In street clothes, Zach Waddell is just another sophomore home from his first year of college on the Mainland. When he takes his shirt off to go skimboarding, however, scars from heart surgery tic-tac-toe his chest.

For his parents, the decision to send him off to a university in northern Arizona meant dealing with college separation anxiety that went beyond everyday concerns. His heart condition meant Zach could die at a moment's notice while his parents, Jo Anne and Drew, would be thousands of miles away.

With proper preparation, high school seniors with manageable health conditions just might be able to undergo that celebrated Hawai'i rite of passage — going away for college. But for parents like the Waddells and others, it's not easy letting their college-age offspring go.

Zach Waddell made his own decision.

"I didn't want to be a year behind my friends," said Waddell, whose congenital heart defect, bicuspid aortic stenosis with aortic insufficiency and regurgitation, affected his heart's ability to circulate blood properly.

Waddell takes his lifelong condition in stride. After all, it hasn't killed him yet, his 19-year-old young-man swagger seems to say. He still does things like dirt biking and bombing hills at 30 mph on skateboards.

Then there's the bickering between son and parents over things like getting a tattoo — which earns responses like "You could get an infection!" from Mom and "Not while we're supporting you" from Dad.

As parents, the Waddells wanted to let their oldest child experience life on his terms, resisting the urge to keep him close. They looked to Jim and Linda Howe as role models.

LETTING THEM LIVE

While the Howes made a courageous choice, they didn't get a storybook ending. Nicole Howe, born with a three-chamber heart, died in her junior year at the University of Southern California.

For the Howes, it wasn't an easy decision to let her go away, and they live with the regrets any parent would feel.

"I know lots of parents will judge us, because I judge myself," said Linda Howe. "You do the best you can."

But she and her husband also said the magic words that resonated with the Waddells, who found the courage to let their son live his dream: You can't let your fears hold your children back.

"If you don't let a person live their life, how much of a living is that?" Drew Waddell said. "There's a point where you have to give it up to God."

While Zach had no outward symptoms, his susceptibility to heart infection meant constant monitoring was called for, as any spike in fever could signal a catastrophic illness.

So when Zach's girlfriend, Shannon Thorp, called Jo Anne Waddell during his second semester away at school to say she was in the ER with Zach, her husband started calling for airline reservations.

Luckily, it turned out to be a virus that Zach was able to kick.

They take great comfort in having hanai family in the area, Jo Anne said.

One thing both Jo Anne and Drew Waddell say they would have done differently when settling Zach in for his freshman year in 2006: Even though they arranged ahead for the worst-case scenario with a cardiac specialist, they failed to hook up with a general practitioner who could monitor Zach's case for minor things like viruses. They'll know better this year.

Their role models, the Howes, knew excellent care existed in Southern California for Nicole, but the news is never good when one receives a call from a school representative at 10 p.m. on a Sunday night.

The back story: Early on, doctors warned the Howes that Nicole wouldn't live past infancy, or if she was lucky, she just might make it to kindergarten. Though she surprisingly continued to grow older, later she would undergo multiple surgeries that failed to correct the problem.

"Pretty much at age 16, the handwriting was on wall," said Jim Howe. "There was no cure. ... We had no idea how long she had. It could've been any moment."

They sat down as a family and were candid with her, he said: "She knew the score. We told her, 'OK, this is not fair, it's not what any of us wish for.' But none of us know if we're going to get up in the morning and get killed on the freeway. We're going to make the most of every day."

What did she want to do with her remaining time? Travel around the world? Whatever it was, they'd do their best to make it happen.

Her response: "What I want to be is as normal a kid as I can be, go to school, be with friends, go to prom," her father recounted.

She went on to excel in high school, so naturally the question of college followed.

"Do we let her go or not?" Jim Howe recalled. "Being such an exceptional student, exceptional person, every school in the universe wanted her."

Jim and Linda Howe took regular trips to to see her, including a week before Nicole died in her dorm room. Jim Howe remembers hugging her tightly, telling her "I don't want to let you go, I love you so much."

"You've got to let me go, this is my life now," she told him.

With the light from the dorm room illuminating her, he remembers as she walked back into her world, a smile on her face.

"That's what I got out of that decision, her confidence, living her life," he said. But in the next breath, he added how he cried every day for years after her loss.

In the four years since her passing, Jim and Linda Howe can look back and recount other lessons learned.

"She did it on her terms," Jim Howe said. "She truly did. I wouldn't have changed a thing. What are you going to do, lock her up in her room, watch her 24/7? That's not a life for Nicole."

Every situation is different, he said, and it was "very, very difficult for us to let her go."

"We were very thorough in the preparation," he said. "We didn't do that without medical, family support in place."

Like Zach Waddell, Nicole never played the sick-kid card.

"You can't let illness define you or define who you want to be as a person," Jim Howe said. "She would not let that twist of fate become who she was."

Linda Howe admits it wasn't easy: "It's not like I didn't try to micromanage every part of her life," she said.

NO SECOND-GUESSING

The real question for both the Waddells and Howes: Are their offspring mature enough to know what's at stake?

For both sets of parents, the answer was, of course.

"There were people who said, keep her home, micromanage more carefully," said Linda Howe. "I thought that myself, too. But you can't go back, second-guessing. ... I don't regret letting Nicole go and live her life. She would not have been so happy had we not let her do that. That's just us, that was her."

She takes comfort in words from others — strangers, even USC professors — who tell her how Nicole inspired them. If they hadn't supported Nicole's decisions, she may never have been able to touch the lives she did.

"We had so many more years and great times with Nicole than we could imagine," Linda Howe said. "She deserved to have a life. It's that whole, 'If you give it up, what comes back to you is even better.' But it's a hard, hard thing."

Drew Waddell knows, but he relies on his faith.

"What happens, happens in life," he said. "If Zachary did not make it out of there, I know I would've been crushed, but I'm not second-guessing."

Reach Mary Kaye Ritz at mritz@honoluluadvertiser.com or 525-8035.