immune suppression – Page 2

Transplant Day 114 and settling in

IMG_20150221_080007 — Patrick and Max rediscovered each other this week. Starting with this moment. Patrick got Max up in the morning and tried whistling for him. Max got it and started singing back.

Whew. It’s been a week that we’ve been home. In some ways, it seems like this week has gone very slowly. In others, it has flown by.

Settling in at home has been a lot of work. For one thing, our vanload of possessions from Nebraska didn’t fit into our new home. I will admit that I had more than one panic attack over the pile of boxes sitting in my living room waiting for me to clean out and make room for their contents. It seemed that no matter how hard I worked, there were always still so many boxes. We finally got the last of them emptied and put away last night. Too bad it took filling another pile of boxes with things to be sorted through and donated or thrown away. At least that pile is in the basement at the moment.

But unpacking, though it took the bulk of my physical effort, was only part of the job this week. I spent a good portion of Tuesday morning sending e-mails and making phone calls. We get some reimbursement for Patrick’s travel home.. just some, but some is better than none and needs to be claimed.

And then there was homecare. It should have been easy to get homecare orders here. But our homecare company wouldn’t accept out of state orders. They had to be rewritten by Patrick’s doctor here. However, those orders got lost somewhere along the way. (And, research turns up, would have been incomplete anyway.) So Thursday morning was devoted to scanning my discharge orders and prescription medication lists, etc. and making phone calls to make sure that medical records actually arrived. Friday, a week after we left Nebraska and our last day of supplies, we finally got a delivery.

Labs with homecare nursing went a bit smoother, but I’m still not convinced that a copy of the results is being routinely faxed to the team in Nebraska.

Other projects included e-mailing Patrick’s school to start working on getting him an education plan, grocery shopping so we weren’t entirely dependent on others to bring us meals, talking to insurance to make sure preauthorizations were all set up, and getting a referral to feeding therapy.

IMG_20150221_080900 — These two are now inseparable. Now that we don’t have to worry about Max biting TPN tubes, and Patrick is learning not to lock Max in random rooms around the house. Max only has to be caged when he gets bitey.

On Thursday afternoon, the weather was beautiful and Patrick was pretty burned out on watching mom unpack boxes and talk on the phone. So after I made it through the morning business, we decided to take a picnic lunch to the park.

Patrick chose some of his foods. Veggie straws and crackers. I picked more nutritious things, too.. Chips and guacamole, chicken nuggets, and an assortment of dipping sauces to experiment with.

Then, I let Patrick pick a park. He asked for the one next door to his school. We didn’t think about that it was by the school until we were there. Then he wanted to go visit his friends at school. School was just letting out and it was kind of hard to have to say no. Thank goodness one little boy came over to play. He wasn’t a best friend, but he was a familiar friend and then helped ease the pain a little.

So did lunch. Patrick ate and ate and ate. He discovered he likes veggie straws in ketchup, but wasn’t a bit fan of the chicken nuggets. That’s ok. As long as he tastes the new foods, I’m happy right now.

Friday we had our first post-transplant appointment with Patrick’s GI, Dr. Jackson. Have I mentioned how much we love that man? He scheduled us in on a day that his clinic was closed. He spent and hour and half making sure that he learned all he needed to from us and that we had time to ask all of our questions. Patrick is in such good hands.

We talked about making a plan for when Patrick gets sick to allow him to bypass the emergency room as long as his ABC’s (airway, breathing, circulation) are intact. We went over Patrick’s medications and new anatomy and diet. We asked about sending him back to school, and found Dr. Jackson to err on the side of caution where our hearts are more than the team in Nebraska does. (We really want to wait out cold and flu season.) He let Patrick be the doctor and check his heartbeat and eyes and ears as well.

The general gist of things is that Patrick is doing well and Dr. Jackson is committed to helping him continue to do so. And it was nice to be back with a doctor who loves teaching. I now understand why and how some lab results are followed.

