Second Verse ... Same as the First

I don't even know what to say here. I have no idea. I feel like my psyche is being tossed back and forth like a ping pong ball between doctors and teachers as we try to plan the best way forward with Minsy. Today we took another sharp turn in our ideas of what will best help Minsy for the future. I hesitate to even call this a final pronouncement because it seems as if diagnoses and opinions change almost monthly. Whatever it is, it does seem to (yet again) force me to rethink my ideas about where Minsy is in her growth.

So here's what happened:

When I last updated all of you about Minsy's progress as we try to figure out a good approximation of her age and development, we had come from Dr. Ladage, a pediatrician in St. Louis who specializes in international adoption patients. She did lots and lots of investigation and observation, and she told us that it seemed likely that Minsy was at least five, just as her Chinese records would suggest. We were stunned, having expected her to tell us that the records would be wrong and that Minsy was much, much younger. But we decided to just work with that and deal with life as it progressed. Minsy was five ... an itty bitty five year-old who would enter kindergarten next year. Eek! I wrote all about it HERE if you are interested in reliving that drama.

Today Minsy went to Springfield to visit Dr. Schwartz, the pediatric endocrinologist who is trying to figure out what is causing her growth delays and develop a course of treatment for her. I like Dr. Schwartz a lot. He is very, very thorough, and I never feel rushed when we are there. He looked through the records of our visit with Dr. Ladage and asked lots and lots of questions. I told him how freaked out I was about her actually being five since she doesn't act anything like a five year-old. I told him that I could wrap my head around her being a super tiny five year-old if her behavior was remotely close to a child that age. But it isn't ... not at all. I can't imagine sending her to kindergarten, but she would be aging out of our early childhood special ed program. I just opened up to him and let him know how overwhelming all of this was. 

Dr. Schwartz showed me several charts he was keeping to track Minsy's development in several areas. He showed how her growth rate in height followed the expected growth curves perfectly. It was just way below the third percentile on the chart. He explained that if she had a true hormonal problem that was leading to her small stature, the growth rate would not follow the same curve. Instead, it would trend downward. So it doesn't seem as if there is a hormone issue. Hurray! Still, we have to keep monitoring her for awhile to see if things change in that area. 

Things looked a lot more troubling with her weight. After a tiny, tiny weight gain between the time of her arrival and our 1st Dr. Schwartz appointment last April, Minsy hasn't gained a single ounce. Nothing. So although she has gotten a bit taller, she has ended up getting a lot skinnier, and she is not a girl who can afford to get much skinnier. This is a concern. We obviously have not done a good job of feeding her high fat, high calorie foods like we were instructed at our last visit. I'll admit to this. I do try to get Minsy to eat, but there is something that just feels wrong about giving a child food that is so terribly bad for her. So I resisted this a lot. It turns out I needed to listen and trust the doctor a bit more on this point because she is losing ground. The big battle for us will be finding a way to give Minsy all the high fat stuff without eating it ourselves. We'll figure it out, I'm sure.

The big discovery today was that Minsy's Vitamin D levels have been dropping like crazy. They were low last April, but after a bit of time taking supplements they seemed to rise to acceptable levels. However, Dr. Ladage ran some tests in Novemeber and found them to be low again, and today they had dropped quite a lot more. That could be a symptom of a larger problem that might be leading to her inadequate growth, so I am getting ready to take Minsy in for blood draws the next few days to monitor things and see if we can determine what the problem is. Poor Minsy. She is deathly terrified of doctors and even more terrified of phlebotomists. It's going to be a rough few days for her.

But anyway ... after talking through all the results of all the tests and what they might mean Dr. Schwartz gave me a suggestion. He said that since China had only arbitrarily assigned her a birth date, we could do the same thing. He said, "What would it hurt if we just decided to make her a three year-old?" He told us to consider moving her age back a few years.

What ??????!!!!

But I'll be honest. I was being very polite in my response to Dr. Schwartz. Here's how I made that statement in my head:

WHAT????!!!!!

I had just started to wrap my head around Minsy as a super small five year-old. Now we were being given the option of making her three which would change EVERYTHING. I felt like my brain was going to explode right there in his office.

He made a good point though. He explained that changing her age would make her growth seem not as below average (although it would still be pretty small), but more importantly it would help her educationally get the assistance she needed right away. If she truly has a mental handicap, changing the age wouldn't do much to aid her educational path, but if it is simply an educational delay that can be corrected with intensive special education, then this would give her a few more years to get ready for kindergarten. As far as monitoring her growth, changing her birth date could screw up charts for her and mask any potential hormone deficiencies, but Dr. Schwartz explained that he is the only doctor who will be closely monitoring all of her growth and hormone levels, and since he would know what was going on, he could take all of that into consideration as he followed her growth. 

So it seems as if we are back to square one.

Was I internally screaming? Oh yeah.

It sure seems like every time we get ourselves attached to an idea of how old to treat Minsy we have ended up being pulled in another direction. I seriously just want to get this decision right. I want to do what is best for Minsy in the long run. She will match her peers better in both size and intellect if we push her back a bit, and that is important. I don't want to make a decision simply to make my life easier. I want it to be best for her. Really the difficult part of making this decision will not be in the near future, but it will be a few years down the line when Minsy is a teenager. Will she feel bummed out to think that we might have pushed her back a few years? I just don't know. But I do know that we can really screw things up for her if we make a decision now that will keep her from doing well in school both educationally and socially.

Ohhhhh the pressure!!!

So we are back at the beginning again. I think that I am leaning toward changing her age. I'm sure that the China ages might be accurate, but still, I think that giving Minsy a few more years to catch up both physically and mentally would be infinitely beneficial to her in the long run. Making this decision legal is the next big step we have to take, and that is a huge step to take. I feel like if we do this, we are cementing our decision. We could change our mind later on, but it would be a huge, gigantic ordeal. I'd rather make the decision only once and then work with it. I'll probably consult Dr. Ladage to let her know what is going on. I can almost guarantee that she will disagree with Dr. Schwartz. They are both good doctors, and I like them both a lot, but they are seriously pulling us in two different directions. Since Dr. Schwartz is dealing with actual medical tests, and Dr. Ladage is putting heavy weight on cultural markers and Chinese orphanage data, I tend to lean toward Dr. Schwartz in this decision. But, holy cow, I just don't know. Here's the one thing we can do. We'll say some prayers and turn it over to Heavenly Father. And things will work out. I know that to be true. 

So the Great Minsy Age Debate continues to live on for another day. I'm just ready to be done and to move forward. Hopefully that can happen now. In the meantime ...

I think I'll just sit here and blow bubbles in my soda for the night.

Ahhhhhhh. Much better.