Tag Archives: health

Caring for Caregivers: Unsung Heroes of Health Care

We are proud to assist family caregivers during National Family Caregivers Month and throughout the year by helping individuals facing a medical crisis fundraise for their out-of-pocket costs, including caregiving expenses. This post from our friends at the Mesothelioma Cancer Alliance highlights how caregivers can care for themselves, too.


graphic-caregiving

November marked National Family Caregivers Month, a time to celebrate the silent givers behind those who need care. It is a month to show support for the tireless work caregivers put in for their loved ones. This year, President Obama released a presidential proclamation stating, “During National Family Caregivers Month, we reaffirm our support for those who give of themselves to be there for their family, friends, and neighbors in challenging times…” Caregivers are often the unsung heroes of home health care, so during the month of November and all year round, we raise awareness for these caring individuals and the issues and hardships they face.. It is a time to celebrate the selfless work caregivers do and provide our support.

Twenty-three percent of family caregivers who have been caring for their loved ones for five or more years report that their current health is fair or poor. More than 65 million people, or about 29% of the United States population, provide care for someone who is aging, chronically ill or living with a disability. They are spending an average of 20 hours every single week caring for their loved one. There is little wiggle room for “sick time,” vacations, or paid time off. Caregivers are often bound to a schedule that they must adhere to for the sake of somebody else’s health.

This information has inspired the Caregiver Action Network 2016 National Family Caregivers Month slogan, “Take care to give care.” It signifies that before you can take care of someone else, you must first take care of yourself. To better care for yourself as a caregiver, you can follow some of the tips provided by the Mesothelioma Cancer Alliance:


Do what you love.


Don’t neglect your own personal life to care for somebody else. Maintain relationships with friends and family. Set time aside to do activities that you enjoy! Even if you must schedule time on your calendar, it’s important to take time for yourself. It’s particularly helpful to take time doing activities that you like and ones that help you relax! Everyone needs a mental and physical break now and then.


Be heard.


Cameron Von St. James, caregiver to his wife, Heather, who is a 10-year mesothelioma survivor (click here to learn more about mesothelioma), offers these insights: if you know a caregiver, offer him or her your ear – someone to talk to. Caregiving can be stressful, so having someone to talk to helps. It helps caregivers to feel socially connected and reminds the caregiver that there are people who care about them.


Know your limits. 


Always remember that there are limits to what you can do as a caregiver. Set realistic limits for yourself and communicate those to your support system. Don’t be afraid to reach out to those around you for help and support.


Focus on your health and well-being. 


Get plenty of sleep, maintain a well-balanced diet and be sure to get exercise. Your health is crucial. It won’t be possible to care for your loved one to the best of your ability if your health and well-being are suffering. Be sure to visit your doctor regularly for checkups, and schedule an appointment if you are sick.


This guest post was provided by the Mesothelioma Cancer Alliance to support caregivers across the country. Want additional information on what it means to be a caregiver? Check out our archived Blog posts.

Gamers, Rejoice! New Science Says Video Games Improve Wellness

In 2015, a group of gamers played The Legend of Zelda for 150 hours straight to raise money for our nonprofit. Their efforts made a significant impact in the lives of our clients and their families. While Zeldathon Hope was raising over $250,000 for charity, the marathon was also raising an interesting question: are video games inherently damaging to health and wellness?

Pokemon GO

Are video games helpful or harmful to our health?

Though some interactive games like Pokémon GO may be an exception, don’t video games basically require participants to be sedentary and isolated? As reporter Martha Clement Rochford put it, “The good news for gamers is that science disagrees.” Here are 5 ways that video games can promote physical and psychological wellbeing based on recent scientific research.


Video Games Enhance Our Reaction Times And Precision


Researchers at the University of Rochester recently concluded that playing an action-based video game daily “has a beneficial effect” on players’ brains. Engaging in a stimulating gaming experience for 30 to 40 minutes per day can improve eyesight, reaction times, mental rotation capacity and the player’s ability to move efficiently from one task to the next. Researchers concluded that if games released in the future are planned and developed specifically for people with chronic conditions, they “can help patients with chronic illness, anxiety and pain management” by encouraging healthy cognitive development and greater physical strength and dexterity.

