Make me no promises

How do the lyrics go? “Make me no promises. Tell me no lies.”

Photo by Nataliya Vaitkevich on Pexels.com

There’s a problem with the messaging being published right now about vaccines. Every day I see a new headline with the title “I’m Vaccinated, Now What Can I Do?” or “Can You Hug Your Grandkids After Getting a COVID Vaccine?” “COVID-19 Vaccine Doesn’t Mean You Can Party Like Its 1999.”

They all carry the same message. Getting a vaccine doesn’t mean you can let you guard down. Nothing is 100%.

The problem is, it’s way underselling the effectiveness off the vaccine.

I saw a viral Facebook post yesterday that, basically, said that if vaccinated people still have to wear masks, still have to distance, can’t hug their grandparents, etc. then vaccines don’t work and they aren’t worth the risk.

THIS MESSAGE IS WRONG.

So how did we get here?

Well, to start, science knows its limitations. Research studies, especially medical research studies, publish a summary not just of the successes, but of the failures. Therefore, there is no 100%.

Then, there’s the problem of medical malpractice and informed consent. If you’ve spent any time in the medical world, you’ve probably observed that doctors tell you every risk, every worst case outcome. It’s part of their job that you know exactly what might go wrong. No one wants a devastating, unforeseen outcome. Especially since, when one happens, malpractice suits often follow.

Doctors are trained not to promise outcomes that cannot be guaranteed. This is why our introduction to Patrick was “life expectancy of 1-2 years.” Before his adoption, the GI who was treating him sat me down and spelled out in great detail how very difficult his life would be. For an hour. Most NICU parents can recount a similar experience where they were told about poor quality of life and low risk of survival and were left convinced there was no hope. This is why the term “defy the odds” is used so commonly in our circles.

The problem with this approach is that it often misrepresents the odds. Skews them towards the negative. Even when prognosis is good.

I’ll be honest, years of being told “the odds” related to Patrick’s transplant had me so terrified that I considered turning down the offer when it came. I cried the entire flight from Utah to Nebraska. Did he defy the odds? Or are the possible wonderful outcomes the exact reason why we take medical risks?

The truth is that, in most cases, the odds being emphasized about are the long odds. The long shots. The off chances.

So if you’ll humor me, I’d like to share some of the answers I wish were being emphasized in response to the questions in the headlines. I’ll follow by explaining what this information means for our family and vaccines.

The questions here come from the social media post my friend shared yesterday.

“If I get vaccinated can I stop wearing a mask(s)?”
At first, no. This partly because we do not know much about the risks of spreading the disease and because of variants. But I suspect there’s a behavioral motive, too. Early experience taught us that some health rules are better universally adopted. It’s easier to encourage everyone to wear masks than to try to split hairs about who should wear them and who shouldn’t. Mask mandates will lift when case counts decrease to safe levels.

A personal aside: Given that mask-wearing, distancing and quarantining when sick have essentially eliminated the influenza that has been a public health crisis for years, I hope we never fully abandon mask wearing.

If I get vaccinated will the restaurants, bars, schools, fitness clubs, hair salons, etc. reopen and will people be able to get back to work like normal?”
Accomplishing this goal will require many people to be vaccinated. In order to resume normal business, we’ll need to reach a certain level of herd immunity. That’s defined as somewhere between 60-90%1 of the population having immunity. We can accomplish this the slow destructive way, by just letting the virus run until 60-90% of the population has caught the virus, keeping precautions in place so our hospital system doesn’t collapse. Or we can do it the faster, safer way, with vaccines. Experts hope that herd immunity will be acheived by summer or at least fall, when most people have had the chance to receive the vaccine. A lot of that depends on our choices. Herd immunity is the point at which business will return to normal, or something like it.
1. https://www.nytimes.com/interactive/2021/02/20/us/us-herd-immunity-covid.html

“If I get vaccinated will I be resistant to Covid?”
Yes. Don’t dwell on the odd outliers. No medical treatment comes with a 100% guarantee. But with the current vaccines, we get pretty darn close to it. In studies, the Moderna and Pfizer vaccines showed 90% effectiveness in preventing moderate to severe illness for those who received both shots. However, the 10% who still experienced mild disease were.. well, mild. In other words, these two vaccines have nearly 100% efficacy in preventing or reducing your risk of severe illness, hospitalization and death.2 Data in the general population is following the same pattern. Johnson and Johnson’s vaccine shows 72% efficacy in studies. (66% overall). However, it was 85% effective in preventing hospitalization and death.3,4
2.https://www.sciencemag.org/news/2020/11/absolutely-remarkable-no-one-who-got-modernas-vaccine-trial-developed-severe-covid-19?campaign_id=9&emc=edit_nn_20210118&instance_id=26125&nl=the-morning&regi_id=94133618&segment_id=49584&te=1&user_id=b1e0880472a5057b2471cc3672dea780&fbclid=IwAR2yregj5DNSXDv9XbidrmP7lhCVlnIqpj6dti58ar2S9E3cvY4T3u3WYHI
3. https://www.nytimes.com/2021/01/29/health/Covid-vaccine-explainer.html?campaign_id=9&emc=edit_nn_20210201&instance_id=26625&nl=the-morning&regi_id=94133618&segment_id=50744&te=1&user_id=b1e0880472a5057b2471cc3672dea780&fbclid=IwAR2dLw3v_WpX2Cr9XuLd-nBI4scgcoD8ldGe1ZMR6EPiO85Q7Iwqz-Y-D6U
4. https://www.jnj.com/johnson-johnson-announces-single-shot-janssen-covid-19-vaccine-candidate-met-primary-endpoints-in-interim-analysis-of-its-phase-3-ensemble-trial

“If I get vaccinated, at least I won’t be contagious to others – right?”
We hope so. However, there are some vaccines, such as the one for polio, that still allow carrier transmission of the virus. And no studies have been done to see if the vaccine provides mucosal (as in in the mucus of your nose) immunity. That would require swabbing a whole bunch of vaccinated people and no one has done that yet. We are still early enough in this disease to be working in hypotheticals. And it’s better to err on the side of caution. So, they recommend that you assume you may still be able to be a silent carrier of the disease.

That said, studies have shown the AstraZeneca vaccine does reduce contagion.5 The Pfizer vaccine showed significant protection from spread in animal trials.6 In general, vaccinated people, even when infected, carry less of a virus than an unvaccinated ill person.6 Reducing the number of infected people is likely to reduce spread. So while we don’t know and caution is still warranted, there are early signs that vaccines reduce spread.

And if there is still a chance of spread by vaccinated carriers? That’s an even stronger argument for more people to be vaccinated.
5.https://www.nytimes.com/live/2021/02/03/world/covid-19-coronavirus?fbclid=IwAR1tjCFBfNX5ykwhaKaBCx2crCjOPmeorZM2GElbVvPJqhwZR71zci1NHOE#astrazeneca-coronavirus-vaccine
6. https://www.bbc.com/future/article/20210203-why-vaccinated-people-may-still-be-able-to-spread-covid-19

“If I get vaccinated, how long will the vaccine last?”
This question is tricky, because we don’t have data yet. The vaccines themselves are less than a year old. Experts predict at least month and possibly years.7 This comes from an understanding that contracting the actual illness provides at least 3 months’ protection, but a recognition that there are cases of reinfection. Different people will have different immune responses. Also, Covid like other viruses can mutate. It’s possible that an annual shot, like a flu shot, might be necessary to keep up with mutations. Only time will tell. However, don’t mistake a lack of information with a lack of effectiveness. The vaccines do protect you from the virus and continue to do so in study participants.
7. https://www.kgw.com/article/news/health/coronavirus/vaccine/verify-how-long-will-immunity-from-the-covid-19-vaccine-last-no-one-knows-for-sure/531-86718292-cef8-4e81-9c54-4333aafbae65

“If I get vaccinated, can I stop social distancing?
It’s hard to make recommendations with less than a year’s data. So the safest recommendation is to continue distancing. As a society, we need to keep social distancing until 1) We establish a certain level of herd immunity, 2) We know more about the effectiveness of the vaccine on current mutations. Remember the behavioral element of this recommendation. It’s easier to tell everyone to distance than to try to distinguish who can safely do so and who can’t.

However, because the vaccines greatly reduce risk, it may be relatively safe for vaccinated people to gather in small groups. Remember that vaccines are only effective 2 weeks after the second dose. And for contact tracing purposes, it’s still best to keep these gathering small and make sure there is no contact with unvaccinated people.8
8. https://www.radio.com/kcbsradio/news/can-vaccinated-people-socialize-safely-with-each-other

“If my parents, grandparents and myself all get vaccinated can we hug each other again?”
People with weakened immune systems may have a weaker immune response to a vaccine than a younger, healthier patient. So there is a possibility that you could pose a risk to an immunized grandparent, especially if you haven’t yet been vaccinated.. If you want to 100% safe, experts say you shouldn’t hug. But they also recommend common sense.

Lucy McBride, a primary care doctor, gave this advice,”If we want to 100% avoid COVID risk, the answer is no. If we want to consider emotional and physical risk and reward in tandem, for our family, the answer is yes because the emotional benefits of hugging an immunized grandparent greatly outweigh the very small risk of sickening or endangering anyone involved.”9 Hugging is safest if everyone is fully vaccinated and at least 2 weeks after their second shot.

I love these other words from Dr. McBride. “We can and should allow ourselves the pleasure of looking forward to the days when we and our loved ones are vaccinated, because our risks of being together will be so very low and the benefit to our mental health high.”9
9. https://www.webmd.com/vaccines/covid-19-vaccine/news/20210203/covid-faq-i-got-the-vaccine-is-life-normal-again?fbclid=IwAR3x4XjLQfPe0t82WdKvXKhNytQQwEdocDACshhLmi43xOaDX_dVIarcO5o
10. https://www.theatlantic.com/ideas/archive/2021/01/giving-people-more-freedom-whole-point-vaccines/617829/

“So what’s the benefit of getting vaccinated?”
If there’s so much we don’t know and the vaccine isn’t the golden ticket, is it really worth the risk? After all, a fast developed, limited study vaccine sounds risky, right?

One thing is abundantly clear from all the data. All of the currently approved and soon to be approved vaccines will reduce your chances of contracting COVID, reduce the severity of your illness if you do, and make you less contagious. Also, it is the fastest way to quickly and safely reach herd immunity.

“Are you sure the vaccine won’t injure or kill me?”
Doctors never say they are sure. However, clinical trials show the vaccines to be remarkably safe. And the rapid vaccination effort in the country provides extra assurance as we have data from 22 million currently vaccinated people. There is a risk of anaphylaxis in those with a history of allergy. That risk is treatable. A few incidents of reported death do not seem to be directly linked to the vaccine, but are being studied. Only 1,000 adverse event reports would be considered serious. Compared to 22 million, that number is very low. Meanwhile, these vaccines themselves are being highly and very publicly scrutinized. As for Bell’s Palsy, which has received some viral internet attention, in studies, there were actually many more cases in the control group than in the vaccinated group. Incidents of other events such as heart attack, stroke and embolism in the vaccinated group were the same as would be expected in the normal population. Some of these events will happen in any group of people.11

Overall, the risk of severe illness and death from COVID-19 is much, much higher than the risk of death or injury from the vaccine.
11. https://www.usatoday.com/story/news/health/2021/01/28/covid-19-vaccines-cdc-safety-data-pfizer-moderna-coronavirus/4281434001/?fbclid=IwAR0yVbrFJgmh0JCA5QXcq17qyD-8Y6YAdCqpJER_zKowouGDq9CIdquaDl0
12. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html?fbclid=IwAR3zADlbswgiETfRL6uN_yZJE9UY2jc_erVQZWEvFe3ZKs22Sn74e1D3qVM

“If statistically the virus won’t kill me, why should I get vaccinated?”
Vaccination protects you, your family, and society at large. True, COVID has a 99% survival rate. But in a country with a population of 328 million, that’s still 3.2 million people who could die. 10-15% of COVID cases progress to “severe disease.” 13 For every person who dies of covid, at least 4 others were hospitalized. The financial impact alone of that many hospitalizations, many lasting months, is significant on businesses, healthcare systems, and especially individuals. 76% of hospitalized have long-term symptoms of the disease.14 20% of reportedly healthy 18-34 year old patients report long-term effects of the disease. 13 And when hospital ICUs are above 80% capacity, the risk of death from other factors such as car crashes, heart attacks and strokes increase as well.15
13. https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-36-long-term-symptoms.pdf?sfvrsn=5d3789a6_2&fbclid=IwAR0tZTv8uWRfP3QAXwE56sPCNiYMWQiV1_bH3SfBkRsCCc3ObKpGCNGureQ#:~:text=Approximately%2010%2D15%25%20of%20cases,about%205%25%20become%20critically%20ill.&text=For%20some%20people%2C%20some%20symptoms,to%20others%20during%20this%20time
14. https://www.healthline.com/health-news/over-75-percent-of-people-hospitalized-with-covid-19-have-symptoms-months-later?fbclid=IwAR0GfQp_Q1pUgPT7d6vd1sfEnMOMgjaucJHXmgJs0AedCAf0lWyD6PcJRUA#Long-term-symptoms-are-common
15. https://www.deseret.com/utah/2020/11/12/21562579/coronavirus-covid-19-pandemic-real-stories-impacts-hospitalization-long-term-effect-salt-lake-county

“If I experience a severe adverse reaction, long term effects (still unknown) or die from the vaccine will I (or my family) be compensated from the vaccine manufacture or the Government?”
True. They are shielded from litigation. Vaccine manufacturers take a considerable risk, especially in rapid production of a virus. The probability of adverse reaction is small, though never none. As of February 14, the rate of death among vaccine recipients was 0.0018%.16 Rate of anaphylaxis (which is the most severe effect reported thus far) is 2-5 people per million.16 Compare this to a 1% chance of death and approximately 20% chance of lasting adverse effects from the disease itself. You will not be compensated for this risk, either.
16. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html?fbclid=IwAR3zADlbswgiETfRL6uN_yZJE9UY2jc_erVQZWEvFe3ZKs22Sn74e1D3qVM

I was worried that the trials had been rushed, too. However, I’ve seen multiple statements, including from doctors whom I trust and who have reviewed the research, that assert the trials were complete and safe. A pandemic creates a unique circumstance where 1)there are many eager trial participants, 2) there is ample opportunity to expose those participants to the disease and 3)the government was willing to remove the red tape that usually slows studies. When they say they expedited trials, what it really means is that they didn’t let them sit on someone’s desk for months between steps.

