New liver; hope for new life
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Wednesday, May 10, 2006

By JASON LAUGHLIN
Courier-Post Staff

DELANCO
Emma Paygar sat in a darkened hospital room with a Bible on her lap, holding
her daughter's hand.

"God, you know everything," Paygar prayed. "I cannot do it alone. Only you
can do it. We have been through all this and you have pulled us through."

It was the pre-dawn hours of April 4 at Camden's Our Lady of Lourdes Medical
Center. Paygar's daughter Ling Fasulo was near death.

"It was like waiting for your last day," Fasulo, 32, remembered of the hours
she spent, sleepless, waiting for 3:30 a.m., when nurses would come to
prepare her for a liver transplant.

"It was really very questionable whether or not she was going to survive,"
said Fasulo's doctor, John Radomski, the hospital's head of surgery.

Today Fasulo's back at her mother's Delanco home and is willing to show off
the upside down "Y" scar that spans her belly. Her high-cheeked face is
gaunt and she gets fatigued easily, but she's animated when she talks. She
laughs as her sisters Eve, 18, and Mandie, 10, tease her about things only
sisters could say. She downplays the danger she faced, saying she always
believed she would survive.

Fasulo, a Liberian, spent most of her adult life surviving the 14 years of
civil war in her West African nation. She believes one of two soldiers in
Liberia who raped her gave her the hepatitis B that ravaged her liver. Her
illness has forced her to confront experiences she has lived with by burying
them.

"I just put it behind me because I just know that it happened to me and
there's nothing to do about it and nothing I can feel about it and I just
have to live with it," she said.

Fasulo, whose father is a white American, said she was targeted in her home
country because of her light skin, a feature considered attractive in
Liberian women. When she was 18 one soldier took her to live with him and
raped her almost daily for eight months, she said. If she said no, he
threatened to kill her.

"It was just constant," she said. "Every day, every day, every day. You're
just like another (stick of) furniture they want and they can use you any
way they want to."

She still carries a scar on her leg from that man's knife. He cut her deeply
once when she fought off his sexual advances.

Two years later, another soldier took her to live with him. By then he had
separated her from her year-old daughter. That man raped her twice, but
ultimately helped her escape after two months, she said. She considers him
someone who did her a favor.

Recently she has tested negative for the virus, and her doctors said in some
cases the virus simply passes out of the system.

Fasulo escaped from Liberia to Senegal, but developed a swollen spleen
doctors said could kill her. She arrived in the United States in March 2004.

America didn't offer an easy solution. The root problem wasn't her spleen.
In 2005, doctors realized Fasulo's hepatitis B necessitated a liver
transplant. That began five months of waiting for a donor liver.

Fasulo experienced the tightrope walk faced by the 18,000 people every year
waiting for livers. Typically a patient has to be near death before they
qualify for a transplant.

"That's a fine line because it's a big operation to do a liver transplant
and patients can get to the point where you think they're too sick to
undergo the procedure," Radomski said.

Ten to 15 percent of people on the waiting list each year will probably die
waiting, he said.

In the past year Fasulo's family became accustomed to a state of constant
vigil.

Mandie shares a bedroom with Fasulo and still has trouble sleeping.

"Sometimes I get afraid to sleep in the room with her, because I get anxiety
with her in the room," Mandie said.

Eve Paygar transferred from Shaw University in North Carolina to Burlington
County College to help her family.

"My mom is like my best friend and I'm the only person she could talk to so
I just wanted to be close by," she said. "And, I mean, that's my sister and
I was stressed out too."

From January to April, Fasulo lived at Lourdes, too sick to go home. Fasulo
lay in a hospital bed, comatose, tubes sprouting like weeds from her nose,
mouth and body. She twitched and shifted silently, as if still feeling pain.

Sometimes conscious, Fasulo was rarely lucid.

"I felt terrible," Paygar, 47, said. "She became like a baby. She began to
cry and she could not sleep. All she would do is cry. She was blind. She
couldn't see anything, she didn't know what was going on."

A small piece of good fortune came from the results of DNA tests that proved
Fasulo's father was a Massachusetts man who had an illicit relationship with
Paygar while he was in the Peace Corps. That allowed Fasulo to receive
Medicare coverage that paid for her treatment. It also allowed her to stay
in the country long after her original six-month visa expired.

Fasulo's father did not return calls for comment.

Fasulo was so ill by the time she qualified for a donor liver, she probably
would not have lived one more month, Radomski said. He credited the medical
team at the hospital, specifically Dr. Raza Hamdani, with keeping her alive
until the transplant surgery.

Fasulo's not out of the woods. If a body's going to reject a transplanted
organ, it's most likely to do it in the three to six months after the
surgery, Radomski said.

And Fasulo may still need her spleen removed. Parts of it's dead and it's
causing her serious pain. That's a decision that'll be made after Fasulo has
recovered from the transplant.

After years of living with the threat of death Fasulo's grateful for a
reprieve.

"At least somebody gave me the chance to live," she said.


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