I first met the Gale family through the University of Iowa Stead Family Children’s Hospital Facebook page. AJ had an infectious smile, and an interesting story.

He was born in 2015 with multiple medical issues, including Down syndrome and hypoplastic left heart syndrome. On top of his long list of ailments, AJ also is dependent on oxygen, a tracheostomy and a gastrotomy tube.

While parenthood is a full-time job, the responsibilities of caring for a child with serious medical conditions requires a lot more work than what meets the eye.

Everything in AJ’s care has to be preplanned and thought out, including providing meals and medications. The family calendar is loaded with medical appointments among other typical family events like school functions and work meetings.

The intention of this photo essay is to give the community a sense of what life is like caring for a sick child — and to show the unconditional love of a family.

Nurse Judy Copriva watches AJ Gale, then 7, as he throws a ball with his classmates during field day at Benton Community High School on May 17, 2023. AJ was born in 2015 with multiple medical conditions including Down syndrome, hypoplastic left heart syndrome, narrowing of his airways and a mutation that can contribute to blood clots. Additionally, AJ is g-tube, trach and oxygen dependent. (Savannah Blake/The Gazette)

Nurse Judy Copriva sings a song with AJ Gale, 8, while his mother Amber Gale does their morning breathing therapy at their home in Keystone on May 17, 2023. AJ wears what they call his “helicopter vest” that helps shake up the mucus in his lungs. AJ has been trach and oxygen dependent his whole life, but received a surgery in 2020 to open up his airways. The procedure allowed him to be off oxygen for short periods of time if his oxygen tube falls out and not have to visit a hospital. (Savannah Blake/The Gazette)

Amber Gale prepares a tube of medicine for AJ Gale, then 7, while his sister, Averie Gale, then 13, plays with him for a moment at a friend’s home in Cedar Rapids on Feb. 17, 2023. The whole family is involved with AJ’s care. (Savannah Blake/The Gazette)

Amber Gale holds hand with AJ Gale, then 7, as they walk to the front door to leave for school at their home in Keystone on May 17, 2023. Amber works from home, allowing her to spend more time with her son, but the family is approved for full-time nursing help through their insurance. However, the family has struggled to find consistent outside help for AJ. (Savannah Blake/The Gazette)

Nurse Judy Copriva walks with AJ Gale, then 7, down the halls before heading out on a field trip at Keystone Elementary in Keystone on May 17, 2023. AJ often misses school because of his medical conditions. The Gale family opted to take him out of school during the winter months to protect him from catching colds at school. A common cold for AJ can mean a trip to the hospital. (Savannah Blake/The Gazette)

AJ Gale, then 7, plays with toys on a large map carpet in his classroom at Keystone Elementary School in Keystone on May 17, 2023. AJ had his first heart surgery when he was 15 days old in Pennsylvania. Due to his heart condition on top of his other medical conditions, the University of Iowa wouldn’t perform the live-saving surgery but did help the family search for second opinions. AJ had two heart surgeries before turning 1, and often flies back to Philadelphia for procedures and treatments. (Savannah Blake/The Gazette)

Amber Gale, left, gathers up AJ Gale’s oxygen tube after finishing up speech therapy while AJ dances in his stroller at ProActive Pediatric Therapy in Hiawatha, Iowa on Thursday, Nov. 9, 2023. AJ has a passion for dancing and requests to listen to music like Pitbull whenever possible. (Savannah Blake/The Gazette)

Amber Gale and family friend Amy Addison put together frozen cubes of blended food for AJ’s meals at the home of Addison’s parents in Cedar Rapids on Feb. 17, 2023. The home in Cedar Rapids has a larger preparation area and a freezer dedicated to AJ’s food. (Savannah Blake/The Gazette)

Amber Gale looks for medical supplies in the basement of the Gale home in Keystone on Oct. 18, 2023. Amber says the family frequently gets donated supplies from the community as they often find themselves waiting on medical supplies due to insurance issues. (Savannah Blake/The Gazette)

Amber Gale prepares AJ’s medications for the week at their home in Keystone on Oct. 18, 2023. AJ receives medications twice a day for his medical conditions. They are given to him through his g-tube. (Savannah Blake/The Gazette)

