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.
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.
Today was Patrick’s last day of kindergarten. It was over almost as soon as it began. I think it finally sunk into him this morning what I was saying because he was very worried as he got ready. Worried about missing his friends and worried about there not even being familiar teachers in summer school. To help with a little closure, I did a quick google search and found some printable thank you notes he could color for his teacher and aide. And then we were off.
I don’t know much about his day, except that he came out laden with gifts. His special education teacher came out with him at the end, too, which I thought was very thoughtful of her. He was given the “jolly rancher” award for always being so happy. And we had to linger a little bit at the park by the school to let him finish a popsicle he’d been given. Then, we met Brian downtown where we went out to lunch to celebrate the occasion.
It hardly seems real, except that getting Patrick needs several bags of supplies and safe snacks for school and all of that is in my kitchen now.
The last day of kindergarten represents the kickoff of a very big transition week for us. In less than a week, Patrick will have his broviac line removed. I am counting down the end of a week’s worth of those supplies in amazement and a bit of fear.
I’ve had some horrible dreams this week. I dreamed that Brian was on TPN, only it wasn’t available and his blood sugar was crashing. I dreamed I had a line that needed changed to a port and I felt so helpless and out of control trying to convince the nurses in the hospital to follow the pre-op directions I’d been given about my medications. It made me realize just how Patrick must feel, which was kind of crushing. Then I dreamed that Patrick was in surgery for his line but 5 hours had passed. That is really REALLY bad for that kind of procedure and brought back some horrible memories. Have I mentioned that it’s common for patients and caregivers dealing with this chronic illness, especially transplant, to suffer from a form of PTSD?
I’m just trying to push forward and take care of what needs to be done to get ready for what’s coming in the next couple of weeks. It is hard to keep them in the right order when new things keep needing my attention.
For example, yesterday I dropped Patrick off at school and ran to Walmart. The goal was to pick up a fruit for dinner and some entertainment for the plane ride to Nebraska. But as I headed to the checkout, my cell phone rang. It was the district nurse calling to give me a heads up that a group of district nurses had met to review the medical needs of students for the upcoming school year. And they had determined that Patrick no longer requires full-time nursing at school.
This is great news. He’ll still have an aide to help him with his many needs during the day. But it’s kind of bad news, too. It means that he no longer has to attend the medical hub school that he’s attending. And they wanted me to tell them where I want him to attend next year.
That’s not exactly a simple question. The school next to our house is quite small and not really given a lot of resources. Sending Patrick there would be very complicated and require bringing in a small army of people to work with him. I think we’ll be asking for an exception to be granted and for him to be able to continue at Whittier, at least for one more year.
It also means that I need to add making a list of care that an aide needs to be able to provide to Patrick, independent of a nurse. By Wednesday, when we’ll meet to also work on revising his IEP to get him through till the next IEP meeting.
In addition to that, Monday Patrick and I will meet with Patrick’s favorite Child Life specialist to help to teach him about having a port. On Tuesday, he’ll have his end of year kindergarten assessment. I’ve got to get orders for supplies for Patrick’s port ordered and delivered before we leave, and prescription refills ordered before we leave.
And in the midst of all of this, our church responsibilities have us pretty busy this weekend. Especially for Brian.
This is just the beginning for this summer and I’m having a hard time wrapping my mind around all of it.
But at least one thing is under our belt. Patrick’s a kindergarten alum. Now if we can just get him caught up a bit over the summer and make the right school plans for next year.
I’m also coming to the realization that summer is coming and that, in the past, I’ve been an amazing mom in the summer with lots of plans for fun and education. I am nowhere near that prepared this year. I am just trying to get through the next couple of weeks. But my mind is starting to hatch some plans and I hope I can make some of our traditional summer magic.
I’ve been saying for days that I needed to blog. But it’s been a doozy of a start to a week. I’ll take my pictures from last week, which was much funner, and tell those stories in the captions.
A week ago Wednesday, we snuck away to a hockey game. We gave up our usual center ice seats and instead snuck into the upper level where tickets aren’t sold. This means we had the section mostly to ourselves.. much safer.
Sunday, Brian made a comment to me as I got home from church about how many diapers he had changed for Patrick while I was gone. I thought, “Oh, we’ve had a lot of that lately” and didn’t really listen. It was a busy day. I’d been at church for 3 hours and we had decided to stay home that day and invite some friends over for dinner last minute. So while Brian was turning out a roast and roasted potatoes, I was throwing some bread in the breadmaker and trying to get Patrick to nap. And, well, I didn’t think of it again.
