Never Fear, Sheridan is Here!

If Mom can't fix my hair, I'll ask my older sister!
I'm sorry I didn't have time earlier to post much other than Mamush's "Michael Jackson" moment. I brought the 3 younger kids to the pediatrician for shots, and I ended up having chest x-rays done on Maritu and Mamush at the hospital. I even had Kenneth come with us, so maybe he would pull some strings to lessen the wait time. By the way, he's just worthless!!! lol! We had to have this done though, or the government might come and take our kids and put them in foster care because they feared they had TB. If they really did have TB, then I'd hate for the Health Department to know that the 400+ people in church the last two weeks, all the people on the KLM flight from Amsterdam and Ethiopia, and all those poor immigrants that were in that long line at immigration in Houston will have to be quarantined too! No, I'm just joking, but the Health Department said that they wanted a chest x-ray. I was thankful they didn't make us go to the Houston health Department for another TB skin test. That was a posssibility too. I mean, how many tests does one have to go through before the result will stand? Well, hopefully the phantom TB issue will be resolved now. Then we just have to get through all of these consults that Mamush's many doctors have requested: genetics, opthamology and neurology.

I Want To Be Like My Family

I couldn't help snapping this picture and making a joke about it. You see, I heard my teenager yelling , "Mom, they made a mess!" So, I went to see what all the fuss was for, and I was tickled when I saw that Mamush had gotten into the chalk for our pool table. Maybe he just wanted to look like his family?!!? lol!!!

Things I Miss About Ethiopia

1. Simplicity of life

2. The food. I love Ethiopian food. I'm not a big pizza fan, but I miss the killer, Ethiopian style pizza. The sauce and crust are completely different. Yum!!! (I wonder if I can find home delivery? lol!)

3. The warm sunshine and cloudless skies

4. Ayele

5. The music and the Ethiopian shoulder dance (I'll have to visit Kristine's blog.)

What's Life Like...

...with 6 children? Come visit me to find out. Well, there's never a boring minute, of course! I was busy before bringing the two toddlers home... I do have advice for anyone considering two children at one time. I would not recommend two unrelated siblings. I might be wrong, but it seems that related siblings have a bond that unrelated ones do not? Hopefully Maritu and Mamush will develop that bond. Right now, they fight terribly! Maritu whacks Mamush over the head with toys any chance she gets. I thought she was a brute, until I caught Mamush. That sneaky devil bites, so don't pity him! I guess they remind me of Cullen and Curran, although they are bio siblings. I guess I just ruined my own theory...

Other than the fighting, it seems just to be a constant battle of who gets my attention. Maritu seems to be more independent though. Mamush would be content to just sitting in my lap all day long. I've been working on strengthening their muscles. Maritu walked a few steps for me in Ethiopia, but now she walks every where, but she still walks like a drunk, Michelin man. I think that huge belly is the problem! On the contrary, Mamush has no desire to stand alone, much less walk!

Hot Hearts

Anyone with teenage children needs to look at this site: www.hothearts.org . Hot Hearts is a high energy "Heart" pumping weekend for students all over Texas and Beyond. The conference is designed with youth in mind and reaches deep into the Heart of what students are dealing with and what they need to know. The conference has changed over the past years but the vision has always remained the same: to provide students with a chance to hear the word of God in an exciting and cutting edge environment. Hot Hearts has always combined the messages of the most effective youth communicators and the very best in Modern Christian music with state of the art video and lights for an unforgettable weekend.
My teen attended Hot Hearts this weekend with many other churches, and thousands of other teens. I wish there would have been something like this when I was a teen...

Medical Update

My little Mamushay has an array of issues. I was told by my agency on several occasions that Mamush's eye problem resulted from a parasite and that he had been treated for it. I'm not sure where they got that information since I never saw a profile on him. I was also told that it was AWOP's responsibility for his medical. You'd think that my agency would ensure that he actually had a medical assessment when they took responsibility of him... Or is this another case of incompetence like Maritu's story? I don't know the answer, but I can say it's bad business... So, what's going on with Mamush? He has a congenital eye problem called coloboma. He never had a freakin parasite! You can tell because he has no residual inflammation in his eye that would be expected had he had a parasite. He is blind in that eye, and it is not treatable. This wouldn't be too bad, and the outcome the same as our worst case senario if his "parasite" diagnosis were true, but a coloboma in a child is indicative of other problems. Now 2+2 is adding up. Here is some information on this condition:

