“A Difficult Decision Was Made”

A room full of people, a room full of stories.  That’s what we encountered the other night.  It was the opening ceremony of the Transplant Games in Cleveland, Ohio.  Attended by over 6,000 people from 40 different teams around the country, there were recipients, living donors and donor families, a term given to those who lost loved ones and even in their time of acute grief, decided to donate their loved ones’ organs and tissue.  You can read the open letter I wrote to Wendy’s kidney donor’s mother here.

The emcee for the evening started the event by saying, “We are all here tonight because a difficult decision was made.”  It’s important to get it out there right away, because it was the elephant in the room.  Everyone was there because of a donor.  Now there are living donors, and that is no small feat, someone who willingly gives a piece of themselves, literally, to keep someone else alive.  They are not only honored at the games, but they are invited to compete as well.  More than that, however, are the donor families that need to be honored for their loss.  Lives were cut short, and lives were extended.  Just because it is a celebration of life, hell, the name of the event is the Donate Life American Transplant Games, doesn’t meant that there aren’t hundreds of people hurting because they have lost someone whom they loved. They wore their loved ones on pins, they posted their pictures on placards, they wore necklaces.  I spoke to a woman who told me all about her son who died when he was in his early twenties, and she said to me, “His friends are all getting married and having kids and I miss him every day. Every day it hurts.”  The emotions will always be raw for them, but it helps ( I hope) to have them see that their loved ones helped to extend the lives of so many more.  That’s what the games are all about.

This was the first time we went to the games and I had to really think about what we were going to say about donor families and what “giving life” really means.  Before the opening ceremonies we talked a little with the kids about Wendy’s donor and how he died and how his parents decided to donate his organs, and that it was likely that they were going to hear a lot of those stories tonight.  The stories would be emotional, but they are powerful and important to bear witness to them.  And, of course, we could talk about it after if they had any questions.

But this is hard stuff.  Life is messy.  This topic is something you don’t often talk about, and here we are sitting in a room full of people, an AUDITORIUM of people, talking about it.  When a story came up on the screen about a father who donated his son’s organs after he had an asthma attack, Penny leaned over and said, “This is one of the stories you warned us about, Mom,” as she held my hand.

Here is the thing that goes along with this knowledge, that people died and their organs were donated:  Palpable gratitude.  An auditorium full of grateful people:  recipients and those who love them.  Families and friends.  Whole teams of people who have gotten together to celebrate this extension of life.

And these people are competing and attempting sporting events they might not ever have done before, because they were given a second chance.  I have lots more stories, there will be more blog posts about these games because I’ve learned a lot in the past few days about  community through resilience, about the power of multiple generations coming together, about giving voice to the pain and the grief and the gratitude all at once.  About how your story is just a part of the thousands of other stories, creating a mosaic of meaning.

I’m going to say one more thing before I close.  Register to be an organ donor so that your loved ones don’t have to make the decision.  Over and over again, I heard how much easier it was for them to donate their loved ones’ organs because they knew it was what the person wanted.

Don’t make your loved ones make that decision.  Make it for them, so they can just follow your wishes.

More to follow.

Photo:  The Auditorium at the Donate Life Transplant Games, waiting for everyone to arrive.

