Oliver, Kirsten, Chris and Soren

Oliver, Kirsten, Chris and Soren

Friday, March 27, 2015

Matching With Our Next Au Pair

It was a sobering realization that living in Minnesota and taking care of four children is not every au pair's dream.  It may be our dream, but when au pairs have one year to live the American dream, they want California or New York and one or two (school-age) kids. I desperately hoped someone would be open-minded enough to look past the number of kids and the location and focus on what we had to offer - friendly, welcoming family, city location, access to a car, steady hours and no evening or weekend work.  Then we found Marcel who was willing to give Minnesota a try and be flexible as adopted two children midway through his year.  I'm sure his experience has not been what he initially expected, but he's nonetheless having a memorable year.

With this living proof that an au pair can have an awesome experience outside of California or New York, I set out on our search for our next au pair with a great deal of optimism.  I updated our family's profile with adorable pictures of our newest additions and wrote about what a wonderful year we're having with Marcel.  As I proofread our profile, I thought, "Who could say no to us?" 

Apparently a lot of people.  Seemingly as soon as I hit send on the introductory e-mails I sent to each au pair candidate, the rejections rolled in.  It shouldn't have surprised me that most of the reasons focused around not wanting to come to Minnesota and/or take care of four children, but it was still depressing.  Even the woman who could do a handstand on a moving horse (she competes in a sport I'd never heard of called vaulting; it's like gymnastics on horseback) thought four kids was overwhelming.  Let me repeat, SHE COULD DO A HANDSTAND ON A MOVING HORSE - yet she was afraid she couldn't handle our four children. 


We did eventually find our next au pair.  She rides horses, but as far as I know, cannot do a handstand on one.  But we're not hiring an equestrian.  We're hiring an au pair.  The one we matched with is almost 20 years old, from Germany, and has an impressive application filled with extensive babysitting experience and an internship at a daycare program for children with special needs.  In Skype interviews and e-mail correspondence, she came across as kind, social, fun-loving and family-oriented.  In fact, she started to seem too good to be true.  So I ended up sending her one final e-mail where I laid it all out.  Winters are long in Minnesota.  Our kids are loud and you won't be able to sleep in on the weekend.  The hours are long.  There's a lot about the job that's not glamorous, like driving the kids to school, packing lunches, cleaning, doing laundry and cleaning up potty accidents.  In your country the drinking age is 16; in ours it's 21.  I had to cut myself off and hit send before I completely scared her off.  I felt confident in her reply that she wants to spend the year in Minnesota with our family, four kids and all. 

Monday, March 23, 2015

Ear Tube Procedure

I don't know if ear tubes are even a surgery.  Maybe they should be called a procedure, which sounds less drastic, because they were so darn easy in comparison to Matteo's palate surgery. Yes, they got general anesthesia, but they were off to the OR and back in less than a half an hour.  They woke up a little groggy, but were reasonably chipper after some food and drink.  And then we were off for home with instructions to administer Tylenol, if needed.

We arrived at the hospital at 6:00 a.m. for Matteo's 7:30 a.m. surgery, which was followed by Kiera's at 8:00 a.m.  In comparison to Matteo's late afternoon surgery when he had his palate repaired, neither kid showed any sign they were thirsty or hungry. As an example of their general good nature, Matteo hugged the teddy bear the woman from Child Life Services gave to him instead of whacking it to the ground (which is so out of character for him!) when he was presented with a similar teddy bear before his palate surgery. 

At 7:30 a.m. sharp, the surgery team arrived to take us to the OR.  I got to carry Matteo while the woman from Child Life Services played with Kiera.  I laid Matteo down on the operating table and got to hold his hand while they put him to sleep.  I was surprised at how well he did.  I would imagine being back in an operating room so soon would bring flashbacks, but it was if he knew what to do instead. 

