Tackling Lupus

Until the spring of 2003, Phil Zerante was an ordinary high school kid. He lived in suburban Illinois with his parents and his siblings. He watched Chicago White Sox and Bears games with his dad. He’d been playing football since he was 8 years old, and he was a member of the Lake Park High School team.

Zerante, then 16, occasionally experienced flulike symptoms and muscle fatigue, but he always chalked it up to an extra-tough practice or some kind of bug. After a family vacation in Mexico in March 2003, though, things got worse – much worse.

“My joints swelled and were really painful, and it was hard for me to get out of bed,” Zerante recalls. He developed a severe rash under his eyes, lost his appetite, and in just a few months he dropped about 40 pounds. Baffled and worried, Zerante’s family sought medical advice.

Marisa Klein-Gitelman, MD, a pediatric rheumatologist at Children’s Memorial Hospital in Chicago, diagnosed Zerante with the most severe type of lupus nephritis – Class IV. His body’s immune system was attacking its own tissue and organs.

Zerante began taking steroids by mouth daily and intravenously once a week, and he underwent a seven-hour chemotherapy treatment each month with the immunosuppressive drug cyclophosphamide. It was the beginning of a long struggle to restore his health.

Playing Offense

Zerante made up his mind that, in just a few months’ time – the beginning of his junior year – he was going to play football again. Despite feeling ill from both lupus and chemo, he worked out regularly and tried to regain the weight he’d lost. In Zerante’s mind, he wasn’t a kid with lupus; he was a kid trying to make first string.

Rather than focus on his illness, Zerante was determined to focus on his health and athleticism – no matter what. “The way I looked at it was, ‘I’ll start training lightly again and eating right. That will help my overall wellness as well as help me prepare to play ball,'” Zerante says. “In my eyes, if I felt OK, then I was healthy.”

That approach wasn’t quite what his doctor prescribed. Klein-Gitelman knew that training might put Zerante’s body under additional strain and that playing football might risk his health. “Steroids can make bones thinner, and football is one of the sports where you can easily break bones,” she explains.

All the same, she was unwilling to tell Zerante he couldn’t play. She knew that his dedication to football was motivating him to stay healthy – physically and emotionally. “I never said I agreed with his decision. But if his identity was playing football and I took that away from him, what would he have?” Klein-Gitelman asks.

Before the 6-foot Zerante went to Mexico that March, he weighed about 190 pounds. When football practice started in August, he was under 150. “I tried to play,” he recalls. “I’d get treatment, then go back to practice. But sometimes I was just too sick to play.”

Unfortunately, Klein-Gitelman’s worries were realized during the first game of the season: Zerante dislocated his ankle and broke his fibula. The trauma caused a flare-up of the lupus, which was exacerbated by skipping a chemo treatment to have surgery on his leg. He didn’t play football again during his junior year.

Comeback Kid

Zerante watched his teammates wrap up a winning season, and their success spurred him on. He was still on crutches when he started working out at the Life Time Fitness in Bloomingdale, Ill., in October 2003.

He split his ambitious exercise regimen into twice-a-day sessions. He persevered through a series of surgeries and endured two cases of shingles so bad they landed him in the isolation ward of the hospital. He tolerated nausea and skin ulcers from chemotherapy. He’d gain 10 pounds only to lose it after a chemo treatment.

Meanwhile, he worked with three trainers: After the first one moved away six months into the training, Zerante met two others with different specialties – one had been a boxer, one had played college football – and he trained with them both through his junior year and the following summer. Zerante cut sweets from his diet, ate plenty of lean meats and drank nothing but water (pop and juice had too much sugar, and because of the chemo, milk made him nauseated). Pound by pound, he put back on the weight he’d lost.

A football fan to the core, Zerante not only loved to play, but he also enjoyed watching the sport. In February 2004, on the recommendation of his favorite nurse, his wish to attend the NFL Pro Bowl in Hawaii was granted by the Make-A-Wish Foundation. He met some of the best players in the league, including Brian Urlacher of the Chicago Bears and Ray Lewis of the Baltimore Ravens.

When football practice started in August, Zerante was one of the fastest players on the team. And he was first in the endurance workouts.

But after just one week, he seriously injured his shoulder during a practice – and kept right on playing. He knew it was bad, but he wouldn’t let the trainers look at it for fear they’d sideline him.

Looking back, Zerante isn’t sure he’d do things the same way again. “If I had known then about the pain, injuries and rehab that were in my future because I played with that injury, I would have definitely thought differently about returning to the field right away,” he says. “I learned a lot about my will to persevere, but I paid a price for it.”

In the second game of the season, Zerante scored his first touchdown. In the fourth game, which he played only four days after a chemotherapy session, he set a school record for single-game rushing (256 yards) and scored three touchdowns. Zerante won several awards, including an all-state honorable mention.

Raising His Game

On the strength of his performance, Zerante was courted by many NCAA Division I-AA and Division II schools. He chose North Central College, a Division III school in Naperville, Ill., because he was assured he’d always have a place on the team no matter what happened with the lupus. Though he was up to about 190 pounds by his freshman year in college, no longer needed chemo treatments and was down to taking low-dose alternate-day steroids, he decided to red-shirt the first season because of his injured shoulder. Two surgeries finally fixed it, and he hopes to be back on the field this fall.

Today, Zerante is also looking beyond the end zone. He’s considering getting a degree in exercise science or chiropractic care so he can help others improve their lives through fitness.

“I’m proud of what I’ve done,” he says. “It was a small taste of what my football career might have been if the disease hadn’t put that in jeopardy. I feel I still have some football left in my body, but more important, I want to finish school – I received straight A’s last semester. I also want to help athletes achieve their fitness goals, no matter what obstacles stand in their way.”

Success Summary

Meet: Phil Zerante, 19, student at North Central College.

Big achievement: Having a record-breaking high school football season while struggling with lupus.

Big inspiration: Phil was inspired by his love of football and his dream of playing for a college team.

What worked: Moderate exercise; being strict about his diet; focusing on personal goals; never letting the disease define him.

What didn’t: Overexerting himself to the point of injury and hospitalization.

Words of wisdom: “It isn’t easy to persevere; you need to fight.”

Resources

You can find information on lupus at the following Web sites:

The Lupus Foundation of America
www.lupus.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.niams.nih.gov/hi/topics/lupus/slehandout

National Kidney Foundation
www.kidney.org

Arthritis Foundation
www.arthritis.org