The graying goatee is back. The salt-and-pepper hair on top of his head is slowly returning. The clothes fit, and the 52-year-old coach is eagerly looking toward his second season in the NFL after staring down the biggest opponent of his life—cancer.
"You never think anything like this is going to happen to you. We all think we're invincible," Pagano told The Associated Press. "You see it a lot, you read about it a lot, but you never think you're going to fall victim to something like this."
Some people might be tempted to label Pagano the unluckiest man in football in 2012. He barely missed reaching the Super Bowl, lost Peyton Manning before he ever coached a game and was diagnosed with leukemia three weeks into his first season as a head coach.
Pagano, however, considers himself the luckiest guy in football.
He realizes now that if Baltimore had beaten New England last January, he would not have been hired by the Colts. Without being in Indianapolis, he never would have had Dr. Larry Cripe on his medical team or seen his old pal, Bruce Arians, presiding over one of the greatest turnarounds in NFL history while Pagano was fighting for his life. He couldn't have started this rebuilding project with Andrew Luck, either.
He's lucky, too, that his persistent wife, Tina, kept pushing him to see a doctor for the unexplained bruises, lucky he had a city and a state full of people rooting as hard for him as they did for his team and lucky Indy's bye week came so early so he could seek medical care.
"You'd love for it (the bye) to come somewhere in the middle (of the schedule) in case you have injuries and things like that so you can rest up and get ready for the rest of the season," Pagano said. "Thank God it was where it was because I probably never would have taken the time. You know in coaching, it's not like you can just call in sick, and so again, by the grace of God, it was after the third ballgame and I went in and got checked out, and I'm glad I did."
Looking back, Pagano can see the signs were there months earlier. The deep bruises during a summer lake trip, the unusual exhaustion during training camp.
As the bruising became more prevalent, Tina Pagano pleaded with her husband to see a doctor, and like most football coaches in the midst of a long, grinding football season, Chuck Pagano kept pushing it down the priority list until Sept. 23. Hours before the Jacksonville game, he finally showed doctors the bruises and asked for their opinion.
Their answer came two days later.
"I get a phone call saying they found something that came back in the tests and I made an appointment for you with Dr. Larry Cripe down at the Simon Cancer Center. That's when you're like, 'Excuse me, the Simon Cancer Center,'" Pagano said.
Being an optimist, Pagano remained hopeful that the second opinion would come back with something, anything other than cancer. Cripe asked Pagano to have Tina drive him to the appointment. She picked him at the team complex early in the afternoon Sept. 26 and along the way, she kept telling Pagano the diagnosis would be OK.
"Dr. Cripe walked in and said, 'OK, Chuck, I'm 99 percent certain that you have APL' and explained to me what APL was," Pagano recalled, describing the form of leukemia they believed he had. "You really don't have a lot of time to sit there and dwell on it because at first, you were hopeful that this was not the news you were going to get, so you have a moment there with your wife and then it was like, 'OK, what's the game plan. If this is what I have, what am I looking at? What's the treatment and so forth? How long? When can I get back to work? What are we going to have deal with?'"
Cripe explained that acute promyelocytic leukemia is an illness with a high cure rate but chemotherapy needed to start immediately. Pagano didn't even have time to go home and change out of his work clothes. He called Colts general manager Ryan Grigson.
Pagano recalls the conversation going this way.
Grigson: "Where are you? I've been looking for you all over the place, I've got some ideas I want to run by you."
Pagano: "'I'm down at the Simon Cancer Center."
Grigson: "What are you doing down there?"
Pagano: "Well, are you sitting down?"
Grigson: "Yeah, I'm sitting down."
After Pagano told Grigson, there was total silence on the other end. Finally, Grigson started talking again.
Grigson: "You've got to, please tell me you're kidding."
Pagano: "I would not joke with you about something like this."
The medical staff, understanding the need to keep this quiet until players and coaches returned from their bye weekend four days later, admitted Pagano under an alias. Tina Pagano came up with the name of a former Hurricanes player turned celebrity who lived near them when they were in Miami: Dwayne Johnson.