One of the very rare moments when Brian got to join us for naptime and Patrick let me out of the bed. Usually, I lay with Patrick and read scriptures through his naps.

And so, here we are. Tomorrow’s plan is to get labs, to change a central line dressing, to try to clean up the pile of boxes in the basement, to make a meal plan, to do some mommy school with Patrick, and to cook dinner (still a novelty for me.)

Oh, and to spend a LOT of time barefoot. I’ve had enough of having to wear shoes and socks to last me a good long time. If it weren’t for labs, I’d maybe even try spending the morning in pajamas.

———-

One more thought. A lot of people are asking rules for visiting Patrick. I really appreciate the caution about keeping him healthy. Here is what I’ve posted on the front door.

Our son recently received a transplant. Please help us protect his gift of life by keeping germs away.

Please advise us if you have recently had or been exposed to a contagious illness. This might include:

Fever

Runny Nose

Cough

Sore throat

Vomiting

Diarrhea

Rash

Pink eye

Nausea or dizziness

You may be asked to wash your hands, wear a mask and/or gloves, or reschedule your visit for another day.

Please do not visit if you have an illness or infection treated with antibiotics in the last 48 hours, or if you have been immunized with a live vaccine (Measles a.k.a. MMR, Smallpox, or FluMist) in the past two weeks. Thank you for being immunized.

In other words..if you are actively sick or think your odds of getting sick are getting high, you might postpone your visit. If you’ve been sick and are feeling better, then ask. Good handwashing is probably good protection the majority of the time.

Transplant Day 94 and still here

For all that the doctors and I always try to say that we can’t rush dates because you can’t predict what Patrick’s body will do, I sometimes accidentally get myself set on a goal and then am discouraged when we don’t meet that goal.

When Brian left, Patrick was flying through recovery. We pushed them to go up on feeds quickly because his belly was handling them. He was eating well. And we said, “I know you sat that he might needs weeks to get over this because he doesn’t have an immune system. But he feels great. And he’s a miracle. And he’ll shake this quick.”

He did not shake this quick. On Friday night, Patrick’s feeds had reached 70 and he was doing great. Two more increases.. one every 8 hours, and then a day of observation and he could be discharged. They turned up the feed rate at midnight, as the clock kicked over to midnight. At 1:30 I woke up to the sound of Patrick’s tummy churning angrily. And then the diarrhea started. And two diapers later, I called the nurse and said we needed to turn the rate back down.

I was already fried on Friday. I’d planned to ask for a volunteer and go back to the house for some laundry. But Patrick fell asleep at 1:00… and he slept till 5. He’d be woken, ask me to come lie down with him again, and then he’d crash again. I’m pretty sure his prograf level had gotten low enough from being sick that the side effect of insomnia had temporarily worn off. And I didn’t have the heart to wake him. But that meant that when he woke, I had missed the chance to get help to go do laundry. Instead, I tried going and getting change and using the one washing machine I know of on hospital property, in the hotel wing called the lied. I finally got someone to break my $5 bill.. but several trips to the washing machine later, I hadn’t been able to start laundry.

That night, I’d begged Patrick’s nurse to sit with him a little extra after giving meds so I could run back to the house and get clothes. I was literally out of clean ones. And that worked…

But then, here we were… awake during the night with a tummy ache and too many diapers and my pajamas got dirty and I had to try to do laundry again.

Patrick’s belly woke him at 6:30 a.m. so I decided to embrace it. I threw on clothes and hauled my laundry back to the other building and started a load of wash. I stopped in the cafeteria because I was still two quarters short of the change I needed to dry my clothes. Then I came back, hopped in the shower. When I got out, Patrick was out of his bed telling me he needed cleaned up. Oh boy did he. So, hair uncombed and socks off, I put together a sponge bath.

When I finally got that done, I was late moving the laundry to the dryer. So I hurried back, moved laundry.. came back and finished cleaning up the room, talked with Patrick’s morning nurse. Then, I went to pick up my laundry and got back to discover that I had missed rounds.

