Maura & Anne Marie are nurses at Six West, the stem cell transplant unit at Children’s Hospital Boston. They visited Andy’s school last Tuesday March 11 to talk to his classmates about his transplant.

It was a great presentation.

Thank you Maura & Anne Marie!

Andy feels more confident.

Andy’s teacher reminded me that I’m not allowed to post pictures or videos…
Here is the script:

 

Andy Trevino < ?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

BTS powerpoint presentation script

 

 

Introduction

 

Hi I’m Maura, and this is Anne Marie.  We are nurses at Children’s Hospital in < ?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />Boston and we’re here today to talk to you a little bit about your friend Andy.  As you probably know, when Andy was younger, he was very sick and he spent a long time in the hospital.  We are going to tell you a little bit about his sickness, the treatment he went through at the hospital, and explain to you why he couldn’t come to school until he was all better.    And answer any questions you may have the best we can.

 

So we have a little slide show.  If you have a question at any time during our talk please raise your hand and we will try to answer your questions.  We hope that you will listen, and participate, and even learn a little bit. 

 

So let’s get started…

 

Has anyone been to Children’s Hospital?  (many children will raise hands).  Children’s Hospital has a lot of different kinds of doctors and nurses who work to help kids get better from all different kinds of sicknesses and problems.

Slide 1 (< ?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />Fenway Park) < ?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

 

Is this Children’s Hospital?  No it is not, it is Fenway Park. But we thought you would recognize this place because it’s where the Red Sox play, and many of you may have been there before.  

 

Children’s Hospital is in Boston right near Fenway Park where the Red Sox play.  It takes about an hour to get there from here.

 

Who loves the Red Sox? I thought so. 

 

Slide 2 (Children’s Hospital)

 

Andy had a sickness with his blood cells and he had to come to the hospital to get a bone marrow transplant.  This is a picture of the front of Children’s Hospital.

Does it look familiar to some of you?  

 

Slide 3 (the pelvis and blood slide)

 

So now you probably have 2 questions:

What kind of problem can you have with your blood?

And..

What is bone marrow transplant?

 

So for the next couple minutes we are going to try to help you to understand and we are going to do a little science, okay? I hope you guys like science, do you?

 

First of all, where is our blood made?

 

Our blood is made in the bone marrow, which is the hollow inside space of our bones.  It’s kind of like a factory for making blood cells. One of the bones that makes a lot of blood cells is right up there on the screen. 

 

Does anyone recognize that bone? (hands will raise).  If you close your eyes and picture a skeleton, you may be able to remember what bone that is. 

 

That’s right, that’s the pelvis bone.  Now if you stand up and feel at the bottom of your back on both sides, you may be able to feel your pelvis bone. It feels hard. 

 

Blood is made in the bone marrow.

 

Bone marrow is like a ‘factory’ for making blood cells,

Why is the bone marrow important? Because it makes blood. Blood just looks like red liquid, but it is actually made up of different kinds of cells.  If we looked at some blood under a microscope we could see these cells. 

 

All of the cells of the blood have a special job.

What blood cells does the bone marrow make?

What jobs do these different blood cells do?

 

So now I need an assistant to hold up these pictures and show them to the class.

What kind of cells are these? (white cells)

 

White cells fight infection. So if you get a cold, or a cough, or a sore throat, or catch some kind of germs, the white cells help get rid of the germs. When we get sick, do we stay sick forever (NO!)  That’s because our white cells helping us to fight the germs.  Sometimes we need medicine too.  Like has anybody ever had strep throat? Did you have to take the pink bubble gum medicine?

 

 I need another volunteer please.

What kind of cells are these? (red cells) Red cells carry oxygen.

Why do we need oxygen?  Did you know that all the parts of your body need oxygen, not just your lungs.  The lungs is the way the oxygen gets into your body, then it sticks to the red cells and they circulate around your body to bring the oxygen everywhere.

  

I need one more volunteer to help me with this last picture. 

What kind of cells are these? (platelets) Platelets help to prevent or stop bleeding.  So who has scraped their knee before, or got a cut? (everyone will raise their hand). Did you get a scab?  Platelets helped to make that scab, and that’s what helps you stop bleeding.

