A Minsy Mystery Solved ... Sort of?

I will never, ever forget my thoughts when I first met Minsy almost eight months ago. I headed to China expecting to pick up a four year old girl who was short for her age. But I was not expecting to pick up a little girl the size of a small two year old. So when we arrived at the adoption center I looked right over her. No way was this little girl four years old. No way.

But the difficult thing about all of this was that it was extremely hard to figure out what was normal for her. Of course, children in China are naturally smaller than Americans, so I expected that. Also I was prepared for her to be a bit smaller simply because of her time in foster care because that was also normal in Chinese adoptions. What I didn't expect was a child so much smaller than the average for Chinese or American children. Even the people in China commented on how small she was for that age. They all guessed about two. And in my head I couldn't think of her as being anything other than two. But I knew that there was no way in the world that her age was off by two years. I guess it is possible that the orphanage lied on their report for us. I know that does happen. But I don't really feel in my heart that that was the case. We seemed to have adopted an extremely small four year old.

Once we got back into the states we decided that we needed to figure out a more accurate estimate of what Minsy's true age was. Because she was abandoned at an older age without a note the orphanage simply made their best guess for her, and that is how she got the birthday of September 1, 2007. Although it doesn't matter too much right now, it will matter when we begin to think about putting Minsy in school. So we wanted to make sure that we got this age thing right. Either her age was totally off, or she was a super small child who was going to need some growth assistance through hormone treatment. In April we were sent to a pediatric endocrinologist in Springfield. He did about a gazillion tests on her to try and determine a more solid age for her and to see if she would be a candidate for hormone treatment at this time. After a day of running all over town to various labs and doctors Dr. Schwartz told us that she had a Vitamin D deficiency and put her on a supplement. He said that her bones had the developmental age of a three year old, but he said that that could be misleading if she was malnourished. Based on much of the evidence that I provided to him he was inclined to believe that she had been severely malnourished since birth. So sad. He explained that it may not have been anything intentional. We'll never know. But it appeared that she was lacking essential nutrients that she needed to grow taller as an infant. And he told us to just wait and see what was going on before we did anything drastic like changing her birth date.

Despite Dr. Schwartz's advice to leave her age as it was, I went ahead and started telling people who asked that Minsy was three instead of four. It was easier to avoid the googly eyes we would get whenever we said she was older. Even as a three year old she is extremely small, so we still get the googly eyes, but they aren't quite as pronounced as they are for our "she's four" answers. So we gave her her vitamins and treated her like a three year-old. Until today.

Today we went back for our follow up visit to Dr. Schwartz -- visits we'll have to make every six months for the next fifteen years, it seems. He measured and weighed her (and, by the way, this doctor is the most anal retentive doctor I have ever seen when it comes to measuring his patients -- he even redoes everything after his nurses until he is satisfied the measurement is correct) and found that she had made some significant gains in both areas. Hurray! She is still EXTREMELY tiny. So, so tiny. But she made great gains in comparison to her size. What I found absolutely horrifying is that I brought along Minsy's China medical records because Dr. Schwartz wanted to see their measurements for her so he could see her growth trends -- something super important to know as he plans whether or not to begin hormonal treatments. Well, it turns out that in the three years that Minsy was in the care of the orphanage there she only gained about two pounds. Two pounds in three years! Unimaginable! How did no one see that this might be a problem? It seems like that was not something you could explain away by saying she was simply small for her age because it ended up that she got smaller and smaller for her age as time went on. So sad.

But the important part of today's visit was that Dr. Schwartz was able to see that Minsy was gaining height and weight exactly how she needed to be in order for him not to worry too much. It proved to him that she would be able to play some catch-up simply by eating our regular diet. So no hormones for now and none in her immediate future. Yea for that! He said that it is simply important that she gets lots and lots and lots of extra calories. He does't even care where those calories come from. He wants us to add extra butter and extra fat wherever we can. He wants us to push things like doughnuts and cookies if we need to. He just wants her to get calories any way she can. No problem there. The problem will be remembering that the rest of us are trying to reduce calories, so we'll need to prepare things a bit differently. Eventually these extra calories will help her in catching up to where she needs to be, although she will probably always be on the short side.

But here's the big mystery solved today:

How old is Minsy?

The reality is that we really will never know. But Dr. Schwartz said that we should leave her birth certificate exactly as it is and begin treating her as a four year-old -- make that an almost five year-old since her birthday will be in September. Wow! I told him that I am going to have to completely rethink the whole way I have approached her if she is almost five. That means that she is significantly delayed in many ways. We expect the delays in language because of the adoption. But there are some delays in some of her fine motor skills and even some gross motor skills. I think that a lot of this is because it is so easy to baby her when it seems like she is so young. I imagine that her foster family in China did this, and I find myself doing the same thing. I'm going to have to change that really soon if she is going to start kindergarten in the fall of 2013. I can't begin to imagine her starting school at that time. But we've got a year. We're probably going to need to place in the early childhood program of our school district in order help her play a little catch up. She'll need remediation in speech and some other skills, so that will be good. She is a smart little girl, though, and with the proper instruction she will be able to pick up on things quick enough. If we get to next year and it seems as if she is still not quite ready for kindergarten we have the right to hold her out another year and give her some time to learn more. But if she's ready we can get her started right on time. She will probably still be the smallest kindergartener in history. But we can make it work if she is intellectually ready to learn at that level. I'll just need to make sure that she is always treated her age rather than treated according to how small she looks. Then she'll end up being babied all through school, and that will hurt her more than help her in the end.

So today my "three year-old" gained a year and is now four officially. My head still can't process that, but at least we have a concrete decision. I've always hated having to answer "we don't exactly know" whenever people ask her age. Now I can tell them and watch their eyes get bigger as they give me a hearty "NO WAY!" Maybe I'll just type out an explanation now so that I don't have to repeat the whole story fifty times a day. Now I think I'll head off and fry some homemade donuts. After all, I've just been given permission by our doctor to cook with as much fat as possible, so I'd better listen, right? It's good for us!