This was kind of the last straw. I knew when I’d asked for feeds to be turned back down that I was choosing at least one more day till discharge.. But to not even discuss the problem and plans with the team because I had been struggling to take care of myself was frustrating.

I broke down in tears. I sometimes really miss the amenities of a children’s hospital designed for parents to sleep over. I also really miss having people around me that I know well enough to say something like “will you do my laundry?”

Anyway – the result was that the nurse decided to give me a break. She said to take 2 hours and do whatever. Knowing we were committed to the weekend in the hospital, I went to the craft store to get more ways for Patrick to pass the time. You know when you’re trying to plan to keep kids entertained for a road trip? Or trying to keep kids entertained when they are home sick from school? Imagine that magnified by a 2 week hospital stay… every other week.. for 3 months. Patrick has toys. But he is so stir crazy that getting him play with them is a struggle. Crafts are a better bet because they are continually new. And so I’ve built in a craft budget.

I felt better after some time to myself. I even picked up french fries and McDonalds and we had a nice lunch. That evening, a friend from church came and sat with him for one more hour, giving me a chance to go back to the house and clean up some of the messes we left behind there.

And then Saturday night, one of the nicer, bigger rooms became available and Patrick’s nurse came and asked if we wanted to move.

This has made such a huge difference! Honestly, I hadn’t realized how cramped we have felt. Not just in the hospital room… I knew we felt crowded there.. But also at the Ronald McDonald House.

I’ve been asked to describe the living accommodations there. Basically, we have a room that’s a lot like a hotel room. We have two twin beds and a double bed, some big dressers, a closet that is stacked floor to ceiling with medical supplies and luggage. We also have 6 totes along one wall filled with toys for Patrick, mommy school supplies, and other odds and ends. It is a nice room, but cramped when 3 people are in it.

The rest of the house is pretty spacious. They have a triple kitchen that we share. (Triple meaning 3 sinks, stoves, and dishwashers.) Everyone is allotted a shelf in a fridge and a small locker style cabinet to store food in. Because of Patrick’s allergies and not being able to eat food brought in by dinner groups, we actually have two. There is also a wall of bar-sized fridges to keep medical supplies in in this pantry area. The kitchen is very nice with just about any kind of appliance you can imagine, though the pans and knives and other basic supplies are pretty well used and worn out. Especially since they all have to go through the dishwasher after very use. Not the best thing for non-stick and knives. The dining room is filled with banquet sized tables. There is a sunroom off of the dining room with a TV and smaller tables. There is a large family room and toy room downstairs, a computer room upstairs, and a smaller sitting room at one end of the hall with a table where we do Patrick’s school and church.

There is also a wing of offices for house staff. Patrick is a people person, so we have to limit time in the common areas of the house because when I turn my back, he sneaks away into the offices to play with his favorite staff members. I don’t mind him visiting, but he would spend all day there if he could. House rules say that children must be supervised by parents. They sometimes bend this rule and let him visit or help them clean while I am cooking or making his formula, but mostly he is supposed to be with me. So I spend a lot of time stopping what I’m doing and going back and finding Patrick and bringing him back.

So, strange as it sounds, this big room with two TV’s and lots of floor space and few places to wander actually feels like a nice break. Especially since the nurses and other staff are taking care of all the responsibilities that usually have to divide my attention. (Formula, cleaning up, making food.) Turning the superbowl on one TV while Curious George played on the other TV and eating snacks and doing crafts yesterday evening was really very nice.

I wish I could say we were making better ground. Saturday morning, they turned up Patrick’s feeds back to the rate that had made him sick during the night. In daytime hours, he did ok with this. He even felt well enough to each a couple of pretty decent sized meals. And his diapers all looked good. But when night came, his belly started to churn again. He laid awake with a belly ache. I got up and changed diaper after diaper. The diarrhea was back pretty full force. And I was worried that something new was brewing or that the virus had done some irreparable harm. (Hence the Facebook post asking for prayers, in case I worried any of you.)

