Diagnosed with a chronic disease at 12, an SDSU swimmer overcame the odds.

Jim McLain knew something wasn’t right.

He knew the pains he felt were a problem. He just didn’t know how devastating they were, or would become.

The pain rushed through his abdomen in waves. It began affecting his daily life, his hobbies, his mood, his ability to swim.

His constant optimism was challenged. He wanted to swim, play soccer or hang out at the pool with his friends, but he couldn’t.

He arrived at an SDSU swim camp at age 12, a camp advised by Brad Erickson – SDSU’s current and only swim coach in program history – when the problems first started. After that, Jim attended a soccer tournament where the issue worsened.

His mother noticed her son trying to hide what would become a major illness before approaching him about it. He confessed what he’d been dealing with, the cringing pain in his stomach, but was too afraid – even embarrassed – to seek help.

The growth expected of a normal sixth grader wasn’t happening. He looked languid when it reached the breaking point, when he went to the hospital.

Finally, Jim was diagnosed with ulcerative colitis, a rare disease infecting the large intestine.

Only 35 to 100 out of every 100,000 people are afflicted with the disease, which he describes simply as, “extremely painful.”

Some people experience a flare-up of the disease once and never again, while others, like Jim, have repeated episodes that require medical treatment.

Photos of the lining of a victim’s intestine show significant corrosion and what look like open wounds coating the colon creating nausea, diarrhea, sharp pain and blood in the stool.

Jim spent a week in the hospital, unsure what all the fuss was about and was positive he wanted to get back in the pool. He complained about missing a family reunion. He wanted to get back to swimming, a sport he took up when he was 7, in large part from the influence of his older sister, a natural at the sport who moved through swimming lessons faster than normal. “I remember sitting in the hospital,” he said, “and thinking ‘this will be nothing, I’ll be fine in a week.’ Then it set in that this is kind of a serious thing.”

He began taking several medications, along with changing his diet. People with UC can help mediate the disease with a diet rich in protein and complex carbohydrates to help control flare-ups. Foods like raw vegetables or high fiber content can induce symptoms, along with caffeine, spicy foods and even popcorn or peanuts. But nothing completely erases chances of a breakout – UC is a chronic disease.

Jim adapted well to the lifestyle change immediately following diagnosis, all the while swimming, and swimming, and swimming.

“He’s always looking at the bright side of things,” said his high school swimming coach, Paula Weeldreyer. “Even when things are really rough.”

Remission

The pain was gone, and for years. By all accounts, Jim went through school like a normal kid, playing soccer, swimming and getting good grades.

“I wasn’t really thinking of the illness at all,” he said, “because it wasn’t holding me back.”

And it didn’t. The day he got out of the hospital, he and his father drove to Rapid City for a team swim meet, even though he wasn’t scheduled to compete. He was climbing back to normal, getting taller and filling out his body that previously lagged behind.

Jim’s disease, tagged by experts as an auto-immune disorder in which the immune system attacks regular cells in the body, appeared dormant. The medication, an oral steroid to prevent inflammation in his digestive tract, worked well.

“Those kinds of things made me more aware of myself,” he said recalling how his eighth-grade mind made sense of the situation. “Things like what I needed to do to take care of myself, to do the things that I wanted to do.”

Like being a normal kid.

The pain comes back

Jim does not recall a specific moment when the pain re-arrived.

He played soccer, well enough to crack junior varsity his sophomore year of high school when the disease kick-started. An allergy to grass may have been a catalyst in jolting the auto-immune disease into activity.

Flares crept into daily life. During a biology test, Jim felt a surge of pain rush from his intestine and radiate through his entire body. He began feeling a need for constant awareness of his surroundings because of a constant unawareness of the next wave of pain.

“I know a lot of people with my disease just sit at home,” Jim said. “They seclude themselves because they have such bad abdominal pain … It’s hard for people to talk about.”