Also, these vaccines use technology that was already in use. For example, Moderna and Pfizer use mRNA technology that was being used for cancer research. (Remember how we fundraise to support cancer research?) Johnson & Johnson and AstraZeneca use technology developed when working on vaccines for Ebola and Zika. They customized existing technology to this specific virus.

And in case you’re wondering, even using nanotechnology, they couldn’t hide microchips in the vaccines without them being detected. Vaccines are reconstituted from powder to make a clear liquid. Even the best microchip using current nanotechnology would appear as a small floating contaminant in the vial. Feel free to ask to inspect your dose. Also, multi-dose vials would make it impossible to hide and equally distribute multiple doses of microchips in a reconstituted solution. (I know you probably don’t believe this, but if you know someone who does.. well, this may not change their mind. But knowledge is power.)

In summary
In my opinion, doctors and journalists need to trust the public a little bit more. We ARE capable of balancing hope and caution. However, when the message of caution is over-emphasized, there is a tendency to give up hope.

As a society, we have prayed, fasted, sacrificed, researched, hoped and waited for an end to this pandemic. Those prayers were answered with the rapid production of not just one but several highly effective vaccines.

This. Is. A. Miracle.

We need to be careful that we don’t let skepticism, caution, politics, or worry lead us to reject this gift. This answer to our prayers. Turning down the vaccines because you may have to wear masks and distance a little while longer is like turning down a new sports car because you’ll still have to follow the speed limit.

The road back to normal is through these vaccines.

So, what about us?
Utah will open up vaccines to the high risk medical group on March 1st. And there are a few questions I am asked regularly.

Will Patrick qualify for the vaccine?
Patrick meets 4 of the criteria on Utah’s high-risk list. Solid organ transplant, asplenia, immunosuppression and cerebral palsy. However, vaccines are not yet approved for pediatric patients. Trials are underway in this patient population. They are taking longer than adults because children are less at risk, parents are more hesitant, and teens are less compliant with study regimens. Still, we hope by late summer or early fall that a vaccine will be available to him. And we have been instructed to get him vaccinated as soon as possible.

What about you and Brian?
I am also in the high risk group because of my immunosuppression for Rheumatoid Arthritis and because of my weight. We have been strictly quarantining for my sake as well as Patrick’s. I’m the only one who has his entire medical picture in my head and he needs me to be here and healthy.

I plan to stalk the health county website on March 1 until I have an appointment. I’ll go off my R.A. meds to improve my immune response. It should be miserable. And totally worth it.

Brian will probably have to wait until the end of the line, unless we can get someone with decision making power to include caregivers of high-risk children in the higher priority groups.

When can we hang out with you again?
Did you notice above that the safest groups were those where everyone was vaccinated? We hope that you, with us, will choose to be vaccinated so that we can get back to spending time together as soon as possible.

Patrick and I both are in that group who may not have as “robust” of an immune response to the virus. So we don’t know how much protection we’ll have. But if we are vaccinated and you are vaccinated, we have much better chances of being safe.

Our initial interactions will be limited to small groups of vaccinated family and close friends. We’ll slowly come back into society like we did after transplant. Large group activities will wait till all of us are vaccinated. But time (and better data) will tell.

If you want to see us before the U.S. reaches herd immunity, get your shot.

Will Patrick be back in school in the fall?
Honestly, I don’t know. I have every intention of sending him back to school when his team says it’s safe. Patrick needs people.

Since we expect it to take longest for children to be vaccinated, it will for sure need to wait until he at least has the protection of immunization.

This could happen in fall. It might be later. And honestly, given how much better math has been with me teaching, the schedule may be part-time. At least to start.

Here’s a header so you know we’re at the end
There’s a lot we still don’t know. There is a lot that can’t be promised. But despite uncertainties, the future is very, very promising.

Hebrews 11 is one of my favorite books of scripture. Verse 1 read:

“Now faith is the substance of things hoped for, the evidence of things not seen.”

And verse 11 tells us that Sarah conceived when she was past age “because she judged him faithful who had promised.”

God hears our prayers and keeps his promises. He still sends angels. He still works miracles. And we are watching one unfold in this moment.

Let’s not be too afraid to accept that gift.

Being the 1% in a pandemic

At the end of last February, my family was in Disneyland. If you haven’t noticed from this blog, we’re pretty addicted. And Patrick can only safely be in crowds when they aren’t really crowds. So, when our tax return came in, we seized the opportunity to skip school and visit one of our favorite places.

I remember so clearly, sitting in LAX waiting for our flight home, watching news reports about this new Coronavirus that was plaguing cruise ships and had just been detected in the first U.S. case of community spread in Washington state. Seeing people flying in masks. And beginning to realize that may, just maybe, this virus wasn’t contained.

For the past year, I’ve had the thought several times that I should maybe write a blog post describing what it’s like to be a transplant family in the midst of a pandemic. I’m finding myself with a bit of time on a Sunday afternoon, so I’m going to give it a shot.

I remember going out to breakfast last year with one of my friends and her telling me that I was her barometer.. the person she was watching to know when it was time to panic. “Coronavirus” wasn’t a new word to me. I’ve spent the past 6 years following virus trends on the Germwatch website from our local children’s hospital and I knew that, for most people, Coronavirus was a common cold. I also knew that children especially seemed to do OK with this new virus. Still, nothing is simple with a child as complex as ours. So I reached out to Patrick’s transplant team in Nebraska and his team here in Utah and asked them to tell me how I’d know if we reached a moment where I needed to pull Patrick from school.

After all, his IEP has a specific provision that says that during cases of viral outbreaks, he was to be transitioned to a virtual connection to school.

On March 13, I got an e-mail from the transplant nurse coordinator “recommending our patients do not attend school for the next couple of weeks.” It was a Friday afternoon. I e-mailed Patrick’s teacher to let her know we’d be checking him out and need to figure out how he could participate in class remotely. Less than an hour later, in a press conference, Utah’s governor announced a soft closure of schools for the next week. Cleaning out his locker and saying goodbye to his friends was hard.

Unlike most of our friends, this wasn’t our first experience with quarantine school. Setting Patrick up for school just required pulling out tools I already had. I cleaned off a desk in the basement, gathered school materials, and set up a picture schedule.

I thought we were ready. Until an earthquake hit the morning that our distance learning classes were supposed to start. My emergency instincts kicked in. I can pack an emergency go bag in 15 minutes flat. It’s a matter of survival, and I’ve packed a lot of emergency go bags. But trying to think through packing a bag for dual emergencies of pandemic (that was supposed to keep us inside) and earthquakes (which might force us outside) was an overwhelming idea. And I had to try to accomplish this while trying to stay calm for a child who was terrified by the frequent aftershocks. I was so grateful that morning for video classes where Patrick could connect with his friends and talk about what had happened.

At the beginning of the pandemic, half of the voices were reciting “this is no worse than a cold” while the other half urged us to “flatten the curve.” In other words, to do everything we could to limit the spread so that hospitals would not be overwhelmed and our unprepared medical system and supply stores depleted.

I’d seen overcrowded hospitals first-hand already. Waited hours in emergency rooms because they couldn’t find a bed on the floor and then ended up assigned to the surgical unit or some other unusual corner of the hospital because it was where they could find space, and just being grateful that we weren’t in a windowless storage closet turned hospital room like some patients. And that was in just an average flu season. The idea of 1% or more of the population needing hospital care at once, I knew, was a very real and serious danger.

I also was keeping tabs on the pandemic on the website used to track national drug shortages. We learned to follow this site to keep track of shortages in TPN ingredients. It was terrifying to see basics such as normal saline, antibiotics, and albuterol appear on the list as critically low. I saw families in the support group I run trying to figure out how to handle dressing changes when masks and sterile gloves were nowhere to be found. And heard first-hand of nurse friends using a single surgical mask for an entire shift. We’d been hospitalized on precautions before. That idea alone was frightening. The stories out of Italy and New York on the news were terrifying. But the inside picture showed that the impacts were reaching us, even if the virus outbreak was not. I started a hashtag within the medical advocacy community. #sharethehealth .. begging healthy people not to hoard supplies that our families relied on for day to day survival.

We felt shortages in other places, too. I stopped at a grocery store to pick up a prescription on that March afternoon as I brought Patrick home from school. People were panic shopping. Shelves were emptied. And the interruptions in supply chain that came from everyone leaving the workplace and coming home were felt for months.

It was terrifying at first for all of us. But there was also a tremendous sense of community. Out of shared uncertainty came shared sacrifice. We were unified and united during those first weeks, even months.

But as weeks dragged into months, life had to go on. At first, we’d stop in to less frequented stores to look for staples, odds and ends you couldn’t get other ways. But as stores shortened hours and crowds competed for supplies, we couldn’t afford the exposure of our full grocery shopping trips anymore. So we learned to buy groceries online. Early on, the demand was so high that you had to place your orders days in advance. And then you crossed your fingers and hoped that the store would have some of what you needed. Checking over our grocery order and seeing what was missing or substituted was one of the biggest heartbreaks of my week. We lived a lot out of our food storage that spring.

And then there was the challenge of figuring out how to get other things we needed without going into a store. Easter especially took creativity to pull off. Gradually, businesses started offering curbside service. But for some things, I’d simply have to call the store and beg for someone to take my order on the phone and bring it out to me at my car.

We left home so rarely that any excuse to get out was a treat. One week, we all went to pick up groceries at Walmart. This outing could take an hour or more, as the demand for curbside was so high. That hot afternoon, we sat in our car with the air conditioner on. And then, when the groceries were loaded, Brian tried to start the car. The battery was dead. We begged the person next to us for a jump start, but that didn’t work. There we were, in the parking lot of a store that sold batteries, trying to decide if it was worth the risk to go in. Eventually, we decided the safest option was if Brian walked to an auto parts store in the same parking lot. There, he bought a battery and tools, changed the battery, and we made it home.

One of the hardest parts of being the family of an immune compromised child in this past year has been learning to forgive other people’s thoughtlessness. Too many people repeat “only 1% will die” or “only those with weak immune systems.” Well, yup. That’s our son. “This is no worse than the flu.” Well, he spent 2 weeks in the hospital with intestinal bleeding from norovirus. His tonsils had to be removed because of the risk of developing lymphoma when he had mono. And after his last immunizations, he’d had to spend a week at home because his body didn’t have enough white cells to protect him should he develop a cold. Having a liver, intestine and pancreas transplanted requires a high level of immune suppression, even at the lowest dose. And on top of that, his spleen was removed as part of that surgery, leaving him with even fewer defenses.

Distance learning was intense. In the mornings, we’d have online groups with Patrick’s class. There was only one girl in Patrick’s reading and math groups and our families got really close working together. In the afternoon, we’d come upstairs and doing science and social skills groups. Patrick’s teacher was amazing in finding ways to connect with the students. And in between groups, we’d complete work offline. I learned several new tricks during this time. Discovered online manipulatives. Mastered Google Meet and Google Classroom. It was a lot of work for me as a mom. But it was SO much better than any quarantine school we’d ever experienced before, that I was mostly just grateful. Especially because it kept Patrick from feeling alone.

The stress of suddenly losing all my supports (respite care, school, therapy and everyone else who had been sharing my load with me) and suddenly switching to a full-time job as teacher by day and a full-time role as playmate at night took its toll. Stress combined with my own immune suppression led to a case of shingles. Thankfully, because I’d been vaccinated when I was diagnosed with rheumatoid arthritis and started on immune suppression, it was mild.. a few weeks of pain and a lingering numb spot next to my ribs.

