Gabriel was diagnosed with Acute myeloid leukemia (AML) and admitted to Cook Children's in November. Over the past six months, he has spent Thanksgiving, Christmas, New Year's and his birthday in the hospital. Now that he's accomplished his goal of walking an ULTRA marathon, Gabriel has set his sights on going home, which could happen at the end of the month. 

Miles in Motion is an incentivized walking program at Cook Children's, which rewards patients with gift cards for miles walked during treatment. The program is part of a larger initiative called Exercise is Medicine, which encourages patients throughout the hospital to stay active. 

“Our Joey likes to move at his own pace,” said his mother Denise Belles.

Joey arrived at Cook Children’s in June of 2019. What his family thought were headaches from recent growth spurts and allergies turned out to be a rare form of cancer called pineoblastoma. A tumor was growing in his head and spinal fluid was building up in his brain.

“At the time, he was going to football camp and loved it. Then we did the CT scan and within days, we got the diagnosis that changed our lives forever,” said Denise.

On July 3, Cook Children’s neurosurgeon Daniel Hansen, M.D. removed Joey’s tumor. Luckily, Dr. Hansen was able to get the entire mass at once. From there, Joey began a strict regimen of proton radiation therapy. In November, he was admitted to Cook Children’s Bone Marrow Transplant Unit to begin stem cell chemotherapy.

“It was really hard on his body,” Denise said. “You deplete them (patients) of everything and start from scratch. But the doctor said to Joey ‘You don’t have a shot if you don’t have the right attitude.’ So we came up with a plan and no matter what, we were going to be positive about it.”

Part of the plan came together after a visit with a physical therapist. She asked Joey to start walking and told him that if he kept track of his progress, he could win a gift card once he hit 10 miles. The incentive is part of a new program at Cook Children’s called ‘Miles in Motion’ which encourages hematology/oncology patients to get moving.

“When I first got here, I was sick and I was moving pretty slow,” said Joey. “We started walking the first day, but I could only do two laps.”

Joey would log his walks on a piece of paper in his room. Soon, the papers began piling up as he started making multiple laps around the unit.

Physical therapist Lydia Robey was part of the team that came up with the idea for ‘Miles in Motion’ as part of a quality and safety initiative to get patients out of their beds and exercising.

“We were brainstorming how to increase activity for this particular group of patients and one of our dieticians pointed out that these kids were losing muscle mass at a far greater rate than they should,” said Robey. “Some of that was due to inactivity, as well as steroids and medications that cause muscle atrophy. We started reviewing the literature and the evidence just became overwhelming of how important exercise is.”

Robey said due to varying blood counts, patients are not always able to do resistance exercise. However, she says walking is always good.

“Everyone agrees that walking is safe, so we wanted to find a way to motivate and empower families and patients to start walking as part of their daily routine,” explained Robey.

Joey and his parents did just that. They committed to walking each day during his four separate hospital stays, which spanned between two and four weeks each.

“For about a week, I did two to four laps a day and then I started getting to 10 and I thought ‘Wow, this is good!’ and then I started doing 20,” Joey exclaimed.

Before he knew it, Joey was walking more than 30 laps at a time, a feat that seemed impossible when he first started.

“There really is a noticeable difference between the first time I saw him and how he is now,” said Haleigh Schreck, one of Joey’s physical therapists. “He walks every single day on his own, no matter what he’s going through treatment-wise. His drive and motivation are very impressive.”

Last week, Joey hit a milestone that not even his physical therapists thought was possible. Joey marked off his 26^th mile in the ‘Miles in Motion’ program, which is equivalent to walking an entire marathon. Walking a marathon was never even a goal for Joey or for the ‘Miles in Motion’ program, but as he got closer to mile 26, he knew he had to go for it.

“We were just like, we’re this close to getting a marathon and I decided ‘I’m gonna do this,’” said Joey.

On Thursday, Feb. 20, Joey made his final laps around the unit were he’d been walking for the past four months. This time, nurses, child life specialists and physical therapists lined the walls. They held up handmade signs and cheered him on. With just five laps to go, Joey took one step at a time, thanking his mom and dad for their support as they finished the journey together.

