Friday started pretty badly, and ended really well. Let's review...
Vindya loves school, so her first unpleasant shock on Friday was that I didn't take her straight to school. Instead, I took her to the University of Minnesota International Adoption Clinic. She recognised this as a medical facility the second we came in the door. She was crying and protesting because it wasn't school, but when she saw where we were, she kicked it up a notch. She wasn't full out freaking, but she wasn't pleasant to be around.
Our appointment was at 8:40am, and we got there about half an hour early. They led us back to the exam room right away. Vindya was crying, but the first person in the room was a Telugu language interpreter. This surprised her into silence. She wasn't communicative at first, but as we went on, she started chattering non-stop in Telugu. This turned out to be helpful for her evaluation, gave me extra information, and cheered her up a lot.
The doctor's assistant introduced herself, told me that they weren't in a hurry and that the doctor would wait until Vindya was calm before she came in. She brought us a box of toys, several juice boxes and packets of graham crackers and left. Vindya was suspicious at first, and kept saying no, but when I opened a juice box for myself she decided to have one, and was soon playing happily with the toys in the box and telling the interpreter about her nightmare experience in New Delhi. I was surprised at how accurate her memory of that was, although I suppose it was traumatic enough to have been seared into her brain.
The doctor came in and talked to us, interviewed me about my concerns, asked a lot of questions, and then said that, based on how wary Vindya was about her, she would like to have the physical therapist come in and do her evaluation, which would be a lot of games, then do her exam, which would be non-intrusive but still clearly an exam, and have the blood draw on the way out. This made sense. A nurse came in and put numbing cream on my arms, and then on Vindya's, so that she could see that it didn't hurt. This was wise, because Vindya tried to hide from them, but after seeing me get the patches, she was eager to get them herself.
The physical therapist came in and talked to the interpreter about translating only exactly what she said, and not helping Vindya or giving her hints. Vindya hid from her, but I started playing with the props (doing the tasks would have thrown off the accuracy of the tests for Vindya) and she came out from behind my chair. The therapist had her string blocks on a shoelace, draw figures on a piece of paper, and a few other things. She asked me if Vindya seems strongly to prefer her right hand at home, since he was using both hands, and maybe even her left a little more. We discussed the very strong Indian preference for right handedness, and agreed that I would monitor this, but not intervene.
Then we went out in the hall and played games - running, skipping, hopping, jumping and throwing. The therapist said that she is definitely delayed, but it was hard to tell how much was physical or neurological, and how much was the result of not being able to practice any of those skills. In general, she has strength but not control. In running, she has the wide gait typical of toddlers, but her knees have turned in as is typical of a 7-year-old, and the result is really awkward. She cannot skip properly, only hopping on one foot and running with the other (try skipping and this will hopefully make sense). She also flatly refused to climb the stairs, although whether because she was afraid or because she was through with this whole activity wasn't clear. (The interpreter said that she kept saying "No!" but wouldn't say why not.)
The therapist's suggestion was that I sign her up for some Occupational Therapy classes. Even though these would focus on sensory issues and fine motor skills, she said that her gross motor skills would be helped as well, based on their previous experience. She said that I could get these services through my regular pediatrician (in a different network), but their OTs are very experienced in the effects of international adoption which could make a difference. I can also continue to request an interpreter for her.
The doctor's exam was fairly cursory, and the doctor did everything to me first. Vindya still cried and struggled to get away. Afterwards, the doctor said that the main concern they had was that her head circumference is small for her age, and below her height and weight percentiles. However, the interpreter was able to tell them that her Telugu pronunciation was clear and correct, her grammar was accurate, and her vocabulary was extensive. She recommended that we bring her back in three to six months for a follow up visit, which will give us trend lines on the measurements, and we can also follow up on whatever we've found from the blood tests.
She also told the interpreter several stories about her life in India, what school there was like, and what she did every day. I had her ask why Vindya doesn't like to go home. Every time we go somewhere and it's time to head home, she says, "Home, no!" and gets upset. They discussed this, and she told the interpreter that she wants to go back to the orphanage. She clearly thinks this is some kind of extended field trip, which isn't unexpected.
