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Quick coordinated care: How Caroline got her spunk back

Caroline Abbott is a high-energy, outgoing kid who loves her friends, doing gymnastics and playing volleyball. But for 10 months, her persistent stomach pain had her parents worried and — even worse — turned Caroline into a quieter, less active version of herself. “She went from a kid who was always on the go, to only wanting to sit on the couch and watch TV,” said her mom, Rachel.

Two trips to the emergency department suggested Caroline was suffering from constipation, so her family was treating her for that. “She didn’t have a fever, elevated blood cell count or any other signs of something more serious,” said Rachel. But then in May the stomachaches became even worse.

The family’s pediatrician, Karen Wegner, MD, at Children’s Wisconsin Mayfair Pediatrics, was out of town but Caroline saw her colleague, Michael O’Reilly, MD, right away. “Dr. O’Reilly was wonderful and he arranged for us to see a gastrointestinal (GI) specialist at Children’s Wisconsin quickly, and started the process of testing,” said Rachel.

Cause for alarm

An initial ultrasound showed no obstructions in the intestines or stomach, but revealed a large mass in the abdominal cavity. “I was at Starbucks when I got the call from Dr. O’Reilly and I will never forget that moment,” said Rachel. “I think I called him back twice more after that, because I couldn’t process any information beyond the word ‘tumor.’ He understood what I was feeling and patiently explained what they knew — and what they didn’t know yet — more than once.”

That same day, imaging staff called the Abbotts and told them to bring Caroline in immediately for an MRI. Kevin Boyd, DO, a pediatric radiologist, rearranged the MRI schedule to make sure Caroline could be imaged right away — something that happens often at Children’s Wisconsin so the sickest kids can be diagnosed and treated as soon as possible.

Fast resolution

Dave Lal, MD, a pediatric surgeon, met Caroline and her parents the moment they arrived at the hospital and saw them through the entire MRI process. “Caroline, being 10, could explain her pain and that helped Dr. Lal understand what to look for,” said Rachel.

What the MRI revealed was a kiwi size tumor that was causing torsion, or twisting, of Caroline’s ovary. “Throughout the process, Dr. Lal took the time to talk to us in terms we could understand, and explain what the problem was and what the team would do about it. It was enormously comforting during a very scary time.”

The surgical team sprang into action the very same day. “Although the scan and diagnosis was not complete until that evening, Dr. Lal told us he would not be able to sleep knowing that Caroline could lose her ovary. She went into surgery that night, and the surgery was done around midnight.”

Throughout the surgery, Dr. Lal and his team took pictures of what they were seeing and doing. The team removed the tumor and untwisted Caroline’s ovary, all the while communicating with her parents to let them know she was okay. Amazingly, the surgery was performed laparoscopically, with minimal incisions, and Caroline was cleared to go home the following day.

Dr. Lal bear

It’s tradition that kids going through surgery at Children’s Wisconsin receive a special stuffed animal bear.

“Caroline immediately named hers ‘Dr. Lal bear’ because Dr. Lal made such a strong connection with her,” said Rachel. “He explained things to her clearly and made her feel so reassured that she trusted him right away.”

Even after surgery, however, the family’s wait wasn’t over. They met with Sarah Dobrozsi, MD, Caroline’s oncologist, the following day. “Dr. Dobrozsi was so thorough and compassionate. She explained everything to us, and was caring but also realistic,” said Rachel. “Although things had looked pretty good during the surgery, we still had to wait three more days to know if Caroline’s tumor was cancerous. Those were the longest three days of our lives.”

Back to her old self

Thankfully, Caroline’s tumor was benign. She was diagnosed with mature teratoma, a type of tumor that could potentially return, but would never be cancerous.

Throughout the agonizing experience, Rachel was certain that the brightest minds — from primary care to specialty care — were working together to care for her daughter. “Out of the most horrific situation, we were amazed at how quickly everything happened and how great the communication was,” she said.

After surgery, Caroline quickly began feeling better, and is now back to her spunky self. “She’s having a great summer, swimming, playing volleyball and hanging out with her friends,” said Rachel. “I’d say she’s back to 100 percent.”