Slide 4 (blank)

Demonstration/ Powerpoint on hold (Maura)

 

So, we need all these kinds of blood cells to make our body work right.  Blood cells are made in the bone marrow.  And like we said before, the bone marrow is like a blood cell factory. 

 

Now we are going to take a little break from the powerpoint pictures and do a little demonstration to show you how the bone marrow looks when it works right, and show you what happens when the bone marrow does not work right.

 

So we are going to pretend that we work in the bone marrow factory, and I need some assistants. 

To make the right blood cell recipe.

 

First I need someone to put the red cells in (cranberries).

Thank you very much.

 

And now I need someone to put the white cells in (Kix).

Thank you sir.

 

And finally I need someone to add the right amount of platelets (rice krispies).  And you can stir it all together.  Thanks. 

 

Now I am going to pour this perfect bone marrow that we’ve made into a jar and we will pretend that the jar is  the bone marrow space in our hips. 

 

Now look at that, isn’t it lovely?

 

It has just the right amount of red cells, so it’s really good at carrying oxygen. 

 

It has just the right amount of white cells, so it’s really good at fighting germs.

 

It has just the right amount of platelets, so it prevents us from bleeding too much and helps us to make scabs.

 

Okay, now we are going to make some bone marrow that is not working properly.  I am the big boss at the bone marrow factory, and I am going to give you the wrong instructions for the blood recipe. 

 

I need someone to help with the red cells again.

Thank you.

 

Next I need someone to add the platelets.  Thanks so much.

 

And now I need someone to add the white cells. Oh, but wait a minute,   before you do, will you mush them up a bit with this rolling pin. Yeah, cause they are not good white cells.  They are broken ones. 

 

And could you mix it all up. Thanks.

 

Okay, our recipe is done.  How do you think this blood will be working?

 

Do you think these white cells are good at fighting germs? No, they are not.  What do you think happens when you can’t fight germ?

Yeah, you get sick a lot.

 

That’s what was happening to Andy when he was little.

 

Slide 5 (Andy in the hospital attached to pump)

 

Okay now back to our regularly scheduled powerpoint presentation.

 

But first, a couple of super important facts about Andy’s broken white cells:

 

Super important fact number one: 

Andy did not do anything wrong to make this problem with his white cells.  It was something he was born with.

 

Super important fact number two:

You can’t catch the sickness from anyone, like you can catch a cold. 

 

Super important fact number three. 

Andy had a bone marrow transplant and now he makes perfectly good white cells.

 

So Andy’s bone marrow factory wasn’t making the right recipe for blood, kind like this one that we made so he was getting sick a lot.  This problem with the blood is called an immune deficiency.  The doctors who know about this kind of problem  knew that just medicine would not fix Andy’s bone marrow.   They knew that Andy needed a bone marrow transplant.  In other words, he needed to get bone marrow from someone else to set up a new factory in his body that would make the right kind of white cells to help him fight germs.

 

Slide 6 (Andy shaving dad’s head)

 

Before Andy could get his new bone marrow, a few important things had to happen first. We gave him special medicine called chemotherapy to get rid of the not-working blood cells.

 

The medicine  can make kids feel nauseous.  Sometimes they throw up.  Have all of you thrown up before for different reasons, like you ate too much or something?  It’s not a good feeling is it? But the good news is, when Andy felt sick to his stomach, we gave him medicines to make him feel better.

 

The chemo did its job of getting rid of the bad blood cells but also made his hair fall out…but we knew it would  grow back in a few months.  Some kids don’t mind having no hair.  Other kids like to wear scarves or hats.

 

And other kids feel better if their dads can be bald too while they have to be bald.  Mr. Trevino likes the way he looks with no hair so he kept it that way, even after Andy’s hair grew back.

 

Slide 7 (Andy’s central line)

 

We gave Andy most of his medicines through a special iv called a central venous line (CVL).  Does anybody know what an IV is?  It’s a tube that goes into your vein. What are veins? They are like little tunnels under your skin that carry blood through your body; if you look at the inside of your elbows, you may be able to see them.  They look like blue lines.   So you can get medicine into your veins and you don’t have to take all the medcine in your mouth.  The CVL is a type of  IV that can stay in for many months.  And blood samples can be drawn off it so we do not need to use needles to get blood samples.   This was a great thing for Andy because he need blood tests every day while he was  in the hospital and many times per week after he got out of the hospital. Special nutrition could be given in the CVL when he didn’t feel like eating or drinking.

