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Under M Health care, mom and newborn daughter beat cancer, birth defect

Stunned by a dual diagnosis, Stephanie Frazier entrusted University of Minnesota Health specialists to save her life—and the life of her unborn child.
Before she was born, Kalinda Frazier was diagnosed with gastroschisis, a birth defect that caused portions of her abdominal organs to protrude outside her body. Days after Kalinda's diagnosis, her mother Stephanie received bad news of her own: She had bladder cancer.

Moments after the Frazier’s daughter was born, the happy parents kissed their newborn, snapped a photo and marveled at the tiny new life they had brought into the world.

Then surgeons brought Kalinda, Stephanie and Cedrick Frazier’s daughter, to a nearby operating room for the first in a series of surgeries intended to save her life.

Months earlier, a University of Minnesota Health care team diagnosed Kalinda with a birth defect called gastroschisis. Because of the defect, Kalinda’s abdominal wall didn’t close properly while she was developing in her mother’s womb, and portions of her abdominal organs protruded outside her body.

Relieved to hear their daughter’s first cry, and grateful to have a few moments with her newborn before the inevitable surgery, Stephanie and Cedrick knew they had done all they could for Kalinda.

“Now it was all in the doctors’ hands,” Stephanie said.

“We couldn’t catch a break.”
Staff at the University of Minnesota Health Women’s Health Specialists Clinic in Minneapolis discovered Kalinda’s birth defect during a routine visit in November 2013. The baby’s diagnosis was difficult to bear for Stephanie and Cedrick, but it was followed up days later with more bad news.

During an ultrasound to determine the extent of Kalinda’s condition, M Health Maternal-Fetal Medicine Physician Tracy Prosen, MD, also saw some irregularities on Stephanie’s bladder. She was referred to University of Minnesota Health urology specialists, and after additional testing, Urologic Surgeon Christopher Weight, MD, and his team diagnosed Stephanie with bladder cancer.

The dual diagnosis left Stephanie and Cedrick reeling.

“It always felt like we couldn’t catch a break,” Stephanie said. “We kept thinking ‘When is the tide going to turn? When are we going to stop getting bad news and start getting good news?”

Stephanie began journaling. Together, the couple created a Caring Bridge website for Kalinda.

Stephanie’s pregnancy prevented doctors from treating the cancer with chemotherapy. Instead, a surgical team led by Weight removed three tumors from Stephanie’s bladder just before Thanksgiving in 2013. She was four months pregnant at the time.

After the surgery, Stephanie’s focus returned to Kalinda. For months, specialists at the University of Minnesota Health Maternal-Fetal Medicine Center closely monitored the baby’s progress, knowing that every day the baby spent in the womb would help her be better prepared for the inevitable surgery.

“We called her ‘Xena, Warrior Princess.’”
In Feb. 11, 2014, Stephanie was admitted to The Birthplace at University of Minnesota Medical Center. Doctors, concerned by Kalinda’s fluctuating heart rate, were prepared to induce labor that day. But Kalinda’s heart rate stabilized and she stayed in the womb four more days. On Feb. 15, she was born via Cesarean section.

Almost immediately, a team led by Pediatric Surgeon Bradley Segura, MD, PhD, brought Kalinda to the operating room. Segura was concerned that Kalinda’s bowels were damaged as a result of the gastroschisis. Fortunately, Kalinda’s organs were functional, so Segura and his team encased them in a sterile “silo” to prevent infection. Then, they let gravity do the work. Positioning the silo above the infant, they waited for pressure to move the organs back to their intended location inside Kalinda.

In 12 days, the organs were back in Kalinda’s body and Segura closed the abdominal hole that allowed them to protrude. In that time, he also led a minor heart procedure that helped Kalinda’s health stabilize.

At the time of her birth, Kalinda weighed roughly two pounds. She stayed in the Neonatal Intensive Care Unit (NICU) at University of Minnesota Masonic Children’s Hospital for 71 additional days, but on April 27—one day before her actual due date—Kalinda was discharged from the NICU.

Just two days later after Kalinda’s discharge, Stephanie underwent surgery a second time; Urologic Surgeon Christopher Weight discovered her tumors had returned. After localized chemotherapy and a third surgical procedure, her cancer is now in remission, though Stephanie continues to receive routine follow-up care.

Now, Kalinda weighs nearly 20 pounds, and is a healthy, babbling child just learning how to walk. Because of Kalinda’s bravery during the journey, and the scars she bears from surgery, Stephanie and Cedrick gave her the nickname “Xena, Warrior Princess.”

Stephanie can’t say enough about the positive care she and her daughter received at the hands of her M Health team.

“I think the care coordination was really great,” Stephanie said. “The NICU staff, the nurses, the surgeons, the obstetricians, the urology team—all of them were really working together.”