By Memorial Day, people were tired of quarantine and risked family get-togethers. And cases started to rise. We knew that eventually, life would have to reopen. Being a republican state, Utah’s legislature rushed and pressured the state into reopening much more quickly than their own plans suggested was safe. People took this as a sign that things were safe, even though nothing had changed. Still despite the rising cases that resulted, we tried to be enthusiastic for our friends who were able to take advantage of the discovery that the virus didn’t spread much outside. But I’ll never forget Patrick sitting at the window, watching our neighbors host a party with several other families.

Our family eventually got used to the routine of all of us being at home together. Yeast shortages and an abundance of time led me to finally learn how to make sourdough. My grandma was famous for her sourdough and I’m grateful and proud that I was able to master this skill. Also, shortages of food prompted Brian to help me expand my garden and learning about canning. We’d already wanted to do this, and pulling it off in a pandemic without being able to go into stores and nurseries was a bit of a feat. To make things harder, everyone was gardening, too. Still, I’ve always found tending a garden to be healing for my soul. And fresh tomatoes and other vegetables in summer made it worth the effort.

We were lucky as far as friends go, though. Patrick’s best friends were also being careful. And they were eager and willing to stay connected. So we discovered how to do video playdates on Facebook messenger and Google Meet. I found a website where you could upload your own gameboard and recreated a few of Patrick’s favorite games so he could play with friends and family. And we started reading Flat Stanley and mailing our own Stanley around the country.

Early in the pandemic, while cases were low, our extended family rented a house together in Colorado near Mesa Verde. I’m so grateful that they were willing to take the precautions to help make that trip safe because it was so good to spend time with them after so much time apart. We didn’t know how long it would be before we could be in person again.

In July, we decided to skip the noise of fireworks on Pioneer Day and take advantage of relatively low transmission in Wyoming. So we took a road trip up to Mount Rushmore. Most of the trip we were easily able to stay away from other people. We ate in fast food parking lots with all the others because dining rooms were closed. We strategically planned gas and potty stops for less crowded stations. By then, wearing masks got fewer odd looks, at least, even if they mostly weren’t worn in rural areas. Mount Rushmore was so crowded we basically ran in, took a few pictures and ran out, but overall it was a happy distanced trip far from other people. Except the hotels.Being around others in the hotels was nervewracking. Some were obviously clean, others more doubtfully so. Staff wore masks under noses or not at all. I brought cleansers with us and we recleaned the rooms and slept on our own pillows. Thankfully, we only spent the nights there. And in the day, we got to see some beautiful parts of God’s creations that were so close to home, yet we’d never explored.

We are no strangers to masks. Patrick wore masks every time he went in public for the first 6 months after transplant. Gloves, too, that we’d take off and wash when he got home. I started sewing us masks before it was the cool thing to do, as I saw families trying to figure out how to extend the life of their masks for dressing changes.

I read dozens of articles and studies looking for the best patterns and materials and finally settled on 800 count sheets as an interior layer and quilting cotton as an exterior layer. This was based on a study done in England as a sort of pandemic planning that compared different materials. Interestingly, that study hypothesized that the two biggest struggles in widespread mask adoption during a pandemic would be 1) comfort and 2) understanding how to wear a mask properly. It was interesting to see that play out in real life. Especially as a certain viral video hoax convinced so many people that wearing a mask would increase their CO2 and cause them to infect themselves with their own bacteria.

It took a few versions for me to figure it out, but eventually I managed some contoured masks with t-shirt yarn strings that went around your head and were adjusted with a pony bead at the back. They are still our most comfortable and most often worn.

But really, we rarely have to wear masks because we are around other people so rarely. There is some comfort in knowing that there is no grey area for you. Fully quarantining in some ways is easier than the decisions others have to make about risk.

Like returning to school. There was no question there. Patrick would join cohort Z, the all online learning option at his school.

But at a school primarily for children with special needs, most of the students chose to attend in person. It’s the best way for most to get the services they need.

And so, Patrick logs in each morning to a live video stream of his regular classroom. His one friend from spring is also at home and they are still in all their groups together. Our families work together on making learning a success and I’m grateful for their friendship and help.

He has an awesome teacher who does so well making sure that the kids who are online know that she cares and that they are a part of the class. We have our awkward moments. At first, we spent a good part of the time looking at the ceiling of the classroom because they’d forget to adjust the camera after tilting it to talk to us.

But, overall, as far as education goes, this may be one of Patrick’s best years ever. 1) He can adapt his learning to his own pace. He’s with the class, but if we need to take some extra time to finish something or take a break, we can. 2) I am entirely in charge of his IEP goals. It didn’t start out this way. The teacher would send us work. But as he and I were working 1:1 on these goals, my teaching training kicked in and I asked to pick the curriculum. I sent the teacher a copy of the book I wanted to use for math and she gave her blessing. Eventually, I took over all the goals. We just report data back and ask for guidance if we’re stuck. 3) We have enough time in the morning. With meds to give and other things, getting to in-person school on time has been a monumental feat. But we are rarely ever late to class online. If we do happen to be running late, he can just eat at the desk. 4) Patrick always has all the accommodations he needs. I know exactly what he’s doing. And especially with math, that he has to learn in a very unique way, I can pull out whatever manipulatives help. Even make some of my own. No more reminding teachers over and over again that they aren’t following the IEP. 5) We don’t have to fight to figure out inclusion. This deserves an entire post of its own. But long story short, P.E. and recess have long been problems for Patrick. But now our P.E. is guided by an amazing adaptive P.E. teacher and done 1:1 or when he feels up to it. 6) He can eat! And eat. And eat. Getting Patrick to take care of himself physically at school has long been a battle. But at home, he snacks when he needs it. He goes to the bathroom when he needs it. He has gone up 3 shoe sizes in the past year! Gained 16 pounds. He is just 5 inches shorter than me now.

There are some things that I can’t wait to end in this pandemic. But the lessons we’ve learned about education are things I’ll never let go. I hope that no healthy but at-risk child ever has to put up with 2 hours a week of “home hospital” education like we had to do after transplant. We know better now.

Another thing I hope never goes back to the way it was is Sunday. Don’t get me wrong, I miss worshiping in person and desperately miss fellowship with my friends. BUT because our church has a lay ministry, meaning most worthy men are ordained to the priesthood, when churches needed to close, we were given permission to have the priesthood-holders in our home (in this case, my husband) perform the ordinance of the sacrament for us.

About a year before the pandemic, our church switched to a home-centered church-supported model for some of our Sunday School lessons. They provided curriculum, but parents were to teach it at home. Well, that has been a life saver. In fact, being able to customize gospel lessons to Patrick’s way of learning. His gospel knowledge, comfort in the scriptures, and faith have been visibly growing, even if it’s still fairly young and innocent compared to others his age.

And to have Sundays be simply a day of rest, worship, and time together is precious.

As cases began to spike, church leaders directed that sacrament meeting be made available via webcast. At first, we were sad to give up the entirely self-paced Sunday we’d gotten used to. But being able to hear news of our ward and listen to talk and see faces, even if we aren’t seen, has been wonderful. Again, this is one of those things I hope doesn’t soon disappear. As we went months without being able to attend church after transplant, I was often envious of those whose wards had decided to make their meeting available to them via broadcast. It’s a little strange to know that others are attending in person every 2 to 3 weeks. But I know we’re not ready to be there yet, and we’re grateful to connect in the way we can. Similarly, being able to join in Sunday classes via Zoom has been great. (I just wish we weren’t always hurried off by Zoom’s 40 minute timeline.)

Another favorite part of Sundays is family chats. My grandfather is 95 and lives alone. My parents also both have medical conditions that put them at high risk. So the weekly Sunday dinners we’ve known all my life weren’t an option. But I worried about Grandpa and others being alone without regular connections. We started chatting on Sundays and I’ve been able to spend more time talking with my siblings than I have in years.

Holidays have been different. Much more low key. We pretty much skipped Halloween. We focused on Patrick’s birthday instead. We rented a whole movie theater for the three of us just to see a movie. We had a video birthday party with his friends. They played Kahoot and chatted. We bought the candy we wanted for ourselves, put a sign on the door, and hid in the basement from trick-or-treaters. Honestly, it was so nice not to have the birthday rushed through so we could get to the trick-or-treating that, quite honestly, just stressed Patrick and me out.

On Thanksgiving, we hosted jackbox games with our families. And for Christmas, we did gift exchanges and cookie exchanges over video. We had a delightful 2 day road trip getaway to go view the Christmas Star (convergence of Mars and Jupiter) at Goblin Valley in some of the darkest sky country in the country.

Christmas Day has always been hurried for us. Too busy rushing between different families. Spending the day at home playing with toys with a few video chats with family was SUCH a treat.

Reinventing traditions has taken some creativity, but has had such great rewards.

That’s another odd thing about being the 1% during a pandemic. I watch so many people worrying about what they’re missing. They can’t imagine letting go of traditions. They fret about their teenagers missing dances and socials. Their kids missing extracurricular activities. When schools don’t offer them, they create them on their own, despite the risks.

And it makes me sad.. because what they don’t see is that in trying not to miss the old things, they are missing so much else, too.

People hate the phrase “the new normal.” I think because it was thrust on them when they weren’t seeking it. The first time I heard that phrase was at a women’s conference when I was struggling with infertility. I was trying to resolve the gap between my hopes and my reality. And I attended a talk by a couple where the husband had had some sudden, severe health challenges. The wife told her someone had told her to stop trying to make the old normal happen, and to learn to embrace and look for the joy in her new normal. That was a lightbulb moment for me.

When I was getting ready to bring Patrick home from the hospital for the first time, the NICU attending sat down with me for, basically, a pep talk. He warned me that things were not going to feel right. That I was going to think I was failing most of the time. And that I’d at least once be sure I’d killed my son, even though I hadn’t. He told me that finding a new normal takes time. At least a month. And that I needed to grant myself grace while that happened.

I found that timeline to be very true. With every hospitalization, every medical change, every setback or triumph, we’d have to figure out a new routine and a new normal. And depending on the extremity of the change, it could take anywhere from 2 weeks to months before normal came. But it took the longest when I resisted the change.

I’ve spent most of my adult life adjusting to new normals. The Lord loves to reset my life on a moment’s notice. So this isn’t all that unfamiliar for me.

That doesn’t mean that I don’t mourn for the old normal. Let’s be honest, my life ended on March 14. My hobbies, my friendships, my space, my time. Everything I’d built was erased and I got to rebuild it from foundations up with my faith, my family, and my home as the beginning stones. So I miss time with my friends. And I miss having the house to myself. And going out to lunch. And Disneyland. And wandering the produce section of the grocery store. And hearing about my son’s day when I pick him up after school.

One of the hardest parts of this pandemic has been learning to offer grace and forgiveness to those who are actively fighting against “the new normal.” I cringe at social media shares of risky choices and neighborhood parties. It’s hard when that holding on to old things or trying not to miss out sometimes directly affects me. Like when we have to avoid the park on a walk because of the soccer game there with maskless crowds undistanced. Or the time I waited an hour at a restaurant for my curbside order to be brought out because there was a crowd inside and the manager thought he had to keep the line moving and so he didn’t serve anyone not inside the store.

The anger in online communication has been among the worst. And it’s taken me time to learn not to get caught up in it. It’s difficult to bite your tongue when your life for 12 years has been based on trusting the medical profession, understanding epidemiology, following protocols to prevent infectious disease, and reading and interpreting studies. There is really nothing about this pandemic or any of the suggested precautions that is new or surprising to me. This is the same science we’ve known for Patrick’s whole life. Except the human element. I have been surprised by the propaganda, the politics, and the destructive power of the share button. And it sometimes takes conscious effort to keep the real person in mind instead of replying to an online persona. I want to correct misinformation. I want to rage at the lies. But mostly, these are people I love. And only love gets people to listen anyway.

It’s easy to feel unseen, unheard, and unremembered when you are the 1% that’s considered an acceptable loss. Especially when it means you are at home, literally unseen and unheard.

But there have been some miraculous moments of our being seen, too. Like the neighbor who showed up on my doorstep one night with raspberries because I told her I missed them and was having a hard time buying them. Or the amazing group of women who flashmobbed me for my birthday. It’s the texts checking in. The picking up odd items for me while at the store.

(Sidenote: Did you know there are things that stores won’t sell to you online? Toy diecast cars was one. Little Debbie holiday treats, for some reason. And just about every high demand item like hand soap, clorox wipes and toilet paper for a while. I’ve had to learn which stores allow which hard to find items. And we’ve had to give up some other things we used to never live without.)

Being seen is little things. It’s a months long running Marco Polo conversation with one of my best friends (who is also sheltering at home with her 1% son.) And it’s those who still invite and allow me to serve with my talents.

It’s been a privilege to continue to serve as compassionate service leader. Welcoming babies and comforting others through sickness and loss almost entirely through text and phone calls. Helping families who lost someone to this virus has been poignant and sacred. (There’s a red ribbon tied around the trees in my front yard in memory of a neighbor taken by the virus that I don’t know I’ll choose to take down myself.)

