Matteo is Four!

Matteo had a special birthday buddy to celebrate with this year. Our au pair, Nina, turned 21 on the same day Matteo turned four. Nina was kind enough to let Matteo pick what we would have for dinner on their big day and they also graciously shared a birthday cake. After dinner and presents, Matteo hit the sack, while Nina made the most of her 21st birthday falling on a Friday and went out to the Wild Onion with friends.

Matteo is still winning hearts with his rosy-cheeked smile, stylish glasses and Pillsbury dough boy laugh. He's so ticklish and it's easy to get him going with a few pokes to his belly. No matter how hard he's laughing, he always wants to come back for more. 

Even though Matteo is the youngest, he's the most empathetic of our children, and overall wise beyond his years at the tender age of four. One afternoon the kids were building Legos when Soren stole Kiera's chair, which caused her to scream and cry as she unsuccessfully tried pulling the chair back out from underneath Soren. Matteo assessed the situation and then pulled a chair from the other side of the room over to where Kiera was standing, tapped her to get her attention, and then very enthusiastically patted the seat to encourage her to sit down.  

Matteo likes everything to be in order and have its place. When Matteo was up at the cabin with his dad and brother, he disappeared into the bedroom they were all sharing. When Chris checked on him, he found Matteo had lined up all the water bottles and snack cups neatly on the nightstand and he was in the process of making the beds. Chris said  he was working so hard he was sweating!

Speaking of the cabin, Matteo loved being up there this summer. Anytime Chris took the kids to the cabin, Matteo and his siblings were giddy with excitement anticipating the opportunity to pack their bags and load up the minivan. Matteo loved spending time on the boat, tubing, roasting marshmellows, having sleepovers with his brothers, pedaling the paddle boat, fishing with his Ironman fishing rod...and well, everything about the cabin and being Up North.  

Being the youngest, Matteo uses a lot of energy to keep up with the rest of the family. He also doesn't nap anymore, except for catnaps in the car. This probably explains why he often falls asleep within seconds of kissing him goodnight and is the last to wake up. Kiera is not the most considerate roommate and often turns on the lights or just causes a ruckus while Matteo is sleeping, but amazingly, he doesn't wake up. 

At four years old, Matteo is approximately 39 inches tall and 33 pounds. He has been in 3T bottoms for awhile, but with the change in the weather, we moved him up to 4T pants. His speech is still very unintelligible, but we're hearing a little bit of progress. As always, everyone says what a joy it is to work with him.

Matteo is so brave when it comes to medical appointments. Granted, this is a kid who's used to having people look in his mouth, but the dentist was still surprised at how compliant a child of Matteo's age was when having x-rays taken. He finished has last cleaning with no tears, happily picked out a toothbrush and stickers, walked out the door of the waiting room and then ran smack into a wall. And that's when he burst into tears. 

My faithful readers who have long known about Matteo's intense fear of dogs will be surprised to read that Matteo is not only no longer afraid of dogs, he now LOVES dogs. Our former au pair spent a lot of time with Matteo (as well as Kiera and Soren) "puppy-training" him by having him spend time with the Great Pyrenees puppy her au pair friend's host family had gotten. Even as he slowly got used to Gustav, his aunt and uncle's large and hyper-active Golden Doodle, Watson, was a little too much for him. And then seemingly overnight, Matteo not just tolerated dogs, he sought them out. Watson spent some weekends at the cabin and when the others grew bored with petting the dog, Matteo made sure he continued to get some attention. He loves throwing the ball to him and doesn't even flinch as Watson tries to grab the ball out of Matteo's hand before he gets a chance to throw it. 

Matteo loves his family. He adores his brothers, is an awesome brother and partner-in-crime to Kiera and lives to be his daddy's little sidekick, whether it's fixing something around the house or making a Home Depot run. And at the of the day, he wants his mommy to put him to bed and kiss him goodnight.

Preschool for Matteo

Matteo started preschool over a week ago and I'm only now posting his back-to-school photos. The truth is, by the time I had gotten my last child off to what is just one of the three schools my four children are attending this school year, back-to-school fatigue had already set in. It felt like a win just to get some pictures taken. Such is the life for a fourth child.

This fourth child had longingly watched his siblings start school and knew what he was due and walked into preschool like he owned the place. Because of his September birthday, he couldn't start Pre-K with Kiera and Soren through the St. Paul School District, so he's back for another year at the preschool he attended last year and with the same teacher. She adores him and eagerly accepted him into the Pre-K class.

When I arrived home from work after his first day, he was excited to show me his "All About Me" poster, which he and Nina had almost finished. 

Fistula Repair and P-Flap 6-Month Post-Op

Matteo had his six-month post-op visit to check up his recovery from his fistula repair and p-flap surgery back in February. Despite how well his mouth has recovered, he did develop a fistula, or in layman's terms, he developed a hole. The hole appears small, but the surgeon can't tell how deep it goes. The good news is that the surgery appears to have been a success given that the fistula is not impacting Matteo's speech and his p-flap closes off properly to prevent air from going through his nose, which gives him the ability to pronounce a broader range of sounds. At this time, we don't think he'll need another surgery to do a revision to the p-flap, which means his next surgery won't be until he's somewhere between seven and 11 years old when he'll have a bone graft.

The bad news is that despite Matteo's incredible work ethic during speech therapy, his repaired and lengthened palate, his age (he's turning four soon) and being home for a year and a half now, his speech is still nearly impossible to understand. And when I say impossible, I mean that I as his mom have extreme difficulty in figuring out what he's saying. It's heart-breaking to hear him repeat a word over and over again with such persistence and helplessly can't understand him.  

