Adoption Reflections: The call

First pictures sent to my parents

November is national adoption awareness month. It’s also the month that we adopted Patrick. The miracles of last year are fresh in my mind right now, and so I’ve decided to write a small series of blog entries about Patrick’s adoption. Please excuse me as I reflect.

It was a miserably snowy Wednesday afternoon. I was sitting at my kitchen table finishing a shopping list and trying to gear myself to go out in the storm when the phone rang.

It was Emily, our caseworker. She started the call like this: “There was a little Korean boy born in Michigan on Halloween.” I’m pretty sure my heart skipped a beat. I’d had this crazy idea in my head all week that I should have heard something about an adoption opportunity by that very week, and now here she was calling. I didn’t quite believe it.

When we’d applied to adopt, we’d explained to Emily that we were open to adopting a child with special needs. So her next statement didn’t surprise me. “He has some health problems,” she said.  She went on to explain the information she’d been given… that he’d had gastroschisis, a birth defect where the intestines develop outside the body, that he’d need to see specialists at an out-of-state hospital, and that he may only live a couple of years.

I didn’t know what exactly to say. I asked a couple of questions, then I told Emily I needed to talk to Brian to decide if we wanted to be considered as parents. She promised she’d e-mail me the details she had. This is the message I got:

We have a baby boy born 10/31/08. He has Gastrocesis and is only expected to live 1-2 years. He is part Korean and part Caucasian.

 

The  LDS birth mother wants to place with an family that will have the baby sealed to them.

Mary the NICU social worker said last night that the baby might be ready to discharge soon.  The adoptive parents would need to be trained in paliative care.  Why the life expectancy?  She said that d/t the TPN the liver would die out soon.  She said that the doctors are communicating with hospitals in Miami, Florida; Cleveland, Ohio; and Pitt, PA to be reevaluated for a surgury.

 

There was a picture attached, too.
My eyes won mom over

I tried calling Brian, but didn’t get through. I left him a message telling him to call me right away. I’m pretty sure I was crying.

While I waited, I called our insurance company to find out if they’d even cover a 5-day-old child with this severe of a medical problem. Meanwhile, Brian called back. He heard the end of my conversation before I told him the news. He said he’d come home right away.

The rest of the day was very emotional and prayerful. We’d said we were open to whatever the Lord thought was best for our family. Now that was being put to the test. What neither one of us had expected when we said we were open to adoption a medically fragile child was the grief we would feel. From the time the call first came, we both were grieving as though we’d just found out about a serious medical problem in a child who was already ours.

We went to the temple, where we could seek an answer through prayer and mediation as to whether or not this child was meant for our family. During the ceremony, I just kept thinking about how drastically this choice would change my life. It meant changing EVERYTHING in my life. But I also kept thinking about the promise of the resurrection, and of eternal families.

I was scared, but when Brian said, “I feel good about this. Let’s find out more,” my heart said “OK.”

So, sent a list of questions off to Michigan through our adoption agency. And then we went to tell our parents.

We had this adorable picture that I couldn’t take my eyes off of. There was something angelic about that little face. So we swore we wouldn’t show it to anyone… But we failed and showed it to parents. The picture was labeled “Patrick,” and we knew that was supposed to be his name.

That night my family started praying for Patrick.

We e-mailed off a list of questions about Patrick, and after we got a few answers, we sent a copy of our profile to be considered. Brian sent this e-mail to our families:

We have a little more information on the baby.  We are not the only parents considering adopting him.  However we did give our case worker the go ahead to forward our profile to the case worker in Michigan (i.e. throw our hat in the ring).

We don’t know when we will hear back, we doubt it will be today.  So the waiting game goes on.

It sounds as if he will need a lot of care (we pretty much knew that already).  They have also said that he will need a bowel transplant at his first birthday (we don’t know more about that).

Emily and I are doing ok.  We are both attempting to work today, I think I have accomplished 2 things since I got here.  I have started about 50 other things.

We are rather afraid of what we are approaching, but can’t even think about not doing this.  We appreciate your support in this decision, please continue to remember us in your thoughts and prayers.

Friday morning, we thought we had our answer. Brian wrote this in another e-mail:

This morning we both woke up with the feeling that he isn’t going to come to our house.  Whether that is just us preparing for the worst, or just a glimpse of what is to come, we don’t really know.

We had flu shots that day at Brian’s work. I had just met him at his office, when my cell phone rang. It was our caseworker. She told us that the birth parents had just seen our profile and wanted us to adopt Patrick.

