Thursday, October 4, 2012

Two competing desires

You are probably wondering how on earth I'm going to adopt a child from Russia and finish medical school and start residency. The answer is, very simply, I'm not. I can't.  Even if I theoretically could work out the time off for trips to Russia, I just cannot justify bringing home a child from an orphanage who has had like no love or attention or consistency in her whole life and who most likely did not win the genetic lottery and say, "so sorry, sweetie. I'm going to work 80 hours a week."  No way. As much as I want to just keep pushing on through the very long and tumultuous process of medical school and residency, I just cannot be that selfish. She needs to bond with me.  And...really...staying home with my kids for a year or 8 months or something will probably help to relieve some of the mommy guilt I feel for working so much. I'm hoping to stay home with them (and I'm hoping I will love it...but will not love it too much, so that in 2 years, when I'm an intern in residency I can remember that I do, really, want to work.)

But...

The adoption is so uncertain and I just can't stop medical school. I have to continue with the process of applying to residency, of continuing my rotations, until the adoption is as certain as certain can be (Ideally, when she's living in our house) But the longer and longer we wait for a second referral (hopefully the next one will be healthy child!) the more frustrated Tim and I become at the uncertainty we are faced with. We are coming up on residency interviews and in February we will provide our ranked list of schools to "the match" and in the middle of March we will receive a lovely envelope telling us where we will be living, and at that point I am legally and contractually obligated to go to that program.  I'm not entirely certain of the problems that will present if I call them and say, "actually...can I come in 2014?" but I think there could me many..depending on the school. And I'm really hoping to not be in that place.  Plus, there is a huge part of me that WANTS to finish and match and become a doctor so that I can get through residency and start making money and working normal hours instead of making no (or very little) money and working terrible hours. Sigh....

But...

The adoption takes 4-6 months to be totally complete from the time we get a referral. And it's October. And we have no good referral. And Russia closes down from Dec 15- Jan 15. So...you do the math.  Our time is limited and we are trying to pursue to very life changing things at the time same time that...in the end...will likely be mutually exclusive in the short term.

If we have to move before the adoption is complete, we cannot proceed with the adoption anymore because our homestudy was for our particular house. And we are not applying to residency programs in Dayton. So we go back to day 1, a year and a half ago, and lose all that money. Which is a lot of money. Trust me.

With each passing day we become more anxious for a good referral, not only because we long to have a daughter but also because we long to know what our future holds.

Pray for us, as we deal with discouragement at how very long this process has become.

To Russia with Engraged Fury

I have said this many times, but the international adoption process is just not for the faint of heart. I mean, really, this is ridiculous.

So last Monday was my birthday and for my birthday I was really hoping we would get a call from our adoption agency saying, "we have your daughter!" but...instead...they called and said, "We have more nonsense for you to do!"  Apparently Russia just changed their laws like September 1st and is now requiring more training of adoptive parents before adoptions can be finalized.  This training is not online, like the training we did 1 year ago but has to be "face to face."  So, in a scramble to meet these requirements and not delay the adoption process for their families, our agency is hosting several in person training days that, of course, are mandatory. But these training days are being given for their families all around the country who are adopting, so the trainings are in: Chicago, Washington DC, California, and Arizona. Awesome. Cause I don't already have 10 residency interviews that are taking me all over creation. Oh wait, I do.

These trainings are not well timed. The first one is Friday the 19th and Saturday the 20th.  Our prior plans were for my to take my Emergency Medicine final exam the 19th and then for us to fly our to Colorado that evening to start my away rotation at the University of Colorado on Monday. So, that won't work.  But the other two trainings are in November, during the time we're in Colorado, when I am supposed to work 6 days a week and only get 2 "sick days" which I am using for interviews at residency programs out there.  So...I can't do the training then, either.  But if we don't do these, we don't adopt. Perfect. So...in a long ordeal I talked to the clerkship director for Emergency Medicine who was less than thrilled about letting me make up the exam and miss the 19th (the last day of the rotation) to do this training. And when I say, "less than thrilled" I mean, she said, "no."  But she did say I could ask the Student Promotions Committee at school and see what they thought. So I did and then a few days later I got a gruntled e-mail from her saying, "well, I don't like this at all, and I don't think it's a good decision, but you can make up the test."  I guess the student promotions committee told her to suck it up and let me make up the test. I think, after two children during medical school and being in the top 20% of my class, I've earned their respect. Thank God. I really need them on my side for this adoption. So the clerkship director gave me all these stipulations for making up the test, including "you will receive an incomplete until you make up the test..."  Really? Is that supposed to scare me? Cause....I was expecting that. And then she kept telling me that if I make up the test I will be at a disadvantage because the "emergency medicine material will not be fresh in your mind."  I wanted to reply and say, "Dear Dr:  I am a 4th year. I have had 2 kids. I have yet to fail anything in med school.   I think I can pass your test even if I take it in April. Love, Katherine."  Ridiculous (now, watch me fail...)  I'll tell you, folks, women doctors are another breed of people. I have had so much more trouble with the whole kid, pumping, adoption, etc business from women during med school instead of men.

