MICHAEL BRYANT / INQUIRER
Physicians Ann Marie Cahill (left) and Lucia Fontalvo perform a liver biopsy on Nadia. The results led a surgeon to remove Nadia's gallbladder and reroute her small intestine to allow bile to drain directly from the liver into the digestive tract.
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First of three parts
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NADIA'S ODYSSEY
A child's catastrophic illness. Her anguished parents' emotional ordeal. And Children's Hospital's fight for the little girl who stole everyone's heart.
That's when it hit them. A liver transplant.
Allison and Joe broke down and cried.
On the waiting list
On Aug. 16, Nadia Kadi was placed on the waiting list for a donor liver. Her condition was serious, but not severe enough to merit an urgent status on the list.
Nevertheless, Allison and Joe were given a beeper and instructed to be prepared to return to the hospital at a moment's notice.
Joe hoped to act as a living donor, to give a portion of his liver to Nadia. Allison wasn't a match. Besides, she was pregnant.
In the end, tests showed that Nadia's main portal vein was blocked. That meant Nadia would require too much of the donor's vein to make living donation possible.
So they waited, and they prayed for the beeper to go off.
At CHOP, Rand waited, too. She held office hours two days a week, made daily rounds on 8 South, conducted research, wrote and directed the fellowship program for the division's 12 young doctors, and met myriad other duties as medical director of the liver transplant program.
Even when she was off, she wasn't. She was routinely consulted by the on-call team and often paged at night and on weekends. And when one of her patients had a transplant, the rest of her schedule flew out the window.
She was a busy woman. Too busy, sometimes.
In the early fall, Rand half-noticed a slight change in her left breast. Over time, the growth became more pronounced. When she stopped and focused on her own body, Rand knew she had breast cancer.
She acted quickly.
She went for a mammogram at 7 a.m. the next Monday. Several hours later she was paged and ordered back for further testing. Tuesday, she had a biopsy. Wednesday, the cancer was confirmed.
A second biopsy the next week revealed the cancer had spread to her lymph nodes.
This was serious. It was out of her control. And that scared her.
She met with a surgeon and an oncologist to develop a treatment plan. Chemotherapy first, followed by a mastectomy on her left breast. Radiation if necessary.
Rand would undergo a 16-week chemotherapy regimen. It began the Monday after Thanksgiving.
She didn't want to ruin the holiday for her kids, Ellie, 10, and Isaac, 6.
She would get a dose of powerful drugs every other Monday for nearly four months.