I’ve loved continuing to serve as PTO president. I was going to call it off the first year, until I realized that I was the one with the budget for teacher appreciation and the end of year celebrations. I was also the one with experience adapting traditions to crazy health restrictions. So I ended up hosting a week-long game show for our teachers. And I bought gifts and decorations for an end of year reverse parade.

Sometimes I feel like a puppet master running PTO meetings by Google Meet and then giving other commands by text message and sending other parents to do the work I can’t do myself. It’s taken creativity to reinvent school traditions this year. But it’s been a wonderful chance to enjoy and celebrate the now and I hope my efforts have others as we learn a different way to do things.

There have been other hard moments in this year. Not directly from the pandemic, but made harder by it. Rioting and civil unrest. And a windstorm that brought hurricane force winds rarely seen in Utah.

Between the trauma of being woken by an earthquake in March and then a night lying awake listening to that windstorm, Patrick has become pretty skittish about sleep, especially in the morning. He wakes in the morning and lies awake waiting for day to come. I finally taught him how to read a clock, and convinced him he should try to sleep if he wakes before 6.

But most days, since he doesn’t understand time, he lies there and waits for the clock to change. Sometimes for hours. And he’s in my room at 6:04 telling me it’s morning. To survive, we taught him how to serve himself cereal or yogurt or cottage cheese so we could sleep a little longer. Growth comes in unexpected ways.

Finally, an end is in sight for this pandemic. Almost. There are vaccines available. I was nervous at first about their quick development. Until, that is, an infectious disease doctor I trust explained out how the sheer volume of people affected by a pandemic had helped them complete trials faster than usual. No corners were cut, there just were enough people for trials. He also pointed out that the technology had been being developed for years and just needed an application.

Still, we have to wait our turn in line. And unfortunately, there are no pediatric studies complete. So the person in our house who needs the vaccine most, Patrick, may not be able to get it until fall.

There are variants that might be resistant. And no one knows if vaccinated people can spread the virus as can happen with other vaccines.

And with the degree of vaccine hesitancy or outright misinformation, I’m not sure that there will be enough herd immunity available to protect him without being vaccinated himself.

I remember last March reading about the Spanish Flu. I’d downloaded a book thinking “This was a major historical event, and I know nothing about it.” So when I finally was ready to face it, I read that book. And I read historical accounts. That pandemic lasted for 2 years. It looks likely that this one will, too.

So we’ll keep doing what we’re doing. Keeping safe, but not waiting. Being patient, but living the life we have.

There are things we have learned we can do without. I used think that we needed to keep Patrick in therapies as much as possible to help make up for the effects of his brain injury. But when those were cancelled, and I started to put in a full school day with him, it suddenly seemed cruel to make him leave school and still do hours of therapy. After years of attending therapy with him, there is a lot I can do for him naturally in his day anyway.

We learned, however, that we did need other support. The sudden change in activity made the effects of cerebral palsy in his legs so much more severe. Especially in the midst of a growth spurt. Thank goodness for a video consultation with his physical therapist and a dedicated adaptive P.E. teacher, we were able to help me find ways to stretch and strengthen so he could walk more easily again. It helped, but when the weather is warmer, we have a lot of strengthening to do for him and for me. We just don’t get to move enough.

My family is closer than we have ever been. Unlike other trials, we’ve spent this one together, not apart, and it’s brought us close. And despite the outright disasters (multiple) of this past year, we have discovered so many other wonderful things.

I hope we never lose the lessons of family and slowing down.I hope to carry lessons I’ve learned on with me. I hope we don’t resume old habits of ignoring sickness or ignoring those in need around us. That we remember what we’ve learned about staying connected.

One basic principle we computer nerds know.. Sometimes it’s best to just wipe out a computer or a device and rebuild it from scratch. Get rid of the unneeded processes that are bogging the system down. I think that’s kind of what we’re doing now.

If you’ve made it to the end of this long, rambling post.. well, either you’re probably related to me or this pandemic has left you with extra time that you’re trying to fill. Mostly, I’ve written this for myself. To remember what happened this year. And because, as a blogger detailing our transplant journey, it’s worth acknowledging the very unusual experience that it is to be a transplant family during a pandemic.

Whenever I get fatigued by his long, long trial I remind myself that we have been gifted many miracles in Patrick. It is a gift to have him with us at all. He died in my arms and was brought back. He was saved from sepsis more times than I can count. We received another gift in his being made nearly whole by transplant. And I don’t take for granted the gift of his donor who, in a way, lives on in him.

I can be patient and grateful in protecting those gifts. I can be inconvenienced by staying in my comfortable home. We’ve survived things this hard and harder and been sustained.

It is a privilege to be rare, to be the 1%, or even less than 1%. And hopefully what we know from our rare journey can help others. The world has been thrust into our unusual life.

We’ll see if I have more time moving forward to keep up on blogging what it is to be 1% in a pandemic. I have nothing but time, but with distance learning, I also have never had less time. But if you made it to the end here, thanks for listening.

I’d normally pack a post with pictures and maybe someday I’ll go back and do that. But for now, here’s a link to Patrick’s 12th birthday video. That’ll catch you up on pictures till Halloween at least.

Flat Stanley

What do you do when you are a survivor of one of the world’s more rare and complicated transplant procedures and you suddenly find yourself in the middle of a global pandemic? How do you possibly show the proper respect for the gift of life given by the loss of another person’s child?

The answer is simple. You stay home.

Patrick and Friends

On March 11, I got an e-mail from Patrick’s transplant team in Nebraska telling us that they felt the threat had become significant enough that we needed to pull him out of school. On about an hour’s notice, I e-mailed Patrick’s teacher saying he’d need to find a way to attend remotely if possible. Then I drove to the school, packed his locker, collected a week’s worth of assignments, said goodbye to the handful of friends we could catch. And we came home.

Of course, the governor of Utah made the call at the same time to also close schools and so to begin with, we weren’t doing this alone. Most of the world came home with us.

But as the world reopens, we are staying in. And that’s a hard thing for an outgoing 11-year-old only child to do in the summer.

Patrick loves summer adventures. He loves travel. He loves people. And so I wracked my brain trying to think of how I could possibly help him to have a fun and memorable summer from our family room.

And then one day it clicked. Flat Stanley!!

If you’re not familiar with Flat Stanley, here’s the basic idea. Stanley is flat because a bulletin board fell on him. But because he’s flat, he discovers that he can travel by mail. There are 15+ books about Stanley and his adventures around the world and we intend to read them all. But also, there’s something called the Flat Stanley Project where kids mail Flat Stanley around the world and people take pictures with Stanley in interesting places, write letters about his adventures, and mail them back.

Patrick can’t go out because of COVID. But Flat Stanley can travel the country and even the world and not risk getting sick. See, he’s flat, so he can travel by mail… and he’s paper, which means he’s immune to viruses! He can visit our friends. He can see the sights. He can collect pictures and memorabilia and stories for us. He can recommend new and interesting places for us to read about or watch on YouTube. He can help connect us to the world.

We’ve got our Stanley made, laminated, and tucked into an envelope for his very first adventure, which starts tomorrow. But we’re also launching a Virtual Flat Stanley Project. (See the instructions on our page here.)

While our paper Stanley’s off traveling via mail, he might as well also “visit” some other places. So we’re publishing a printable version of our Stanley as well as a link to a template where you could print and create your own Stanley.

We’re also sharing a website where Stanley’s adventures can be logged as entries on a world map.If you’d like virtual Stanley to visit you, just print him off and take him on an adventure. Take pictures, collect memorabilia, write a story.. whatever. Then shoot us a message letting us know that Stanley’s visited and we’ll get you info about how you can share the adventure with Patrick either electronically or by mail.

We really hope that this will be a fun way to help Patrick feel more connected to the world. And we hope you’ll have fun joining in the adventure with us.

Since last I wrote..

This blog has been quiet for a while. It takes time and work to get settled into a new home, school, and life. Honestly, for the first several months I was just unpacking and painting and decorating in every moment I could get. It’s been a year and a half and that job still feels less than half done, though I’m sure it’s not that bad.

That first summer, we unpacked what was necessary and otherwise I tried to focus on having summer. In this neighborhood, there are “summer recreation” classes at the park in the summer. On the days we didn’t have class, we had therapy. We decided to shift some of his goals towards life skills and so our therapy sessions went to the grocery store where Patrick practiced not running into me with the cart and walking as slow as the other shoppers.

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At the end of June, Brian and I had the amazing opportunity to visit Rome, Milan and Paris together. I can’t tell you how amazing it was to get to visit the Vatican Museums, the cathedrals, the Louvre, the Duomo. To just soak up all of that early renaissance art. To see the evidence of the reawakening after the dark ages and apostasy, as people’s hearts began to turn again to their Maker and their Savior. We also learned to make real pizza dough (with a lot of help), spent 3 hours being taught about mosaic and micromosaic art from the family who maintains the amazing mosaics at St. Peter’s Basillica and other masterpieces around Italy.

That was perhaps my favorite experience. Another was visiting the construction site of the Latter-Day Saint Temple in Rome. It was humbling to walk where early apostles had walked, and then to stand on land dedicated by living apostles for the same work. Brian ran into a family that he knew from his mission there and we ended up spending hours learning about the symbolism and architecture in the temple. (Such as marble replicas of the statues of the apostles made from marble from the same quarry that Michelangelo used for his sacred sculpture, Pieta, for example.)

After several days in Rome, we took a train to Milan to catch up with a friend of Brian’s who was living there. And then we flew to Paris where we spent a day before flying home. We were so exhausted that we went to bed while the sun was up that day.

I returned home just on time for July 4th while Brian went on to work in Ukraine. Patrick and I celebrated the 4th by immersing ourselves in parades, fireworks, and all of the other things our new neighborhood had to offer.

The rest of our summer was a little surreal. We had moved from such busy responsibilities and lives. But we weren’t busy yet, except with unpacking. I spent most summer evenings sitting in the window or in the front yard reading the entire Harry Potter series while Patrick rode bikes in the front yard with the neighborhood kids. We were really blessed that first year to have a lot of kids his age available to play with just outside the front yard.

July and August went quickly and soon, Patrick was in school. Moving Patrick to this school and moving to be close to it was worth all of the sacrifice it took to get him here. His teacher this year was amazing! I walked out of our first IEP meeting just stunned. I’d known that Patrick’s IEP was weak and even more weakly honored. Honestly, we all had a good laugh at just how terrible it was. Then, they went through and fixed it. Made goals that really would make a difference for Patrick. Offered enough support to actually make those goals work.

And then, for the reset of the year, they actually worked on those goals. I’ve known for years that Patrick’s strength was reading and spelling and was frustrated to know that he wasn’t being taught even what would have been basically offered in kindergarten and first grade about phonics. I did all I could to make up for it at home, but since his evenings were filled with laborious and frustrating homework that could take 3 hours or more, there just wasn’t opportunity for me to do so.

Well, this year, Patrick actually gained a grade level in reading. For the first time since kindergarten. And his self-esteem just soared. He also came home excitedly talking about things he’d learned in science or social skills.

Math is still his hardest subject and he’s missing some foundations, but although a lot was over his head, he understood place value and basic fractions. And, at the least, he was excited to try instead of frustrated by the same things over and over again.

Also, amazingly, he made friends. In fact, he made a best friend. Who, although he moved from the school mid-year, we have been able to spend a lot of time with this summer. And it’s been thrilling to see him with another child who shares his obsession with cars and just enjoys his company.

While Patrick was at school, I unpacked, painted, went to the temple, went out to breakfasts and lunches with new and old friends, read the Book of Mormon, and then started an intense study of the New Testament. I volunteered in his class teaching music every other week. And I helped his teacher, or at least tried to help his teacher, turn her ideas for fun projects and field trips and class parties into reality. I dressed as a witch and made a witches brew for Halloween, for example. I also got involved with the PTO the school tried to start this year. And by the end of the school year, had somewhat accidentally stepped into a leadership role there. I’ll be co-president this year with another mom who’s become a great friend and hope I’m not in over my head.

Also, I spent a good part of the school year being sick. Or taking care of Patrick while he was sick. The treatment for my Rheumatoid Arthritis is immune suppression. And I had completely underestimated how having both mother and son with weak immune systems could affect the family. Patrick and I took turns catching things and giving them to each other. I have never experienced illness like this before in my life.

I’m happy to report that the RA is not as severe as it was before I started treatment. It’s rare for me to have knees so unsteady I can’t walk or hands so swollen that I can’t straighten my fingers. But it also isn’t entirely gone. And the busy year and change in routine means I am not as strong as I was when I moved here. One of my goals in this coming year is daily exercise and hopefully some strengthening so that I can walk 2 miles without pain again.

This disease has been a different kind of trial for me as I learn to keep going when I hurt or am sick. I am trying to learn not to complain and not to quit. But to rest when needed. And it’s a hard lesson in patience.

At least, I have a great example in my son. And a very supportive husband.