The doctors told me what I already know, that he has a severe articulation disorder. Of the 44 phonemes (the smallest units of sound that distinguish one word from another) in American English, Matteo can only pronounce nine according to his speech therapist's evaluation. His speech includes multiple phonological errors, such as phoneme omissions ("poon" for "spoon"), syllable reduction ("jamas" instead of "pajamas") and difficulty sequencing phonemes in single words. Just like Kiera, Matteo doesn't readily initiate verbally and communicates in one- to three-word phrases at most. 

Aside from identifying that Matteo has a "severe articulation disorder", they can't do further testing on his expressive language skills due to how unintelligible his speech is. So we must plug away at speech therapy and wait until he develops more intelligible speech to be able to identify a more exact speech disorder. 

Matteo is so smart and inquisitive and like his sister, I'm curious what he's thinking and wish he were able to tell me.

Matteo Update: 3.5 Years

With his super stylish glasses and a personality that makes an impression upon everyone he meets, Matteo elicits adoring comments from just about everyone. His can-do attitude and eagerness to please is just so darn endearing.

In the coming weeks we need to make a decision about preschool for next year.  Matteo's September birthday means that he's not eligible for Pre-K along with Soren and Kiera, but he likes learning and we want something that will be challenging enough for him and fun all at the same time.

We're super impressed by how many letters Matteo knows and he likes to point them out to us, especially the letter M!  Chris took Matteo and Soren to the boat show and while Soren's main interest was climbing aboard every boat, Matteo's favorite activity was to look for the license number decaled on each boat and pointed out if he saw any M's or 3's.  (He's very proud of being 3, so of course that's his favorite number.)

My only nervousness about schooling of any kind, even preschool, is that Matteo's speech is still very difficult to understand, if you can understand him at all. We're hoping that this is the reason he doesn't try to talk much unless we actively engage him.

We hit a milestone recently when Matteo tattled on his brother.  I was downstairs getting ready for work when I heard Kiera crying.  I ran upstairs and found her sitting on her bed crying, but she was unable to tell me what had happened.  Matteo, however, was very eager to speak up for her.  His speech was still very difficult to understand, but Matteo was able to communicate, "Oliver hit back" and pointed to Kiera's back. Yup, when you have a child with such a profound speech delay, you get excited about any form of verbal communication, even in the form of tattling.  

Matteo loves swimming and was fearless jumping in the water at the Y. He didn't even plug his nose like his mom still needs to do.  He's a pro at his tricycle, and is now just barely big enough for one of his brother's hand-me-down bikes, which he immediately got the hang of and cruised down our block. 

The one thing he has feared has been dogs, but slowly (very slowly), Matteo is warming up to them.  My brother-in-law and sister-in-law's exuberant Goldendoodle, Watson, is still a bit much for Matteo, but Celina is having luck helping Matteo grow to like dogs by hanging out with her friend's Great Pyrenees puppy, Gustav.  Although Gustav will quickly outgrow Watson and seems like a odd choice to bring around a kid terrified of dogs, Great Pyrenees are pretty chill dogs. He's clearly growing more comfortable because when I asked a guy at the park walking two Great Pyrenees if I could pet his dogs, Matteo ran right up and voluntarily gave each dog a quick pat on the back. One turned and licked him in the face and while he wasn't thrilled about that, he didn't shriek in terror. 

Between preschool, speech therapy sessions and all the things Celina keeps him busy with, Matteo is tired by the end of the day. He doesn't nap anymore, but if we drive anywhere farther than Target, he falls asleep in the car.  Because he so desperately needs at least a catnap, we sometimes plan a post-lunch drive to give him a chance to sleep.  The only problem is that Matteo is GRUMPY when he wakes up.  

I'm not sure what's fueling that little body of his because he's getting a little pickier with food and for the most part won't touch vegetables.  However, he'll still eat vegetables if they're chopped up and mixed in a dish.  He's not the type of kid to refuse to try something new and if there's nothing else for dinner he likes, he'll eventually eat what's being served.

Whatever Matteo is eating, he's still growing.  He very recently moved up from 2t pants to 3T, but is in 3T shirts for the time-being.  I can see him being in 4T shirts by mid-summer.

Fistula Repair and P-Flap Post-Op

Matteo's recovery from his fistula repair and P-flap surgery has gone so much better than last year and his surgeon confirmed that when we went in for his post-op appointment. His mouth is still healing, but that's to be expected, and why the poor guy has another week and a half of a liquid and then soft foods diet.  But so far the fistula repair is still intact, which is really a miracle, because his surgeon said nearly all children with a bilateral cleft palate (especially to the degree Matteo's was) end up with at least a small fistula. There's still a possibility for that, but with each passing day, I feel more and more confident that we won't see the repair completely fail. The doctor isn't worried about a hole the size of a pencil eraser or smaller, especially if his speech isn't affected and food doesn't come out his nose.

After the doctor's visual inspection of Matteo's mouth and my report that he's snoring loudly, his surgeon thinks the P-flap is healing and doing what it's supposed to do.  Unfortunately, snoring is a side affect of the surgery because when the lengthened the palate, his throat can now be blocked off, which will help him make sounds that would be otherwise inhibited if air could escape.  The snoring will lessen in the coming weeks and months, but sadly for his future partner, won't completely disappear.  His surgeon, who's getting close to retirement and has been married many, many years, gave Matteo a fist bump and assured him that he's done just fine and his wife hasn't kicked him out yet.  Matteo of course had no idea what the joke was about, but flashed the surgeon his beautiful smile for good measure.

