IOWA CITY — As she prepared to take down the Mickey Mouse bed of a little boy she and her husband had just let go, Tammy Mock five years ago fell to her knees, holding his blanket, and felt crushed by the loss that might be familiar to many foster parents.
“A child going back home — if it’s not always in the best interest for the child — is devastating,” Mock, 49, said. “It’s almost like a death in your family, because we had had him for so long. And I was just in his room, just praying.”
It was in those moments — in that sand-colored bedroom of her west-central Louisiana home — that Mock found herself thinking of another child needing a family. Her family.
Within days, Mock would receive a call.
“They asked, ‘Hey, are you willing to take a little girl? She has very special medical needs. She has a trach,’” Mock recalled.
Dr. Sohit Kanotra, a pediatric otolaryngologist now with University of Iowa Health Care, was in New Orleans in 2015 and cared for a battered baby — abused since birth — who had developed blood clots in the brain and challenges breathing. The infant was placed on a ventilator, but the breathing tube created such severe scarring that her windpipe narrowed to the size of a pinpoint.
Kanotra and his team did a tracheostomy, making a hole in the child’s tiny windpipe that allowed her to bypass the narrowing and breathe through the tube. “That’s how I saw her for the first time,” Kanotra told The Gazette, noting, for context, how pediatric trach tubes typically pose “huge life-quality issues” for kids and their parents.
“They cannot talk because they’re breathing through their trach,” he said. “They cannot go swimming. And the parents are always on the edge. Their whole life essentially revolves around the plastic tube in their baby’s neck. So it’s pretty intense for the whole family.”
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That was the intensity facing Mock and her husband in December 2015 in deciding whether to bring into their home an infant with potentially lifelong injuries requiring constant care.
But the baby’s last name was Hope — Keona Hope. And Mock said the baby radiated it, giving the family little pause in saying yes to the foster request.
“I knew right away,” she said — and felt immediately that Keona would be with them forever.
“I believe it was just love at first sight,” Mock said. “I just felt, in my heart, she was ours.”
The adoption process wasn’t simple. Keona’s biological father went to jail, but her mother did not — and Mock had to take Keona for visits, creating stress and anxiety for the child.
“Even at her young age, she would not stop crying,” Mock said of Keona’s reaction to her biological mother. “We would always have to eventually wind back up at the at the doctor’s office because her respiratory system would just go completely out of sorts.”
The Mocks officially adopted Keona on Aug. 17, 2017, allowing them to focus on her health care needs — which were numerous — as Dr. Kanotra endeavored to free the toddler of the restrictive tube.
As director of the pediatric airway program at the Children’s Hospital New Orleans, Kanotra said his center was among only a few capable of performing the airway reconstruction he undertook on Keona in December 2017 — using parts from her own rib cartilage.
“The surgery was a great success,” he said. “And then she eventually started talking for the first time, which is pretty moving for the family because they had never heard her voice.”
Keona’s first word was a greeting, “Hi.”
Then came “mommy, eat, binkie, blankie, and daddy,” before she quickly jumped to complete sentences, according to Mock. Now, at age 4, Keona loves to sing — among her favorites being “How Far I’ll Go,” from “Moana,” and “You Are My Sunshine.”
“The overwhelming joy of hearing her voice makes me thank God every day,” Mock told The Gazette. “We hardly ever tell her to be quiet.”
Although the operation freeing Keona of the tube was three years ago, she still requires annual checks and follow-up operations, which is why the Louisiana family panicked upon learning Kanotra was moving in 2019 to Iowa City to take a position directing and expanding the pediatric airway program at the UI Stead Family Children’s Hospital.
“I was devastated. We all were devastated,” Mock said. “We could not even think of him moving away from here at first. I just cried and cried.”
Once reality set in, Mock said, the family decided, “OK, well, we’re going with you. Wherever you go, we’re going.”
True to the Mocks’ broad and ever-expanding definition of family, Kanotra became one of their clan.
“There are no other doctors that we trust and, in our mind, are capable of taking care of her the way that he has taken care of her,” Mock said.
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For the family’s first trip to Iowa City, they coordinated a travel through Miracle Flights, which provides free flights to families needing medical care outside their communities. The Mocks would have used that organization again for their return visit this month, but the coronavirus pandemic grounded their flying plans.
Considering Keona’s high-risk condition, the family decided to make the 16-hour drive with all their kids — they have five in the house but 10 total, including adult children who have moved out.
And despite the hours and the challenge of avoiding public spaces on a road trip, Mock said they were overwhelmed by their care at the UI Stead Family Children’s Hospital.
“I was blown away by how professional and yet interactive they were with Keona,” Mock said. “It was just so well-organized, and everything just fell in place. It was like, wow.”
Thus the family doesn’t have qualms about continuing treks to see Kanotra in Iowa City as needed. Though the doctor said they won’t be necessary forever. Because, despite her many injuries as an infant, Keona has caught back up to the cognitive milestones for her age.
“She is so smart,” Mock said.
Keona likes playing doctor. She has a stethoscope and Band-Aids and gives shots and does surgery on her dolls suffering various maladies. She’s also kind.
“She is full of life,” Mock said. “She is the most caring, thoughtful, helpful little girl. She’s always wanting to help someone. It’s amazing, and I hope that we’ve played a part in that and showing her, hey, this is what family is, and this is what you do when you love someone.”
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