I spent a few minutes with Kiera before it was time to take her back for surgery.  She wouldn't lie down on the table, so the anesthesiologist put her mask on her sitting up, but she otherwise was so chill about the whole thing that everyone was commenting on how they have never seen such a relaxed child, much less a child so young. 

When I got back to the post-op area, Matteo was already back in his room.  No sooner had the nurse delivered some apple juice for me to help him drink when I heard that they were bringing Kiera back from surgery.  The nurses asked if it would be easier for me if they could transferred Kiera to Matteo's bed and I happily agreed. 

Before we were discharged, the ENT doctor came back to talk to me.  Matteo's surgery had gone as expected.  He had quite a bit of fluid built up in his ears and for kids with cleft lip and palate, tubes are pretty much par for the course.  As for Kiera, we assumed she'd need tubes.  She's three and didn't speak Chinese. (Although she's starting to mimic us.)  Her audiology testing indicated she has mild conductive hearing loss.  However, when the doctor cleared out all the ear wax, he said her ears looked very healthy.  While that it in itself is great news, it leaves us to wonder if there's more behind her language delay than simply mild hearing loss.  Both kids will have audiology testing again in a month so we'll learn if a lot of earwax was all that was impairing Kiera's hearing.  The only sign we've gotten so far that she can hear better is when she covered her ears while I pureed soup for Matteo's lunch.

Kiera and Matteo got lots of attention during our short stay.  Everyone was so curious about them and we got a couple questions about whether they were biological siblings or even twins (asked by people who all had access to their charts with their birthdays - six months apart, so negative on both).  Other than getting their own beds for the OR, they shared a bed in pre-op and post-op and the sight of two tiny, hospital gown-clad children playing peacefully in bed and sipping apple juice was too much for the nurses to not stop in and say hello. 
Being prepped on what to expect with surgery
The nurse who helped us out to our car said it's very rare to have two siblings in for surgery at the same time, so that's why they were attracting so much attention.  He could only think of one other instance, but said the children were a lot older, and therefore not as cute. 

Sunday, March 22, 2015

Post-Adoption Report Pictures

We need to submit eight pictures of each child for Kiera's and Matteo's one-month post-adoption reports.  They're supposed to show what our children have been up to since joining our family and how they are doing.  Since we haven't done a whole lot that's picture-worthy since coming home (we're supposed to be cocooning, and it's mostly been cold here in Minnesota), I've had to make a point to keep my camera on me and try to take pictures when we're out and about, or simply when I catch the kids in a good mood.  My kids have heard way too many times, "Smile!  I need a picture to send to China!"

When I finally uploaded all my photos onto my computer, I was combing through them when I came upon this one. This is what "real" siblings do, right?


Okay, really, I'm not going to let that one make the cut. Oliver and Soren actually play quite nicely with Kiera and Matteo and have been awesome big brothers.  There were so many other pictures to chose from that it's going to be hard to narrow them down to just eight.

Matteo
Clockwise from top left: 1. Guangzhou. 2. Playing with blocks at home. 3. Guangzhou. 4. Choo Choo Bob's train store.

Clockwise from top left: 1. Cruising the hospital in his car before his cleft palate surgery. 2. Family picture on Kiera's birthday. 3. Going for a walk pushing three kiddos. 4. Every time he sees the camera, he throws his arm around Kiera for a picture.
Clockwise from top left: 1. Matteo wearing his big brothers' hand-me-down overalls. 2. Donning their junior firefighters hats on a trip to our local fire station. 3. Posing with their siblings, friends and two friendly firefighters at the end of our tour of the fire station.
Clockwise from top left: 1. Kids love carrying their stuff in bags. 2. Snuggled up for a cold winter's walk. 3. All four siblings "smile" for the camera at the Minnesota Children's Museum. 4. Matteo "helped" me bake.

Kiera
Clockwise from top left: 1. Kiera and Matteo "helped" me bake. 2. Getting her teeth cleaned at the dentist. 3. Playing with trains at Choo Choo Bob's train store. 4. Getting a loving hug from Matteo while playing blocks.