So...anyway....we are going to Chicago for this training Oct 19 and 20th. Two long days of ridiculous training. And to mention, my schedule until then is as follows:
Oct 4 (today) through October 8: work
October 10 through 12: work
October 13: Matthew's party
October 14: work night shift
October 16: Fly to Wisconsin for my first residency interview
October 17th: return from Wisconsin
October 18th: drive to Chicago
October 20: return from Chicago
October 21: fly to Colorado to live for 4 weeks.

Someone please tell me when I'm going to see my kids.

So...Russia...with your stupid laws stemming from the stupid woman who sent her son back to Russia: you better start giving me a referral instead of giving me more hoops to jump through or I'm going to.....continue to post blog posts about how annoyed I am.

Love, Katherine

The 6 month saga

The moral of this post is as follows: drop out of medical school.

I am delayed on Samuel's 6 month post because I've been waiting for the story to finish so I could give you the entire thing.  Knock on wood, somebody, but I think I'm ready to tell you the saga.

So like a week or so before Samuel turned 6 months I thought it was time to try solids. I made my own oatmeal cereal from steel cut oats. I was so super mom. Only the healthiest for my baby. So Samuel did fine with it for a few days but then we started pooping a crazy amount. Like 7-8 times a day. And then it got worse. His little bottom became flaming read, his poop started having mucus in it, and my happy little baby was super fussy all the time.  Then, at his 6 month check up he weighed 15 lbs 12 oz and had dropped to the 17% and was only 25 3/4 inches long, had dropped to the 10%.  My pediatrician was not worried, just said it was an allergy to oats.   But I, you see, I am in medical school. So, clearly, my son had some horrible, rare disease.

The rare disease I diagnosed him with was Celiac's disease, an autoimmune condition where the body cannot tolerate gluten and alters the intestine so it cannot absorb nutrients. People who have this disease are in horrible pain experience horrible diarrhea, and cannot gain weight.  Oats are often contaminated with gluten. I was certain this was it. I talked with a friend whose son has a milk allergy (pretty common) when she has dairy in her diet (because, clearly, Samuel had developed a milk allergy suddenly, at 6 months old, as well) and learned that the mucus can stay in the poop long after the offending agent was removed.  About 3 days after we stopped the oats, Samuel was much less fussy and his bottom cleared up, but his constant pooping didn't get better and his poop still had mucus. I fretted. I was convinced something was horribly wrong, so I went gluten free for a day until I decided...perhaps totally changing my diet was a bit premature.

He was doing better on the fussy scale, but I was so certain he wasn't gaining any weight. We were weighing him at home on our fool proof cookie sheet laying on top of a postal scale. Error free---for sure. And our scale showed us he was losing weight. Celiacs. For sure. I started him on rice cereal (store bought, this time, I was done being super mom) and that night he had one episode of diarrhea. I made Tim call Gerber who said that there is a chance it could have been contaminated with Gluten. Celiac's for sure.

The next day he came down with a fever.  I stopped the rice cereal and continued him on just homemade fruits and veggies. THEN a few days after the fever was gone, he broke out in a rash.


