Showdown at Adoption Corral

I had a nice face-off with the SW (male) yesterday. Posting earlier would have been nice but my computer service has been down.

Yesterday morning, my devotional time in "Our Daily Bread" was about Grace. Good thing considering all I had to deal with a couple hours later.

The DSHS SW showed up, as well as our agency SW. In a nutshell, the DSHS SW wanted to "right-fight" about the email I sent him the day before (telling him the same things I mentioned in the last blog post). I've never seen this guy angry before yesterday. I got a good helping of it to now last me a lifetime.

To make a long story short, I didn't back down on a single point. He wanted to argue line item by line item on the email. So away we went, as the agency SW (female) just watched us volley.

Counseling Issue. He told me flat out that he never cancelled our daughter's counseling. I kept telling him that's interesting, considering all the counselor told me the day before. Finally he thru his hands in the air and barked "ARE YOU CALLING ME A LIAR???" I said, "I'm not calling anyone a liar. I'm just telling you what she said, which is completely different from what you are telling me. Perhaps you two should both put your thoughts and requirements in writing, via email, and send it around so that this dysfunction will stop." He really couldn't argue with that. Did I mention the counselor testified in court against him & his boss recently? Hmmmmmmmmmm. Perhaps that's why they don't like one another.

Missing Sensory Integration Referral. He said he called them a while ago, they don't have staff currently for these kids (at the only hospital within hours of us that offers this service), and that they will have staff in February or March. My husband pointed out last night "Isn't it February right now?" ya, and no referral.

UW FAS/FAE Referral- He told me he was incorrect in what he said recently. He was incorrect to tell me that UW has rejected the referral for a second time. He said they are actually looking at our daughter's file.

Respite-I asked for respite a couple weeks ago when we were dealing with the height of the Enuresis/Encopresis, when our daughter projectile vomited everything she drank/ate ON ME for two days straight. The SW denied respite at that time, via not responding to my voice mail request. Nice. He has now stated that he dropped the ball and should have called me. He needed to tell me that they are currently not offering respite to adoption placements (folks adopting legally free kids, where the adults have no foster license. Ie..our family). So, he offered up paying for part-time daycare for our daughter so I can get appointments, grocery shopping, cleaning, errands, etc. done during this time. I won't have to deal with our daughter running away, wanting to pee every 30-35 minutes, screaming, tantruming, throwing herself on the floor for 45 minutes straight in public, etc. I told him I feel guilty even considering daycare, since I am parenting her full-time, and she has several issues and problems that are not resolving. I guess I feel rather like a failure for not being able to help her better. Even though all the professionals tell me I'm doing all anyone could possibly do, I'm doing an outstanding job, whatnot. Since the SW is not offering her any other services, I took him up on the Day Care. I signed her up today for all day Tues & Thurs 8am-5pm, where daycare will transport her to ECEAP preschool and back. This is about the only point at which the agency SW interjected. She told me it's not that I'm a failure. She said I have needs, our family has needs, and this little girls needs are so great that the needs of the rest of the family aren't being met. She told me to go for the part time daycare and get alot done during that time. So we are moving forward with that.

FCAP & ECEAP- The SW told our counselor that he (the SW) was denying our daughter access to counseling because "FCAP & ECEAP would meet all her needs." I told him this is false. ECEAP has never been in the business of adoption support and/or counseling for grief, loss, Encopresis/Enuresis, adoption transition, Adjustment Disorder, emotional/behavioral/mental issues, etc. Additionally FCAP (foster child assessment plan) has NEVER contacted me. Their service is to give an independant set of eyes to the child's case, and make helpful referrals. I told the SW, "how will FCAP help us when you and your office are denying her counseling, treatment for encopresis/enuresis at the only clinic around, and services in general etc.? FCAP can make the referrals, but you won't pay for her to go to treatment, neither will Medicaid, and even where Medicaid pays, you won't allow her to receive treatment." He couldn't fight his way out of a bag to save his life at this point. Essentially, what he has said, he is sticking to. But he says we can get all these services paid for thru Adoption Subsidy (Post-Adoption Support) from the state when the adoption is finalize in April/May. Sigh.

To wrap up, he stated that he only became our girls SW in the 11th hour, the same week we accepted the referrals. He stated he really didn't know much of anything about the girls, so much was not disclosed to us due to his lack of knowledge on the girls (duh). My question is, why couldn't the girls old SW be on top of all this? Ah yes, she got off the case when one of the girls bio relatives started stalking her, DSHS, and restraining orders had to be sought.

So, what the SW & our agency don't know is that the old counselor referred us to a new counselor. I can attend with our daughter as "Family Therapy" and my personal insurance will cover 15 visits per year. I think I could use all these sessions with our daughter easily in the next couple months. And it will give us alot of help before the adoption is finalized. And I don't have to tell the state about it. And that's legal.

To add one more thing, I got the girls an appointment for Cognitive Testing & SI testing thru our public school district. So, I can atleast get that out of the way next Friday Feb 15. We still have both girls getting developmental testing & neurological appointment at Childrens Hospital in April. Again, before the adoption is finalized.

