Discussion
Learning how best to approach life's obstacles is a task for all teens as they enter young adulthood. With changing minds and bodies, the teens in this study were faced with the additional obstacle of growing up with CHD. A striking characteristic of the 10 teens was their overriding sense of self as being similar to their peers and friends. This was present regardless of age or developmental level and granted them a sense of satisfaction with their life that we conceptualized as quality of life for them. This was in contrast to their history of serious CHD and their need for ongoing care and monitoring from cardiac specialists. On the surface, these teens came across as perceptive individuals who had learned to take their early-in-life CHD diagnosis in stride. Although their CHD did mark them as different from their peers, each teen described the ways in which they saw fit to portray a life of normalcy. Similar to their healthy peers, teenagers with CHD met developmental milestones, completed school work, and were in the process of formulating hopes and dreams for the future. However, certain elements of their lives set them apart from their peers: their physical activity levels, their scars, and their relatively frequent interactions with health care practitioners. The three main points of discussion that have arisen for further examination relate to normalization, physical activity, and choices about CHD as a foreground or as a background issue. An understanding of quality-of-life issues and where and how they come into play is also addressed.