On Thursday, 60,000 runners will test their lung capacity when they run The Atlanta Journal-Constitution Peachtree Road Race.
Michael Keim, 29, will be one of them, participating in the race for the first time. But he will run with lungs and bone marrow that originated in someone else's body.
Thursday's event is a race of individuals, but for him it's a celebration of the team that got him this far, who were always at his side in a journey when he faced and turned back death several times and defeated the almost zero odds of finding a matching pair of lungs.
"This is my first opportunity back home to fulfill my wish," said Keim, who lives in Powder Springs. "To be in it and finish it."
Struggles from the start
Keim was the equivalent of a Bubble Boy.
After many instances of sore throats, colds and other ailments, he was diagnosed with severe combined immunodeficiency when he was 4 years old, very late for a child to ensure a good outcome. His mother, Helen Vanegas, said he wasn’t born with it and there is no family history.
To help him lead a life free of the bubble he received a medicine, IVIG, once a month.
Still, he and his family had to be on constant alert for the slightest signs of illness. Small things that are annoyances to the healthy had to be treated very seriously. Colds would turn into bronchitis.
The combination of medicine and vigilance helped.
Keim played baseball and soccer growing up in Vidalia. He did chores. Helen said if Michael wanted something, he had to earn it.
“My parents never treated me differently,” he said. “They always held me to the same standards as my brother and sisters.”
But there’s only so much anyone can do.
Despite everyone’s best efforts, by the age of 26 his lungs were so scarred that they were functioning at 33 percent.
He was told to choose between a lung transplant or the dreaded, “we can make you as comfortable as you want.”
“I didn’t hesitate,” he said. “Lung transplant.”
Slim odds for success
Before Keim, just one double-lung, bone-marrow transplant from one donor had been successfully performed.
The challenges were immense. The first was finding a donor. The second was finding a donor with healthy lungs. The third was finding a donor with lungs of a size comparable with Keim’s. Finally, the donor and Keim had to have comparable bone marrow, which was needed to help Keim develop healthy stem cells and decrease the chances that his body would reject the lungs.
Keim said the chance of success was 3 percent.
But Keim had some things in his favor. First, his primary doctor, Dr. Robyn Levy, recommended he go to Duke University to be evaluated. Second, Dr. Rebecca H. Burkley, his immunologist, studied under Dr. David Zaas, who performed the first single-donor double-lung, bone-marrow transplant.
Burkley sent Keim’s charts to Zaas, in Durham, N.C., to see if Keim had the potential to be the second recipient.
In January 2011, three months after his first interview, he was told he was a perfect candidate.
But the doctors wouldn’t put him on the waiting list because he needed to gain weight.
“They said you are too weak, you won’t survive,” he said.
By July, he was down to 80 pounds and running out of hope. After living in Durham for the previous six months to be near the hospital, he wanted to return to Atlanta to watch his siblings run in the Peachtree Road Race. Helen, who quit her job to move to Durham to take care of her son, loaded their car with oxygen tanks for the six-hour drive.
At the race, Robert, Jessica and Angie wore blue shirts with “Fight like Mike” written in gray letters.
Michael sat in his wheelchair near the bottom of the Cardiac Hill, waiting on his siblings. Participants who didn't know him would point and say, "We're running for you," giving him high-fives as they began the last ascent in the 6.2-mile race.
Keim would smile and answer, "You keep on going."
Needed strength gained
By August he was down to 76 pounds, 14 pounds less than the minimum the doctors wanted. They decided to put him into a coma because the carbon-dioxide levels in his blood were too high.
The euphoria of the promise of a new life, given less than a year earlier, had ebbed away.
“I was low,” he said.
The doctors told him he likely would never leave the hospital.
He was told to prepare his goodbyes, but Helen wasn’t ready to accept the doctor’s suggestion.
“We told them it wasn’t going to be that way because God put him there,” Helen said.
Keim was in a coma for 10 days, during which time, even with his scarred lungs, his carbon dioxide levels began to improve.
As soon as he woke, the doctors told him to begin walking around the hospital wing to regain his strength. One lap on the first day turned into 28, the equivalent of 1 1/2 miles, before he returned to the house in Durham a month later. He began to get stronger. He began to add weight.
In September, Keim got another piece of good news: He was being put on the transplant list.
“My mom said it was because of God,” he said.
Healing and gratitude
The call came at 2 a.m. April 17, 2012.
"Are you ready for some lungs?" Keim recalls being asked.
Three months later, Keim walked in his first 5K in Durham. He was the last person to finish. It took him 45 minutes. He didn't care.
“Just to be able to do it … not having to switch out (an oxygen) tank, I was like, ‘what’s next?’” he said.
Keim knew what was next.
It was time to repay the village that made all of this possible.
Keim, who now weighs 110 pounds, was offered long-term disability, but he refused. He returned to Cobb County EMS because he wants to pay off his house in Powder Springs. He wants to give it to Helen and his dad, Ruben, so that they can one day sell it should Keim’s body does eventually reject the lungs or bone marrow, which could still happen.
He also wants to repay all the acts of kindness done by co-workers and others in Cobb County, who contributed portions of their annual leave or organized Chick-fil-A nights or sold Tupperware to help the Keims with medical costs, which started at $35,000 and surpassed $1 million.
Insurance paid for part of the costs. The family is still paying for the rest, a total that Keim said he couldn’t even estimate.
“I’m now in far much better shape, and I can’t wait to pay it forward one day — when someone is sending out an email asking for donated annual hours,” Keim said.
Every day’s a celebration
On April 17 of this year, the anniversary of his transplant, Keim and his mother hiked up Stone Mountain. It took him 38 minutes.
Helen took a picture of Michael standing on top, his arms raised in the air in triumph. They stayed for an hour. They thought about all of the people that helped them. They have given copies of the photo to many of those people.
Of course, there is one person that Keim will never be able to meet, though they now share lungs and marrow.
“I wanted to do something to remember my donor,” he said. “I can’t do Everest, but I can do Stone Mountain.”
Keim reached out to the family of the donor in hopes of meeting them.
Every holiday after his surgery, Keim added to a letter that he was writing to the donor's family. He took snippets from each and combined them into single-page, hand-written note that he gave to the hospital to give to the family after his one-year anniversary. He said the contents are private, but he promised the family that he would do everything he can to take care of the lungs. He has no idea if they received it or if they will ever make contact.
“They are the reason I am here,” he said. “Every holiday, every day I get to celebrate.”
Keim is doing everything he can. He exercises every day. He strictly takes his 23 pills over five sessions every day.
He tries to enjoy life. He loves to read. He loves Georgia football. He loves the Braves. He loves to run. He loves to spend time with his family, doing simple things such as playing the board game Battleship with his sister, Jessica.
That's why he looks forward to returning to the Peachtree Road Race, where all five family members will be running. He will be the guy giving the high-fives instead of receiving them.
When Keim says "We," it is so much more than just his family. He is running for everyone who has helped him.
“We started out as a team, and we are going to finish it,” he said.
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