Photo of a smiling little boy standing in front of greenery holding a handmade “Class of 2032” sign.

I never thought I’d get to write this to you, and so I’m not sure quite what to say. You start kindergarten tomorrow, your first day of school, and in a life filled with so many firsts we never expected, this one looms large. It feels significant, heavier, somehow, than things that should logically carry far more weight. First laugh. First words. First open heart surgery. First time on bypass. First frantic run through hospital hallways to make sure you hadn’t suffered a massive stroke. All of that, and this is the one that’s bringing me to my knees.

First day of kindergarten.

Since the day we found out that your heart had formed so uniquely, that your organs were scattered like leaves in the wind, I steeled myself against the worst. I knew I’d see you covered in bandages, tethered to machines that would keep you alive when your tiny body wasn’t strong enough on its own, and so I rearranged the furniture in my dreams to fit into a much smaller space. Instead of college, I quietly, carefully let myself hope that you’d take a step one day. Instead of a driver’s license, I let myself look ahead as far as your first birthday, maybe. I couldn’t bring myself to take the tags off your pajamas until you’d actually grown into them, so there’s no way I was planning your outfit for the first day of school.

That outfit, the monster shoes and the dinosaur backpack with the extra t-rex patch and the shirt that proudly proclaims that you are writing your own story? It’s laid out carefully, waiting for tomorrow, and I’m sitting here wondering how you’ve come so far, wondering how I can possibly fit everything I want you to know into this black and white when my own heart is bursting with a thousand colors.

You are strong. Your heart has seen the light of day four times now, stopped twice for hours on end and started up again to power you farther and faster than we ever believed possible. Remember after your last surgery, when you realized you could run without getting tired and you took off down the boardwalk, arms outstretched, screaming that you were Superman? That’s the strength I want you to carry with you while you head into that school tomorrow.

You are kind. This, more than anything, is the measure of the man I’m starting to let myself hope you’ll be one day. You know what it means to hurt, so make sure you keep your eyes open for kids around you who might be hurting. You know how it feels to need someone to speak up for you, so now it’s your turn to use your voice to speak up for the vulnerable.

You are brave. I don’t mean you’re never scared; that’s not real brave. You’re the kind of brave that’s faced the darkest fears and held tight to my hand while you stared them down. You’ll have to let go of my hand tomorrow, but just remember that you know how to look fear in the eye and come out the other side. You’ve done it before. You can do it again.

I’ll be waiting for you at the end of the day, at the end of every single day from now until forever.

Happy first day of kindergarten, Ethan. You’re my favorite reason to hope.

Love,
Mama

Reposted with permission of the author, Ali Chandra, from Hope for Ethan

Reports by the New York Times, Huffington Post and Yahoo News, among a myriad of additional media outlets regarding the treatment and conditions in detention centers all over the southern border are chilling and infuriating. We’re learning  that U.S. Border Patrol agents are confiscating children’s medication. They are being kept in unsafe and unsanitary conditions, exposed to temperature extremes, without access to hygiene items we all take for granted and are even being kept from hand washing, despite cold and flu outbreaks. For those of us in the Little Lobbyists community, the reports are terrifying. Our children have complex medical conditions and disabilities, and while the U.S. health care system offers daily threats to our children’s lives, we have the ability to stay home and fight back.

None of us in the U.S. should remain complacent about the privilege citizenship offers us. Like the migrants seeking asylum at our southern border, any of us might have to flee our homes and seek shelter and good will elsewhere. Over the last several years, thousands of U.S. citizens, including the families of children with complex medical needs, have had to flee natural disasters, seeking safe harbor in other states. Little Lobbyists has been one of many organizations sending crucial medical supplies to charities distributing these essential items to U.S. citizens who have had to leave such first world luxuries behind. Children’s lives hung in the balance.

My own son is 22; on 9/11, Robert was only 4 years old, a Buzz Lightyear fan enrolled in preschool. Our family lives in Bethesda, Maryland, and we were face to face with fear that day: Should we stay put and hope for the best, or should we join the gridlock on major highways to flee the area? We chose to stay because packing Robert’s medical equipment (including machines that require electricity), his multiple medications (some of which require refrigeration), and his other personal supplies (most ordered from medical specialty vendors), seemed overwhelming. 

Had Robert needed only one or two prescription drugs, however, I think we would have fled. That’s the reality for current migrant families facing political turmoil and immediate danger. Equally stark were decisions made by U.S. citizens fleeing recent hurricanes Harvey, Katrina, and Maria; many remain displaced to the current day.

On 9/11, my family put our faith in a belief the world would return to normal. But no one in the DC metro area really knew what might happen next. Were we lucky? Or were we trapped within a first-world fantasy of citizenship? Given current U.S. policy, if my family had to flee a disaster today, could we expect any better than to have Robert separated from us, stripped of his medications and medical devices? Would other nations treat us any better than we’re treating their citizens now? Robert would die within 72 hours, too late for any humanitarian agency to intervene. 

The events of 9/11 left me terrified. After the F-16s stopped rattling the windows of our home, after the Jersey barriers went up in front of congressional office buildings, after Robert returned to school, I grabbed a cheap green backpack and methodically packed every essential item Rob would need to spend five days on the road to some place safe. Every September for almost a decade, I replaced the pills and solvents and tubes and syringes to ensure the backpack would be ready to go at a moment’s notice. That green backpack had a special place in Rob’s closet. We all knew where to find it.

How can our government confiscate the backpacks of children like my son? Backpacks hurriedly filled by anxious parents fleeing political violence? How can border patrol agents refuse medication to children with epilepsy, asthma, diabetes, and many other diseases? Why is the treatment of medically complex children at our border even controversial?

The situation at our border merely reflects the broader systemic cruelty of our domestic health care. If Robert and I had to flee Maryland today, even to Delaware or West Virginia, what Robert needs to survive and thrive might not be available to us, simply because Medicaid rules and covered items are not the same, state to state. Even Medicaid as a form of insurance is not transferable from one state to another. Our zipcodes have become borders and barriers to treatment for our most vulnerable citizens.

In fact, any U.S. citizen who takes a prescription medication is vulnerable in the event of an emergency that requires crossing state lines, let alone international borders. Some private insurers are local, some are national, and state and federal regulations for prescription drugs are complex. 

It’s said we are a nation of immigrants. Each of us needs to keep that in mind, and push our elected representatives to ensure basic human decency at our borders, the basic human right for refugees to carry essential medication to continue treatment. We would want the same human courtesy extended to us should any of us have to flee the comfort of our homes. 

As the mother of a medically complex young man, I dare to hope that the U.S. can do more for all medical immigrants, both within its own borders and at its international boundaries.

Photo provided by U.S. Customs and Border Protection of children at the Central Processing Center on June 17, 2018 in McAllen, Texas.

The Author’s son, Robert.

The spring of 2010, when the Affordable Care Act was signed into law, was preceded by a hard winter for my family. In February, two major snowstorms hit the DC area where we lived within one week, dropping thirty to fifty inches of snow. They called it Snowpocalypse. During the height of the second storm, I slipped out a bedroom window onto our long porch roof, afraid it might collapse from the weight and knowing we couldn’t afford to repair it.

