The drug, muromonab-CD3, would obliterate the T-cells leading the attack on Nadia's transplanted liver.
It was not a decision Rand made lightly.
Nadia would need to be hospitalized for the week or two of IV treatment with the drug. Moreover, the long-term side effects of OKT3 could be serious, including an increased risk of cancer. The short-term side effects were no fun, either: fever, nausea, diarrhea.
But the doctor was running out of options. If this didn't work, Nadia could develop chronic rejection.
She could lose her liver. Rand leaned back in her chair and closed her eyes. Nadia needed to be readmitted.
Twenty feet away in the waiting room, Allison and Joe sat with Nadia and her baby brother. They expected to get Nadia's test results and go home.
Rand walked out to meet them, and took them back to the little office. She called up charts on her computer screen. They could see Nadia's liver enzyme levels rising.
"This isn't dangerous in the short term, but obviously it isn't right," Rand explained. The rejection was becoming chronic, and the benefit of steroid therapy had diminished.
Nadia was doing well, but Rand wanted to make sure she stayed that way. She wanted Nadia to have another biopsy to confirm her diagnosis.
She told them the OKT3 treatment would require Nadia to be hospitalized.
Allison and Joe were floored.
Why was this happening? Why did Nadia keep rejecting her liver? When would they stop living in a hospital? When would their little girl be well?
"Yeah, it's getting frustrating," Rand acknowledged. She reassured them. They would get Nadia out of this rut.
Looking over to where Joe held Nadia, Rand saw the little girl sipping on her bottle. The doctor reached over and grabbed it.
No more eating before her biopsy.
Saving Nadia
On the first night, Nadia got the OKT3 at 8 p.m. A nurse checked on her every 15 minutes, then every half-hour, and finally on the hour through the night.
First, Nadia's numbers went down. Then, on the Sunday of Memorial Day weekend, Nadia spiked a fever above 104.
Just before midnight, she and Joe were moved to the pediatric intensive care unit one floor below. Allison and Adam stayed in Nadia's room on 8 South.
Within hours Nadia's fever abated. By noon the next day she was moved back to 8 South.
|
|
|
|
|
|
Philly.com Promotions
Post a comment
