At 35 years old, in the prime of my personal and professional life, I was diagnosed with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). As a healthcare professional (D​​octor of Podiatric Medicine [DPM​]​) and life-long athlete, this diagnosis brought me to a harrowing halt in all aspects of my life.

I had spent the summer of 2023 living out personal dreams of trying to start a family with my partner, Kathryn, renovating our cabin in the mountains of Southern California, and white-water rafting, among many other adventures. That summer, I had also taken the professional step of opening my own private practice, while also balancing the role of primary caregiver to two of our beloved aging grandparents. Life was busy, yet exciting​,​ as my wife and I entered new professional and personal chapters together.

By late summer 2023, I was fatigued, worn down, and experiencing deep bone pains that I initially chalked up to busy schedules and an active lifestyle. As healthcare professionals, we are often guilty of not heeding our own advice to patients, and so I continued to try to push through the pain and exhaustion and continued to see patients and balance home responsibilities to our grandparents and fur babies. Despite having a high pain tolerance, within 2 weeks, the bone pain had localized to my right collar bone and jaw, and I was barely able to put my scrubs on in the morning, let alone complete a full day of treating patients. On September 7, 2023, while attempting to get ready for work, I developed severe chest pain and a feeling of an ‘electric ping pong ball’ throughout my ribs and knew that I needed to go to the hospital to be evaluated.

Once I arrived at the local emergency department, I was triaged quickly​,​ and within a couple of hours was told that my blood panel was abnormal. Ultimately, the doctor came in and shared that the tests indicated that I had a form of acute leukemia. I was then sent for a bone marrow biopsy to confirm the type of leukemia. I sat in disbelief at the diagnosis I was just given, as I was there for chest pain and collar bone pain. As I would later learn, I had a pathological fracture of my right collar bone from my poor bone marrow quality secondary to my leukemia. The bone marrow biopsy confirmed that I had Ph+ ALL. The oncologist shared with me that this type of leukemia is common in children; however, he had no experience with treating patients in my age range and, therefore, transferred me to City of Hope Cancer Center for my treatment.

Once I was admitted to City of Hope Cancer Center and met my oncologist and treatment team, I had full confidence in the treatment plan they proposed. I was admitted for 4 weeks and was sequestered to a negative pressure (isolation) room for the duration of my admission, because I was also positive for COVID and continuously tested positive, as my immune system was too weak to clear the infection throughout this period. My induction phase of treatment consisted of vincristine, dexamethasone, and ponatinib (a TKI to treat the Ph+ mutation). By the end of this period, my body was deconditioned and frail. I was discharged home and then began the consolidation phase of treatment​,​ which required another hospital admission to monitor my side effects of the immunotherapy treatment I started. This phase of treatment consisted of: blinatumomab (an immunotherapy) ×5 cycles, each lasting 28 days, continued ponatinib (TKI), and 15 lumbar punctures to prophylactically treat and prevent the leukemia from crossing into my cerebrospinal fluid (CSF). Additionally, I received an intermediate dose of methotrexate as CSF prophylaxisduring a third hospital admission. I had interval bone marrow biopsies performed throughout this period and was MRD​-​negative after my first cycle of blinatumomab.

As of today, I remain in remission and in the maintenance phase of treatment​,​ which consists of daily ponatinib, low-dose aspirin, and prophylactic antivirals. Given my initial and continued response to the immunotherapy and TKI protocol, I do not require a bone marrow transplant unless I relapse. Remission is a blessing that is not lost on me. It is a complex period to be in, but I am navigating my way through. Listening to and nurturing my body has led to several avenues of healing, many of which come from being outside and within the power that nature affords. Nature nurtures​,​ and I have found strength in finding new ways to live in the warmth of the sun.

Leukemia has challenged me physically, with countless lumbar punctures, bone marrow biopsies, hospital admissions, and medication side effects. It has challenged me mentally, with patience for healing, unknown test results, and most recently, with remission anxiety. It has challenged me emotionally, with making peace with my new physical deficits, the loss of specific dreams and freedoms, and with confronting the uncomfortable idea of mortality. Undoubtedly, it would be easy to get lost in it all. My compass is rooted in honoring the hard, embracing the easy, and leaning into the love that surrounds me.