We were stunned! We locked ourselves in Brian’s bosses’ office (thank goodness he was at lunch) and we started making calls. Because we’d been chosen as parents, we were now allowed to talk to the hospital social worker and the birth parent’s social worker at their adoption agency.

We sent one more e-mail to our families with what we’d learned.

Patrick was a full term baby.  He is completely normal except his bowels don’t work (they aren’t sure if they aren’t there, or if they just don’t work). Because he can’t eat he is somewhat fussy (who wouldn’t be).  We need to explore if he is a candidate for a bowel transplant, but that can’t be performed until he is 1.  He will be on a feeding tube until he can eat on his own.

The hospital won’t discharge him until we have things in place to take care of him here.  He will need to be on a TPN machine (what that means, we aren’t sure).  But that is equipment that we will need at our house.

Chicken and I have decided that we are going to go out to Michigan and see exactly what it is going to take to care for this Patrick.  We have not committed to take the child, but this is the last step before we do it.

I will give you more details once I can think straight, course that probably won’t happen for a while.  So I will give details once we get a bit more settled in Michigan.  And I’m sure that I will be in contact with you soon.

The rest of the day was a flurry of excitement as we ran around trying to pull together the necessary details to be able to fly to Michigan in the morning. We went to the adoption agency to finish the paperwork required for us to be able to see Patrick in the NICU. Meanwhile, my mom and grandpa worked to get us airline tickets. We packed for an indefinite stay in Michigan. One small bag held all the baby things we owned, including a baby quilt I’d just finished Tuesday night. We made a shopping list for the nursery that Brian would come home and put together if we followed through on the adoption.

And then we tried to sleep. It was probably one of the longest nights of my life! We didn’t know what the future held, but we knew already our lives had changed forever.

It’s a year later and some things are the same. This Wednesday was sunny, but I still sat down and made my list of errands to run. And today, Friday, we’re headed for our flu shots. Our families are still 100% behind us. And we’re still depending every day on prayer. But, as expected, pretty much everything else is different. What I didn’t expect was that, with as challenging as it all is, it is much more wonderful and rewarding than I’d ever expected.

How everything changed in a moment

WARNING: THIS POST INCLUDES DETAILS OF PATRICK’S CARDIAC ARREST AND SUBSEQUENT PROBLEMS IN THE ICU, INCLUDING PICTURES.

I’ve been asked to explain several times the events of this week. I’ve decided it’s probably easiest if I just take some time to sit down and write this in a blog. It will save frequent emotional repetitions for me… preserve some of the last week while it’s still fresh in my mind… and hopefully give some answers for those who are wondering how things got to where they are. These are things that are still hard for me to remember and talk about so please don’t be hurt if I don’t want to talk more about what I’m posting in this entry.

In my last post, I wrote about a yeast infection called candida that Patrick had in his central line and in his blood. He was hospitalized for 11 days in June for that infection and then went home on antifungal medications. On July 5th his fever returned and we came back to the hospital to learn that the infection had grown back again.

In order to treat the persistent infection, they decided to return to giving him a very dangerous medication called amphotericin (a.k.a. “ampho-terrible”). He was on a very high dose but seemed to be doing ok. He always got chills while it was being given and wanted to be held and held very still, but all other signs pointed towards it doing it’s job without too much problem.

On the 15th, we were making plans to go home. We would give 3 more weeks of treatment at home to make sure the infection didn’t come back. However, before we went home, we decided to try giving the medication the same way he’d get it there. This meant shutting off his TPN (IV nutrition) for a few hours while the medicine was being administered.

He’d been doing so well that I ran home to shower and take care of a few things right before they were supposed to start the ampho. I got back an hour into it and he just didn’t seem to be tolerating it well. His hands were as cold as ice, despite several blankets and heatpacks. He was pretty restless. We tried to feed him to comfort him, but that just make him sicker.

About 3:30 p.m. he got really agitated and started to squirm and pull at his ears and cry. Then he just went limp. I called his nurse in and she called in one of the charge nurses. They took him from me and started administering CPR.

They also hit a button on the wall that pages for a “Code Blue” on the PA system. In under a minute the room was filled with people. A PCT who had cared for Patrick before came immediately to my side, as did a social worker and they stayed with me until we were delivered into the hands of another social worker in the PICU.

One doctor took charge of calling out orders while another kept track of everything that had been done. There were at least 10 people bedside helping with CPR, medications, watching vitals and I don’t know what else.

After about 15 minutes (a.k.a. an eternity) they finally revived him and they took Patrick straight to the Pediatric ICU. I followed with the social workers and his nurses in another elevator.

On the way up I finally got a hold of Brian and told him to come up and where to find us.