What is Coloboma?
A coloboma is a gap in part of the structures of the eye. This gap can be large or small and is normally in the bottom part of the eye. A coloboma is caused when a baby’s eyes do not develop properly during pregnancy. The eyes develop between the fourth and anything up to the fifteenth week of pregnancy, though development is usually completed around eight weeks. This condition occurs in about 1 in 10,000 births.
Coloboma can affect one eye (unilateral) or both eyes (bilateral). Coloboma can affect a number of different parts of the eye. A coloboma does not mean that there is a hole in the eye, but that certain structures or parts within the eye did not fully form.
Which parts of the eye does a coloboma effect?
A coloboma can affect the iris which is the coloured part at the front of the eye. It can affect the lens, the part of the eye which helps focus light onto the retina. Coloboma can also affect the choroid which is a thin network of blood vessels which help to keep the retina healthy. Finally, it can affect the retina at the back of the eye. Very rarely coloboma can also affect the optic disc or the eyelid.

Does it only affect the eyes?
Sometimes children with coloboma may have other problems and some 'syndromes' which include coloboma, such as CHARGE, a rare condition which stands for:
C - coloboma
H - heart defects
A - atresia of the choanae (problems with the nose passages)
R - retarded growth and developments
G - genital hypoplasia (undescended testicles)
E - ear abnormalities.


Now when I said that 2+2 was adding up, that was because Mamush has most of the Charge problems... I believe this labels Mamush as "special needs." This makes my heart ache for him. It also upsets me because our fees should have been discounted. Now, I guess I'll see how my agency handles this situation. I'll post if they make good on their claim of discounting fees for special needs children... If not, I've got a loud voice... I think this is the test of a good agency, but until then, it looks like we spend our days in the offices of our pediatrician, ENT, urologist, pediatric opthamologist, and cardiologist.

So how's Ms. Maritu? Well, her TB test was negative. So, she never had a difinitive diagnosis of TB. She has also had a negative TB test, negative x-ray, and 3 negative gastric washings. What more could the Health Department want? They've been calling the house but don't leave messages. I've called and left voice mails to no avail, so we'll see how this ends. Surely, they will accept all of this proof and not make her take any more medicines. She has already been exposed to 4 TB meds for a month that she did not need.

On a good note, we evaded lice, scabies, and ring worm! (but not Giardia) Yea!!!

Tests, Tests, and More Tests

So what's the first thing Maritu and Mamush did on their first day in the US? Go to the doctor! Poor kids! Besides a routine check-up with poking and proding, they had an array of lab work:

a. Antibody Titers (children over one year of age) measure the presence and amount of antibodies in the blood to determine immunity developed from previous illness or vaccine. Your pediatrician uses this information to determine which immunizations your child has already received and which are needed. Most Adoption Medicine specialists use titers to measure antibodies in order to avoid re-immunization. Titers are not used for children under 12 months because they are likely to carry antibodies from the birthmother. Titers are used in concert with the immunization record from the country of birth. (You should receive a copy of your child’s medical records from the agency.) You should discuss this further with your pediatrician.
Diphtheria
MeaslesTetanus
MumpsPolio
RubellaChicken pox (varicella)

b. Complete Blood Count (CBC) with differentials and platelets counts the number of red and white blood cells, the total amount of hemoglobin, and other data about the red blood cells. For example, a high number of white blood cells indicates infection, and low hemoglobin indicates anemia, which is common in about 25% of children adopted from abroad.

c. Hemoglobin electrophoresis – tests for different types of hemoglobin (including sickle cell disease); unusual hemoglobin levels may indicate anemia, malnutrition, lead poisoning, heart disease and other issues.

d. Lead levels – determines the amount of lead in the blood. Exposure to lead-containing gases from gasoline and the burning of coal are the two most common causes of elevated levels; this appears to be a rare medical issue for Ethiopian adoptees.

e. Hepatitis – Hep A, Hep B and Hep C. Hepatitis is a liver inflammation -- A, B and C are common viruses that cause liver inflammation. The children are tested for Hep B during the intake physical.

