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State-and-regional
Living with cancer in the country: Many Wyoming residents must leave home to seek the care they need

Bob Overton is all too familiar with the 140-mile stretch of land between Thermopolis and Casper.

He and his wife, Sherry, made the two-hour trip in their white pickup dozens of times while Bob was undergoing treatment for lymphoma in 2015. Even with the help of Alan Jackson and Martina McBride’s music, the hours still lagged, with nothing to stare at except endless grassy plains.

“That trip is pretty monotonous, and it doesn’t get any better with time,” he recalled.

But the couple didn’t have a choice. Their hometown of Thermopolis, population 3,009, doesn’t offer the care Bob needed.

And the Overtons aren’t alone.

As the least populated state in the country, Wyoming appeals to those in search of space and wilderness. But the peace and quiet comes with drawbacks: Services that urban residents may take for granted, like advanced medical care, aren’t readily available for thousands of people living in small towns and rural areas.

Many of those battling cancer in Wyoming subsequently end up seeking treatment in Casper, according to Rocky Mountain Oncology’s Patient Navigator Sam Carrick. She said the center is the only medical facility in the state that offers radiation, chemotherapy and Positron emission tomography scans.

Other areas may offer one or two of those services, but many prefer the convenience of a one-stop shop, she said.

About 15 percent of their patients are from out-of-town, added Carrick, who is responsible for guiding all patients through the treatment process. She said it’s often devastating for people to learn that they can’t get the care they need at home.

“First you are hit over the head with a diagnosis that you didn’t want, and then you can’t get treatment at home, so you have to travel and be away from your family members or pets,” she said.

Some patients drive back-and-forth, but temporarily relocating often becomes necessary during the more intensive treatment phases.

And that was the case with Bob. The 75-year-old initially remained in Thermopolis, only traveling to Casper for intermittent doses of chemotherapy. But he said that wasn’t possible while he was undergoing radiation, which he needed daily for 30 days.

Sherry remembers breaking down into tears when she realized they had to leave home. Already faced with the possibly of losing her husband, not to mention mounting medical bills, the thought of relocating for a month was overwhelming.

“That was just more than I could handle … I just thought, ‘How are we going to do this?’” she said.

***

Carrick quickly reassured the Overtons that they wouldn’t be going through the process alone. The center commonly works alongside patients to help find them find and afford lodging.

“She said ‘It’s handled, don’t worry about it, it’s taken care of, we got you,’” recalled Sherry. “Unless you’ve been there, you can’t know what that meant.”

Carrick arranged for the Overtons to stay at Masterson Place, a small motel in Casper that exclusively caters to those traveling for medical purposes. Although the facility offers low prices, the patient navigator pointed out that even affordable rates can add up during extended stays, which is why she also connected the Overtons with the Wyoming Foundation for Cancer Care.

The nonprofit offers a variety of services for cancer patients, including financial assistance for travel expenses.

Bob, who has been in remission for more than two years, said he considers himself “blessed” to have received so much support from the community. But being away from home was still challenging.

The retired Burlington Northern Railroad employee said he especially missed his dogs, Jade and Buffy, who weren’t permitted to stay at the motel. The Overtons — who have lived in Thermopolis for decades — had neighbors who offered to watch the canines.

Everybody in Thermopolis tends to help each other out, according to the couple. It’s one of the the benefits of living in a little community where no one is a stranger.

“It’s just a real great place to live,” said Bob, explaining that he enjoys knowing all his neighbors and being surrounded by nature.

***

Battling cancer is difficult for anyone, but those living far away from treatment centers need extra help, said Wyoming Foundation for Cancer Care treasurer Kara Frizell. Finding the money for gas and hotel accommodations can quickly become a serious problem.

“It’s not something you can just come up with,” she explained.

Frizell said the Casper-based charity annually spends between $20,000 and $30,000 assisting patients with necessary travel expenses. The nonprofit also oversees a network of volunteers, called Angels, who help out-of-towners feel at home by delivering meals or dropping off gift baskets.

Sixty-five-year-old Velena Grayswan said she sometimes called the Angels for help last summer while she was receiving treatment for colon cancer in Casper.

The Rawlins resident explained that she stayed at the Masterson Place during the weekdays while undergoing radiation and chemotherapy and then traveled back to her home on the weekends to care for her two cats.

Without any family in the area, Grayswan said she relied on former co-workers for transport. Even with someone else driving, the 2.5-hour trip was tough, especially when they drove over rough terrain.

“It felt like my guts were falling out,” she said, explaining that treatments left her insides raw and sore.

She wouldn’t have been able to make the drive every day, but staying in Casper would have been too expensive without help from the Wyoming Foundation for Cancer Care, Grayswan said.

