Going From ‘Crigler Kid’ to Post-Transplant Adult

By 
Thomas Hiscock
May 5, 2022
Blog post originally written by the AllStripes community team. AllStripes was acquired by PicnicHealth in 2023.

Condemned to a life of medical woe before even being born, I emerged as a 1-pound, 13-ounce premature miracle. With skin that was nearly luminescent because of inexplicably severe jaundice, I began to attract immediate attention from concerned professionals. Halfway through a three-month stint in the NICU, I was diagnosed with Crigler-Najjar Syndrome, Type One — a “needle in a haystack” genetic condition that nullified my body’s ability to rid itself of naturally occurring toxic byproducts. 

Unfortunately, my complicated origin story was only the first stepping stone in a long, at-times treacherous path. After undergoing surgery for a pair of hernias and then again for gallbladder removal, my life prior to turning three was riddled with hospital stays and hurdles a plenty. But despite my condition, the ages between five and nine were different: I was graced with a period of “normalcy” that allowed me to experience life just like my peers. Under an onslaught of responsibilities such as school, piano lessons, baseball and friendship, worries about my health (or lack thereof) faded into the distance. In fact, if it hadn’t been for the galactic blue hue spilling from my bedroom each night, betraying the secret of the phototherapy lights within, the world may have never known I harbored a darker truth inside. 

All of this changed in August of 2009 when my family and I made the momentous decision to place me on the transplant-recipient list through Boston Children's Hospital. Blessed with an unusually quick turnaround, only two months passed from the time I was listed until the morning my family received the call informing us that a donor had been found. 

From the moment the phone rang, piercing the morning silence like breaking glass, I could feel the air shift; the atmosphere was charged as if the world knew that life itself was about to change. One simple call turned the next ten hours into a flood of activity, emotion and vast unknowns. After an inordinate amount of confusion and stress devoured the day, it was suddenly 10 p.m. and I found myself lying in a hospital bed with my parents huddled around me. As they said their good-byes, the pre-op nurses prepared the first round of anesthesia. The three of us knowingly made eye contact, aware the river our family was about to cross ran swift and deep.

Unable to find peace, my parents grappled with their worries, standing guard against the crawling night. As a new morning arrived and dawn spilled into the sky, the sun rose on this next chapter of my life. The initial ten days I spent as a patient in Boston Children’s consisted of rehab and recovery, adapting to an unfamiliar list of necessities that this unfamiliar role of transplant “recipient” demanded of me. I was discharged as a tentative outpatient from the Pediatric Transplant Center at Boston Children’s Hospital with high spirits and good health, frames of body and mind I would soon lose to a cascade of internal issues.  

After a turbulent two years replete with countless surgeries, setbacks and near reenlistment on the transplant list, the dust finally settled and I found myself clinging to a fragile sense of stability and health for the first time since receiving my liver. 

It's like when I was young I had an outfit that I loved and wore all the time. These clothes, my identity that included being a child with CN1, represented me — they were comfortable. Then one day, when I was slightly older, something changed and that first outfit was no longer appropriate — I couldn't wear it! The clothes no longer did me justice, represented who I was, made me feel like myself. I donned a new outfit and learned how to adjust, how to settle in, and eventually these threads began to feel like home as well. I could still see my first outfit in the closet — my pre-transplant identity — but I knew I could never wear it again. 

In the future, now even older, the status of my health changed yet again. Once more, I had to abandon my current set of clothes. I still loved this outfit, felt connected to it, but yet again, the style soured and became inappropriate, not quite acceptable for who I am: a creative, free-spirited college student carving a path toward the future through art, music and positive intention, dragged down by the hidden weight of scars past. So now, at the onset of my graduation, I have two outfits in the closet I can look at, remember, think about, touch even — but not wear — and I’ve struggled to find a third, leaving me proverbially exposed in this arid purgatory of self. 

I had spent my entire life growing as a person, defining myself — who I was, in these two outfits. Now, as a young man, I'm left standing completely naked, unable to don the clothes I'd worn my entire youth but unable to conjure a new outfit out of thin air. More than ten years after my transplant and I’m standing here stuck … alone ... my lights have gone out but I’m still just as raw, as exposed as I once was. Each and every day when I wake up, it's left to me, thread by thread, to tailor a new outfit that I can confidently call my own skin, an absolute sense of self. 

About 

Thomas Hiscock

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List the names of all the doctors, hospitals, and other facilities your loved one visits regularly, along with those they have visited in the past. Try to go back as far as you can, striving for at least the last 5-10 years, but do your best. Even if you can’t remember them all, having a strong baseline can help you quickly identify gaps in records.

Ensure You Have the Appropriate Legal Status

It is important to make sure that you are fully empowered to make decisions on behalf of your loved one with Alzheimer’s. Your relationship status with the patient may not be enough to legally give you access to your loved one's medical information. It is a good idea to talk to an expert about securing special legal status, such as Power of Attorney (POA), a legal document that allows an individual to name someone as their decision maker should they no longer be able to make decisions on their own.

Gather and Organize the Medical Records in One Place

It’s important to have all of your loved one’s medical records together in one spot. This makes it much easier for you and your loved one’s physicians to accurately map the patient’s medical journey and more easily share information between doctors. Fortunately, tools exist to make record management and access simple. A free resource like PicnicHealth helps you collect and organize all of this information. PicnicHealth’s intuitive timeline allows you to pinpoint data across the medical history, eliminating your need for keeping heavy binders filled with paper records or keeping track of multiple software portal logins.

Review the Medical Records to be an Informed Advocate

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1

Build a support network.

When you’re juggling appointment times and insurance claims, putting a robust support system together might not strike you as the most urgent task. Investing the time to cultivate relationships with people can turn to in times of need will pay dividends. The next time you need a last-minute ride or just someone to listen, you won’t be on your own.

There are many condition-specific support groups and support groups for caregivers generally in person or online. In addition to the encouragement and empathy they provide, support groups can be a helpful source of tips, resources, and recommendations for navigating caregiving.

2

Stay organized.

The backbone of effective caregiving is organization. Keep medical information, appointment schedules, and medication lists in order. Use a planner or a digital service like PicnicHealth to stay on top of your responsibilities. This attention to detail can prevent future complications and reduce day-to-day stress.

3

Explore treatments and clinical trials.

We’ve seen incredible breakthroughs in treatment over the past couple of years, powered by patients and their caregivers participating in research. Stay in the loop about the latest in medical advancements and available resources that could benefit your loved one. Whether it’s a new therapy option or a community service that aids independence, being informed can make a world of difference in the quality of care you provide.

4

Make time for self-care.

It may seem self-centered to focus on self-care—but when you feel good, you can be a better caregiver. Whether it’s exercise, a mindfulness practice, a soak in the bath, or just time to rest when you need it, carve out those moments in the day when you can unwind, reset, and stay healthy mentally and physically. Think of it as building up your reserves of kindness, patience, and understanding—which can only benefit your loved one. No one can pour from an empty cup.

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LC-FAOD Odyssey: A Preliminary Analysis, presented at INFORM 2021

Data from real-world medical records:

(from 13 patients with LC-FAOD)

16 yrs old

Median age at enrollment

38% Female

15 providers / patient

7.5 years of data / patient

Data from patient-reported outcome (PRO) survey

(from 13 patients with LC-FAOD)

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However, it's important to consult with a healthcare provider or registered dietitian to determine the appropriate amount of protein for your individual needs. In general, a diet with moderate protein intake (about 0.8 grams per kilogram of body weight per day) is recommended for people with kidney diseases.

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