Clockwise from top left: 1. Kiera on her third birthday. 2. Wearing the birthday crown Oliver made her while everyone sang Happy Birthday to her. 3. Riding in a wagon at Grandma and Grandpa's house. 4. Trying on her new shades from Uncle Andy and Aunt Danielle.
Clockwise from top left: 1. Guangzhou. 2. Kiera with Matteo and Daddy in Guangzhou. 3. Family picture on Kiera's birthday. 4. Matteo and Kiera.
Kiera had no fear jumping into the ball pit.  As you can see, she loved it!
One day we were all sitting at the table eating when Oliver said out of the blue to me, "When you send those pictures to China, you need to tell them that Kiera and Matteo are really happy here and we love them very much."

I will certainly do that.  I have no idea if their foster families will ever get any of the information from our post-adoption reports, but I asked our agency if they can at least make sure the families get the pictures of their former foster children.  Kiera and Matteo were loved so much and if pictures say a thousand words, hopefully no translation is needed to convey that Kiera and Matteo are happy and they are loved. 

Friday, March 20, 2015

Palate Surgery Recovery - Finally Better Days

The day after I wrote about Matteo's rough recovery from his palate surgery, things finally started looking up for him.  It started with actually getting a decent amount of food into him that night and for the first time, he might have actually felt satisfied.  Not being hungry does amazing things for your mood!

Although the rip in his palate continued to look worse into Wednesday, by that evening, it looked like it was started to retract, just like the doctor said it would probably do.  I brought him in for another post-op visit this morning and low and behold, it looks like his palate has actually fused back to his gum line in a few places.  (I know those are not very technical terms, but that's the best way I can describe it.)  The doctor thought things looked worlds better compared with what he saw on Monday.

Unfortunately, he did see another hole had formed towards the back of Matteo's palate and he was unable to see if there was also a hole in his nasal palate.  He couldn't tell if what he was seeing was a fistula, which would require surgery to repair.  Matteo wouldn't have another surgery until at least six months after the palate repair and I've heard it's "easier".  A lot can happen in the next couple of months, but I'm preparing myself for the reality that Matteo may need another surgery. His next post-op visit isn't for another three months, so we won't know what our next steps are until then. 

The doctor wants Matteo on a liquid diet through Monday, but from Tuesday on, he can have soft foods.  After two weeks of drinking his food, the soft food diet is going to be amazing!  He'll be able to have bread (with crusts cut off), pasta and eggs that haven't been pureed.  He can have anything that doesn't require a lot of chewing and just needs to stay away from anything that will be hard or rough on his mouth.  The soft food diet lasts a week and hopefully he's cleared for real food. 

Thursday, March 19, 2015

Liquid Diet

Since Matteo has had his palate surgery, I've played this awful game with myself of trying to decide what the worst surgery is to have and decided that palate surgery just might be right up there simply because of the liquid diet you're subjected to for at least two weeks (followed by at least a week of a soft food diet).

As uncomfortable as it sounds, a liquid diet is necessary because the cleft repair is not strong enough and chewing food can easily damage it.  The mouth needs time to heal.  Until then, patients can only consume foods that can be swallowed without any chewing.  Children's Hospital of Minnesota has a helpful pamphlet on feeding your child
 
Some of the foods we've tried:
  • Jello
  • Applesuace
  • Yogurt made with whole milk
  • Baby foods of every flavor, including the ones with the pureed meats
  • Whole milk
  • Carnation Instant Breakfast drink
  • Oatmeal (pureed)
  • Eggs (pureed)
  • Soup (pureed)
  • Tomato soup with crushed crackers
  • Beef broth
  • Beef broth with baby food added
  • Ice cream
  • Milk shakes
  • Whipped cream
  • Pudding
  • Mashed potatoes
Matteo quickly (very quickly) grew tired of the traditional "liquid" foods of jello, applesauce, pudding and yogurt.  We bought a bunch of baby food, but he had zero interest in that because the flavors were probably too boring for him.  (Ironically, trying to feed our two-and-a-half-year-old after a cleft palate surgery was the first time we ever bought baby food since we had done Baby Led Weaning with Oliver and Soren.)  We thought maybe he'd like the combination of flavors in those pouches of pureed fruits and vegetables.  Soren and Oliver loved those things.  Nope, Matteo turned his head at that too. 