Call of Duty

Action games “generated a moderate helpful effect on the overall cognition”

Other recent studies have corroborated those claims, finding that “action games generated a moderate helpful effect on the overall cognition.” Action games like Call of Duty help to develop “fast and precise responses” and “may produce structural changes in the brain“ by encouraging greater neural plasticity, particularly in young adults whose brains are still developing. Greater neural plasticity means an enhanced ability to learn and remember new information, adapt to change or react quickly to new circumstances and challenges.


Video Games Help Us Study And Fight Cognitive Decline


A trial in the United Kingdom is studying how Parkinson’s disease impacts cognition. The twist? Researchers will be using “a scientifically-designed video game as a non-invasive medical device.” The game will be specialized based on each participant’s unique mental processing and memory storage challenges and will offer “holistic training” to improve memory, processing speed, function and attention.

Link Zelda

New games could be used “as a non-invasive medical device” for cognitive training

For now, the initiative will focus exclusively on testing the potential for video games to improve life for people living with Parkinson’s disease, but the results could influence how medical professionals assess and treat multiple cognitive conditions, including traumatic brain injuries, PTSD and “cognitive deficit caused by cancer.”


Video Games Can Be A Physical Rehabilitation Tool


“When I was at Rusk Rehab at NYU Langone,” explains HelpHOPELive client Nicole Seefeldt, “I saw the hospital-based rehab center using Wii Fit and Wii Sport to rehab certain skills in their patients at all age groups. It inspired me to get one because I saw that patients were not only enjoying it but receiving benefits from it.

Wii

Nicole saw Wii games used as tools for hospital-based rehabilitation

Nicole also believes apps can help encourage people to engage with physical therapy and get in touch with their health in a way that “is a lot more dynamic than just sitting in a chair with weights. Several systems also have brain games which are good to play for cognitive development, too.”


Video Games Have Meaningful Psychological Benefits  


Gaming doesn’t just physically alter and improve your cognitive capacity. According to studies on the psychology of gaming, “gamers can address their fundamental psychological needs through playing games.” As cyberpsychologist Berni Good concluded, gaming can help players to feel competent as they master each level and challenge, which improves their psychological wellbeing. Whether through a multiplayer online game, couch co-op or a little social media gloating, gaming can also help players to “relate to others in a meaningful way” as they collaborate on game challenges and share their experiences with others.

Zelda coop

Personal achievements and co-op play can improve psychological wellbeing

Don’t think these results only apply to massive multiplayer action wars or shoot-‘em-up thrillers. Gaming can also tap into “the idea that we need to be masters of our own destiny,” encouraging players to feel like they are making independent choices that are reflected in real-time changes to the game environment or questlines.

Zeldathon

Moffit (center) believes gaming for good can lead to emotional fulfillment

Combine video games with good deeds, like the Zeldathon Hope team, and you have a recipe for social and emotional fulfillment. “We’re creating something more than just a marathon,” explained Zeldathon founder Matthew Moffit. “We’re a real community, dedicated to forces of good. We like to think that we’re working to defeat the evils of the world through our marathon.”


Video Games Help Us Track And Treat Chronic Symptoms


Microsoft Research in Cambridge is tapping into the Xbox Kinect tactile gaming platform to support people living with multiple sclerosis. The console’s motion sensor system will be integral to new research on the effectiveness of MS treatments and the progression of symptoms. Through Kinect-compatible tests, people with MS will be asked to move or touch certain parts of their body and researchers will use a rating scale to track the strength of MS symptoms that affect mobility.

kinect

The Xbox Kinect has been used to track MS symptoms

A recent study found that cognitive training video games developed by neuroscientists could help people with MS to strengthen their neural connections to promote cognitive wellness. MS can impact the thalamus in the center of the brain, leading to the cognitive dysfunction or “brain fog” experience in people living with the condition.

Study participants “had significant increases in thalamic functional connectivity” after participating. One researcher concluded that “video games can promote brain plasticity and can aid in cognitive rehabilitation” for people experiencing cognitive dysfunction due to MS or other brain-disrupting chronic conditions. Researchers hope to use their findings to add to existing rehabilitation pathways for people with MS.