We won't know how much the P-flap surgery will impact Matteo's speech until he's completed another six months of speech therapy.  We'll be back in August for the six-month post-op visit and will also meet with his speech therapist at that time.  About 15% of children who've had a P-flap surgery need a revision.  Thankfully, that's an out-patient procedure with minimal pain and "only" five days of a liquid diet.  So a walk in the park for a brave little boy like Matteo.

I'm still in disbelief by how well Matteo's recovery has gone.  I really had prepared for the worst.  However, in the hospital, the surgeon told me that for some kids, this type of surgery ends up not being a big deal.  I can't believe Matteo ended up in the "1 in 10."  We have the advantage that he didn't end up with a double ear infection and stitches that ripped apart, both of which only added to his misery. 

Post-Surgery Recovery

Matteo's post-surgery recovery is going a lot better than this point last year.  Of course having this extra year together has helped, both in attachment and Matteo being a year older and able to understand that much more.  But I give a lot of credit to Matteo himself.  This kid is such a trooper!

Matteo was seemingly back to his usual self when I arrived back at the hospital the morning after his surgery.  He was sitting in bed watching a movie and although Chris hadn't been able to get him to eat more than a few small bites of ice cream, he had been drinking plenty and his pain seemed under control.  Chris went to work and Matteo and I hung out the rest of the morning and into the afternoon.  We received visits from various health care providers, played a matching game, put stickers in the sticker book Grandma had brought him and then cruised through the hospital in a wagon.  It was a lazy and quiet day at the hospital for us.

The only time Matteo appeared in pain is when I cajoled him into eating a few bites of his lunch.  Granted, he was eating pureed chicken mixed with gravy, so that there might have been the root of his discomfort, but I knew the nurses weren't going to discharge him if he didn't get some "solid" food into his stomach.  I otherwise wasn't concerned by what he was or wasn't eating because he had practically chugged two bottles of PediaSure and Carnation Instant Breakfast in one sitting and was willingly drinking plenty of water. He had already defied the surgeon's prediction that he was going to barely drink anything for five days following the surgery due to his throat, so I considered Matteo to be ahead of the game.

Into his second full day of recovery, Matteo continued to only want to drink Carnation Instant Breakfast, but I made it with whole milk and added some of the protein powder Marcel had left behind in an attempt to get as many calories and as much protein into his body to fill his tummy and heal his mouth. I got him to eat a fruit puree pouch and then a bowl of chocolate ice cream for dinner, but if he otherwise just wants to drink Carnation Instant Breakfast for the next two weeks, I'm fine with that if it means we get him through the liquid diet.

Overall, I can't believe how much better this surgery has been compared with last year's surgery and compared with what I had prepared myself for.  I brought Matteo into work this afternoon to visit my co-workers, some of his biggest fans, and no one could believe what a good mood he was in.  He was hamming it up for everyone, playing peekaboo from behind the cubicle partitions and basically acting like a typical three-year-old kid who had NOT just had surgery 48 hours prior.

As thankful as I am for his easy recovery, we're definitely not out of the woods.  I'm still very nervous that his palate could suddenly fall apart.  A small opening the size of a pencil eraser or smaller wouldn't be concerning and "shouldn't" affect his speech, but anything bigger than that is something they want to keep trying to repair.  My question was how.  They could do another fistula repair, which would be possibly an out-patient procedure, but would require the same liquid diet during recovery, or they could do a procedure where they take skin from the inside of his cheek and "fill in" the hole.  I know I shouldn't be focused on the options for another repair since it hasn't come to that yet, but it does make me feel a little better knowing that there are options.

Thankfully the p-flap procedure, which extended his palate and will do the most to improve his speech, has a high success rate and the doctor isn't worried about that coming apart.  There is the possibility that the surgeon will need to "tweak" the p-flap at some point in the next year if the desired speech results aren't achieved, but that's at least an out-patient procedure and less painful of a recovery.

In addition to Matteo's physical recovery, a lot of speech therapy stands ahead of him as he learns to retrain his muscles to make all the sounds that have been impossible for him until now.  Even though Matteo had not made much progress in speech therapy prior to his most recent surgery, I took comfort in hearing his speech therapist tell me that all the hours of therapy was time well spent because he was learning proper placement of sounds, even if he couldn't actually master those sounds. He has the practice in place so that once the surgery is completed, he has the potential to make more rapid progress than if he had done no speech therapy prior to his surgery. 


While hearing all this from Matteo's speech therapist was promising, a lot of unknowns still remain about how much progress he will actually make and in what time period.  My biggest concern is that Matteo's speech may be affected by more than just his cleft palate.  My gut has been telling me lately that there's maybe more going on and Matteo's speech therapist admitted the same hunch to me.  She had never mentioned anything until now because a speech disorder is too difficult to properly diagnose in a child who doesn't have much discernible speech. It's an observation she had tucked away and will wait to look into more a few months post-surgery. 

Chris does not believe anything beyond a cleft palate is affecting Matteo's speech and predicts that by his fourth birthday we'll have trouble keeping him quiet.  Let's hope he's right about that!

Fistula Repair and P-Flap Surgery

Matteo had his second cleft palate surgery today. It was a "twofer" surgery with fistula repair (to repair the hole in the roof of his mouth that was created when his palate repair dehissed) and a pharyngoplasty, (also called a "P-flap" surgery) which will lengthen his soft palate and, fingers crossed, improve his speech.

Matteo has heard us talk about the surgery a lot, but we'd never actually sat him down and explained what was going to happen and I realized I owed it to him, even if he's barely three and a half years old, to do that.  Given his lack of a sense of time, I chose last night, the night before surgery.  I explained that when he woke up he wouldn't be allowed to eat or drink anything and that right after getting dressed, we would be going to the hospital for a surgery to fix his mouth.  He seemed sad and when I asked him if that made him scared, he shook his head yes.   

