Not flesh of my flesh
nor bone of my bone
but still miraculously my own.

Never forget for a single minute
you didn't grow under my heart
but in it!

Wednesday, December 31, 2008

Christmas 2008

Gabriella was sick during Christmas week. She came home from Morton Hospital on 12/24 and went back in to Children's Hospital in Boston on 12/25. On Christmas morning we showed her some of the big items that Santa brought for her, but she was not too interested to play with them at that time and was not interested in opening any of the wrapped gifts.

There were presents for Gabriella all over my house. This is just some of them:
Since being home from the hospital we have opened a few presents each night. She became really good at unwrapping presents. The toys she really liked she would say, "Ooohh!"
Gabriella loves her ATV. She is not afraid to push the button to make it go and loves to ride aound the house on it with Ken following closely behind her and helping her steer. Ken can't wait to bring her outside on it in the summer.
She enjoys pushing a doll (this doll was my childhood Cabbage Patch Kid) in her baby carriage...
...but she prefers to sit in the doll carriage herself! She throws the doll out of the seat and struggles to fit in it!
I LOVE that smile...!
Gabriella with Auntie Danie:

Gabriella's First Steps

When Gabriella first came home from Guatemala she was pulling herself up and scooting around while holding on to things. She would also walk around with the assistance of us holding on to both of her hands. She then graduated to "one" hand and kind of lingered at that stage for quite a while. During that time she would also stand unassisted on the bed. She would only do this in the bed, because she must have figured that falling on the bed wouldn't hurt as badly as falling onto a hard floor. She would clap while standing and even slowly turn the top half of her body. Standing on a bed certainly takes some skill, though, because it is harder to balance on a softer surface. So, we knew that her non-walking was more of a confidence issue rather than a skill issue. So, while walking with her we would often try to sneak our hand away and she would immediately purposely fall to the ground. We knew she would walk when she was ready.

Well...she was ready on Tuesday, December 30th! On that day we had the pull-down attic stairs pulled down in the hallway. My father and Ken were in the attic and my mother and I were watching Gabriella. Gabriella decided to climb the attic stairs. (Yes, we know this is dangerous, but our hands were surrounding her and we only let her climb a couple of the stairs.) The stairs are more like a ladder and about as steep as a ladder. It was hysterical and we laughed so hard at her determination and lack of fear. If we would have let her she would have climbed right up into the attic. My mother told her, "If you can climb attic stairs, you can walk!" So, she stood with Gabriella in the hallway while I stood a few steps away and she let her go. Gabriella proudly walked to me unassisted. We grabbed the video camera and me, Ken, Grammy, and Grampy cheered her on while she did it a few more times.

These photos were taken the next day on December 31st while visiting with Auntie Danie.

Look at the determination in her eyes!:

She was so excited!:
After each round she would clap proudly with us:

Each day she is walking a bit further and further and her confidence is increasing. Ken and I know we are in trouble now!

Tuesday, December 30, 2008

Messy Eating

When Gabriella arrived home from the hospital, she wasn't much interested in eating so Ken and I were willing to try just about anything to get her to eat. We thought that a scoop of pudding on her highchair tray, although messy, would be fun for her to play in and we figured some of it would get into her mouth!
After a few bites, she realized she was messy. She reminds me of me when I was little; I hated to be dirty. She immediately wanted to clean up!
So I gave her a napkin and she tried to clean the mess!:
Gabriella is also wanting more independence. She wants to feed herself now and her self-feeding skills are becoming more coordinated.
When she was done eating, she decided to play with the yogurt and poured the remainder of it out on her highchair tray!

Christmas in the Hospital

Not quite the way we planned to enjoy Gabriella's first Christmas home, but at least we were together!

