In the Clear: Ismael's Story

As a toddler, Ismael triumphed over a cancer diagnosis that could have robbed him of his vision. He is thriving today thanks to early detection by AltaMed pediatrician Tiffany Damikolas, M.D., his own resilience, and his loving family.

When Ismael was 18 months old, his aunt noticed something unusual about his eye: Ismael’s iris would go from black to looking like a crystal ball, and then to black again. So she told mom Ariadna, who had never seen this happen.
Ariadna would notice nothing unusual until the new year. “Ismael woke up, rubbed his eyes and it turned literally like white crystal,” she says. Immediately, Ariadna took a picture. “Then he rubbed his eyes again and it went back to normal.” Concerned, Ariadna made an appointment with Tiffany Damikolas, M.D., at AltaMed. 
“The picture Ariadna showed me is a picture you never want to see,” says Dr. Damikolas, Regional Medical Director of AltaMed’s Orange County clinics. “As a pediatrician, you always want your kids to be healthy.” 
Dr. Damikolas performed an exam of Ismael’s eye and saw a gray-white mass in the back of his eye. She talked to Ariadna about the possibility of a tumor. Dr. Damikolas left the exam room and called a pediatric ophthalmologic subspecialist at Children’s Hospital of Orange County (CHOC).
By that evening, Ismael was admitted as an inpatient at CHOC so he could get an MRI and a CT scan. The diagnosis was retinoblastoma, a type of childhood eye cancer that can spread very quickly. By the following week, the family had an appointment to see Jonathan Kim, M.D., then the Director of the Retinoblastoma Program at Children’s Hospital Los Angeles—and a treatment plan.
“When I heard the word ‘cancer,’ everything went down from there,” says Ariadna. “Dr. Damikolas was on the phone, too, when I got the news from CHOC. She told me I needed time to process what was going on. Later, Dr. Damikolas filled out all the paperwork and explained it to me. It was smooth because of her. She’s so lovely, so friendly. Straightforward, but in a good way.”

At AltaMed, a holistic approach has long been our strategy for creating a healthier, more equitable world. Born of a social justice movement, AltaMed advances medical care while addressing social factors to close gaps in care. This whole-person, community-based approach is the foundation of the AltaMed H.E.L.P. (Health, Equity, Life, Programs) campaign.

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Caring for the Mind, Body, and Spirit

During Ismael’s treatment, Dr. Damikolas linked Ariadna to mental health care, case management, transportation vouchers, and a program for siblings of children affected by cancer. “Filling out forms is the least I can do,” says Dr. Damikolas. “When mom needs other types of assistance, I make sure I can do all those pieces so that she can just be a mom with her son.”

Ismael received six months of chemotherapy to dissolve the tumor. At the six-month mark, scans revealed that the chemotherapy was dissolving some of the cancer, but some cancer cells were spreading, too. “Dr. Kim told us that this was dangerous and it could go to the brain, and it would be more difficult for the chemo to work,” says Ariadna. “So that’s when he told us the second option was to remove the eye. That way, there would be no more chemotherapy, no more nothing, just regular checkups. We decided it was for the best.”

Now, Ismael visits his oncologist just once a year. Ismael’s story illustrates the importance of AltaMed, says Dr. Damikolas. “We choose to work at AltaMed to provide much-needed care that would otherwise not exist. If we weren’t here, Ariadna may not have had the ability to see a pediatrician when she took that photo of Ismael’s eye. She might have gone to an emergency department, potentially without any pediatric specialists or pediatric-trained doctors. They might have been sent home.”

Today, Ismael is a happy, active kindergartner. “He’s always smiling,” says his mother. At a recent parent-teacher conference, she learned that his classmates “fight” over which one of them gets to play with Ismael. “I often think about how strong Ismael was through all of it,” Dr. Damikolas says. “He’s in the clear now. We made it. And we made it with his vision intact.” 

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two children playing

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