Normally parents are taken to a waiting room, but they knew us and how involved we are with Patrick’s care so they let us stay and watch as they placed an arterial line to monitor his blood pressure and worked to find out what happened.

The best guess is that his weakened little body was hit with a few things at once. Being off his TPN caused his blood sugar to drop. At the same time, his weakened kidneys weren’t processing potassium in the right way. When those two things hit at the same time, it created a sort of perfect storm that caused him to seize and caused his heart to stop.The next day they worked madly to stabilize him. His organs had been starved for oxygen for long enough that they’d forgotten how to work. His blood sugar was all over the charts. His potassium levels were out of control. He was anemic and his platelet count just kept dropping. His nurse that day didn’t sit down for the entire 12 hour shift.

Over the next few days things started to stabilize but there were a lot of things out of whack still. His spleen, which had already been in bad shape because of his cholestasis (liver damage) and prolonged infection, decided to protect itself by sequestering all the platelets that went through it. As a result, although they were giving multiple transfusions, his platelet count was still low and he was bleeding easily from anywhere that could bleed. His kidneys also had kind of shut down and so all of the extra fluids being poured in to give transfusions and electolytes and medicines weren’t being cleared by his body. Instead they were soaking through the veins and collecting in the other tissues of his body.

To top it all off, he had some bacteria “leak” from his gut and get into his bloodstream causing a bacterial blood infection.

Saturday they tried to extubate him, but by Sunday morning it was pretty obvious that he was having trouble breathing. X-rays showed that the fluid in his tissues had made it’s way into his lungs. And so they had to put him back on the ventilator and started to give him medicines to make his body shed the extra fluid.

We watched and prayed and waited and tried to get ready to say goodbye until Wednesday when something amazing happened. Patrick peeked at me through heavy eyelids and seemed to know that I was there… He started reaching with his hands and so I gave him a rattle… and he shook it! The next day I was actually able to get him to laugh!

As the day went on, he woke up little by little and started to play peek-a-boo and smile and hold toys. His X-rays and labwork improved. As he woke up, they started to wean him slowly off the ventilator and off the sedatives.

His throat was very swollen and we weren’t sure if the airway would stay open without the tube in. But Friday evening they decided the only way to know would be to try. So they took him off the ventilator and put him on high flow oxygen. And he was the happiest kid you could imagine.

Without the breathing tube to bother him, they were able to turn off his sedatives and we became aware of what might be another problem. We noticed as Patrick started waking up that he wasn’t focusing his eyes well… staring off into space and not always following what’s going on in the room. He’s also been holding his head and arms very still. When these issues didn’t go away when the sedatives started wearing off, we became more concerned.

Neuro came to see him and said that they think there is reason to evaluate him. He will have an MRI on Monday as well as a neurodevelopmental workup. There is a possibility, especially considering how long he was down, that Patrick’s brain was damaged. Neuro will be able to help us see if that is true… and if it is, they’ll help us do all we can to help him do the best that he can.

Regardless of how weak his body is, though… the spirit inside of it is still Patrick’s. His eyes still sparkles and he loves to play and laugh with us. It has been a gift to be able to hold him and play with him again… to know he knows us and loves us still. It breaks our hearts to see that magnificent spirit confined by such a weak little body and we hope that those limitations will be brief.

As far as long term planning- Patrick will need to stay in the ICU until he is better able to breathe on his own. He is doing it right now, but he is working very hard at it. He’s on hold for transplant until he can go back to Seattle for another evaluation. At the very least, he will probably now need a liver transplant along with the small bowel transplant. We won’t know if he’s still healthy enough for transplant, though, until he is evaluated again. We’ll continue working with the doctors and therapists and nurses here to help Patrick regain as much as he can. And the rest we’ll leave in the Lord’s hands.

We’ve always known that there was a plan for Patrick’s life. We’re just humbled to get to be the parents in that plan. We trust Heavenly Father to take care of the rest.

Sealing and blessing

As of 4:10 p.m. on February 13th, Patrick is officially a member of our eternal family!

We started out the weekend’s events with a little bit of humbling. Howie took the day off to help get the house ready and I was going nuts trying to take care of every little detail from ironing temple clothes to prepping food for the open house. But, a flat tire on the freeway ay 10:30 the night before we went to the temple was a good pull back into reality. Changing the tire was easy, but it revealed other bigger problems and we made it home on a prayer and half a rotor on the front passenger side. Boy did my priorities realign quickly, especially as I watched our car be taken away on a tow truck, just trusting that we’d get through the weekend all right anyway.