Finally, we had the worst part of the visit - the lab. The numbing cream meant that she didn't feel the needle, but she still screamed and fought and was really upset. I held her on my lap in a special chair where both of us were strapped in, and then one lab tech held her arm down and the other one inserted the needle. They took three large vials of blood, because they are going to titer for vaccinations, test for various infections, and a few other things. Vindya was really really upset by the whole thing, even though the staff was very gentle and matter of fact. Everyone agrees that she had some kind of really bad doctor experience in India, and we just have to work through this.
I've referred a fair number of people to the clinic, and I knew that they are one of the best in the field, but I was blown away by their kindness and concern for her comfort. At every turn, they told me that they were only going to do as much as she was comfortable with, they backed away when she got stressed and upset, and they treated both of us with warmth and good humor.
I give them an A+. Let's see what Vindya thinks of them:
Looks like a D-.
After a very happy afternoon at school, I totally ruined the remains of her day by taking her to a friend's house and leaving her there while I went off with LiJun. She totally lost it. Luckily, the friend is also an adoptive mother and gets it. She let her cry and hang out by the front door, and sat nearby telling her over and over, "Mama always comes back." Eventually Vindya calmed down, although she came up to her every 15 minutes or so to ask, "Mama come back?" and be reassured that "Mama always comes back." By the time we came back, she was very happy, having convinced the whole family to walk over to Izzy's and have ice cream.
Where did I go? I took my older girl to the State Fair. I'll take both of them later, but there are all sorts of things that Vindya can't do (like most of the rides), and LiJun needed some Mama time. We ate roasted corn and Sweet Martha's cookies, rode the Crazy Mouse and the Scrambler, and checked out the Kid's Art Exhibit in the Education Building, where we found this:
That's LiJun's portrait of a cat with a blue ribbon in the back row. LiJun looks less excited than she was, because she had been eating blue cotton candy, and the first picture I took showed her with blue teeth. Striking, but not really the look she wanted.
So, we're heading into the holiday weekend on an up note!
Vindya loves school, so her first unpleasant shock on Friday was that I didn't take her straight to school. Instead, I took her to the University of Minnesota International Adoption Clinic. She recognised this as a medical facility the second we came in the door. She was crying and protesting because it wasn't school, but when she saw where we were, she kicked it up a notch. She wasn't full out freaking, but she wasn't pleasant to be around.
Our appointment was at 8:40am, and we got there about half an hour early. They led us back to the exam room right away. Vindya was crying, but the first person in the room was a Telugu language interpreter. This surprised her into silence. She wasn't communicative at first, but as we went on, she started chattering non-stop in Telugu. This turned out to be helpful for her evaluation, gave me extra information, and cheered her up a lot.
The doctor's assistant introduced herself, told me that they weren't in a hurry and that the doctor would wait until Vindya was calm before she came in. She brought us a box of toys, several juice boxes and packets of graham crackers and left. Vindya was suspicious at first, and kept saying no, but when I opened a juice box for myself she decided to have one, and was soon playing happily with the toys in the box and telling the interpreter about her nightmare experience in New Delhi. I was surprised at how accurate her memory of that was, although I suppose it was traumatic enough to have been seared into her brain.
The doctor came in and talked to us, interviewed me about my concerns, asked a lot of questions, and then said that, based on how wary Vindya was about her, she would like to have the physical therapist come in and do her evaluation, which would be a lot of games, then do her exam, which would be non-intrusive but still clearly an exam, and have the blood draw on the way out. This made sense. A nurse came in and put numbing cream on my arms, and then on Vindya's, so that she could see that it didn't hurt. This was wise, because Vindya tried to hide from them, but after seeing me get the patches, she was eager to get them herself.
The physical therapist came in and talked to the interpreter about translating only exactly what she said, and not helping Vindya or giving her hints. Vindya hid from her, but I started playing with the props (doing the tasks would have thrown off the accuracy of the tests for Vindya) and she came out from behind my chair. The therapist had her string blocks on a shoelace, draw figures on a piece of paper, and a few other things. She asked me if Vindya seems strongly to prefer her right hand at home, since he was using both hands, and maybe even her left a little more. We discussed the very strong Indian preference for right handedness, and agreed that I would monitor this, but not intervene.