He was emotionally on edge. The medication began to work less effectively, and new medication didn’t alter symptoms. If things didn’t improve, surgery was the last option. That meant no swimming for a while, no soccer, no being himself. UC was robbing him of his strength. It was taking all of it, and not going away.

His immune system worked at hyper-speed, so powerfully that doctors wanted to begin chemotherapy treatments to dull his immune system and quit attacking his body.

The treatments brought back some vitality. A couple weeks after going through a treatment session, Jim swam at a meet in Brookings, racing extremely well. His future coach, Erickson, was there.

“I remember going up to Brad [Erickson] and going, ‘I think he’s going to be OK,’” said his mother, Kay. “[Brad] said, ‘Yeah, he’s pretty amazing.’”

But like several other moments during Jim’s sophomore year of high school, remnants of a recovery were overlooked by the steps back that followed them.

Surgery

The days closed in on Jim’s junior year of high school, and the threat of surgery appeared more and more imminent.

Chemotherapy treatment over the summer helped, but the procedures irreparably broke down his colon. The steroids had side effects of their own to deal with. He entered the Mayo Clinic in Rochester, Minn., in early October 2007, not leaving the hospital for two weeks and not seeing a classroom until mid-December.

The surgery, called an ileo-anal anastomois, was a complete removal of his entire colon. By this point, he couldn’t wait much longer.

“Let’s just do this,” Jim remembers speaking, as if acknowledging that surgery was the last step toward any return to normal, to swimming.

The procedure took 10 hours, severing Jim’s colon and manufacturing an ostomy, a makeshift stomach, to aid in digestion. Doctors said the deadened colon “looked like hamburger meat.”

Swimming again, at that moment, looked implausible. Jim had reached a low point, but a necessary one to regain his health. He now weighed 95 pounds.

“I was worried,” his mom said. “There was nothing to him.”

He stayed in the hospital for two more weeks. Siblings chatted with him on Facebook. They wore swim caps with Jim’s initials written on the back. His father made periodic and prolonged stays during recovery. He worried most about Kay, whose time away from work and away from home began stockpiling.

“She was there for the good, the bad and the ugly,” he said. “I worried she wasn’t getting any sleep.”

They worried about infection. Jim lost an entire portion of his large intestine, and had been susceptible to bacterial infections to that point. Pouchitis, an infection causing swelling in the ileal pouch, would be another regression, and at Jim’s peak moment of vulnerability.

Jim had one setback. Another surgery was planned while he was home to remove the temporary ostomy bag. He was eating when it happened.

His abdominal muscles, considered largely unaffected from the surgery, squeezed over his small intestine, removing any opening for food to pass through. Undigested food sat in his gut, unable to move anywhere.

“The pain was indescribable,” McLain said. “It was over the top.”

He went to the hospital in Pierre, then to Mayo Clinic for emergency surgery, emerging from the ordeal OK after suffering his most painful night waiting for the procedure the next day. A nurse approached Jim’s mother after the night was over. “You have the most incredible son,” she said

‘“With all he was going through, all he could do was say ‘thank you.”’

Months of homework waited for him after his procedures.

Jim’s grade point average that semester was 4.0.

“What I wanted to do,” Jim said, “was get back to swimming.”

Back in the pool

He had miles of swimming to make up. Three months removed from the greatest challenge of his life, he was back in the pool, barely topping 100 pounds. He had none of his previous endurance.

Jim couldn’t get from one end of the pool to the other without gasping for air. He wanted to swim his senior year of high school, even if it meant his final season swimming competitively.

“Can I do it? Could I physically do it?” he said, remembering his inner apprehension.

The process was slow during the spring semester of his junior year of high school. He swam a lap, rested for 10 minutes, then swam another.

The routine got longer. He swam 100 yards one day, then 200 the next, then 500, then 1000 to regain strength and stamina. Weeldreyer says the first practice he swam 200 yards, “his eyes lit up.”

He was motivated by his sister, who swam well her senior season and received an athletic scholarship from Boise State University. His own senior season was about to begin.