Until the next morning when Patrick’s nurse checked his temperature while I ran upstairs to grab some supplies to draw labs. I came downstairs to him telling me, “He doesn’t have a fever, but his temperature is a bit high. You might keep an eye on that.”
But Patrick wasn’t complaining. He just needed a lot of diapers changed. And we’d just changed his formula to be a little more concentrated so it would run over less time and I thought that was all that was up.
When it was naptime, though, I checked Patrick’s temperature. To do this, we always check ours first to be sure the timpanic (ear) thermometer is working. And, well, Patrick’s temperature was still 99.6. But mine was 100.4.
All through naptime, Patrick’s and my bellies gurgled and talked to each other. By evening, I was feeling pretty darn sick. Apparently stomach bugs know how to get past our germophobic defenses.
Knowing Patrick had been feeling a bit stir crazy, and also knowing it wasn’t wise to go out, I’d embraced Dr. Seuss’s birthday wholeheartedly with books and themed activities for mommy school. I’d promised Patrick a dinner of green eggs (jello eggs) and ham. So, sick or not, I threw on a pair of gloves and still got dinner on the table and prayed that was enough to protect anyone who needed it.
The night was rough, but at least I was already up to be able to watch to be sure Patrick was ok. By morning, I was a bit better, though exhausted. Patrick’s temperature was down. His Monday labs had shown elevated liver enzymes.. an early sign of illness.. and there were some small hints of dehydration. I saw this online on Monday, but because Patrick’s prograf levels were late posting, I didn’t get to talk to his doctor until the middle of the day Tuesday. We decided that if he wasn’t seeming sick, that we’d wait and check labs again on Thursday.
At 11:45 a.m. an alarm went off reminding me that Patrick’s new feeding therapist was due to come. Oops. I probably should have cancelled. But knowing that I was taking super precautions to protect Patrick and that stomach bugs aren’t airborne, we opted to go ahead.
Patrick grabbed my camera and took pictures of his room for me during the week. He is in love with his license plate collection. Cars+letters. What’s not to love? Especially since they are sent to us from friends all over. His nurse brought him the logo off of a car, though and now he thinks he should collect those, too.
Amazingly, Patrick was a rockstar for feeding therapy. He ate, including swallowing, a few slices of lunch ham. And half of a soynut butter sandwich. Then he asked for hummus and carrots.. practiced biting and chewing the raw carrots (though still not ready to swallow those.)
Sure, it made his belly pretty unhappy. But Patrick only knows unhappy bellies and so he didn’t mind. And after she left, when I made myself a bowl of Progresso beef stew, he decided he wanted to join me in eating that, too.
Note the pouch in Patrick’s mouth. We went shopping that morning and Patrick spotted these pouch baby foods. We had talked about trying purees with his feeding therapist. Patrick had seen his friends with applesauce and decided he wanted these. He had a “smoothie’ in his hand for 2 days straight. Then I gave him peas. Now he won’t touch them.
Yesterday, I finally was feeling better. Patrick got up in the morning just bouncing off the walls, though. He asked me if we could “do move our bodies,” our Mommy school code for getting gross motor exercise in every day. And then he asked if it was exercise class day at the library.
It was.
And knowing that he really, really needed to get out, we chanced it and went to Mommy and Me exercise time at the library. The teacher there has seen us through 2 summers. I made sure we arrived early so I could explain what he’d been through and she was super careful with him. He did pretty darn well, actually. Better participating than I’ve ever seen from him there. But about 15 minutes in, he was too tired to go on.
That was ok. We went and picked books. I let him get his first library card. And we went home.
It snowed Tuesday. Patrick was so excited to play in it. Only his 2nd chance this winter. So on Tuesday, sick as we were, we went out and shovelled walks. Wednesday, he was thrilled the snow wasn’t gone. He declared we were making a snowman. And a snow elephant. And a snow gorilla. He went to sleep talking about it.
And I woke him while it was still warm. The snow was all crunchy from melting and refreezing and not at all right for snowman making. This got me off the hook for the other creations. But we did manage a little snowman. And because I had carrots to give it a nose, Patrick was more than happy.
