When “just tired” is something more: The lifesaving power of routine testing

When a clinic called to confirm an appointment she didn’t remember making, she told them they had the wrong person.

“I said, ‘That’s not my doctor, that’s not my appointment,’” Ceola Karchner recalls.

But it was. Her nephrologist, Jamie Alton Green, MD, had scheduled it after noticing something off in a routine urine test, even though at the time, Ms. Karchner felt mostly fine — just tired.

She went to the appointment anyway, thinking nothing of it.

A life built around family and routine

For decades, Ms. Karchner’s days were shaped by the roles she took on at work, at home and in her community.  

She worked as a secretary, then farmed with her husband, selling produce at local markets. Later, she drove a school bus for children with disabilities — a job she held for 17 years.

Ms. Karchner has 2 daughters nearby, a granddaughter who calls every night on her way home from work and 2 great-grandsons just a few miles down the road. She still lives on the same farm with her husband, though they now rent the land out.

“We have a wonderful family,” she says.

Most days are simple and steady. She cooks dinner each night, keeps up with the laundry and finds time to crochet when she can. It’s a life built on showing up, quietly and consistently.

A stunning diagnosis

At her follow-up appointment, doctors ordered more tests and bloodwork. The diagnosis: multiple myeloma, a type of blood cancer that affects the bone marrow.

“When you don’t expect to be sick, you don’t really understand what is happening,” she says.

The news was overwhelming. The diagnosis came with a flood of appointments, medications and decisions all at once.

Her care team at Geisinger Knapper Clinic in Danville walked her through what came next. Treatment would be ongoing and her immune system would grow weak. She started a clinical trial, though she hesitated at first.

Her physician, Andrew Medvec, DO, a malignant hematologist at Geisinger Medical Center, explained that the clinical trial, called EAA181, combines proven medications. 

"Usually with trials, we combine standard of care medications, chemo, immunotherapy and other drugs that are already on the market to see what's the best-case scenario," Dr. Medvec says. "I think patients feel better cared for in that situation, because there’s a lot more people checking in, they're getting more calls and there’s a lot more support.” 

For Ms. Karchner, her routine includes oral chemotherapy at home — 21 days on, 7 days off — plus a monthly Darzalex® injection (during the maintenance phase of the trial), a targeted treatment that helps her immune system find and attack cancer cells. Her dosage was adjusted over time. Some medications were added, others removed.

As treatment took shape, so did the team around her. Dr. Medvec took time to talk through concerns. And she found a steady guide in her clinical trial nurse, Bethany Vanemon.

“If I have a question, I can just call her and she’ll take care of it,” Ms. Karchner says. “She’s great.”

Treatment hasn’t been simple. Her immunity remains low, so she’s cautious about public places, swapping trips to Walmart for online shopping. Over the past 2 years, she’s been hospitalized twice — once for a severe cold and again after an episode of intense chills that left her disoriented.

Still, there are signs of improvement.

“I can’t complain about anything they’ve done so far,” she says. “I’ve been happy with my progress.”

Dr. Medvec says Ms. Karchner is responding well to treatment. "She handles everything with grace and is really into what's going on,” he says. "She asks really good questions. I think she’s done remarkably well with taking care of herself. She’s one of my good patients that I look forward to seeing every time she comes in.”

Moving forward one step at a time

Lately, Ms. Karchner has started to notice something small but meaningful — she’s less tired. She keeps up with the house, making sre everything runs the way it always has.

“The fact that I haven’t been laid up — that’s my greatest thing,” she says.

Her world is also beginning to open up again. With her doctor’s encouragement, she even attended her class reunion. 

Looking back, she keeps coming back to that one moment — the appointment she almost skipped.

“If I hadn’t had that kidney doctor appointment, who knows how long it would have been or how bad it would have gotten?” she says. “I’m just so thankful that they caught it early.” 

Next steps: 

Read and watch more stories
Learn about nephrology care at Geisinger
How to support someone with cancer