When the doctors came for rounds, they said that they didn’t love seeing him stool so much, but that his labs were stable so we are still getting him enough hydration and nutrition so far. So, they didn’t got up that last 10 cc’s that he needs to not be on IV fluids.. but they didn’t turn things down either.

They said that this is just his weakened immune system still fighting the virus. Pay attention to this: the virus Patrick has is a common stomach flu. It lasts 24-48 hours in most people, but is contagious for up to a week after symptoms. I was sick for 36 hours. It’s been a week and a half and Patrick still has at least 2-3 more days of hospitalization ahead of him.. and that isn’t getting him back to where he was before he got sick. That is just getting him healthy enough to not need to be in the hospital.

We are extremely careful about germs in our family anyway.. but will be even more so when we get home. And yes, we will ask you to stay away if you are or have been sick. And we will ask you to wash your hands over and over again.

Anyway – this post is quite long. Long story short.. Patrick’s belly is still getting sicker at night than in the day, but he did a little better last night. Odds are good they will try to turn up his feeds one more time today. Odds are good this will make his belly sick again for another couple of days. At least. They tell me this can take transplant patients down for weeks or even months.

We are ok. Honestly, I’d prefer to be at the hospital right now instead of the Ronald McDonald House. Yes, it is exhausting to try to keep myself fed and dressed. But, it’s nice to have the help while Patrick’s belly is so unsettled. It’s kind of nice to be a little alone. And it’s Monday. Which means there will be more help here today. The ward brings food on weekends and comes and gives me breaks as they can. Nurses and volunteers and child life do their best to get me breaks, too. (If I just stop being tough and ask.) So I can just take care of Patrick and me.

Oh – one other thing… I got to see a real Nebraska snowstorm. Church was cancelled yesterday. Schools are closed today. I hear the roads are pretty slick. Curious to go compare this to what I’m used to in Utah. I’m learning things are colder and wetter here.. which usually means more ice. And their roads are so much narrower that I kind of get why things shut down for weather here.

So I’ve been pretending that we’re all snuggled into a warm cozy room for a winter day here. Put aside the reason we’re here, and it’s not too bad.

Transplant day 86 and Sick, sick, sick

Well, I think it would be safe to say that the past 48 hours have been among the hardest we have been through. Friday, Patrick seemed to be feeling better. Well, except that he still had very frequent, black diarrhea (sorry, remember, blogging about intestines here, remember.) The team explained that bleeding in the GI tract wasn’t unexpected in an immune suppressed patient wasn’t entirely unexpected for an immune suppressed patient with Norwalk, a.k.a. norovirus.

Otherwise, Patrick was happy and playing all day. However, as the day went on, I started to feel worse and worse. I made a bit mistake by eating a great big, yummy burrito for dinner. About half an hour later my body told me that, yup, that tender tummy feeling meant that I had caught what Patrick has. Not a big surprise, given just how often Patrick had gotten sick while I was holding him the day before.

Well, my sweet husband saw that I was looking worse and worse and, even though he was also starting to realize he was sick, sent me back to the Ronald McDonald house for the night. Good thing, too.. I am sure I wouldn’t have been able to take care of Patrick at all that night. I was SO sick! But, on the way home, I stopped at the store and picked up medicines and gatorade and I spent the night trying to pull myself together enough to be mommy again in the morning.

And, amazingly, by morning even though I felt very weak, I was doing well enough to go back.

It sounds like Brian and Patrick had a pretty rough night.. changing diapers every couple of hours. When I came in, Patrick was laying on the couch and looking quite pale, but happy. I sat down next to him and asked him how he felt. He said he was ok, but I’d check again every few minutes. Then his nurse gave him his morning medications. I asked how he felt, Patrick said, “sick!” and then started throwing up blood.

We put his g-tube to drain so he wouldn’t throw up anymore.. but that kind of seemed to be the kick off for a rough day. Not long afterwards, he started to act as though his belly hurt. That got worse and worse throughout the day. (We think it was stomach cramps and maybe gas.) But at its worst moment, Patrick was screaming in pain, curled up in a ball, and not willing to be touched.