 

Here is a picture of Andy’s CVL.

 

And here is a doll that has a cvl.

( Anne Marie show cvl doll. Demonstrate with syringe how we pull blood off without a needle).

 

 

Slide 8 (Sofia or Sofia and Andy)

 

So the second thing that had to happen before Andy could get his new bone marrow, was, they had to find someone that exactly matched his blood cells.  They tested everyone in Andy’s family and found out that his sister Sofia had the exact kind of white cells that would work in Andy’s body.

 

When Andy was ready to get his new bone marrow, Sofia had an operation to take out some of her bone marrow to give to Andy. They left plenty of bone marrow in Sofia so that she would continue to make her own blood cells.
Slide 9 (Michelle hanging Andy’s bone marrow)

 

When Andy was all ready to get his new bone marrow, it is what we call ‘Day 0’.  Some kids call it their new birthday, because it is the birthday of their new bone marrow factory and they celebrate it each year because it was such a special day in their lives.  What’s your bone marrow birthday Andy? 

 

Here’s a picture of Andy getting his new bone marrow.  It looks just like blood.  His nurse named Michelle hooked up the bone marrow to his central line and let it flow in.

 

(show cvl doll hooked up to bone marrow)

 

Slide 10 (Andy crossing his fingers)

 

While Andy’s bone marrow was going into his cvl, he crossed his fingers for good luck.  Do you ever cross your fingers for good luck?

 

 

It took many weeks before Andy’s new bone marrow began to make new blood cells. 

 

Slide 11 (the Trevino family picture)

 

 

What do kids do while they are waiting for their bone marrow to make new blood cells?

 

Some days, they may not feel well.  They may be nauseous, or have a fever, or have a sore throat.  They might not feel like doing much at all.  We give them a lot of medicines to help them to feel better. 

 

If kids feel well enough, there are quite a lot of things to do both in their rooms and on the floor. 

 

First of all, you can decorate your room all homey.  You can bring your own blankets and toys and decorations.  There’s a parent bed so your mom or dad can stay with you and sleep over every single night that you’re in the hospital. 

 

This is a picture of the whole Trevino family playing with Andy in the hospital. 

 

Slide 12 (activity therapists and play room)

 

But you don’t have to stay in your room all day.

There is also a play lady named Amber who sets up activities both in the playroom and in the kids’ rooms.  There’s arts and crafts, games, playstation, movies, and books.  Sometimes special entertainers come to the floor, such as the music therapists, magicians, and clowns.

 

 

Slide 13 (trick or treat in hallway)

 (spiderman)

 (batman)

 

Andy was still in the hospital when it was Halloween and he was feeling pretty good so he came out to the hallway for trick or treat.  The nurses all got dressed up that day too.

 

There he is dressed up as batman.

 

And here he is as spiderman.

 

I don’t have a picture of this but…

Another thing Andy enjoyed doing when he was in the hospital was playing tricks on the nurses.  He had a special toy oven that made creepy crawlers and sometimes he would hide them in places and when we would find them, we would scream.  He has a very good sense of humor. 

 

Slide 14 and 15 (Jimmy Fund)

 

After the doctors decided Andy’s new bone marrow was making enough good blood cells Andy got to go home from the hospital.  But he still had to go for a lot of appointments at the Jimmy Fund Clinic. It’s a doctor’s office that is right across the street from the hospital.

 

Slide 16 (Andy’s blood draw without cvl)

 

Andy’s better now, so he doesn’t need to go for as many appointments any more and he doesn’t need to get his blood drawn very often.  He doesn’t have his central line anymore, so once in a while when he gets blood drawn, it’s the regular way.  Some of you may have had your blood drawn before.  Look how brave he is!