This was the accessible home we’d built for our son Robert, a medically complex child disabled due to an undiagnosed disease. We’d been chasing a diagnosis and treatments for him for 12 years. I bit the shovel in deep and pushed the heavy snow forward, watching it cascade into piles on the front lawn. Snow clung to my eyelashes, my vision spotted with haloes from the street lights. As fast as I shoveled if off, it accumulated.

Struggling with health insurance in the days before the ACA had been much like shoveling my way through an unending financial storm. My family had had 6 different health insurers in those dozen years, always one step ahead of bankruptcy by medical expense, whether due to annual caps, lifetime caps, or the tens of thousands of dollars we’d spent on co-pays, medications, uncovered items, and other out-of-pocket expenses. I’d taken a job I didn’t really want as an editor for a federal advisory committee, just so we could have the golden ticket: federal health insurance.

But I wanted more: The ability to live how I wanted to live. The freedom to do what was best for my family. That meant choosing where we wanted to live, pursuing work for the love of the job, not the health insurance tied to it, and knowing my son could be insured even if a good work opportunity didn’t offer health benefits.

During the 2008 campaign, Obama had promised to deal with our country’s health insurance crisis, yet during the summer of 2009, his opposition had gotten the upper hand: health insurance reform meant no one would be able to choose their doctor and the federal government would establish death panels. I’d watched a town hall meeting at which a senator from Oklahoma heard a sobbing woman describe her brain-injured husband’s eviction from a nursing home when his benefits expired. He had a feeding tube, and she was now expected to retrain him to drink and eat on her own. The senator replied, What’s really missing here is the failure of neighbors to help others who need our help. The audience burst into resounding applause.

Self-reliance, rather than government hand-outs, was the yardstick of freedom that audience understood. I’d learned self-reliance growing up in 1970s Vermont, when the state was still staunchly conservative. That mentality from my youth had me futilely shoveling snow off my roof in the middle of the night, without considering how easily I might fall off. We were always in danger of falling off and losing everything.

Our neighbors had helped us as they could, but I relying on them would be just another form of dependence. None of them had the money or expertise it took to pay for my son’s healthcare or assist with his home medical needs.

Robert’s illness taught me that self-reliance and freedom were not the same thing. If you’re free you can go anywhere and do anything, right? But you’d better not have anyone depending on you. Janis Joplin sang, “Freedom’s just another word for nothing left to lose,” yet in my life, I’d had everything to protect and keep. She and Bobby McGee were drifters, criss-crossing the U.S. That’s not the type of citizenship most of us experience, even if we admire its free-wheeling nature.

Freedom and self-reliance are a delicate balance. There are few opportunities without a solid base of support: some self-reliance, some neighborly, and, yes, some from the government. It is our government; it is we the people who form it. Our government can provide a platform for each of us to seek freedom. Let me put it this way: If I had certainty with healthcare, then I could take other chances. Then we could chase a better way of life—the American dream.

That spring of 2010, the ACA proceeded to a final vote, and Speaker Pelosi struggled to keep her caucus in line. Bart Stupak of Michigan was the final hold-out. In his floor speech, Stupak said that he wanted women to know that if they had a child and that child had medical problems, he or she would be entitled to medical care. I cried. Stupak understood what my family had gone through, all that long winter. Freeing my child meant freeing me and my family.

The ACA remains under attack today, snowflake after snowflake piling up and threatening to keep all of us in a permanent winter. Let’s not allow the critics to snow us in. Let’s move forward, once again, to a new spring of improved healthcare-for-all, so we can each manage our competing responsibilities and free-wheeling dreams.

“The greatest tragedy that can befall a child with Autism is to be surrounded by adults   
who think it’s a tragedy”. ~ Ellen Notbohm

Raising an Autistic child can change the very heart of who we are as parents, and as people. It’s a life that provides deep rewards, a broader perspective of the world, and an unspoken fellowship with other parents who can understand and connect with one another from across the aisles of Walmart – and hopefully across the aisles of political parties, as well.

This life can also be overwhelming. It can be easy to get tunnel vision when you’re far into IEP preparation, therapies, and appointments; alongside the day-to-day challenges of life for our kids with Autism. This parenting gig (a different job than most!) requires a lot of focus: focus on today, tomorrow, this year, maybe even five years from now. Navigating the uncertain terrain is intense, scary, and isolating. It’s exhausting.  

Parents of Autistic children often travel a modified timeline for developmental milestones. We try not to compare our children with the kids of friends and neighbors, but I know from experience it can be hard not to filter the comparative ease of “neurotypical” experiences through an alternative lens of emotion and insecurity, self doubt and exclusion.

We’re told we need to learn to be flexible in our expectations. We talk about our need to adjust our dreams for our kids according to their diagnosis.

Knowing this, why would anyone be surprised to learn that some Autistic adults have feelings of resentment toward parents? That there’s anger, sadness, disappointment, suspicion, and distrust? If you think about it, it makes sense – for decades we work on care plans meant to “fix our kids” and help (force) them to fit into a world that my own autistic son, Sam, tells me feels “sharp and jagged” to him sometimes.

It would be easy for our kids to get the feeling that we think they are broken.

It should be easy to see that our alternative lenses don’t always show us an accurate picture of “best practices” for our children’s therapies, education, and more. That after years of traumatic events for our families, our perception as parents and protectors might be somewhat skewed.

For example, I was truly surprised to learn some adults in the Autism community want to be referred to as Autistic. I still struggle with this – as a mom, my gut feeling is that I want more for my child than this “label,” which feels like a limitation to me. I wonder why I can’t say artistic or athletic instead? Because my son is both of those things, too.

But maybe it’s the viewpoint of neurotypical parents (like me) - who’ve seen Autistic as something lesser in comparison to traits like artistic or athletic - that’s contributed to an impasse between the worlds of parenting someone with Autism and being someone with Autism. We lack the insight needed to accurately understand the full Autistic experience.

I first learned about the negative feelings some Autistic adult advocates have towards parent advocates when I joined Little Lobbyists, who’ve been advocating alongside self-advocates since they began. Little Lobbyists know our kids with disabilities will grow up to be adults with disabilities. We want to empower them to be the next generation of self-advocates, and to do that we know they need role models who are themselves disabled.

When you get a tip for who to bet on in a horse race, it’s most valuable (and accurate) when it comes directly from the “horse’s mouth”- the jockey or the trainer. Moving forward, I’ve decided to take advice straight from the most reliable source.

Only an Autistic person can be an Autism expert. I can trust that.  

“You have the power. If you do indeed, as you claim, want to be allies, then I suggest you start acting like it.” – Julia Bascom, Executive Director of the Autistic Self Advocacy Network

The author, Daya, with her son Sam.

The realization hit hard, like a punch to the gut. Almost as hard as the day I learned my son has Cystic Fibrosis, an incurable fatal illness. I’m nearly 39 years old, have always considered myself an ally to marginalized communities, and have loved all people of all varieties all my life. I’m aware of racism, sexism, and ableism - discrimination against people with disabilities. But what I wasn’t aware of, until today, is that I myself have been an ableist.

Why am I calling myself an ableist? After all, I’m part of Little Lobbyists, a group of caregivers who advocate for kids with complex medical needs and disabilities, to ensure lawmakers understand our needs. Yes, I just said “our needs” and you’re probably wondering how I could be ableist? Good catch.

Recently, Little Lobbyists leadership were discussing how we define who Little Lobbyists advocates for. Within this definition, there was one sentence I was completely offended by. It read: “Kids with complex medical needs have disabilities.”

