BALTIMORE — Dawn Shepherd has a tough time recalling much from the beginning of her scary and painful medical journey that started in 2019.
"I was so sick. I didn't realize how sick I was," she said. "I knew I was in bad shape but I didn't realize I was near death."
Shepherd was going in and out of emergency rooms with various aches and pains in places like her back, ribs and abdomen. The pain was so intense at times, she has trouble remembering everything and relies on her husband Mickey Shepherd to fill in the gaps.
"We probably went to five to six doctors," said Mickey. "The fact is they just missed it, didn't quite see it until her arm broke in half."
That broken arm, which turned out to be a hole in Shepherd's bone, led her to Dr. Matthew Wallace, an orthopedic oncologist at MedStar Franklin Square Medical Center.
"She just looked absolutely miserable. She was lapsing in and out of consciousness, very uncomfortable, just very very miserable," he said. "By the preliminary blood work by the end of the day, we diagnosed her with multiple myeloma."
Dr. Wallace said myeloma is cancer of the plasma cells in the bone marrow. It can cause a number of problems including holes in bones, destructive lesions, and fractures.
"When you have that much bone destruction, it really puts a lot of stress on other organs," said Dr. Wallace. "By the time she was admitted, her kidneys were in shut down mode, her calcium levels were twice the normal range and that tends to cause things like heart arrhythmia, coma, mental status changes and a lot of abdominal distress."
A team of MedStar Health doctors started treating Shepherd right away. She was critically anemic, which would normally require a blood transfusion to make treatments like chemotherapy and surgeries safer and more effective. But a blood transfusion wasn't an option for Shepherd.
"We had a lot of confidence in the team. We realized it was complicated by the fact that we are Jehovah's Witnesses and won't accept a blood transfusion," said Mickey Shepherd. "But fortunately MedStar [Health] is very progressive."
"Part of what we do, at least as a multi-disciplinary team, is what we call shared-decision making with the patient," said Dr. Wallace. "What are our patients willing to tolerate, what are they going to agree to or not agree to and work within those parameters."
Dr. Wallace was able to fix Shepherd's arm without a blood transfusion and she slowly began to get better. She is getting a round of radiation to address newly-discovered lesions.
There are many lines of treatment for multiple myeloma and Dr. Wallace believes Shepherd has a good prognosis.
"While most patients will have to live with this to some degree, like a chronic disease, it something that has very good long-term survivorship these days," he said.
Shepherd knows she'll have to deal with myeloma for the rest of her life but she has a support system both at home and at MedStar Health to get her through it.
"The MedStar system and what they've provided for me, I can't say enough," she said.