Speaking of Brian, his responsibilities at work have just continued to grow. He heads 5 teams now. He’s been put in charge of fraud prevention, in addition to development and management duties. And that’s pushing him into the field of security more and more. And honestly, I don’t know how he could have kept up with both this intense level of responsibility at work and continued in the bishopric (meaning one of two assistants to the lay bishop in our local congregation).

He’s currently working as both cub scout committee chair and scout committee chair, as well as building scheduler. So he’s busy, but a different kind of busy.

I taught the 4 year old Sunday School class for a year, and have recently changed from that responsibility to being in charge of the Compassionate Service committee at church. Basically, that means that I help coordinate meal trains when someone is sick, has a baby, or is otherwise struggling. I terribly spending Sundays with the sweet little children. However, it is wonderful to be able to turn my years of trials into a chance to serve others. I owe an unpayable debt of gratitude for all of the times we have been ministered to.

In spring we did a consultation with Shriner’s Hospital for a second opinion on his cerebral palsy. Ultimately, we decided that any treatment would be far too traumatic to be beneficial for him. And that we should just find ways to let him play.

So, we signed him up for an adaptive soccer team, which proves to be much more productive than physical therapy for keeping him active. He had a great time! We can’t wait for it to come back in fall.

Shriner’s also helped us to trade his little training wheels for big “fat wheels” adaptive wheels on his bike, which has helped him gain confidence in riding. And we’re working on helping him get brave enough to go around the block.

It’s summer again. We’ve spent the past few months at summer rec in the park. His best friend’s mom and I signed the boys up for summer rec classes together and so we’d see them at class and then get together to play once a week or so.

Patrick also asked for swimming lessons, so we’ve had private lessons once a week at the pool near home. It’s slow progress, but he’s slowly getting over his fear. I’m also hoping this is helping to strengthen him. Though right now, he needs a whole day to recover after a half hour swimming.

Brian’s Ukraine trip was in spring this year. So we’ve had several family vacations this summer. A family reunion in Montana. Patrick’s aunt bought him a fishing pole and sparked a love of fishing in him. (Although he’s currently fishing without a hook and I don’t know how he’ll react when there are actual fish involved.)

Not long after, we decided to take our first family tent camping trip. Patrick did amazingly! Slept happily in the tent both nights. Complained about the idea of roasting hot dogs on the first, and then devoured several.

And just a few weeks ago, we took a spontaneous trip to Disneyland because we’d heard that crowds were smaller than average for summer. They were. It was hot, but a lot of fun!


We don’t have may medical updates. We celebrated the 4th anniversary of Patrick’s transplant and the 10th anniversary of his cardiac arrest this year. Patrick has outgrown his allergy to peanuts entirely. He is still allergic to eggs, but as long as they are cooked, he does ok with them. The worst reaction we have noticed is a fine rash when he eats mayo-based products. We’re hoping that with increased exposure, those reactions will get less and less until they’re not a concern anymore. Tree nuts, however. Patrick’s reaction to tree nuts is still in the scary range. So we carry epi and avoid cashews, pistachios, and all their family.
It’s August again and back to school is just around the corner. I’m nervous as always about him being in a new class. But I’ve heard great things about the new teacher.

We’ve had some great blessings over this past year. I’ll be honest, though. Picking up and moving our family was a little tough. It’s taken time to make friends, find routines, and feel like we were at home. It’s made us grow in good ways.

An example. Or maybe a metaphor. Our new house is in an area with a very high water table and, as a result, basements are not very deep here. And all of the homes have long entry stairways. Add to that high ceilings that are popular in newer homes and there are a LOT more stairs in my house now than before.

A lot of people questioned whether this was a smart choice for someone who was just diagnosed arthritis. But there’s been an unexpected blessing in it. Doing more and longer flights of stairs every day has strengthened my knees.

Moving has made me stronger in other ways, too. It took me out of my comfort zone. It took Patrick out of HIS comfort zone, which was especially hard for him. We have been incredibly blessed by this new home. Sometimes because it made things easier. And sometimes because it made things harder.

It’s been a good year, and really a good summer. And I’m excited for the opportunities that fall brings as we’re starting to find our rhythm in this new place.

Some big changes

It’s the beginning of a new era for the Hoopes Family. Our lives are filled with packing, cleaning and painting right now. Why? Well, because as of Monday, we own a new house. It’s about 20 minutes north of here in a quiet little neighborhood.

I can’t remember if, when I was writing about Patrick’s tonsils, I also wrote about his name having come up in the lottery for a special needs charter school. I was so buried in tonsillectomy recovery with my husband out of town that all I could think to do that week was complete the required paperwork.

Well, things settled down a bit and we decided we’d better figure out what needed to be done to know if we wanted Patrick to attend that school. I’ll be honest, my first impression was that I didn’t want to give up all of the great things I had going on right then and didn’t see any reason at all to move.

BUT I did follow through by setting up some school tours and meetings with the school principal. And, well, given the length of the drive (and the added complication of having to use the freeway for the commute,) I decided to look around the neighborhood in case Patrick did great at the school and we wanted to consider living closer.

Well, from that moment on, we just couldn’t seem to leave the investigation alone. A house caught our eye, we looked it up. Found flaws. Then another appeared. I couldn’t stop thinking about it so I drove out to see it. It wasn’t right. Nor was another. And we didn’t really think we were house shopping. Just getting to know the neighborhood.

Until… Brian spotted one nearby but NOT in the neighborhood we were looking at. We did a walk through and as we talked about it we could see so many great things for Patrick’s future in that house. A quieter neighborhood, proximity to parks, proximity to a great school, space for a bedroom downstairs and away from us when he gets older.. and the list went on and on. As we talked, I was filled with this sense of total peace.

So before we found an answer about the school and just 2 weeks after even discussing the possibility of moving, we put an offer on a house.

IMG_20180428_095501.jpg

The rest has fallen into place very quickly. Through a ton of quick work, we cleaned up our house, did some staging, held and open house. And found a buyer. In fact, not just a buyer but one we’re really excited about selling the house to so we don’t feel quite as guilty for leaving. The financing came through in record time. The sale came through without a hitch.

IMG_20180515_184458.jpg

And so by the end of this week, we’ll be moving. I’m not ready. It’s gone SO fast! And I’ve got just this week (one Brian’s working evenings in, even) to repaint the entire basement, finish packing, be present during Patrick’s last 2 weeks of school, tie up loose ends with PTA and church.. and be ready for the movers to come on Monday.

 

I am exhausted and I hurt everywhere. And there is so much still to do.IMG_20180515_192417.jpg

That brings me to another new thing in our family. Mostly, another new thing for me. Remember that post a few months back where I said that I just kept developing tendonitis everywhere as I tried to get in shape? And did I mention as I wrote about Patrick having EBV that we think I had it too?

I know I didn’t mention that at the end of November one morning I woke up and I just couldn’t walk. My knees were swollen and unsteady and it felt like I was ice skating. It took about 4 weeks to finally get to the point of doing cortisone injections which restored function pretty immediately. Except that things weren’t quite right. Not in my knees. Or my wrists or my elbows.

Well I finally got enough of a moment of quiet to go to the doctor who said, no, none of that is normal results of going from inactive to active. She ordered several blood tests looking for autoimmune diseases and other things.

And, well, one came back positive.

As it turns out, I have rheumatoid arthritis.

Our theory is that it was kind of there latently.. but when I started to exercise it brought it to the surface. And then, when I got sick (possibly with EBV) it triggered the auto-immune response.

RA is a lifelong, chronic illness with some pretty scary possible outcomes if left untreated.

The good news is, it’s one of the ones they are having success in treating. And we caught this quite early, we think.

So with immune suppressants, my new doctor thinks that he’ll be able to put the disease into remission and really minimize it’s effects.

It’s scary. The drug I am on is some very serious stuff. I’m now scheduled to have labs and follow up visits as often as Patrick is. This is a HUGE life change.

On the other hand, I’ve only given myself just one shot of the new medicine and it gave me 3 wonderful days with very little pain. The doctor said that in about 3 weeks it may be built up enough in my system to be considered remission. And it’s great to know that this hasn’t been all in my head, or because I was out of shape, or wimpy, or bad at taking care of myself.

And I’m thankfully so very busy with the move that I can’t really think too much about it right now.

It’s been such a whirlwind that it’s kept me, in part, from thinking too much about all the things that we’re leaving behind. I did lie awake fretting about that a lot at first. We really do have a beautiful home with wonderful neighbors. I’m going to miss my kitchen, my gardens, just being in the neighborhood of my family.. and most of all, I’m going to really miss my friends.

The only thing getting us through is this amazing peace that I feel whenever I drive out to our new home. The Lord is providing that in ample doses. And I know it’s where Patrick and we belong.

Waiting on the Lord

I have never done this and likely won’t do it again anytime soon. But.. this past Sunday Brian and I spoke in church for Mother’s Day. And, as we’re moving soon, was our last opportunity to speak to the congregation we’ve been attending. (I’ll tell you about the move in a post I’m just about to write.)

Back to why I’m sharing a talk in my blog.. Last November or so I found myself wide awake in the middle of the night with this talk in my head.  And I had a very clear new interpretation of the parable of the ten virgins that unfolded itself in my mind. I’ve never experienced that before. I doubt I will again.

So – this being the last opportunity to speak, I took some extra time to sit down and study out the thoughts I had that night. I was kind of blown away by what unfolded. And it happened to be just perfect for Mother’s Day, too. The result is the talk that follows. I’m including lots of reference links because there was so much more I could have shared if time had allowed.


The parable

Many of your will recognize the parable of the ten virgins. (Matthew 25)

1 Then shall the kingdom of heaven be likened unto ten virgins, which took their lamps, and went forth to meet the bridegroom.

2 And five of them were wise, and five were foolish.

3 They that were foolish took their lamps, and took no oil with them:

4 But the wise took oil in their vessels with their lamps.

It is a custom among the Jews for the bridegroom to come at night to the bride’s house, where her bridesmaids attended her. When the bridegroom’s approach was announced, the maidens went out with lamps to light his way to the house. The weddings usually began in the evening, with the lamps lit at dusk.

https://www.lds.org/ensign/2009/03/the-parable-of-the-ten-virgins?lang=eng

Now, it is of note that each of the virgins came to the wedding with a lamp and with oil. These lamps typically were fueled by olive oil which was inexpensive and readily available. Each came thinking she was prepared. But this parable tells us that, on this occasion,  “The bridegroom tarried.”. Contrary to tradition, he came late. At midnight. (Matthew 25:5-6) When the call finally came, some of the bridesmaids found that because of the late hour, their oil was spent (Matthew 25:8) .
(About oil lamps and fuel: https://en.wikipedia.org/wiki/Oil_lamp )

What was the difference between the wise and foolish virgins? The foolish virgins brought only the oil in their lamps. While the wise each brought a vessel with other oil. In other words, they came prepared for a wait.

The words of Isaiah could be applied to the wise virgins. “They shall not be ashamed that wait for me.” (Isaiah 49:23).

I want to talk with you about the principle of “waiting on the Lord”.  I hope to answer a few questions: Why is waiting a part of Heavenly Father’s plan? How is “waiting on the Lord” different from just waiting? How can we prepare ourselves to wait on the Lord? And what promises are given to those who wait on Him?

Robert D. Hales taught:

The purpose of our life on earth is to grow, develop, and be strengthened through our own experiences. How do we do this? The scriptures give us an answer in one simple phrase: we “wait upon the Lord” https://www.lds.org/general-conference/2011/10/waiting-upon-the-lord-thy-will-be-done?lang=eng


When we moved into this ward, we were newlyweds. Brian had just graduated from college and started his career. And we were trying to have a baby.

Now you didn’t know that. We’d been trying for a couple of years, had started to work with doctors. It was just long enough that my feelings about it were pretty raw and I wasn’t ready to tell anyone about the struggle. But I was acutely aware of not yet having any children.

That trial was one of the hardest of my life. I became a bit obsessed with studying the relationship between faith and hope. Convinced that if I had more faith or more hope, that infertility would be easier.  I especially loved Hebrews chapter 11 which cites many examples of miracles wrought by faith. I clung to verse 11 which reads:

Through faith also Sara herself received strength to conceive seed, and was delivered of a child when she was past age, because she judged him faithful who had promised.

(I wondered at verse 39. “And these all, having obtained a good report through faith, received not the promise”)

I think the hardest part of that waiting for me was not understanding. I often wondered if the reason I still wasn’t a mother was that I was somehow lacking, unworthy, forgotten or rejected. I struggled with my first question often.

Why is waiting a part of Heavenly Father’s plan?

Waiting plays an important role in our growth in mortality. Most, if not all of us, will have reason at some time or in some way to wait on the Lord. Lehi’s family waited for the promised land. Noah waited for the rain to stop. The early pioneers waited to find Zion.