The degree of offense I felt was one of the greatest I’ve experienced. This one sentence and my reaction to it rocked my world. (I want to acknowledge here that I have benefitted from a very middle-class, white-privileged life. I realize, those reading this who have endured far more discrimination than I ever have, might be spitting out their coffee and laughing at my ignorance as they read this, and rightly so. I fully understand my experience is not remotely close to what so many others face every single day. For my part I continue to strive to do better.)

During the conversation that followed about this sentence I indicated that, though my son is medically complex, I in no way identified him as disabled. I could tell the other moms, who do identify their children as having disabilities, were surprised by this. We’re all Facebook friends, so they have a view into my son’s medical needs. I suspect much of what they see is similar to their own experience, and so they assumed we also identified as part of the disability community. We had a positive and open exchange about why I didn’t think my son was disabled, they listened to my opinion and didn’t push me to identify differently.

But since that day, I have found myself frequently revisiting that conversation and asking myself why don’t I identify my son as disabled? Is it because he has no cognitive disability? No visible physical disability? Because he doesn’t qualify for disability services under SSI? Could it be related to the first, and often repeated, thing the CF care team said to me when he was diagnosed – “your baby is a normal baby, who happens to have Cystic Fibrosis?” Is it because of the heavy stigma society puts on the word “disability?” Honestly, I think all of these things have played a role.

The ADA defines disability in this way: “ a person who has a physical or mental impairment that substantially limits one or more major life activity.”

My son Jack takes over 50 pills and 14 different medications per day. His respiratory therapy takes 2 or more hours every day. He spends a large portion of his life in the hospital. He’s not in school this week because he is not absorbing food, isn’t breathing as well as usual, and we have to implement new therapy techniques and train his school nurse to perform them.

Cystic Fibrosis (CF) is invisible, progressive, and deadly. Until his lung function drops below 80%, I consider him healthy in comparison to other people with CF. However I know full well that every single day, every organ in his body sustains more damage. His medications help slow the disease but cannot stop it. A simple cold could end his life.

Clearly Jack has a physical impairment that substantially limits one or more major life activities. My son is disabled. It is the first time in his nearly 8 years of life that I have said those words, accepted them, and fully understood what they mean. My son is disabled. Tears are dropping on my keyboard as I type this, tears from shame – not for my son, but for myself. For the first time I realize that I am an advocate for the medically complex and disabled community who could not see her own ableism.

Fortunately, Jack did not inherit my ableism. I suspect he self-identifies as a disabled person without realizing it. He is drawn to other children with disabilities and befriends them immediately. He says “mamma that kid is like me, we are gonna be best friends!”

My job now is to be like Jack and embrace this part of him. I need to acknowledge my shame, and work to change the stigma against disability that was so deeply ingrained in me that I could identify my son as medically complex but feel offended by the word “disabled.” It is up to me to shed the ableism society has instilled in me from youth. Doing so will make me a better person, parent, and advocate.

Being a member of Little Lobbyists has opened me to a world beyond Cystic Fibrosis. It has helped me focus on all forms of medical complexity and disability. Our advocacy isn’t about a specific disease, syndrome, or disability, because we really are stronger together. It’s about raising ALL of us up to create a voice loud enough to get Congress to pay attention to our children with complex medical needs and disabilities and consider them every single time they write a new policy or review a proposed law that impacts them.

Thank God for my friends in Little Lobbyists who did not judge me as I walked this path of discovery, but gently educated me while embracing me and encouraging my advocacy. I have a feeling I’m not alone, and am writing this in part as an invitation to other parents who may, like me, be in denial about their child’s disability. It’s time to take a good look at why we fear this word. Ending society’s stigma against our children with disabilities must start in our own hearts.

Little Lobbyist Jack in front of the U.S. Capitol.

It's the eleven year anniversary of my diabetes diagnosis and the government still wants me dead!

My brand of insulin costs $340 if I were to be uninsured. That's $0.34 a unit. A unit is ONE HUNDREDTH of a mL. If something seems wrong about that to you, that's because it is. (1)

Technological advances has increased to the point where human and analog insulin can be produced for under SEVEN DOLLARS a vial. For anyone following along at home, that's a nearly 5,000% increase in cost. (2)

It's estimated by the World Health Organization that the average diabetic will use 40 units of insulin a day. At the current price point, without decent health insurance, living a single day costs about $14. A week $95. A month $432. A year comes in at just under $5,000. (1)

There are no "generic" insulin brands on the market, no older options like "pork" or "beef," so to say, animal-based insulins, available in the United States any longer. This is due to "evergreening," a technique used by the big three insulin producers (Sanofi, Eli Lilly and Novo Nordisk) slightly tweaking the formulas for their insulin before their patents can expire, thus extending the patent. (3, 4)

That's why a drug that has been around since the 1920s is still so expensive. While, yes, progress has obviously been made, the Big 3 have slowed the process of change, with Sanofi filing a lawsuit against two producers, Merck and Mylan, from introducing a generic form of Sanofi's primary insulin. (4)

Now, you may be saying "if it costs so much, just suck it up and get health insurance. It's not the government's fault that you don't -" yeah, I’m gonna need you to stop. Because this is where the issue of Big Pharma and the American government's lax health care collide.

This past year, TWENTY STATES filed a lawsuit against the Affordable Care Act (which in March of 2010 made it so that insurance companies couldn't penalize those of us with preexisting conditions by refusing us health care) that moved to revoke the protections in place for us. Texas vs Azar went so far as to say that the protection placed on pre-existing conditions was "unconstitutional." I guess they missed the "life" part of that whole "life, liberty, and the pursuit of happiness" bit. (5)

Not only have legislators tried to take away something that keeps people with pre-existing conditions from, often, a painful, PREVENTABLE death, we've had to watch them mock us in the media. Mo Brooks (R-AL) decided that we simply weren't "living the right way." Or Mick Mulvaney (Officer of Budget and Management for the Trump Administration) declaring "that doesn’t mean that we want to take care of the person, or should be required to take care of the person, who sits home, drinks Coca-Cola, no offense, drinks sugary drinks, and doesn’t exercise, and eats poorly and gets diabetes." Which not only shows a fundamental lack of knowledge on diabetes, but a lack of empathy as well. (6, 7)

While the ACA has yet to be repealed, the window to apply for insurance through the ACA has been shortened from 90 days to 45 days and the awareness budget has been slashed by 90%. Now, there's also the option for Medicaid, which at base-country wide level, will offer coverage if you're under the 138% poverty mark- with individual states having the option to expand coverage to under that point.

I make under $9,000 a year and I only fall at the 73% poverty point, to help put things into perspective. And a basic plan at that rate, without Medicaid, runs on the national average (for me, a single household 21 year old nonsmoker) between $230 and $370 dollars. That's more than my rent if you were curious. (8)

All this to say, health insurance, even with aid, still isn't cheap. And when the cost of insulin is so high, there are still out of pocket charges you have to pay monthly. I know diabetics who have gone without insulin because they just can't afford it; they can't afford insulin; they're trying to save their parents' money. (9)

Diabetes affects over 30 million Americans, with 1.2 million having Type 1 specifically. There are, on average, 1.5 million new cases diagnosed each year. In 2017, the nationwide total cost of diagnosed diabetes came in at 327 BILLION dollars. It comes as no surprise that diabetes is the 7th leading cause of death in America. (10)

I'm 21 years old, and today, I've been diabetic for eleven years. The average life expectancy for a Type 1 diabetic is 15 years shorter than that of the average person. For a woman in the United States, the average is 81. (11)

That means for me, that average is 66. According to statistics, I've got 45 years left. And I'll be damned if the government takes a single year of it.

