Three Young Adults. 22 Years.

Interview with Jill Woodworth, mother of 4, three with Tuberous Sclerosis, managing the transition from pediatric to adult medical care. Fascinating, frustrating, heart-breaking, and inspiring. Silos and boundaries,  crossing the threshold, primary physician,  autonomy, self-management. One of the scenarios with the most boundaries, cracks, and thresholds is where young adults with complex medical conditions transition from pediatric to adult care. "If there's any communication, that has to go through me. Unfortunately, I have to network that system and that's just really cumbersome." "I can also help other people that have questions about how to transition. I'm certainly not an expert. But boy, it is something that I wish I always say do it the earlier the better. The earlier you can think about it the better." "He's learning. Like I taught him to get his own meds, you know, it's kind of meeting each one of them where they are and what they can do. But it's hard."

Throughout my 45-year career in health care, I’ve been attracted to boundaries, the cracks between those boundaries, and have found myself drawn to welcoming people as they cross the threshold between those boundaries and cracks. Healthcare professionals often refer to silos. The silo of cardiology, the silo of surgery – silos by specialties. Then the silos of setting – hospital, home, clinic, long term care, emergency care, intensive care. Then the silos of professions – doctors, surgeons, nurses, therapists, then “other” professionals – social workers, acupuncturists, chiropractors. So, you see where I’m coming from when I say boundaries and cracks. Well, I’m a fixer by nature.  Not the Michael Cohen variety of fixer but making it better. And the opportunity for better can be found at boundaries and cracks. These boundaries are never going away. It’s a product of specialization. To be an expert in something you need boundaries. “My specialty is within these boundaries.” Therefore, fixing can be found when we treat boundaries as thresholds and welcome people across thresholds.

In my experience, one of the scenarios with the most boundaries, cracks, and thresholds is where young adults with complex medical conditions transition from pediatric to adult care.

So, welcome to the Health Hats podcast series about young adults transitioning from pediatric to adult medical care. In this series, I will interview young adults with complex medical conditions, their parent or guardians, point-of-care clinicians caring for these young adults, and whoever else I find of interest in this fascinating, frustrating, heart-breaking, and inspiring world.

My first interview of the series is with Jill Woodworth, a mother of four who has three children with Tuberous Sclerosis. Tuberous Sclerosis Complex or TSC is a genetic disorder that causes tumors to form in various organs, primarily the brain, eyes, heart, kidneys, skin and lungs. It’s also the leading genetic cause of both epilepsy and autism. I met Jill through her podcast, TSC Talks. I reached out to her and we set up a two-way interview. You can find Jill’s interview of me on her website. It’s Episode 28, Ripple. You can find these links in the show notes.

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Episode Notes
PREFER TO READ, HARD OF HEARING, OR DEAF?
Find full transcript here
Time-stamped sections
Series introduction. 1

Podcast introduction 2:32. 2

Episode introduction 03:04. 2

Please contribute 04:01. 2

One Parent. Three Young Adults. 22 Years.  04:28. 2

Silos and boundaries 04:48. 3

Transitioning? The earlier the better 09:56. 4

Primary physician who knows you best? 12:52. 5

Autonomy. Meet them where they are 12:52. 6

Is there hope for the system? 18:01. 7

How do you find a minute? 20:06. 8