Finally, they got some pain medicine to stay down and he fell asleep, which made a difference.

Because of the bleeding, they decided to give him a transfusion. Those run over several hours and we let him rest while it was running. His color started to come back. For most of the day, Brian and I took turns laying in bed with him holding his hand and helping place stethescopes and thermometers so he trusted they wouldn’t hurt him. (This was a good way for sick mommy and daddy to rest, too.)

Meanwhile, we sipped gatorade and slowly started to eat again.

Then, once the transfusion was done, we made him get out of bed to be weighed. I hate doing this: making him get up and move when he’s in pain. He just clings to my neck and begs me not to hurt him. But moving helped his body reset a bit and over the next couple of hours, his pain started to improve.

By evening, Brian told Patrick we needed him to get up and walk again. We got him out of bed and he sat on the couch playing with toys until almost 10.

And last night, he slept peacefully all night. That was amazing. We ALL needed the rest.

I am feeling 80% better this morning. Patrick’s pain seems to be gone, though he is really guarded.

The plan discussed with the team yesterday was to take him down for an endoscopy today if the bleeding hadn’t stopped. Patrick’s diarrhea has slowed. But his g-tube has been to downdrain and there is still blood there and in his occasional diaper, so I’m assuming that is still going to happen. I know he was put on the schedule yesterday because someone from anesthesiology already came to talk to us.

I am trying to find the right way to break this news to Patrick. I’m sure he’s terrified of anesthesia here because it has always ended in surgery. Not sure I can explain to convince him otherwise.

But I hope we can find some answers that will help him finish getting better. We knew taking down Patrick ostomy meant more endoscopies and so this is going to be a part of his new routine.

I hope that all of us being sick together in the hospital doesn’t become routine. Sure, it’s nice that we can pick up a phone and order food and the nurses really have been kind to all of us. And, since he’s in isolation, we at least aren’t putting anyone else at risk visiting here. (In fact, it’s probably better than hanging out at the Ronald McDonald House). BUT I don’t want this to be the precedent for the new normal in illness after immune suppression.

We know illness is going to hit him hard every time and be hard to shake. But hopefully the next one doesn’t take down the whole family. Right now, we really hate Norwalk.

Transplant Day 38 and Look Mom!

Patrick has been DYING to get his hands on this statue of Robert Frost since he first saw it. We also visited Thomas Jefferson and some other sculptures today.

‘m blogging at 3:30 p.m. because I expect Patrick to sleep all afternoon. He had a pump alarm at 5:30 a.m. and the nursing staff tried to pull a “while you’re awake” rush at vitals and other care. The result was that he was wide awake, and since labs were due half an hour later.. well, he was up. But I wasn’t ready to be up, so I we talked and agreed to turn on Blues Clues so he wouldn’t wake up the neighbors and then I layed down and slept while he watched. I’ve decided that, given that insomnia is a well-known side effect of steroids, I need to just go with the flow when he can’t sleep and this is one solution that has worked.

The problem is that this worked almost too well. Patrick would wake me every 10-15 minutes or so and tell me something about his show. And I’d tell him I’d get up at the end of the episode.. then I’d fall asleep again. It was like I was a teenager with a snooze button again. I slept till 9.

But it worked for us today. When I got up we were productive. Bath. Dressed. Playtime. Meds. Cleaned up the room. Zofran worked so when he got up, he felt fine.

Rounds came early. The doctor heard Patrick’s number and looked at me and said, “Well, do you want to go out?” He was entirely sincere, I think. The resident, however, got this panicked look on his face and said, “The coordinators (transplant coordinators) said not on the weekend!” I knew that really they need tomorrow to pull things together the right way and kind of laughed it off. It’s good to hear that they are earnestly considering discharge, though.