Howie’s family helped get the church set up for us to go the temple, and then his mom made it here just on time to watch Patrick while we got dressed to go. She drove us to the temple and we tried took a few pictures. Although it was sunny, the wind was bitter cold and Patrick was NOT happy so we didn’t stay too long.
My mom and dad met us at the temple. Mom was there to take care of Patrick in the nursery. (Including dressing him and reconnecting his IV’s). We left him there in capable hands and then went off to get dressed in white.

We met the sealer (this is the official title for the man who performs a sealing ceremony in the temple). Turns out he had been the community doctor in the town where my family grew up, so he knew my grandparents and dad, and some of my mom’s family, too.

They kept trying to start early… But my grandpa and some of my friends hadn’t made it there yet.. So we just made everyone wait. Our friend Tifanie was so excited that she couldn’t contain herself and ran over and gave me a hug… making everyone cry.

Finally everyone all of the guests had arrived and they went and got the man of the hour. My mom brought him in, dressed in a white tuxedo and wrapped in a white afghan she made just for the occasion. Brian and I knelt across the altar from each other, holding hands, and Brian’s mom brought Patrick and laid his little hand on ours. At first, he was a bit fussy, but we turned him around so his right hand would be on ours, and he caught my eye, and he settled down immediately. We watched each other’s eyes the whole time.

A sealing for a child is quite short… just a few lines said by the sealer that bind the child to his or her parents (in the eternal record) and then promise special blessings. Patrick seemed to soak up the entire experience, and then, completely content, went right to sleep as soon as it was over and I had him in my arms.

We celebrated and welcomed him into the family that evening with an open house at the church. I went smoothly (thanks in part to awesome family who helped with the food prep, set up, and clean up). There were enough people there that I couldn’t quite make it to talk to them all. Finally we wrapped up, cleaned up, and got home COMPLETELY exhausted! And with way, way, WAY too many leftovers. I think next open house I’m going with punch and cookies.

Saturday we got to recoup a bit as we visited with family, which was nice because we knew Sunday would be another big day. Patrick got to know his cousins and aunts and uncles a bit better.

Sunday morning Patrick could barely sleep. After his morning feeding, I sat in his room holding him and he just kept waking up and grinning at me. I swear he knew what was going on that day.

Because he had us up early, we were able to take our time getting ready. He spent a little time cuddled with his Daddy in the bed, and then we got him dressed and ready for church. Our ward has classes first, followed by sacrament meeting, so I went off to Primary with the children and Patrick went with Brian to his classes.

We snuck out a bit early to change Patrick into his white tux… and luck of all luck… found that his ostomy bag had started to leak. Luckily, by now Howie and I are a pretty smooth team and we were able to pull of a pretty amazing quick change in one of the classrooms and still make it to the chapel on time.

When the time came, Brian took Patrick to the front of the chapel. Brian is an Elder in our church, and his brothers, some of my brothers, our fathers, and my grandfather are also priesthood holders, and therefore could help with the ordinance. They surrounded Patrick, each with one hand holding him, and then Brian performed the blessing.

In a baby blessing, the child is given a name and then given personalized blessings. Among other things I remember from the blessing, Patrick was reminded of the love that brought him into our family – both our love and the love of his birthfamily. He blessed him with strength to face the difficult medical journey ahead. He reminded him that he was a child of miracles.

When they came back to sit beside me, Patrick was just glowing. His daddy held him and I could see the love that they had for each other. I also knew, as I looked at Patrick, that he understood all that had gone over the weekend and was happy about it. I really believe that, although he was adopted, the Lord promised He would waste no time in making sure that Patrick received these two very important ordinances.

Since then, well, I can’t quite get enough of my son. I don’t know what the future hold, though I’m sure there are rough times ahead. But I do know that I was blessed with a very special gift and a very important calling in this life when I was given the opportunity to be Patrick’s mom. And I will never forget the day he was sealed a part of our family forever.

3 months old

Patrick is 3 months old now and is starting to look and act much more like a little boy than just a baby. Oh sure he still wakes us up at night. And I can still tuck him under my arm and carry him around like he weighs nothing (of course, he’s still very small). But he’s growing (8 lbs 13 oz) reaching that fun stage my family calls “interactive baby”.

First of all, he’s started to give out smiles all the more willingly. I can bet on the fact that I’ll get a big grin whenever he wakes up and realizes I’m holding him. This past week, he’s also started to react more when I play with him. He’ll laugh and talk when I sing him songs or talk to him, and I can get him outright chuckling if I pretend to eat his cheek or tummy. He also is starting to take an interest in peek-a-boo. Of course, this is all the more incentive for me to sit and do nothing for hours besides just trying to get smiles from Patrick.