A Bright Future For Gaming-Based Research And Treatment 


Video game platforms and interfaces continue to evolve year after year, and researchers are chomping at the bit to assess their health and wellness applications. In fact, though virtual reality has just barely reached the consumer market, it is already being used to test and diagnose individuals with cognition and memory challenges. It’s good news across the board for gamers, who now have a tangible way to defend their digital obsessions with legitimate scientific research.

virtual reality gaming

Virtual reality is already being used to diagnose some cognition issues

Think these findings supersede the need for balance and moderation in gaming? “When we think about the effect of video games on the brain, it’s very similar to the effect of wine on health,” explained Dr. Daphne Bavelier in a TED Talk. “There are some very poor uses of wine. There are some very poor uses of video games.” But, as new research proves, “when consumed in reasonable doses,” video games can be a beneficial tool for managing symptoms, improving cognition and building positive psychological foundations.


Are you a gamer living with a chronic condition or disability? We’d love to hear about your experiences with gaming and wellness on Facebook.

5 Major Transplant Headlines You Missed

Here are some of the milestones and newsbreaks that have touched transplant families since this time last year.


5. Scientists 3D Print Human Body Parts


After a decade of research, scientists managed to engineer functional human body parts including bones, muscles and ears.

Lab grown organ

Will lab-grown organs replace donor organs? Photo via source.

Quote: “This technology could potentially be used to print living tissue and organ structures for surgical implantation.”

Click for more


4. Total Artificial Heart Could Eliminate Transplants


After a 60-year break, the total artificial heart (TAH) is being revisited as a potential permanent implant that would eliminate the need for heart transplants.

Total Artificial Heart

Diagram of a Total Artificial Heart. Image via UCLA.

Quote: “There are people that are desperate for this technology…I think it has the potential to save a lot of people’s lives”

Click for more


3. Ending The Waiting List…In Our Time?


In addition to lab-grown organs, bioprinting and cold storage could dramatically improve circumstances for transplant candidates on the waiting list.

bioprinting

Will bioprinting and cold storage end the waiting list? Image via source.

Quote: “We can expect the first fully engineered bioidentical no-immune-suppression-needed organ transplant in humans within 10 years.”

Click for more


2. Have Money, Will Transplant


A study indicates that wealthy people are more likely to secure a transplant and less likely to die while waiting for one.

Money organ transplant

Can money get you on a shorter waiting list? Image via source.

Quote: “It takes money and knowledge…traveling can make a huge difference in how quickly you get an organ.”

Click for more


1. Incompatible Donors Can Donate A Kidney


Donors may now be able to give a kidney to an incompatible recipient through a process called desensitization.

incompatible donors

Incompatible kidney donation is now possible. Image via source.

Quote: “Desensitization…can cost about $30,000 [but] dialysis would rack up a higher price tag and a considerably lower quality of life.”

Click for more


Did a health headline touch your family this year? Reach out to us on Facebook and share the stories that moved you.

HelpHOPELive Clients In The News March 2016

Spring is a season of hope, renewal and rebirth. For these three clients, spring represents a chance to enjoy a healthier, happier future with help from community fundraising.


Scott Truran: Veteran Sets Sights On Treatment For Debilitating MS


Thirty-nine-year-old Scott Truran was diagnosed with a progressive form of multiple sclerosis in 2011. Before the diagnosis, the former Marine was very active and prioritized staying in shape. Today, he has to rely on a cane to walk and his right side feels like it’s been “dipped in concrete,” he explained.

Scott Truran HelpHOPELive veteran MS

Scott will continue to lose mobility as his MS progresses

Scott will continue to lose mobility as his MS progresses. It’s likely he will eventually need a wheelchair to get around. Scott and his family learned about a treatment option for MS that may help to limit Scott’s mobility losses. The treatment involves wiping out his immune system with low-dose chemotherapy, then using stem cells, previously harvested from his blood, to rebuild a new immune system. This treatment option is only available as a clinical trial in the United States. Scott and his family will need to raise $80,000 to receive the treatment in Mexico as well as additional funds to offset the out-of-pocket costs of travel and temporary relocation for Scott and a caregiver.

Scott Truran HelpHOPELive veteran MS

Scott is appealing to his community for support for his treatment goals

“The money is the biggest obstacle,” Scott explained, “but it’s a small price to pay for a chance to slow [the] disease or stop it entirely.” Scott will fundraise with HelpHOPELive to maximize his chances of securing the funds he needs to potentially halt or reverse the progression of his MS. (Veteran’s family asking for help with progressive form of multiple sclerosis)


Theo St. Francis: Young Man With Spinal Cord Injury Plans “His Comeback”


In 2013 while taking part in a pre-orientation at MIT, Theo broke his C6 vertebra in a diving accident. Theo became paralyzed from the chest down with some shoulder and arm movement and limited finger dexterity. Doctors told Theo he would likely never walk again.