An allergy? I didn't think so. I suddenly had enough clinical foresight to note the rash was viral, but I still took him to the doctor (who agreed with me...).  I told her all about my woes, how he was certain to have Celiac's disease, how I was not looking forward to going gluten free. How he was losing weight. We weighed him. 16 lbs 8 oz (two weeks after his 15 lbs 12 oz) 20%, right back to where he belonged. He's not fussy at all now, and is doing quite well on his fruits and veggies and his pooping, praise God, is now well under control and fully back to normal.  I'm still a little hesitant to re-introduce rice cereal, but I am hopeful his diarrhea that night was from his virus. The oats...I'm still out on that. But if he had Celiac's disease, I think he'd be reacting to the gluten in my diet and losing weight.

Crisis averted.   So we will try rice again in a week or so. And who, knows maybe oats too (rolled this time, not steel cut).  This whole incident may have just been a long virus.

But, for now, he is a happy go lucky (albeit short, he's still in the 10%) 6 month old baby who can now sit up (pretty well) and who loves to spend time on his hands and knees rocking back and forth.  It will not be long now until he's chasing after his brother.

I promise, I do not over diagnose other people and other people's kids with rare diseases.  Just me. And my own kids.   It's exhausting, being me.   I think its more exhausting being Tim, who has to listen to my nonsense.  Medical school friends totally understand, because I know I'm not alone. Medical school and parenting don't mix.

Matthew's favorite thing in the world is to take pictures with my phone. Don't tell him that we got him his very own kid camera for his birthday. I think I'm more excited then he will be, cause then I can get my phone back. But here are a few he has snapped of Samuel:



At the doctor getting his 6 month shots...I had no idea Matthew even had my phone:

This one is from like 5 months old, but it's still cute. I am terrible about loading pictures from our camera onto my computer...so a lot of blog post pictures are limited by what's on my phone.

Thursday, August 30, 2012

Matthew's Summer

Matthew doesn't get much love on our blog, but that's not because I love him less.  I suppose it's cause he changes a lot less than Samuel since he's older. We are currently trying to think about plans for his 3rd birthday in October. Can you believe it?!?!

"Matthew, do you know that I love you very much?"
"I know, mommy.  Mommy?"
"Yes, Matthew?"
"When the traffic light turns red, we stop.  Mommy?"
"Yes, Matthew?"
"When there's a fire drill, we go outside.  When there's a tornado drill we go into the hallway where there's no glass windows and cover our heads. "

--Typical conversation.

My biggest brag on Matthew is that at 2 1/2 he can swim.  He can swim half the width of the pool at swim class under water all by himself.  He doesn't know how to swim on the surface yet and he can't come up for air under the water and then keep going, but he beats out a lot of kids years and years older than him already.  My fearless little athlete.  Here are just a few summer pictures:













One Month Later...

Well, it's been just over a month since we got and subsequently turned down our referral from Russia.  I've had lots of people ask us how we are doing and how much longer it will be so I thought i'd post.

It feels like such a long time ago that we got a referral, it's really hard to believe its only been like 5 or 6 weeks. It's been a hard wait, because patient has never been my strong point.  I was doing quite well waiting, until we got that referral and saw that little girl's picture and realized how badly I want this to happen.  I pray every day that we'll get a referral soon, within the next month, but I know that such timing is not my own...  It's hard to wait when my longing to meet my daughter and to have her home has grown, but we don't really have a choice.

We are making so many plans for this fall:
Next week, September 7th, I finish up my family medicine clerkship. Then, September 22 I take step 2 of my boards, then the 24th (my birthday), I begin my Emergency medicine clerkship.  Sometime about October 20th we manage to move the entire family, plus our temporary babysitter (thanks, Alicia!) and likely the dog across the country to Denver, CO for me to do my subinternship in internal medicine at University of Colorado Hospital.  Then, around November 16th, we again somehow manage to move the entire family across the country to Chapel Hill, NC so I can do a an elective in endocrinology at UNC Hospital.  Then, a month later, we return home to Dayton and it's pretty much Christmas.

So...it's not like we have a tone of time and space to sit around waiting for Russia to call, but still, I long for them to call.  I tell Tim all the time that instead of doing any of the above activities, I'd rather go to Russia. So we'll see. I don't have any control over when they call or what I have to miss.

As far as timing, we really have no idea.  I haven't been given any time frame or any information other than to say that referrals coming out of Russia are "slow."  A passing comment was made to Tim from the adoption agency that she would be surprised if we didn't have a referral by November. But who knows, really. That still seems like a long time away to me, so it doesn't offer much consolation.

