medication or what exercise. But opportunity comes by to each one of us every day. And none of us capitalizes on all the opportunity we have. George is the kind of guy, if he had one, 10 or 50 chances of getting better, he was going to take every bit to see it he would make it.”

How he places or even whether he finishes Saturday doesn’t matter, said Curd. “It’s just what he’s done. “