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UAB Medicine Social Worker Battles Multiple Myeloma into Remission

UAB Medicine employee Sally Herring is a social worker who helps patients transition from hospital to home. Her experience has taught her the value of ongoing communication, empathy, and supporting patients on the path to wellness.

That experience took on new significance in February 2017, when Herring was diagnosed with multiple myeloma (MM), a cancer that forms in a type of white blood cells called plasma cells. It causes cancer cells to build up in the bone marrow, where they overwhelm healthy cells and develop into multiple tumors, usually in the bones. People with MM often suffer from anemia (a shortage of red blood cells), bone and calcium problems, infections, kidney issues, and other complications.

March is Multiple Myeloma Awareness Month, so Herring used the opportunity to share her story. Several years ago, she underwent routine blood tests before starting a medication to prevent osteoporosis (brittle bones), a condition her mother had. The tests revealed that Herring had monoclonal gammopathy of undetermined significance (MGUS), a condition in which an abnormal protein is present in the blood. It often causes no problems but can lead to some forms of blood cancer such as MM.

Monitoring

She visited UAB Medicine hematologist/oncologist Uma Borate, MD, who began monitoring the MGUS. “I didn’t even research it,” Herring says, “because I know how scary it can be to go online and start learning about your own medical problems.”

In fact, Herring wasn’t overly concerned at the time, because MGUS leads to malignant disorders in only 16 percent of cases, and only about 10 percent of patients with MGUS develop MM over time. Blood tests every 90 days initially revealed no changes in her numbers. Once changes began to register, however, Dr. Borate suggested that Herring begin seeing UAB Medicine hematologist/oncologist Kelly Godby, MD.

“While Dr. Godby was watching my numbers, I was still stable, but in the fall of 2016 I began showing signs of anemia, so I began taking an iron supplement,” Herring says. “I had two biopsies and PET scans, but we saw nothing to be concerned about. I still had plenty of energy. I’ve always been very active and athletic, and I really didn’t feel any different. Then one week, just as I was about to have some tests done, Dr. Godby called and said I wouldn’t need those new tests. Or, to put it another way, I was diagnosed with MM. It’s the kind of news that certainly knocks you back for a moment, and I had that moment. But then my first question was, ‘Okay, what are we going to do now?’”

Drug Trial

Herring recalls that Dr. Godby already was preparing a care plan, including at the possibility of participating in a drug study that was in its second phase at UAB. She ultimately was approved for the drug trial and began treatment in March 2017.

“From March through June of that year I had an infusion of the study drug every Monday, along with chemo injections,” Herring says. “I could feel the effects start to hit about two days after receiving the meds. I was worried about how that would affect my workday. The hospital and all the employees I work with and supervisors have been so amazing and wonderfully understanding, so I never wanted to take advantage. I didn’t want to play my ‘C’ card. I take the shuttle from the parking lot to wherever I might be working with a patient and the transition care team on a given day, or I walk if the weather is nice. I was determined to do that, even during treatments, because something about maintaining a normal routine seemed to help. The walk was a good time for me to get centered, and it was also my prayer time. Then one Thursday I got weak and shaky. I was going to need stem cell replacement.”

Herring would undergo an autologous stem cell transplant, followed by high-dose chemotherapy with autologous stem cell rescue. In an autologous transplant, a patient’s stem cells are harvested via centrifuge and frozen. After chemotherapy, the cells are returned via intravenous infusion, and when they reach bone marrow, they grow, multiply, and help the marrow make healthy blood cells again.

“They harvested my stem cells in June last year,” Herring says. “Then on the first day of July I received the biggest, meanest chemotherapy that I think even exists. I can’t imagine what could make me feel worse than how that chemo made me feel. The pain was pervasive, and the nausea was ridiculous. I think I was throwing up for the entire 30 days. Once my body was able to produce red blood cells, I went home. I was fortunate that I only had to drive a couple of miles to get home. You’re still very, very sick and miserable, even though it seems like getting home will be this magical transformation from the effects of chemo. It wasn’t. It took a few weeks to even get my energy back. Then there was a day when all of sudden I felt like I was back to my normal self. I’ve dealt with pneumonia, then the flu last fall, and recently a case of bronchitis. But the idea is to keep the MM in remission, and that’s where I am right now. And I have a lot of people to thank for that.”

Paying It Forward

Herring says her experience, as difficult as it has been, provides her with what she calls “authentic” empathy, which is a resource she will call on in her future work at UAB Medicine.

“If I tell a patient about my own treatments, that builds trust, because they will know that I have a practical understanding of what they’re dealing with, not just sympathy,” Herring says. “When I went into the hospital to have my stem cell transplant, a lot of people who didn’t know I had been ill said ‘Oh gosh, I didn’t know Sally had been sick all this time. She always looks so healthy.’ A friend at church replied to them, ‘Yes, Sally does cancer well.’ Of course we laughed, but I really do take that as the best possible compliment. Early on, Dr. Borate said she was confident that I would never let my illness define me. She was right. It’s a part of me, but it’s not who I am. Now I hope I can pass that idea along to the patients I help.”

The UAB Multiple Myeloma Clinic – a collaborative effort between UAB’s Division of Hematology & Oncology and the Bone Marrow Transplant Program – is the first and only clinic of its kind in Alabama. Click here to learn more.