Today we signed our daughter up for part time daycare. I really like the place. It's quite large, and it comes with great references from friends of mine. We went on a tour of it, and I got the paperwork filled out. She'll start tomorrow. They had me talk to the school district transportation dept because she will need transport to/from ECEAP on daycare days. The school district said "no problem" and also said they will transport her to/from our home to school on Monday/Wednesday. WONDERFUL!!

So, I feel I did a really good job facing off with the SW. The agency SW just sat there smiling. We were probably the best entertainment of her day.

Our 4.5yr old has been in panties for a few days straight now. She has one-three accidents a day. She really wants to keep up with the panties. By the way, her accidents are not at home (other than her intentionally peeing on the family room carpet last Saturday). Thank God. I've told her if she pees her pants at home, she will be back in diapers & only allowed panties on at school. She apparently wants to keep the panties.

If you have read this entire post, God Bless You!!

Pissed Off

UPDATE at bottom.

I did not get to go to the conference. My husband drove home this am, and ended up in a ditch himself with his SUV and studded tires. He got out of the ditch (2 miles from our home) and had to stop for two more accidents before he got here. One accident had 7-8 cars blocking the road. They all had to push each other off the road. Then there was a 5 car accident a block up the street from that mess. Glad we are all home and our cars are not damaged.

Now, for the thing I'm pissed off about. My husband called me a "f*ckin ogre". This is because our 4yr old daughter peed her pants this morning before her nap, she didn't ask for a dry pullup (big health no-no to sit in pee), we discovered she had a full pullup a few minutes ago, and she burst into tears telling me she wanted a hug. I told her "pee in pants is wet and smelly. I'll be happy to hug you when you are dry and smell good. Feel free to go take a bath or shower to clean up."

I got that idea from several other bloggers who have adopted older children, going thru the "wetting" experience.

So, what does my husband do? He says "Jesus God. You are a f*ckin ogre". Swell. AND he scoops up the 4yr old (she's almost 5) and hugs and smothers her in affection.

I never said I wouldn't hug her. I gave her a natural consequence for her actions. My husband already thinks it's consequence enough to be in pullups and diapers. I think she needs a gentle reality check, in several aspects of natural consequences, if they apply to the situation. I told my husband "there are lots of consequences to say, being an alcoholic." It's just so. I'm not trying to punish her, but open her eyes to the consequences of her actions.

In the meantime, our daughter is crying profusely into my husband's chest because I won't hug her (since she hasn't bathed yet).

I told her "Well, how about if I wet my pants, and ask you to come sit on my lap and give me a hug? How would that be?" She screams "NOT GOOD!" Well, there you have it. I told her I feel the same way, but I'm more than happy to hug her when she's cleaned up.

Mainly I worry that she has the naive view that this can continue with willy nilly consequences (pullups and diapers), and she thinks the rest of the world is fine with this behavior. I feel it's my job to open her eyes. We have told her countless times that if she pees her pants in kindergarten, kids will make fun of her. We haven't told her this to be mean, but to give her a glimpse of social consequences to her actions. Already she's at the point now where people at church don't want to deal with her in the preschool class. Sigh................
Makes me feel warm and fuzzy, but that's another story entirely.

So what do you think? Think I'm a f*ckin ogre for being straight up with her, telling her I would be more than happy to hug her after a bath and clean clothes? Please weigh in.

UPDATE: We found out she peed her pants this am, just before we sat down to dinner. So, not a real opportune time. But what is with kids? Before today, she's had numerous meltdowns with discovery of her peeing her pants, and once or twice she asked for a hug. I told "no, not at this time". I didn't want her to feel rewarded for peeing her pants, and I didn't want to hug her then and have her use that as a way to manipulate getting hugs. So today I thought I'd go a step further and say I'd hug her after she cleaned up.

A New Day and Half a Pig

Today our 4yr old woke up, went into the bathroom and sounded like she was vomiting. Lots of noise and coughing. I went to check on her and was met with "Want to see my fart?" Well, you can't see a fart. I told her I would come look. She said "It's THIS huge!" I'm wondering if she's being really imaginative. She showed me a huge pile of poo in the toilet. She looked up in delight and said, "Now I get to play in the family room". I smiled and told her good job on the poo (not a fart apparently, although, could have been a fart as well) and said "yes, you get to play in the family room".

BINGO! Yes, she does now get to play with her toys in the family room. Hopefully the art of holding toys/activities/treats over her head will keep her inspired to poo. Also, hopefully the deterrent of knowing she has to have an enema if she doesn't poo, will motivate her permanently as well.

I'm not holding my breath. Everyone has told me this is not a quick fix, but a long term learning process for her. Let's hope she is on the road to wellness.

Her preschool teacher is coming over today to meet her. I decided to start her next Tuesday instead of today, in light of all the energy that went into yesterday's antics. We are all looking forward to meeting her teacher.