So do me a favor for my anniversary, keep health care in mind when you vote.

The author of this post, Jodi Aleshire

---

SOURCES:

1- https://www.goodrx.com/…/how-much-does-insulin-cost-compar…/

2- https://beyondtype1.org/how-much-does-it-cost-to-produce-i…/

3- https://www.nejm.org/doi/full/10.1056/NEJMms1411398

4- https://health.usnews.com/…/whats-behind-the-rising-costs-o…

5- https://www.forbes.com/…/possible-removal-of-pre-existing…/…

6- https://insulinnation.com/…/trumps-omb-director-wasnt-alon…/

7-https://www.chicagotribune.com/…/ct-health-care-pre-existin…

8- https://www.kff.org/interactive/subsidy-calculator/

9- https://www.cnn.com/…/30/health/rising-drug-costs/index.html

10- http://www.diabetes.org/diabetes-basics/statistics/

https://jdrf.org.uk/…/about-…/complications/life-expectancy/

11- https://www.statista.com/…/life-expectancy-in-north-america/

Medical parents will know exactly where I’m going the second I say the following, “January is coming.” January is easily the hardest month for any medically complex family. In this month it does not matter if we have employer sponsored insurance, private insurance, Medicare or Medicaid—we all are all rendered equal in our work-load.

Why is January so hard for us? There is an annual avalanche of work created for us and our medical providers office by our insurers.

In my family of five there are two of us that are medically complex. I have a rare auto-immune disease called Behcet's as well as a rare blood clotting disorder. My 7-year-old son Jack has Cystic Fibrosis; a progressive and fatal disease that affects most of his major organs. To meet us, you would never know we fight illness. We both look and seem healthy.  By contrast, when you see our medical claims, you would think we were on death's door.

Every January I spend between ten and eighteen hours making calls to insurance companies, providers, pharmacies, and facilities. This work happens whether we have an insurance change or not. Where do we start? We first check our plan benefits and formulary (list of covered medications) to see if there have been any changes.  If our plan has changed pharmacy contracts, we must call and set ourselves up with our new local, mail order, and specialty pharmacy, then if there are formulary changes and insurance is dictating an alternate similar medication, I call the doctor's office to request a new prescription as well as all the other prescriptions be sent to the new pharmacies. While we are on the phone for that we are requesting new prior authorizations for all our expensive medications.

Most of our medications require a prior authorization so that insurance will cover them. Prior authorizations can take anywhere from 24 hours to ten days to complete depending on whether appeals are needed or not. If appeals are needed, then my work increases and I spend hours proving that my child’s medications are medically necessary. The irony of that is the person making the determination is rarely clinically licensed.

Next, we move to calling each of our medical  provider’s offices. Between my son and I, that is 11 different facilities I contact. Many families with medical complexities rely on grants and co-pay assistance programs which must be re-applied for annually and often provide new identifiers and cards. As soon as we are approved for those items, we make all the calls again.

Many of us incur a little extra work if we elected different insurance during Annual Enrollment, as I did this year. I filled our medications on 12/28/18 with my previous insurance and will fill them again with the new insurance on the first day it is effective 1/7/19. This is because we always need to have a 60-day supply on-hand in the event that we go through a lengthy appeals process, there is a natural disaster, or shipping is impacted. At all times, I must think ahead with every decision we make because without his medication, my son will die. I cannot hope to have enough.  It must be here, ready and on-hand.

This year my family’s insurance has changed, which means I’ll spend closer to 18 hours getting everything updated, ordered, approved, and shipped. The other thing I must be weary of is the dreaded gap. My old plan ends on 12/31/18, the new one begins 1/6/19. This creates a five-day gap where if a claim is submitted for medical care or medications I pay toward my deductible and out-of-pocket on the old plan which will not be attributed to the new plan. If we need medical care in those five days, we are increasing our annual out of pocket over the maximum.

January is full of research, phone calls, planning and care coordination. It is a complex mosaic that sets us up for relative success for the remainder of the plan year. On the other side, our medical providers are working just as hard to update our information and provide the items we need. If you happen to be a person that does not have the same January stress as the medically complex you may instead be a person that notices your doctor’s office running a little differently. The phone queue may be longer, you may have a longer wait for your appointment or a return call. Every piece of work we, as patients, are met with, the doctor's office meets in-kind.

My 7-year-old son Colton is in hospice.

Our entire family has been gathered around his bedside for weeks. His health, which had been slowly declining for over a year, rapidly deteriorated the day after Christmas. I’m grateful that he made it to Christmas, my smiling boy’s favorite time of year, to give us the gift of one last holiday together as a family.

The time will soon come when his broken body will be at rest, and my constant fight to ensure his access to health care will become a distant memory.

But not yet. Even in these final moments, when I should be able to focus the whole of my broken heart on saying goodbye, our fight is not over. Once again, our health care system has failed us. Once again, I am consumed by the fire of outrage at the suffering our children are needlessly forced to endure.

Obtaining hospice care for a medically complex child like my son is no easy task. The flat rate allocated for home hospice by Medicaid is not enough for a child like Colton; who needs a trach, feeding tube, supplemental oxygen, ventilator, medical supplies, medications, and more (we don’t call him our “million dollar kid” for nothing). Negotiating difficult contracts with agencies to set up care was complicated and stressful, to say the least.

As Colton became more ill, he needed more pain medication to remain comfortable. The prescription was written, but when we tried to fill it the medication was denied. Over the next few days, the script was denied four times. No matter what our physicians and pharmacists tried, it would not go through. As we ran out of medication, my greatest fear as a mother was coming true - my child would die a painful death and there was nothing I could do to help him. The health care system in our country is so broken that it prevented my child from accessing the medicine he needed to ease his suffering in his final moments.

I refused to accept this. I turned to the Little Lobbyists community I have been advocating alongside and my fellow mommas went into action. Through Twitter and Facebook, we shared Colton’s story. Generous friends and strangers donated funds and clicks alike. We cried out to the world for help and our voices were amplified by collective compassion and matching outrage. No family should have to endure this. Not here, not now, not ever

Fortunately we were heard by the people who needed to hear us. We finally got the attention of the pharmacy responsible. They explained they had made a mistake due to confusion over a new law in our state and were correcting the situation. After more than a week of worry, pain, and distraction, Colton finally got the medication he needed.

I’m filled with relief and gratitude that my beautiful little boy will not have to endure unnecessary suffering at the end of his life. But I cannot stop thinking about all the other mothers who are facing the death of their child. We should not have to fear the loss of health care coverage while we are trying to say goodbye. This is excruciating enough -- without fighting for hospice, without needing a “GoFundMe,” without exposing ourselves in our most vulnerable moment to the public scrutiny of social media in the hope that sharing our story will facilitate access to desperately needed care. This is wrong.

In his all-too-brief 7 years, Colton has taught me so many things about strength, and love, and the gift of life. To all who hear his story, I pray you learn just one thing from him – that the right to health care extends throughout a person’s life. My child deserves to live with dignity and as free from suffering as possible from the time he was a newborn in the NICU all the way to this moment in hospice, as he lies beside me struggling to hang on for just one more day.