We finally got him interested in very soupy mashed potatoes.  I bought the instant kind and added whole milk and extra butter to get as many calories as I could in him.  One time I poured in cream.  Once he discovered the potatoes, he started refusing all other foods, including sweet foods.  I think he liked having something warm to eat. When a nurse called from the hospital to check in on Matteo, I'm glad she mentioned that kids tend to find one food they like and stick with it, because I would have otherwise worried that all he was eating was mashed potatoes.

Unfortunately, the mashed potatoes fad didn't last forever.  There were some days when he I honestly don't think Matteo ate more than 300 calories.  He reluctantly ate a couple of those fruit and vegetable squeeze pouches he at first refused to eat.  But at 60-90 calories each, they don't pack much punch.  However, compared with the dairy-laden diet he'd previously consumed, he could benefit from a little fiber, so something good came of it. 

Chris was eating eating a beef stew one night for dinner and while he couldn't give Matteo the big chunks of meat, he gave him some broth to sip and he slurped it down.  We realized that other than the mashed potatoes, Matteo's diet had been devoid of salt and he was probably craving it.  For a few days thereafter, each morning I prepared a pot of beef stock to have on hand for the day.  For meals, I mixed a cup of stock in a bowl with one or two of the baby foods and he gobbled that up.  I also pureed a can of soup I found in the cupboard and he liked that too.  One day he wanted to squirt strawberry-flavored applesauce from one of those pouches into his soup.  I thought there was no way he was going to like it, but he ate it.  I guess it shouldn't matter that I thought it was gross, just as long as he was eating. 

Just as suddenly has Matteo had devoured his "soup," he was done with it.   He also refused any of the other foods he had previously eaten.  I had once tried preparing Carnation Breakfast drink, but he had refused to even try it.  Unlike American kids, Chinese kids are given really hot drinks (formula boiling hot, tea, etc.), so on a whim, I decided to give the Carnation Breakfast drink another try by boiling the milk before adding the mix.  That was the trick! He went through two of those each morning and at over 250 calories for each drink (when using whole milk), he finally finished a breakfast with his tummy full. 

Because it makes no sense why he loves something one day and hates it the next, or vice versa, our strategy has been to keep a lot of different foods on hand, try to ignore all the food we're wasting and just keep trying until something interests him.  Unfortunately, sometimes it's taken all day, or even longer, to stumble upon something he wants to eat, but when we do, it's an awesome sight to watch him happily eat. 

Tuesday, March 17, 2015

Rough Recovery

Matteo's palate surgery recovery has been rough going.  Most of last week was difficult as he was enduring those painful first couple of days after surgery and we desperately tried to stay on top of his pain medications.  Even with his pain controlled, he's miserable on a liquid diet.  He cries so much and I know it's because he's hungry.  He shows little interest in what we serve him, presumably because he wants real food.  I haven't seen him eat pudding since he left the hospital and has turned down ice cream and yogurt too.  Instead he moped around the kitchen while I made dinner and with a desperate look in his eyes, pointed at the noodle casserole on the counter.  Another day, we were eating lunch, and he refused what I had served him.  He wanted to sit on my lap while I ate my sandwich and Sun Chips.  He picked up a chip and held it in his hand.  I was curious if he'd try to eat it, but he knew he wasn't allowed to and instead tried to gently lick the chip.  That was one of the most pathetic sights I've seen!  It broke my heart and made me wonder if this experience is going to damage his healthy relationship with food.  Matteo has a healthy appetite and has shown no signs of food insecurity like we'd learned about during our adoption training.  He lived in a foster family his whole life and was never deprived food.  But that's exactly what we're doing to him now.  He has no way of knowing that what we're doing is actually meant to keep him healthy. 