I'd say my main emotions are just impatience.  I am also filled with a deep longing that leaves me, at times, feeling empty and sad.  But I am so in love with all 3 of my boys that I am not weighed down by my sadness.  Occasionally we'll be driving or running or cooking and I'll turn to Tim, "Timmy?" "yes?" "I want a referral."  

Please, oh please, Russia.  Call us soon!


5 months old!

Ok, so I am really behind with the monthly posts on Samuel, cause he will be 6 months in 2 weeks. Alas, time flies.

Well, we went to the neurosurgeon to discuss his head and she diagnosed him with "mild to moderate plagiocephaly."  She recommended that we try aggressive "positional changes" to keep him off of the right side of his head in order to see if we get any change.  She thinks that with work, we can avoid the helmet, which seems to be a lot of work. You have to go to the doctor all the time with the helmet to check for skin breakdown and for fittings. So we are trying lots of things. The first step was to not swaddle him at night anymore.  I know a lot of mom's probably stop swaddling their kids a lot younger than 5 months, but I was attached to him sleeping through the night and worried that he would have a rough time.   Luckily, it was a seamless transition.  He still sleeps through the night but now he likes to sleep on his side (his left side) and sometimes rolls onto his stomach so now he is not sleeping and putting pressure on that side of his head.  I think this will help a lot.  He spends lots of time upright in his bumbo or exersaucer.  He is also "tripoding" now so he can hold himself sitting up on his arms for several minutes. I think in a few weeks he'll be sitting independently and this will also help a lot, too.   We try to never put him on his back during the day, but he rolls a lot so he ends up there at least part of the time. We go back in 2 months for a follow up.

At his neurosurgery appointment right at 5 months he weighed 15 lbs 1oz.

He wants to crawl really badly and he can scoot pretty well and does a lot of push ups to move himself forward.  He will be crawling after his big brother in no time!

He is a happy, vocal baby and has become quite fascinated with Matthew.  He loves to look at Matthew and laugh and smile, and Matthew laughs and talks to him and Samuel smiles back.  It is so precious to see my boys forming a bond and beginning to play together.  Having children is just so precious.  Time to bring in that sister....

Wednesday, August 8, 2012

4 months old!

Oh, baby Samuel.  I am so in love.

Samuel loves to smile and talk.  He recently has started laughing.  Priceless.  And he enjoys watching his big brother, which I am sure will continue for many years.  He continues to sleep and eat well, spit up like a fountain, and poop explosively through his outfits.  He ensures that we do laundry often!  He is still the happiest, most mellow baby on the block.

Samuel was 14 lbs 11oz at his check up (21%) and was 25 inches (20%).   He now rolls over both ways and can sort of sit up with balancing on his hands for about 2 seconds.

But...

His head is lopsided.  I have diagnosed him with Plagiocephaly, a condition where part of the head is flat, usually caused by prolonged laying with his head resting on one side.  Apparently being such a good sleeper has its drawbacks.  I also think it has to do with how he was positioned when I was in labor...he as turned in a funny way and I think he head was pressed up against my pelvis.  Since my parental diagnosis, we have been putting him a lot more on his tummy (he is now quite active and enjoys the beached wheal inspired army crawl to move.  He is quite good...) and also sitting him up in his bumbo more often.  I switched him to sleep with his head at the other end of the crib.  These are all recommended to try to help the shape return to normal by decreasing the pressure on the spot of his head that he favors.  But not much has changed.  His condition isn't getting worse, it's just not getting better.
 If the condition is really bad, babies have to wear a helmet to correct their head shape. So our doctor, who agrees that his case is somewhat beyond the level you'd expect to go away on its own, is referring us to a Neurologist. I have heard that getting into to see the neurologist is really quite a challenge, and that it takes months to get an appointment. But we don't have months, because they say you need to treat between 4-6 months.  Though, she did say she's not sure they will do a helmet at all.  They see the "really" bad cases that she doesn't, so they may not be impressed.  This condition shouldn't cause any neurologic damage, though she thinks they might do some imaging to make sure his growth plates haven't closed prematurely.  She doesn't think they have because his head circumference is growing perfectly.   His condition is not that noticeable from the front, and he is so cute, I'm sure he'll rock the helmet look if needed.