On Monday the 22nd, after her doctor's appointment and blood work, Gabriella went home with Grammy to rest. She proceeded to get worse through the day with fever and lethargy and she vomited lots of mucus. I called her pediatrician again and made another appointment for 3:30 PM that same day. By that point all of her blood work results were back and everything appeared normal. They catheterized her to test for a Urinary Tract Infection and that came back negative as well. At that point, the doctor decided to admit her to Morton Hospital, our local hospital, for observation and more testing. Ken and I took her home, quickly packed bags, and were were admitted to the hospital by 6:00 PM on Monday. They did a chest x-ray (to check for Pneumonia) and stomach x-ray (not quite sure what they were checking for with that) and both came back normal.

We knew sleeping that night at the hospital was going to be very tricky. They have the chairs that pull out into very narrow cots for the parents and, of course, a crib for the babies. Gabriella has never slept in a crib. She wants to be in the bed with us and wants nothing to do with the crib. She has a lovely crib at home with a very top-of-the-line mattress, but has yet to sleep in it. She occasionally sleeps in the Pack-and-Play next to our bed, but I have never pushed the issue because after many discussions with our adoption social worker and other adoptive families, co-sleeping is a good option for adopted children. I cuddled her in the cot and then we snuck her into the crib while she was sleeping. The nurses were in and out of the room to check her vital signs at least every hour, so the first time they came in, she woke up, and cried to get out of the crib. We pushed my cot against the wall and I wrapped my arms around her to keep her securely in the cot. She is a little wiggle worm when she sleeps. She wiggled her way to the head of the bed and fell right off of the top edge of the bed. Ken and I screamed, the nurses came running in. Luckily the cot was pretty low to the ground and, thank God, she was not seriously injured. She got a little egg on her forehead. Gabriella cried a bit, but not the screaming that we expected. I moved the cot into a corner and lay awake with her the rest of the night while she slept.

The next morning they re-ran her blood work and compared the results from the previous day. All of the numbers were still normal but slightly improved from the day before. They then took a nose culture to test for Respiratory Syncytial Virus (RSV) and a throat culture to test for Influenza. She tested positive for RSV. Not good news, but I felt a bit of relief because finally we had an answer. RSV is a major cause of respiratory illness in young children. It causes infection of the lungs and breathing passages. It is very serious in children under eight months and appears only as a common cold in adults. Common illnesses hit Gabriella often and hard, so we were expecting a bit of a battle with it for her. RSV is not treated with antibiotics but often triggers other respiratory illnesses that are treated with antibiotics.

The RSV caused extremely labored breathing and wheezing for Gabriella. We began breathing treatments with a Nebulizer in the hospital and the nurses were closely monitoring her oxygen. They were often suctioning her nose as well to help her breathe. She was also very fevery with her fever averaging around 101, but periodically spiking to 103 and almost 104. The key at the hospital was monitoring her and managing the symptoms - her breathing, temperature, oxygen level, and heart rate.

That night Ken had a great idea to bring in our Queen-sized air mattress to the hospital. We snugged it up to a corner of the room and we were able to all get a more comfortable, restful night of sleep. Our hospital room was huge and we were alone in there because Gabriella was on contact precaution because of the C-Diff and now the RSV. The nurses at Morton Hospital were very accommodating, extremely experienced, and simply wonderful.

While at Morton Hospital, Gabriella's pediatrician consulted with an Infectious Disease doctor out of Children's Hospital in Boston to make sure that nothing else was going on. The ID doctor felt that Gabriella was being exposed to new bugs in day care that her body had not previously built defenses against and that regular winter-time illnesses are effecting her hard as a result.

The next day, Christmas Eve, the doctor came in and listened to her lungs. The RSV had caused a mild case of Pneumonia and Bronchiolitis which they began treating with antibiotics. The nurses monitored her through the day and because her oxygen level was above 95%, her fever was relatively low at 100 to 101, and she was drinking okay, the doctor decided to release her. She was even acting a bit silly, eating directly from her high chair tray with no hands! Appropriate to the Holiday, she was acting like Randy from "A Christmas Story!":

