The doctor relented.
After some frantic moments getting Nadia hooked up to the oxygen, the little girl took on her normal color. She cheered up.
She had barely touched her bottle all morning, but now she eagerly drank seven ounces of formula.
Rand watched her, pretty sure Nadia had an infection, possibly the beginnings of pneumonia.
They started Nadia on an IV antibiotic.
She remained on 8 South for a week. During the stay, her liver-enzyme numbers rose again. Rand bumped up Nadia's steroids to halt the rejection.
It seemed to work.
By May 14, the day Nadia turned 18 months old, she was ready to go home again.
Waiting for their final discharge orders in their room, Allison and Joe played with their baby. Sitting on the sofa, her oxygen tubes still in place, Nadia reached out, grabbed the back of the couch, and pulled herself to her feet.
The parents stared, thunderstruck.
"Oh, my God!" Allison cried. She and Joe cheered, and were rewarded with a huge smile.
They knew most babies accomplished this feat by nine or 10 months. For their daughter, it was a major development. A good omen.
The Kadis were scheduled to come back for blood tests in three days, on May 17.
Rand didn't think she'd even need a full checkup. They could just come in for the blood work to look at Nadia's enzyme levels and 15 other factors, from glucose levels to platelet counts.
Things were looking up. Rand said she'd probably just give them the results right away so they could go home.
Time for the big gun
At 9:45 a.m. on Thursday, May 17, Rand leaned back in her chair in her small office on the third floor of CHOP's Wood Building. How, she wondered, should she break the news to Allison and Joe?
She had studied the numbers carefully.
The last steroid treatment hadn't knocked down Nadia's immune response. The toddler was again rejecting her liver.
Rand had conferred with transplant surgeon Abraham Shaked, and they had agreed: It was time to pull out the big gun, OKT3.
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