Today we both were finally feeling better. Patrick got up a little too early, but it meant we were ready for labs. I was going to blog first thing, but the internet was down. So we dived into mommy school instead. The theme of the week has been fairy tales and today we learned about The Gingerbread Man. Patrick is a little miffed that the main character of the story got eaten. He has a lot to learn about fairy tales. It was a good theme, though. I was able to squeeze a little more math in that usual.
Patrick is really, really mad at the idea of addition. He doesn’t like the extra symbols. He HATES the word “equals” (or as he says it, “eekso”). But today, by using teddy grahams that he was allowed to eat as we did the math, he played along a little bit better. Plus, I said “1 plus 2 makes” instead of “equals” and that helped.
I’m trying to be patient waiting to get Patrick a teacher. Not that I can guarantee that it will even make a difference for him. I just worry that I am not making ground on helping him catch up after all he missed this year. I really wish sometimes I could send him back to class. I admire moms who homeschool and are able to make that work in a consistent routine. Today was a good day. Patrick gave me an hour and a half before he got restless and asked to outside and I declared “recess” and let him go play in the remnants of snow.
I was hoping better looking diapers would have meant also better looking labs. But Patrick’s labwork this afternoon still showed elevated liver enzymes, dehydration creeping upwards, and an elevated white count. I called Patrick’s transplant team and asked if we should change his formula recipe and they opted to add back in some extra fluid for the weekend. I am sad he needs it, but at least I won’t be as worried about dehydration. Patrick’s been doing great drinking water and powerade and eating popsicles, but I was still worried.
Meanwhile, as long as Patrick is still looking and feeling happy, we will just keep an eye out. They might do some blood tests for a few viruses on Monday. But hopefully, things will get back to normal.
Tonight was one of those nights where things just felt comfortable and happy at home. Our bird, Max, was in a really cheerful mood.. simply playing. Patrick snuggled up in my lap to play tonight. Max climbed up, too and let Patrick pet him. (This is a HUGE compliment from Max, who is fairly bitey.) Brian was in his chair playing with a new geek gadget. And everything was right with the world for a little bit.
People have asked if we have a new normal yet. Some days I feel like we have found a rhythm. But so far, nothing sticks for more than a couple of days. We are still figuring it out. And as long as there are looming follow-up appointments and the hope of Patrick starting school just around the corner and little medical enigmas lurking… Well, it’s hard to imagine we’ll be settled for a while yet.
Before this mad, crazy week.. my mom and dad took Patrick for the evening so Brian and I could go on a date. After all we’ve been through, it was nice to just be laid back. We went bowling, had ice cream for dinner, then went to Home Depot and bought a mailbox.
Tomorrow marks 3 weeks since Patrick’s last day of school. For most people, summer vacation is in full swing. For us, we’re finally starting to get our bearings. It’s been an unusual start to summer.
Things seemed smooth enough. I spent that first weekend after school ended gathering myself to start a tradition Patrick and I are calling “Mommy School.” Between therapies, Patrick has a LOT of “homework”. He’s supposed to spend 10 minutes every day doing eye exercises. He’s supposed to be practicing writing and cutting and and gluing and using a keyboard. We’re supposed to be strengthening his core, working on activities that use both sides of his body evenly, and encouraging him to cross midline. He’s supposed to be practicing telling me stories in various verb tenses, using articles, and correcting his use of pronouns. Plus working on vocabulary building, sorting skills, categorization skills, social skills, attention skills and on and on. All of this to help keep him progressing on his current trajectory which, discouraging as I may find it, is approximately two years behind most of his peers.
Except, it seems, when it comes to the alphabet. Patrick has the alphabet down pat and tested in the top 25% of his preschool class.
Our first day of Mommy School. Learning the shapes of letters by building them from playdough.A practical life mommy school lesson on how to sweep.
And so, this summer we introduced “Mommy School.” We’re doing an abbreviated letter of the day curriculum, since letters are what Patrick loves. Every week is assigned two letters and every day a word that starts with that letter. Then I go out and scrounge up books, worksheets, crafts, activities and field trips on that theme.
B is for Bears, and a teddy bear picnic.
The first day of Mommy School went GREAT! Until, that is, Patrick developed a fever. The next day of summer break was spent cuddling a sick, feverish kid in a chair. He had a cold and we were grateful to be able to stay home sick like other children. By Thursday, Patrick had mustered the energy to play on his own again. But, by then, I was sick.