We arrived home at about 6:00 PM on Christmas Eve. We got home and Gabriella quickly spiked a high temperature of 103.4. Her breathing was more labored and she wasn't interested in drinking. She vomited more mucus. I consulted with the doctor on-call. They said that some vomiting of mucus was normal with RSV. We decided to keep her home and monitor her through the night. Christmas morning she was still lethargic. Later in the morning we walked her into the play room to show her the toys that Santa brought. She was not enthused by the enormous train table, ball pit, Elmo Live or other millions of presents. She, of course, was not interested in opening any other presents. We laid real low with her and tried to get her to drink. She vomited again. By 2:00 PM on Christmas Day we had our bags packed again and this time we were on our way to Children's Hospital in Boston. During the ride she became almost unresponsive. I had to shake her and call her name to get movement. Her oxygen level was down to 86%, her heart rate was up to between 160 and 180, and her temperature fluctuated between 101 and 103+. Her breathing was extremely labored. With each breath her belly would pull in and her nose would flare further indicating her difficulty breathing. It was very scary. They admitted her, of course. They gave her an IV because she was nearly dehydrated. They felt that the near dehydration and fever were causing her heart rate to be elevated. Plus, we were giving her Albuterol through the Nebulizer, as prescribed, to help her breathing which was also elevating her heart rate. They gave her another chest x-ray and saw some gook in her lungs but her Pneumonia was not that bad. They changed her antibiotic to treat the Pneumonia. They were constantly checking her vital signs and keeping her hydrated through IV. They were real concerned the first night because her oxygen kept dipping real low.

Sleeping was an issue again, of course. She was in a single room because she was still on contact precaution but it was a tiny room. There was certainly no room for an air mattress and they looked at us like we had five heads when we mentioned it! They said I could sleep in the crib with her! Truly! They said it was common for parents...and it worked out quite well. Ken slept on the cot.
The next day, Friday the 26th, they continued to manage her symptoms and she seemed a bit better. The doctors had told me and Ken that we would most likely catch a cold from her. He and I automatically knew that that meant Bronchitis for the two of us! Colds for me always turn into Bronchitis and Ken has Asthma so he commonly gets Bronchitis as well. My coughing was worsening and I was concerned about waking her every time I had a coughing fit. So I went the the ER next door at the Brigham and Women's Hospital to get antibiotics while Ken stayed with Gabriella. Ken's Bronchitis held off a bit and he did not get antibiotics until today.
Gabriella's oxygen had consistently increased to 91% and her fast heart rate was finally slowing. Her temperature was holding at about 100 to 101. They wanted to release her on Saturday the 27th. I would not let them and had to fight with them to keep her another night. I did not want her to leave the hospital until she was able to keep her oxygen level above 95% on room air. They grudgingly obliged. By Saturday afternoon she was more energetic and full of life again.
She was released from the hospital on Sunday the 28th. She still has a tiny bit of wheezing. We followed-up with her pediatrician yesterday, Monday the 29th, and he was pleased with her condition and progress. He said some of these final symptoms should last for about another week.

Gabriella learned a few new things during her hospital stays this week. She learned the words "all done" and would often yell it out beneath her face mask while we were struggling with her during breathing treatments. She now adds hand movements, flipping her palms up and to the sides, while saying it. She also learned what a hospital vomit pan is for! When it appeared that she would likely vomit I would position the pan near her. So now, when she sees a vomit pan she positions her head over the pan, sticks her tongue out, and makes the vomiting sounds! She also learned what a stethoscope is for. She would take the end of the nurse's stethoscope and place it on her belly.

It certainly was a scary, tiring and trying week. Ken and I were dying for a decent meal and for a restful night sleep. Christmas flew by in a blur. The good thing, of course, is that Gabriella is feeling better. We will continue to open a few Christmas presents each night and continue to lay low. She loves her new rocking chair from Grammy and Grampy (the NC State shirt is from her Aunt Donna, of course!):

We began the year off in a hospital because of my car accident and we ended the year off in a hospital with Gabriella. The time in between has not been too smooth either. We know, at the same time, that we have tons to be thankful for. Being in a hospital such as Children's Hospital certainly reminded us of that. We are still very excited to ring in the new year!