The former custodian was laid off a month before she was diagnosed with cancer in May. She has since been too sick to find a new job. Paying for gas and motels was out of the question.

“It takes every cent I have just to pay [my bills] here,” she said.

Grayswan, who is currently recovering from the flu in Rawlins, will eventually be returning to Casper for surgery. Despite having to travel for care, she still enjoys many aspects of country life.

She never liked all the rules and regulations that came with urban life like when she lived in Seattle. One of her neighbors in the city once got in trouble with a homeowners association for painting his house lavender. Grayswan she appreciates having more freedom.

“I like independence...I don’t like having somebody always telling me you can’t do this or you can’t do that,” she said.

***

Robert Rasmussen also lives in Rawlins, but he hasn’t had much of a chance to grow attached to the town. He moved from Tuscon, Arizona, in search of peace and quiet. But about a year after moving, he was diagnosed with stage four throat cancer last fall.

It quickly became apparent that traveling back and forth to Casper for treatment wasn’t a safe option.

Sitting in his bed in January at the Shepherd of the Valley Healthcare Community — where he’s recovering from surgery — the emaciated 50-year-old removed his oxygen mask and explained that intense radiation and chemotherapy treatments left him far too nauseous and exhausted to drive.

Rasmussen temporarily relocated to Casper in October and brought along his dog, Piggy. The Australian Shepherd is family, and he couldn’t bear to be without her.

“She’s the only thing that keeps me together,” he explained.

Although Rasmussen was worried hotels wouldn’t allow animals, Carrick arranged for both patient and pet to stay at the Sleep Inn in Evansville. The patient navigator also connected him with the cancer foundation to help with the bill.

The hotel staff has since fallen in love with Piggy, according to general manager Carmen Bartow. Employees walk her each day, sneak her treats from the breakfast buffet and even take her to visit her dad.

“She’s our mascot,” said Bartow.

The manager said the inn annually receives about 15 guests who are in town for cancer treatments, likely because of their close proximity to the oncology center. The hotel offers discounted rates for its sick visitors and employees try to help them out in any way possible.

“If we can’t help one another out then there is something wrong with us,” she said.

Rasmussen greatly appreciates everyone who made it possible for Piggy to stay in Casper.

His condition is serious, and distracting himself from the possibly of death isn’t easy, he explained. Surrounded by feeding tubes and beeping monitors, it’s impossible to forget his situation.

“I try to read or watch TV or just focus on something different, but when I’m just sitting here by myself, it’s hard,” he said.

But Rasmussen said he can manage with Piggy by his side for support.

Although his former home in Tuscon was closer to advanced medical care, Rassmussen said he prefers living in small towns because its safer and more peaceful.

“I don’t have any regrets [about moving],“ he said. “City life isn’t for everybody.”


Casper
After bullies beat him for being blind, a Casper man trained to be an MMA fighter

Jared George scrawled his name across the top of a printed form, his face so close to the page it was nearly touching. His step-father knelt at the other side and filled out the rest, which asked about various medical conditions.

Did he have high blood pressure? No.

Did he have diabetes? No.

Had he ever suffered a concussion? Luckily, despite all the fighting, no.

But the form never inquired about the condition that’s shaped his entire life, the condition that made him a fighter.

A few minutes later, George stripped to gray boxers and stood on a scale for the weigh-in inside the Industrial Building at the Natrona County Fairgrounds. Outside of competition, he often flashes the same smile that got him out of trouble at school. Now he stood nearly expressionless, his hands on his hips, his hair shaved close to the scalp, as the officials watched him.

He had been training for the following night’s mixed martial arts bouts for his whole life. This was his official debut, the beginning of the 20-year-old’s plans for a career in the sport, and he was nervous.

His weight cleared. He was officially slated for the following night’s Infamous MMA 1 fight in the light heavyweight division. He sized up his opponent for the next night as they faced each other for a photo.

But the view a few feet off was a blur. He could tell his opponent was larger. He couldn’t see details like the definition of the man’s muscles, but could tell they were large. The shape of his opponent’s torso hinted he might rely more on strength and quick bursts of energy rather than longer endurance, George guessed.

For George, these details are crucial. Because he’s legally blind, he’s even more reliant on strategy than fighters who can see every detail during a bout. But George doesn’t view his blindness as an impediment — it’s what brought him to the sport in the first place.

When he was bullied as a kid for being blind and overweight, he learned to fight. When he was told he couldn’t play school sports because he’s blind, he started learning MMA.

“It’s going to be my livelihood,” George said. “It’s my dream. It’s been something that I’ve wanted for a long time.”