He’s taken a new interest in his toys. He loves to sit in the bumbo seat that Howie’s co-workers gave him. He’s actually learning to hold things so his gym, rattle, rings, etc. are suddenly much more interesting.

Course, he’s also learned to hold onto his central line… which is a bit more of a problem. Don’t need him grabbing that and giving it a yank. Thankfully, my mother in law modified a bunch of onesies to a design I came up with that send the line out the side instead of being right in Patrick’s reach and those are helping.He’s sleeping through more of the night and spending more of his days awake. Part of this may be that he’s finally feeling better. (His anemia is resolving himself and we are starting to get a hold on keeping him hydrated again). But I think part is just that he’s growing up.

Daddy went on his first business trip since Patrick came home this week. Thanks to all the friends and family who were there to watch over us, we made it through just fine. And now that Howie’s home, Patrick is just eating up the daddy time.

Perhaps the best news is that it was all pretty good news when we went to see Patrick’s gastroenterologist this week. If you don’t know, the past couple of weeks have been a bit scary as we almost had to take Patrick to the ER a couple of times. First, we suspected he might be developing a fever. Second, out of nowhere his stool output went through the roof and he walked a line with dehydration that we had to watch VERY closely. (Patrick doesn’t have the portion of intestine that reabsorbs fluids, so diarrhea will dehydrate him much faster than other children).

As so often has happened for us, though, the Lord was watching over Patrick. The right doctors were on call at the right times and they were able to teach us how to take care of things at home rather than taking Patrick into the ER. We had blood cultures drawn by his home nurse. He was put on an oral antibiotic to help fight any bacterial overgrowth that might be there. (With so little intestine, Patrick’s body can’t get rid of the “beneficial bacteria” that live there the way the rest of us can and he can get infections in his intestines that could cause diarrhea or worse.) He had his 2 month (yes, I know it was late) checkup with his pediatrician on just the right day so they could do labs to check for other stomach bugs.

And, in the end, the great news is that there is no sign of anything malicious that’s causing the change in output. We monitored him closely and gave IV replacement fluids at home so he wouldn’t get dehydrated. He got pedialyte instead of formula, and then watered down formula for about a week and a half. This week we were finally able to start giving him full strength formula in very small amounts (about a third of what he was getting, before… he’s up to a teaspoon now). And so far, so good. In fact, we’re on the other side of things right now where he’s not losing enough fluids… a sign that we need to increase his feeds. (We want him to need some replacement fluids because that’s where he gets his electrolytes).

So – if our emergency watch level were on the same scale as homeland security, we’ve backed down from red (severe) to blue (guarded). I’m getting to spend more time being mommy and less time being nurse.

I’m so grateful that Heavenly Father answers prayers. And I’m grateful for priesthood power in our home. Brian is an elder in our church and was able to give Patrick a blessing of healing this week. And really, the fact that Patrick is still home with us, and feeling happy and healthy, is nothing short of miraculous.
Speaking of miraculous, (as this blog post reaches an eternity in length), just a reminder that Patrick will be sealed to us in the Jordan River LDS Temple on February 13th and we’ll be having an open house to welcome him into the family that same day. Any of you who are in the area and would like to celebrate with us are invited. For those who are out of town, we’ll try to be quick in posting pictures, thoughts, and memories so you can share in the day with us.

Gotcha Day

In the adoption community, the day an adoption is finalized is known as your “gotcha day.” Well, miraculous as it is, Patrick’s adoption was finalized on January 7th.

It took a couple of days for the news to get to us, and a week before the papers arrived and it really seemed real. But, late as the news is in arriving on this blog, it is true.

LDS Family Services’ lawyers were amazing and petitioned the court for early finalization so that there would be no legal hurdles to our taking Patrick out of state to be evaluated for transplant. And, well, the court agreed.

In following his holiday tradition, we submitted our part of the petition on Christmas Eve. But Patrick managed to finally have his own day in his gotcha day. January 7th is the day after we celebrate the Italian tradition of Befana in our house and wrap up our Christmas season.

We’ve made arrangements to go to the LDS temple with him on February 13th so that we can be sealed for time and eternity as a family. This is a special ceremony in our faith. We believe that marriage and families are intended by God to be eternal, not till death do us part. Marriages performed in LDS temples are performed for time and for eternity and children born into an “eternal” marriage are likewise a part of that family for eternity. A sealing ceremony provides that same promise for adopted children. Patrick will be tied to our family as though he had been born to us. This is something that his birth family wanted for him and a day that we have been looking forward to for a long time.