As a flight medic in the U.S. Army, Nicklaus Lego knew heroes came in all shapes and sizes. But now, as a bone marrow transplant recipient, Nic also knows that sometimes heroes don't wear combat fatigues. Sometimes they wear medical scrubs — saving lives with compassion and kindness.
Two years ago, Nic was diagnosed with acute myeloid leukemia and underwent a bone marrow transplant at Mayo Clinic. During his transplant, which was overseen by oncologist Jeanne Palmer, M.D., in the Bone Marrow Transplant Program, Nic experienced the steadfastness and strength of a medical team dedicated to his survival.
The care Nic received from his team at Mayo Clinic's Arizona campus not only restored his health, it stirred in him the desire to be a part of that lifesaving group. In February, Nic got his wish. Now he works alongside the Mayo clinicians who gave him a second chance at life.
"A lot of times, people who go through transplant don't want to deal with it anymore," says Nic, who's now a scheduler in the Department of Hematology/Oncology at Mayo Clinic's Arizona campus. "But I wanted to be around the people who took care of me. If I could make their lives easier, that was my goal."
In 2015, Nic was stationed at an Army hospital in Honolulu, Hawaii, "living the dream," he says. But in late December of that year, two months before he was scheduled to deploy to South Korea for a training mission, the husband and father of three small children began feeling off-kilter.
"I was doing 12-hour hospital shifts four to five days a week. But I didn't just do the shifts. I did two hours of physical training in the morning," Nic says. "So being tired was kind of what I was used to."
Along with fatigue, however, Nic started to notice other problems, too. He developed petechiae, a rash-like bruising, on his body. Running up stairs caused shortness of breath. A broken ankle became severely bruised and didn't heal properly.
Days before his departure to South Korea, Nic received a series of inoculations. Vaccinations usually caused Nic to feel tired. This time, however, the shots sidelined him completely. He developed a fever and had trouble getting out of bed. "I couldn't get my temperature down," Nic says. "I was not coherent and wasn't aware of what was going on."
Nic's wife, Michelle, managed to get Nic out of bed and into the emergency department at his Army hospital. At the hospital, a colleague recognized immediately that Nic looked unwell and took him for bloodwork. A short time later, several members of his care team approached Nic, telling him to brace himself.
He learned his white blood cells, the cells that fight infection, were incredibly high. Meanwhile, his platelets, which help blood clot, and red blood cells, which carry oxygen through the body, were extremely low. "They said, 'We don't know exactly what you have, but it's probably cancer,'" Nic says.
Nic was transferred to an intensive care unit. Over the next five days, he had numerous tests and blood transfusions. His situation was dire. "I had a couple of oncologists tell me, 'Its acute leukemia, and it's pretty bad,'" Nic says. "They said, 'We really don't know if you're going to make it.'"
Like Nic, many people who develop acute myeloid leukemia, or AML, brush aside their initial symptoms as something minor, Dr. Palmer says.
"A lot of young people come in thinking they're just having a cold or feeling like they're just run-down," she says. "It's a bit of a shock to their system when someone draws their blood and says, 'You have acute leukemia.' And then they have to stay in hospital for a month."
Nic was transferred to a nonmilitary medical facility where his bone marrow was biopsied and his leukemia treatment began. Nic remained in the hospital for two months, receiving high-dose chemotherapy to reign in the leukemia. In May, with the cancer in temporary remission, Nic and Michelle flew to Mayo Clinic to meet with Dr. Palmer for a bone marrow transplant (BMT) consultation.
"Dr. Palmer was very open and willing to discuss everything," Nic says. "When you go in there, you don't have any idea of what to truly expect with BMT. She was very willing to sit there and talk me through every little bit of the transplant, which was really nice."
"(Dr. Palmer) made me feel like she was the kind of person that was going to get me through the process. It was good to hear those things to get the kind of hope you need and want."Nic Lego
During their conversation, Nic learned that the transplant and recovery process can be long. "Patients get admitted for about a month, where they get high-dose chemotherapy, and then the stem cell product is transfused," Dr. Palmer says. "In the hospital, their blood counts go down to nothing, and they are at a high risk of infection. They will kind of feel like a Mack truck hit them."
