Leukemia patient Michelle Bail celebrates four years cancer free
Michelle Bail never thought she would be fighting for her life five years ago during the holiday season.
“I thought I had a bad stomach virus and was very nauseous, and had no interest in eating because I couldn’t keep anything down. I was also more tired than usual, especially at work, and the lymph nodes under my arms were swollen, which I ignored,” said Bail, identifying some of the common symptoms of leukemia.
After spending a less than “Happy Thanksgiving” at a large gathering of family members, the South Hadley woman found herself at her primary care doctor the following Monday.
“He ordered blood tests, and then I heard from the office the next morning and they wanted me to come in right away. When I got there my doctor asked me who my oncologist was. I told him that I didn’t have one and he said to me, ‘You do now,’” Bail said about learning she had leukemia.
“I was devastated and very angry for some reason upon learning the news. I couldn’t stop thinking of my husband, our children and grandchildren, and wondering what I did to deserve this fate,” she added.
Wasting no time, her doctor had her admitted that afternoon to Holyoke Medical Center.
“I met with an oncologist there, who I liked very much. But the doctor told me that because of the acuity of my leukemia, I really needed to be at Baystate Medical Center. Before the day was over, I was transferred by ambulance to Baystate,” said Bail, who noted that before even arriving at the hospital, she was told she needed to be treated by Dr. Richard Steingart, a hematologist oncologist in the Baystate Regional Cancer Program.
Bail’s leukemia diagnosis was for acute myeloid leukemia, a cancer of the blood and bone marrow, whose symptoms often mimic those of the flu. Considered to be the most common type of acute leukemia in adults, this type of cancer usually gets worse quickly if it is not treated.
A common, but deadly disease
According to statistics from the American Cancer Society, in 2016 an estimated 19,950 people of all ages in the United States will be diagnosed with AML, the second most common type of leukemia diagnosed for both adults and children. An estimated 10,430 deaths will occur from the disease. The five-year survival rate is approximately 26 percent and depends upon a number of factors such as age, the subtype of AML, which gene or chromosome changes the leukemia cells have, and response to treatment.
“The good news is that thanks to advances in cancer research, supportive care, and the development of new treatments, more and more people are surviving this blood cancer today,” said Steingart.
Chemotherapy is the main treatment for AML, aimed at killing rapidly dividing cancer cells. Patients who are younger than 60 respond best to treatment, with some 80 percent going into remission after their first round of chemotherapy, referred to as the induction phase. But, at the end of a year, only 30 to 40 percent are alive as relapses occur commonly.
Although Bail’s primary care physician suspected leukemia based on the results of her blood test, it wasn’t until after being admitted to Baystate and being placed on intravenous hydration that a bone marrow test confirmed her diagnose of AML on Dec. 2, 2011.
A turn for the worse
Just days after being transferred to Baystate, Bail’s health took a sudden and unexpected turn for the worse.
“I was sitting next to my wife one evening in the hospital and noticed her breathing pattern was labored….not the same as it normally was. She was taking long, deep breaths, almost like she was hyperventilating. So I called for the nurse and before we knew it, Shelly was being wheeled up to the intensive care unit,” said Bail’s husband, Christopher.
“Everything was failing, her liver, her kidneys, her lungs, and Shelly was put on a ventilator,” he added recalling what he referred to as a “harrowing experience” for all.
Clinical staff in the intensive care unit (ICU) frantically tried to reach Dr. Steingart to inform him what was happening. They were able to track him down in New York City, where he was visiting for the weekend.
“Michelle had chest pain, shortness of breath, and hypoxia (oxygen deprivation) with fever. Initially, we thought that she could have cardiac dysfunction, but this was ultimately ruled out. It was then felt that the pulmonary infiltrate (blockage to an air space in a lung caused by the build-up of a substance that is foreign to the lung) seen on her chest x-ray could be due to her leukemia and high white blood cell count. That’s when I made the decision to proceed immediately with chemotherapy while she was being monitored in our ICU,” said Steingart.
A dire message
“About all I can remember is someone coming in to tell me they had reached Dr. Steingart and that we had a choice to make. She told me that he wanted her to tell me that he wanted to start chemotherapy immediately and ‘if the leukemia doesn’t kill you, then the amount of chemotherapy I’m about to give you probably will,’” said Bail.
She made the right choice.
