Difficult start, bright future for Karina
When Christie went in for her routine 7-month prenatal ultrasound, she and her husband, Bill, had little reason for concern. After all, Christie had given birth to seven healthy children, and they expected their eighth would be the same. Imagine their shock when the test results indicated that their unborn child, Karina, had a potentially life-threatening, lemon-sized tumor on her lower left jaw that threatened her ability to breathe, and would require immediate attention after birth.
“I was pretty calm in the examining room, but I cried on the way home as I was talking to my mom,” says Christie.
The family was referred to Northwestern Memorial’s Prentice Women’s Hospital, where physicians determined that Karina’s best chance for survival was for Christie to undergo a rarely performed procedure called an ex-utero intrapartum treatment, or “EXIT” procedure. Surgeons would deliver Karina’s head and upper body by C-section, but the rest of her would remain in Christie’s uterus still attached to the umbilical cord and placenta. That way she would be able to continue to receive oxygen-rich blood while doctors worked on clearing her airway.
The complicated procedure required the carefully choreographed participation of dozens of specialists from both Northwestern Memorial and Children’s Memorial Hospital working in concert with each other. The Children’s Memorial team included otolaryngologist (ear, nose and throat specialist) James Schroeder, MD, assisted by Lauren D. Holinger, MD, head of the hospital’s Division of Pediatric Otolaryngology, as well as a neonatologist, anesthesiologist and two nurses. Special equipment was transported from Children’s Memorial for the procedure, which required a “run-through” prior to surgery.
During the procedure, Schroeder was quickly able to establish an airway using a breathing tube, and within hours tiny Karina was transported to Children’s Memorial’s Neonatal Intensive Care Unit (NICU), where she would spend the next eight weeks. Transport of newborns like Karina from the delivery room to the NICU will be greatly eased when the Ann & Robert H. Lurie Children’s Hospital of Chicago opens in 2012 adjacent to Prentice.
Karina underwent several biopsies to determine if the tumor was cancerous. Although tests determined it was benign, the tumor still needed to be reduced to allow Karina to breathe without assistance. Surgeon John Maddalozzo, MD, originally recommended surgery to remove the mass, but later decided it would be too devastating for such a young child. In consultation with oncologists, he recommended a course of chemotherapy. Amazingly, within the first eight weeks of the 26-week treatment, the tumor shrank markedly.
During Karina’s time in the NICU, Christie stayed at the Ronald McDonald House, a “home away from home” for families needing to stay near the hospital. Family Services specialists helped Karina’s siblings understand her illness, even demonstrating how a tracheotomy worked using a doll. The kids also spent much of their time at the Janice and Kimberly Brown Family Life Center, playing games and working on arts and crafts projects. Christie says she was impressed with the attitude she saw throughout the hospital.
“Everyone who works at Children’s seems to love what they do, from the caregivers to the custodians and cafeteria workers,” says Christie. “They all play an important part in helping and caring for kids.”
Finally Karina came home after eight weeks in the hospital, although she continued to need a breathing tube until she was seven months old and required weekly chemo treatments and frequent blood tests and follow-ups at Children’s Memorial.
While a portion of the tumor remains, Karina is now an active 18-month-old toddler, running, jumping, playing with dolls and beginning to speak. She is developmentally on par with other children her age. Karina will need reconstructive surgery in the future, but for now, the family wants their little girl to continue to thrive.
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“Karina’s face may not look perfect, but we don’t think of her as being any different from our other children, and we treat them all the same.” says Christie. “It’s just amazing to see how well Karina has done.”
Children's Memorial Hospital seeks philanthropic funding to enhance its programs and services. As a proud partner of the Children's Miracle Network (CMN), all funds raised in the Chicago area through CMN also benefit Children's Memorial. To find out how your support can help the hospital better serve children and families, please contact the Children's Memorial Foundation at 773.880.4237 or Foundation@childrensmemorial.org.