Patrick sees 3 therapists on a regular basis in the summer. It’s hard work, but fun too. Patrick’s reward for a good hour of work in physical therapy is the chance to climb the rock wall.In occupational therapy, Patrick gets to take sensory breaks in the gym. Diving in the ball pool is a favorite exercise.
Our second week of summer break, Patrick and I were finally starting to be healthy again. But Brian wasn’t. And it didn’t matter if we were healthy or not because on Saturday of that week, my little sister was getting married in my backyard. So, I declared “C is for Camping” and we pitched a tent in the living room. Amazingly, this both occupied Patrick and kept the room clean while he binged on movies and we scrambled to finish last minute details on the house and yard.
I meant to pitch a tent outdoors, but it rained all that day, so we brought it inside. It worked so well we kept it a second day, too.
We also sneaked in a couple of outings.. a family night at Red Butte Garden and a field trip with friends to the Natural History Museum. (I picked up a free month-long museum pass at the local library just so we wouldn’t have excuses to just stay home and work.) Besides, in order to get Patrick to let us work, we let him watch his birthday movies on endless loop, which left us all craving some family adventures.
Patrick loved the children’s garden best, especially hopping on stepping stones across the fish pond.The best part of our trip to the Natural History Museum was not the dinosaur bones. It was the chance to be there with other friends who know exactly what living with Short Gut is like.
The wedding went smoother than expected, though playing hostess and trying to keep Patrick from completely melting down about how his house was filled with children who were not sharing his toys with him kept me busy enough that I didn’t manage to take a single picture.
I was too busy to take pictures, but there were lots of cameras there. I snagged this one off my mom’s Facebook page.
My sister was a beautiful bride and the happy couple truly looked happy and in love. Patrick eventually settled down with Grandma who let him fetch endless cups of water from the refreshment table and pour them all over himself and her and all went well enough.
Except that it turns out that maybe the bug that had Brian sick isn’t the one that had Patrick sick as I ran a fever all night.
So, Sunday we took a sick day and we stayed and home and did absolutely nothing except that Brian cooked us a delicious roast. The day was delightful and refreshing. Perfect after two frantic weeks.
Yesterday, I put together a week’s worth of Mommy School worksheets, made a chore chart, got Patrick’s TPN labs drawn and kind of regrouped. Then, in the late afternoon, I changed Patrick’s central line dressing and discovered that, much to my dismay, what had once been a tiny little hole in the clotted side of the line had grown big enough that I was worried it would pull off. But it was after hours and I wanted the head of the IV team to be involved in choices about the repair.
So today, we spent our kind of restart to summer day exactly as summer days seem to go for us.
Over breakfast, I made a bunch of phone calls to people at the hospital trying to find the best way to get the line repaired. Eventually, I sat down and had a little cry because I wasn’t getting in touch with the people I wanted and I knew we’d have to go to the E.R.
Then, Howie gave me a pep talk and a hug and a kiss. Then he talked to Patrick and helped him to gather the courage to get his line repaired. (He was terrified that it was going to hurt when they cut the broken part off of his line.) We headed up to the E.R. where our timing really was perfect. We didn’t wait at all for them to start working. Patrick’s line is a different brand than our hospital stocks because it was placed in Nebraska, so that complicated things and the repair took about an hour and looks a bit sloppy. But it will do for a clotted line.
And then, when all was done, we headed off to the Children’s Museum for a couple of hours. We managed to get there at a nice slow time on a nice slow day. Patrick actually got to enjoy exploring the museum and would have happily stayed there all day. His favorite spots were the Bob the Builder exhibit, the gas station, and the pretend E.R.
I didn’t know they’d built on a pretend E.R. with the life flight display. Patrick found a little girl willing to play the patient and had a great time
Eventually, we had to go because I was parked in a 2 hour parking space and, honestly, we both needed a rest. So we stopped in at daddy’s office to pick up the leftovers from a lunch he’d cooked for them today. And then we came home and convinced Patrick to nap by 4.
Which brings us to right now. Brian just walked in the door to a quiet, clean house and me blogging and said, “Now that’s a sight I don’t see very often.” Here’s to maybe a little bit more of this? Perhaps a few prayers for this line to hold out through the summer and grant us a little bit of peace ..and maybe even health?
Patrick Hoopes 