"It was everywhere," Nelson said. "At that point, it was just everywhere."
Cancer had returned. And it was in her liver, her bones, her lungs, her spine, and a CT scan revealed hundreds of sunflower-seed-sized tumors in the brain.
The couple, who would have celebrated their 21st wedding anniversary this week, knew the odds were not good. Still, they chose to fight and to fight publicly.
As Fatcyclist.com changed its tone from a humorous blog focused on cycling, traffic grew.
"People, I think, sort of saw themselves in it," Nelson said. "I think it was something an awful lot of people relate to on a very personal level."
But it wasn't just average, anonymous readers catching the Fat Cyclist spirit. Some of the biggest names in the cycling industry have jumped on the bandwagon and offered up far more than just an electronic hug.
Companies such as Shimano, Orbea, Ibis and others have donated products to auction off, with all proceeds going to the Lance Armstrong Foundation in Nelson's name.
Shortly before Susan's death, a bicycle valued at nearly $10,000 was auctioned off on Fatcyclist.com with entries going for $5 per chance. More than $136,900 was donated to the Lance Armstrong Foundation in the name of Team Fatty.
Nelson then traveled to Philadelphia for the LiveStrong Challenge where Team Fatty combined for $251,363 in funds raised.
There are four LiveStrong Challenge bike rides, and with one to go, in Armstrong's hometown of Austin, Texas, Team Fatty has raised $626,305 — shattering any records for funds raised by a group.
"I don't do this to break records," Nelson said. "But just seeing how our fight is something so many people can identify with and want to be a part of, it's really kind of mind-boggling. I'm so touched by the generosity of strangers."
A bicycle clothing company in Minnesota, Twin Six, joined the fight and has designed a series of jerseys, shirts and other Fat Cyclist gear, with proceeds donated to Nelson's fundraising efforts. When Susan's cancer returned with a fury, Twin Six created a special pink jersey to support the fight and the jersey typically sells out in a matter of days. The 2010 models went on sale this week at twinsix.com.
"It always brings a smile when I see total strangers out there wearing the jerseys," Nelson said. "It's just another testament, I guess, to how many people cancer affects."
Gary Fisher, a legendary bike maker, has been known to wear the Fat Cyclist jersey and is not shy about supporting the effort Nelson is behind and wears the jersey on occasion.
Lance Armstrong himself has mentioned Susan and Fatcyclist.com several times via Facebook or Twitter posts.
"I've never actually met Lance Armstrong or even talked to him," Nelson said. "But I know he's well-aware of us and to have his support has been great."
A couple of weeks ago, Nelson did something he didn't think was going to be possible.
He raced in the Leadville Trail 100.
Having completed the race 12 times previously, No. 13 appeared to not be in the cards because of Susan's condition — he couldn't stand the thought of leaving her for a weekend knowing there might not be many weekends left.
When she died, he made the decision to race the weekend after her funeral.
"I haven't had a lot of time to go for long rides," he said. "But I've been riding 'angry.' "
Nelson, as part of 100-mile mountain bike race, planned to ride as hard as he could and then limp across the finish line with whatever energy he had left after the brutal climbs on his single-speed Gary Fisher Sugarfly bicycle.
What happened wasn't expected — crashes rarely are.
While flying downhill on a paved and rain-slicked portion of the course, Nelson overestimated his turning ability and flew over the side of the road and down a 40-foot drop into a rocky ravine.
Amazingly, he had only some cut knuckles, a bloodied lip, and plenty of aches and pains — but no serious injuries.
After a dozen successful Leadville 100 races, Nelson's unlucky 13th ended in a crash.
Though Susan's fight with cancer didn't conclude with the storybook ending the thousands of anonymous "friends of Fatty" hoped and prayed it would, Nelson vows the fight is not over.
"I think of my daughters," he said of the identical twins, Katie and Carrie. "Their mother had breast cancer. Their grandmother had breast cancer. There's a pretty good chance, I figure, that they might get breast cancer."
Fatcyclist.com will likely return to its roots as a cycling-first blog, Nelson said, as the coming months are turned on the calendar. But the fight against cancer will not end.
"My fondest wish," Nelson said, "is that by the time they get to the age where they might have to worry about it, that they won't."
The Fat Cyclist, aka Elden Nelson
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