f. Liver enzymes – checks the composition of liver fluids

g. Rickets screen – Rickets is a disease involving softening and weakening of the bones, primarily caused by lack of vitamin D, calcium, or phosphate. The Rickets screen tests for these substances. Rickets may also be associated with premature birth.

h. Syphilis – Syphilis is a sexually transmitted disease easily treated with antibiotics. Infants may initially test positive for syphilis if the birth mother was infected.

i. Thyroid screen – Checks the thyroid. A number of parents have reported a slightly enlarged thyroid at the initial exam, but not necessarily an elevated thyroid function test. The enlargement could be related to malnutrition and/or iodine deficiency. This is very common in Ethiopia. Parents have shared that the thyroid was normal size when rechecked after several months of improved nutrition in the U.S.

j. HIV – In addition to an arrival screen, the HIV test should be repeated about 6 months after arrival. The test used could be either an ELISA (tests for HIV antibodies) or PCR HIV DNA (tests directly for HIV presence). The ELISA can be less accurate for children under 24 months because they may test positive for HIV if the birth mother was infected with. The ELISA looks for antibodies, which babies may receive from an HIV-positive birthmother and carry for 18-24 months. The PCR DNA test is more accurate for these children, and also for the few people who have HIV but for some unknown reason do not produce antibodies that can be detected by the ELISA assay. (For more information on these tests, consult your doctor, local Health Department, or one of the online medical resources below.) Due to the prevalence of HIV in Africa and its long incubation period, pediatric infectious disease specialist Dr. Jane Aronson recommends the HIV ELISA with confirmatory Western Blot, followed by a PCR DNA test for all children coming to the US from Ethiopia. NOTE. Within her practice, Dr. Aronson orders an HIV ELISA with reflex Western Blot as well as a qualitative PCR HIV DNA at the initial evaluation.
Note regarding HIV testing in Ethiopia: As of January 2007, the ICL laboratory in Addis recommends children to be tested with the ELISA, with a follow-up PCR. Children under about 18 months should be tested a third time, with the ELISA, prior to traveling to the US. Dr. Jane Aronson believes that PCR HIV testing is the gold standard for HIV testing in youngsters under 2 years of age, which is the standard in the U.S. That said, the resources are limited in countries outside of the U.S. We are indeed fortunate to get any PCR HIV testing outside the U.S. The only countries with international adoption programs where it is available are Ethiopia and VietNam. With this understanding, Dr. Aronson supports the use of a step approach using the HIV ELISA and the PCR as noted in this section. Finally, however, all parents must recognize that there are scientific circumstances wherein a child may have a negative ELISA and turn out to be infected with HIV. This is why Dr. Aronson tests every child on arrival in the U.S. no matter what the age with an HIV ELISA and confirmatory Western Blot as well as a PCR HIV DNA qualitative test.


k. TB – A tuberculin skin test (TST) is also called a Mantoux or a PPD (Purified Protein Derivative). The test involves injecting a small amount of inactivated – harmless -- TB bacteria under the skin (usually on the forearm), forming a small bubble. The bubble disappears and the skin must be checked for a reaction 48-72 hours later by the person/agency who administered it. It is strongly recommended that your child be re-tested 3-6 months after arrival -- false negatives may occur when the patient is affected by malnutrition or an immunodeficiency of some kind, and there is a possibility of exposure shortly before travel to the U.S. Children may receive a BCG vaccination at the Intake exam if they have not already received one. Be aware that some doctors will not want to do a PPD on a child with BCG, but adoption medicine practitioners and the RedBook on Pediatric Infectious Diseases say the PPD should be given even when the child has a history of BCG vaccine. (See the “Tuberculosis” description below under “Common systemic issues and treatment,” or your health professional for more detailed information.)
NOTE: Dr. Aronson recommends that anyone traveling to Ethiopia have a PPD test 2-3 months before travel, and again about 3 months after travel. Because TB is prevalent in developing countries, travelers could easily be exposed to a contagious individual without being aware of it.

