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I have always heard people talk about the germs and sicknesses their kids bring home from school and how they try to protect their children. But when you have a child with Alagille syndrome (ALGS), concerns about schoolhouse germs are amplified. These concerns are especially relevant when your child has had a liver transplant. 

My son has done well post-transplant in terms of limited hospital admissions, overall good lab work, and no rejection since our initial stent a few days after the transplant. He does seem to get sick more easily than his siblings, but it does not seem like it takes him extra long to fight it off. 

Over the summer we had a great streak going where he was not sick at all and even avoided sicknesses his siblings had. However, when he went into kindergarten I was not sure what to expect. 


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We are just entering our fourth week of kindergarten. I expected my son to bring home some germs and have a cold, but I was not expecting anything crazy. He went to preschool last year, granted for only 3 days a week, but he did well and did not have any sort of increased illness in my opinion. The preschool also went from masking for COVID-19 to letting the kids start attending unmasked and it did not increase any sort of sickness for him. 

I can now state I was so wrong in my thinking that it would be an easy transition. It is a month into the school year and my son has already missed 5 days of school. 

Before school started, I had the pleasure of having a conversation with the school nurse. I let her know that he’s immune-compromised and that it is important to keep him safe. I told her I would need to know certain things, like if there was an outbreak of the flu at school or if several kids in his class were getting sick with certain viruses.

I know there are HIPPA laws surrounding this type of information, so I made it clear I did not need to know who it was or if they were even in his class, but I just needed to prepare and make the decision whether I needed to pull him from school to avoid the sickness. 

The first week he got sick it was a pretty nasty cold, but manageable, and we were able to get him back to health and sent him back after missing 3 days. The following week, he got sick again. When I picked him up from school, I noticed another runny nose, and immediately my heart sank. I was hoping it was just allergies or from getting colder outside, but of course, as expected a day later, he got an extremely high fever accompanied by vomiting. 

It has already become frustrating to me that he’s missed so much school and that we have been dealing with constant viruses. Not only is he sick, but the viruses are passing on to his siblings and everyone is continuing to be run-down. I have spoken with the school another time and am trying to get certain things put into effect like separating him from students who seem sick and ensuring he can wash his hands before lunch instead of using hand sanitizer. I know it may take some trial and error and adjusting, but I’m hoping we can settle into a good spot, especially before winter illnesses come along.