February 18, 2000

The Frasheris consider themselves lucky to have immigrated to the United States from their native country of Albania. If they hadn't moved from their homeland and sought medical care at the MGH, two of their family members probably would have died from complicated diseases.

Llambi and Margarita Frasheri first learned of their baby daughter's serious illness in 1996, while still living in Albania. Several local doctors had diagnosed then 11-month-old Aleksandra with Cushing's disease — an endocrine disorder characterized by high levels of the hormone cortisol. Her physicians concurred that the kind of treatment she needed could only be found in the United States.

At first, the Frasheris had little hope of making such a trip to save their daughter's life, but luck was on their side. Soon after Aleksandra's diagnosis, the family received immigrant status from the United States through the Green Card Lottery system.

Right, Aleksandra Frasheri with her grandmother, Persefoni, and her father, Llambi.

After arriving in Boston in May 1996, the family desperately sought medical help for Aleksandra. They knew no one and could speak very little English. However, good fortune found them once again. They were referred to John Crawford, MD, of the MGH Pediatric Endocrine Unit, who recognized immediately that Aleksandra did not have Cushing's disease, but had Cushing's syndrome, a much more complicated disorder that in her case was characterized by an adrenal carcinoma, a malignant tumor located near her left kidney.

Aleksandra underwent a successful six-hour surgery, performed by Patricia Donahoe, MD, chief of Pediatric Surgery. Although her recovery was complicated, Aleksandra's health eventually improved, and she has had no recurrence of Cushing's syndrome in the last four years.

"Aleksandra was very lucky that she got here," says Crawford. "Because Cushing's syndrome weakens the immune system, even the slightest cold or infection could have become fatal."

Relieved that their daughter was on the road to good health, the Frasheris thought they could finally begin their new lives in this country. But medical problems came to plague the family again. This time Margarita Frasheri was diagnosed with cancer and suffered from unforeseen complications.

Margarita Frasheri was first admitted to the MGH for what appeared to be a normal appendectomy (removal of the appendix), but her physicians found an unusual malignant tumor in her appendix — of a type usually occurring in the placenta. During follow-up after the tumor was removed, Margarita's physicians discovered even more cancer in her liver and lungs. She then was treated with chemotherapy and radiation.

To compound Margarita's battle with cancer, she also developed a blood clot in her brain that had to be treated by a team of interventional radiologists, who dissolved the clot using heparin. "At that point, we didn't think Margarita would survive with this additional complication," says Najmosama Nikrui, MD, of the MGH Gillette Center for Women's Cancers. "Over the course of the year, she kept having recurrences of the cancer, she developed yet another blood clot in her brain and also had to have a hip replacement. But we didn't quit on her. We continued with radiation and chemotherapy, and now she is cancer-free. It is a miracle that she recovered from all of these problems."

After two such devastating illnesses in their family, the Frasheris now are enjoying their lives in the United States. They still come to the MGH periodically for follow-up visits and will tell anyone who asks how they feel about the care they received at the hospital.

"Without physicians like Doctors Crawford, Donahoe and Nikrui, I don't know what we would have done," Llambi Frasheri says with an Albanian accent. "For me, this hospital is the best in the world. I don't know in English the words to say how I feel about this place."