But Dr. Palmer also reassured Nic and Michelle that there were reasons for optimism. "She made me feel like she was the kind of person that was going to get me through the process," Nic says. "It was good to hear those things to get the kind of hope you need and want."
Following the consultation with Dr. Palmer, Nic and Michelle returned to Hawaii to wait for Army orders transferring him to Arizona. During this time, his wife prepared the family to relocate while Nic underwent another two-week round of inpatient chemotherapy.
Nic's orders came through in early July. He and his family flew back to Arizona, where they moved in with Michelle's parents. On July 20, Nic was admitted to Mayo Clinic Hospital, and he began pretransplant chemotherapy to prepare his body for the bone marrow transplant. Nic received his new cells via an infusion on July 31.
Although Nic had received chemotherapy before, the pretransplant chemotherapy was harder for him to handle. He experienced severe nausea and vomiting, and developed mouth sores. Nic also had an allergic reaction to one of his medications and went into kidney failure. But the attention and compassion of his providers helped him through the ordeal.
"The nurses were phenomenal. They were very aware of what I was going through," Nic says. "They were very kind and very willing to make sure I got every bit of care that I needed. It wasn't just about my physical health, but my emotional and mental health through the process."
During his lengthy hospital stay, Nic was visited by several physicians who encouraged him. He recalls talking with one hematologist in particular, Allison Rosenthal, D.O. "Dr. Rosenthal told me that she had been through leukemia treatment and made it through," Nic says. "Her story of being a leukemia survivor helped me realize I wasn't alone in this process. Her significant act of human connection had a huge impact on my care early on."
Nic was discharged after more than a month in the hospital. Then for the next several months, he returned to the clinic several times a week for lab work and medications. "The road to recovery for me was a long process," Nic says. "I really, truly started to do normal things at about six to eight months after the process, but I haven't truly felt good until six months ago."
"The kindness from the nurses and doctors was something that was so different that it made me think that if I could be a part of that on any level, maybe I could make an impact in others' lives by working at Mayo Clinic."Nic Lego
Nic says keeping his body and mind active throughout his rehabilitation helped him deal with the lingering effects from the transplant. He continued cooking meals, doing chores and exercising as much as possible. He learned new hobbies, dabbling in woodworking, welding and knife-making. He also spent time thinking about how we wanted to spend the rest of his life.
"The kindness from the nurses and doctors was something that was so different that it made me think that if I could be a part of that on any level, maybe I could make an impact in others' lives by working at Mayo Clinic," Nic says.
He began the process of medically retiring from the Army and started searching for open positions at Mayo Clinic. When Nic saw a vacancy in the department that had provided his treatment, he applied for and was offered the job.
For Nic, who will continue receiving regular bloodwork to check for signs of cancer recurrence for the rest of his life, going to work each day is a pleasure. "I get to be around the people that I connected with already, and it's made my job easier. They all know who I am, where I've been. Coming into that kind of environment really helped in the healing process. Just like deployments, AML is a very difficult thing to get past mentally, and it's very difficult to let go of the memory of it all."
For Nic's colleagues, seeing him thrive following his medical ordeal is gratifying, Dr. Palmer says. "He has a terrific attitude about him, so it's great to see him working here. He's always been very fun and easy to work with. He knows the nurses really well, so he's a good morale booster. Plus, it's always good to see a successful outcome."
Although the route Nic traveled to arrive at his position took him near death, it changed his perspective on life. "I am grateful daily for the people who are around me — a team that matters far more than they will ever know," he says. "The countless hours they spent working to get me better I can never repay. But I'll give all that I am to the people who quite literally saved my life."
Tags: Acute myeloid leukemia, Bone Marrow Transplant program, Cancer, Department of Hematology/Oncology, Dr. Allison Rosenthal, Dr. Jeanne Palmer, Kidney Failure, Mayo Clinic Hospital, Mayo Clinic in Arizona, Transplant