"The nurses would say, 'What do you want to go by, do you want us to call you Mr. Johnson, do you want us to call you Dwayne or The Rock?' And I said 'What are you talking about?'" Pagano said.
Virtually everybody else was kept out of the loop until Pagano called Arians that Sunday night.
Arians, a prostate cancer survivor, was stunned.
"My first reaction was how is it? Is everything going to be all right? How's Tina? How are the girls?" Arians said the day after he found out. "He wanted to totally convince all of us that everything was going to be great like he always does. When I talked to him, the football was the easy part of the conversation. Football is not who we are, it's what we do. As players and coaches, it doesn't define us, family does, faith does."
The reaction from players and coaches was similar after they were told at a team meeting Oct. 1.
"It puts everything in perspective. We still play a kid's game," said Reggie Wayne, who met Pagano 16 years earlier when both were at Miami. "People living out there with life decisions every day. It just pushes me more and more to go out there and play hard and give it everything I've got, and in some kind of way bring home a game ball for him."
On that next Sunday, Oct. 7, with most players dressed in pink for breast cancer awareness, Wayne lived up to his promise. He got the football across the goal line in his orange gloves -- the color for leukemia awareness -- to complete an incredible comeback against Green Bay.
It was only the start of a season full of remarkable feats -- seven game-winning drives in the fourth quarter,, Arians' record-tying nine wins following a midseason coaching change, the Colts' first playoff berth without Manning since 1996 and, of course, the grand celebration for Pagano's return to the stadium in November and his actual return to the sideline on Dec. 30.
Back at the Simon Cancer Center, Pagano was still fighting.
The chemo made him ill. He lost weight and his hair. And it was just as tough watching games with his wife.
"She'd be the first to tell you, never again," Pagano said, starting to laugh. "We did 12 of them. They got better as they went, but you know Green Bay was the first one, and I'll never forget, the first time they snapped the football, she started screaming and throwing stuff and gyrating and I just looked at her and said, 'Really? We've got three hours of this? This is exactly how you act during a game?' She looked at me and said 'What? What are you talking about?' I just kind of laughed."
The Colts raised money for leukemia research through the Chuckstrong campaign, and Pagano received hundreds of letters and emails from other leukemia patients including one from a 9-year-old boy who told him to stay positive, believe and use the strawberry Popsicles to avoid mouth sores.
With each passing day, Pagano was winning. Cripe sent him home from the hospital Oct. 21. Two weeks later, Cripe said the illness was in complete remission and he even gave Pagano clearance to start attending home games.
Indy clinched its playoff berth on Dec. 23 at Kansas City. The next day Pagano walked into the team meeting, reclaimed his job as head coach and turned off the light switch in his office, the one Arians had left on since the Oct. 1 announcement that Pagano was taking an indefinite leave.
"I've cried so much already, it's like I don't know if I have any more tears in there," Wayne said when asked how that Dec. 24 team meeting went. "I'm just glad to see him back. He's a great man as well as a great coach."
The private reaction was nothing like the rousing reception he received Dec. 30 when an entire league watched Pagano walk back onto the Lucas Oil Stadium turf, put on his headset and lead the Colts to a 28-16 victory over AFC South champion Houston.
Texans defensive coordinator Wade Phillips hugged Pagano. Arian Foster tapped the Chuckstrong sign in the back of the end zone after scoring a touchdown and during the locker room celebration, Robert Mathis prompted Pagano to jump around and chant like he was a teenager.
For the Paganos, this is just the start.
He will continue to undergo regular checkups and take medication to ensure the cancer does not return.
He will spend many of his spare hours helping others battle leukemia and other forms of cancer.
He will cherish all that time he has with his family and friends.
But most of all, he's grateful.
"You always look at these opportunities and understand how lucky you are and what a privilege it is to coach and play in the National Football League," he said. "I don't know if it's changed me. I know I never really took anything for granted and most certainly now, I don't take anything for granted, not one day, and if I can pass that on with an even greater, stronger message with the people I work with and you know the guys we coach, that might have a little bit more credence to it."