Image description: Tonya (the author) and her son Colton embracing nose to nose.

On January 3, 2019, the 116th Congress was sworn in, with Democratic party leadership.  At 4am I had yet to close my eyes, even though I had a full day ahead of me. I couldn’t sleep because January 3rd was the day we had worked for two years to reach.  The day the Nancy Pelosi regained reclaimed the gave and became Speaker of the House. This was the day that ended the Republican majority in all three branches of Federal Government.  We made it. Checks and balances have been brought back to the US Government.

Americans with pre-existing conditions, families with medically complex children and adults, people who are chronically ill and in need of sufficient healthcare, all relaxed just a bit, knowing that the Affordable Care Act (ACA) will not be repealed by legislation for now.  I was one of them. My daughter Emma, a former 28 week micro-preemie twin along with her sister Sara, relies on the protections against pre-existing condition exclusions and the lifetime coverage limits the ACA put a stop to…

When Speaker Pelosi reclaimed her gavel I breathed a little easier knowing that the Republican party agenda to repeal the ACA  without a replacement cannot pass while the Democratic party leads one of the chambers of Congress. We saw that the GOP could not repeal the ACA even  when Republicans held the majority in both chambers, but the devastating threat constantly loomed. With Democrats in the majority of the House, the threat has been somewhat neutralized for now.  Instead of being on the defensive, we can resume and expand our plans to improve the framework and execution of the ACA instead of fighting off its demise.

I have never, in my 40+ years of life, followed politics so closely as I have over the past two years.  I have never been so personally impacted or attacked by members of my own government and my fellow citizens who support an agenda that includes removing healthcare and Medicaid supports for millions of families, including my own.  That is why I joined forces with the Little Lobbyists. I could not sit and remain silent as Emma’s right to access healthcare was attacked, belittled and dismissed as unimportant. My daughter is not expendable. None of our children should be thought of as a budget line item.

I was astounded when Speaker Pelosi shared credit for the Democrat’s victory with “our Little Lobbyists,” in her first speech as Speaker to House Members and the American public. When she credited part of the progress we have made during these scary and tumultuous times to the Little Lobbyists it hit a lot of us like a lightning bolt!  It served as validation that the innumerable hours, late nights at our kitchen tables, butterflies as we approach the microphone to speak, or write to share stories about our families have, in fact, made a difference. In those early morning hours, between enteral tube feeds, checking ventilator settings, covering for another missed nursing shift, emergency room visits and lengthy inpatient stays, we realized that the time we have given in service of the Little Lobbyists goals have been an important part of the fight to stem the erosion of healthcare in our country.

We now have allies leading the US House of Representatives, and no greater champion than Speaker Pelosi. January 3rd was the day the landscape has changed. It was the day we have had circled on our calendars since before the midterm elections.  The day everything changed.

Stacy’s daughter Emma is the reason she cannot sit and stay silent.

I wish y’all could have seen my face when I was handed a megaphone, of all things. Actually, it may be better my reaction was mainly internal, because I can tell you I did not feel nearly as confident as my picture portrays.

After more than a year of calling and emailing both of my US Senators, with hardly any response, I felt pretty ineffective. I was sure people would want to know the human cost of their proposed Healthcare changes. It had to be a mistake that both Senators had repeatedly voted to repeal the Affordable Care Act. They must not know what it means for my girls, and millions of children like them, who would be in mortal danger from such an unstudied and hasty change. To be fair, I had never approached them with a constituent issue in the past. Honestly, I didn’t even know their names until early 2017. Still, I had no way to anticipate the apathy I was greeted with by Senators Burr and Tillis.

I felt bold when I accepted the request from Little Lobbyists co-founder Elena Hung to speak (gasp!) in front of people (gasp!) at a political rally (gasp!), but in the days leading up to the #StopKavanaugh rally in Atlanta, my courage evaporated. I was left with the feeling that we all experience when asked to speak in public – all kinds of scary scenarios ran in a loop in my head. What if I fall over? Has anyone ever barfed at one of these things? Fainting seemed like a real possibility.

In the car, I poured over my carefully written remarks and practiced the purposefully placed pauses to my family, who listened in hopeful support. Together, we navigated through downtown Atlanta in our matching Little Lobbyists t-shirts and marched to the rally site. As I watched the three speakers ahead of me, I already felt the support of the crowd. This was a safe space filled with like-minded, active citizens who were angry about what we’re seeing come from our legislators. The unrest was pointed away from me, aiming straight for Washington DC.

Megaphone aside, when I spoke my first words, “My name is Stacy. I also answer to ‘Mom’, ‘Mommy’ and <ASL sign for ‘Mom’>…” I knew the crowd was already on my side and full of encouragement. I continued to tell the story of my beautiful twin toddlers, former micro-preemies who have fought every minute of their five years on this earth to stay with us. My voice broke as I shared snip-its from the early days in the NICU, when my willpower and determined stare were not enough to bring up oxygen saturation. The helpless feeling we have when the monitors are blaring and nurses move swiftly to intervene. I did my best to convey the impossible fragility of a 2lb newborn that has more wires than skin. When I waivered, I felt hands on my shoulder. I heard calls of encouragement from the crowd. I looked into the sea of faces and I saw genuine concern. Not just for our plight, but for the ongoing threat to their lives from a political party bent on undoing the accomplishments of the prior administration.  

I ended my speech by asking for help. Beyond outrage, we need action. We need concerted efforts and relentless outreach to our legislators.  Every day and twice on Sunday, we need calls, office visits, tweets and signs of protest to keep these critical issues top-of-mind. In April, I promised myself I would do at least one thing each day toward the goals of voter registration and story sharing. I see my daughters faces’ in the daily pictures of “100 Little Lobbyists Who Need You to Be a Health Care Voter” series we are sharing on social media.  

I am a newly minted parent activist and I know there are more of us out there. I know you’re angry and worried about what’s happening. You want to get involved, but you’re constantly exhausted and a little unsure about how to take the next step. Recent weeks have been especially difficult for us. We have witnessed conduct that would have been unthinkable until it all unfolded on our televisions. It would make perfect sense to recoil in despair.  

But consider this: What if we continue to speak up? What if our actions become stronger than our fears? What can we accomplish if we keep going? Just like we have done with our children and their medical teams, we can continue to advocate for them to reach their highest potential. I can help you. You can help me. We can do this together! Who’s with me?

The author and his sister, Little Lobbyists Ben and Claire Smith

Best Friend on Wheels shaped me because it taught me that it is okay to have a sister with a major disability. Before I read this book, I thought it was not okay to have a sister with a disability. Although I am ashamed to admit it now, I was embarrassed by my older sister Claire who has a microduplication of chromosome two, uses a wheelchair, is autistic, and has many other medical issues.

You may ask how did this book teach me that it was okay to have Claire as my sister? Best Friend on Wheels taught me this because it is a book about a girl with a similar disability.  At the beginning of the book Sarah, a girl with a disability, rolls into the classroom and a girl stares at her wheelchair but does not look at Sarah. At first, she looks away, embarrassed that she might say something wrong and hurt Sarah’s feelings. This is like when I was younger and I always stared at Claire’s wheelchair and thought that she would not be able to play with me. Now I am ten and I think of Claire’s wheelchair as a neat accessory like a piece of jewelry rather than as something that makes her different.

