Being one of the nation’s top hospitals is a reputation we strive to earn every day, for every patient. We’re proud that U.S. News & World Report has recognized Atrium Health Carolinas Medical Center as “Best Hospital” in the Charlotte region for the fourth consecutive year and has nationally ranked Atrium Health Levine Cancer Institute as “Best in Cancer” as a part of their annual hospital rankings.
Jack Wheeler, who lives in Seven Lakes, N.C. (about two hours east of Charlotte) with his wife, Sue, has lived with multiple myeloma – a type of blood cancer – since 2000. Many people with multiple myeloma can live for a long time with the disease, but they must be monitored closely and may need different courses of treatment over time.
A little over a year ago, Jack became a patient of Saad Usmani, MD, FACP, chief of plasma cell disorders at Atrium Health’s Levine Cancer Institute (LCI). He was referred to Dr. Usmani by Dr. Bart Barlogie, who first diagnosed Jack with multiple myeloma at the Myeloma Institute in Arkansas and had served as a mentor to Dr. Usmani.
A new clinical trial offers promise
“When Jack came to see me, he was looking for a new clinical trial because he’d already tried several other treatments and was running out of options at that time,” says Dr. Usmani.
Dr. Usmani enrolled Jack in an immunotherapy clinical trial using a bi-specific antibody called teclistamab that helped get his multiple myeloma in near remission. The treatment for this trial included injections of the medication administered at LCI.
Dr. Usmani and his team had extensive experience with teclistamab, having administered the medication to the first human to ever receive the drug, right at LCI in 2016. This past May, Dr. Usmani presented his research and data on teclistamab at the annual American Society of Clinical Oncology conference to overwhelming praise and recognition from oncologists across the world.
Jack’s situation takes a turn
Despite his initial success while enrolled in the clinical trial, Jack’s immune system was compromised from having had multiple myeloma for so long and from the different treatments he’d received over the years. Then he began to develop some troubling symptoms – and that’s when things went in a drastically different direction.
“Things had been going well – and then, in March, I started having mouth sores,” Jack explains. “I went to my dentist, my family doctor, and even an oral surgeon, who did a biopsy, but I still didn’t get any answers.” Jack also developed a fever that would come and go.
He went to see Dr. Usmani for a routine injection and was running a slight fever that day. Dr. Usmani advised holding off on the injection and running some tests. A few days later, Dr. Usmani called Jack and told him to come into the hospital immediately.
“I suspected that he had pneumonia, which is very common in multiple myeloma patients,” Dr. Usmani says. It turns out Jack had a life threatening fungal infection and viral infection in his lungs at the same time
At that time, the COVID-19 pandemic was just beginning to arrive in Charlotte. Jack was initially admitted to a local hospital, but was not getting better, so he was transferred to Carolinas Medical Center. By then, Jack’s respiration was getting worse and he ended up on a ventilator. He started to develop multiorgan failure.
According to Dr. Usmani, “Jack was in a very perilous situation at that time. I had a very difficult conversation with Jack’s wife about the possibility of him not surviving.”
Jack’s family gathers around him
While Jack was in the hospital, his son, John, came from Salt Lake City, Utah and his daughter, Emily, arrived from San Diego, Calif. due to the seriousness of Jack’s condition. Along with Jack’s wife, Sue, they received updates several times a day on Jack’s condition via their phones as they were not permitted to be in the hospital due to the new visitor restrictions in place from the COVID-19 pandemic
“In the middle of the pandemic, we called the nurses’ station twice a day getting updates,” says Emily. “The nurses would help us have video calls with him. And every day we talked to at least one doctor on his team. Everyone on the team – the doctors, nurses, and PAs – was amazing. We wanted to hug them, but of course we couldn’t!”
Sue was able to visit with Jack in person just a handful of times when he was on the ventilator. “I realized later that the doctors only let me see him because there was a possibility he might die. When I came back one day and was told I couldn’t go in, I knew that meant he was recovering.”
Soon after Jack’s worst day, there was a glimmer of hope.
“That difficult conversation I had with Sue was on a Friday afternoon, by Tuesday or Wednesday of the next week we saw him stabilizing and then starting to get better,” says Dr. Usmani. “In another few days, he was able to get off of the ventilator. I have never seen a patient who has that kind of fungal pneumonia coming off of a ventilator.”
A multidisciplinary team delivers the right care at the right time
Dr. Usmani attributes Jack’s miraculous recovery to the fact that he received the right medications at the first signs of his problems – plus the strong team that remained in constant contact with each other to help coordinate his care. . “The interpersonal communication that we had between the different team members across both Carolinas Medical Center and Levine Cancer Institute was the key. We had access to wonderful physicians in critical care, infectious disease, nephrology, cardiology and other areas of expertise,” he says.
Part of the multidisciplinary team that cared for Jack included Zainab Shahid, MD, FACP, medical director of bone marrow transplant infectious disease for Levine Cancer Institute. Dr. Shahid is Dr. Usmani’s wife – and the two have known each other since they were teenagers in Pakistan who trained together in medical school.
Dr. Shahid agrees that being part of a multidisciplinary team is of critically importance. “I am honored to be part of a team where I have access to the best cardiologists, the best critical care folks, the best nephrologist, a very involved pharmacy team and the best nursing team,” she says.
Dr. Shahid says when caring for Jack she had to “just breathe and make sure that every step is done correctly before you move on.” She had to phase out all the chaos and stress surrounding COVID-19 and stay present, focusing on the task at hand. She says, “Our mission is to be able to care for all our patients, irrespective of what is going around you. Because your focus in that room in that moment is only that patient. And so we were able to navigate all of this with one goal in mind: to get Jack home.”
Dr. Shahid also understood the stress that Jack’s family was under, especially since they could not be with him in person while he was in the hospital and took it as her responsibility to treat Jack as if he was family.
Post-discharge, Jack is doing well
When Jack was discharged from the hospital, the initial plan was to transfer him to another facility for rehab. But Jack insisted he wanted to go home, so the family created a home healthcare plan. Emily and John were able to work remotely because of the COVID-19 crisis, so they stayed in North Carolina and helped care for their father. Emily put together a spreadsheet of Jack’s medicines and John handled his nutrition. A physical therapist came to the home for Jack’s physical therapy.
At first, Jack was weak – he’d lost 35 pounds while in the hospital and needed oxygen for even the smallest movements. But little by little, he got stronger. Just a few weeks later, something that seemed impossible happened: Jack walked into Dr. Usmani’s office on his own, without the aid of a wheelchair, walker, or oxygen tank. That’s when Dr. Usmani knew that Jack was ready to get back on the clinical trial that was keeping his multiple myeloma in near remission.
“I think Jack will continue to do better. The way that he has come out of all of this gives me a lot of hope,” says Dr. Usmani.
Learn more about U.S. News & World Report 2020-21 rankings.
