During the four months Sacha Cardinal spent living on the fifth floor of an Ottawa hospital, she found the late evening was the best time for homework. It was quieter and easier to focus on the law and calculus assignments that brought her closer to her goal: attending her graduation ceremony.
The 17-year-old lives with Type 1 diabetes, and developed a rare allergy to insulin injections. She was admitted in February to CHEO, a pediatric health care and research centre in Ottawa.
“That was basically the only thing going through my head,” Ms. Cardinal said. “Being able to be out by that day and to be able to attend graduation with everyone and not stress about going back to the hospital.”
Ms. Cardinal envisioned reaching this milestone, even trying on her dress and shoes and walking through the hospital-unit hallway with her intravenous pole.
She was discharged earlier this week, thanks to a determined doctor who overcame the barriers of a global pandemic, and a surgeon was flown in from Germany to train staff to perform a rare procedure.
On Thursday, Ms. Cardinal’s hopes became reality. She wore a floor-length deep purple dress as she climbed out of a car with her mother. She accepted her high-school diploma at école secondaire catholique de Plantagenet, a 45-minute drive east of the hospital, in a drive-through ceremony.
“I’m so happy and proud and excited,” she said in the moments after picking up her diploma.
Ms. Cardinal was diagnosed with diabetes when she was two years old. It was only recently that she started developing painful welts on her body.
Sylvie Gelinas said her daughter became so weak that she would get tired even climbing upstairs from the basement.
Ms. Cardinal had an allergic reaction to insulin when she injected it subcutaneously, in the fatty layer under the skin. The red, inflamed, painful bumps caused by insulin injections were found on a biopsy to be from inflammation in the subcutaneous layer.
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“It was a big question mark for us, because she needs this [the insulin] to live,” Ms. Gelinas said.
Doctors exhausted all treatments, including topical ointments. Ms. Cardinal was admitted to hospital and given insulin through an intravenous line because the pain grew severe, her reactions were worsening and her blood-sugar levels were high.
Alexandra Ahmet, a pediatric endocrinologist at CHEO, has known Ms. Cardinal since she was first diagnosed with diabetes. She said allergies like this are rare.
Dr. Ahmet and her colleagues learned of a device called the DiaPort system that would bypass the subcutaneous layer where Ms. Cardinal had an allergic reaction, and take the insulin directly to the abdominal cavity. The procedure involved insertion of a device that has only been provided to approximately 70 patients worldwide, none of whom are in Canada, Dr. Ahmet said.
Dr. Ahmet spent hours on the phone with Health Canada and border services to try to bring the treatment and a surgeon to Ottawa from overseas.
She had to manage COVID-19 safety protocols, while trying to access a procedure for her patient. Dr. Ahmet said she spoke with someone at Roche Canada, the pharmaceutical company, which found a way to fund the materials and the procedure.
The company arranged to fly in a surgeon from Germany earlier this month, who guided the Canadian doctors in performing the operation.
Dr. Ahmet said she is hopeful that this is the solution for Ms. Cardinal. Her only concern is that the special insulin used by this system and produced by Sanofi will be discontinued next year.
“I was extremely stressed because I really wanted this to happen for her. She’s been such a trooper. She’s been through so much,” Dr. Ahmet said. “It’s a huge deal for a 17-year-old. We really wanted to see her get there [to graduation].” She added: “And we wanted her to do it pain free.”
Ms. Cardinal said she doesn’t know if she would have made it to her graduation ceremony without the work of Dr. Ahmet. “I’m so grateful. She worked days and nights for me. And so did her team.”