Sharon Francis

Sharon Francis came to Mayo Clinic for the first time with a history of medical concerns. They included a family history of breast cancer, a lumpectomy of her own, and peptic ulcers. She had been through a lot, but nothing like the mind-numbing headache she now faced. It was starting to shut down her life.

The aching had begun on one side of her head and traveled to her neck, then to her shoulders and back, then to her face. At one point, the pain was so severe it caused her to pass out. For weeks, Sharon sought answers.

"I went from doctor to doctor and had test after test. But the pain on only one side baffled everyone," she says. "I couldn't go to work. I couldn't function. All I could do was lie in the dark and pray that God would take the pain away. Finally, a friend demanded I go to Mayo Clinic."

Sharon made an appointment at Mayo Clinic in Jacksonville, Fla. "When I arrived at Mayo Clinic, just being on the grounds gave me a feeling of peacefulness and confidence," she says. "It was like a park with its trees, flowers and fountains."

That first visit began a journey that not only led to relief for Sharon's agonizing headache, it also resulted in the early detection and successful treatment of breast cancer, and it connected her with Mayo's Familial Cancer Program, which has helped her along the way.

Dealing with challenges

Sharon had faced adversity before. When she was only 20, and a single mother of three, her own mother died of breast cancer. Sharon took in her younger sister and brother. Now responsible for the well-being of five children, she worked two jobs to keep them in good neighborhoods, good schools and good food.

"I got so overwhelmed that I developed an ulcer," she says. Over the next 10 years, the children became teenagers. Sharon earned an associate of arts degree and moved forward in her career as a graphic designer.

In her spare time, she designed clothes, eventually launching her own fashion label, the S. Francis Collection. "My mother didn't have much money for school clothes, so I learned to make my own," she says. "When I entered the business world, I had nothing to wear, and I wanted to walk the walk. I got out the machine, designed corporate wear with a flair, and it caught on."

Although she had faced many challenges, Sharon took it all in stride — until her family's history of cancer caught up with her.

"I was 31 when I found the lump in my breast," Sharon says. "It scared me. Every woman in my family had died from some form of cancer. We had zero survivors."

Sharon had surgery to remove a lump the size of a golf ball. With that, she believed she was putting cancer behind her. Then, the headache began. At its worst, it made her other travails seem like a cakewalk.

"I had never experienced that kind of headache before," says Sharon. "The pain was constant and unbearable. It hurt so much that it caused my teeth to chatter and my vision to blur."

As the pain in her head started to hinder her daily living, Sharon tried to fight it off with over-the-counter medication. At one point, she was taking more than 100 pain relievers a week. Not only did the medication do little for the headache, it caused her ulcers to flare. She visited a number of doctors but couldn't find an answer. Finally her friend insisted Sharon go to Mayo Clinic.

"Living in Jacksonville, I had seen Mayo Clinic," says Sharon. "It's right down the street from where I work. I thought it was just a hospital. My friend, who is a longtime Mayo patient, told me about it a couple of times , but I didn't go. Then, on the third time, she insisted because I was going to different doctors and wasn't getting any results. I decided to give it a try."

Evaluating every angle

At her first Mayo appointment, Sharon met with Ruel Scott, M.D., a Family Medicine physician in the Mayo Primary Care Center.

"He did a complete physical, ordered tests and, because of my history, he brought in a team of specialists who would work together to reach a diagnosis," says Sharon. "I'd never known anything like it."

Dr. Scott recommended Sharon be seen in Neurology, Gastroenterology, Physical Medicine and Rehabilitation, and Gynecology. He also ordered a number of tests, including a magnetic resonance image (MRI)of her head; X-rays of her back, chest and neck; a thyroid ultrasound; and mammograms.

"At Mayo Clinic, we provide care using a team approach," says Dr. Scott. "That approach gives us the ability to involve many specialists and to provide the best care quickly and easily. We are then able to develop treatment plans based on a comprehensive evalua- tion of the patient's situation and needs. Our greatest therapeutic intervention is our commitment to care for our patients."