A lot of people stare at Claire when we walk to a toy store in our neighborhood and think that she cannot communicate what she wants. This reminds me of a part of Best Friend on Wheels when Sarah and her friend go to get ice cream and the lady at the counter asks Sarah’s friend what would she like thinking that because Sarah has a disability she cannot talk. Although my sister cannot talk, she can point and let us know which toy she wants that way, but people do not always give her the chance to do so.

Best Friend on Wheels showed me that people underestimate kids with disabilities all the time, not just my sister, and that I had to speak up for my sister so that people would realize what she is capable of. I’ve continued to do this by going to Capitol Hill and rallies to speak up for kids with disabilities and will do so for the rest of my life.

When the girl in Best Friend on Wheels becomes friends with Sarah, it is not because she feels bad for her for being in a wheelchair, but because of her pins showing that she is a “ROCKHOUND.” This may seem unimportant, but it is very important because it shows that people with disabilities can like the same things as people who do not have disabilities. The girl in the book did not notice Sarah’s pins at first because she was too busy staring at Sarah's wheelchair. When she does look beyond Sarah’s wheelchair she realizes they both collect rocks and have a lot of other things in common too. This showed me that people with and without disabilities can have a lot in common if they just take the time to talk to each other, even if what they have in common is just watching movies or reading books.

Best Friend on Wheels taught me that it is okay to have a sister with a major disability because it showed me that a person with a disability can do everything people without disabilities can do too. Just like the two friends in the book, I have learned that I can do everything with my sister Claire that my friends can do with their siblings. We enjoy going to amusement parks, eating ice cream together, swimming, and playing games.

Thanks to Best Friend on Wheels I stopped being embarrassed that my sister had disabilities and realized how much fun I could have with her. Now she is one my best friends. I am so glad I am not missing out on having so much fun with her just because of her wheelchair.

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Ben's essay was a finalist in the Library of Congress' 'A Book That Shaped Me" contest. He was recognized for this accomplishment at the National Book Festival in Washington, DC on September 1, 2018

Click here for a link to where you can purchase the book, Best Friend on Wheels by Debra Shirley.

This Sunday, I’ll be celebrating Father’s Day as a dad for the eighth time. My first one was pretty easy albeit uneventful, “uneventful” later becoming an eternal goal in our lives. My daughter Penny was born in the spring of 2011, and for the first three months of her life, she exhibited all the signs of a healthy baby girl.  

That’s when she started doing this thing with her arm. That’s what we called it, an odd, repetitive motion. We brought her to her pediatrician, explaining that she kept doing “this thing.” He observed her, and within a minute, Penny did it again. He instantly instructed us to take her to the emergency room at Cornell Medical Center, explaining that she was having partial seizures. Within 48 hours I no longer had a healthy baby girl. I had a daughter with Aicardi Syndrome; a severe developmental disability that only impacts girls. It includes epilepsy, intellectual disability (severe in Penny’s case), physical disabilities (also severe with Penny), and communicative difficulties. Penny cannot talk or willfully communicate aside from a whine when she’s unhappy, a squeal when she’s happy, and occasionally tapping the table when she wants an object.  

It’s still remarkable to reflect on how the life that I had envisioned for myself and for Penny had been obliterated and replaced with a different one, one far scarier and more uncertain, in the space of a couple of days. Even scarier was how isolating it felt to have a daughter with an illness so rare you could potentially go years without meeting another person affected. My first big break was finding a support group for parents of Aicardi children online. The feeling of belonging and support got me through those first months. It wasn’t only people helping each other and it wasn’t just the moral support, both of which were huge. It was the pictures I saw and stories I read about families having fun with their daughters – the girls getting to enjoy beautiful experiences in their communities, out in nature, on road trips, and in school. I read dispatches from normal life, people simply talking about “normal” stuff, like going to the movies and out to dinner.  

Something that was rare in the group (though certainly not absent) were posts by dads. I don’t know exactly why dads are less likely to participate in such groups – if it’s simply not one’s thing, great – but I’ve spoken to some dads who claim they don’t feel it’s meant for them. They feel intimidated by how overwhelmingly female such groups sometimes are, or are embarrassed. It is not, however, because they are less interested. I have come to know some of the most spectacular special needs dads that I could ever meet. I’ve known dads to build entire rooms to accommodate their kids, convert a van themselves, carry a 60-pound daughter miles through the hilly woods because she loves it, change jobs and move the family cross country for better services for their children, and create enough adaptable devices (and Halloween costumes!) to earn an engineering degree.  

There’s been a lot written about how special needs dads can be overlooked or are more likely to be silent about their child, so I want to dedicate this Father’s Day to all the special needs dads who are pouring their heart into their kids. I don’t know if I would have even thought to do all I do with my kids without your inspiration. I thank you for that. And thank you from the entire special needs community for doing more than most people even know is possible.   

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There are many ways to support Little Lobbyists and get involved!

If you are the parent or guardian of a child with complex medical needs and/or disabilities, share your story with us here. If you would like to learn more and stay in touch, connect with us here. If you would like to donate to help us continue our work, please click here.

Thank you!

Finding my voice with the Little Lobbyists.

I know a lot of people say they don’t like to “talk politics.” I was once one of them. I was informed, I cared, and I voted, but talking about politics just seemed too icky.

So I surprised myself a little when I decided to begin visibly and vocally engaging in politics. Aside from a term on middle school student council (one year as president, thankyouverymuch), it wasn’t something I saw in my future. I’m a graphic designer who loves helping people communicate but doesn’t particularly like conflict. I design, teach, and try to help create a more beautiful world, work which has always fulfilled me.  

Until, suddenly, it didn’t seem like enough. A little over a year ago, the political powers-that-be began to overtly threaten my disabled son Simon’s health care, education, and civil rights. Our country had changed in a scary way. I lost the privilege of sitting on the sidelines believing everything would be “okay.” A privilege I’m sorry to say I’d taken for granted the previous 8 years.

I do have some prior experience diving headfirst into dark water, ever since a doctor told me there was something “very wrong” with my baby's brain. Any parent of a medically complex child could tell you some variation of the same story: their baby was sick and the pediatrician couldn’t help, so they sought out specialist after expert specialist. Farther and deeper they searched until they found someone with answers. Perhaps, like me, they even found themselves plunging into previously unfathomable depths (shout out to NIH Undiagnosed Diseases Network!). But ultimately, on this voyage we each discover that there’s no one better than ourselves to navigate these unchartered waters with our children.

One day you realize the expert you’ve been waiting for is you.

You read the wonky medical journals and memorize the vocabulary. You even train the residents about your child's conditions (OMG so YOUNG!). You learn how to separate fact from BS and you refine your advocacy – polite but very firm – until you have just enough fire glinting in your eyes for folks to know not to cross you. You will get what your child needs whatever it takes.

It turns out those skills are exactly what you need to be an effective political activist.

Instead of medical journals, you read equally wonky policy articles and memorize some new vocabulary (bad news: still lots of acronyms, good news: less Latin!). You train staffers (OMG why are they all so young?), separate fact from BS, and advocate with the same firm, fiery, politeness. You will get what your child needs whatever it takes.

It also turns out that both physicians and politicians are just people you need to communicate with.

Sometimes the communication is icky. Some people can’t, or won’t, help you. Some will lie to you. Others will tell you like it is, but admit they don’t actually care much.