Fighting from the start

George has always been a fighter, his mom, Kelly Cunningham, said.

She was 19 when he was born six weeks early. Doctors told her they didn’t know how he’d survived because there was no amniotic fluid in her womb. He needed kidney surgery at age 1. By age 7, he was blind from keratoconus, a disease that changes the shape of the corneas.

While legally blind, his world isn’t total darkness. He sees the world as if through a magnifying glass that’s being held too far away — the center of his sight is blurry but becomes clearer at the periphery. The other kids in his grade school knew this.

He had to duck or change course when he saw older students in the small northern California town of Burney where he grew up. They shoved him, hit him and threw rocks at him on the playground. They bullied him because he was overweight and blind, but always made sure the adults didn’t catch them.

So George learned to fight. It came naturally and eventually started getting him into trouble.

One day in the third grade, three older students surrounded him on the playground and started hitting him. This time, he was ready.

George punched back, fending off two of them. He grabbed the arm of the third kid and snapped it backwards, breaking the bone.

George was suspended from school. He and the other student eventually apologized to one another and became friends. His confidence grew, though he continued to be the victim of bullying.

“The kids there wouldn’t back off, even if I beat them up,” he said.

He enjoyed fighting and tried to channel that interest through organized sports. At age 12, he started MMA training. He knew by then he wanted to be a professional fighter.

People laughed at him, or worse, shrugged off his aspirations. They didn’t think it was realistic, especially for a blind boy.

Their doubt steeled George.

“I’m a little hard headed, so I guess I wanted to prove them wrong,” he said.

He probably would have found himself in worse trouble as he grew up, he said, but then his mom moved the family to Wyoming in 2011. She wanted a better life for her two kids. There were no extracurricular activities at their school, which was underfunded, and sports programs were few and far between, she said. She was worried about George getting in trouble.

So she packed the car and headed to Casper, where her boyfriend, Keith Jensen, lived.

George, who was in seventh grade at the time, hated the move. So much so that when the family paused at a rest stop in Rawlins, Cunningham made George hand over his coat and shoes because she thought he might run and try to hitchhike back.

His first day at school, he sat near the front of the bus to avoid other students. He was afraid they were going to pick on him, just like the kids in California.

“Hey, red hat!” he heard from the back of the bus. He assumed it was someone picking a fight. But it was Caleb Enders, who invited the new kid to sit by him. He thought he looked lonely.

Now, seven years later, they call each other brothers.

Beating the odds

Enders is the one George wants in his corner. George makes adjustments mid-fight on his own, so he doesn’t need a lot of advice. But Enders acts as his eyes, pointing out things George can’t see.

For the most part, George has adapted to his lack of vision. He doesn’t use visual aids or other services, and while he was growing up, his mom was called to the school several times to show documentation that he’s blind. Instead, he relied on his ability to listen and pay attention.

His mom never told him he couldn’t skateboard or play sports. He couldn’t pass the visual exam to play sports in high school, though he eventually was allowed to wrestle.

“I’ve been a single mom pretty much all his life raising him,” she said. ”So when they told me he was blind, I don’t know if it was my lack of ability to deal with it really, but we never treat him like he’s blind.”

In 2016, a surgery helped improve his vision. He still can’t see the top of the eye chart, but his vision in that eye greatly improved, he said.

Now, Enders helps drive him around town and to the odd jobs the pair work together. His best friend is also his training partner. The sessions are usually impromptu wrestling matches when they’re hanging out.

Despite her son’s independence, Cunningham still wants to jump in the ring sometimes, especially when he was fouled in a recent boxing fight. (George took a break from fighting for several months and started training in boxing last fall to prepare for his return to MMA.) The fight’s promoter had to tell her to sit down three different times, she said.

She still worries about him every time he gets in the ring, whether it’s boxing or MMA.

“But I believe in his ability,” she said “Fighting is what puts his soul afire, and I can’t extinguish that dream.”

Getting ready

Two nights before the Infamous MMA fight, George heated a steak in the microwave for dinner.

He added a few dashes of pepper and topped the meat with avocado. Just looking at the hot sauce in the kitchen was torture, he said. He still had to drop 5 more pounds in the next 24 hours to make his weight division, so his diet called for low sodium and low carbohydrates.

He wistfully flipped through photos on his phone of his mom’s enchiladas and other meals she learned to cook for his fight diet.

“She can make no salt and no flavor taste amazing,” he said.

It had been a stressful two days. During the requisite pre-fight physical, a doctor detected a mass under his ribcage. An X-ray the next day found nothing alarming and he was cleared to fight.

