These are a few things parents should know who have a child who is chronically ill or are living with a transplanted child. y A sick child in the family creates social, financial and
emotional issues for every one. Stress is part of the whole
picture. It is how you live with it that makes the difference.
There is a sixty percent divorce rate for parents who lose a
y Andy and I do not get upset over the little things like
some people. We fight the battles that are important and save
our energy for dealing with Nick. We look for the true gifts in
life. We enjoy time together as a family and are grateful for
the milestones Nick has achieved, like going to school, instead
of being saddened by them. Each milestone represents another
y The bulk of our questions came around two to three days
after the transplant. Parents need to ask all the questions they
can while in the hospital. There is no better time. Around three
to four months out, if the patient is doing well, is the time to
join a support group. Even if the one spouse will not attend,
the other should go for themselves. This is a wonderful place to
get questions answered, but be mindful that not everyone handles
y Find a good pharmacist when your child is listed. The pharmacist needs to be a person who understands what is going on and will listen to you about your child’s medications. We had to change our pharmacy because of insurance coverage at one point. We used a chain pharmacy where the same pharmacist never filled Nick’s meds twice. After a year and a half we got to go back to our original pharmacist. He has caught, on more than one occasion, problems or possible issues with Nick’s meds. Parents need to make sure their home pharmacy has the medications that are needed before leaving the hospital. After the heart transplant surgeon and the cardiologist, your pharmacist is the first line of defense to keeping a transplant patient alive. Have a great pharmacist, I do.
y Cyclosporine is a major problem to get in most
pharmacies. It is not a medicine that is kept on the shelf
because of its cost and there is not a huge demand for it. The
main places that do have it are large teaching hospitals but
they do not want to issue it to an outpatient.
y On one vacation I hunted for Imuran in Key West, Florida
for an entire afternoon and was unable to find it. Imuran is an
older medicine and usually not stocked. I located it on the
y Nick never takes herbal supplements because they can
interact negatively with his regular meds. A transplanted person
should always ask their doctor before taking herbs while on
y I make a point of being aware of the “H” signs when
traveling so that I can take Nick to the hospital anywhere. On
more than one trip out of town I used the signs to direct me to
the nearest hospital. Without the signs I would have wasted
y I carry paper copies of Nick’s prescriptions with me when
we travel. That way I always have a way of getting his
medicines without calling the coordinator.
y Being in the hospital is like being in the Twilight Zone or
the Bermuda Triangle -- I want to know how to get out. It seems
Nick goes in for a simple test and gets stuck for an indefinite
time. I learned to deal with the slow process of healing, and
y I spent a huge amount of time seeing about medical bills. I
knew I had to watch them, making sure we were not over charged
and checking to see that the insurance was paying their share.
y We made an effort to give special attention to Nick’s
brothers and sister when they were younger. Children can
experience many different emotions when they have a sick
sibling. These emotions can be resentment, guilt, and jealousy,
as well as pride and love. A parent must keep these in mind when
dealing with the siblings. We handle these emotions by
supporting them in their activities. If one child is in the
band, then the whole family goes to the band concert, if another
y As parents one of the problems is the inability to offer
attention and support when the other children need it. My mother
helped out in this area. She was a constant by filling in for me
when Nick was at the hospital. We make the effort to tune into
our children in order to know what is going on with them, and
listen to what they have to say. We are not always good at this
y I have tried to include Drew, Mary Beth, and Zach when Nick
got to do something fun at the hospital. They have gone to
parties, parades, and baseball games sponsored by the hospital.
I never wanted everything to be just about Nick. I am not sure
what effect having a brother who is so sick has had on them but
as far as I can tell they are well-adjusted. As they have
matured I know they are more aware of Nick’s illness and
y Sometimes because of financial issues with a sick child
another might not be able to have what they want. An example
could be not having money to be able to go off to college, or to
get the car of their choice. Each problem must be handled case
by case; sometimes there is no way around resentment.
y All our children have chores including Nick. Everyone
makes up our family and should have a part to play even if they
have a medical problem. It is important for all the children to
y We try to be fair disciplinarians. This is hard enough when
there are no sick children involved. We cannot win this battle,
y Children will behave like their parents. Andy and I have
tried to give our children strong coping skills, so they
understand that you can cry and survive. We let ours know when
we are afraid. We talk to them about the situation making an
effort not to scare them, but explaining to them what they can
do to help and give them the facts honestly. I like to be up
front about the problem. Coloring books, literature, and
hospital visits can be helpful in siblings understanding better
what is happening. I have asked Dr. Vincent more than once to
show Nick’s brothers and sister something in the hospital so
y When Nick got older we talked to him about his condition
and Procedures being done to him. He had to learn
to face his medical problems and be proactive in them. I read
Death Be Not Proud which was written by a father about his son
who had cancer. This book was written years before people
survived cancer. My impression was that the parents were to
scared to talk to their child about his illness and death. Up
until just a few days before the youth died he had no idea how
sick he was. I could not believe how unfair they were to him. He
y I realized many years after Nick was transplanted that in
the beginning I told anybody that I even had a passing
conversation with that Nick had had heart surgery and later a
heart transplant. I am not sure why I did this. Maybe for shock
value, or I thought it defined part of who I was. I would
introduce myself by saying, “I’m Susan May and I have four
children and the last one has had a heart transplant.” I guess I
wanted people to ask me about Nick. I was proud of how well he
was doing. It was my opportunity to share that transplants work.
