How exciting, we can watch our dossier go to China!
"Dear Families:
Congratulations!!! We are excited to let you know that you are now one
step closer to your little one! You are officially DTC today, September
1, 2006, via Fed Ex Package 7900 5635 4682. Please wait 24 hours before
trying to track the Fed Ex package. It sometimes takes that long to get
into the system.
In a few days you will be receiving a copy of your dossier. Several
weeks later CCAA should inform us of your official log-in date (LID),
which usually occurs within 2 weeks of DTC (it sometimes takes longer
for us to be informed than for you to be logged in--try not to worry!!).
Referrals are currently running about 14 months from LID.
If you have any questions, please let me know. Once again,
congratulations from everyone here in the office!"
I'm hoping that the length from LID to referral collapses back down - it
was 12 months before the CCAA office moved this summer, so hopefully as
they get settled in, it will shorten again.
Our friends who adopted from this agency said that they went out for
pickles and ice cream the day they were DTC, because now they were
officially pregnant. We're thinking maybe we'll skip the pickles and ice
cream, but we'll have to do something celebratory this weekend!
I am so proud of Laurel!
Laurel's teacher sent home an activity sheet for September - there's an
activity for every day, but we're supposed to pick two a week and do
them, then turn the sheet in at the end of the month. Even adapting them
heavily, it's going to be a challenge to come up with two every week she
can do, but one obvious one was to help her make a leaf rubbing, so I
did that with her last night. It went well - we were actually on our
third rubbing when Laurel stopped letting me help her move her hand, and
then gave me a big look when I asked her if she was done. Afterwards,
she was very interested in the leaf, and was feeling it and crumpling it
in her hand. Then Bob asked her if she could pick the leaf up and give
it to him. She tried right away, but when she tried to pick the leaf up,
her hand opened. And again. And again. And again. We finally told her
that that was OK, she had tried really hard and she didn't need to keep
doing it. But she wouldn't stop! She tried over, and over, and over. She
must have tried at least a hundred times before she finally stopped when
I picked her up and put her on the floor to change her diaper. I'm so
frustrated because I can't come up with a way to help her figure it out
- but SO proud of our stubborn girl! 
Gosh, could there really be a magic bullet? These
links about zolpidem (sold as Ambien) were recently posted to a brain
injury therapy list I'm on:
http://www.guardian.co.uk/medicine/story/0,,1870279,00.html
(cases that would be more relevant to Laurel's are a little more than
halfway down the page)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=PubMed&term=zolpidem+brain+injury&tool=QuerySuggestion
I'm trying not to get too excited, but it's hard not to. Bob and I are
thinking we'll forward these links to Laurel's pediatrician and see what
she thinks. If this isn't the magic bullet, maybe this means that there
will be one someday? 
We spent a pointless evening at the ER last night...
Laurel's afternoon aide (i.e. former babysitter) called and said that Laurel seemed to be in a lot of pain and that her PT thought her hip should be x-rayed. So we get her in to the pediatrician, who sends her to the x-ray technician, who says "Her hip's dislocated" and sends us to the ER. We spend many hours waiting around for the orthopedists with Laurel only being able to be comfortable being carried or lying on her left side (the side with the problem). Somewhere along the line and long after it's been promised to us, Laurel gets some ibuprofen - we also get an offer of an IV painkiller, but knowing Laurel's difficulty with IVs we're reluctant to have one placed unless she needs one anyway. Nobody knows what will happen or whether she'll need one. Finally at 8:30 (this odyssey started at 3:30 at the pediatrician), the orthopedic residents show up. Without even bothering to look at her, the mouthpiece proclaims that Laurel scissors her legs and can't move her left leg out away from her body (not true and not true). He says that he's sorry that she's having some discomfort (!), but that there's nothing they can do now except give her some Valium because she probably needs surgery and we'll have to talk to her orthopedist on Friday (an appt we already had) about it. In a point for the residents, one of them (not the mouthpiece) does come back a few minutes later and actually examine her - and is surprised to find that her left leg movement is actually pretty good. By the time we finally get the Valium prescription and escape, it's about 9:45, and it's about an hour later by the time we stop by the 24-hour pharmacy and get home.