Later that day he took a stroll with Enders to Paradise Valley Park for one last wrestling match. He often goes there for cardio training or to practice moves with his friend. Enders has learned a lot about MMA, though he’s not much into fighting. Enders doesn’t mind playing along, though.

They wrestled on the grass a little before the cold drove them home. Despite the hard work and the bruises, fighting is a feeling George can’t replace.

“In that moment when I’m fighting you’re not worried about 10 seconds from now; you’re not worried about 10 years from now,” he said. “It’s the clearest moment. You only have one goal, and that’s all you’re thinking about, is to get that win.”

But there’s a philosophical reason, too. Fighting brings out a person’s true personality, George said. You can’t pretend in the ring. You are who you are. You leave it all on the mat.

“At the most, it’s the highest physical manifestation of how you feel inside,” he said. “Everyone fights differently.”

The fight

Jared “Mexico” George strode toward the ring, his self-selected intro song blasting.

“I never let you down/I’m a shine on sight/Keep your mind on your grind/And off mine alright,” rapper T.I. rhymed over the loudspeakers.

George opened his arms to the crowd, then grinned as he gestured toward his family.

Then his eyes fixed on the blur of his opponent, waiting across the cage. He could see the light shining on his opponent’s skin, and the form grew clearer as George approached.

When the two drew near, mere feet from each other — close enough for George to finally see him — he looked his opponent right in the eyes. He didn’t blink.

His opponent, Cody Amman, proved even stronger than George thought. But MMA is a mental game, as George sees it. The young fighter figured he had better cardio endurance – “a bigger gas tank,” as he called it. His plan was to wear Amman out.

Still, George managed to pin Amman to the ground before the first round ended.

In the second round, Amman pinned George on his back with his head against the cage. George could see Amman loading the punches, swinging his arms into the air before coming toward George, who deflected them.

He started fighting back, but soon the bell rang. George knew he was wearing his opponent down. He could hear Amman’s ragged breathing.

George had noticed a pattern. His opponent continuously attempted a head and arm take down, where the fighter traps his opponent in a headlock before using all of his weight to bring the opponent to the ground. The move was familiar to George — it was similar to the methods bullies had used to beat on him for so many years.

He let Amman toss him to the ground. George hooked his leg under his opponent’s thigh and wrapping one arm under his neck.

“Come on, Jared!” his mom called as she stood with his stepdad and sister next to their seats.

Amman lay on top of George, striking him with his fists. But George remained in control.

“You’re never going to defeat me,” he told Amman, when he knew he had him, when he knew he was about to win his first official MMA fight.

They rolled together onto their sides, and George applied a choke hold. Amman submitted.

George had won. The crowd cheered over the voice of the announcer. People chanted his name.

He’d imagined this moment his entire life. Despite the doubts and the bullies and his vision, he’d done it.

As the referee pulled George from his opponent, it hit him.

He stood — scratched and bruised — and turned to the crowd.

He roared.


LARRY MAYER, For the Star-Tribune 

An annual winter elk count showed Yellowstone's Northern Range herd has grown. 


Sports
2018 WINTER OLYMPIC GAMES
Three Wyoming women will go for the gold in South Korea

Wyoming encompasses nearly 98,000 square miles, making it the 10th largest state by land area. But all of Wyoming’s Olympians this year hail from a tiny corner in the state’s northwest.

Alpine skier Resi Stiegler grew up in Jackson and still calls it home. Her teammate, Breezy Johnson, was born in Jackson but grew up in Victor, Idaho, just across the border. Freestyle skier Jaelin Kauf, meanwhile, was born into a skiing family with Olympic heritage at nearby Alta.

Now, they are bonded under one name: the United States Ski Team. The three Jackson-area natives qualified to represent the United States at the 2018 Winter Olympic Games in Pyeongchang, South Korea.

“It’s a dream come true,” Kauf said. “It’s the largest stage I’ll ever compete on and it was my goal when I dedicated myself to the sport.”

It will be the first Olympics for both Johnson and Kauf while Stiegler will compete in her third Games. Each took diverging paths before becoming teammates for the first time. If any of them places first, they could be the first female skier from Wyoming to win Olympic gold.

Stiegler, the veteran

Resi Stiegler, daughter of former Austrian Olympic champion Josef Stiegler, started skiing at age 2 and began racing just four years later. Still, she insisted that no one ever made her ski.

Skiing was a natural part of her upbringing. Her family skied and worked at Jackson Hole Mountain Resort so she was never too far away from a pair of skis.

In the summer months the Stieglers would travel back to Josef’s native Austria. Resi was only in grade school but she adapted almost immediately. Her father helped ease the seasonal transition and she absorbed the European ways and culture. This only grew with time, which prepared her for traveling as part of the Junior Olympic and Nor-Am teams.