Then we went out in the hall and played games - running, skipping, hopping, jumping and throwing. The therapist said that she is definitely delayed, but it was hard to tell how much was physical or neurological, and how much was the result of not being able to practice any of those skills. In general, she has strength but not control. In running, she has the wide gait typical of toddlers, but her knees have turned in as is typical of a 7-year-old, and the result is really awkward. She cannot skip properly, only hopping on one foot and running with the other (try skipping and this will hopefully make sense). She also flatly refused to climb the stairs, although whether because she was afraid or because she was through with this whole activity wasn't clear. (The interpreter said that she kept saying "No!" but wouldn't say why not.)
The therapist's suggestion was that I sign her up for some Occupational Therapy classes. Even though these would focus on sensory issues and fine motor skills, she said that her gross motor skills would be helped as well, based on their previous experience. She said that I could get these services through my regular pediatrician (in a different network), but their OTs are very experienced in the effects of international adoption which could make a difference. I can also continue to request an interpreter for her.
The doctor's exam was fairly cursory, and the doctor did everything to me first. Vindya still cried and struggled to get away. Afterwards, the doctor said that the main concern they had was that her head circumference is small for her age, and below her height and weight percentiles. However, the interpreter was able to tell them that her Telugu pronunciation was clear and correct, her grammar was accurate, and her vocabulary was extensive. She recommended that we bring her back in three to six months for a follow up visit, which will give us trend lines on the measurements, and we can also follow up on whatever we've found from the blood tests.
She also told the interpreter several stories about her life in India, what school there was like, and what she did every day. I had her ask why Vindya doesn't like to go home. Every time we go somewhere and it's time to head home, she says, "Home, no!" and gets upset. They discussed this, and she told the interpreter that she wants to go back to the orphanage. She clearly thinks this is some kind of extended field trip, which isn't unexpected.
Finally, we had the worst part of the visit - the lab. The numbing cream meant that she didn't feel the needle, but she still screamed and fought and was really upset. I held her on my lap in a special chair where both of us were strapped in, and then one lab tech held her arm down and the other one inserted the needle. They took three large vials of blood, because they are going to titer for vaccinations, test for various infections, and a few other things. Vindya was really really upset by the whole thing, even though the staff was very gentle and matter of fact. Everyone agrees that she had some kind of really bad doctor experience in India, and we just have to work through this.
I've referred a fair number of people to the clinic, and I knew that they are one of the best in the field, but I was blown away by their kindness and concern for her comfort. At every turn, they told me that they were only going to do as much as she was comfortable with, they backed away when she got stressed and upset, and they treated both of us with warmth and good humor.
I give them an A+. Let's see what Vindya thinks of them:
Looks like a D-.
After a very happy afternoon at school, I totally ruined the remains of her day by taking her to a friend's house and leaving her there while I went off with LiJun. She totally lost it. Luckily, the friend is also an adoptive mother and gets it. She let her cry and hang out by the front door, and sat nearby telling her over and over, "Mama always comes back." Eventually Vindya calmed down, although she came up to her every 15 minutes or so to ask, "Mama come back?" and be reassured that "Mama always comes back." By the time we came back, she was very happy, having convinced the whole family to walk over to Izzy's and have ice cream.
Where did I go? I took my older girl to the State Fair. I'll take both of them later, but there are all sorts of things that Vindya can't do (like most of the rides), and LiJun needed some Mama time. We ate roasted corn and Sweet Martha's cookies, rode the Crazy Mouse and the Scrambler, and checked out the Kid's Art Exhibit in the Education Building, where we found this:
That's LiJun's portrait of a cat with a blue ribbon in the back row. LiJun looks less excited than she was, because she had been eating blue cotton candy, and the first picture I took showed her with blue teeth. Striking, but not really the look she wanted.
So, we're heading into the holiday weekend on an up note!
Please tell LiJun congratulations! It is quite a feat to get a blue ribbon at the State Fair. Impressive! Way to go LiJun!
ReplyDeleteKelly
Congratulations to LiJun!
ReplyDeleteVindya's look of disapproval is...daunting.