AJ Gale, 8, laughs as he plays the sock game with his mom while blasting his favorite artist, Pitbull, at their home in Keystone on Oct. 18, 2023. Most everyone in their community knows who AJ is and he can be identified by his smile and willingness to say hi to everyone he meets. (Savannah Blake/The Gazette)

Amber Gale takes AJ Gale, 8, out of his stroller to play before his speech therapy appointment at ProActive Pediatric Therapy in Hiawatha on Nov. 9, 2023. (Savannah Blake/The Gazette)

Amber Gale, left, holds up an iPad to distract AJ Gale, 8, while getting an echocardiogram at his cardiologist appointment at the University of Iowa Stead Family Children’s Hospital in Iowa City on June 7, 2023. The echocardiogram shows a picture of the heart and shows blood flow through the heart and valves. (Savannah Blake/The Gazette)

Amber Gale helps hold up AJ Gale, then 7, to get his height during this cardiology appointment at the University of Iowa Stead Family Children’s Hospital in Iowa City on June 7, 2023. AJ, who has hypoplastic left heart syndrome, visits the cardiologist twice a year to check in on his heart function. (Savannah Blake/The Gazette)

Averie Gale, 14, left, stands by her brother, AJ Gale, 8, and her mom, Amber Gale, as AJ competes in a costume contest during a trunk-or-treat event at the Keystone Community Center in Keystone on Oct. 31, 2023. (Savannah Blake/The Gazette)

A long oxygen tube follows around AJ Gale, 8, as he wanders around a trunk-or-treat event for Halloween at the Keystone Community Center in Keystone on Oct. 31, 2023. AJ is oxygen dependent and carries an oxygen tank everywhere he goes. (Savannah Blake/The Gazette)

Nurse Judy Copriva, right, and Keystone Elementary employee Jenna Fenske walk with AJ Gale, then 7, to the next activity during field day at Benton High School in Van Horne on May 17, 2023. AJ often needs assistance walking longer distances whenever he can’t use his stroller so he doesn’t overexert himself. (Savannah Blake/The Gazette)

Amber Gale, left, and nurse Judy Copriva, right, help AJ Gale, then 7, check his oxygen levels on a pulse oximeter while waiting for his cardiology appointment at the University of Iowa Stead Family Children’s Hospital in Iowa City on June 7, 2023. (Savannah Blake/The Gazette)

Amber Gale pours blended food into bottles for AJ’s meals at a friend’s home in Cedar Rapids on Feb. 17, 2023. AJ is fed through a g-tube, which requires the family to prepare large batches of blended food for him. (Savannah Blake/The Gazette)

AJ Gale, 8, helps his mother press down on a syringe of water to hydrate him after a speech therapy appointment at ProActive Pediatric Therapy in Hiawatha on Nov. 9, 2023. (Savannah Blake/The Gazette)

Aaron Gale, left, Averie Gale, 14, and Amber Gale sit down to eat dinner with AJ Gale at their home in Keystone on Oct. 18, 2023. While AJ cannot eat solid food, the family likes to sit down to eat together whenever they can. (Savannah Blake/The Gazette)

Amber and Aaron Gale clean up AJ after he vomited while painting at their home in Keystone on Nov. 15, 2023. AJ has a hard time keeping liquid down, which means checking his levels more often to make sure he isn’t getting dehydrated or losing oxygen. (Savannah Blake/The Gazette)

Family friend Amy Addison, of Cedar Rapids, French braids the hair of Averie Gale, 14, Nov. 15, 2023, at the Gale home in Keystone in preparation for an upcoming wrestling match. Addison has known the family for almost 11 years and likes to offer a helping hand wherever she can. (Savannah Blake/The Gazette)

Aaron Gale sits back to rest for a moment while watching his son, AJ Gale, 8, play with his toy in the bathtub at their home in Keystone on Oct. 18, 2023. During bath time, AJ’s oxygen tube is monitored to make sure it doesn’t fall out. (Savannah Blake/The Gazette)

Aaron Gale feeds his son, AJ Gale, 8, through his feeding tube while AJ plays on his iPad at their home in Keystone on Oct. 18, 2023. The family goes to a friend’s home in Cedar Rapids every couple of months to make large batches of blended food for AJ. The food is a mix of vegetables, fruits and protein sources that are frozen in cubes and thawed for the next several days of eating. AJ is typically fed through his g-tube two times a day. (Savannah Blake/The Gazette)

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