Monday, December 22, 2008

Sick Again!

Hard to believe but yes, it's true. Gabriella went to bed shortly after we got home from our Polar Express adventure. She woke up two hours later fussing. I touched her to console her and she was burning up. I took her temperature and it was 103.8! We immediately gave her Motrin and changed her into a lighter weight nightgown. We gave her a cool beverage and wiped her face with a wet, warm cloth. Less than an hour later her fever was down to 102.1 and completely gone by the middle of the night. She was up, though, fussing and crying just about the entire night. We contemplated bringing her in to the ER, but opted to wait for morning because the roads had turned into one sheet of ice during the night. At 4:00 AM she had her second dose of Motrin and the fussing ceased and she fell asleep until 8:30 AM. Her doctor saw her at 10:30 AM. While at the doctor's office she spiked another fever of 102. Her ears looked fine and he ran a rapid strep test which came back negative. The complete strep culture will be completed tomorrow. They also ran bloodwork to try to get to the bottom of what is going on. The unfortunate thing is that we cannot get our hands on accurate medical records for her from Guatemala. I am extremely concerned and hope we can figure out what is happening.

Sunday, December 21, 2008

Christmas 2007: Gabriella's First Cristmas

One year ago today, my mother and I were saying goodbye to Gabriella after our first time meeting her. It was the hardest day of my life and I was not sure how I was going to stay strong enough to make it through the remainder of the process. I don't typically drink alcoholic beverages, but I remember boarding the airplane to come home with swollen eyes from crying and I immediately ordered a Bloody Mary with a double shot of Vodka! Last Christmas was the saddest Christmas of my life knowing that I would not be able to celebrate Gabriella's first Christmas with her. I am thankful, though, for the time I got to spend with Gabriella one year ago when she was only four months old.

The past few months have been filled with many "this-time-last-year" memories. It's hard to believe that we've been home almost four months and at the same time hard to believe that I've ever been without her...

The Day We Adopted You
Author: Unknown

If we had it to do over again
Adoption is what we'd choose
We got more than we had hoped for
The day we adopted you.
For you have given us more in life
Than we could ever want or need.
You made our house into a home
And made our family complete.
We love you more than life itself for all the things you say and do
And if we had it to do over again
You'd be the only one we'd choose.

Polar Express Train Ride

The Wakefield Music Boosters (through the Wakefield, MA public schools) hosted a 70 minute Polar Express train ride with Santa and his elves from Boston directly to the North Pole! We decided to brave the ferocious weather and join the fun.

Gabriella was not a huge fan of the costumed entertainers. She clung on to me and would not look at them, but did not cry.
The littlest train conductor!:
Getting ready to board the train:
Gabriella with her cousin Vinny:
Gabriella with her cousins:
She enjoyed the train ride and chatting with her family!:
Enjoying a snack of grapes (with no skin, of course!). Gabriella LOVES grapes and would be happy if they were a part of every meal!:
Gabriella is not a big fan of Santa Claus. Notice the focused look on her face. As Santa came close Gabriella clung on to me.:

It was a fun time and Gabriella enjoyed it.

Gabriella HATES the Snow!

It began snowing here in Massachusetts on Friday at about 2:00 PM and pretty much has not stopped since. We showed Gabriella the snow from inside the house, but she did not act very enthused. She did, though, enjoy picking up the tiny snowballs that the dogs tracked into the house after they came in from the outside. She enjoyed holding the snow until it melted and looked at the remaining water in amazement. We decided to take her outside to play in it yesterday afternoon. The minute we began bundling her up, she started to look unhappy!:
We only got one glimpse of a smile from her...:
...but that was the only smile we saw while she was in the snow! The remainder of her facial expressions indicated thoughts such as, "Why on earth do you have me outside in the cold when we have a nice warm house only a few feet away?!"
"Are we having fun yet?"
"I can't move my hands in these stupid mittens, but even if I could, do you actually think I would want to touch that stuff?!"
"They didn't have this stuff in Guatemala and I preferred it that way!"

