By MICHAEL E. YOUNG / The Dallas Morning News
Friday, December 1, 2006

Keith Gaisford likes hitting plastic golf balls in his back yard - especially if they clear the fence or land on the roof and his daddy has to fetch them. And he likes school and T-ball and playing Hungry Hungry Hippos.

Most of all, he likes being with "Miss Kelly," Kelly Kinamore, who served as Keith's child life specialist during his all-too-frequent stays at Children's Medical Center Dallas.

So when 5-year-old Keith was asked to be one of about 45 Children's patients to take part in Saturday's Neiman Marcus Adolphus Children's Parade, he said sure - as long as Miss Kelly rode beside him.

Keith may not have realized it, but his choice was perfect, because all proceeds from the parade support the child life program at Children's, Ms. Kinamore said.

Since 1988, the parade has raised more than $1 million for the program.

Children's parade participant Keith Gaisford, 5, with mom Martha, has had one liver transplant and needs another.

Ms. Kinamore has been at Keith's side for much of his life - on his hardest days and his best ones, too.

Bright, inquisitive and cheerful - he laughs aloud as he shows a visitor a carol-singing Big Mouth Billy Bass at his North Dallas home - Keith mostly lives a normal life, his parents said.

"He's in school, he has play dates, we do family holidays," said his mother, Martha. "We just can't go very far."

When Ms. Kinamore began working with Keith, he was 2 years old and already had spent much of his young life in the hospital. At 2 months old, he received a diagnosis of biliary atresia, a rare condition that prevents bile from draining properly from the liver, damaging and scarring the organ.

A precarious operation "bought him some time," as one of his surgeons explained to a family member. Six months later, Keith received a liver transplant, with one of his aunts donating a portion of her liver.

"He got the transplant, and a week later he had to go back in, and then two weeks later he coded and went into septic shock," Mrs. Gaisford said.

"They tried to prepare us for some bad things," she said.

"But we didn't believe them. And neither did he," Mr. Gaisford said, nodding toward his son.

"That's when we think the [new] liver sustained most of the damage," his mother said. "Then two years ago, Thanksgiving '04, he contracted a virus and took a hit, 30 percent damage to the liver.

"We weren't sure how we'd come out of that one," she said. "But Christmas
Eve, we came home."

In the midst of all that, Ms. Kinamore began working with the Gaisfords, answering their questions and serving as a liaison to their doctors.

Mostly, though, she helped a growing child deal with all the tests and procedures he faced as his ability to understand grew and evolved.

Kelly Kinamore, Keith Gaisford's child life specialist at Children's Medical Center Dallas, has used "medical play" to help him understand what he's going through.

"He was in and out of the hospital a lot and at an age when he started to question what was happening - why he was in the hospital and other kids weren't," Ms. Kinamore said. "He was starting to act out, as all kids do when they're in and out of the hospital.

"That's when the 'medical play' really helped him turn around."

His mother is still amazed at the transformation.

"It was incredible," she said. "I did not know him. But Kelly came with some doctor materials and a 'Shadow Buddy' doll, and they did some shots and some other things, and the turnaround was amazing."

"We used real medical equipment on a doll and let him work through his emotions," Ms. Gaisford said. "He named his doll after one of his surgeons."

Now when Keith spends a night or two at the hospital, "he's never ready to come home," his mother said. "We had a week stay in June, and when I was packing up his room, it was, 'No, Mom, can't we go home tomorrow?' "

"All my friends are there," Keith said.

He still makes weekly visits to monitor his condition. And he begins each day with medication.

"It's a part of his everyday life now, and it will be for the rest of his life," his mother said.

Keith is a bit smaller than most kids his age, and his tummy is distended because of an enlarged spleen, "one of those collateral things that have happened along the way," Mrs. Gaisford said.

And through his medication, he now has osteopenia, which makes him more susceptible to fractures. So we aren't pushing a bike."

Mostly, Keith is eager to do the things other 5-year-olds do. He charges down the hallway of his home, showing off his toys. Then he clomps into the living room, strapped into a pair of skates.

"Can you do me two big favors?" he asked his mom. "Push down on that [buckle] and tighten up on this one.

"Mom, I need the pant leg on the inside," he instructed.

What does he want for Christmas?

"A fish bowl and a Game Boy," he said.

Seconds later, Keith had an addendum.

"Mom, Mom, I just made this up on my list, maybe for when I'm 8 or 7 or 9 - a kitty!"

"He has it in his head that he needs a pet," his mother said.

"I'm going to walk it every day," he replied.

Mr. Gaisford calls Keith "the little big man."

"He's tougher than I am, I'll tell you what," he said.

Given what he's been through, and what he faces, Keith has needed to be.

Several months after coming home from his lengthy hospital stay two years ago, he was placed on the transplant list again, for a second liver.

The first time, surgeons took a piece of his aunt's liver. This time, his father said, Keith needs a whole organ.

"We have to have all the plumbing," Mr. Gaisford said. "The bile ducts are a problem. The hepatic artery is a problem."

And finding a liver, the largest organ in the body, to fit a small child is perhaps the biggest problem of all.

While there aren't nearly enough donated organs to meet needs, transplant officials say, child donors are extremely rare.

Fortunately, Keith's needs haven't reached the critical stage yet.

And he has so many things to do, so many games to play.

"We are, I think, so fortunate for his attitude," his mother said. "When we're at the hospital, he's just, 'Let's get this done so I can play.' We couldn't be more blessed than that."

She turned to her son and asked about his big day on Saturday.

"Keith, who will you see at the parade? Tweety Bird? Sylvester? Wile E. Coyote?"

"Miss Kelly," he said.