You want to do WHAT??

Minsy hates doctors. She absolutely hates them. It's been that way from the first time we met her. I don't know what happened in her early life to cause her to have such intense visceral reactions to medical facilities, but something has caused her to have some intense negative feelings when it comes to doctors and all they represent. At first she would say nothing, but we would notice her sitting very, very still with a look of pure terror on her face, trying not to be noticed as these tiny little tears would be rolling down her cheek. So, so sad. So heartbreaking. But what could you do? She had to see these doctors. Now she is a bit more vocal about her dislike. If we ever make the mistake of mentioning the fact that she has a doctor's appointment in the future she will come up to us CONSTANTLY to say, "I don't want to go to the doctor." Over and over and over. When her pleas go unanswered and we load up the car to head toward a doctor's appointment she breaks out into sobbing tears. Her anxiety about this is so strong that she had a mini-meltdown when we were stuck in the American immigration holding cell ... er, waiting room ... for two hours last month. It seemed so much like a hospital waiting room that she was convinced that we were bringing her to the doctor. Poor girl. We have tried what we can to make the process not as terrifying for her, but nothing really works.

Knowing Minsy's negative feelings about doctors, I wasn't feeling super hopeful that we would have a positive experience visiting a pediatric gastroenterologist this week. What does a gastroenterologist do? They basically specialize in conditions involving the digestive tract.

Basically a gut doctor.

I did a little looking, and it seemed like most procedures involving such a doctor would be invasive and not too fun. Oh no!

Why was Minsy seeing a specialist like this? I don't know if you've noticed or not, but Minsy is a tad small. REALLY, really small. Even using the Chinese growth charts which account for the generally shorter Chinese people, Minsy is on the extreme lower end of the chart as an almost five year-old. To make things even crazier complicated, there still is this strong possibility that she really is almost seven. In that case she doesn't even touch the chart. She is almost dangerously small for her age. We have been seeing an endocrinologist for the past two and a half years, and he has been tracking Minsy's growth and development. She has grown right along the chart curve, just at that lower end. If she had been malnourished as a child we should have seen a marked jump in her growth rate as soon as she started receiving better nutrition, but that hasn't happened. She just seems to be meandering along at her own pace, way below schedule. When Dr. Schwartz learned that the Mercy system in Springfield would be adding a brand new pediatric gastroenterologist this summer he signed Minsy up to see her right away. He wanted to make sure that there was not something about her digestive system that was preventing her from getting all the nourishment she needed. 

When the day of our appointment arrived Minsy was a mess. She cried and cried and cried as she begged us to just stay home that day, but I was a big, giant meanie and put her in her booster and drove on our way to Springfield. Minsy cried forever, it seemed, but by the time we got to Lebanon she was fast asleep. She didn't sleep all that long, though. When I was driving past Marshfield I heard her wake up and say in a super happy voice, "Are we at the doctor's yet?" A happy voice. Who just woke up in the back seat of my car? It couldn't be Minsy, because she NEVER shows any joy at being driven to a doctor. But Minsy was super happy to go. Then when we arrived at the clinic in Springfield she hopped right out of the car and danced and sang her way all the way to the doctor's office. What in the world? A big tender mercy.

Dr. McGhee's office was perfect for Minsy. There were very few patients in the waiting room, and the room just looked like a big, giant play place for kids, not the sterile, boring rooms that she normally sees. She saw that her favorite cartoon was on the television and there were some little games she could play as she waited. She walked right in and put on her normal happy social face and greeted everyone in the room. It's hard not to love Minsy.

Dr. McGhee. Love her!!

This appointment was just an initial visit to see what was going on and what course of treatment we might pursue. I absolutely loved the nurses and Dr. McGhee. They were all so peppy and positive, and they made Minsy feel right at home. I told Dr. McGhee all that was going on, and she looked at the charts that Dr. Schwartz had sent her. The big problem we face with Minsy is that we have no family history, so we have no idea what we are really dealing with. If her parents are both three feet tall, then Minsy's growth is normal for her. We aren't exactly sure if her body is having trouble absorbing all the calories she is intaking or if we just aren't giving her enough. So the first thing we need to do is to figure out exactly how much is entering her body. This will be a hassle, but it won't be too hard. 

I told Dr. McGhee that we have just been letting Minsy eat all day whenever she wants in order to let her have more calories. We figured that if she was constantly eating that would naturally lead to more calories and faster growth. I learned that this is actually not the best plan. What happens when she grazes all day long is that she can fill herself up with lower calorie, non-helpful foods and then end up not eating as much of the higher calorie stuff when she sits down for dinners. She told us that we immediately needed to get her (and our family) on a strict eating schedule with three sit down meals and just one snack in between with maybe one before bed. That would help to regulate Minsy's eating, keeping her hungry enough to scarf down the higher calorie meals we prepare for her. In order to help her the entire family was going to have to adopt this schedule, closing the kitchen for a good part of the day. I know they will survive. That is the way things were when I was growing up, but our kids have gotten used to just being able to grab a quick snack whenever they needed one. When I broke the news to them that night the scene looked much like this one:

Anyway, regulating the food would require a change in lifestyle, but it was doable. That was step one. Step two involved recording every single thing that entered Minsy's mouth for three days. We would keep a journal of her foods and then send it back to Dr. McGhee. Then she would sit down with a nutritionist and calculate exactly how many calories Minsy was eating each day. That would give us a good idea of what we were working with. If Minsy was getting enough calories and not growing, then something wasn't working right. But if she was not getting enough calories each day we needed to move to step three.

Step three did not sound fun. We would have to put a tube down Minsy's nose and throat that would stay there for at least a month. During the day it would just be there, but at night we would use that tube to feed her the extra calories she was not getting during the day. It sounded AWFUL. I can't imagine having a tube stuck up my nose all day. But Dr. McGhee assured us that kids generally don't notice it at all once it is in. She said the worst part of the whole experience is getting it inserted, but after that kids just learn to live with it. I don't care what she said. It still sounds horrible.

But that nose hose seemed like heaven compared to Step Four. If it turned out that Minsy showed growth and improvement with the added nightly calories then we would need to do something a bit more permanent ... not forever permanent, but surgery and in for a while permanent. They would go in and put a direct line into her stomach that would allow us to add the calories without her having to wear the nose hose all day. I guess it is better because you aren't sporting the nose accessory, but the surgery sounds a bit icky to me. 

I was a little horrified when I heard what they were proposing. Surgery? Would that really be necessary? I immediately asked if we had to do such a thing. Did this mean that she was having to have surgery simply because I was doing a horrible job feeding her? If that was the case I would just feed her more. We could just sit her down all day long and make her eat if that would prevent her from having to have surgery. But Dr. McGhee reassured me that it has nothing to do with how I am feeding her or not feeding her. Some kids just need a little extra oomph to get them growing as they should. This would provide that. I believe her. I do. But still I feel like I will first make sure that I am doing all I can on this end before we force Minsy to this solution. After all the good feelings Minsy had in seeing this doctor, it would be a shame if this doctor was the one who ended up having to do the invasive surgery on her. 

Still, we have several steps to work on before we get to that one. Our first mission is to better regulate all our family meals. That'll take some time and skill, but we can do it. Hopefully that is all that it will take. We shall see. For now I am counting my blessings that we have found at least one doctor out there who inspires peace and happiness in Minsy. I'm hoping that we can keep it that way. Sadly, right now after all this talk of food regulation I find myself badly in need of my own second breakfast. Oh well.

Minsy with "Oma" , her bus driver.