Stiegler was 17 when she made her World Cup debut in the slalom and finished 11th. A year later, she won bronze in the slalom and the combined at the Junior World Championships.

She continued to climb in the World Cup standings just as the 2006 Olympic Games in Torino, Italy, approached. Stiegler was just 20 years old but she qualified for the Olympics, just like her father.

The fun, however, did not last. Her competitive edge controlled her throughout the games and inexperience kept her rigid. She finished 11th in the combined and 12th in the slalom, which she wishes she had focused less on.

“It was not the most fun,” Stiegler said, “and so now I have learned to enjoy it and to worry less about the results and to go in with an appreciation of how hard you have worked and coming together with the rest of the world.”

She had to wait to implement her hard-earned lesson, however. Stiegler suffered a devastating injury during the team section of the 2007 World Cup. She crashed on a finals run, breaking her left forearm and right shinbone while also tearing ligaments in her right knee. She also suffered a bruised face and hip.

The injuries eliminated any chance for the 2010 Olympics games, but she isn’t sad or upset about lost time. That time away helped her appreciate the sport again.

“I still love racing and competing and that won’t change any time soon,” she said, “so it’s kinda cool to be looking at your life a little differently but still be in the hunt for what you wanted when you were a kid.”

Stiegler returned to skiing with her cleared head and stayed near the top of the World Cup standings. She went on to qualify for the 2014 Olympic Games in Sochi and, now, the 2018 games.

Kauf, the youthful

Much like Stiegler, Jaelin Kauf was born into skiing. Both of her parents skied professionally and her older brother grew up skiing mogul — encouraging her to take up the sport.

Mogul skiing is freestyle skiing, which is scored upon tricks, as opposed to the conventional timed alpine skiing that Stiegler and Johnson compete in.

Kauf didn’t stay in Alta long. Her family moved to Steamboat Springs, Colorado, during her freshman year of high school. She carved a name for herself on the slopes of Colorado for three years before it was time to move on. That’s when she made the decision to be a professional skier.

Less than a year after appearing in her first World Cup she was named World Cup Rookie of the Year. Then she won a U.S. Championship and a World Cup.

From then on, she did was what necessary to qualify for the United States Ski Team. Still, receiving the official word was a relief.

“It was amazing to finally be named to the team, though,” Kauf said. “It’s something I really wanted for a long time and a stepping stone in my goals.”

She dedicated herself to that season and approached the off-season with a renewed mentality. She admits that she relied too much on her natural talent in seasons prior, so she focused on her own hard work and abandoned the pressures she had previously put on herself. She even moved to Park City, Utah, where the American team is based.

Kauf officially qualified for the Olympics on Jan. 11 when she finished second on the first day of the Freestyle World Cup. Her third podium of the season not only earned her a spot on the U.S. Ski Team but also moved her to No. 1 in the women’s world rankings.

“It’s amazing to see that hard work pay off and to accomplish this goal,” she said.

Kauf has already reached out to plenty of skiers to help prepare for her first Olympic Games. Her boyfriend was a member of the team for eight years and has helped smooth the learning curve. She’s also reached out to former Olympians Hannah Kearney and Heather McPhie, who have helped immensely.

Going for gold

With the experience of two previous Games under her belt, Stiegler has taken the pressure off herself. She’s already experienced the consequences of pushing too hard and crashing. Instead, a free spirit has followed her to South Korea.

“Sometimes you want something too much,” she said. “So it’s time now to step back and enjoy what you have worked for and how far you have come and really be a part of something special!”

Stiegler no longer wears the tiger ears that used to serve as her trademark. She won a dispute with the International Olympic Committee that allowed her to wear them on her helmet during the 2010 Olympics. Those ears were a way for her to stand out among other skiers, but she doesn’t accessorize anymore. She’s got experience instead.

The first-time qualifier, Kauf, takes a more youthful approach into the 2018 Games than her veteran alpine teammate.

“Now is the time to work my hardest and do my best on the Olympic stage,” Kauf said.

Still, she has enough experience to keep her from getting too focused on results. Kauf travels with a plush Curious George monkey named George Junior. He’ll make his Olympic debut at the 2018 Games as well.

In Pyeongchang, Stiegler will help guide teammate Breezy Johnson, who did not respond to a Star-Tribune request for an interview.

Stiegler was in Europe before departing for South Korea while Kauf spent a few extra days in America before flying to South Korea on Wednesday, just over a week before Opening Ceremonies. Kauf begins freestyle competition hours before opening ceremonies while Johnson and Stiegler begin alpine competition on Feb. 11.