Jackie Pische received her son's donated bone graft for back surgery.

APPLETON — The list of lives changed by Joshua Richards' final gift continues to grow.

First, there was Benny the Heart Guy. In July, Jackie Pische met a man who received another of her son's organs and christened him Larry the Lung Guy.

In a unique turn of events, Pische herself has now joined their ranks.

On Wednesday, Pische had back surgery that required donated tissue. In May, she casually brought up the idea of using tissue donated by Richards, 25, of Green Bay, who was fatally shot Dec. 8 in the doorway of Luna Lounge in Appleton. While Pische believed it was a long-shot, she knew there was no other donor she'd rather have.

"It would really just be a huge honor to have a piece of Josh," Pische told Post-Crescent Media. "He'll always be with me, but this will be a different piece. He'll help me heal and make my back better, which is something he would have wanted."

With less urgency and a longer shelf life, it's possible for family members to receive tissue donations from their lost loved ones, said Lori Shinstine, vice president of operations for the American Tissue Services Foundation.

In her 20-year career, Shinstine said Pische's request was the second she'd received. The first, about two years ago, was for a young woman who lost her brother four years earlier and was able to use his connective tissue following a soccer injury.

"I think from a mom's perspective, she carried this child, and he is her only son who was tragically taken," she said. "To know a part of him saves her from pain and suffering of the back injury, to know he's come back as a part of her, this is kind of a circle of life."

After hearing about Pische's request, Shinstine contacted Medtronic, a Minneapolis-based biomedical engineering company that processes tissue donations and delivers them to hospitals and clinics. The company assured her it would process some of Richards' bone into the needed grafting material for Pische.

On Wednesday, surgeons used Richards' demineralized bone for Pische's anterior lumbar interbody fusion. The graft is used to help the backbones heal or fuse together, said Eric Epperson, spokesman for Medtronic.

While there were many steps involved in coordinating this particular donation, Shinstine said it was one of those experiences that make her job worthwhile.

"Situations like this can bring hope to families who have said yes to donation at the most difficult time of their lives with no expectation in return. There is no greater gift," she said. "We know that it won't bring Josh back, but if in the days, months, years following the death, they find comfort knowing they were able to help other people, that's why I can do what I do."

Unlike organ donation, where vital organs can only be used for a short period of time following a death, the impact of tissue donation can be felt for years, Shinstine said.

On average, one tissue donor helps at least 50 people in life-saving or life-enhancing situations. When a donation is received, it is tested and processed, which eliminates much of the concern regarding compatibility.

"Most of the tissue transplants are more of an elective-type procedure," Shinstine said. "You may need spine surgery, but you don't have to have it within the next two days to live; you need to have it so you can return to work, raise your children and have a normal life."

For Pische, meeting donor recipients and becoming one herself made the impact of her son's gift more of a reality.

"I guess we don't think about (tissue donation) because it doesn't make as much of a splash," Pische said. "But people's lives are really enhanced and saved."

Post-Crescent Media last spoke with Pische in May, when she met heart recipient Benjamin Adler and hosted a charity golf outing for the Joshua J. Richards Charitable Foundation.

Two months later, Pische received a letter from a mom about to celebrate her son's seventh birthday, where he asked guests to give him money to donate to the foundation. Describing Richards as her son's hero, she asked if Pische would meet them so he could give her the $600 he raised.

What Pische didn't know was the boy's grandfather had received one of Richards' lungs.

"Just despite losing Josh the way we did, it's amazing what's been going on," Pische said.

Since Pische launched the foundation in January, it has raised over $15,000. Pische has orchestrated donations to Gillett Secondary School (Richards' alma mater) and a program that grants wishes for sick children to go hunting with their parents.

On Oct. 2, Pische and two of Richards' organ recipients will present a donation to the UW Organ and Tissue Donation program.

"It's huge for us," Pische said. "A lot of people are signing up to be organ donors, and that's really what's important."