Theo St. Francis HelpHOPELive

“I am done managing. I am overcoming.”

As the Sonoma Index-Tribune reported, Theo “set his brilliant mind toward devising a plan for his comeback.” In December 2015, Theo reached a major milestone when he was able to sit on a barstool during a celebration with friends. He tries to spend time away from his manual wheelchair, pursuing activities that “align with what my goals are,” from driving an adaptive car to biking, skiing, surfing, kayaking and traveling.

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Fundraising with HelpHOPELive is allowing Theo to pursue the intensive spinal cord injury therapies he credits with helping him improve his mobility over time. Theo emphasizes the word “recovery” and spends his days looking forward. “I put the impossible in quotes,” he explained. “I am done managing. I am overcoming.” (Theo St. Francis overcoming odds to regain mobility)


Michael Mahan: Community Supports Man Facing Intestine Transplant


In 2012, what Michael Mahan and his family believed to be an upset stomach turned out to be a dangerously twisted small intestine. Since doctors removed the failing organ, every 6-8 weeks, Michael ends up back in the hospital with septic blood. With no small intestine to help his body process food, the husband and father of three relies entirely on intravenous nutrition as he waits for an intestine transplant.

Michael’s priority today is raising funds to cover the out-of-pocket expenses associated with an intestine transplant and follow-up care. He may need to spend up to 10 months in a transplant center after the procedure, and the cost must be paid up front before he can be put on the transplant waiting list.

Michael Mahan HelpHOPELive

Michael is a husband and father of three

Fundraising with HelpHOPELive is helping Michael to secure the funds he needs to get the transplant, but it’s also connecting his family with their supportive community. “We’re just so excited to do everything we can to help him out,” said local resident Jon Rosenlund. “He is a wonderful man and a great father. It’s an honor to help him, but we need a lot of help.” (Fundraiser to benefit man awaiting intestinal transplant)


Get your campaign in the news! If you need help with press releases and media outreach, contact your HelpHOPELive Fundraising Coordinator today.

Post-Transplant Expenses You Need To Know About

Jennifer Alley was born with myopathic intestinal pseudo-obstruction, a chronic rare disease. She received an intestinal transplant in 2004 with support from her husband and son.

Jennifer Alley HelpHOPELive


How has the transplant impacted your life?


I have been sick since birth. Before my transplant, I was always in and out of the hospital and I had three internal tubes: one to empty my stomach, one to empty my bladder and one that served as a permanent IV line in my chest to deliver total parenteral nutrition (TPN). My body is now free of those tubes! Before my transplant there was no chance of me having a baby, but thanks to my organ donor, I was able to give birth in 2008. To honor my donor, we gave our son my donor’s name, Steven, for a middle name.

Jennifer Alley HelpHOPELive

“We gave our son my donor’s name, Steven, for a middle name”

It’s important to realize that a transplant is an improvement, not a “poof, it’s gone!” cure. Transplant recipients are immunosuppressed, so I can get sick very easily. Even something like the flu is much worse and much more threatening to me than to others, so we are always asking family members if they are sick before we go to see them. There are also certain foods I still can’t eat.


Are there emotional adjustments?


A transplant has a big emotional impact. I still am in and out of the hospital at times and I still have to leave my home and go to the transplant center in Pittsburgh when things go wrong. That includes leaving my son at home with my parents when my husband and I go. I miss my son and family so much when I’m there. My dogs help me emotionally; they have since I was little. Not having a dog with me at Pitt is hard!


Were you prepared for the financial impact of your transplant?


We knew getting a transplant would be expensive and it certainly was. A small intestine transplant is one of the most expensive transplants out there. However, we were not prepared for the post-transplant care expenses. After transplant, you have ongoing expenses to keep your organ working. That has taken a financial toll on our family.

Jennifer Alley HelpHOPELive

“You have ongoing expenses to keep your organ working”


What are some of the post-transplant expenses that recipients must cover?