l. Ova and Parasites and Girardia Antigen. You will need to collect stool samples from 3 different bowel movements, each at least a day apart, to check for parasites and other gastrointestinal abnormalities. Three samples are used because there is not always evidence of parasites in every bowel movement – and sometimes parasites are missed even with three samples. Most children from Ethiopia are treated for parasites. Your doctor will check the lab results with medical reference books to determine if your child needs treatment and which medication(s) will be most effective. To avoid spreading parasites to other family members, practice very good hygiene – wash hands well with soap, use antibacterial hand sanitizer when out and about, etc. Some families use the antibacterial or disinfecting disposable cloths to wipe down “public” surfaces, such as toilet seats and levers, sink levers, doorknobs, remote controls, etc.Adoption Medicine specialists generally are very aggressive in treating even the slightest abnormality because there is a high prevalence of bacteria and parasites in the water in developing countries. If a child shows a failure to thrive or lack of growth/weight gain over time, this is an indicator that parasites should still be considered. *Although some parasites are sufficiently common in the U.S. that U.S. children are not treated unless the child is symptomatic, this does not apply to children adopted from Ethiopia *Some parasites are more easily transmitted than others, and some medications cannot be administered concurrently. *Some children may be symptomatic even if their stool samples are negative, so your doctor may choose to prescribe treatment based on the symptoms (i.e. empiric therapy).
Older children. For many children this is a significant source of embarrassment. Be prepared to give positive reinforcement or a special treat for willing compliance. Be alert to times they are likely to defecate – after breakfast is typical.
1. The doctor or lab staff will give you a plastic “bowl” to lay over the toilet for your child to defecate (“kaka” or “arrr”) into and vials with comprehensive instructions. 2. After your child has used the bowl, you will open a vial and use the scoop inside to collect small amounts from different parts of the sample and place them inside the vial. Close and shake – the fluid inside preserves the sample and prepares it for examination. Label accurately.
3. Collect samples for 2-3 vials on each of 3 days, at least 24 hours apart. 4. Take the vials to the doctor or lab – some facilities prefer that you bring all samples in at one time, some allow you to bring them whenever ready. Results may be available within a week, depending on the facility.
Babies and toddlers. If your child is out of diapers, try the procedure above. For children in diapers, your doctor will probably ask you to use plastic wrap to obtain an “uncontaminated” specimen. This is easier if you are able to predict somewhat when a bowel movement will occur. Lay plastic wrap inside the diaper before putting it on your child. Be prepared for mess -- urine will leak out, and if your child has diarrhea, it may not be contained very well. Test of cure (Re-check). After the course of treatment is complete, your doctor may ask you to re-test your child. Also, if your child continues to have symptoms or if any family member begins to show symptoms, your doctor should retest the child and/or family members. A few children have needed a second treatment or different medication to eliminate symptoms. If your child is gaining weight, has formed (if stinky) stools, tests negative for parasites, and otherwise appears healthy, she may simply have bacteria in the colon that is indigenous to Ethiopia, which can take years to change.

m. Malarial test


The Center for Disease Control and Prevention website has a standard immunization schedules as well as a “catch-up” schedule at http://www.cdc.gov/nip/menus/vaccines.htm#Schedules

We didn't even consider immunizations at this visit because both kids have respiratory issues...

Welcome!

Welcome to "When Love Takes You Home." I created this new blog to share with anyone interested (or bored) what life is like after adopting children. If you didn't already know, I took the line from Steven Curtis Chapman's song "When Love Takes You In." If you haven't heard the song, click on my Minipod on the right side of my blog to play the song. In the meantime, here are the lyrics:


I know you’ve heard the stories
But they all sound too good to be true.
You’ve heard about a place called home
But there doesn’t seem to be one for you
So one more night you cry yourself to sleep
And drift off to a distant dream
Where love takes you in and everything changes
A miracle starts with the beat of a heart
When love takes you home and says you belong here
The loneliness ends and a new life begins
When love takes you in
And somewhere while you’re sleeping
Someone else is dreaming too
Counting down the days until
They hold you close and say I love you
And like the rain that falls into the sea
In a moment what has been is lost in what will be
When love takes you in everything changes
A miracle starts with the beat of a heart
And this love will never let you go
There is nothing that could evercause this love to lose its hold
When love takes you in everything changes
A miracle starts with the beat of a heart
When love takes you home and says you belong here
The loneliness ends and a new life begins
When love takes you in it takes you in for good
When love takes you in

I hope you enjoy my posts, and maybe learn a thing or two. Feel free to leave me warm fuzzies,or email me with questions.