Wednesday, March 4, 2015

Brave Girls go to the IAC

Today I took Hannah to the International Adoption Clinic (IAC) at the University of Kentucky.  Let me begin by saying we had heard through the grapevine that we would not be disappointed with this experience, so we went in feeling rather positive about it.  Our adoptive friends were not at all wrong.  I was thoroughly amazed by the whole process, the passion, and genuine care in each of the people we met with today.  I am so grateful we live in a city with an International Adoption Clinic, where the doctors are so well versed with common medical problems, tests, etc. for the internationally adopted child.  I wasn't completely certain what to expect today, but was worth the time, energy, and cost.

Things got off to a frenzied start thanks to pouring rain, horrendous traffic, and some hiccups, BUT, God provided for Hannah and I to arrive right on time despite some unexpected obstacles and we were able to be calm and focused once we arrived.  I was very nervous about Hannah's previous medical experiences--she had tremendous fear at the consulate medical appointment in China--so I asked for prayer warriors to cover us for this appointment, and He answered mightily.  Hannah took each bit of the process in stride and was ever so incredibly brave.  The doctor and nurse went on and on about how sweet she was and renamed her, "Gem" because she was just so brave.

The appointment and various tests took us four hours to complete.  FOUR HOURS!  Two of those hours were spent almost solidly in face to face time with the pediatrician there.  I am not kidding.  Quality, face to face time, talking with a pediatrician.  Hard to imagine we would have so much to talk about since so much of her medical, developmental, and social history is unknown to us.  The doctor was so thorough and got the ball rolling in so many directions for us right then and there--it was honestly a bit overwhelming to start seeing all these appointments coming at us from all directions.  The appointment today assessed Hannah in many areas and pointed us in directions for further follow up and exam.

So the skinny on her exam...there were very few surprises, which encouraged me and my ability to do my "Mama/Former Social Worker" assessment on her and be pretty dead on.  The physical therapist was very happy with where she is and saw no need for further intervention--maybe some focused time on some fine motor, but those things are likely due to lack of exposure and should catch up rapidly.  Her development all appears normal and right on target for a little girl of her age and with her history.  No major delays or areas of concern other than her speech.  She is bright and smart and all her little systems appear to be in good working order.

The surprises of the appointment....her finger.  Remember the finger injury from back in December?  We knew when we got her that it didn't look "right."  She also does not use it very much and keeps it held straight out most of the time.  We had sent the photos of the injury to the doctor back in December when the incident happened and she reviewed them, but photos can be deceptive and it is hard to tell the extent of things.  One look at it today and the doctor immediately suggested we run our own set of tests and even mentioned the word "possible surgical repair."  We had x-rays taken today while we were at UK and we will review those results in the next couple of weeks.  Currently Hannah appears to be a right handed child and this injury is on her right hand and definitely impacts her ability to use her right hand.  So we will wait and see what the x-ray reveals and what (if anything) we will do further for that.  The second surprise.  Girl has a whopping ear infection.  Like massive bulging in the right ear and so much wax in the left ear that even after several attempts to clear it, the doctor couldn't even get a look at it.  This was surprising!  About 1.5 weeks ago, we took Joshua to the pediatrician for treatment of an ear infection.  I had the doctor check Hannah's ears at that time because she had been tugging a lot on them.  Nope.  Nothing.  Of course this could have easily cropped up in the last several days, but there has been no real indication of a problem.  The doctor at the clinic said this is not unusual with adopted children--they have learned to be survivors and live through a good bit of pain.  They don't really get needs met quickly so they don't ask for help promptly.  So sad!  I felt awful for not knowing about it, but the doctor was very reassuring that cleft kiddos especially likely live with perpetual ear infections, so she probably doesn't even notice it that much.  We are treating the ear infection today and also attempting to clear the ear wax so we can get a good look when we go see and ENT.  The other surprise?  Her cleft.  Ha!  How on earth can that be a surprise, you ask?  Wasn't that the primary special need we were informed of?  Why yes, yes it was...however, her cleft, from what the pediatrician could tell, is unique.  All open on the right side, which is what we saw and knew about, but there appears to be a second, smaller cleft on the other side, too.  I haven't gotten a fantastic look in there myself, but I will say, now I am rather intrigued and want to check it out!  We will see what the pediatric surgeon says when we meet with him.

In addition to our appointment today we had x-rays taken. TB test done, stool samples sent to the lab, and probably about 10-15 vials of blood (I kid you was enough to make an adult get squeamish and cry).  The blood work was by far the worst and saved for last.  Unfortunately for her it just wasn't flowing and we blew through one vein and had to re-stick her in the other arm, but we got all we needed in that last stick.  It took 3 technicians and me to get it all done.  She was exhausted, I was exhausted, and that was the end.

Now we wait on lab results to see if there are any other little unknown surprises waiting.  They have tested for literally everything under the sun, so it ought to give us a good place to start.

I feel a bit like my head is spinning.  Where do we go from here?  We treat the ear infection and schedule an appointment with an ENT within the next two weeks (she will likely get tubes the same time we do her cleft surgery).  We follow up with our regular pediatrician to read the TB test on Friday.  We are waiting for a call from a speech therapist who is great with cleft children and will take whatever appointment they give us (she is booked till June, but is going to fit Hannah in prior to that!).  We meet with the surgeon to handle her cleft at the end of this month and will discuss options regarding the timing of her procedures.  We are waiting to hear about the x-ray and if surgery is indicated, there is a good chance we can use the same pediatric plastic surgeon who will handle her cleft.  I don't know if we could do that procedure the same day as the cleft surgery, if it is warranted.  We wait for blood and stool results to see if we have any other areas of concern (parasites, TB, anemia, etc.).  We schedule an appointment with the pediatric dentist immediately after our consult with the cleft surgeon if dental work is indicated prior to the surgery.  Within the next 6 months she will see a pediatric eye doctor since cleft kiddos can also have their vision impacted.....  Goodness, that sounds like a lot, but I actually think I am leaving some things out!  It is going to be a frenzy of appointments these next several months, but I am so thankful we get to do this with and for Hannah.  What a blessing to get her the care she should have had years ago. 

We need to mention that we could not attempt to get through all of this without the tremendous outpouring of love and support from our family.  Chris' mom, especially, sets aside so many days to travel to Lexington to stay with the big kids so we can get to all of these appointments.  Friends continue to bring us food and meals for our freezer and I will say, having those things on days like today, when I spent four hours at a medical appointment and have a thousand phone calls to make, is such a huge tremendous blessing.  I don't have time to worry about dinner and lucky me, it is okay!  My family will still eat a delicious, hot meal tonight because of the generosity of others.  Wow.  It takes an army and we are just so deeply blessed by each and every single soldier in our army of helpers!

So, lots to think about, process, and prepare for, yet we are so glad we are getting things started for Hannah.  We cannot wait to see how God is going to use this brave little girl!

Brave girl, chillin' in the stroller, waiting for the blood draw.

Didn't even make it out of the parking garage.....

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