y After years of living with Nick’s condition I still
wake up at night with worries over his health. These thoughts
y One of the ways I cope is by working through organizations
like Lifelink of Georgia and the Georgia Transplant Foundation
telling people about the need for organs. Another is by reading
and listening to what is going on in the field of
transplantation. I watch movies that come out about transplants
so that I can answer questions with confidence. I stay involved
in issues that have to do with donation, and I take advantage of
media opportunities. I write to newspapers, magazines, and TV
stations when they say something positive or negative about
y Andy and I were already organ donors by signing our
driver’s licenses before Nick needed one. We did not have to
adjust to the idea. Many parents have to grasp the larger
concept, before they can consider a transplanted organ for their
y A friend once told me that people tolerate a sick child,
but do not like a spoiled sick one. There is truth to that
statement. I have always encouraged Nick to live as normal of a
life as possible. Part of that is participating in life, by
responsible to himself and others. I believe part of mine and
Andy’s job in raising Nick is to see that he understands his
responsibility to others through sharing his story. He is
learning as he grows to support children who are in the same
y Our goal for Nick is for him to be as happy as possible and
to enjoy each day to its fullest. An organ transplant should not
be used to just keep someone alive. It should be done in order
y I have learned to be realistic about Nick’s abilities. He
did not feel comfortable riding a bike until he was eleven, but
he found he loved it. He did not want to water ski when I
thought he should, but learned when he was ready. Physical
abilities did not come as easily for him as others his age.
y From the practical side Nick needs to know how to listen to
his body. He has to understand the importance of
taking his meds. He needs to learn to speak up and ask questions
in order to find out all he can about his care and his body.
Making the most of every day and staying close to his family and
friends is a major part of living a full life. The most
important of all is having faith in God.
y I keep Nick’s medicines stocked and now he lets me know
when they are running out. I urge him to eat right. The
transplant diet is generally the way we all should eat. I try to
teach that by example. We encourage Nick to be active in some
lifetime sport so he will get exercise as an adult.
y Finding doctors and a hospital we could trust was important. You need to believe in them. We had to make sure we understood what the hospital staff was telling us. I
learned to repeat what the doctors said back to them. I wrote questions down so that time was not wasted trying to remember what I wanted to ask. Ask questions - it is your right to know, plus you are paying the doctor to talk to you. If he does not, find a new one. Ask the questions that will help you get back to life after the transplant. y I know I am biased, but Nick has the finest doctors and nurses in the world. It is their job to know what to do. I appreciate their God - given talents. A second opinion is good, second guessing is harmful to both your state of mind and your child’s care. I believe I would feel the same way if all had not gone well for Nick. This is what Nick should strive for:
“The ultimate way of saying thank you to your donor is to live life to the fullest. Smell the flowers, enjoy your family, give back to others, hug someone, give all you can back. Tell about your transplant. Share your story. The miracle of a transplant may encourage others to donate. You may help save someone else life. Count the single minutes, hours, days, week, months and years. Cherish the holidays, weddings, birthdays, trip graduations, new jobs because the donor offered the gift of life.”
This is the concept I hope Nick grows to comprehend.
It is the attitude he needs to have about life. As he gets older he will better understand, but as his mother I can appreciate these concepts. Nick knows his new heart belongs to him, not borrowed from someone. It is a gift to be cared for and cherished.
Spécialiste qualifié en chirurgie orale Ancien Assistant Hospitalier Universitaire Maîtrise de Sciences Biologiques et Médicales 17 4 01105 6 QUESTIONNAIRE MEDICAL Madame, Mademoiselle, Monsieur, je vous remercie de consacrer quelques minutes à remplir le questionnaire suivant. Celui-ci me renseignera sur votre état de santé général et votre historique de
Pre-Authorisation Evaluation of Medicines for Human Use COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE SUMMARY OF POSITIVE OPINION ∗ ACOMPLIA International Nonproprietary Name (INN): rimonabant On 27 April 2006 the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion,∗∗ recommending to grant a marketing authorisation for the medicinal produ