His mood changed at the hospital and he was suddenly excited to push the buttons on the elevator and show me where to go.  He goes to the hospital for speech and other appointments, and it's clear he's become quite familiar with the place.

That his mom is late for everything actually ended up working in his favor.  Last year Matteo had an afternoon surgery, which started late, and it was tortuous trying to keep a hungry, thirsty and cranky two-year-old distracted.  He had what I thought was a 9:00 a.m. surgery, which meant we were supposed to be there at 7:30 a.m.  Well, the surgery was at 8:30 a.m., so we should have been there at 7:00 a.m., but well, I was shooting for 7:30 a.m., and of course we were late.  When we showed up at 7:45 a.m., the staff was waiting for us, checked us in quickly and whisked us back to a pre-op room.  One after another, nurses, the surgeon, the pharmacist, a nurse anesthetist and the anesthesiologist stopped by the room to check in. At exactly 8:30 a.m. a trio of nurses wheeled him back to the OR, he calmly let them put his mask on, he quickly fell asleep, I gave him one last kiss, and the surgery I'd grown so anxious about in the preceding weeks was finally underway.   

The surgery took about an hour and Matteo ended up spending longer in recovery than he did in surgery thanks to needing an extra-large dose of Morphine, which caused him to take an extra-long nap. His surgeon met with me while we waited for Matteo to wake up and he reported that both procedures had been completed without complications. Despite the uncomplicated surgery, he reiterated how painful the next 5-7 days could be for Matteo since a p-flap surgery involves taking skin from the back of the throat to use to lengthen the palate.  He also reminded me how fragile his palate is and why a strict liquid diet is going to be crucial to his recovery.  The failure rate is still relatively high, which makes me nervous.

We spent the afternoon settled in Matteo's hospital room, where he went in and out of sleep.  When he was awake, we tried to get him to drink and eat something, but that was a tough sell because swallowing clearly caused him a lot of pain.  My mother-in-law had come to keep me company, so we hung out and did our best to help Matteo stay comfortable.

I know the therapy dogs are there for the kids, but with Matteo sleeping off the anesthesia, I got to spend some time with Freddie, a six-year-old Golden Retriever. 

Chris and Celina came over after dinner with the kids, who seemed to have forgotten why Matteo was in the hospital and fixated on what they thought was a sweet set-up - all the juice, pudding, ice cream and DVD's Matteo could ever want.  Not even Matteo throwing up dried blood (and what looked like a lot of it!) scared them away.

Chris volunteered to do the night shift, which I'm so thankful for since I find sleeping overnight in hospitals so incredibly lonely.  I'll be back in the morning to relieve him.  Hopefully Matteo's stomach has settled by then and he is finally able to eat something.  He won't be discharged until he's eating and the nurses feel like his pain management is under control. 

Another ER Visit

It was a long, long week at our house.  The kids passed around illnesses ranging from 105 fevers to ear infections and in the middle of it all, Chris hopped on a plane to Dallas for another business trip.  He sent me this text from the airport.  

Dropping the kids off was a breeze.  Matteo didn't even give a hug goodbye.  He was so pumped about coloring with his friends.  That was a nice way to start a work trip.

I was still smiling after reading Chris' text when I opened up the other text I had received.  This one was from Celina.

Soren pushed Matteo down the stairs and he is crying a lot because his arm is hurting.  I don't think it's broken, but I'm not sure.  One arm is bigger than the other one. 

We hadn't received the bill from Soren's fishhook ER visit and back to the hospital I was headed with another injured kid.  I wasn't even sure Matteo's arm was even broken though.  You had to look closely to notice the swelling, but then Celina mentioned that when she lifted his arm, she heard a crackling sound.  She imitated the sound and there was nothing lost in translation.  That's no sound a bone should make.

Matteo is a stoic little boy.  Once he stopped crying after he fell, he remained pretty calm.  He wanted to lie on the couch or sit in someone's lap instead of playing, but if you didn't notice his arm limp at his side, he could have fooled you that he wasn't injured.  He even looked slightly amused about getting to ride in a Radio Flyer wagon at the children's hospital and used his good arm to curiously point at pictures in the books I brought to read to him while we waited.

The triage nurse, the ER nurse and the ER doctor all examined Matteo's arm, noted his demeanor and decided he must be suffering from "nursemaid's elbow," even as they admitted that diagnosis didn't make much sense since such an injury is caused by pulling on the arm and not falling on it like Matteo had. I called Chris and complained that I was sitting in the ER for something I could have probably fixed myself and he made me promise I'd leave fixing his future middle linebacker's arm to the professionals.  The professional tried twisting the ligament in Matteo's arm back into place, he screamed, the doctor apologized and sent Matteo straight for an x-ray.

Matteo's arm was broken.  He had a fracture of his supracondylar humerus, to be exact.  The humerus is the upper arm bone between the shoulder and elbow and I think "supracondylar" means "above the elbow." The location of the fracture is a spot in the humerus that is much weaker in young children than adults, which is why the fracture Matteo experienced is the most fracture to occur in children.  


A supracondylar humerus fracture can cause complications, such as nerve damage and impaired circulation, and sometimes requires surgery (in addition casting) to correct.  Based on what the doctor could see in the x-ray, she suspected Matteo might need surgery.  She sent Matteo home with a splint and some painkillers, and told us to follow up with the orthopedic the next day.

