Advanced Gastro Treatment is Music to Vocal Coach’s Ears
February 12, 2025
The only thing Troy Randall loves as much as his family is music. A longtime vocal coach, songwriter and artist developer, the 61-year-old resident of Smyrna, Delaware, has devoted his entire life to it, having coached such big-name artists as Wyclef Jean, Patti LaBelle and Lyric, just to name a few. In fact, Troy loves music so much that he sang his vows to his wife on their wedding day and named his two daughters Symphony and Jazz.
Passion that powerful is hard to quell. Nevertheless, a shocking medical diagnosis almost snuffed his musical flame before he found the care he needed at JFK University Medical Center.
Diagnosed With Rare Rosai-Dorfman
The journey started in 2018 when he had to take his daughter to a local hospital. “It was at night, and she had a very bad headache. So bad that she was crying,” recalls Troy, who suddenly began feeling lethargic upon arriving at the emergency room. For months prior, he’d been having bouts of itching and fatigue, which his doctor had attributed to low testosterone. Since he found himself at the hospital, however, he decided to have himself checked out while he was there. That’s when he suddenly collapsed.
“My daughter was OK – she’d had a migraine – but I ended up being in the hospital for 11 days,” continues Troy, who appeared jaundiced, and therefore doctors initially thought he had a liver condition. Upon completing more tests, however, doctors decided it was likely something much worse: cancer. Troy’s biliary ducts—thin tubes that are part of the digestive system and connect the liver, gallbladder, and small intestine—were obstructed. This blockage caused a backup into his bloodstream of bilirubin, a dark yellow waste product that the liver creates to metabolize hemoglobin from aged red blood cells. A backup of bilirubin causes jaundice.
Left untreated, Troy’s symptoms would continue to worsen and could ultimately result in a lethal infection, doctors told him. However, before they could treat him, doctors had to determine what they were dealing with. The source of Troy’s biliary duct obstruction was likely a tumor, they believed. Upon operating, however, there was no evidence of cancer. Instead, doctors determined he had Rosai-Dorfman disease, an extremely rare condition that occurs when the lymph nodes overproduce white blood cells known as histiocytes.
Troy had actually been diagnosed with Rosai-Dorfman 10 years prior when he broke his right humerus. When it’s present in the bones, however, the disease mysteriously resolves itself when the bone heals. So, once he recovered and tested negative for the illness, neither Troy nor his doctors gave the condition another thought. That is until Troy’s surgeon found it in his liver.
Treating Rosai-Dorfman Disease
The path forward was brutal. Although Rosai-Dorfman is benign, Troy’s doctors determined that the best way to treat it was with chemotherapy.
“I went through chemo for six months and wouldn’t wish it on anyone,” Troy recalls. “During that time, the Rosai-Dorfman went into remission, which is great, but the damage it had done still had to be handled. If it were cancer, they would be taking out a tumor. But in my case, my biliary ducts are being obstructed on the inside by lesions caused by the Rosai-Dorfman disease. Doctors can’t remove lesions. It’s like having a welt from being struck by something. How do you remove a welt? You don’t. You have to treat it.”
At the time, Troy had to wear biliary drainage bags under his clothes to collect the foul-smelling bilirubin that would otherwise flood his system. “I couldn’t possibly explain the wear and tear that had on my psyche. Trying to keep a fighting stance was difficult, but I did,” says Troy, who ultimately saw a gastroenterologist who devised a novel treatment: reconstructing Troy’s constricted biliary ducts by creating a new tract to drain them through the stomach rather than the duodenum, the part of the small intestine that connects to the stomach. “He put stents in my biliary ducts to open them up to let the biliary fluid go through—which is a great solution but a temporary one because those stents must be changed. So since about 2019, I’ve been going to the hospital every two to three months for a stent replacement.”
A Path Forward at JFK University Medical Center
Then, in late 2023, his gastroenterologist left his position at the hospital. Suddenly, Troy had nowhere to go for his treatment. He was on the verge of panic when he received a referral to gastroenterologist Iman Andalib, M.D., at JFK University Medical Center.
“When I met Troy the first time, I sat down with him for about an hour to talk about my experience and to go over the procedure with him, even though he’d gone through it multiple times before,” Dr. Andalib says. “I think that gave him the confidence to trust us with his care. That, and the nursing staff in the endoscopy unit. They’re very friendly and do a wonderful job making sure patients feel comfortable with their procedures.”
“Comfortable” is an understatement if you ask Troy. “Relieved” was more like it. “When I got to JFK, it was clean, it was organized, and I was spoken to, looked at pleasantly and welcomed,” says Troy, whose mother was a nurse and taught him early the importance of good bedside manner. “I was amazed because I hadn’t received that kind of treatment since I was a kid.”
The procedure itself remains difficult. But the warmth he feels at JFK makes it infinitely more palatable. “I was lost, doubtful and uninspired, if not downright depressed, about my future quality of life before I found JFK,” continues Troy, who says Dr. Andalib and his staff have given him a newfound excitement for living—and for making music again. “Before she died, my mother wanted me to release an album. I’ve been helping other people make albums for years, but I never released one of my own. My experiences at JFK have lifted my spirits so much that now I feel able to do what I promised my mom I would do.”
Next Steps & Resources
- Meet our source: Iman Andalib, M.D.
- To make an appointment with a gastroenterologist near you, call 800-822-8905 or visit our website.
- Learn more about gastroenterology at Hackensack Meridian Health.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