Some things you have to take into account are lodging, rent or mortgage payments while you relocate, meals, gas, airfare, and lab and biopsy expenses, which are ongoing, frequent and costly. Then there are co-pays for clinic trips and doctor visits. Medication co-pays can add up, especially early on when you are taking a lot of meds and the meds can change frequently. During every trip to Pittsburgh, there is a chance that we could need to be up there for weeks or months. And then there are some rare but very costly expenses that can come up, like a medical jet or helicopter ride if something is going very wrong and there isn’t time to take a commercial flight.


How do you combat high post-transplant expenses?


The costs are very extreme and unpredictable, so it is very important to fundraise. I will continue to fundraise for my care. Fundraising can help you cover medical expenses and get the care you need post-transplant.


Follow Jennifer’s story on her HelpHOPELive Campaign Page. Which post-transplant expenses has your family encountered? Reach out to @HelpHOPELiveOrg on Twitter and your story could be featured next!

Voices of Hope: Living With LAM

I once wondered if I would make it to age 30; I’m 38 now. I am Nicole Seefeldt, and I have been living with the chronic lung disease lymphangioleiomyomatosis – more commonly known as LAM – for more than 10 years.

Nicole Seefeldt HelpHOPELive

Nicole after an improv workshop


My Story


In 2010, I began having a yearly talk with my doctor about a (double lung) transplant. I was feeling fine at the time with my LAM, but my doctor knew it was a good idea to bring it up as soon as possible to prepare me. At every session, the doctor would check my oxygen numbers to determine whether or not getting evaluated for a transplant would be in my immediate future.

For me to stay on my insurance plan, I had to work 30 hours a week. That was a significant reduction to my original work hours, but my energy levels became so unpredictable, I could only work for an hour or two on a good day before needing a break. I was planning to work up until my transplant evaluation, possibly part time. But my doctor advised me to quit working in July 2015 when I experienced a rapid drop in my oxygen levels and had to be taken to a hospital immediately. My doctors still don’t know what caused the desaturation, but since then, I have needed oxygen 24/7.

I had to talk with my parents and friends to tell them I would need their support and a dedicated caregiver to help me through the process. My best friend stepped up right away! Luckily, support is one thing I was not lacking as I began to prepare for transplant: I am well-connected via social media, volunteer work and improv comedy, which I like to do in my downtime.

Nicole Seefeldt HelpHOPELive

Nicole set a goal of $20,000 when she started fundraising

When I started fundraising with HelpHOPELive, I set a goal of $20,000 in order to cover the expenses I would be responsible for when the time came for my transplant. The $20,000 would also allow me to receive two challenge grants from HelpHOPELive.

HelpHOPELive: Contact your Fundraising Coordinator today to learn more about how to get a challenge grant when you reach a fundraising milestone.

Since last year, some of my disability insurance benefits have been decreased, changed or even eliminated, so my out-of-pocket expenses may continue to increase, especially the temporary housing costs I’ll face during my post-transplant recovery period (I don’t meet the distance requirements set forth by my insurance provider to be covered or reimbursed for this expenses). That’s why fundraising is an essential part of this journey.

It’s easy to feel shame and guilt when you have to stop working because of an illness. Fundraise to take some of the pressure off for you and your family and free up your expenses to stay afloat until you can get to a healthier place. It’s important to be transparent if you’re struggling. You have to say, look, this is why I need this money: I am on X medications that cost me X per year; my insurance premiums cost me X per month, even with Medicaid. People understand that as long as you give them something quantifiable.


How I Keep Hope Alive


There are a few things I do to fight back while I wait for a life-changing transplant:

  1. Keeping myself healthy. My exercise levels are back to a healthy level so I can do a few light weights and other things to build up my upper body for transplant. I need my upper body to be strong enough to rebound and heal after the transplant takes place. There were times in the past where I wouldn’t feel good and would get frustrated with exercise. But exercise is one thing I feel like I can control, and my lungs feel much clearer when I do it. It’s the one gift I can give my medical team to fight back.
  1. Staying patient. Living with a chronic illness and facing your own mortality puts your priorities in order in terms of what you value. Ultimately you learn that it’s rough, but it’s not insurmountable. You find your ways to cope and reconcile things. You have to at least in some aspect use whatever you have to fight back and to hang in the fight. I’m empowering myself and other people to make life more manageable. Maybe the research is too late for me but it might not be too late for someone else.