I called the next morning and the nurse I spoke to said that if he needed surgery, they would want to do it that day, which meant that poor Matteo was cut off of all food and drink from that point on.  This also meant poor Celina, because she was the one at home with a kid she wasn't allowed to feed all day.  (I'm telling you, this woman is earning her stripes with our family!)

Thankfully surgery wasn't required and I let Matteo tear into the snacks we had brought with us before they sat him down to put a cast on his arm.  They brought out samples of the colors available and he chose a blue cast. 

Now to keep our fingers crossed that his arm heals quickly and he only needs to have the cast for the estimated four weeks. 

Our little man with his new cast.

Matteo at Age Three

A year ago today I was so sad we couldn't make it to China before Tao Tao's second birthday.  September had seemed so far off when we first laid eyes on his picture in May.  Our dossier had already been translated and our agency was predicting a quick approval from China and I honestly believed it wouldn't be long before we'd have our children in our arms.  Instead, by the time Matteo's birthday came, we had experience multiple delays and were in the middle of a never-ending wait for approval from China.  Instead of being happy, I was depressed. 

A year later and I was at a park with a friend and as my kids were running around enjoying the sun and the chill autumn air, and she turned to me and commented how she can't believe Matteo and Kiera have been in our family less than a year because it seems like forever they've been a part of our lives.  Although I will never forget the ache in my heart as I hoped to one day finally hold my children in my arms, my sadness has been replaced with joy.  Matteo and I were seperated for his last birthday, but he is forever part of our family for all his birthdays to come.   

Matteo is a joy for a son.  He's not the most smiley of kids, but gosh, when he does smile, he lights up a room with his huge grin.  There's really so much to love about this kid.  He has such an agreeable personality who generally goes with the flow and is up for what anyone else is doing.  He loves books, baths, reading books, coloring, building with blocks or Magnatiles, playing outside and tagging along to anything his brothers are up to.    

He loves going to preschool and is thriving there, as are his siblings.  I wish I could send him five mornings a week instead of only three because he likes it that much 

Matteo takes it easy on us parents in that he's completely potty-trained (and has been since we met him), is a great eater and sleeps well. Don't those issues comprise the top three complaints parents tend to have about their three-year-olds? 

Matteo works very hard during his speech therapy lessons and his therapists continue to be impressed with his attention span and persistence.  He currently has four sessions a week between what he qualifies through the school district and then private speech therapy.  Unfortunately, his speech is still largely unintelligible unless you know are really paying attention and have direct context (as in he points to the object as he says in the word).

As the fourth child, Matteo's naps have been pushed to the wayside.  We're able to get away with this because he's such an easy-going child, but most afternoons, it's clear he could benefit from a catnap.  If we're in the car in the afternoon, it's rare he stays awake, even for a five-minute drive.  When he wakes up from a short-lived nap, is one of the few times we see him truly grumpy.  The post-nap period is prime cuddle time.  

He's pretty attached to Chris and his brothers.  Sometimes Chris and I divide and conquer with the kids and we each take two and head in separate directions hoping to get as much done as possible.  Matteo is so sad if he see Chris leaving with Oliver and Soren and he gets left behind.

Something else that continues to incite tears in Matteo are dogs.  It doesn't matter how big or small, puppy-like or elderly, well-behaved or needs to go to obedience school, he steers clear of any dog at any cost. 

A recent development we've noticed in Matteo is wanting to do things by himself.  Whereas he used to get upset if someone wouldn't help him put his shoes on (even though he could do it himself), he now gets upset if you try to help him.  He also wants to try to dress himself, which can really test one's patience. 

These Three Are Off to Preschool

Oliver started kindergarten two weeks ago and my other three finally had their first day of preschool today.  It was an extra special day for Matteo, because after accompanying his three older siblings to school last spring, he got to walk into school, not as a younger sibling, but as a classmate.  Due to a mixed-age class and a teacher willing to be flexible with a September 1 age cut-off, (Matteo won't be three until the end of the month) Soren, Kiera and Matteo are all in the same preschool class this year.  When I learned that there are only nine kids in the class, their teacher pointed out that if my kids get sick, there goes a third of the class!

Aren't little kids with book bags just so adorable?

Celina dropped them off on their first day and reported that everything went very well.  Kiera and Matteo knew exactly what to do and were happy to be there.  Soren also did better than we expected since he only needed a few extra hugs and reassurance.  It warms my heart that they like school and am thankful for those three mornings a week they get to play with other kids their age. These next two years are precious to me because they're the only time these three will spend in the same class together before they're going to be split up across two grades. 

Cleft Palate Repair Follow-Up

If you had asked me a month ago how Matteo has been doing since his cleft palate repair in March, I would have told you we were expecting another surgery in the fall.  While much of his palate did heal like the doctor said it would, even after it looked like it was falling apart a week after surgery, his palate still has a sizable hole and any time he sneezed, lots of food shot out of his nose.  Then one day I realized I couldn't remember the last time I had wiped his nose and I began to have a glimmer of hope that another surgery wasn't necessarily a given. 

Last week Matteo had an appointment with the craniofacial surgeon and a craniofacial speech language pathologist at Gillette's.  The pathologist sat on the floor of her office and using toys, books, pictures and games, enticed Matteo through a series of exercises to evaluate what sounds he can and can't make.  He was a model patient in that he was eager to please and very curious.  He loved the attention and had no idea he was at therapy. 