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Find Your Tribe

It’s important to find groups and organizations who support you in your journey as a caregiver, both in the short term, and in the long run.
Wendy had a strange illness. It wasn’t a genetic defect, or cancer, or cystic fibrosis. She was born completely healthy. Her illness was a result of a bacterial infection that turned into a syndrome. As a result, there weren’t a lot of support or advocacy groups out there.
Advocacy groups are great. They are a clearing house for information , because usually the thing you worry about for your child is a normal worry associated with that illness. There are so many advocacy groups out there for cystic fibrosis, heart disease, low birth weight, cancer of all kinds, food allergies Crohn’s disease, kidney disease, you name it. Many times you can find a local chapter of your needed advocacy group nearby and it helps to talk to people who are going through exactly what you are going through.
We found that though the syndrome didn’t have an advocacy group, that there were other avenues we could travel down for the same kind of support. One was STOP foodborne illness, which is an advocacy group that supports people who have been struck by illness associated with food, like e-coli or salmonella. They do work in the legal sphere trying to cut down the use of antibiotics in factory farming, but they also support people who have been struck down by the illnesses they are trying to prevent.
We also turned to the diabetes advocacy groups. As a result of her illness, Wendy’s pancreas works at 15%, which means that she needs insulin on a daily basis to digest her carbs and sugars. She’s neither a type 1 or a type 2 diabetic, but she has the same concerns as a diabetic kid. She feels isolated and left out as a result of her illness, because she’s the only one who has to check her sugar, count her carbs and give herself insulin. She LOVES being in a room where everyone else is doing those things too. She loves to go to diabetes camp as a result. She loves to belong to a bigger group.
We also are a part of the transplant community. This one is a little more ambiguous. It’s multi-age, and multi-organ because there aren’t many people in the world who have organ transplants. I like this group because it’s amazing to sit in a room full of people who wouldn’t otherwise be there except for the generosity of a donor or a donor’s family. And as a result, the people who are the recipients just radiate gratitude. They know they’ve been given a second chance in life. They know what’s important.
Part of being in groups like these isn’t just receiving their collected wisdom, it’s also about participating and giving your energy as well. It’s just as important to give back, once you are in a place to do so. Obviously you can’t give back when you are in a time of crisis, nor does anyone expect you to. But once you’ve calmed down, it’s important to give back to an organization that you have used as a support and an anchor. I’m not just talking about money, but manpower as well. Wendy does a run every year to raise money for her diabetes camp, The Barton Center. It’s a summer camp dedicated to diabetic girls, with nurses in every cabin. It emphasizes self reliance and not putting barriers on yourself. It brings in speakers who are both diabetic and amazing, like triathletes or ultra marathoners. It shows the girls that anything is possible, and diabetes is just a part of their identity, not their whole identity.
Wendy also is going to participate in the American Transplant Games this year, in Cleveland Ohio. She is going with Team New England and she is going to participate in both the swimming and the track and field events, and she’s going to kick butt if I do say so myself. But more importantly, Wendy’s participation and the participation of all of the transplant recipients showcases the worth of organ donation. When you see all of the people who have been touched by organ donation, in one convention center, it is a very powerful thing.  I’m sure that I will be blogging from there in June.
It’s not just about joining a group, and I can’t stress this enough. As a parent of a chronically ill kid, your time is stretched too thin already. It’s about finding meaning and purpose in a group, and it might be a group that isn’t centered around your child’s illness, exactly, but will still do a world of good.
The best thing that I do is sit on the Family Advisory Council at Massachusetts General Hospital. It’s a body that is half parent and half provider-staff. We meet once a month and help to make the hospital better for all children. Often we are a resource to proofread new source material for the public, give feedback on architectural designs for new departments, or run workshops on staff helpfulness. We speak to new residents about what it’s like to be the parents of kids who are in the hospital a lot. We sit on hospital wide committees for quality and safety, ethics, or inpatient satisfaction. We even sponsor a Grand Rounds once a year that focuses on family centered care. It not only improves care for every child through fostering communication between provider, parent and patient, but it makes the hospital better for MY daughter, every time. I know more of the doctors, more of the nurses. At the very least the residents and fellows have all seen my face, and I know a lot of the attending physicians by name. It keeps a connection so that the next time we go in to the hospital (because there will always be a next time) that we’re not met with brand new faces in a large city hospital. I honestly think it’s some of the best, most measurable, work I do on a macro scale.
Another benefit of being on the FAC at Mass General is that I also come in contact with parents just like me who are not only concerned, but passionate about making the hospital better, who come to the work not out of anger because of the hand they have been dealt, but constructively taking their experiences and working with doctors, nurses, and staff to collectively make the hospital stay better. Honestly, sometimes I look around that room and marvel, the men and women sitting at the table could be considered “professional hospital parents” because their child (or children) have been inpatients so often, some of whom have passed away as a result of their illnesses, and yet they choose extra time to be there, in the evening, to work out the snags and make the hospital better. I take strength from their strength.
Being the parent of a chronically ill kid is isolating, but there are places of refuge. Advocacy groups, hospital committees, or even online groups. But don’t just be a bystander, don’t just be a taker. Give back. Your contribution not only makes the organization stronger, but makes you stronger as well.

Find your Tribe.

Everyone benefits, and as a result, there are flashes of brightness in the dark. Together you can find a way to make your child’s illness better, and hopefully the experiences of other families better too.

Dear Mom of My Daughter’s Kidney Donor

Dear Mom of My Daughter’s Kidney Donor,

In just a few days we will celebrate the seventh anniversary of my daughter’s life saving operation, the successful graft of your son’s kidney.  Every year I prepare for this day, that is filled with such conflicting emotions.

You see, my daughter was so very sick and had been for almost two years at that point.  She was on five different blood pressure medicines.  Her heart had been weakened.  She was only allowed 750 mililliters of fluid a day, that we handed out to her a tablespoon at a time.  She was on fourteen different medications, that we gave to her every two hours around the clock.  We checked her blood pressure twice a day.  We checked her blood sugar eight times a day.  She was on a low potassium, low sodium, low magnesium diet.  She had two doctors’ appointments per week, one blood draw per week, and we spoke to her doctors twice a day on the phone.