You likely find yourselves waiting, too. Maybe you’re waiting for motherhood like I was. Or for marriage. Maybe you’re waiting for a loved one to return to the gospel. Or for conflict in your marriage to resolve. Maybe you are waiting to endure a semester, or a difficult assignment, or potty training. Maybe you are waiting for healing or waiting through grief. Maybe you are waiting for direction on a difficult question. Or maybe you are just waiting, trying the best you can to endure to the end.

It is easy in periods of waiting to question why a loving Heavenly Father would seem to stay his hand, especially for those who righteously follow him.

President Dieter F Uchtdorf gave one answer:

I think God knows something we don’t—things that are beyond our capacity to comprehend! Our Father in Heaven is an eternal being whose experience, wisdom, and intelligence are infinitely greater than ours.Not only that, but He is also eternally loving, compassionate, and focused on one blessed goal: to bring to pass our immortality and eternal life.

https://www.lds.org/general-conference/2014/10/living-the-gospel-joyful?lang=eng

Keeping in mind our Heavenly Father’s great love, consider another answer from Elder Robert D. Hales:

In my life I have learned that sometimes I do not receive an answer to a prayer because the Lord knows I am not ready. When He does answer, it is often “here a little and there a little” because that is all that I can bear or all I am willing to do.

https://www.lds.org/general-conference/2011/10/waiting-upon-the-lord-thy-will-be-done?lang=eng (Please note I hesitate to include this quote as I don’t want to imply that not being ready is equivalent to not being worthy. Those are different things entirely.)

And don’t forget the answer given to Joseph Smith when his suffering and the suffering of the early Saints led him to proclaim “O God, where art thou?” To him, the Lord said:

My son, peace be unto thy soul; thine  adversity and thine afflictions shall be but a small moment; And then, if thou endure it well, God shall exalt thee on high; (D&C 121:7-8)

All these things shall give thee experience, and shall be for thy good (D&C 122:7)

How is waiting on the Lord different from just waiting?

Robert D. Hales:

What does it mean to wait upon the Lord? In the scriptures, the word wait means to hope, to anticipate, and to trust.

https://www.lds.org/general-conference/2011/10/waiting-upon-the-lord-thy-will-be-done?lang=eng

It may sound contradictory to say, but unlike passive waiting, waiting on the Lord is defined by action. While the process is helped by attributes such as faith, patience, humility, meekness, and long-suffering, waiting on the Lord is a form of doing. It is trusting, seeking, obeying, praying, planting, nurturing, submitting, enduring. (see https://speeches.byu.edu/talks/henry-b-eyring_waiting-upon-lord/)

As you can tell, waiting upon the Lord is a skill to be developed. One developed through practice. To that end, the apostle Paul wrote:

But we glory in tribulations also: knowing that tribulation worketh patience;
And patience, experience; and experience, hope (Romans 5:3)

Waiting on the Lord is being ready to act the moment we are called. It is doing as directed  in D&C 33:17:

17 Wherefore, be faithful, praying always, having your lamps trimmed and burning, and oil with you, that you may be ready at the coming of the Bridegroom

How can we prepare ourselves to wait on the Lord?

It is apparent from from the parable of the ten virgins that it is possible to come prepared for waiting. We do this by metaphorically filling and carrying extra vessels of oil.

Consider this counsel given by our prophet, Russell M. Nelson, in our last general conference:

To be sure, there may be times when you feel as though the heavens are closed. But I promise that as you continue to be obedient, expressing gratitude for every blessing the Lord gives you, and as you patiently honor the Lord’s timetable, you will be given the knowledge and understanding you seek. Every blessing the Lord has for you—even miracles—will follow.

https://www.lds.org/general-conference/2018/04/revelation-for-the-church-revelation-for-our-lives?lang=eng

We develop the ability to wait upon the Lord as we practice obedience, gratitude, prayer, and patience.

And then? We will eventually see that the heavens were not closed after all.

Elder Uchtdorf put it this way:

Part of our challenge is, I think, that we imagine that God has all of His blessings locked in a huge cloud up in heaven, refusing to give them to us unless we comply with some strict, paternalistic requirements he has set up. But the commandments aren’t like that at all. In reality, Heavenly Father is constantly raining blessings upon us. It is our fear, doubt, and sin that, like an umbrella, block these blessings from reaching us.

https://www.lds.org/general-conference/2014/10/living-the-gospel-joyful?lang=eng

What blessings come to those who wait on the Lord?

Consider these comforting words from a loving Father recorded in Doctrine and Covenants 98:

1 Verily I say unto you my friends, fear not, let your hearts be comforted; yea, rejoice evermore, and in everything give thanks;

2 Waiting patiently on the Lord, for your prayers have entered into the ears of the Lord of Sabaoth, and are recorded with this seal and testament—the Lord hath sworn and decreed that they shall be granted.

3 Therefore, he giveth this promise unto you, with an immutable covenant that they shall be fulfilled; and all things wherewith you have been afflicted shall work together for your good, and to my name’s glory, saith the Lord.

Blessings are waiting. Answers are waiting. It may be that you will someday understand the purpose of your waiting. And when you do, you will see that the Lord was there showering you with blessings all along.

 

After 5 years of infertility,  Brian and I received on the same day and in the same moment a clear answer that it was time for us to adopt. We immediately started the application and it was only 9 months later that we received a call telling us about Patrick.

All at once, it became clear that our prayers had, in fact, been heard. We hadn’t been forgotten.  In fact, for years we had been very carefully and lovingly prepared for the very challenging task that lay ahead of us. Patrick had been born with a serious birth defect. He was given a 1-2 year chance of survival. He would need constant medical care to survive. And eventually he would need a transplant.

Intestinal transplant was such a new procedure at that time that, had Patrick been born 5 years earlier, his chances of survival would have been very small. Timing was everything for him and for us.

Of course, we traded in one period of waiting on the Lord for another as I became very familiar with the constant waiting that exists in the medical world. From waiting rooms to the transplant waiting list, it seemed my every moment became waiting. We waited 6 years for Patrick’s transplant, struggling with sudden illness, physical limitations, and the knowledge that at any moment he might be called home..

Finally one night at about 10 p.m., as we were turning out the light, the phone rang again. We were told organs were available and we needed to get to Nebraska. Right then. So we grabbed the bags we packed literally years before, called family together for a priesthood blessing, and we went. 24 hours later Patrick was in surgery receiving a new liver, intestine and pancreas.

The few months of recovery that followed were some of the most difficult and sacred of our lives. As we waited for healing, we relied heavily on habits of prayer, fasting, scripture study, and covenant keeping. I came to appreciate the blessings of the sacrament as it was brought to me week after week in his hospital room. Patrick and I held “primary” every Sunday, singing a few songs and telling stories from the lesson manual. We found respite in service to other patients. And we relied heavily on each other and on the Lord.

I have been witness to countless miracles. I have been the recipient of countless acts of service. I have been strengthened when I thought I could not handle another hour.

There is a promise found in the Book of Isaiah:

But they that wait upon the Lord shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint. [Isaiah 40:31]

 

This Mother’s Day, to any of you who find yourselves waiting, hurting, longing, or afraid.. I bear witness from my experience that this is a promise that the Lord will fulfill for you. Now. While you are waiting. Even if other blessings may still require waiting.

(see https://speeches.byu.edu/talks/henry-b-eyring_waiting-upon-lord/)

Let me share with you one more promise given voice by President Nelson:

When you reach up for the Lord’s power in your life with the same intensity that a drowning person has when grasping and gasping for air, power from Jesus Christ will be yours. When the Savior knows you truly want to reach up to Him—when He can feel that the greatest desire of your heart is to draw His power into your life—you will be led by the Holy Ghost to know exactly what you should do.

When you spiritually stretch beyond anything you have ever done before, then His power will flow into you.

https://www.lds.org/general-conference/2017/04/drawing-the-power-of-jesus-christ-into-our-lives?lang=eng

As you wait patiently upon the Lord, may you echo the words of the hymn:

Savior, may I learn to love thee,

Walk the path that thou hast shown,

Pause to help and lift another,

Finding strength beyond my own.

Savior, may I learn to love thee–

Lord, I would follow thee.

(Hymns: Lord I Would Follow Thee)


Through His grace, this is possible, as we come with our lamps trimmed and burning.

 

Additional reading:

https://www.lds.org/general-conference/2011/10/waiting-upon-the-lord-thy-will-be-done?lang=eng

https://speeches.byu.edu/talks/erin-kramer-holmes_waiting-upon-lord-antidote-uncertainty/

https://speeches.byu.edu/talks/lynn-clark-callister_wait-upon-lord-metaphor-

https://speeches.byu.edu/talks/henry-b-eyring_waiting-upon-

https://www.lds.org/ensign/2007/06/oil-in-our-lamps?lang=

https://www.lds.org/ensign/2014/11/general-womens-session/prepared-in-a-manner-that-never-had-been-known?lang=eng

 

Transplant Day 1,214 and Tonsils

This is a bit of a catch up post and it may be long. I write today from Patrick’s bedroom. He is lying in bed watching Cars 3 running a Powerade drip into his g-tube on day 5 post tonsillectomy and adenoidectomy.

Patient Zero

How did we get here? Well let’s rewind to the day before Christmas break when I noticed that I had a fever and a horrible neck ache. It likely started with me, though it was Christmas break and I never did get diagnosed with anything more than a virus causing crazy swollen lymph nodes.

The Onset

Mid-January, Patrick got sick. We thought at first it was a cold. He had an ear ache and I took him in to urgent care to be checked with me for an ear infection where we were told it was just one of many viruses, no ear infection. But he got sicker and sicker and on the 3rd day when he refused to eat and I looked and saw the size of his tonsils all covered with white spots, I took him to the pediatrician. She ran a strep test, which came back negative. And we were told again to just go home and wait out the virus.

Sometimes I’m good with that answer. Especially with a kid who’s immune suppressed. But sometimes the mommy spidey sense goes a little crazy. (Ok, ok. It’s actually the extra guidance mothers sometimes get through the Holy Ghost when their children need help.. but we call it mother’s intuition.) Anyway, this time I didn’t feel settled with that answer. So I texted Patrick’s GI and told him what was going on and asked if he had any concerns from a transplant perspective. He called me back almost immediately and told me that he wanted to know what was making Patrick sick so we could stay ahead if it was one of the big viruses that are dangerous for transplant patients.

Diagnosis

So the next morning at 7 a.m. Patrick and I headed up to the hospital’s outpatient clinics where Patrick’s doctor met us and arranged for labwork, an exam, and a viral panel. It was a long morning with a couple of hours of tests. And then we headed home. By evening, all of the preliminary viral tests had come back negative. Despite the brutal flu season, Patrick didn’t have Influenza, RSV, or any of the other circulating respiratory viruses. The doctor said good news. I felt even more at a loss.

Meanwhile, Patrick just kept getting sicker and sicker. We camped out in the basement and I had to start using his g-tube to keep him fed and hydrated. He was miserable. I was exhausted. And I just kept checking for lab results because as the day went on, I became more and more convinced that with everything else ruled out, that Patrick must have the Epstein Barr Virus (EBV), commonly known as Mono.

Sure enough around 4 p.m. the results for that test came back positive. I texted the doctor and said “what’s next?”

Some history

I’m going to take a break in the story here to make a confession. Part of the transplant workup is a very long afternoon where you sit in the room with a transplant nurse and they explain to you in detail all of the risks associated with transplant. You’re aware of a few of them. Of course the risks of surgery. And rejection. Susceptibility to illness. But there is so, so, so much more that comes with immune suppression and transplant. Activity restrictions. Diet restrictions. And perhaps the worst is something called Post-Transplant Lymphoproliferative Disorder (PTLD).

PTLD is caused when a patient who didn’t have EBV before transplant. When they catch this virus the first time while immune suppressed, it can cause the lymphatic system to go a bit crazy. It involves into a form of cancer called lymphoma. So, yeah, transplant can lead to cancer.

And the day that sat us down and talked to us about all of these restrictions and risks, especially this one, we were so overwhelmed by the understanding that the treatment called transplant was much more of a trading in of problems than the cure all the happy ending stories on TV had showed us.. we were so overwhelmed that we couldn’t even stand to talk to anyone that day.

3 years later in another evaluation, we knew this information was coming. But it was still hard to hear and even harder to talk about. So, well, we didn’t. We just warned you that transplant wasn’t a cure.

PTLD workup

Returning to the current story.. I talked to Dr. Jackson in the early evening and he reminded to me that more than my immediate concerns about having a kid with mono, we needed to be thinking about PTLD. I thought we’d set up testing within the next couple of days. But when he called back just after we put an exhausted, sick Patrick to bed to stay he wanted us to come in to be admitted the hospital right away, we were a little caught off guard.

And so we advocated for the value of rest and protection from other illnesses and Dr. Jackson consented to try to set something up outpatient.

But at 5 a.m. he texted and said that admission was the best way to make sure Patrick got in for a CT scan right away. They needed a CT scan of his entire body to check to see if there were signs of PTLD. And he said to prepare to stay for an emergency tonsillectomy.

So that’s what we did. Headed in prepared for the worst and hoping for the best.