The surgeon believed that the hole I could see in the hard palate is a fistula, which means it goes through both the oral and nasal palates, because the pathologist had observed moderate hypernasality in Matteo when he talked.  Ideally there would be no fistula, but the presentation of one isn't necessarily a problem if nothing is coming out of a child's nose and a child can speak clearly.  The fact that we have seen a significant decrease in anything coming of Matteo's nose is a very promising sign.  Of course we don't know yet how his speech will progress until we've given speech therapy some time.  Thus the surgeon wants Matteo to continue speech therapy for six months and reassess his degree of hypernasality.  If there isn't enough improvement, he will probably need the fistula repaired this winter. 

Starting Speech Therapy

This week starts speech therapy for both Kiera and Matteo.  I'm relieved they have finally been evaluated and recommended for therapy because I know they need the extra support.  Too many people have made excuses for them because "they're still learning the language." I think everyone who has interacted with my kids has really low expectations because they can't wrap their minds around these children moving around the world to a new family, language and culture.  And then they see two happy, well-adjusted kids and probably think, what more could I want from them?  

We underestimate being able to communicate, especially in young children who've gotten by so far with a lot of pointing and smiles.  Whether you're deaf and communicate with sign language or are hearing and communicate with spoken language, having the ability to communicate with other human beings impacts our happiness, our friendships and our learning.

While I never lost hope that Kiera and Matteo would experience an English-language explosion, my gut told me ignoring the problem wasn't going to help.  I know that if my children were speaking Chinese, they'd have the ability to learn English, and that they should be able to pick up words in a new language quickly, even if it takes up to two years to catch up to native-speakers.  The reality is that my children spoke no more than five words in Chinese when an almost-three-year-old like Kiera should have been jabbering away.  Some children leave China already speaking a couple words in English, whereas as at five months home, my children don't use more than five words in English to communicate.  We have recently heard them imitate words or randomly say a word, but not in context to communicate a need or want.  

For awhile I tried to stay patient.  Matteo needed surgery on his palate and wasn't physically able to say most sounds without a repaired palate.  Both children were diagnosed with conductive hearing loss, which we addressed through surgery and they passed their repeat audiology test one month later.  It was in the weeks following their surgeries that I really had hope that just any day now their language would come together, but it never did.  

I contacted Help Me Grow, a state-funded program that provides free therapy services for children from birth to age five.  Matteo easily qualified, and starts his first session this week, but since Kiera is over age three, it's harder to qualify for services and we'll need to wait until the fall to have her reevaluated. 

I also asked a fellow China adoptive mom in my area where her boys with cleft lip and palate go for speech therapy, and in addition to working with Help Me Grow, she recommended doubling up on therapy by also working with Gillette Children's Hospital, where Matteo had his palate surgery.  Kiera started her first session this week and we're in the process of scheduling Matteo with a therapist who works specifically with kids with cleft lip and palate.  

Therapists with both programs cautioned me that they're not miracle workers and that speech therapy takes commitment and time.  This is especially true for Matteo since kids with cleft lip and palate typically need years of speech therapy.  But we're now doing something proactive to support their speech development and that makes me feel better than if we were doing nothing at all. 

And that my children are able to attend their recommended appointments I owe all to my mother-in-law, Nan.  Each child will have one to two appointments through Help Me Grow and Gillette's each week, which means there could be some weeks in the fall when we have a total of eight therapy appointments scheduled.  Without Nan's offer to take them, the reality for our two-working-parent household is that we would not be able to pull off that level of therapy.  And that's even though I work ten minutes from home and five minutes from the hospital and have an incredibly flexible workplace.  

In addition to bringing Kiera and Matteo to their appointments, my mother-in-law takes incredible notes.  The evening of Kiera's first appointment, Nan e-mailed Chris, me and our au pair a summary of the session, the ten words in sign language we need to learn and practice with Kiera and links to a website to learn the signs.  (Sign language foster language development by giving non-verbal children a way to communicate.)  Chris and I may not have been able to make the appointment, but Nan made sure we didn't miss a thing.  

Now let's see if we can teach Kiera one more sign before her next appointment. 

Retaining Adopted Kids' Native Language

Today marks our fourth month home from China.  Although I assumed that Matteo had lost virtually all his comprehension of Mandarin, today's speech evaluation confirmed he hadn't.  We've been working on getting Matteo qualified for speech services through the school district.  They had evaluated him in English last week and while it was clear he's delayed in speaking, he did a really good job following most of their directions through the hour-long session.  For today's evaluation, they insisted on bringing a Mandarin interpreter even though I told them I didn't think it would do any good. However, the Mandarin interpreter led him through similar tests today and he did just as well following directions in Chinese as he had in English the week before. 

Hearing Chinese again and watching my son follow the interpreter's playful directions was bittersweet for me.  I was happy Matteo still holds onto a vital piece of his culture, but also sad, because I know his retention of his native language won't last much longer.  When I had assumed Mandarin had slipped away permanently from him, I got a surprise glimpse into his still-bilingual mind.  But the next time someone addresses him in Mandarin could be the time he stares back at the speaker as blankly as his American-born family, unable to understand beyond a simple greeting.

Anyone who has struggled to learn another language later in life would give anything to know a second language early in life.  It would be wonderful if Matteo (and Kiera) could grow up bilingual in Chinese and English.  Sadly, maintaining their native language is not realistic given our family's resources.

Since kids' brains are like "sponges" and they pick up languages "quickly," it's easy to overestimate their ability to either acquire another language or retain one. Language acquisition or retention require routine practice and another human being to speak with. I know a family who is hosting the college-age child of family friends from China.  What an incredible resource for helping their newly adopted seven-year-old son keep up his Chinese.  Another family has hosted Chinese au pairs since their daughter's adoption three years ago.