But, sometimes, it isn’t.

Sometimes, people will listen, tell you like it is, care, and help you. You’ll see the fire in your eyes reflected in their own. You’ll learn they’ve been fighting for you all along and it’s stories like yours that inspire them.

Our stories are powerful. These are our truths which we hold to be self-evident. The love of a parent for a child; of an American for justice, freedom, and equality. It’s not a perfect union, but a work in progress we must all participate in.

Sometimes, people cry with you. The first Senator I visited, Debbie Stabenow from Michigan, had tears in her eyes as she took my hand to tell me she was so happy to meet us, but so sorry we were there because our government is threatening our vulnerable children.

Meeting Senator Stabenow (Simon requested snacks... fortunately she had lots of Kellogg's cereal on hand! Did you know Kellogg was based in Michigan?)

Sometimes, people race to be at your side, the way Senator Wyden ran to meet us the cold, rainy night of the “People’s Filibuster” of the GOP Tax Bill.

Senator Wyden talking about the impression our kids with complex medical needs made on him at the night time People's Fillibuster. He was very kind and very, very tall.

Sometimes, people give you hope. I’ll never forget shaking Senator McCain’s hand and thanking him for his vote against the repeal of our health care. His face was bruised from battling cancer but his gaze was strong and steady as he told us he cared about us. He said he prays for our families every day, and we pray for him and his.

My husband Brian shaking hands with Senator McCain. This is Brian's "wow" face. Because, wow. Also, it was Halloween and we went trick-or-treating in the Senate (as one does) and that is a giant seahorse costume we made for Simon's wheelchair. He was Aquaman. I don't always wear a Wonder Woman crown, just as needed. I'm thinking about keeping it in my handbag...

Sometimes, people embrace you. Senators Schumer, Casey, Booker, Warren, Duckworth, Harris, Bennet, Cortez Masto, Hirono, Murray, Reed, Kaine, Murphy, Hassan (whose own son has cerebral palsy just like mine), Warner, Van Hollen, Cardin, Schatz, Baldwin, Gillibrand...have literally embraced our kids. (If you noticed a blue tint… well, friends, unfortunately that’s just how it is right now. Though not from lack of effort on our part, I promise. Yes, we will keep trying.) These legislators fight for our “Little Lobbyists” because as constituents they are their children, too.

Senators Warren and Duckworth meeting some of the Little Lobbyists. So much love and so much cuteness right there.

Senator Murray invited us to visit for the holidays. I loved learning that she started her political career as a "mom in tennis shoes" advocating for education as a preschool teacher. The kids loved the candy canes. (If you look closely by my feet -- I'm the gal in the Santa hat -- you'll see Simon lying on the floor. He had a small seizure while taking this photo. One second after saying "cheese" his service dog Tigger brought me his meds and we treated him right there, on the floor of a Senate office. We Little Lobbyists keep it real!)

Sometimes, people empower you. Leader Pelosi has invited me and many other parents to tell our stories at her press conferences. She carried our children’s names with her into the House of Representatives. My family’s story is now part of the permanent Congressional record. She even warned her colleagues not to “trip on Simon’s wheelchair” as they try to get between a special needs mother and the care her child requires. That’s on the record, too.

Just a mom giving a speech in the Capitol at Leader Pelosi's press conference. You can watch my speech here.

Leader Pelosi needed no explanation, premise, or pitch when it came to protecting our kids. She’s championed our children with complex medical needs and disabilities in every way she can. She’s a mother and a grandmother. To me, she demonstrates the impact of women in office -- they understand and vote for what our families need. Leader Pelosi knows our children and they know her, not as a political powerhouse, just as one more badass mama who loves them and protects them.

Leader Pelosi thanking my daughter Olivia for being a great big sister and standing up for what she believes in. Yes I am crying, you would too.

Leader Pelosi getting a hug from Little Lobbyist Charlie. No, our kids could not be any cuter.

So, to all my fellow badass mamas (and papas) of kids with complex medical needs and disabilities who are already fighting and wondering what more they can possibly do, I see you. I know you’re the captain of a ship on choppy seas, made worse by the tempest our government’s created. It is terrifying to think of weathering this storm alone. So don’t.

There’s a light in this lighthouse and people who will row to shore with you. Just one year ago, we came together as Little Lobbyists, and we’re continuing to grow our fleet. Families like ours are all over this country – connecting, calling, writing, showing up. We learn, share, and communicate with each other and our legislators so our children will have the more just and beautiful future they deserve.

You already have all the skills you need. You’re the one we’ve been waiting for. Join us.

Some of our Virginia Little Lobbyists families meeting with Senator Tim Kaine.

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There are many ways to support Little Lobbyists and get involved!

If you are the parent or guardian of a child with complex medical needs and/or disabilities, share your story with us here. If you would like to learn more and stay in touch, connect with us here. If you would like to donate to help us continue our work, please click here.

Thank you!

The first time a doctor suggested that my son was mentally retarded was a shock.

Simon was five, and though he’d consistently missed milestones, his doctors and teachers said it was just “developmental delay” and recommended more therapy to help him catch up. Since he’d started life with a stroke and had multiple surgeries, it seemed reasonable he’d need a little extra time and help. I tried not to worry about the future, a delay was only temporary.

Until it wasn’t. Simon was falling further behind. Testing revealed his academic skills had “plateaued” and his social skills were “abnormal.” Lots of charts with bell curves and deviant scores were drafted to explain what I couldn’t quite comprehend; my beautiful little boy with hydrocephalus, epilepsy, and cerebral palsy, also fit the clinical definition of mental retardation.   

The weeks following Simon's diagnosis brought a lot of research and reflection. I suddenly found myself noticing something that had always been there -- the careless way “nice” people used my baby’s medical condition as derogatory slang. It was a painful revelation. Every time I heard it felt like a stab in my heart, and I heard it often. People said it to describe something foolish, when annoyed by someone, angered by a situation, even to be self-deprecating. “Retarded” was a synonym for nonsensical, unworthy, lacking value, rejected. It embodied my deepest fears for Simon’s future as a person with cognitive and physical disabilities.

It’s well established that in our society fitness and intelligence are paramount. We define ourselves by what we “do.” What we produce has become more important than who we are. Achievement is virtue, work is worth. If a person cannot participate as such, they are marginalized. Look no further than current political rhetoric for examples: “makers vs. takers,” “poverty is a mindset,” work requirements for health care, and so on.

And of course, there’s this.

With ongoing attacks to health care, education, and the ADA, our country is an increasingly hostile place for people with disabilities. If, as President Jimmy Carter famously said, the measure of our society is found in how we treat our most vulnerable citizens, we are falling far short of greatness.

My son, however, is not lacking. Through him I’ve come to rediscover the “better angels of our nature,” as Lincoln and Obama directed. Simon taught me that a person is more than the goals they score, the grades they get, or the money they make. We must learn to measure our value by the kindness we show, the laughter we share, and the love we create. Worth is intrinsic to every life.  

Simon’s diagnosis was six years ago. Since then, we’ve seen many specialists and most choose other (better) words to describe his diagnosis. Cognitive or intellectual disability describes the condition without denigration, helping us find a path for understanding. Though I’ve grown past my initial fears, the old echo of “retarded” still follows me. When I hear it, I worry about Simon’s future, about the stigma and ostracization he will face when he’s no longer a child and I cannot protect him.