We’ve had a good day so far. The morning kind of dragged. Hospitals are so quiet on Sundays. We did a little bit of primary (Sunday School). It didn’t go over as well today. Patrick’s body was saying “move” and so sitting talking wasn’t going over so well. Singing time was a little better. I bought a little app that plays the church songs with a bouncing ball over the words and I sing along. He mostly just watches me. But I did get him to try and repeat one of the Christmas songs. And we watched a couple of videos. Today we talked about the resurrection and Patrick hands down refuses to believe that Jesus died. He knows “He is just ok, mom!” So I tried to explain that He died and is alive again and we used some exam gloves to demonstrate the spirit in the body and not. But I think this concept is still beyond him, oh well.

Because Patrick was needing to be up and moving, we went to the playroom. I set up bowling. He took one throw, then grabbed a chair and told me bowling was better sitting down. Yeah, his body is saying move, but it’s also saying “Gee, I’m tired.” So we tried bowling from a chair and that didn’t work so well. So we tried just sitting on the floor rolling a ball back and forth which worked better, but wore him out pretty quickly, too. He got up to play with magnets and his feeding pump started to alarm because it had run dry.

He ran away so fast once he had a backpack on that I could barely catch a picture

Today, though, that was good news. I asked his nurse this morning how she’d feel about letting me use Patrick’s home pump for the afternoon. That way, I could practice with it, Patrick could get used to it.. and we could take advantage of how dead the hospital is on a Sunday.

No sooner had I put the pump in the bag than Patrick was asking for it on his back. And with it on, away he went! He just about ran out the door without me.

We went all over the hospital today. We went up to the NICU where the rooftop garden is. The garden doors were locked for the weekend. (BOO!)… But Patrick insisted on playing on the flight of stairs leading up to them. He long flight made him huff and puff, but he found a set of 4 steps that he declared were “easy peasy.” And, easy or not, he tried them a few times.

Then, we decided to walk over to other hospital building called Clarkson tower. Think walking from Primary Children’s to the University of Utah… only with the connecting corridor being about 2-3 times as long. We had to stop to take a few breaks. Thanks goodness for benches and Christmas trees along the way. But he made it… and at one point, he shouted, “Look, Mom! I’m runnin’!” And away he went down the hall until he couldn’t go any more.

We visited the chapel. We played in the guest pavilion. We found every Christmas tree we could muster. We passed the attending surgeon on the way and he gave Patrick a HUGE smile. (Bet that wins some discharge points.)

He claimed to really like this view. I think he really liked the window ledge to rest on.

We washed our hands about a billion times. (Patrick is more than happy to wear a little portable hand sanitizer around his neck and wash his hands as well as the hands of anyone else standing near him.) We practiced pushing elevator buttons with wipes and with our elbows. We talked about what it’s safe to touch and what’s not safe to touch.

Learning to be immune suppressed is going to be a big stretch for Patrick. We’ve always said that Patrick was fragile, but needed an immune system and so we have exposed him to as much as possible before. Now, the opposite is true. Before, a cold would have taken him a while to recover from but he could fight it. Now, he might not be able to fight what for us is just a mild virus.

So hand washing and mask wearing and no touching and germ fearing and crowd dodging are going to be our norm. At least for the immediate future. The transplant team here has told us not to keep him in a bubble. But also to be careful. And right now we may be erring on the side of too careful… But this recovery has also gone too well and we don’t want to risk undoing that if not undoing it is even an option.

We came back to the room to take the sacrament. Patrick has really taken to the young men’s president who brings it. He just squeezed his way right into his arms today. And for the first time in weeks, he swallowed the bread.

Of course, he also has had 1/4 cup of chicken broth and a few bites of pasta today… all his own idea. There may be hope of eating yet. Especially once we get outpatient and the foods are safe and familiar. If I can just figure out how to teach him it’s ok to swallow now.

Anyway – I expect we’ll wrap this day up with a video chat with Daddy and the family at Sunday Dinner back home in Utah. We’ll make our Christmas advent ornament while we watch the annual Christmas Devotional, one of my favorite holiday traditions. And then bedtime might be a bit late because Patrick will have napped late. And if all of that holds true, this post will auto post at 9 p.m. tonight. (If not, you’ll never even know I wrote this last two sentences.)

