The gift of life — Woman receives liver transplant from daughter-in-law

RAPID RIVER – Looking at Nancy Froberg today, it would seem almost incomprehensible to believe that she was at death’s door only six weeks ago. The 66-year-old Rapid River woman underwent a life-saving liver transplant at the Mayo Clinic in Rochester, Minn., in mid-May and has made a remarkable recovery.

And also surprising is that Nancy has her daughter-in-law to thank for the gift of life she has received.

Nancy suffers from primary biliary cirrhosis, an autoimmune disease of the liver marked by the slow progressive destruction of the small bile ducts of the liver. When these ducts are damaged, bile builds up in the liver and over time damages the tissue. Female sufferers from this disease outnumber the males nine-to-one.

“That’s why they tested my daughter and granddaughter,” Nancy said. “Not only to see if they are a match but because they might one day suffer from the same disease. My mother died of liver cancer but she never went to see a doctor to determine if it was really cancer. She may have had it and never knew. I also had two aunts who died of possible liver cancer.”

Nancy became aware something was wrong with her when she was about 36 years old, Although doctors knew there were problems with her liver, because she suffered from a variety of other afflictions that masked the seriousness of the her liver disease, the diagnosis of primary biliary cirrhosis came only after several years of treatments and surgery. Because of her condition, her lungs kept filling up with fluid and needed to be tapped. She also was diagnosed with a prolapsed uterus and later underwent two surgeries, the last at the Mayo Clinic in Rochester, Minn., where Nancy ultimately went to seek treatment.

“I never really had any symptoms but I had hot flashes all the time,” she explained. “I never sweat but I was always wringing wet.”

Nancy sought treatment locally and in Green Bay but nothing seemed to improve her condition.

It was her daughter, Linda Froberg, who ultimately made an appointment for her mother to visit the Mayo Clinic two years ago.

“We just got tired of not having any answers so I did some research on the computer. We went there and she was admitted right away to St. Mary’s Hospital,” Linda said.

At first, physicians thought Nancy was suffering from pneumonia but a barrage of tests soon followed.

“I was admitted for a checkup and was only supposed to be there two days,” Nancy said. In the process, the tests revealed that the liver disease was at the root of all of her problems.

But even though a successful diagnosis was made, Nancy was informed that, while a liver transplant might be her only cure, it was initially thought to be a long way off.

“They said I would eventually need a transplant, but it would not be for another 25 years or so,” she said.

But Nancy’s condition continued to worsen and her serum bilirubin levels rose to a dangerous level. In cases of liver disease, a patient’s serum bilirubin level is an indicator of the possible survival rate. A level of 2-6 means a survival rate of four or more years. In Nancy’s case, her levels were between 9-11, an indicator of a survival rate of about one year.

The subject of a transplant was revisited, however, it was uncertain whether Nancy would qualify to receive a liver from a deceased person or a portion of a living person’s liver.

“Doctors said they wouldn’t use a living donor until Mom’s rate was up to 30,” Linda said. “If you hit 30, you’re almost dead.” A level of 15 or more qualified for a transplant from a deceased donor.

Linda, herself, was ruled out as a possible donor because she suffers from multiple sclerosis. So the first person that was tested was Nancy’s daughter-in-law, Sarah Froberg of Dundee, Mich., wife of Nancy’s son, Rob. After being tested in April of last year, Sarah turned out to be a perfect match.

“Doctors said they never heard of the first person tested to come in a perfect match,” said Linda with a beaming smile.

But still Nancy’s physicians were hopeful. “They said I may never have to have the transplant if my levels stayed below 30,” she said.

But this past year has been “a nightmare” for the ailing woman.

“I got to the place where I couldn’t do anything,” Nancy said. “I could dress myself and take care of myself, but that was about it. My husband (Robert) did all the housekeeping and the cooking and the laundry.”

Nancy was hospitalized again on April 31 for 10 days in an attempt to bring her sodium levels back up and to repair her prolapsed uterus. By then, the possible transplant became eminent. Nancy had initially considered that a deceased donor would be more acceptable to her rather than to have her daughter-in-law take the risk of undergoing the operation. However, because of Nancy’s deteriorating condition, the surgery was scheduled to take place in June.

It was while Nancy and Linda were preparing to return home from Minnesota after treatment that they were notified that a change in scheduling moved the transplant date up a month and Nancy finally underwent her life-saving surgery on May 17. Sarah’s surgery began at 8:30 a.m. and was completed four hours later. By 10:30, Nancy was already prepared for her own surgery that was over by 2 p.m. In the process, Nancy received 69 percent of Sarah’s liver and the recovery process was underway.

Although doctors said Nancy would not be able to communicate with visitors until possibly the following day, by 9 p.m., Sarah was brought in to see her mother-in-law for a short time.

“Before she went into surgery, my mom was so yellow and so sick I wasn’t sure she would make it,” said Linda. “But by the time she woke up, there was already color in her cheeks.”

“And my feet were warm,” Nancy joked.

Six days later, Sarah was released from the hospital and Nancy followed four days later.

Nancy will undergo blood tests through OSF St. Francis Hospital once a week which will be transmitted to Mayo and have to take anti-rejection drugs for the remainder of her life.

To help both Nancy and Sarah’s family with medical expenses, a fund-raiser is planned for Saturday at the Rapid River Legion. Because her immune system is weakened because of the transplant, Nancy will be unable to attend the fundraiser.

Although both families are covered by medical insurance, the travel and housing expenses have been extensive. In addition, because Sarah is a self-employed mother of two children, she will have to wait three months before she is able to return to her regular work schedule. In Sarah’s case, because of the liver’s ability to regenerate over time, Nancy is sure her daughter-in-law’s remaining liver has already begun to be restored.

“My brother, Rob, has been amazing through all this,” said Linda. “He was scared to death for both of them but was anxious to have it over with. He’s really kept our spirits up.”