WASHINGTON - heart of Courtney Montgomery was not quickly, but furiously, 16 years old was denied when his doctors and his mother, a transplant.
Previous surgeries had not helped and the daughter of North Carolina did not believe that this scarier operation would be. It should be an another teen is growing with a new heart to change opinion.
"I was like,"no, I do not want this."." If I'm going to die, I die,'"Said Courtney." "Now, I look back, I realize that wasn't think about the way I would have been.
Teens can add a complex psychology in organ transplantation: even if they are minor, they need to be on board with a transplant because it is for them to take care of their new organ. Depression, anger and cramping normal teenagers - tug-of-war with parents, try to adapt - can intervene. It is not just a matter of having the registry, but they are motivated how to stick with treatment anti-rejection for years to come.
"Making go us through, in terms of our ability to weigh the factors of rational way, probably not mature until you're in your late 20s," explains Dr. Robert Jaquiss, Chief of Pediatric Cardiac Surgery at Duke University Medical Centerwhere Courtney finally was transplanted. "It brought a huge level of complexity to care for these children."
Then there is the sense of isolation. Adolescents much less that older adults undergo organ transplants, making it unlikely that a young person has never seen the speed at which their peers can bounce.
Between 700 and 800 adolescents aged 11 to 17 years have some type of organ transplant each year. This almost 40 percent of Pediatric transplantation annual approximately 2 000. Teens are probably better than any other child or adult - age - the first year after surgery. But long-term, adolescents to make a little more evil that younger children, and the reason is biological, said Jaquiss. It is that teenagers and young adults tend to begin to slip on all required follow-up care.
A study found up to 40% of adolescents liver recipients possibly missing doses of drug or health. It can be normal development as teenagers start sleeping late and simply forget the dose of the morning, or sometimes the rebellion. There are side effects of medicines which said Jaquiss can be particularly troubling for this age group concerned of their image: weight gain, acne, and unwanted hair growth.
And research with the beneficiaries of heart was found at children's Hospital of Pittsburgh, chronological age is not linked to "medical maturity." For example, young patients who had difficulty accepting a transplant as normal and which avoids family discussion of problems, were less likely to consider carefully.
Mother of Courtney, Michelle Mescall, said that, when the Medical Centre has informed that her daughter should accept to go on the transplant waiting list, "I said, ' well it is a minor, what do you mean?" I'll take this decision. "I have just floor was now his decision. ?
Legally, the hospital could proceeded to OK the mother. But clinical social worker Shani Foy-Watson said that if this happened, the resentment of Courtney could torpedoed his healing, setting up these kinds of problems with follow-up care.
Foy-Watson, said it is not unusual for children living with a serious illness for years to have difficult to imagine the normality - at the same age when it is normal to seek more independent of their terrified parents.
Courtney, of Asheville, N.C., has been diagnosed at the age of 8 with hypertrophic cardiomyopathy, a heart thickened and hard at the pump which is the main cause of death in young athletes. His mother tried to avoid warnings from the death of physicians, but says that Courtney became anxious and depressed from the start.
She had an implanted defibrillator and cardiac surgery more later that offered only temporary relief, fueling the resentment of medical choice of his mother. Courtney had finally to give up his beloved flap, and last year needed home-school.
As a few weeks past with Courtney still withstand a transplant, the social worker tried a new tack: a 17-year old football player received a new heart at Duke a few months earlier by the same condition and was already back to school in Raleigh. He would meet with Courtney?
It was a bet. Nobody said Josh Winstead, now 18, the reason for the meeting, and they could not beat it. But they have fact, and Courtney immediately changed his mind.
"I suppose do me what I do, as a child, contributed to most," said Winstead, who took of Courtney to his prom a week before her surgery. "It was more just showing his normal how is my life.".
You will hear all the advice of friends and physicians, Courtney, said, "but he is not hit home as when Josh told me," I have the same scars that you do and is how he felt and how I feel now."" ?
She received her new heart last month. She is recovering well and exercising in the hope of getting back the pom team.
His mother helping Courtney learn to manage a huge 33 pills a day and is proud of the way in which his daughter joined: "I am just deal with how to let go and let him fly, but also be the parent of a child of 16 years".
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