Sean Ahmadi holds the front tire of a red bicycle steady between his knees.
"Hop on," he tells Jamie Schanbaum.
The 22-year-old college student swings a leg over the bike, sliding first one, then the other prosthetic foot into plastic cages that hold her feet on the pedals. As the tires start rolling, Ahmadi runs alongside her, like a parent balancing a child just learning to ride. Then he dashes back to his own bike, jumps aboard and races after her.
Schanbaum used to ride her bike everywhere. Then, in November 2008, when she was a sophomore at the University of Texas, she caught meningococcal septicemia, a life-threatening blood infection caused by the same bacterium that causes meningitis, an inflammation of the protective covering of the brain and spinal cord. It can be spread through sneezing and coughing.
She spent six months in the hospital. Ultimately, her fingers and lower legs were amputated.
Suddenly, she couldn't get out of bed or walk, much less ride a bike.
Far more serious than the flu
Schanbaum had gone to a friend's house to do laundry on a dreary Wednesday night. She didn't feel well when she got there, so she curled up on the couch for a nap.
As the hours ticked away, she felt worse. She stayed the night, but began vomiting repeatedly. Her skin grew so sensitive she put towels on the tile floor to cushion her feet. She couldn't shake the chills.
Still, she didn't think it was anything more than the flu. She drove home the next morning and buried herself under blankets.
"I still didn't think it was serious," she says. "I had important tests coming up, and a Ghostland Observatory concert to go to."
She crawled into bed and ignored the ringing phone. A few hours later, her sister, concerned something was wrong, came to Jamie's apartment. She realized Schanbaum was seriously ill and drove her to Seton Medical Center Austin.
By that time, Schanbaum couldn't walk. Her body was shutting down and blood was no longer flowing to her extremities.
She had meningococcal septicemia.
Nurses administered antibiotics and started dialysis. Her mother, who had just moved to McAllen, drove back to Austin.
In the following weeks, Schanbaum lay in a hospital bed as her hands and feet, then her arms and legs, changed color. "I literally watched my limbs go from red to purple to black to dying off," she says.
She underwent dozens of skin graft surgeries and 50 days of oxygen therapy in hopes of salvaging her suffocating extremities.
"(Meningococcal septicemia is) like a hurricane," says Patsy Schanbaum, Jamie's mother. "It comes and does all this damage, and we're left to clean it up."
Finally, doctors at St. Joseph's Hospital in Houston, where Jamie had been transferred, decided they had to amputate the fingers on both her hands and her legs below the knees. "When they did tell us, I cried," Schanbaum says.
After the surgery, she woke up in excruciating pain. "I literally could not move. I didn't lift my arms over my head until January. I didn't sit up in bed until March," she says.
The normally outgoing, laid-back college student fell into a depression. Then she grew angry.
"It breaks my heart every day," Patsy Schanbaum says. "As a mother, you want to protect her."
After six months in the hospital, Jamie Schanbaum finally went home. But that meant new challenges. She had to face the stares and questions of friends and the public.
At first she used a wheelchair. Eventually she was fitted with prosthetic legs. She started to learn to walk again in August 2009.
During a visit with her prosthetician earlier this year, Schanbaum learned about two Austin men with prosthetic legs who had learned to cycle. Her prosthetician put her in touch with those cyclists, and connected her with Bicycle Sport Shop, which donated a bicycle. She also met multisport coach Sean Ahmadi, who has worked with physically challenged cyclists and rowers for several years.
But she couldn't just hop on a bike and start pedaling. "I was really unsure what I could do without seeing her," Ahmadi says.
The bike would have to be modified, since Schanbaum doesn't have fingers to move brake levers or gears, and no feet to clip onto pedals. "We had to take the variables out so she could work with the things more easily," Ahmadi says.
Simple push levers were rigged to handle braking and shifting duties. Pedal cages would hold her prosthetic feet in place.
They started working in a gym, strengthening Schanbaum's legs on a stationary bicycle and her core muscles with mat exercises. Finally, just before Schanbaum's birthday on Oct. 4, it was time to try the real bike.
"The first time (she rode) I was really, really nervous, because I can't afford for her to fall, not even once, with her skin grafts," Ahmadi says.
Schanbaum fastened a yellow plastic sunflower given to her when she was in the hospital to the bike's seat post. Ahmadi held the bike while she climbed aboard.
"After all this time, it was so amazing to feel the wind on my face, blowing by my ears, and it was great to be one with the moving scene," she wrote on her blog after the ride. "To write what I felt at that moment is hard to describe. Sean even pulled out his iPhone to record me, and in it I was just smiling. Couldn't even talk."
When she was ready to dismount, Ahmadi jumped off his own bike and caught her as she coasted to a stop.
Like that, her world expanded.
"Oh my God, he's so great," Schanbaum says of Ahmadi. "When we go up hills and I'm not strong enough, he pushes me."
She set her goal on cycling in the Livestrong Challenge, a group bike ride that raises money for Lance Armstrong's charitable foundation. On Oct. 24, she rode 10 miles at that event.
"She's been amazingly brave," Ahmadi says.
Advocate for education
Since her daughter's illness, Patsy Schanbaum has moved back to Austin and now lives with Jamie.
The two have become active in the meningitis community, creating a nonprofit organization called the Joint Advocacy for Meningococcal Information and Education, or JAMIE, Group. In January, the Jamie Schanbaum Act, which makes it mandatory for Texas students living in college dorms to take a meningitis vaccine, went into effect.
Today, mother and daughter both spend time speaking to groups about the importance of getting a meningitis vaccine.
"You feel so guilty that you didn't know more about this vaccine," says Patsy Schanbaum, who raised four children as a single mother after their father died of cancer when Jamie was 3 months old. "But I could have lost her. She's still alive."
Jamie Schanbaum says her bout with meningococcal septicemia could have been worse. It could have made her blind or deaf, or caused brain damage. She came close to dying.
She rides her bike often, zooming around the paved trail at the Veloway, a cycling path in Southwest Austin that is closed to motorized traffic, and along the access road of South MoPac Boulevard.
It makes her feel free, and she says her bike is her best friend. She calls it Lady Maybellene, after a Chuck Berry song about a hot rod race.
She's making plans to go to New Zealand through UT's study abroad program in February, and she's looking for a longer group ride to challenge her cycling skills.
"I'm pretty lucky," she says.
More about meningococcal septicemia
Meningococcal septicemia is a severe infection of the blood that is caused by the same bacterium that causes meningitis, an inflammation of the protective covering of the brain and spinal cord.
An average of 1,500 Americans get some form of meningococcal disease each year. Of those who survive, about 20 percent have brain damage, kidney disease, limb amputations or hearing loss.
The bacteria cannot live outside the body for very long, so it is not as easily passed as a cold virus. Still, it can be spread by close contact with a sick person, including coughing, sneezing, kissing, or sharing a toothbrush, cigarette or eating utensils.
Early symptoms of meningococcal septicemia are similar to the flu, but are very severe and occur very rapidly. They include sudden fever, fatigue, vomiting, cold hands and feet, cold chills, severe aches or pain in the muscles, joints, chest or abdomen, rapid breathing, diarrhea and, later, a rash.
Many forms of bacterial meningitis can be prevented by vaccination.
Source: National Meningitis Association and Centers for Disease Control