Room to breathe

Sarah Ostenfeld juggled pharmacy school, baby with cystic fibrosis

The first year of pharmacy school was supposed to be the hard year, adjusting to the rigorous demands of a professional program.

But when the second year began, the classes remained unrelentingly difficult. Sarah Ostenfeld was taken by surprise and cautions, “You can really get burned out if you don’t pace yourself and relax and take a break sometimes.”

For Ostenfeld, however, the biggest challenge of pharmacy school came wrapped in a NICU blanket in September 2015 as she began her third year of the program.

Olive, the baby girl she dreamed about playing dress-up with and taking on family camping trips.

Olive, a name Ostenfeld and her husband Neil picked just because, not realizing Sarah would appropriately don an olive doctoral hood at her pharmacy convocation ceremony.

Olive, who had her first surgery on her second day of life and was diagnosed with cystic fibrosis shortly afterwards. 

A new routine 

When Ostenfeld was pregnant, her classmates asked her if she planned to take time off. No, she decided. It would be harder to drop everything then have to pick it up again. She might have to refresh herself on the material. She would persist.

Olive’s first hospital stay lasted six weeks. The Ostensfelds were forced to accept that hospitalizations would be a routine part of their daughter’s life.

“After you’ve been in the hospital a few times, you just kind of become numb to it,” she says. “This is normal for us. This is what we’re going to do. She’s going to be in and out of the hospital, but we can’t put life on hold. Life goes on.”

Ostenfeld, her husband and her sister Greta took turns sleeping in the hospital, and Ostenfeld’s parents also pitched in so Neil, a piano teacher, could work and Ostenfeld could go to her rotations.

When Sarah returned to classes after giving birth, she said she was amazed by the reception from her peers and faculty at the College of Pharmacy.

“What touched me the most was how incredibly kind and supportive all of my professors were,” she says, especially Amy Grant, associate dean of student affairs and diversity. "Dr. Grant gave me a lot of leeway that semester, and she was always there to talk to me about the things I was worried about and give me a hug when I needed one.

“That really meant a lot to me because it wasn’t just about treating me like another student. They treated me like a human being. To find that in a school is something really special.”

Clinical instructor Kathy Quarles–Moore says Ostenfeld’s calm demeanor through challenging circumstances was inspiring.

“I’ve always thought of Sarah as very strong, and I’ve always had a lot of confidence in her,” Quarles-Moore says. “While I felt the compassion I did for her, I knew she’d be fine. I believed that her strength would come through.

“She was just rolling with the punches and just as calm and collected about it as she could be. The strength I saw in her was tremendous. She is one of my heroes.”

Based on her outstanding academic record, Ostenfeld was inducted into the Rho Chi Society in spring 2015. Quarles–Moore describes her as a conscientious, humble student who took initiative and always went beyond baseline expectations. 

“Everybody always asks about Olive. Our class has really rallied around supporting my daughter, and it means a lot to me.”

Sarah Ostenfeld, Class of 2017 graduate

Ostenfeld is straightforward about how she managed her school obligations while caring for her daughter.

“It’s just a matter of making it work,” she says. “You do what you have to do.” As a type 1 diabetic, Ostenfeld has a lifetime of experience dealing with a serious disease. 

During Olive’s 19 months of life, she has been hospitalized numerous times and undergone five intestinal surgeries to relieve bowel obstructions, a common complication from cystic fibrosis. “She just springs right back,” Ostenfeld says. “She’s very resilient.”

It is a quality she must have inherited from her mother.

In the fourth year of pharmacy school, students are required to complete nine, monthlong advanced practice rotations. Olive was hospitalized during eight of Sarah’s rotations.

Social skills and a love of science

After earning her bachelor’s degree from USC in environmental sciences in 2010, Ostenfeld encountered a bleak job market. She worked as a receptionist and realized she enjoyed talking to people.

A friend who worked as a pharmacist encouraged her to consider pharmacy school. Ostenfeld had worked at a chain drugstore in high school and admired the pharmacist there.

“He always helped people out and knew all of his customers and kind of saved the day for people,” she said. “I thought that would be a really fun career to help people out on a daily basis.”

Pharmacy seemed like an ideal career path to combine her social skills and love of science. Ostenfeld spent three semesters at Carolina to complete the Pharm.D. program’s prerequisites while working nearly full-time as a pharmacy technician at Hawthorne Pharmacy.

And then she was accepted to the College of Pharmacy at Carolina. Her path was clear. She was ready to learn so she could help others. She didn’t realize, however, that she’d also apply that her knowledge to help her family.

Cystic fibrosis is an inherited disease that worsens over time, causing persistent lung infections and damage to the digestive system as a result of mucus thickening and buildup.

Since Olive was a few months old, she has received twice daily nebulizer treatments with albuterol and hypertonic saline to break up the mucus in her lungs and reduce the risk of bacteria buildup and inflammation. Afterwards, either she or her husband pounds on the child's back to break up mucus there. Ostenfeld says it was important to establish a care routine at an early age so Olive would be accustomed to the steps she must take to manage the disease.

Having a pharmacy background helped Ostenfeld to research her daughter’s condition and have in-depth conversations with Olive’s care team about treatment options.

And she has found other opportunities to merge her two worlds of pharmacy and family. For her grand rounds seminar, she presented information to faculty and classmates about Orkambi, a new cystic fibrosis therapy. Knowing that her pharmacy family cares about a topic that is dear to her and being able to increase their knowledge about CF so they can help other patients was satisfying, she says.

Ostenfeld and her family have channeled their emotions and anxieties about Olive’s diagnosis into fund-raising for the local chapter of the Cystic Fibrosis Foundation. In 2016, they raised more than $4,000 through the Great Strides walking event and have raised more than $1,000 to date this year.

Several classmates participated in last year’s walk, and many more made donations or bought “All in for Olive” T-shirts.

“Everybody always asks about Olive,” Ostenfeld says. “Our class has really rallied around supporting my daughter, and it means a lot to me.”

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