But for now, with Patrick napping so deeply, I might as well see if I can get a few things done just in case we do make it out of here tomorrow.

Top 10 ways you’ll know that Patrick has had his transplant

It seems that our fundraising efforts have created some confusion about Patrick’s transplant. The fact that the Produce for Patrick stands coincided with Patrick’s intestinal reconnection surgery has led a lot of people to believe that transplant has already happened. As much as we wish that were true, Patrick is still waiting for his transplant.

I’m asked every few days how the transplant went. And when I explain that we’re still waiting, the response I almost always get is “Well, you’ll let us know when it does, right?”

So – for all who are afraid that they’ll miss word of Patrick’s transplant, here is a list of ways you’ll know it’s happened. (It’s also a little intro to what we expect life to be like after transplant.)

1) We’ll be in Washington. Patrick is having his transplant done at Seattle Children’s Hospital.

2) Brian will be alone when he’s at home. Patrick needs to live near Seattle Children’s for at least 6 months. I’ll be there with him.

3) Brian will achieve frequent flier status. The plan is for him to go back and forth between cities until Patrick and I can come home.

4) We’ll be germophobes. To prevent rejection, Patrick’s immune system will be suppressed. We won’t often take him into public places, and when we do, he’ll probably be wearing a mask. If you visit us, we’ll demand that you be healthy, and that you make sure to wash your hands… often.

5) Patrick will be allowed to eat. Not just a teaspoon of formula and one bite of solid food every 3 hours. He will need normal quantities of real food because…

6) Patrick won’t need TPN anymore. At first they’ll slowly decrease the number of hours that he has it. A goal before he comes home will be that he doesn’t need it at all anymore. He won’t have an IV anymore. It’s possible that for a while he’ll be fed through the tube in his stomach.. but eventually, even that will not be needed.

7) Patrick and I rack up a different kind of frequent flier miles. For the first little while after coming home, Patrick will need to go back to Seattle Children’s much more often than he goes now. To make these trips while he’s on immunosuppressants, we will probably stop flying commercially and use smaller planes through a service like Angel Flight. Since small planes fly more slowly, the trip will take a day each way, not counting time in clinic.

8 ) We’ll have to start watching our budget even more closely than we do now. Right now, most of Patrick’s care falls under our insurance company’s catastrophe protection. However, immune suppressants are a pharmacy benefit, to which no out of pocket maximum applies. Co-pays for transplant medications average hundreds of dollars a month.

9) We’ll probably change a lot of what we do. Patrick’s care will require a whole new and different routine. Because his health will be at risk, we’ll have to be careful of where we go with him, as well as what we do around the house. (For example, gardening is a huge health risk for Patrick.)

10) WE’LL TELL YOU! I promise, when it comes time for Patrick’s transplant, we will be overflowing with excitement, fear, and anticipation. An intestinal transplant is MAJOR. You won’t be guessing if it’s happened. It will be all we can think about for a long time.

Now, the next question I’ve been getting is this. “If Patrick hasn’t had his transplant yet, why are you fundraising?” The answer is this… Patrick’s transplant is a VERY expensive one. It’s a newer form of transplant with higher rejection risk, and so follow-up care for this transplant is quite intesive. Furthermore, we have to travel to have the transplant done, which ups our cost exponentially, especially when you add in cost of living and travel on top of out-of-network medical bills and medication co-pays. Raising $70,000 can take some time, and we’re trying to be prepared and to help in the fundraising efforts while we are still in a position to do so.

There is, of course, the possibility that Patrick’s health could fail before he gets to transplant. This is one of the biggest reasons that we decided to work with COTA to do fundraising. Any money raised that Patrick doesn’t need will go to the transplant-related expenses of other children.

So there’s my educational spiel of the morning. Hope it helps to answer some of the questions you may have.