I was on 'The Bachelorette' and 'Bachelor in Paradise.' Behind the scenes I was struggling with a me

• Cam Ayala was on the 15th season of "The Bachelorette" and 6th season of "Bachelor in Paradise."
• Behind the cameras, he was struggling with lymphedema, and in a lot of pain. 
• Last year, he had his leg amputated.

This as-told-to essay is based on a conversation with Cam Ayala. It has been edited for length and clarity.

Growing up, I was a super active child, keeping my parents busy with football, basketball and baseball. The year I was 11 I enrolled in a summer basketball league near Houston, where I lived. There, coaches and parents started noticing that I was limping, and sort of skipping down the court rather than running. 

At first my parents thought it was growing pains. Today I'm 6'4", and at 11 I was having my first major growth spurt. Still, the pain in my back and knees were so severe that my parents took me to an orthopedic surgeon. He immediately noticed that my right leg was 1.5 inches shorter than my left. When I walked, it was similar to how you'd feel with one shoe on and one shoe off. 

The visit also detected some dark spots that the doctor thought might be bone cancer. I needed a surgical biopsy to test them, which was terrifying. Luckily, I didn't have cancer. But during recovery is when I saw the first signs of the condition that would stay with me for the next 22 years: lymphedema.

Lymphedema is a swelling condition caused by issues with the lymphatic system. That system carries fluids throughout the body and helps fight infection. When it's not operating well — as I'd soon learn — it causes lots of problems. After the biopsy surgery, my right leg swelled to three times the size of my left leg, which was incredibly painful. 

I started battling recurring infections that required surgery

There's no great treatments for lymphedema, which is incredibly frustrating as a patient. I wore compression leg wraps and had massages to encourage drainage. But for the most part, I managed to stay active — I even played NCAA basketball for a year. I never told my coaches, or anyone else, about my lymphedema. I didn't want to be treated differently. 

In 2014 I had just graduated and was excited to get into the real world. That's when I had my first major bout of infection in my right knee joint. Between 2014 and 2021 I had nine separate infections, resulting in 16 knee surgeries. I wanted to live life — dancing, traveling, and yes, trying reality TV — but I was in this constant ebb and flow of infection. 

In 2021 I made a last ditch effort to save my leg. My doctor proposed doing a total knee replacement. With the knee gone, the infection would be too, we reasoned. Unfortunately, the operation didn't work. After the surgery, I could only bend my knee to 45 degrees, not the 90 needed for a normal gait. 

I found a new healthcare team and unexpected relief

That's when I connected with Dr. David Doherty, an orthopedic surgeon with UT Health Houston and Memorial Hermann. He immediately realized that my replacement knee was the wrong size and in the wrong position. I had two options: I could go through an excruciating revision process without promised results, or I could choose to have an amputation above the knee. I chose amputation. 

Over the next two months I prepared physically, emotionally, and spiritually to lose my leg. I worked out to build strength in my other leg, upper body, and core. I spoke with Dr. Vinay Vanodia, medical director of the Amputee and Limb Loss Rehabilitation program at TIRR Memorial Hermann. I talked to other active young men who had amputations, and I prayed a lot.

When I woke up from surgery, I didn't want to see the missing limb. I even had a nurse put a pillow under my hospital blanket to mimic where my lower leg had been. When I saw my residual limb, I wanted to be intentional. 

The next day, with my pastor by my side, I looked down for the first time. The tears of frustration and grief were inevitable. I had literally lost a part of myself, the leg that had launched me to shoot a basket and propelled me into the end zone. But soon, there was levity: my pastor presented me with one sock, telling me I wouldn't need the other anymore. 

It's been nearly a year, and life is different now

It's been nearly a year since my amputation. My quality of life now is different — not better or worse, just different. I've had some great wins, like getting back to my CrossFit gym only two weeks after surgery. 

There have also been hard times. I haven't dated since the amputation, and for a while wondered if I would be a burden rather than a blessing to prospective partners. 

But I've realized it's up to me how I respond to this. I can let it defeat or define me, or I can use it to inspire and support others. I like to think I'm FLAWsome — awesome with all the flaws I have. And I know that eventually, the right woman will come my way and embrace the flawsomeness. 

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