Uncovering the answer

The following week, Sharon went to see David Capobianco, M.D. In addition to being a Mayo Clinic neurologist, Dr. Capobianco is the director of Mayo's Neurology Residency Program in Jacksonville and a member of the American Headache Society's board of directors. Headaches are his specialty, and fortunately for Sharon, he knew exactly what was causing her pain.

David Capobianco, M.D.

"Sharon had all the symptoms of a headache syndrome called hemicrania continua," says Dr. Capobianco. "It's a continuous headache of moderate to severe intensity that occurs exclusively on one side of the head. The disorder is quite rare. And unfortunately, patients who have it often are misdiagnosed."

Hemicrania continua is a subtype of what neurologists call chronic daily headaches. According to Dr. Capobianco, most chronic daily headaches are very challenging to successfully treat. Hemicrania continua is the exception.

"Once this condition is correctly identified, we have some very effective treatments," he says.

Because of Sharon's medical history, she was unable to take the anti-inflammatory medication that is the most effective treatment for hemicrania continua. Instead, Dr. Capobianco gave her a prescription for a medication that had been shown to be effective in patients with seizures. By the end of one month taking it, Sharon was pain-free.

"The headache went away and never came back," she says. "The other doctors I saw didn't know what it was and didn't know how to treat it. I came to Mayo Clinic, and they took care of it. That was pretty amazing."

Facing an old foe

Ruel Scott, M.D.

Jack Fulmer, M.D.

Returning to her work as a graphic designer and to her passion, fashion design, Sharon was back to her old self. So she was surprised to receive a new appointment schedule in the mail from Mayo Clinic. She called Dr. Scott who reminded her that he had seen something on one of her mammograms. Given Sharon's history, he wanted a biopsy.

"I knew about that little spot," says Sharon. "It had been there for years. I'd had it checked before, and it was benign. But he said we needed to check again."

Mayo Clinic Jacksonville was among the first in the country to offer MR-guided breast biopsy, a procedure that uses a vacuum-assisted needle to draw out suspicious tissue, so patients do not have to undergo surgery for a biopsy. And Sharon was one of the first patients of Mayo Clinic to benefit from the new technology.

The biopsy results showed that she had ductal carcinoma in situ (DCIS), an early-stage cancer that was still confined to the breast ducts. When Sharon met with Dr. Scott and Jack Fulmer, M.D., a Mayo Clinic surgeon, who recommended surgery and radiation to eliminate the cancer, she was worried and apprehensive.

"I was pretty upset. My first surgery for breast cancer had not been a good experience, and I didn't want to go through it again," she says. "At Mayo, they took time to carefully explain why they thought I needed the surgery. Dr. Fulmer went into detail describing what the surgery would involve. He also suggested I might want to get another opinion. After the conversation, though, I didn't feel like I needed one. I had the surgery. He did a beautiful job. I had very little pain afterward and hardly any scars."

To ensure the cancer was gone, Sharon went through a course of radiation therapy after surgery. When that treatment was complete, she began receiving mammograms every six months in order to detect early any other areas of concern that may arise. Sharon also is working with physicians in Mayo Clinic's Familial Cancer Program to evaluate her genetic risk of cancer. Her sister and daughter will eventually be evaluated through the program, as well.

Back in full swing

Today, Sharon's life is back in full swing, a big change from when she arrived at Mayo Clinic for her first appointment. She's still working as a graphic designer, as well as ramping up her fashion business. With a recently completed business plan, Sharon is looking into having her clothing placed in stores.

Although medical concerns aren't front and center in her life anymore, Sharon gives credit to her doctors at Mayo Clinic for what she has today.

"When I had gone to doctors before, I really didn't have much faith in them," says Sharon. "Now, at Mayo, I feel safe with every appointment. Every specialist they send me to, I feel confident in their care. The doctors there have a passion for helping people. Look at me. I went in with a headache and came out with my life."