The Challenge
In 2008, Jaime Jo McDonald was a young, elementary school teacher who was newly married and excited about her future. On the morning of February 27, that future became a question mark.
“I had pain right under my chest,” Jaime recalls. “It got so bad, I couldn’t stand up straight.” Thinking it was appendicitis or gall bladder-related, Jaime’s doctor sent her to the emergency department in Clarksburg, W.Va. “By then, I was in excruciating pain, and I didn’t know what was going on.”
The hospital ordered blood work and a CT scan. About five hours later, an intern approached Jaime and her family. He explained that she had a bleeding tumor in her liver. For a seemingly healthy woman, the news came as a shock.
Jaime was sent by ambulance to a hospital in Morgantown, W.Va. There the emergency department ordered another CT scan and found eight small holes seeping blood from a tumor in Jamie’s liver. They performed an embolization - a minimally invasive procedure - to stop the hemorrhaging. Twenty-four hours later, as Jaime was waiting to be discharged, the head of oncology came into her room and delivered more shocking news. It was possible, he said, that she had cancer and might need a liver transplant.
The Path to UPMC
Jamie and her husband were taken by ambulance to UPMC Presbyterian in Pittsburgh.
The doctors ran more tests and then met with Jaime and her husband. “They thought the tumor was probably benign, but he needed to be sure,” Jaime said.
The doctors told Jaime that 65 percent of her liver was damaged. By removing the damaged part, given a biopsy determined it was not cancerous, her liver could regenerate on its own from the 35 percent that was left. Liver transplantation could be an option to aid in the transition of Jaime’s care if he found more liver damage upon surgery.
“It was very surreal,” Jaime recalls. “I had only been married six months, and I had this life-changing decision to make. I was still bleeding, despite the embolization and I was in a lot of pain. So, I agreed to the surgery.”
The Solution
The very next day, Jaime was in surgery for five hours, during which time doctors performed a liver reduction, removing 65 percent of her liver, including the tumor and her gallbladder, which had been damaged by the swelling.
"The tumor had been on the verge of exploding. It was toxic, and if it had burst, the septic fluids would have killed me.”
Even though she didn’t need a transplant, Jaime was moved to the liver transplant floor, where her doctor and his team could keep a close eye on her. Looking back, she remarks, “UPMC is one amazing hospital. The nursing staff was unbelievable. They were so positive. They had a huge role in my recovery.”
After one week, Jaime was released and asked to return for a check-up in four days. Unfortunately, her homecoming was short-lived. “I was home for one day, and the next day, I woke up not feeling so well.”
When she began vomiting, her family called UPMC. “They said it sounded like I was vomiting bile fluid, and I needed to come back right away.” As it turned out, Jaime had severe jaundice. The doctor ordered an MRI, which indicated that Jaime’s bile ducts had fused shut, due to the trauma and swelling caused by her tumor. He performed an ERCP, an endoscopic procedure that allowed him to put two stents in Jaime’s bile ducts. The stents would need to be replaced every four months until Jaime’s bile ducts could stay open on their own.
Jaime had ERCP four more times. The doctor lifted her spirits by telling her that in a year, she would feel like herself again, as long as she rested and continued to walk.
The Results
Jaime has a scar that runs from underneath her breast to the middle of her abdomen, and then back towards her liver, “like a crooked smile.” Fortunately, her tumor was not cancerous, and her liver has been able to regenerate.
Soon after her surgery, Jaime started physical therapy. She lost a lot of weight, and her immune system was weak, but she was determined to get better. In May, her family and friends held a huge homecoming party that doubled as a way to raise funds for the newlyweds, considering that throughout her treatment she couldn’t work. “I received prayers and cards from people all over the country,” she says. “It hit me then that I had almost died. I tried to stay positive. If I’d gotten depressed, I would not have gotten better. It’s been a growing experience.”
Three years later, her health isn’t all that’s growing. Jaime and her husband are going to have a baby. “He’s due July fourth. We’re going to call him Joseph Patrick.”
This fourth grade teacher is back at work, and once again, her future looks bright. “Life is wonderful now. I can do everything that I could before. I go to the gym four days a week. I’m doing prenatal yoga.” She hopes her pregnancy continues to go well, because she’d like to have more children.
“I was very fortunate,” Jaime says. “The doctors and the staff were phenomenal. My goal now is to stay healthy.”
Ms. McDonald’s treatment and results may not be representative of all similar cases.
