Jai Costello's had so many surgeries — almost 100 in his short life — that when it comes time for another, he pulls the anaesthesia mask down himself.
The 9-year-old Tauranga boy knows the drill when it comes time to have his surgery to trim a growth in his airway - a process he goes through almost every month.
And his parents, Kayla Mackenzie and Anton Costello, know the drill too.
They know they're going to Auckland for the night, they know Jai will undergo a one-and-a-half to two-hour surgery and, most importantly on that first, frightening emergency journey to Starship Hospital and the many scheduled visits since, they know where they'll sleep.
For the family, which also includes younger children Portia, 7, and Mack, 2, the Ronald McDonald House accommodation at Starship Hospital is like a second home, Mackenzie told the Herald.
"[Before we first arrived] I thought it was just a room at the hospital, but it's not. It's in the hospital grounds, has rooms and a communal kitchen, and volunteers come in and cook a couple of times a week.
"It's amazing, and it just takes that stress away. I look at it as a second home."
The family are sharing their story to raise awareness of Ronald McDonald House Charities, which every year provides free accommodation for thousands of families — 3700 last year — with children in hospital, and which next month will launch a campaign to raise $100,000 to keep supporting families in need.
The House to House campaign is encouraging people to run, walk, cycle or swim 210km in March — the same total of kilometres families travel each month to stay at a Ronald McDonald House when their child is in hospital away from home. Entries can be individual or team.
Mackenzie's first experience with the charity came when she arrived in Auckland with then six-week-old Portia, trailing the ambulance that had taken Jai, then aged 20 months, and his dad — newly redundant — to Starship for urgent surgery.
After 10 days in Tauranga Hospital, trying to get to the bottom of breathing problems that had plagued Jai from birth, they had been given 10 minutes warning that he was being transferred to Starship.
"I was freaking out, and I had a newborn and it was torrential weather. [The worries were] everything — what are we going to do, how long are we going to be away for, how are we going to afford it?
"We were pretty young, I would've been 20 and Anton was 23. Anton had just been made redundant, we had a toddler and a newborn and just couldn't have afforded to pay for accommodation in Auckland.
During surgery, doctors discovered the cause of Jai's breathing problems — he had laryngeal papilloma, a growth on his airway, Mackenzie said.
"His airway was so blocked he was breathing through [a gap] the size of a needlepoint. It's pretty incredible."
If the growth hadn't been cut back, within a few weeks Jai would have stopped breathing, Mackenzie said.
He now has surgery every month to six weeks to trim the growth.
The family are hopeful Jai will grow out of the condition, but until then they'll keep making their way to Starship, keep coming back to their home away from home, and keep being impressed by their boy's courage.
"He's amazing," Mackenzie said of her eldest child.
"He just goes in there and gets on with it."
*For more information and to register go to www.housetohouse.org.nz