By DAVID DUPONT
BG Independent News
Danielle Nagel Rywalski turned yellow for Halloween, and it was no laughing matter.
In October 2020 her skin turned yellow, and as a chiropractic doctor she knew she was jaundiced. But why. A specialist in Toledo referred her to a doctor at the Cleveland Clinic.
That hepatologist determined she needed a liver transplant. She needed one urgently. Her MELD score, which determines how high a patient places on the list to be a recipient when a potential donor dies, was 28 on a scale of 6 to 40.
Rywalski had been healthy her whole life. She felt fine. She was busy treating patients at Nagel Chiropractic Center and with her family. She’s married to Mike Rywalski and they have a 7-year-old son Grant.
Even as a doctor she was unaware of how extensive the process was to get on the list for a transplant. She had to undergo blood work, EKG, MRI, and mammograms, and be examined by a dermatologist and dentist.
She was listed in January 2021. “I was at the top of the list.”
Rywalski and the transplant team were looking either for an organ donor who died or a living donor.
Because the liver regenerates itself, the living liver donor can give up 60 percent of the organ. The body regenerates the donated liver within four months. Cleveland Clinic can do the procedure laparoscopically, so the recovery is minimal.
However in terms of matching the donor must be under 70, of the same size as recipient, with a BMI 32 or lower, and the same blood type among many other factors. They must be in “pretty pristine health,” Rywalski said.
“I was blessed and completely humbled that I got a lot of offers to be a living donor.”
Through all this she continued working. She did have to go in to have the 2.5 liters fluid that built up in her abdomen removed. “I lost 10 pounds in 10 minutes.”
Rywalski didn’t realize how critical her condition was. “I was within a month of dying.”
Then in February she was called to the Cleveland Clinic. A donor had been located.
She arrived at the clinic. Then she had a false positive COVID test, though she’d been getting tested continually before.
That liver from a recently deceased person went to another patient.
Rywalski admits to having concerns about that liver which had been exposed to hepatitis B. That would mean a lifetime on medications for hepatitis.
“I wasn’t frustrated,” she said. Throughout she maintained a positive attitude.
“Twenty percent of people die on the transplant list, so I feel completely grateful and kind of bewildered that this happened so fast because I know people can be on the transplant list for years. I was still working. I was caring of my family. I was still pretty sick.”
While she was still at the clinic for the first donor, spending time on the COVID wing, another donor became available. “I just know it was a perfect match for me,” she said.
On Feb. 25 she received the transplant. She went into surgery at 10 p.m. She was talking with her husband on FaceTime early the next morning. She only spent four hours in the Intensive Care Unit before she was moved into a regular room. Rywalski was told to plan to stay six to eight weeks. She was out of the hospital in four days. She stayed with her in-laws in Akron a few days before returning home.
Throughout she maintained a positive attitude. As she went through the process, she relied on her faith. Morgan Heritage’s “Take Up Your Cross” helped keep her spirits up. “I’d sing that and knew I would be fine.”
That was true even when her body started rejecting her new liver. That was scary for those around her, Rywalski said. For her though it was “a bump in the road. … I just had faith that everything would be OK. I had a positive attitude.”
Not that the transplant and a subsequent procedure didn’t take their toll. She was fatigued and lost 70 pounds, and much of her muscle. She’ll be on immunosuppression drugs for the rest of her life. She has been immunized for COVID-19 and waiting for guidance on when to get a booster.
But she’s slowly recovering and hopes to reopen Nagel Chiropractic Center soon.
The 1990 graduate of Bowling Green High School has been in practice for 22 years, opening her first clinic in Fostoria. She now operates the clinic in Bowling Green.
“I always knew I wanted to be some kind of doctor, ”Rywalski said. “I just like the natural approach and helping people.” During her treatment and recovery “I miss being able to help people.”
Now she has a new mission to promote organ donation. She volunteers with Donate Life Ohio, and is a booster of the Cleveland Clinic. “We’re very lucky to have such an amazing facility in our state.”
Rywalski does not know who her donor was. She would like to contact the family though. That’s up to the family. She’s written the letter, though she hasn’t sent it yet.
Rywalski hopes they will want to get to know her. “That’s every recipient’s dream, but you have to honor their wishes. I just know I’ll be eternally grateful. I don’t know how thank someone for this gift. I will always pray for the family.”
