At Stanford Children’s, a Young Patient Battles Heart Failure—and Rediscovers Joy in Movement

Puuwai was just 4 years old when he arrived at Stanford Medicine Children’s Health in November 2024. His heart was failing. The medical team in the Betty Irene Moore Children’s Heart Center acted quickly, implanting a ventricular assist device (VAD), a mechanical pump designed to keep his heart working while he awaited a possible heart transplant.

The months that followed were marked by a series of challenges for Puuwai—or “Puu,” as his caregivers affectionately call him. Prolonged sedation, limited mobility and numerous medical procedures left him weak, unable to perform even the simplest movements. But in the midst of a complex medical recovery, Puu began another journey: one of rediscovering how to move, play, and to smile again.

Guiding him along that path have been occupational therapist Jen Rivera and physical therapist Leslie Lam, who make up the core of Puu’s Pediatric Rehabilitation Services team. Their sessions have become a daily ritual of music, movement and small but significant victories.

“Witnessing Puu’s bravery as he accepts every challenge we throw his way during our therapy sessions has been an inspiration,” say his therapists. “Our rehab team is honored to be part of his journey.”

Puu’s hospital stay has included many procedures with long periods of sedation. The months of inactivity left Puu weakened. But with a regimen carefully tailored to his needs, his care team has helped him regain basic abilities: moving in bed, sitting up, standing, and now, walking with support.

Their sessions have become a celebration of joy and milestones. The Addams Family theme songs—complete with snapping and dancing—opens many of their sessions. There are high-fives, balloon games to celebrate his stuffed animals’ birthdays, and hugs to encourage standing and strengthening. In one breakthrough, Puu sat upright on a tilt table for the first time and exclaimed, “Happy!”

What makes Puu’s journey particularly unique is the role his VAD plays. The device is used as a bridge to heart transplant, and his medical team specifically selected it to give him time and the strength to undergo intensive rehabilitation.

Now, months into his hospital stay, Puu is no longer just sitting up or standing—he’s cruising the hallways on scooter boards, embarking on scavenger hunts, and flashing his bright smile.  

There’s still a long road ahead. But for his family and his care team at Stanford Children’s, Puu’s courage and progress serve as a powerful reminder of what’s possible.