His times improved, eventually surpassing the finishing numbers of his sophomore season, before the wave of problems hit. But the defining moment of his recovery, as he puts it, happened that summer.

The “A-Ha” Moment

He was in Indianapolis, Ind., August 2008, just 10 months removed from surgery and seven months from entering the pool again. He was swimming in the Central Zone Meet, at the same facility Jim swam in the Summit League conference tournament this season.

Jim’s times from the summer qualified him for Team South Dakota, a contingent of around 70 of the best swimmers in the state. All the Midwest had state teams of their own represented, and Jim was slated in the 100 meter breaststroke – a field of 24 finalists.

“I remember thinking the day before that I’m going to have a lot of fun with it,” he said. “I hadn’t been back swimming for long, and it made me think ‘I’ve got nothing to lose, I’ve gone through so much to get here’.”

He didn’t torpedo the field to a first-place finish, but he placed 17th while setting a personal best by over a second, feeling minimal strain from the sheer adrenaline of the race. At that moment, Jim says he fully ascertained his capability of swimming in college.

He stayed in shape. His times drew the interest of Erickson, who Jim considers a family friend and made Jim’s decision to enroll at SDSU easy.

“He always believed in me and wanted to know me as an individual,” he said.

From that point, Jim was only one obstacle away from his position now.

A rough year

Kay was terrified of her son leaving for college, taking care of himself without her. She believed Jim’s toughness was a blessing and curse. That meant grinding through pain or sickness more than he would admit.

His first year typified that.

“He got so thin from working out,” said Erickson of Jim’s first season, “that he was shivering in the water.”

They discussed what they felt was best for him, a redshirt and a year away from competition.

Jim was in rough shape. On one occasion, he simultaneously dealt with the flu and pouchitis. His fever was 103 degrees.

That sent him to the emergency room, then back to the Mayo Clinic for further examination. The doctors suggested more chemotherapy, but his family was adamant about a different form of antibiotics.

He was given another prescription, but his doctor was doubtful it would help.

Within two days, he was replenished. The new medication did everything his previous prescriptions didn’t.

It was March when Jim began swimming again. The Jacks had finished their team season in late February, and virtually everyone began off-season workouts. He was practicing harder than ever, in an obvious hope to get back in shape and fulfill his swimming career.

“He said, ‘I’m annoying the hell out of them’,” Kay said. “‘But I just have to try and get back in shape.’”

The comeback

He spent the summer with no problems. It looked like, after a redshirted season and roadblocks during that year, he was poised for a quality season.

Jim won two races and helped SDSU’s 200 medley relay set a school record, among several the team would set during the year. Not only that, he made the 200 finals in the breaststroke at the Summit League conference meet.

“If you could have seen his face,” Erickson said. “It was just an ear-to-ear grin.”

Jim would designate five minutes to venting his anger while in the hospital and was now swimming finals in the Summit League championships in less than half that time.

His team backed him up, finishing third in the conference tournament, enough for Erickson to earn coach of the year honors.

“It definitely had an influence on our team,” said Erickson of Jim’s bounce-back season. The sophomores, juniors and seniors knew what he was going through, and I think it made the whole team appreciate and go, ‘Hey, if he can overcome that and do that well, I need to get myself going a little more.’”

Earlier this month, he attended his younger brother’s state tournament swim meet, spending two and a half days as a volunteer coach, getting swimmers into right lanes and voicing encouragement.

“A lot of younger kids look up to him,” Weeldreyer said. “He’s always giving advice.”

Jim and the rest of the SDSU swimming team are undergoing offseason workouts. For the first time since beginning college, he’s on the same track as his teammates in March, in quality condition, hopeful for continual good health after three tumultuous years.

“I remember him saying one time, ‘Nobody can take this away from me,’ Kay said. ‘I’m always going to be able to swim and no one can take this from me.’”

Contact Drue Aman at [email protected]