Since Chris and I both work full-time, hiring a caregiver who also speaks Chinese would probably be the only feasible way to get regular language exposure.  With four children, hosting an au pair is really our only affordable childcare option. We looked au pairs from, and Germany and Brazil and Mexico and from everywhere else in the world because it's very difficult I discovered to find an au pair willing to come to Minnesota and take care of four children, so we had to cast our search wide.  That said, we weren't going to chose the first person who agreed to this and spoke the desired language we want our children exposed to.  In the end, the most qualified person happened to be a German-speaker.

To be honest, I might never have been able to bring myself to pick a Mandarin-speaker for our first au pair after adopting.  If we had lived in China and my bio children had learned the language and I wanted them to retain it after returning to the states, it would have been a no-brainer to pick a Mandarin-speaking au pair.  But I'm also not worried about my bio children's attachment to me as their new parent.  Given the challenges with attachment we have faced with both of our children, I can't imagine it would have helped our attachment if we had a third adult in the house speaking to them in their native language.  Of course there would have been other benefits like making our children feel comfortable and maintaining their native language.  But I was stressed enough with how the presence of our non-Mandarin-speaking male au pair was going to play in the bonding process. 

Since our au pair doesn't speak Mandarin, our only other option with children as young as ours (two and a half and three years old) would have to hire a Mandarin-speaking babysitter or a tutor.  But that would have put us back in a position of struggling with how to best support Matteo's and Kiera's attachment to us.  We also don't have a lot of extra money or time to hire someone extra.

Others have suggested language classes, language instruction videos, music and television show and moves online.  Those are all wonderful resources for language exposure or supporting fluency, but they alone cannot make or keep someone fluent in a language.  You need a human to interact in the language with, most likely multiple times a week, at least with the young ages of our children.

Adoption adds unique considerations to how we help our children preserve their first language.  It's hugely important to many adoptees to maintain a connection to their culture, including language, but as adoptive parents, we have so many needs we're trying to balance on behalf of our children.  The first few months home (or longer) are just about survival.  We're still getting to know our new children and adapting to changed family dynamics.  The last thing on my mind was adding something to my plate that didn't absolutely have to happen, like taking care of my children's medical needs.  We've been home for four months and while our adjustment has gone better than I could have hoped for, I know we still have a ways to go until we fully settle into our new normal. 

We'll continue to support Kiera and Matteo's connection to their Chinese culture and first language, but I do mourn the loss of their fluency in their native language and the fact that there's only so much I could do to prevent that.  

Matteo: An Adoption Story

Matteo has been featured twice on the Love Without Boundaries blog.  The first post was written about "Smiling Matt" and the second post, Matteo: An Adoption Story, was written by his mom - me. I was so honored when a staff member at Love Without Boundaries asked me to write a blog post about Matteo for their series on foster families.  I wrote from my heart not just about my love for an incredible little boy I get to call my son, but also for his foster parents.  The foster care director read my post and asked if she could share it with Matteo's foster parents so they know how valued their work is.  Without question, yes. 

Matteo Update: 2.5 Years

What I love about Matteo is that what you see is what you get.  For instance, he does NOT like to be woken up before he's ready and will bury his head in his pillow like a grumpy teenager, and it's clear, DO NOT DISTURB.  But once he's slept, he'll wake up ready to start his day and there's no question he's happy.  He shrieks with happiness when he sees something he likes and dives right in to playing.

Luckily he's a mostly happy, fun-loving kid.  He's a typical two-and-a-half-year-old who's into what you would expect a child this age to be into, like blocks, cars and playing outside.  He even tries building with Legos with his brothers even if his attention span and fine motor skills aren't quite there yet. 

I love how much this kid loves books!  He still hasn't figured out how to hold a book right side up, but he loves looking at them nonetheless.  He's got the  bedtime routine down.  He knows to go pick out a book and that whoever books Mommy or Daddy is reading, that's who gets to sit in Mommy or Daddy's lap.  I took him to story time earlier this week and he loved it.  I don't think he would have been able to stay engaged if all the librarian had done was read a book, but it was a very interactive story time with songs and movement along with the stories and he actively participated nearly every minute of it.  We sang "If You're Happy and You Know it (Clap Your Hands)" and he enthusiastically clapped through the whole song, even when we changed to stomping and then turning in circles.

One thing he does not like though are swings.  He's interested in them, to the point you think he wants to sit on the swing, but then you push him and it's clear he's terrified.  Even with a gentle push, he has that "stomach-dropping" look that you normally get during the downward plunge on a roller coaster.

Matteo still isn't saying any discernible words. I've noticed he no longer says that one Chinese word anyone could discipher ("ay-ya", which kind of means "yay!") and now mainly yells, "Ma!" at everything that excites him or when he's trying to get your attention.  His ear tube surgery went well, but we haven't noticed whether he hears more than he did before.  He goes in for another audiology test in a few weeks and all we can do for now is keep our fingers crossed that his hearing has been restored.

Despite his lack of speech, Matteo makes his needs and desires known, mostly through a lot of pointing.  He will also come up to me and pat me on the arm to get my attention if he wants to show me something. 

We had Matteo in diapers for two weeks while he recovered from surgery.  The liquid diet was causing him to wake two to three times a night as it was.  It got pretty ugly during those midnight bathroom breaks because Matteo is otherwise a deep sleeper and does not like to be awake if he's tired.  There were so many times we wished he'd just go in his diaper, because he probably would have been happier than he was when he needed to use the toilet.  Unfortunately, we got our wish - right when we decided to put him back in underwear.  It took a couple of days of pretty much non-stop laundry, (we're also in the process of potty-training Kiera) but we might have gotten him back on track.

