When Donna Ford, 52, took a tumble at her home in Livingston, Texas a year ago, she shrugged it off.
Her left leg was amputated previously so "falling is not uncommon for me," Ford, a nurse, tells TODAY.com. Although she fell on her bottom, she felt a "charge" all the way up in her head. "I didn't hit anything, but I felt it," she says.
Ford went to work that night and developed a headache, "but that's not unusual either," she says.
However, by the time she got back home from her late shift the next morning, Ford says her vision was "off" and she heard a "rushing sound" in one of her ears. At that point, she asked her husband to take her to a standalone emergency room, which transferred her to a nearby hospital.
There, Ford was diagnosed with a subdural hematoma, which occurs when blood pools in the skull and puts pressure on the brain, the Mayo Clinic explains. Ford received a brain scan and was then discharged, she says, but her condition soon became more serious.
"I went home and I slept that night," she recalls. "But when I woke up, I started puking. And as a nurse, I knew that that was not a good thing."
Back at the standalone emergency room, another brain scan confirmed that Ford's brain bleed had gotten "significantly worse," she says. So the staff decided to fly her to Memorial Hermann Memorial City Medical Center in Houston, where she received an even more surprising diagnosis: leukemia.
Sometimes, unusual bleeding can be a sign of cancer
Ford was diagnosed with acute promyelocytic leukemia (APL), a specific type of leukemia that affects the bone marrow and is caused by two specific genetic mutations, according to Medline Plus. Like other forms of leukemia, APL affects the blood cells and platelets, making it more difficult for the body to properly form blood clots.
Most people who have APL have relatively mild symptoms, Dr. Adan Rios, an oncologist with UTHealth Houston and Memorial Hermann who treated Ford, tells TODAY.com.
Those signs might include bruising easily, heavy periods, nosebleeds and small red spots under the skin called petechiae, Medline Plus says. Other APL symptoms can be more vague, such as fatigue, joint pain and loss of appetite.
But about one in 10 patients "will have serious bleeding, and it's often bleeding in the brain," Rios says. People with this type of cancer have issues with excessive bleeding, which can make it challenging to treat the complications like this that require surgery, he explains.
Severe bleeding and an experimental treatment
Today, APL is quite often treatable with the current treatments we have, Rios says. “So (a brain bleed) is a complication that can derail a potentially curable disease.”
Until recently, doctors only had two options to treat patients in Ford’s situation: First, if the bleeding wasn’t too severe, they could progress with cancer treatment and hope the bleeding didn’t get worse, he says. Or, if the bleeding does get worse, they would require invasive brain surgery to treat the hematoma.
"That becomes a very challenging process,” Rios says, which comes with higher risks for the patient. "You can envision how complicated and potentially catastrophic this set of circumstances is," he says.
But there was another option. And Ford became the third patient in the U.S. to successfully undergo a new minimally invasive type of treatment.
During the new procedure, surgeons snake tiny catheter tubes up through the groin area into the brain. From there, they can block the artery in the brain that's feeding the bleed, most often the middle meningeal artery, Rios says.
With the correct artery blocked, "the blood supply to the hematoma ceases and the hematoma starts decreasing in size," he explains.
A dramatic recovery process
The surgery may be minimally invasive, but the results can be dramatic — and fast.
"In a matter of 24 to 48 hours, (patients are) basically back to normal without having to undergo neurosurgical intervention in the brain," he says. "That's a wonderful illustration of the progress that has been made in the management of these complicated disorders."
After the procedure, "I had a small little bandage on my thigh, but that's it," Ford recalls. "I felt no pain anymore. The vomiting was gone. I just felt a lot better."
The confusion that Ford had felt after her fall also cleared up within a week of the surgery, she says. "It took a little while for me to know exactly what was going on and to remember stuff that they'd told me," she recalls.
But, once the brain bleed had been treated, her doctors could focus on treating the underlying cancer. And, just last month, Ford finished her last of four rounds of chemotherapy, she tells TODAY.com. She'll now continue to go for follow-up appointments
And, she says, her 15 years of experience as a nurse helped keep her spirits up throughout the process, even when her situation was severe. Ford, whose parents donated their bodies to science, is proud to follow in that lineage, becoming a success story for a developing surgical treatment method that Rios says may soon become the standard of care.
"It was pretty scary, but in the back of my mind I knew what was going on, and I knew it could be taken care of," Ford says. “I was calm in the sense that I knew I was where I needed to be.”