All any parent wants for their child’s future is happiness, and the key to that happiness is being accepted for who you are. Fear of my son’s diagnosis made me reluctant to accept it, and inhibited my ability to accept him. But the scary part of “mental retardation” isn’t the condition itself. People with cognitive disabilities have meaningful lives, and bountiful gifts to offer those who choose to see them. The thing we should be afraid of is our acceptance of hate speech, which gains its meaning from crushing our humanity. It’s the rejection and devaluation the word “retarded” has come to define from use as a slur. And it’s time for that slur to go.

Spread the word to end the word.

I chose life.

I chose life when my husband and I planned to have a baby.

I chose life when we celebrated the two little lines on the pregnancy test.

I chose life when I started to eat healthier, took my prenatal vitamins every day, and eagerly attended every appointment with my midwife.

I chose life at my 20 week ultrasound, when the doctor referred me to a maternal fetal specialist.

I chose life when the maternal fetal specialist said something was not quite right with my baby’s heart.

I chose life when we met with the genetics counselor, who used words like “abnormal” and “atypical” and “syndrome” and “termination.”

I chose life when I was labeled “high-risk” and scheduled for weekly monitoring.

I chose life when I had a million conversations with my doctors and midwives and prepared for every possible scenario.

I chose life when I was induced at 39 weeks because my baby stopped growing and her movements slowed down.

I chose life with each contraction in labor — gentle mild ones over three hours, crazy intense ones over twenty minutes — and when I brought her into this world with three quick pushes.

I chose life when I held her in my arms and kissed her moments after she was born.

I chose life when the neonatologist examined her at bedside and then rushed her to the NICU.

I chose life the next morning when the cardiologist recommended we transfer her to the cardiac ICU at the local children’s hospital.

I chose life when I sent her on her way, armed with the name Xiomara, which means “ready for battle.”

I chose life when we did Kangaroo care every chance we got in that hospital room full of life-saving machines.

I chose life when I handed her over to the surgeon who would perform her heart surgery when she was 11 days old.

I chose life when I pumped breastmilk for her round the clock for months on end.

I chose life when I attended rounds with the doctors every single day and obsessively Googled every new medical condition discussed.

I chose life when I walked her down to the OR to get her tracheostomy and feeding tube placed after she was unable to breathe and eat on her own after nearly three months.

I chose life when I did my trach care training and learned how to care for her medically.

I chose life when my husband and I took turns sleeping at her bedside in an uncomfortable hospital chair for 169 nights straight.

I chose life when we finally brought her home for the first time on a cold December day.

I chose life with every scary 911 call and terrifying ambulance ride that followed.

I chose life when I gave her manual breaths with the AmbuBag every time she turned blue and stopped breathing.

I chose life with every suctioning of the trach, every tube feeding, and every nebulizer treatment.

I chose life every time I forced myself to get back up after breaking down.

I chose life when I fired every therapist, home nurse, and doctor who didn’t have her best interest at heart.

I chose life when I powered through after days without a shower or sufficient sleep.

I chose life when I researched every therapy, medication, program, doctor, and procedure that could possibly help her in any way.

I chose life when I fought with our health insurance to cover the care she needed.

I chose life when I applied for Medicaid on her behalf to prevent our family from financial ruin.

I chose life when I gathered documents and applied for grants to pay for “non-covered benefits.”

I chose life when I helped her with her physical therapy exercises all day long, every single day, so she could finally hold her head up on her own at 8 months old.

I chose life as we learned sign language together so we could communicate.

I chose life with every new therapy toy or medical equipment acquired.

I chose life when we turned occupational therapy exercises into fun games every day.

I chose life when my husband and I attended one doctor appointment after another…after another after another.

I chose life when we loaded up the car and drove 9 hours to Cincinnati Children’s Hospital because they have the best Aerodigestive program in the country.

I chose life every three months when we drove to CHOP in Philadelphia because her pulmonologist there specializes in kids on home mechanical ventilation.

I chose life when my husband and I did her trach care every night and trach change every week to help prevent infection.

I chose life when I lugged her ventilator, oxygen tank, pulse oximeter, feeding pump, suction bag, and emergency bag everywhere we went.

I chose life when we enrolled her in a pre-k special education school program so she could socialize with her peers.

I chose life when we went to story time at the library and waved to the animals at the zoo and and played on the swings at the playground and splashed around in the kiddie pool and cheered loudly at baseball games and watched Sesame Street together.

I chose life when I fought for every chance for her to just. be. a. kid.

I chose life when I met my U.S. Senator and looked him in the eye as I told him why he needed to fight tooth and nail for my daughter.

I chose life when my friends and I walked the halls of the Senate office buildings all summer on behalf of medically complex children across the country in desperate need of access to affordable quality healthcare.

I chose life every single time, every single day. I am still choosing life for my daughter.

The Republican tax plan does not choose life.

It chooses to repeal part of the ACA, which will lead to 13 million fewer Americans with health insurance. Americans that include children with medically complex needs like mine.

It chooses to raise insurance premiums on the millions of American families who do not have the “freedom” to go without health insurance because of the medical conditions in their family.

It chooses to create over a trillion dollars in debt — debt that our children will have to pay off — so that corporations and wealthy individuals can have more money.

It chooses to create that deficit with the idea that they will make up for it down the road with hundreds of billions of dollars in cuts to Medicaid, the program that keeps our children alive and thriving.

In short, it chooses to threaten the quality of life of the most vulnerable amongst us, including our children.

If you support this bill, you don’t get to call yourself pro-life.  If you support this bill, you are not choosing life.

I chose life.  If you also choose life, join me in this fight.

~ Elena

I keep thinking about anonymity. That’s what President Obama gave us. For 6 years, since my son’s birth in 2010, I was able to post pictures of my children to just my friends; to celebrate, to enjoy, and to brag about how wonderful they are, just like a lot of other parents do on social media.

We didn’t have to publicize my son’s story on national media outlets.

The ACA gave us the ability to focus on our children, not on saving healthcare for all Americans.

Why is it different now? Why do we have to tell the world who we are and what we are fighting for? Because it’s difficult and sometimes nearly impossible for people to care about an issue if there isn’t a face on it or they don’t know someone who is affected by it.

That’s why we’ve seen such overwhelming support from 275 parents from 48 states submitting their stories to not only us, but to many other story-collecting, awareness-raising entities, not because they are bragging about their kids or celebrating who they are (though that’s a big part of it), but because they want people to see that their children are real people, worthy of life, and endlessly valued. There’s been parents who have accidentally submitted their stories to us more than once; they’ve submitted their child’s story to so many places, they’ve lost track of who they’ve contacted and who they haven’t. That’s not pride in your child. That’s desperation. That’s very real fear. And that’s why we fight.

100% of parents who have submitted their child’s story to us have told us to share their stories with their Members of Congress. 95% of these parents have said they are willing to share their child’s story with media outlets. It’s such a high percentage because these parents understand the value of public pressure on their Member of Congress through the media. They have come to terms with releasing their child’s information, their diagnoses, their interests, their struggles. They’ve been open about how vital insurance and Medicaid are to the health and well-being, the survival of their child and their families (these are families who have every type of socio-economic status imaginable). They have shared their child’s story openly with the public in an effort to humanize their child and to show our nation’s lawmakers that a vote for humanity should not be partisan.

It should be a given.