Matt Serra felt pain while sitting in the corner during an MMA fight. Nothing unusual for the lifelong fighter, except for one unique distinction this time: he wasn't the one fighting.
Instead, the former UFC welterweight champion from East Meadow was cornering one of his fighters at Ring of Combat in Atlantic City on April 5. It was a pain that would put Serra in the emergency room for four days, lead to the surgical removal of one of his ribs and now, cause his exit from mixed martial arts competition.
"It's hard to say it," Serra told Newsday. "It's like you can't say it, even though it probably is true. I would love to put closure on my career with one last fight at the Garden, but at the same time, if that doesn't happen, I definitely consider myself done. It's hard to say the 'R word.' I might never say the 'R word.'"
That thrill of fight night, when the adrenaline pumps through the veins, the fans scream and invincibility consumes the brain and body -- putting that in the past is never easy. Not for Serra, the only man on the planet to knock out Georges St-Pierre in a pro fight. Not for many athletes, regardless of sport.
"I really think I'm walking away," he said. "I'm going to be 39, I just had my rib taken out. I'm having my third kid. My schools are doing well. What am I doing, looking for another pay day? It's not really for that. I mean, it doesn't stink, but it's not really for that. Am I still trying to hold on for the glory? Glory is a drug, dude. I'm telling you, that's the problem. It really is. I know why guys can't walk away. I absolutely get it."
Serra had always contemplated one more fight, but the ordeal of the past six weeks has forced him to face a new reality.
Serra first felt pain in his left arm after a Brazilian Jiu-Jitsu training session at one of his academies two days before the Ring of Combat event. He figured he had just pulled a muscle.
He came home to Massapequa after the fights. The pain never left. It intensified. Serra couldn't bend his arm. He couldn't lift his hand to touch his neck. He got out of bed around 2 a.m. and drove to the emergency room at Winthrop University Hospital in Mineola. Tests revealed two blood clots in his arm and another in his lungs.
"Then I got freaked out," Serra said. "You don't catch that [and] after the lung, that stops your heart or your brain. Then you're done. I'm very fortunate to, basically, be here. Sounds kind of morbid. If I didn't catch that -- I was about to go to bed. I'm like, man, something's not feeling right."
Serra was put on blood thinners to address the clot in his lungs. He must now inject himself in the stomach with Lovenox, an anticoagulant, every day for the next three months.
The clots in his arm created a significant health issue as well. Serra's collarbone and first rib were compressing a blood vessel and restricting blood flow, a condition known as thoracic outlet syndrome. Serra had the first rib on his left side removed in early May, a procedure performed by Dr. George Hines, chief of vascular surgery at Winthrop. Hines estimated that Winthrop does about six of these surgeries a year.
"It's like taking out the floor of the whole area," Hines said. "You remove the rib and everything drops into place."
The procedure can take up to two hours to complete, and patients typically return home the following day.
"They had to cut me open through my armpit and cut through whatever they had to cut through and get my rib out," Serra said. "It's definitely strange and I'm feeling it in there."
Doctors told Serra he would need six to eight weeks just to recover from the rib removal. A month or so after that, Serra is expected to no longer need to take blood thinners and can resume active jiu-jitsu teaching and training.
"I need my jiu-jitsu, man," Serra said. "I don't need to spar. I don't need to kickbox or box every day. Even if you see me with some pasta, I'm still strangling and arm-locking people at least five days a week and I need that."
Serra could not bring himself to actually say the word "retire," but his active MMA career is essentially over. Serra (17-7, 7-7 UFC) last fought Sept. 25, 2010, a unanimous-decision loss to Chris Lytle at UFC 119. He turns 39 next month and doesn't want to be one of those athletes who hangs around too long.
"An aging fighter?" Serra said. "You know, it's like an aging stripper, but not as funny. Not a lot of people want to see that."
The biggest moment of Serra's career also serves as one of the greatest upsets in UFC and MMA history. On the night of April 7, 2007, inside the Toyota Center in Houston, Texas, Serra did the unthinkable. A 9-1 underdog, Serra took St-Pierre's welterweight title with a first-round knockout.
St-Pierre has since credited Serra with helping him become the fighter he is now, one who beat Serra in the rematch and has eight straight title defenses, second best in UFC history behind Anderson Silva's 10.
Serra earned that title shot by winning Season 4 of "The Ultimate Fighter." That comeback season, the only one in the show's history, featured fighters who had competed in the UFC but never won a title.
"I know I can be beat by some of these guys, but I know I can still knock some of these guys out and be a threat on the ground," said Serra, the first American to earn a black belt under Renzo Gracie. "But at the same time, it used to be that the thing that made me happiest was the next fight. Now, I whistle to work going to my schools. I love hanging out with my kids, my family. That's something you never really anticipate or understand it until you have a family. I love spending time with my girls. I'm a very involved dad."
Serra runs successful BJJ academies in Levittown and Huntington and recently opened a third in Bayside. He is also working to create affiliate Serra BJJ schools across the country, a system where those who earned their black belts under him would open academies under the Serra BJJ flag.
Serra and his wife, Ann, have two daughters with a third due in June. Angelina is 4, Maria is 2.
"Angelina is already arm-locking me, and I have her teaching Maria," Serra said. "They're doing it on the teddy bears. It's awesome."