At the final lap, excitement built as the medical staff cheered his name. “Joey, Joey, Joey!” they chanted until breaking into a loud roar as Joey ran through the finish line, a paper streamer strung across the hallway.

He did it. Joey walked a marathon.

“It was awesome,” he said basking in the wonder of his achievement. “I could have never done it without my family, the whole team we have. Everyone has been so supportive of me. It’s just truly amazing what we have done, me and my parents.”

This wasn’t the first marathon completed by a member of the Belles family. Denise ran the New York marathon in 2010, but she said this one was much better.

“This one is more rewarding,” Denise said. “His training was harder. I definitely feel more fulfilled with his than mine. It means so much more.”

If that wasn’t enough, finishing a marathon wasn’t Joey’s only major accomplishment of the day. It was also his final day of chemo.

“In the beginning, I really thought this was going to be devastating,” said Joey. “But everyone has been helping me and pushing me. With them, I knew I could get through this and do it with power.”

While he did have a supportive family and medical team, Joey also did what his doctor advised and had the right mindset throughout his cancer journey.

“Joey has been an amazing patient to work with,” said Haleigh. “I can’t remember a time when he wasn’t just smiling and having the most positive attitude. He blew all of our expectations out of the water.”

“I’m so proud of him. It shows how if you have the right mindset then you can overcome anything,” his mom said.

With his treatment coming to an end, Joey and his family are making plans for the future. They’re downsizing to a smaller home so they can take more trips together. This summer, they hope to go to Italy.

“We’re a close-knit family. We just love being together, but this has brought us so much closer,” said Denise. “We don’t want to wait to do stuff, like travel, anymore. We enjoy each other and we don’t take anything for granted.”

Jonathan has set an example for his entire family. At 11 years old, Jonathan was scheduled to compete in his fourth Cowtown, the Cook Children's 5K, event before it was canceld. And while he had hoped to place in the top three against more than 8,000 other kids, Jonathan's mom said her son has already motivated the family to achieve more goals than they ever could have ever expected.

Jonathan, his two brothers -- Elijah, 13, and Matthew, 10, -- and their dad, Juan, all run. This weekend’s race will be Jonathan’s sixteenth 5K in five years. Elijah has run in six Cowtown 5Ks and 18 total in eight years and Matthew was scheduled to run in his first Cowtown and third race since October of last year.

Juan has been inspired by his sons to run and in the process lose about 60 pounds in the past six years. He’s managed to keep the weight off by training and was going to run his first half marathon at Cowtown.

And while the family all competes at some level, it's Jonathan who has excelled the most with the most raw, natural ability. Lorena Barron, Jonathan’s mom, credits his first grade teacher, Mrs. Gaylene Chrystie, and his running coach, Cindy Rau, both at Burton Hill Elementary School in Fort Worth, for helping to motivate him to work hard.

"Jonathan liked running from the beginning," Lorena Barron, Jonathan's mom, said. "He was very good and competitive right away. So when Jonathan first started, he didn't have to try as hard. His teachers explained to be good in sports, you have to be good in school. You need to try hard in everything you do, including in the classroom. If he wanted to continue running as he got older or even someday compete in college, he would have to make good grades."

Jonathan listened. He became more focused in school and his grades improved. He became driven. Even at such an early age, Jonathan has learned to set goals for himself and work hard to achieve them, thanks to what he's learned from running. Jonathan ran the Cowtown 10k last year, the longest he had run at the time. He won his division and overcame the pain he felt from the longer distance.

"Running makes me feel happy," Jonathan said. "I liked being competitive. I like when I win, but even when I haven't won, I feel good if I know I've run my best. When I ran my first 10K, it was way harder. My legs hurt after the fifth mile. That was the longest I'd ever run. But I felt really good after it was over because I finished it."

Since he began running, Jonathan has changed in many ways from being more confident to being fit. He drinks water instead of soda now and orders grilled chicken and salad over burgers and fries. But he's not the only one who's seen the benefits of running.

"Running has helped the whole family," Lorena said. "When Elijah started running, Jonathan and my husband wanted to train with him. Being as overweight as Juan was, it wasn't very easy on him. But he kept going and now he's just as healthy as my sons. I don't run, but I walk with them. We all try to eat healthy and take care of ourselves. Running has helped to make our whole family healthier."