School Reentry

• Explaining a Transplant to a Child’s Classmates
• Explaining Medication Side Effects After Transplant
• Presentations to Classmates
• Educating the School After Transplant
• School and Quality of Life
   

Explaining a Transplant to a Child’s Classmates

Some parents go to the school with their child after transplant to help explain things to the other kids. The kids are usually great; they ask a question and if they get an answer, they’re happy. And they have a lot of questions. The child who had the transplant is different enough from the other kids anyway, because of what they went through, so having someone explain things can be helpful. The kids are pretty concrete in their thinking, so if they are told, they’re happy, and life goes on. I think it would be harder for adolescents to go back to school because of self-consciousness and body image issues.

Maura Harlen, Cardiology Staff Nurse I

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Explaining Medication Side Effects After Transplant

It is very useful to help other kids at school understand how and why the child is different because of the transplant. After a transplant, because of the medications they are on, most children experience weight gain and hair growth, so when a lot of the kids go back to school they have hair on their face, and their hair is darker. Somebody who had very light hair will come back from a transplant with darker hair and bushy, thick, dark eyebrows. If the other children understand they won’t be so apt to pick on the child and make fun of them for the way they look. I think kids also need to know that it’s temporary; some kids look like this for the first year, others for a little bit longer.

Beth Donegan-Driscoll, Child Life Specialist

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Presentations to Classmates

We have a lot of kids’ school age and up who do some great presentations, either for science or just for their class. Parents have always commented that it’s a big process for them to go through because their kids’ peers think that they’re missing school for fun, and have no idea why they were out. I did a presentation with a kid in his homeroom class about the fact that yes, he was missing a lot of school, but he wasn’t missing it for fun. We came up with the idea of showing them how many medicines he has to take every day. We put the amount of M&Ms that he would have to take on a plate, and it filled up almost the entire plate. The kids were shocked. They couldn’t even eat that many M&Ms in one sitting or one day, much less that amount of medicine. It’s good for the other kids to know a little about what their classmate is going through.

Heather Bastardi, RN, PNP, Heart Transplant Coordinator

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Educating the School After Transplant

Sometimes it can be a hard transition back to school. It is often helpful to educate the school nurse on what has happened recently with the child. We give them what we call our Parent Book, which is basically all of the information about a transplant: all the medicines and their side effects, the signs of rejection and infection, and all of our contact numbers. We give them that and some medical background on the patient: what the patient’s current medications are, and what were the recent issues and events. Then, we connect with them via phone to make sure the lines of communication are open. They often have many more questions that come up over the phone.

Schools are very happy to get as much knowledge as they can. We really push that these kids are actually healthier now than they were pre-transplant. Sometimes that takes a bit of conversation to get that across, but we do that, certainly, before the kids start school. A homeroom teacher has often been a home-base person for the kid. Sometimes before the kid comes back to school, the homeroom teacher will do a little presentation on what transplants are all about because the kids can often think very differently about what has gone on with their classmate. We respect that some families don’t want a lot of information given out, but at a minimum the school nurse needs to know what is going on. The rest of the faculty and the other students don’t actually have to know what’s happened. Our biggest worry is infection, so we ask that the school nurse send a note out, anonymously, not identifying which class the patient is in or which kid it is, but saying that if there is chicken pox going around, we need to know about it.

Heather Bastardi, RN, PNP, Heart Transplant Coordinator

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School and Quality of Life

Transplant is not a very common thing, so a lot of people have never truly understood what it means. Sometimes the expectations of what the child is going to look like and feel like are very different from reality. The majority of them want to seclude the patients so that they don’t get infected and not have them take gym because they don’t want them to fall and break anything, but we really push to have these kids get back into a normal lifestyle as soon as possible. Our goal throughout this whole thing is quality life, and quality life for a seven year old is to be at school and to take gym and not to be labeled as different or be singled out. That is probably the biggest piece we have to get across.

Heather Bastardi, RN, PNP, Heart Transplant Coordinator

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