I am sure that she will enjoy the snow better next year, especially when she is more mobile and when she can understand what the strange white stuff falling from the sky is.

Thursday, December 18, 2008

She's Feeling Better and I'm Home

So, as you know from my last post, Gabriella had a stool sample that tested positive for a bacteria. The bacteria is Clostridium Difficile or C. Diff and causes antibiotic-associated diarrhea. She began treatment on Monday with Metronidazole. She seems to be feeling much better, less fussy, and we have not had any major episodes of diarrhea like we had been battling with for several weeks.

I, on the other hand, feel completely wiped out! My job requires business travel but I have not gone on any business trips since January due to the injuries associated with my auto accident that month. I had to, however, go on my first business trip since January on Monday afternoon. It was only for two nights and it was only to New Jersey, but it was so difficult having to be away from Gabriella, and even harder being away from her with my concerns for all of her recent health issues. Ken, my parents, and Ken's mother held down the forts tremendously and Gabriella did not even seem phased when she woke up and saw me this morning!

Monday, December 15, 2008

Another Evening in the ER

Due to her recent illnesses, we kept Gabriella in the house all weekend to rest. All of the stomach issues seemed resolved but but she had been fussy all day yesterday (Sunday) which was unusual because Gabriella typically doesn't fuss much. We put her down for bed at her normal bedtime which is around 7:30 PM. She cried a lot going to sleep and then kept waking up through the night crying. Finally at 12:30 AM, Ken and I decided to bring her in to the ER. I suspected that the fussing was from another ear infection. When we were checking in at the ER, Gabriella had a major episode of diarrhea that went through her diaper, her clothes, and my pants. After five hours we learned that Gabriella has a urinary tract infection. When we were in the ER last week they had wanted to catheterize her to test her for a UTI, but I would not let them. She was already going through so much and I did not want to induce more pain and stress. I wouldn't let them catheterize her this time, either. They were able to collect a urine sample in a bag. The doctor also pointed out that the results were back from Gabriella's stool sample that her pediatrician ran the day after she was in the ER last week. It showed a bacteria that may be causing the diarrhea. The doctor said that he has never seen this bacteria in a pediatric patient. We do know, though, that it is a new bacteria for her because she was tested for it previously in November and it was negative. We have to follow-up with her pediatrician tomorrow for that.

Friday, December 12, 2008

Feeling Better

It has officially been a full 24 hours with no medical issues! The vomiting and diarrhea have completely ended. The vomiting ended after we left the hospital and the diarrhea continued through 3:00 AM last night. She is back to being full of life as opposed to the limp, weak little girl from 48 hours ago. We kept her on clear liquids and minimal foods all day yesterday. She had stopped drinking Pedialyte, and though not ideal for a baby, we had switched her to Gatorade. So, her diet yesterday consisted of Gatorade, dry Cheerios, Saltine crackers, apple sauce and a banana. We are going to slowly add more options to her diet tomorrow. Ken and I are complete wiped out and Gabriella cannot afford to lose anymore weight, so we are being extremely cautious.

Wednesday, December 10, 2008

First Hospital Visit

After another evening of more vomiting and not being able to hold down liquids, Ken and I brought Gabriella to the hospital at 2:00 AM. The second they began the fluids intravenously we noticed a change in her almost immediately. She obviously did not do well when they were setting up the IV line and she was curious to pull at it once it was in, but did better when the newness of it wore off. At the end of the evening the doctor reached out to shake her hand and she shook his pointer finger! It was precious.

Hopefully she will be less nauseous now that she is re-hydrated and will be better able to hold down liquids. We have another day (hopefully the final day) of clear liquids and no solids.

During the exam they also noticed that her right ear appeared dark (her previous two ear infections were in her left ear) so I am hoping it is not another ear infection. We will be following up with her Pediatrician later today about the stomach bug and her ear.