Just when we thought we could ease him off the prescription pain medications, Matteo suddenly seemed to be in as much pain as he was the day after surgery.  When his fever spiked to 104 in the middle of the night, I called the triage line in a panic thinking that his palate had become infected.  The doctor told me they rarely see a post-surgery palate infection and the likely culprit was an ear infection.  He sent me to the pediatrician the next morning who confirmed not one, but two badly-infected ears, which he managed to get despite being on an antibiotic after the surgery.  She prescribed daily antibiotic injections, assured me the shots are fast-acting, and even double-checked his palate.  I felt relieved leaving the office that we were back in control of Matteo's recovery. 

Matteo continued to be fussy at breakfast the next morning and didn't want to eat, which we assumed was because his ears were still hurting him.  When I looked at him from across the table, I saw what looked like a flap of skin hanging down from the roof of his mouth.  I darted around the table and looked in his mouth to see my fears confirmed.  The stitches from his palate repair were coming undone.  To me it looked like the roof of his mouth was coming apart. 

I called the triage line again, this time in tears.  Matteo's surgeon called me back and tried to assure me it wasn't as bad as it looked and promised me he's not in worse shape than before the surgery.  Unfortunately, the front of the palate is very fragile and there was a high likelihood it wouldn't hold.  But because the palate is made up of two layers (an oral palate and nasal palate), he explained we only needed one to hold (preferably the nasal palate).  Whatever was happening with the oral palate I was seeing coming apart, it wasn't something a few stitches could fix and we'd have to let it be and reevaluate in six months whether another surgery would be needed.  I hung up the phone feeling like I'd been talked back off from the roof ledge.

I panicked again the next morning when I looked in Matteo's mouth and saw that more stitches from his palate had come undone and a flap of palate that had once connected somewhere right behind his teeth was close to resting on his tongue.  I called the triage line again and asked to see any doctor since I knew Matteo's surgeon was in surgery all day.  I was shocked when the nurse called back and said the doctor would see Matteo between surgeries if I could meet him at the hospital in an hour.  We happen to live close to the hospital, so I loaded all four kids in the car and headed over.

I almost wanted the doctor to look in Matteo's mouth and gasp about what rough shape he was in because it would mean they'd have to do something.  Instead I heard much the same from what he told me the day before.  There's nothing they can do.  He only needs one layer to hold.  The nasal layer is intact.  I questioned what to do about the layer of his palate hanging above his tongue and he assured me the whole thing wasn't going to rip away.  I can't imagine Matteo starting back on solid food in this state, but the surgeon said the layer will eventually retract and his mouth is going to look a lot different a month from now.  I guess I just have to trust him. 

As if he had read my mind, he said he never blames the parents or the child, because as careful as we are, a child sticking his finger in his mouth or a parent hitting the roof of his mouth while spoon-feeding isn't a likely cause.  If the it was going to fail, it was simply going to fail.  In a way, that was nice to hear since Chris and I had been racking our minds trying to pinpoint when everything went wrong. 

The doctor also recommended we stop looking in Matteo's mouth, because it does look worse than it is and we'll only worry.  That's harder said than done when I can literally see part of his mouth hanging down above his tongue! I have been peaking and, yup, it looks worse today than it did yesterday.  Yet I'm slowly starting to trust the doctor.  We have another post-op appointment on Friday and hopefully enough time has passed at that point that we'll be able to assess what the rest of his recovery is going to look like.

Monday, March 16, 2015

Adoption Announcement

Since I had made birth announcements for Oliver and Soren, I couldn't wait to make an adoption announcement for Kiera and Matteo.  (Okay, I didn't actually make anything.  A talented person with an Etsy shop takes all the credit. Check out Judy Lee Studios.)

Without further adieu: