Amid Ailments and Loss, a Mother Forges Ahead Nelsy Peralta with her son Pedro, 4, in their Bronx home. Pedro's twin, Nelson, died in 2010 from a bacterial infection. Above Nelsy Peralta's bed is a photograph of a birthday cake amid baby pictures pasted together in a large collage. The cake has vanilla frosting with a bright blue trim. A message reads, "Happy Birthday to Pedro and Nelson." They are Ms. Peralta's fraternal twin sons, born in 2007. But the rest of the photos are only of Nelson, who had a bacterial infection in his brain when he was 3. "They took eight months trying to get the bacteria out," Ms. Peralta said. After eight months, they gave up and sent him home from the hospital. A month later, in October 2010, Nelson died. The collage is one way that his mother keeps his memory alive. Ms. Peralta now lives with Pedro, 4, in a one-bedroom apartment in the Bronx. Mother and son have both grappled with medical ailments, and she has dealt with financial instability while trying to support her son. Ms. Peralta has sickle cell anemia; Pedro, who was born premature at 24 weeks, is severely developmentally delayed. Pedro has asthma as well as strabismus, a muscle disorder that causes his eyes to point in different directions. He attends a special-education preschool program in the Bronx. Ms. Peralta, 29, has persevered through chronic pain because of her disease, which affects the body's red blood cells. She has received blood transfusions since she was a child in the Dominican Republic and has been hospitalized more times than she can remember. She has not been able to work full time since learning in 2003 that she had the disease. "I was fainting all over the place," said Ms. Peralta, who had been an optical saleswoman. Since then, she has lived on disability benefits. Spending time with the mother and son, it is hard to determine who supports whom more. But Ms. Peralta said she had gathered strength from her son. "He's always paying attention to me," she said, smiling. "He goes to my room and he says, "Mommy, are you O.K.?" " Pedro's concern is justified. Last January, Ms. Peralta learned she had been living with dextrocardia, a heart condition, since birth. "My heart is on the wrong side," she said. You're supposed to have it on the left, and mine is on the right. Nine months later, Ms. Peralta began to experience acute pain in the left side of her chest, and it turned out to be because of a diaphragmatic hernia, an abnormal opening in the diaphragm that allows the abdominal organs to move into the chest cavity. The hernia may require surgery. Ms. Peralta's afflictions are compounded by fears that she will be unable to support Pedro and another son, Vladimir, 10, who lives in Tampa, Fla., with an aunt. "I don't care about the pain I have," Ms. Peralta said. I have to take care of my kids. A home attendant from St. Mary's Hospital for Children helps her look after Pedro. Since July 2008, she has received counseling as a single parent, as well as help with public assistance and housing, from a social worker at New Alternatives for Children, a member of the Federation of Protestant Welfare Agencies, one of the seven agencies supported by The New York Times Neediest Cases Fund. Ms. Peralta has endured several rough transitions. After the twins were born, the family's medical expenses became overwhelming. In August 2009, she was unable to afford the $1,250 rent for her apartment in the Bronx, and spent a month in a shelter with Pedro and Nelson. With the help of the Children's Advantage voucher program, the family moved to an apartment in the northern part of the Bronx; the program paid the monthly rent of $1,094 for two years. But the apartment was in a rough area. "A lot of drugs, a lot of shootings," Ms. Peralta said. In September 2011, the voucher program ended and she could no longer afford the rent. Ms. Peralta receives $606 in Social Security benefits, $111 in Supplemental Security Income and $345 in food stamps each month. Pedro also gets $697 a month in Supplemental Security Income. Her twins" father does not provide financial support, she said. Ms. Peralta eventually found a safer, more affordable apartment in the University Heights section of the Bronx. She was able to pay the first month's rent and the moving expenses, but the landlord also wanted a security deposit and the last month's rent up front. She sought help from New Alternatives for Children, which gave her a grant of $1,800 from the Neediest Cases Fund. Ms. Peralta and Pedro moved in October, and have since lived a quieter life. "I don't feel threatened here," she said, as Pedro came over with a video game. Leaning over the small screen, he gleefully traced his finger along virtual snowcapped mountains. I win it! I win the game!" he said, looking at his mother. "Yes," she said. You won.