Our lives revolved around keeping her alive.  There was no respite.

It was difficult to acknowledge  that I couldn’t be the donor, nor could my husband, nor could any immediate family members.  We had to jump through the hoops of getting on the list for a deceased organ donor, and we had to fight the insurance company to let us have the operation at the hospital that we considered to be our medical home, rather than the hospital on the other side of the city that the insurance company did the most business with.

Weeks went by and she continued to fail.  The doctors kept saying “Keep her healthy, the kidney is going to be coming soon.”  Her blood pressures were increasingly more difficult  to control.  I remember planning for her fifth birthday on January 9th, a swimming party at our local pool and while getting all of the decorations ready, breaking down and weeping because I wasn’t sure that she was going to have another birthday and then pulling myself together because it was going to be happy, dammit, it was going to be her best birthday.

We had a false alarm.  A kidney was ready.  We raced to the PICU, we brought her to surgery.  We went upstairs and waited.  The surgeon looked at the kidney and turned it down.  We were devastated.  I  can’t tell you how horrible that night was.  Wendy had finally reached the point where she had to go on dialysis, and so a few days later she went back into surgery to have the catheter placed.  I had to go for training to learn how to run the dialysis from home.  Supplies were ordered and sent to our apartment near the hospital.

To add to the worry, I was six months pregnant and wondered how long I was going to be able to keep everything together. These memories always are accompanied by the heaviness of pregnancy.  I wondered when the baby arrived, if I was going to be able to do everything that needed to be done.

On the night of January 31st, Wendy was in the hospital recovering from her catheter placement.  The nurse came in excited.  There was a kidney on its way.  We were to prep for surgery.  Now.  Wendy’s nephrologist came over from her home and brought Wendy a snow globe to keep her busy while we got her ready.  It was a weekend, at night, so the operating floor wasn’t busy.  In fact, it was really, really quiet.  I wasn’t allowed to go into the surgery with Wendy because of my pregnancy, so I waited in the hall, looking in to the surgery theater when the door opened.

I remember when the fellow walked down the hall with the kidney.  In my memory, the hallway feels very long, but I don’t know if it actually is in reality.  The kidney was in a wax covered cardboard box. The fellow carried it carefully, but had to put her mask on before entering the surgery room, and so she held onto the box with one hand and put the mask on with the other, and I worried that she would drop it!  Seriously, don’t they have a cart or something?

Finally, Wendy got settled, they got started, and we had to wait.  Again.  We got the call that everything went well and we were to meet them in the PICU around 2 am, February 1st.  We saw her come up in her bed.  The kidney had already produced urine.  After almost two years, it felt like a miracle.

From that day forward, she has continued to thrive.  Medicines were shaved down and removed altogether.  She progressively got stronger and stronger, exceeding what her doctors even expected.  Today, she runs a mile in under seven minutes, she competes in triathlons and wins them.  She plays soccer, skis, swims competitively.  She is an amazing and compassionate kid, a good big sister, thoughtful beyond understanding.  She is the kid that gets up for the old lady on the train.  She is the kid who gives her balloon up when the toddler loses his to the air above.

She still has hurdles, still has health issues.  She is still a diabetic, she still takes medication daily, worries about infections, has some dietary restrictions.  But in comparison these are manageable things.

We call the anniversary of her transplant her “Kidneyversary” and celebrate it like a birthday, with friends coming over, chili for dinner (kidney beans!) and a cake.

But, Mother of my Daughter’s Kidney Donor, I have felt guilty about celebrating the life of my child when your child has died.  That the best day of my life, the fulcrum of it, the time stamp where everything else is measured against it as “before the transplant” or “after the transplant” seems horribly unfair knowing that it is also the fulcrum for your life as well but for the opposite reason, the nightmare of every parent.

My only solution to this has been to make the official date of the transplant in my mind be February 1st, when the surgery was finished, not when it began the night before.  On the 31st of January, I give you the day to mourn, and I mourn with you, for the life of your child,  your fourteen year old boy, who would have been twenty one this year.  It is the next day that I celebrate in gratitude for your amazing gift to my family.

Wendy knows about your son, that her kidney is  a “boy kidney” as she calls it.  We give thanks to you and your family at our holiday toasts, I give thanks for your every day in my morning meditations.

I guess ultimately, what I want you to know is how often I think of you, and your son, and your sacrifice.  Your gift is truly a gift of grace, one that you gave and expect nothing in return.  In fact, your gift can not be measured, and there is nothing I can do to repay  you.  I can only be grateful.

This letter is written to you to let you know that I truly am.  Thank you, thank you, from the bottom of my heart.

Sincerely,

Darcy Daniels