Patrick did amazing in CT. We thought he might need to be sedated to hold still. But then decided that he is most cooperative when he’s helped to understand what is going on an given a chance to cooperate. When he feels in control. We got lucky in that we were able to get Patrick’s favorite child life specialist there right on time to go down for the scan with us. And though he was nervous, he was very brave and still.

In the end, the CT scan came back negative for PTLD. (Though it did describe in pretty amazing detail the way that Patrick’s vascular anatomy has changed as a result of his lost central venous access.) So they treated him with an IV antibiotic for a raging ear infection they discovered when he came in. And we got to go home.

Getting better

Patrick actually did get better pretty amazingly from the EBV. His immune suppression is pretty low right now because he’s had no issues with rejection. And so the virus mostly ran its course in a couple of weeks. The blood tests went from virus counts in the tens of thousands to “unquantifable” low levels.  Patrick’s appetite and energy came back. And the doctors agreed that Patrick had had just an acute case of EBV and had fought it off.

However, his tonsils stayed big. Not just a little enlarged. So big that they were touching each other big. So large I couldn’t understand how he could swallow big.

And, well, EBV is a tricky little virus. I’ve learned a lot about it over the past month. And one of the things I’ve learned that there’s a family of viruses that stays forever in our DNA. Chicken Pox, herpes, and EBV. That’s why you only catch them once. That’s why they are sometimes reactivated when we are stressed. (Shingles, cold sores, “mono makes you tired for months!).

And because EBV lives mostly in the tonsils, their not getting smaller was a problem both clinically and because it meant a long-term greater risk of PTLD.

Meeting with ENT

So we scheduled an appointment with an Ear, Nose & Throat doctor who took one look and said there was no doubt. Patrick’s tonsils were huge and even without transplant concerns, they needed to come out.

We didn’t spend the visit discussing the need for tonsillectomy. We spent it talking about the problem of pain control when ibuprofen wasn’t allowed. Because that’s one of those lifetime commitments you make with transplant.

Tonsillectomy and adenoidectomy

So Patrick had his surgery on Thursday. We were told 30-45 minutes for the procedure. That’s what I expected, too. I’ve sat in lots of surgery waiting rooms watching ENT doctors go in and out every 30 minutes as they reported about placing ear tubes and taking out tonsils. I often wished I could be one of those parents whose concerns were as brief and uncomplicated as those parents. I felt a bit arrogant at times that I was the one who knew the waiting room attendant by name. Who came to stay there.

So it was strange to be in that “simple procedure” role. Except that, of course, we weren’t.

The doctor came out after a little more than an hour to finally tell us that the procedure was done. That the tonsils really were huge enough to need to come out and that the adenoids were even bigger. That Patrick was doing well, but there had been some “oozing” that had made the procedure a little more complicated. And that he’d be awake soon.

And then an hour later, when they still didn’t call me back to the PACU, despite our insistence that Patrick needed us there when he woke up of he’d be combative and inconsolable, the phone finally rang for us. It was an OR nurse who explained that Patrick had continued with “oozy” bleeding and they’d spent all that time trying to get it stopped.

So we waited some more and the doctor finally came back out to say that things were finally settled. And he thankfully hadn’t needed a transfusion. In all, the procedure took 2 and a half hours. We were at Patrick’s side to help wake him, and then moved to post-op.

Observation

Patrick was what they call a status A-11. Meaning he wasn’t admitted but he wasn’t discharged. He had 23 hours that he could stay for observation without having to involve the insurance companies for authorization. So we spent the night in Post-Op Recovery.

Patrick was really inconsolable as he first woke up. He just cried and whimpered and wouldn’t talk. Would barely open his eyes. Finally, I left the room to go to the bathroom and as I listened, I realized he wasn’t as much in pain as he was just angry. So I tried a crazy approach where I came in and told him to stop pouting. Then tried to distract him. I made him start taking sips of water despite protest then pointed out that it helped more than it hurt.

It amazingly worked. His anesthesia wore off. His pain meds kicked in. And he woke up sore but pretty happy. We ordered dinner and he wanted some. And soon he’d eaten 3 yogurt cups and drunk some Kids Boost. But the anesthesia made him nauseous and he couldn’t keep much down.

The night was rough. We turned on the movie channel and let it play all night and would doze off and wake again. Eventually as the anesthesia wore off his pain overwhelmed his hunger and he stopped eating. He’d fall asleep but the swelling in his airway made it so his oxygen levels would fall and the monitors would alarm and wake him again. Or he’d start coughing. And his temperature started to creep up very slowly.

But we made it through the night. Post-Op was so very quiet. Our nurse was great. And by morning, I thought we were in pretty good shape. I even though we might beat the odds and go home at 23 hours after all.

And more observation

When ENT came to check in, they decided they’d like to take a little more time to observe. So they moved us to a big comfy room in the surgical unit. And we watched. And what we saw wasn’t exactly comforting.

Not having ibuprofen was proving to be problematic. See, ibuprofen is an anti-inflammatory and inflammation is a big issue with tonsillectomy. It can cause fevers. It can cause airway narrowing. And of course, there’s the problem of finding a balance with pain control when you have to use an opiod.

It took the whole day and night to get a handle on using the g-tube to keep him hydrated and his gut moving, to figure out how to help his cough and keep his saturation up. And to make sure the fever wasn’t getting worse.

They did a chest x-ray to rule out pneumonia. But did advise us that with that long of a procedure, Patrick’s lungs would need help to refill the air sacs.

Home again

But after a second night, we finally reached a stable baseline and headed home. The first day home Patrick was just exhausted. He fell asleep anytime he held still. Wherever he was. They warned us day 3 is the most painful and, well, it was.

Yesterday, he started to perk up a little after a good night sleep. I finally was able to convince him to start sipping some water. And he even ate a little bit of macaroni and cheese. Which wore him out.

But he started to play and tease a little bit. It was good to see his smile back. And our bird, Max, followed him everywhere he went.

He fell asleep by 5 p.m. But that’s good as his cough has gotten worse again overnight. But his pain is a little less, he’s more awake. And before I finished this post, he happily though tentatively ate some KFC mac and cheese for lunch.

This recovery is a slow process. And unfortunately, Patrick’s having to do it the hard way. As caregiver, I am very tired. Sleep, food, and personal care have been hard to come by.

But we’re getting there. And it’s only supposed to last 7-10 days.

And on the other side, my son is acting completely loving and smitten with us, instead of his usual independence seeking self. I’m going to soak up every minute of a cuddly loving boy who just wants to be with me. Because soon he’s going to really be too big to hold on my lap for half an hour.

I hope to post more updates. But remember, as always with this blog. Usually the times I’m quietest are the times that are calm. If I’m not writing, it probably means that we’re busy and happy.

Dear Laura

This morning, I got a concerned Facebook message from a woman I’ve never met, but who knows one of my friends and apparently has been following this blog. I haven’t been writing. She was concerned.

To all of you, friends, acquaintances, and family, especially those who have relied on this blog for updates.. can I say I’m sorry? This has been a growing year for me personally and I haven’t been writing because I’ve been busy with a lot of things.

Proof we are still alive.

The short version is this (and I really need to devote a post to this topic)… I went to a doctor in December and learned that 8 years of full-time caregiving and saying “I can’t take more care of myself. I’m taking care of my family” kind of all came together into one disaster for my health. I discovered I had high blood pressure, overweight, out of shape, one seriously messed up knee, and was borderline prediabetic.

This may sound like bad news, but really, for a long time I put myself last. And this was just the nudge I needed to recognize that if I wanted to continue to be the kind of mom I wanted to be, some things needed to change. So I started working with doctors and a physical therapist. I got a gym membership. I started tracking what I ate. I got started meds for blood pressure. I pushed for asthma testing, got diagnosed, and started taking medications to bring that and allergies in control. I discovered kinesiology tape tape. I kept up with regular counseling because this was a serious blow to my ego and I had a month where I tangoed a bit with anxiety and depression. I gave myself tennis elbow. And tendonitis in several other ways as well. I adopted the motto “Pain is temporary. Quitting is forever.”

And after a fair amount of time and effort, I’m happy to say that I’m making some progress. I’ve lost some weight (more still to go) and kept it off. Most of those health issues are considered well managed. I’ve been hiking and biking and swimming and playing on the trampoline with my family in ways I haven’t been able to in a very long time.

But learning to take better care of myself has been a learning curve and it often didn’t leave me much other time.

Meanwhile, though… life went on. And in the short version, here are a few of the highlights.

In spring:

We went to Disneyland. Because we are seriously addicted. It was spring break and far too busy and I’m not sure I’ll ever choose to go during spring break again. Highlight of the trip for Patrick was meeting Doc McStuffins. Though he pointed out to us that she was too big. And couldn’t talk. Highlights for the grownups: We went on a foodie adventure and tried several secret menu options. Mac and Cheese in a breadbowl proved too big for any of us to eat. But the cinnamon roll at the Starbucks inside of California Adventure was delightful! And the World of Color Dessert Party was more than worth it.

We tagged along with Daddy on a business trip to St. George. We surprised Patrick by taking him to visit Pioneer Park, a state park full of Utah’s trademark red rock formations. He was upset the park didn’t have a playground. Then he surprised us by absolutely loving climbing the rocks.

We discovered and signed Patrick up for an adaptive baseball team. In adaptive baseball everyone fields, hits and runs. You can use a tee or they’ll pitch to you until you hit the ball. There are no strikes. There are no outs. You play at least 2 innings per team. More if you’re having fun. Or you can quit early if everyone is cold or tired. Everyone cheers for everyone. It is, perhaps, my favorite form of baseball ever. Patrick loved his uniform and his coaches and his teammates. He hated fielding, but kind of liked tracing letters in the dirt. He tried to learn to throw the ball in fancy ways and ended up with a crazy windup the always landed the ball behind him. He got a little bit better at hitting off the tee. And then, like nothing.. the season was over. We had a great time. And will certainly be back next year.

Patrick wrapped up 2nd grade with a fair amount of success… stronger in reading and finally making progress in math. He had an amazing 1:1 para for the 2nd half of the year when his previous aide got promoted. She brought out the best in him for sure.

In summer:

The bishop went on vacation for a month, leaving Brian in charge. That was a fun adventure. Patrick helped housesit there and also for another neighbor.. and we learned that he is a REALLY good housesitter. He’s not quite tall enough to get all the mail from the mailbox. And he isn’t strong enough to pull a hose around. But…He NEVER forgets that we need to pick up the mail or water the lawn. And he’s not afraid to ask for help. He earned a little bit of money doing it and used it to buy some toy cars and a fidget spinner.

Our ABA provider completely and totally screwed us up. We’d assumed that Patrick could get into their treatment center for summer services, then were told he couldn’t, then were told he could. And then, after a lot of back and forth and spotty service for the first month of summer, finally provided us with the right medical forms. Only to read them over and decide they didn’t want that liability. So I ended up with a lot of unexpected 1 on 1 time with Patrick. We got a museum pass and did our usual tour of museums and zoos, etc. We played with kiwi crates. We worked in dollar store workbooks. We practiced some educational computer games a lot. We got through, but it was a pretty messy and disorganized start.

I signed Patrick up for adaptive swim lessons. With no central line, this is now a possibility, and Patrick really needed somewhere to go and some help with his fear of water. His mom really needed a way to keep exercising and a minute of respite. Thankfully, he had an amazing teacher who was totally fine with me swimming laps while she taught him. And he got brave enough by the end of the summer to float, dunk his head under the water, blow bubbles.. and he was working on learning how to move his arms to swim.

Also, as a summer highlight… we bought a pass to the local amusement park, Lagoon, and Patrick and I spent several days up there over the summer. They would totally burn him out. We’d leave with him starving. He’d down an entire Arby’s kids meal on the drive home and then fall asleep for hours. He loves the rollercoaster, the small ones. He loved riding kid rides without me. He loves bumper cars. Or any cars really.

Our motto of the summer was “I can do it myself” and Patrick did make some great progress in learning to heat up simple foods in the microwave, get the mail, water the lawn, play in the neighborhood, fold his own laundry, clean up after himself, write more neatly and on and on. He grew a lot!

Oh, and one other summer highlight. Thanks to our awesome respite provider who is a teacher and had extra time because it was summer, Brian and I took a weekend getaway to San Diego. Just because. We slept in every morning. Played tourist and foodies. Even pulled of tickets to a baseball game. 3rd row on the 3rd base line.

And then, in fall:

Patrick survived his first overnight camping trip. There was some ice, but officially we didn’t hit freezing.

Patrick started 3rd grade. He’s now the old kid in his class. I think the 2nd oldest by 3 days, if I remember right. They had a bunch of 1st graders start this year. Half the class is tiny. Half the class is big like Patrick. He’s not used to being the big kid and the first couple of weeks he would just reach a breaking point shortly after school, yell, throw, and then collapse in tears at the frustration of having to hold it together and watch out for the little ones.

