From Cyclist to Survivor: Kegan Machen's Unexpected Journey with GPA
Kegan is a 32-year-old attorney and avid cyclist in Idaho Falls, Idaho, who faced a life-altering diagnosis of granulomatosis with polyangiitis (GPA) at age 29. This rare autoimmune disease, causing blood vessel inflammation, rapidly reshaped his reality, leading to extensive hospital stays, multiple joint replacements, and the daunting task of rebuilding his career while navigating a new physical landscape. Despite immense challenges, Kegan embodies grit, empathy, and a steadfast sense of humor.
His journey to diagnosis was swift. “I began coughing up blood, and when my blood oxygen dropped into the low 80s, I was rushed to the ER and quickly admitted to the ICU at St. Luke’s Boise Medical Center,” Kegan recalled. His lungs were filling with blood, leading to a GPA diagnosis within days in January 2022, thanks to the critical involvement of rheumatologist Dr. Achini Dingman and other specialists. The process involved a CT scan of his lungs, followed by a definitive kidney biopsy. Kegan had never heard of vasculitis before his diagnosis. “The only good thing about having such a quick and serious onset was a quick diagnosis,” he added.
Post-diagnosis, a cascade of complications arose. High-dose steroids caused avascular necrosis (bone tissue death from lack of blood supply) in his hips and shoulders. Within a year of diagnosis, Kegan endured four major joint replacements—both hips and both shoulders.
Before GPA, Kegan was exceptionally active, enjoying various sports, especially cycling. The joint replacements drastically altered his physical capabilities. “Accepting that I can’t do a lot of the things I used to enjoy was the hardest part,” he admitted. Though he’s returned to cycling, it’s a struggle. “My lungs are still not the same,” he explained, making the comparison to his past performance a “gut punch.”
Beyond physical limitations, persistent fatigue became his most frustrating battle. Kegan’s diagnosis coincided with law school graduation and bar exam studies. Despite being discharged from the hospital on oxygen just weeks before the exam, he persevered and is now a practicing attorney, a demanding profession that, combined with chronic fatigue, requires immense fortitude.
Kegan achieved remission in spring 2023, but a change in insurance in November 2024 led to a relapse when he was switched from Rituxan® to Ruxience®. “My body did not agree with this, and I officially relapsed,” he said. His markers spiked, and he felt absolutely miserable while still working full time.
“When I moved from Boise, Idaho, back to my hometown of Idaho Falls in June of 2022, I began seeing rheumatologist Craig Scoville,” Kegan said. Fortunately, Dr. Scoville, advocated for Rituxan’s re-approval. Kegan’s current treatment regimen consists of taking Tavneos® and receiving two routine Rituxan infusions every four months.
Even in remission, a consistent feeling of being unwell persists. “I never actually feel that great or even close to what I felt like before diagnosis,” Kegan shared. The emotional and mental toll has been significant, intensifying his pre-diagnosis anxiety and depression. “It was accepting that everything I thought my life would be is now very, very different.” Yet, this adversity also revealed his resilience. “I have learned that I can do hard things,” a mantra that, along with “it could always be worse” and his late grandpa’s “a-okay,” guides him.
In a testament to his determination, Kegan completed a 100-mile bike ride (a “century”) in May 2024, just months after his last shoulder surgery. “It was incredibly painful physically, but mentally it was just a whole other level,” he recalled, grateful for proving to himself that he “could do it and did it.” He plans to repeat the ride, continually pushing his boundaries.
Kegan attributes his survival and perseverance to his “incredible support system,” especially his wife, Jocelyn Biddulph. During his critical hospital stay, when COVID-19 restrictions prevented visitors, she received updates while caring for their two young children. “I truly believe that I would not be alive today if it were not for her,” he emphasized, noting doctors confirmed he would have drowned in his own blood had he delayed seeking care.
Kegan’s father-in-law, an orthopedic surgeon with his own autoimmune disease, provided crucial medical insights. His brother, a professional photographer and cyclist, also inspired Kegan, making their century ride together “one of the most impactful and important experiences of my life.”
Kegan manages his condition by relying on his medical team, using short bursts of prednisone for flare-ups, and finding relief in Epsom salt baths. He emphasizes the importance of movement, noting, “the less I move the worse I feel.” He has also increased exercise and lost 65 pounds since diagnosis.
While he hasn’t experienced a profound shift in perspective from his near-death experience, Kegan cherishes the ability to witness his children grow up. He grapples with lingering bitterness and anger, drawing strength from friends who’ve faced even more dire circumstances.
Looking to the future, Kegan finds hope in his family and small victories. His markers are back in the normal range, fueling his ambition for another century ride with his brother, Karter. “Those little things give me hope and things I look forward to,” he said. He aims to continue challenging himself, growing mentally, physically, and emotionally, and looks forward to playing with his children and attending their events.
For those newly diagnosed with vasculitis, Kegan offers heartfelt advice. “Validate your fear, frustration, pain, and questions. Be patient, but most of all be patient with yourself.” He acknowledged the profound isolation the disease can bring and the difficulty others have in truly understanding. “You can do hard things,” and encourages joy in small victories as simple as putting on your socks. He cautions against self-pity, emphasizing processing grief without letting it consume life. “You undoubtedly will get stronger as you battle on.”
Kegan is involved in GPA (Wegener’s) Facebook groups, sharing his unique story to help others.