Nicole is fundraising with HelpHOPELive for LAM-related expenses, including a limited period of lost wages as she remains on long-term disability, COBRA insurance payments, oxygen rentals and other uninsured costs.

Voices of Hope: Celebrating Black History Month

February is Black History Month, an opportunity to delve into the unique challenges and triumphs experienced by African-Americans. Here are two client perspectives on coping with discrimination, holding onto hope and serving as a self-advocate for your health.


David A. Jeffers

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David (above, with his wife Yasmine and sons) became paralyzed while at the beach with his family in August 2011. His family began fundraising with HelpHOPELive a month later.


Have you personally experienced or witnessed discrimination?

I’ve experienced discrimination both as a result of being black and as a result of being disabled. I have been treated as uneducated and unintelligent. People often choose to talk to my wife instead of me and ignore me, even when I address them directly. Little do they know that the black guy in the wheelchair is an active father, husband and mechanical engineer who graduated with the third highest GPA in my major.


How have you served as your own advocate?

Honestly, I’ve had to fight for almost every service I’ve used and the assistance I’ve received, including public transportation, rehabilitation and making sure neighborhood amenities are accessible. I document my experiences on my blog. I would advise others who face a similar struggle not to take ‘No’ for an answer. You must be persistent. For several issues I encountered, it took months to find a resolution.


What does Black History Month mean to you?

I wish we didn’t need to have Black History Month. I wish the history books and school curriculums could reflect events as they happened with a reverence for all cultures, but until that happens, it will remain an important month to me and my family.


What do you associate with the word ‘hope’?

A catastrophic injury like mine is truly life-changing. I could have died. As a quad, your whole approach to life has to change. You gain a totally new perspective on life. Hope gives me the ability to survive and thrive. Without hope, me and my family would not be as healthy or happy as we are today. My wife and kids are my main motivation and they help me find hope.


David is currently fundraising for Lokomat training ($85 per hour) and exercise therapy ($35 per hour) to improve his mobility. He has noticed a drop in strength and energy level since he stopped therapy in June of 2015 due to financial constraints.


Alison Jones

Alison Jones and son Alerique Dariso

Alison (above, with son Alerique Dariso) was diagnosed with polycystic kidney disease (PKD) when she was seventeen. She is seeking a living kidney donor so she can receive a life-changing transplant. Alison and her son started fundraising with HelpHOPELive in June 2015.


Have you personally experienced or witnessed discrimination?

I have had to seek numerous medical opinions to get treatment. Organ transplantation was never included in potential treatment options as my kidney function declined. I had to initiate the conversation myself. After speaking with other African-Americans, the majority knew people who were on dialysis or had died on dialysis, but only a small percentage knew someone who had received a transplant. In comparison, when I speak with non-minorities, I often hear, “A friend of mine had a kidney transplant. You are going to be just fine.”

The most painful racism I have experienced: one Valentine’s Day while my son was enrolled in a private preschool, he drew a picture of his “valentine,” who had blonde hair. His teacher pulled him aside and told him he couldn’t have a blonde valentine. That incident shaped my parenting and I began to prepare my son for discrimination and teach him that no one can limit his choices in life.


Any advice for other people who are facing the challenges of PKD?

For anyone living with chronic kidney disease or PKD, I strongly suggest participating in a support group. My greatest life strategies have evolved during support group meetings. Speaking with others who are experiencing similar health experiences is therapeutic and helps you to avoid depression.


What does Black History Month mean to you?

Black History Month is a reminder that generations of people have overcome insurmountable obstacles through diligence and continuous effort. Black History Month reminds me that giving up is not an option.

African-Americans make up a minority within the general population, yet we face higher rates of hypertension, heart disease, diabetes and obesity. All of these conditions can lead to kidney failure. One of the reasons I am looking forward to receiving a kidney transplant is so I can teach and advocate for early kidney function testing and proactive health behaviors to change current health trends.


What do you associate with the word ‘hope’?

I am so thankful to all of my loved ones who have supported me during this journey. To me, hope is another day of breath and opportunity. Every time God gives me another breath, I want to make it count, and that is living hope. After my life, hope will be there for more generations to strive to reach their highest level of potential and opportunity.


Alison is fundraising for uncovered costs associated with her kidney transplant preparations, including the cost of a lifetime of post-transplant anti-rejection medications.