Unexpected Diagnosis After Birth

In 2022, Danika Hilmer, then 32, was recovering in bed after the birth of her third son, Banks. Nurses noticed she was losing more blood than normal. After keeping an eye on her for about half an hour, one of them administered a shot to help manage the bleeding. Unfortunately, it didn’t work. A doctor ordered bloodwork, which revealed a shocking diagnosis.

“We were just enjoying our new baby,” Hilmer, now 34 and from Marion, Iowa, recalled to TODAY.com. “Then the doctor told us the labs came back, and it was positive for acute leukemia.” The term “acute” didn’t register much; all she heard was “leukemia.”

It felt surreal to her.

“I froze,” she says. “My fiancé and I exchanged looks of shock. I turned back to the doctor and asked, ‘Could you repeat that?’”

Normal Pregnancy, Unexpected Diagnosis

For most of her pregnancy, things seemed routine. Blood tests hadn’t indicated any issues, and she felt generally well. However, in the last month, she started experiencing, well, intense pains.

“The pain radiated from down my arms and lower back, right through to my legs,” she reflected. “I thought it was just sciatica; it’s pretty common in late pregnancy.”

Struggling to find a comfortable sleeping position, she sought help at the emergency room, where they reassured her it was “normal pregnancy pains.” On October 22, 2022, she went into labor at home, anticipating a smooth delivery.

“The delivery went fine,” she mentioned. “It’s normal to lose some blood afterward.”

But when the nurses checked, they observed her bleeding more than expected, leading them to monitor her closely.

“They pressed on my stomach for about 30 minutes, measuring the blood loss,” she noted. “I was hemorrhaging… losing a lot of blood.”

A nurse gave her medication to slow it down, but the bleeding persisted. Doctors debated a hysterectomy as a solution. Thankfully, the doctor who delivered Banks first decided to run blood tests to get to the root of the problem.

When the doctor returned, he delivered the harrowing news that she had acute myeloid leukemia.

“Wait, are you saying I have cancer?” she recalls asking. The doctor confirmed, “Yes, that’s what the labs show.”

She was taken aback.

“I just kept thinking, ‘Is there any chance this is wrong?’” she said. The doctor explained her platelet counts were dangerously low, which explained the heavy bleeding.

She was transferred to the University of Iowa “without my baby or anyone else.”

“I was hormonal from just having a baby, and then suddenly faced with a cancer diagnosis,” she shared. “I felt scared, sad, angry—just overwhelmed with emotions.”

She also tested positive for COVID-19, leading her to be isolated with doctors and nurses in full protective gear.

“I started chemotherapy just hours after giving birth,” Hilmer mentioned.

For the next month, she underwent numerous chemotherapy sessions and waited for her blood counts to improve. At one point, she had to use supplemental oxygen due to pneumonia from COVID-19, which made breathing difficult.

“That was terrible,” she admitted. “I really wanted to breastfeed, but I couldn’t because of the chemotherapy… it broke my heart.”

Once home, she continued to have bloodwork done at a local hospital. She had to get blood and platelet transfusions “multiple times.”

“My counts were so low, it was dangerous,” she explained.

Doctors were hopeful for a stem cell transplant, but first they needed to find a donor. She began maintenance chemotherapy while waiting, and by January 2023, a match was found.

“About 60 percent of the cells in my body were cancerous, which is considered moderate to high risk,” she noted. “They wanted the stem cell transplant for the best chance of avoiding a relapse.”

She returned to University of Iowa Health Care for “intense” chemotherapy intended to eliminate as many cancer cells as possible.

“It was tough,” she recalled. “My donor’s healthy cells were infused into me, replacing the old cells.”

After a few weeks in the hospital, she was finally able to go home.

“The transplant was successful,” she confirmed.

Understanding Acute Myeloid Leukemia

Acute myeloid leukemia (AML) can affect people of any age, but most commonly appears around age 70, according to Dr. David Dickens. It’s a cancer influencing the white blood cells.

“Dealing with someone younger is rare for AML patients,” Dickens, director of the Adolescent and Young Adult Cancer Program at University of Iowa Health Care, said. “The coincidence with childbirth is even more unusual.”

Leukemia originates in the bone marrow and can spread rapidly throughout the body.

“Blood cell production happens within the liquid space of the bone, mainly located in the pelvis and lower back,” Dickens explained. “Because blood circulates, the disease can easily spread.”

Some symptoms could include swollen lymph nodes and unusual bleeding or bruising, among others.

• Unusual bleeding or bruising

• An off-color to their skin

• Fever without illness

“Not all patients exhibit zero signs or every symptom,” he remarked, noting that many signs can be easily mistaken for something benign, like general exhaustion.

Typical treatments for leukemia involve chemotherapy and possibly a stem cell transplant. For those with certain genetic mutations, a transplant might be especially effective.

“For younger patients able to tolerate it, a bone marrow transplant may be advised,” Dickens added.

Hilmer’s uncommon diagnosis prompted her doctor to conduct blood tests before suggesting surgery.

“Anyone worried about excessive bleeding should definitely get a blood count,” Dickens advised. “There are many reasons for abnormal bleeding, but those tests will detect leukemia if it’s present.”

The Miracle Baby

Since her transplant in 2023, Hilmer’s leukemia has remained in remission. At her six-week postpartum visit, her doctor revealed that if they had proceeded with the hysterectomy without prior bloodwork, the outcome would have been drastically different.

“I likely would have bled out during surgery,” she recounted. “I wouldn’t have survived.”

As for Banks, he is healthy, and Hilmer and her fiancé affectionately think of him as their “miracle baby.”

“If I hadn’t been pregnant, who knows how long my cancer would’ve gone undetected,” she reflected. “If I had waited even longer for a diagnosis, I might not be here.”

However, just last month, she received unsettling news: she has Stage 1 invasive ductal carcinoma breast cancer. Plans for a double mastectomy are in the works.

She shares her experience to emphasize the need for proactive health care.

“Cancer can arrive without warning,” she cautioned. “Even when things seem fine, it’s crucial to have regular check-ups with your doctors.”