 

 

Slide 17 (outside picture)

 

 

Since the bone marrow was still new after Andy got out of the hospital, he needed to be protected from germs that could cause an infection.  Even though Andy’s new bone marrow was working, it’s wasn’t working as well as yours or mine.  This means that it was really easy for him to catch germs.  So he had to be extra careful and there was a lot of rules about what he could and couldn’t do for a while after he got home from the hospital.

 

Here’s some things that he could do:

 

*go to the clinic (wearing mask):  (Anne Marie show mask)

 

*play at home, be in his yard

 

*be outside in open spaces, where there’s not a lot of people

 

 Everyone was working really hard to make sure that Andy  didn’t catch any germs.

 

 

 

Slide 18 (the crowded places slide)

 

What he couldn’t do and where he couldn’t go:

 

*school:   A lot of kids it takes about a year before they can go to school after a bone marrow transplant

 

*to the mall (why do you think?)

 

*to the supermarket

 

*to the movies

 

*anywhere where there’s a lot of people

 

Slide 19 (Andy and family and dog at home, need picture)

 

So now, as you know, Andy’s all better and he can be back at school with all of you.  That makes us all very happy, and very proud of him for all he had to go through to get better.  It was a lot of hard work. 

 

Now that’s the end of our slides so we are going to shut off the projector but we still have a few activities….

 

Does anybody know what unique means?

 

That’s right, it means different, or special in some way.

Andy is unique because he had a bone marrow transplant.  I think he’s also very unique because he got a chance to meet a lot of the famous Red Sox in person.  Everyone is unique in some way.

 

Like for example, I am very old but I can still do a cartwheel.  Anne Marie, what’s unique about you?

 

Now some of you may have noticed that Andy is smaller than most kids your age.  He needs a special desk and chair in the classroom.  That’s because some of the medicine he got when he was younger interferes with growing somewhat.  But he recently had a checkup and he is growing now and getting bigger.

 

 

Would anyone like to share anything unique about themselves?

(give a chance for participation)

 

 

But in most ways we are the same, aren’t we?  I’ll show you some examples.   First I need you to all stand up. 

 

Okay, everybody who’s in second grade, sit down. (everybody sits down)  See, that’s a way that you’re all the same. 

 

Okay stand up again.  If you like school vacation, sit down.  ( See, even your teacher likes that).

 

Okay, one more time.  Who has somebody at home that loves them very much?  If you do, sit down. 

 

See, we are the same in many ways.  And that means we are part of a community. And when we are part  of a community that means we care about each other and take care of each other.  And respect the differences that make us unique and special.    

 

 

Now we have just one more thing to do today, and that’s talking just a little more about germs.  And that’s because not spreading germs is one way that we take care of each other.

 

So first I want to find out what you know about germs…what are some ways we stop the spread of germs?  (Many hands will raise).

 

Washing our hands.

 

When’s a good time to wash your hands?

 

What do we do when we sneeze?

 

Do we come to school if we are very sick? Why not?

 

 

Now I need some volunteers for the soap experiment…This is an experiment where I prove to you that you need soap and water, not just water, to get rid of germs.  Andy will you be my soap expert? Okay and I also need someone who wants to pretend they don’t like to wash their hands.

 

Okay, here’s some pretend germs, they are really stuck to your hands.

 

Now you’re going into the bathroom and just going to rinse your hands with water and come out and show us what happens……did the germs come off? (NO!)

 

Now Andy, will you go into the bathroom and scrub your hands with soap and water. Yup, first wet them, them rub the soap in and rinse them.  How long should it take to really wash your hands?  About as long as it takes to sing happy birthday.  So why don’t we sing happy birthday while Andy washes his hands. 

 

(sing happy birthday)

 

Andy come on out and show us if the pretend germs came off.

 

So next time you wash your hands, what are you going to use? (SOAP!) By the way, hand sanitizer or purell  is also a good way to get rid of the germs on your hands. 

Well, that’s the end of our presentation. 

Does anyone have any questions about what we’ve talked about or learned today? 

 

Allow time for questions. 

 

If anyone has any questions after we leave, you can ask your teacher, and if he doesn’t know the answer he can email us and we will try to get the answer for you.  Thank you so much for letting us come today, and thank you to Andy and his family for inviting us to come to the school and talk to you.