So. Meanwhile Bob has talked to her PT and she a) had not meant to panic anybody b) thinks that the problem is different from what the resident thought it was, and that surgery probably won't help (I would definitely prefer not to do surgery if we can possibly avoid it, among other reasons because I'm pretty sure it would involve her being in a body cast). Laurel's pediatrician thinks we may have to go to the baclofen pump (BTW, I haven't heard anything from her in response to my e-mail about Ambien, it was a different pediatrician we saw yesterday, and Bob forgot to ask when he talked to her today). Laurel was scheduled for Feldenkrais this weekend (and this Feldenkrais practioner is a PT, too), so I'm going to call the therapist tomorrow and talk to her about whether she thinks there is anything she can do to help and what she thinks about surgery. I wouldn't be surprised if the orthopedist pushes surgery on Friday, just because that's what they do. The resident denied that anything other than surgery would help, but we (and the PT) think that the problem stems from the way she is rotating her hips, and we thought that she had started to make some progress on it in San Francisco.
Laurel is doing better tonight. We think we have aggravated the problem by the way we hold her, so she was held less tonight and in a pretty decent mood. We'll try sending her to school tomorrow without the Valium - it wasn't clear that periods of her doing worse vs. better had so much to do with the Valium as the positions she was in, and we worry that it's tiring and disorienting for her. I'm very nervous about the orthopedist appt on Friday and hope we can come up with a non-surgical solution!
Report from our visit to the orthopedist this morning...
It started out very strangely - the first thing
they tried to do was send Laurel for a foot x-ray! Huh??? 
She was having problems with her ankle a few months ago, but it
was x-rayed then and they didn't see anything - and it's been fine
lately. Anyway, nobody seemed to know why we were supposed to do it or
what foot was supposed to be done, so we didn't do it.
After that the appt actually went OK as far as being a rational
discussion, albeit a depressing one. Basically what has happened is that
Laurel's persistent turning to the right has resulted in the femur on
the left being somewhat dislocated for so long that it no longer has
quite the right shape to fit into the hip socket. She can wear a brace
that will help keep her from turning that way, but it sounds as though
this has already gone on for too long and she will have to have surgery.
The surgery would basically involve cutting a wedge out of the femur to
re-angle it and then putting that wedge in the socket to change the
shape of the socket. Then she would have to wear long leg casts for four
weeks. He says that for Laurel's case he estimates this surgery would
have about a 90% chance of fixing the problem, but I have heard bad
things about hip surgery from other folks so am going to have to
research this. He was at least very understanding about the need to do
that and even wrote down (without my needing to ask) the names of the
procedures (femoral osteotomy and acetabular osteotomy).
I mostly try hard not to kick myself for water under the bridge but I'm
having trouble not feeling basically sick with guilt over this one. I
really think if we had tried harder to correct her posture sooner, this
wouldn't have happened. I so hate to think of her having to go through
this surgery and wearing casts for four weeks when we could have
prevented it. And I'm really worried about the long-term consequences of
the surgery, because it seems to me that's where I've heard the problems
lie. But it just sounds like there's nothing for it. I am
grateful to the doctor for recognizing that we need some time to process
this. The more I think about it, the more I want to cry. 
No news on the adoption front...I haven't even
heard what our log-in date is yet. (When I do, I'm getting a ticker!)
But it took the group before us almost a month to be logged in. 
I don't doubt that we'll find plenty of ways to occupy ourselves during
the wait, though.
We took Laurel up for Feldenkrais this weekend. The therapist worked
really hard on her hips/pelvis and it went REALLY well, although Laurel
was so tired and cranky at the end that stopping in and seeing Jen (who
lives pretty close to the therapist) didn't seem like a good idea. We
think she is maybe having some muscle pain now - I know from my own
experience (I have a chronic problem with my neck) that when you try to
get your muscles to do something they're totally not used to doing, it
can be rough! Her posture sure looks a lot better, though. The therapist
thought that there was some hope for avoiding the surgery with more
intensive work - apparently one of her other patients did. We've decided
to at least give it a few months of getting Laurel in for therapy more
often and redoubling our efforts with her positioning at home.
Ummm...let's see...in other news, we got a new dishwasher last week! We
just started it for the first time right when I left the house today (it
was some sort of teacher in-service day today, so Laurel had off and Bob
and I took turns), so Bob gets to find out how well it works. Hopefully
a lot better than our old one, which was ~27 years old and the kind that
you pretty much had to wash the dishes before you put them in. A few
months ago the spring on the door broke, so although it was still
useable Bob and I decided that enough was enough. 
That's it for now...