A leg injury turns into a series of health obstacles

In January 2021, William Reece was living a busy life as an auditor for US customs, a pastor of his church, a husband of 41 years, and a grandfather of four. His daily life changed very quickly when he was taking the Christmas tree out of his house. He twisted his left thigh and noticed that for the coming days, his pain got progressively worse.

A few days later, he went to Henry Ford West Bloomfield Hospital to get his injury looked at, only to be diagnosed with myelodysplastic syndrome –a condition that often progresses to leukemia. He was seen by hematologist Dr. Philip Kuriakose and was started on chemotherapy.

The next step

While improving slowly with chemotherapy, he saw Dr. Edward Peres in preparation for a stem cell transplant. However, it was found that his heart had aortic regurgitation. During aortic regurgitation, the flaps on the valve don’t close tightly and blood flows backward into the heart resulting in congestive heart failure. William was next referred to Dr. Madhulata Reddy.

In the meantime, William was hospitalized for a blood infection and afterward, the aortic regurgitation worsened. He was now being hospitalized for heart failure as well.

Since William had multiple underlying conditions, he was deemed high risk for heart valve surgery. Unfortunately, by October of 2021, his myelodysplastic syndrome had transformed to an acute leukemia and he began a more intensive chemotherapy treatment. Although he needed to proceed with a stem cell transplant to reach a cure from his leukemia, his underlying medical conditions put him at too high a risk. He had to wait to allow his body to heal enough to be able to receive a transplant.

“In a case like this where the valve was severely leaky resulting in heart failure, he would not be able to tolerate the stress of the stem cell transplant. During the stem cell transplant, all cells are brought to zero with chemotherapy and plenty of intravenous fluids, which the heart needs to be strong enough to handle,” said Dr. Reddy.

A vital piece of technology

Dr. Reddy collaborated with the structural heart team to pursue aggressive management of William’s heart valve condition despite having leukemia. William was placed on an ECMO (extracorporeal membrane oxygenation) machine. This vital piece of technology took over the function of the heart and lungs so that William could recover enough to receive an aortic valve replacement and then a stem cell transplant.

William recalled, “I was pretty much out of it for two weeks and I really don’t remember anything from that. I was there physically laying there on the machine, but mentally I definitely wasn’t there.”