13 Feb 2024
Adapting to life with ALL: Ricky’s story
Tiredness after a family wedding for 400 people was what Ricky Duggal originally thought was making him feel so under the weather. The 32-year-old Leeds dentist had also started to get back pain and neck pain.
“We’d just celebrated my cousin’s big wedding at the end of July 2023, and I felt a bit run down and fatigued the week after,” said Ricky. “I had had back pain before – dentists often get it because of our bad posture whilst working with patients. I went to the physio who loosened it all up but it didn’t seem to make much difference. I was also waking up with nights sweats, and I had a purple bruise on my leg. The tiredness continued and I noticed I had lost a lot of strength at the gym and couldn’t manage the weights I’d lifted before. Then the headaches started. Not the usual type of headache but in my scalp at the back of my head. This was the symptom that worried me the most.”
Ricky had a routine day off work and decided to go and see his GP. He was immediately referred to hospital for a CT scan to see if he had a bleed on the brain.
“It was a shock but I felt they were overreacting a bit so I started to backtrack and think oh my symptoms aren’t that bad,” said Ricky. “But I went to A&E where they did all the tests including a lumbar puncture for viral meningitis. I’m quite a relaxed person and still thought everything would come back fine. After all the tests a haematologist came to see me. He said everything was clear apart from the blood tests which showed a raised white blood cell count and that ‘some of the cells looked different’. As a dentist, you are accustomed to delivering challenging news and the way he was explaining it did ring alarm bells.”
Ricky had 12 more vials of blood taken and stayed overnight with his wife Simi at his side. The following morning the consultant explained he needed a bone marrow biopsy to rule out anything sinister.
Another doctor then attended to perform the biopsy. “He said to me ‘I’m sorry to hear the bad news’,” said Ricky. “This took us by surprise as we were not expecting to be told anything at this point. He explained that they were working on a provisional diagnosis of acute lymphoblastic leukaemia.”
Ricky was officially diagnosed with ALL on 11th August 2023 and was told he would need to stay in hospital for treatment to start immediately.
“Things had gone from having a nice day off to not being able to leave hospital for five weeks,” said Ricky. “It was a huge shock. I’m quite an independent person and hate being cooped up and they told me I wouldn’t be able to leave the room because of infection. It was very traumatizing and hard to take in.
“They started chemo within the hour. Those next four weeks were a bit of a blur but my family really helped me get through it. My wife, who’s also a dentist, took time off work and stayed with me most days and overnight. Family brought me home-cooked meals twice a day. It was hard telling my business I wouldn’t be back for a long while as I’m passionate about my work. Fortunately in this first cycle of chemo there was really only one week where I felt fatigued and lost my appetite. I had an exercise bike in the room and tried to stick to a routine.
“But when I got home I struggled. I expected to go back to normal but I found it hard to even walk upstairs and kept needing to lie down. I had to accept life was not as it was before. On the plus side, I’d had a bone marrow biopsy after the first cycle of chemotherapy which came back clear. So I was in remission.”
ALL carries a significant risk of relapse, so doctors proceeded with the plan for three further cycles of chemotherapy. Regular blood and platelet transfusions were also required to maintain a healthy amount of red blood cells and platelets. Ricky completed the second cycle of chemotherapy in November, the third in December, and the final consolidation cycle will begin in February.
“I’m so grateful for being in remission since the first cycle,” said Ricky. “I’ve learnt to slow down and create a new routine, going for walks and reading books. I’ve started to help out with the business side of the dental practice from home, and when my blood counts are normal I can go into the office, although I can’t see patients. I’ve only had one night in six months where I was repeatedly sick. And fortunately I haven’t lost my hair – people see me and are shocked that I look exactly the same!
“I hope that by the summer I will just be on maintenance chemotherapy which will last for two years. Everyone else was making new year’s resolutions and mine is simply to get through this treatment.
“Being positive has helped so much, and the support of my family. And also putting it out on Instagram! It took me a while but I had an account for my dental work there which I didn’t use very much. After it had all sunk in I felt ready to share. There’s a lot of support out there, others have reached out to me who are going through the same thing. It’s good for us to share our stories.
“The other thing that’s helped is that I feel they caught it really early. I saw my GP within ten days of having symptoms. At that point my white cell count was 22. Normal is between 4 and 11 but leukaemia can push it as high as 600. So mine was only slight raised. I’m glad I didn’t delay, and no one should ever ignore any symptoms.”
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