Hana is starting to walk. She takes a step, or two, before she falls down. Getting to this point took quite a bit of "home physical therapy" with 1 hour "sessions" about twice a week, and mini daily sessions every morning and evening. At first she was terrified of moving her legs while standing. She'd stand okay, but when you asked her to "come here" as you squat 3 feet away, reaching out your hands...she'd just stand there and cry. Crying to the point I considered perhaps there was something actually/physiclal painful about walking for her. But...now she's getting over it...and jolting forward off balance as she lundges for my hands...squealing in delight the entire time.
She's only gained 2 pounds so far. Expected weight gain is more along the lines of 1-2 pounds per month for a child without a history of malnutriton. Given her history, and expected "catch up" growth, we'd like to see more of a weight gain, so Pedi recommended adding boost, ensure, pediasure, or carnation instant breakfast to supplement her diet.
Hana was a self-soother, which is excellent. But so much so, that she almost didn't *want*...or rather *expect* to be held while sleeping/relaxing, or hugged and rubbed. If you sneak into the bedroom while she's sleeping, and rub her head, she'd wake right up. She couldn't/wouldn't fall asleep in your arms. It's like, she didn't understand that touch doesn't have to stimulate. And she certainly didn't understand falling asleep in Mommy and Daddy's bed.
...so we've been doing (almost) nightly cuddles, rub downs, kisses, and lounging in the "family bed.".
Hana is a very intelligent baby. Tell her something once, show her something once, teach her something once...and she's got it!! She's babbling, smiles for everyone, waves "bye," and scoots as fast as her little legs can crawl into the kitchen at meal times when she realizes brother and sister are running to the dinner table for a meal.
I've started using organic/natural products on her (as with the rest of the family). See, initially I didn't use organic stuff on her because either: it wasn't medicated; it wasn't strong enough; or it wasn't readily available. Now that we're home, and she's decontaminated with soft, well-healed skin, less blow-out diaper poops, no URI, no distention, etc, I feel that gentle stuff may be sufficient.
Diet: now that she's one, she's eating everything we eat (sans peanuts) - including eggs, and milk. Yep, she's tolerating lactose, which is good. Most likely her GI tract has healed from the parasites, viruses, and protozoa/giardia. The intestinal villi are functioning, and she's tolerating everything. I still give her probiotic, vitamin supplements, and the occasional reglan for spit-ups.
Grooming: Hana now gets a bath about 4x/week. She loves very warm bubble bath with lavender added, she gets a shampoo and conditioning treatment. Aveeda lotion, then natural oils on her body. Powder. I use isopropyl alcohol to clean her ears, and any spot that looks like it's trying to get infected. I use triamcinolone to treat the residual/minor flakiness that occurs when needed. I use Aveda Beautifying Composition on her hair, and a boar bristle brush to help stimulate her scalp. She get her 4 teeth brushed, and her earrings cleaned every bath. Nails clipped, and diaper cream...
...phew, lots of work goes into this grooming ritual. But, as she heals, and her skin improves, and I become more comfortable that she's okay...this will decrease in the same way it has for Haley and Ian over time.
Lastly, we've been going to Pedi ID (infectious disease) specialist for a couple of months now (since hospital discharge). Her gastric aspiration eventually grew out AFB (positive for TB); and she was started on 4 anti-TB meds. She's been taking those for 2.5 months. We have a public health nurse that comes to the house. He administered PPD (TB tests) to everyone else in the house...and they were all negative. He will come out again in the next few week to repeat the PPD placement one last time. Hana has not been sick at all with sign/symptoms of active TB. The AFB were sensitive to all TB meds (which is excellent). She continues to take Rifampin and INH for another 3.5 months. Pedi ID said that the BCG vaccine kept it from disseminating, and us adopting her...saved her life. They are all confident that she would have certainly succumbed to this disease (as her mom did) had she not began treatment ASAP.
Post-placement report - our post placement report is due this month. Will have to call social worker to come over for a visit with Hana soon.
***
It's been 3 months!! Hana is taking small, unbalanced steps. She's still sleeping very well. She's babbling, still can't quite understand her. She's a very happy, easy-going baby...but she is started to express herself a bit more. For instance, if Haley and Ian take something from her, she "yells at" them. If someone upsets her...usually with the work "NO," she will make it clear that she prefers the other parent for awhile...the one that didn't say "no." If a new person comes up to her, she may (or may not) cry...and reach/lean towards a more familiar person.
When we pick her up from daycare, she shrieks and crawls over to us with such speed!! And when I arrive home at 6 or 7pm, she is just as "excited" and loud, and yelling, as Ian and Haley. "MOOOOMMMMMYYYY!!"
On the healthcare front: She has gained 3 pounds and up to 17 pounds 9oz...putting her on the curve at about 3rd percentile. Her head circumference is still solidly at the 40th percentile. Her length at about the 25th percentile (or so). So she still has a bit of weight catch up to do. After consultation with a dietitian (and multiple pediatriticans), it was recommended that we stop the formula, and instead give her pediasure/ensure or boost; give her all table food with added butter, sour cream, cheese, etc. Okay to give peanut butter and eggs now (African kids tend *not* to have all the food sensitivities that we find here in the United States....apparently their immune systems have *other* things to do then to attack peanut or egg allergens!!)
She completed just over 2 months of Rifampin, INH, PZA, and ethambutol. The PZA and ETB was stopped per protocal after 2 months, and the RIF and INH to be continued until end of June (6 months). Pedi ID doc* is happy with her progress, states that one more set of (optional) blood tests will be done, per my request (to check her liver and kidney function, and also, since her prealbumin was low, that too), and end of course CXR. He is confident that Hana's TB is gone already, but continuation of meds for 6 months (even if the disease was dissiminated, which in her case it is not) is standard. He said he doesn't need to see Hana again. He also said that a negative PPD at 12 weeks post possible exposure will rule out the possibility that anyone else was exposed to TB.
(*pedi ID doc is this highly recommended guy who worked all over the world including Africa, Cambodia, Thailand/Asia, and has lots of exerience with international adoptees, TB, and international pediatric infectious diseases...and the fact that he thinks everything is all good with Hana, that she's absolutely doing better, not contagious, and TB-free, is reassuring).
So, everyone had a repeat PPD (TB skin test) placed...and all were negative still!! So no TB exposure in Africa, Dubai, or home here with Hana. Eventhough they say she can't really spread TB...common sense tells me that it is indeed *possible.* How could it not be? And the pedi ID doc agreed with me. So we are super happy that we retain our non-conversion status with regard to PPD.
We had our 3-month post placement visit last week. Interview, clean house...you know the drill. Hana was perfect...happy and full of personality. Ian was home as well, and he was actually perfect as well. Haley, was at school.
Social worker was very interested in the "before" and "after" regarding her health status, growth, and adjustment. Wasn't so interested in much of anything else. She stayed here about 90 minutes. Wanted to walk thru the house, see Hana's room/bed, and spend a bit of time playing with Hana. It was light, and kinda fun to talk to someone about our experiences so far with Hana at home. She offered a bit of insight, stories, etc. And that was that. I made a collage from this site to include with the post-placement report that has to be submitted to the placement agency at 3, 6 and 12 months, to be done by a social worker. Then once a year thereafter until Hana is 18...to be done by us.
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