“It was like a miracle. For someone who was supposed to die that night, when Shelly woke up the next morning, her breathing was much better and she spoke very coherently,” said her husband.
Bail’s long-term treatment consisted of one cycle of induction chemotherapy and two cycles of high-dose Ara-C consolidation chemo.
“The consolidation is a means of giving high dose therapy to ensure that the leukemia does not come back,” explained Steingart.
Complications set in
According to the Baystate hematologist, each time Bail received her consolidation chemotherapy in the hospital, she later developed neutropenic fevers. Considered by some doctors as an oncologic emergency, patients with neutropenia must be quickly diagnosed and treated appropriately to survive.
“One thing I can say about Dr. Steingart is that he was always so available," said Bail. "He would come into my room and explain everything to me about my cancer, what was happening to me, how my treatments were going, and any challenges I would be facing. I can still remember one of his very first visits with me when he was brutally honest and I appreciated that. He told me, ‘I am going to treat you and you are going to be very, very sick along the way before you are better.’ I never felt in the dark about my treatment and what was going on. And, as I got to know Dr. Steingart better as a doctor, I always felt safe when he came in to talk with me.”
Her husband agreed about Steingart’s willingness to explain everything and his ability to make it understandable.
“For example, when Shelly landed in the ICU, Dr. Steingart explained when he returned from New York that what had happened was the white blood cells were attacking her lungs and that was making it difficult for her to breathe. He also used a great analogy, talking about your lawn and weeds, to explain how the chemo was going to make my wife better,” he said.
In the hospital more than out
Bail said it seemed as if “I was never out of the hospital more than a week at a time.” She eventually had her last round of chemotherapy around Memorial Day in 2012.
“I distinctly remember being in the hospital for Valentine’s Day and even for Christmas; on Christmas Eve we Skyped to the celebration at my daughter’s house,” she added.
On several occasions, Bail was septic, meaning she had severe blood infections requiring antibiotics requiring additional stays in Baystate’s ICU. She was admitted when she was neutropenic. And she also had C. difficile infections – all as a result of her immunocompromised state.
“I was so sick at times with a fever as high as 106 degrees. I remember waking up at one point in the ICU and seeing my husband and children crying and surrounding my bed. I remember saying to them, ‘Am I dead?’” said Bail.
A stint in rehab
Bail needed some intense physical therapy after one of her long stays in the hospital. She spent a month at Weldon Rehabilitation Hospital to help get her strength back and to improve her walking after being bed-bound for so long.
“I was afraid to leave the hospital. I know it sounds weird to say that, but Baystate had been my home for so long. It is not always easy to find a place at the Weldon Center, but Dr. Steingart worked very hard to get me in there. He always had my best interests in mind,” she said.
Once her inpatient chemotherapy was completed, Bail began a long process of visits to her hematologist.
“It was nerve wracking going in for visits, but comfortable at the same time. Every time I had blood work I was afraid for the results, but Dr. Steingart always personally called me at home with the results, which were always good,” said Bail.
Four years cancer free
“I remember having my last bone marrow aspiration and biopsy on July 12, 2012 at Dr. Steingart’s office. I was so scared to learn if I was in remission; if not, I would need to get a bone marrow transplant,” she added.
Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is the removal of a small amount of this tissue in liquid form for examination. It is not the same as bone marrow biopsy, which removes actual marrow for examination. The process is used to diagnose and follow the progress of various conditions, such as cancer.
Since September 2012, Bail has been in remission and recently celebrated four years of being cancer free. She no longer has regular visits with Dr. Steingart, but must have bloodwork 1-2 times a year as a precaution.
To say Bail’s admiration for Dr. Steingart is boundless is an understatement.
Tears of joy
"Whenever I saw doctor Steingart outside of the hospital setting, I would cry. He once said to me, ‘Whenever you see me, you start to cry.’ I responded by telling him, ‘You gave me my life back. You are the person responsible for me being able to do the things I do today and for the rest of my life,'" said Bail.
“Dr. Steingart was just so unbelievably good to me, a wonderful doctor and man. And, I’m sure he’s the same way with his other patients. He still hugs Chris when he sees him,” she added.
She also had kind words for the hospital’s Oncology Unit.
“I don’t know how they [staff] do it...working with very sick cancer patients day in and day out. They became like family to me and were so supportive of my own family as well,” said Bail.