Tom Kramer runs to clear his head; it is a way to cope with the immense weight on his heart.
"It's really the elephant in the room. We don't talk about it a lot, but it's there," Kramer said.
14 years ago, Tom married his wife, Pam Price, who just 2 years later was diagnosed with a rare and life threatening blood disorder called Myelofibrosis.
In healthy people, platelets in the blood release scar tissue to help stop bleeding, but it's a different story for Pam.
"What's happening with me is those platelets are releasing their scarring chemical in my bone marrow," Price said.
The result is that in time, her marrow will stop making blood cells and Pam could die.
The only known cure, and even it carries huge risks, is a bone marrow transplant.
The problem is finding a match as just 7-million people are registered as possible donors.
"So that's not a lot compared to the population," Kramer said.
So, Tom decided to do what he knew best. He hit the road and started running a website called RacingtoRegister.com, linking his long distance runs with registration drives.
His efforts not only got hundreds or more onto the bone marrow registry, they got noticed by the organizers of the Iron Man triathlon which invited him to take part in the race next month in Hawaii.
The race is a 2.4 mile swim, followed by 112 mile bike ride, capped off with a marathon.
It is an invitation extended to just 4 people in the world.
Pam's appearance betrays the actual toll this condition is taking on her life. But every now and again, as was the case Tuesday, this couple is dealt a difficult reminder as her platelet count on that day was far lower than they either hoped or expected.
Those moments are all the more reason for Tom to run as if his life depended on it because hers just might.