First Day of 3rd grade

His amazing aide got a great job offer a week before school started. That didn’t really help things. The first week, I tagged along and helped at lunch at the school. (And especially the first day when they had a class full of brand new kids and an eclipse viewing party to try to pull off safely.) By the 2nd week ,they had hired a new aide. And she’s really been kind of amazing for him. She’s older that his other paras have been. Which is kind of nice in that she’s not as afraid of getting in trouble for advocating for him. She’s really been quite kind and attentive and helpful. And she has really taken to the task of helping his eating. She asked for a menu of what he could purchase at lunch and has him buying and eating boxed ham and turkey sandwiches on wheat bread. He ate a whole banana for him a couple of days ago! This is perfectly timed as a summer of swimming caused some weight loss and the dietitian wasn’t exactly happy with me for it.

Also, I started a new role as PTA treasurer. This has been a much bigger and busier job than I imagined. But it’s also been good for me in a new world of not always putting myself last. I mentioned to Patrick’s teacher that I used to do bookkeeping. She looked at me and and said, “You used to do a lot of things.” And she’s right. I did. I had a lot of years single and then more years married without kids. And I did a lot of things. Now that Patrick’s health is better, it’s fun to be doing some of those things again.

A favorite way to spend an afternoon. Lining up cars & watching TV

I’ve kind of dived in full-time as a volunteer. PTA (which is settling down now that we are past the start of the year a little.) Still volunteering with reading groups. Primary music in the children’s sunday school at church. And in this past month, I’ve been asked to be Patrick’s cub scout leader. That’s another thing that happened this fall. Patrick earned his wolf rank. So he moved into the bear den a month early with me. We’ve done neighborhood cleanup with garden tools, woodworking, and pocket knives so far. Wednesdays are crazy. But I love being a scout.

Patrick’s settling in at school. Reading 100 words a minute. That’s not counting the random words he’s picked up from his scripture study. Like abominations (pronounced “abominable nations” by him.)

I threw a fit and got all new ABA providers and that has helped a great deal. I feel like he’s making progress on most of our goals there.  He wrapped up an OT session and is diving into PT again with focus on learning how to throw, catch, bounce and dribble a ball. So far, his schoolwork is almost all review and far too easy. And he’s really becoming quite grown up and and helpful around home. I love hearing his thoughts.

Anxiety has been bad for him of late. He started stuttering over the summer when he’s nervous about what he’s saying. So far everyone tells me not to worry and he’ll outgrow it. His fear of rims without hubcaps has reached a peak and I sometimes have a hard time helping him be brave enough to walk past school buses at the end of the day.

I’m hoping it’s just the start of school and the difficult memories fall weather can bring.

We’re headed for his 3rd annual post-transplant checkup in a few weeks and I’ll try to update on that soon.

And in the meantime… well of course we had to go back to Disneyland last week. This time’s highlight? Brian went to Disney Institute, a leadership training workshop.. for work. We got to stay in the Grand California hotel. Which mean walking out of our hotel straight into either downtown Disney or California Adventure. It was a treat to just return to the room if we forgot something or were tired. Also, as Patrick just discovered a love for the Toy Story movies, and since Brian was travelling ahead, we sent a Buzz and a Woody doll ahead with daddy that were waiting in the room when we arrived. Patrick had a happy little Toy Story binge in Disneyland.

Patrick has entered a new phase for rides. While he still loves his roller coasters and the Small World.. he also discovered the storybook rides. Peter Pan. Mr Toad’s Wild Ride. Pinocchio. That he couldn’t stand before. We discovered this at the end of our last day, alas. But it means some different experiences next time I’m sure. Also of note, we made him ride Splash Mountain. (He loves the log flume at the park near home.) That was a little scary. But we all survived.

Anyway, dear Laura… and our other family, friends and followers who have wondered where we went this past year and what we were doing.. that is what is happening. I haven’t been this busy since before we adopted Patrick. I’m not used to it. I’m used to surviving and being trapped in a hospital or at home by health issues. I’m not used to meeting deadlines and being places when I promise. I’m used to having to always cancel plans, not making and keeping them.

Hopefully I’ll get better at this with time. But for now, just know that we are ok. And if I’m not finding time to sit down and write, it means that we’re not quarantined, not in a waiting room, not hospitalized. We’re out and living. And we’re not very efficient at it yet.

Transplant Day 804 and Look Ma. No lines!

**Composed yesterday in the surgery waiting room**

This is a good news post. But I’m finding myself so very out of practice at writing updates in the surgery waiting room that I am having a little bit of a hard time getting started.

At 7:30 this morning, we kissed a very drugged and giddy Patrick goodbye at the O.R. doors. He is having his port removed today. We haven’t needed it in a while. We left him with a central line because this his veins are so scarred that putting in a new line will certainly be difficult. This port has been so much healthier than any other central line he’s had before. And it saved him trauma with labwork. We didn’t feel any rush to get rid of a line

But this summer Patrick’s bloodwork started to come back so stable and consistent that his decided to switch labs to every other month, the port became more effort and risk than benefit. (They have to be flushed every 30 days regardless of if they were used.) We knew we’d need to have a talk about removing the line soon.

Last October, we took Patrick for his annual transplant checkup. When we raised asked the doctor if we should be considering taking the port out, he was surprised to find it was even still there. There was no question that it was time. Soon… But of course, we still took our time.

We allowed time for the doctors here to talk to the folks in Nebraska and know what would be involved in removing a direct superior vena cava line. We tried to wait for the end of cold an flu season.

But also at Patrick’s follow-up in October, the doctors decided to stop Patrick’s prednisolone, which was a major part of his immune suppression. Within two weeks, he started to have a severe pain in his side. After about a week, a small bump finally formed. And when we took him on a rollercoaster ride, that bump burst revealing a small abscess.

For some reason, one of the dissolvable stitches in Patrick’s ostomy scar never dissolved. It just stayed there as long as his immune system was heavily suppressed. But as soon as the prednisone was gone, his body started to rebel against a foreign body. He’s had a recurring abcess for several months now. Just a little pimple that would rise and fall. But it hurt like crazy. And that’s what finally got us here.

So here we are. An hour after Patrick went back, the surgeon was back out to report that all had gone well. He’ll have a little bit of an open wound where the abscess was an a pretty sore area on his chest until the space where the port was heals.  But overall, this should be pretty easy.

We’ve taken the port for granted for the past year or so. That makes this transition a little bit simpler. But the simple realization that Patrick has IV line for the first time in his life is a little bit disorienting.. miraculous.. scary.. comforting.. umfamiliar.. splendiferous!

Now not every fever could mean sepsis. Now he’ll have to have labs drawn from the shoddy veins in his arms. Now we won’t have to wake up early once a month to apply numbing cream before the port is accessed. Now we may not have numbing cream at all. Now he won’t have to protect his chest to play. Now it matters more if he eats and drinks. Now we won’t have to worry if a clot is forming. Now he may not automatically qualify for nursing. Now there’s one less thing that makes him different from other kids.

But really, it’s about time. Because I keep forgetting that it’s time to access his port. And I keep forgetting to tell doctors he even has one. He really didn’t need it anymore.

I’ll leave you with the words of a song that Patrick is singing or making me sing at least once an hour right now.


“I feel better, so much better
Thank you doc for taking all the ouchies away.
I didn’t feel so good till you fixed me like I knew you would
And I feel better. So much better now.”

It’s great to be 8!

On Monday, Patrick will be celebrating his 8th birthday. 8! 8 whole years! And 2 whole years since his transplant!

I’m working hard to pulling together his birthday video. We’ve had a big and busy fall so it’s going to be a little late this year. But it’s just astounding to see how he has grown in the past year. In every way.

The year after transplant, Patrick’s body was shocked and he didn’t grow. But this year we can barely keep up with his clothes. We upgraded him from the only bed he’s ever known, one of those crib-bed combos, because he had gotten too tall for it. His clothes are a medium now and he’s in that awkward size 13 shoe that’s right between little and big kid styles. He is just inches below my shoulder now. And honestly, sometimes I turn around and am surprised to see that he is still small because he feels so big.

He’s grown a lot in spirit, too. For the time being, we have hit upon the perfect mix of medications for his ADHD that keeps him calm and focused while still letting him be his boisterous self. (His psychiatrist warns me he will outgrow these doses soon, but for now they are working.) That has given him the opportunity to grow in a lot of other ways. To sit still and listen and understand. To have his own ideas of how to do things and then to stand up for them. He is becoming more helpful, more responsible, more patient.

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He is still the amazingly compassionate child we have always known who is endlessly concerned for the happiness of others. He is the first to give a hug when someone cries. He remembers others’ needs he heard of throughout the day in his prayers. He can tell you all about each of his classmates favorites. And he sees the best in even those who sometimes seem the most different.

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With glasses helping his vision, Patrick has grown into a voracious bookworm. He reads all the time. Bedtime reading time is non-negotiable and he’s often found on his bed looking at books. His reading fluency is growing by leaps and bounds. He reads everything to me. And is pretty darn good at spelling. His handwriting is really getting better which is very impressive in light of the fact that he is right-handed and his brain injury has left his right side fairly weak and uncoordinated. He doesn’t like math. But if he forgets to protest because he doesn’t like it, he’s even getting the hang of addition.

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We bought a trampoline last spring and Patrick can often be found in the backyard jumping. He went from not jumping evenly with both feet to starting to do jumping tricks. One of our favorite summer passtimes was to go into the backyard and alternate between jumping until he was too tired and reading Dick and Jane. He’s discovering joys we didn’t think possible like bike-riding and swimming.

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He earned his Tiger Cub Rank last month and most of the available beltloops. He’s excited to move on to Wolves and we hope he’ll be as happy and welcome in his new den as he was in the one we left. He had a wonderful experience at scout camp this summer. Patrick loves scouting and I love what it teaches about being a good boy and growing into a good man.  He is really trying to be trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent… and HUNGRY.

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We went to a Patrick’s annual follow-up appointment with his transplant team last week. They were so happy with what they saw in him. The first thing the surgeon said was “well he has changed since we last sawl him,” commenting on how tall and grown-up Patrick seems now. While Patrick sat on Dr. Mercer’s lap and took pictures on his cell phone, we reviewed his diet, growth and medications. With everything going so well, Dr. Mercer decided that Patrick may not still need steroids to prevent rejection. They gave us instructions on how to gradually wean him off of them and the acid controller that they have made necessary for him, too.

He gave him the all-clear for sports. (Adaptive baseball here we come, we hope?) And we decided it’s time to start planning to remove Patrick’s port. With things so stable, they think that he can soon only need labs 4 times a year. That makes the port not worth the risks. Still need to talk to the doctors here about how to go about that.

 

With so much growth, we faced a big choice for Patrick this year. In the Church of Jesus Christ of Latter-Day Saints, 8 is the age at which children are generally considered old enough (accountable) to be baptized. We believe that younger children are innocent and unable to sin and repent, therefore baptism is not required for them. Most 8 year olds are able to understand enough about the gospel, baptism, promises, and repentance (if not more) to be able to decide if they want to be baptized. Living in Utah, where the church is so prevalent, 8th birthdays are a really big rite of passage.

So we have been watching. And studying. And praying. And finally a few weeks ago we met with our Bishop to talk about baptism. By that interview, the answer was fairly simple. We decided that Patrick is still not at the same level as most 8-year-olds. Right now, he is still innocent. And so, for the time being, he will not be baptized.

For those of you wondering about the doctrinal implications of this, the Book of Mormon teaches:

Listen to the words of Christ, your Redeemer, your Lord and your God. Behold, I came into the world not to call the righteous but sinners to repentance; the whole need no physician, but they that are sick; wherefore, little children are whole, for they are not capable of committing sin; wherefore the curse of Adam is taken from them in me, that it hath no power over them;

To be clear, Patrick has a very strong love for Heavenly Father and Jesus. Just this morning he refused to get out of the car because I’d forgotten to say a morning prayer and he wanted one. He wants to be baptized. And we believe that in a few years, he’ll be ready to understand and make that choice.

For those with logistical questions: Because we believe Patrick will someday be able to be baptized, we are not doing any replacement baptism celebrations. Those things can wait a couple of years so he can appreciate them. For the first time in his life, something can wait. He has years ahead of him so this is ok.

I’m going to throw in a separate bonus post about this decision, but in light of an 8th birthday, I thought at least this much should be answered for now.

Instead of 8th birthday traditions, we are going to do something that Patrick has rarely experienced in his life. We are going to have a plain old ordinary birthday. With terminal illness, then transplant, birthdays have always been a bit unusual. This year, Patrick’s school is celebrating Halloween today and not next week so he won’t have to share except for trick-or-treating. It’s a long weekend. We’ll have cake and present with family at Sunday dinners. We’ll go to an amusement park on Saturday so he can ride rollercoasters and drive cars. We’ll send treats to school We’ll decorate with a banner and balloons. I’ll make him his choice of dinners. And we’ll have cupcakes and sing to him and open presents. Just us. Just boring. It will be wonderful.

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Because he is wonderful. And we have been blessed with a little bit of ordinary. And for Patrick, ordinary deserves to be celebrated.

8 years, buddy! I am so proud of the boy you are becoming.