Matteo is adjusting well to his glasses.  When he first put them on, he touched the glass and pulled them on and off his nose.  I was told that's normal as they just get used to them.  That first afternoon with the glasses he kept pulling them down his nose or tried touching the glass and needed reminders to keep them on and leave them alone, but ever since then, he pays them no notice.  He lets us put them on him in the morning and goes about his day without a complaint.  We haven't seen any evidence he sees better with them, but we were told if he "high steps" (which I thought he did a bit), this would probably disappear.

When we named our newest son Matteo, we intended for his nickname to be Matt, a name I love.  And maybe that will be one of his nicknames someday, but right now his dad and brothers call him Tao Tao (his Chinese nickname) and Kiera calls him Teo because she can't pronounce Matteo yet.  That's fine with me because I think nicknames need to develop organically and that makes Teo and Tao Tao that much more special.  

File from Love Without Boundaries

Pictures and reports of Matteo's life before we knew him recently arrived in my e-mail inbox.  His orphanage in Fuyang is supported by Love Without Boundaries (LWB) and his lip repair and foster family were sponsored by the organization.  They run many wonderful programs for children across China.  In addition to sponsoring surgeries and foster families, they provide medical care to children so they can stay with their birth families, they set up schools inside orphanages and provide children with well-balanced meals.  These much-needed programs required a lot of resources, yet Love Without Boundaries still takes the time to catalog all the photos and reports for each child in their programs so that if they are adopted, they can one day pass along all this information to the new parents.

The Love Without Boundaries website has a link under it's Contact page called Request for Child Information.  Once the adoption has been finalized, adoptive parents may submit a request for any information the organization has on their child.  I filled out the online form and hit send, but wasn't sure what I would receive or how long it would take. 

Exactly a week later, we received the gift of a glimpse into Matteo's life before we met him.  Love Without Boundaries had responded to our request with a Dropbox link. I clicked on it to find four electronic folders from the different stages of LWB sponsorship: Matteo's two stays in healing homes, his hospital stay for his lip repair and his time with his foster family.  In each folder, meticulously labeled and organized into sub-folders were monthly reports (thankfully written in English) and pictures.  There were 170 pictures from his Anhui Healing Home stay alone! 

I will be forever grateful for the care Matteo received before he became part of our family.  He needed that surgery and of course he needed loving care, like every child deserves.  What we don't necessarily "need" is the information LWB provided.  As much as the origanization was able to share with  us, it still leaves many pieces of Matteo's early life unknown and questions unanswered since LWB can only provide information about Matteo's life while he was under their care.  Yet I will argue that every person deserves to know his or her history; therefore, I am as thankful to LWB for having the discipline and organization to record all this information for each and every child in their care as I am for the medical needs they fulfill. 

I spent an evening scrolling through all the pictures and enjoyed seeing images of him that I had never seen before.  It was also bittersweet to be playing catch-up through pictures of my son's early childhood, yet again, I'm thankful for everything and I wished there were more. 

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. 

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. 

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.

Palate Surgery Recovery

I am thankful I acknowledged what I thought was best for my family and insisted that Matteo's palate surgery be done while I'm on family leave, even if that meant scheduling the surgery less than a month after he came home. His doctor was in support of this, but I know some adoptive parents recommend waiting until your child has had more time to adjust.  Unfortunately, I don't have the benefit of time.  And now that we're in the recovery phase of his surgery, I have no idea how we'd properly care for Matteo during his estimated two-week recovery with both of us back at work.

Matteo was in quite a bit of discomfort throughout the night, but when I arrived at the hospital this morning, he was contently sitting in Chris' lap.  He was not happy to see Daddy leave though and we went and raided the toy closet in attempt to cheer him up.  

We were late being discharged from the hospital today because the nurses were concerned that Matteo's pain wasn't properly under control.  With a two-and-a-half-year-old who doesn't talk and is still learning English, it's difficult to establish what he's feeling.  His crying could have been because his dad, who had spent the night with him in the hospital, just left, because his pain medication was wearing off, or because his sister was sitting on the other side of his hospital room eating a sandwich and he wasn't allowed to have one.

No sandwiches are allowed because Matteo is on a liquid diet and that, more than pain management, is going to be the hardest part of his recovery.  At first I didn't think it would be so bad.  He just needs to eat soft foods, right?  Then I saw the remains of his breakfast, which included pureed scrambled eggs.  I never thought eggs could inflict much damage, but when they say "liquid" diet, they aren't kidding.  The nurse sent back the yogurt she ordered for Matteo when she saw fruit chunks in it.  I learned that scrambled eggs and yogurt with chunks and anything soft with lumps in it has to wait until week three. The doctor had explained that his repaired palate is so fragile right now that a soft poke with a finger could pierce it.  Yikes!

Another adoptive mom of two kids with cleft lip and palate had warned me about the food restrictions during recovery from palate surgery, but she insisted it wasn't so bad.  Her children had also had their surgeries shortly after coming home and she said that after living in an orphanage without a lot of variety in their diet and where children are bottle-fed much longer, they hadn't yet developed a taste for real food.  But Matteo knows real food.  He had lived with a foster family who fed him well and when he came to us, he refused the bottle the orphanage had insisted he was still drinking from. 

Dinner was no better than our experience in the hospital.  He cried and cried as he watched everyone else enjoying their dinners of solid food while his mashed potatoes and bowl of pureed meat and carrots baby food got cold.  He didn't even show interest in chocolate pudding.  I'm hoping that when he is in less pain he'll be more interested in eating, even if the food is pureed, but I'm nervous it's going to be a long two weeks.