Last week I booked her a neurological appt at Childrens Hospital. Her appt is in April. It will consist of an hour with an OT, an hour doing a Peabody Test (developmental testing), and an appt with a neurologist. I'm looking forward to the insight this appt will bring. After I found out all about it, I got the ball rolling for a referral for her 2yr old sister. Can't hurt. She has had some minor delays, nothing as profound as her sister. With that though, they have the same genetics, environmental history, etc. She has had a speech delay. If she is found to have anymore going on than that in delays, she will qualify for therapy and ECEAP (this fall). So that will all be really helpful. Early intervention is great!

You may be wondering what the Pig is doing in today's post title. Well, the girls and I had lunch with a friend. She offered to sell me half of one of her pigs when they go to slaughter. I said "Heck Ya!" It will go well with the half a COW my husband purchased last month. He sprung that on me with no warning. Several years ago, we bought 1/4 a cow every year for the cooking meat. Great deal and outstanding quality meat. $2/lb for anything you bought. Where else can you get T-Bone steak for $2/lb? Nowhere. So, we went to bed one night about a month ago, and were drifting off to sleep, when my husband pipes up with "Today I bought half a cow.", like he bought a kite or something. Half a cow? Do you realize how many pounds of meat that is? About 400 pounds of meat.

So the pig will go nicely with the beef in the freezer. We'll be getting about 100 pounds of pig. I better get to emptying out that freezer now..................

Today's Update

We took our daughter to her doctor appt. With no notice, our doc has decided to not take her variety of medicaid any longer. They turned us away. So why the hell did he allow the appt to be booked? GRRRRRRRRRRRRRRRRRRRRRRRRRRRRR.

I then called the PCP on her medical card. Their office is closed today. So I called her health insurance. They told me to go to the ER.

So off we went to the ER. A five hour trip included:
urine sample, 6 xrays, the xray crew gathering more and more people to come look at how backed up her poop looks in the xrays (Real mature....NOT!), then a several hour wait to hear that there is NO impacting, and NO obstruction. She's just holding it in. Which was confirmed additionally as they gave her an enema. I was told that this is pretty rare that a kid will hold in an enema. She didn't go until my husband put her on a commode, and said she had to sit there until she pooped. She did it kicking, screaming, crying, etc., only to produce a tiny amount of really soft slimy poop. It's not a physical impairment for her to poop. She just doesn't want to. Also, she doesn't have huge hard poop, which would be painful to pass. This is entirely all in her head (& soul). I confirmed repeatedly with the staff, and they said she feels like holding it in no matter what, but we have to move it along.

Soooooooooooooooo, we picked up her prescription 2day supply of suppositories, and went home. I'm to give her Miralax 3 times a day, a teaspoon. That is more than Childrens Hospital had her on for maintenance. I'm hoping that will help. We also have to have a PCP follow up appt Friday. Now, this is at the walkin clinic that takes all medicaid. Waiting there for five hours Friday should be about as fun as a colonoscopy. Or jabbing a fork in my eye.

So many people have told me this is her control issue. Well, that's great and all, but she's harming her health in the process. A developmentally delayed kid is really hard to communicate with about anything they don't care about. I realize she didn't control being taken from her parents. I realize she didn't control being placed with us. And life is not fair. She will have to come to terms with alot. The good news is, she does control a whole hell of alot of her day. She is given countless choices every hour. Yea, that's not good enough for her. Well, she's going to have to change her idea of "ideal". We all are. We are the parents here, not her.

I'm forcing the issue harder. I took all her toys out of her room. They are downstairs in the family room. She can only have tv/video time and play with her toys, treats and priviledge choices, if she poops at least once a day. For her health, we are being ordered to strongly force the issue

I can't spank her. I can't do much of anything really, other than to change what I'm doing here. I'm totally revolted that I have to deal with shit all day. I guess I have to tell myself, "this too shall pass." Hopefully it will pass before she naively harms her own body.

Surgery?

And I thought things were going so well.

I realized about 48 hours ago that our 4yr old stopped pooping. Sigh. Suppositories on top of laxatives aren't producing anything. So Childrens Hospital told me to redo the "cleanout" plan we did last week. They had me tell them how much she pooped last week, and they said it's not nearly enough. Apparently from the looks of her xray, she needs to poop out so much that it clogs up the toilet and/or enough to have to flush the toilet twice each time for a few days. We were nowhere near that level, and I had no gage as to how much she needs to poo.

Currently she's not going at all. And last night she started throwing up.

Coincidentally, as of yesterday she wanted to be "a baby". So I went along with it. Baby food, bottle, sleeping in the crib, etc. So she's only had soft food, which is good. I gave her Gerber prunes twice. Still no poop.

This am she threw up her breakfast, followed by throwing up just water three times. She's had three baths. I called Childrens Hospital again. They said to stop the laxatives, suppositories, and oral intake. And get her immediately to my PCP for an xray and surgery consult.

Off I go on another poop adventure. I shudder to think of how they operate to get out impacted poo.

Dancing Queen

We like to watch movies as a family. Last night we watched "Grease", a family favorite. Good music sort of movie.
Our 4yr old was dancing to the music during the movie and saying "I'm a whole new person!" over and over and over.
Music to my ears.

It's a Miracle

The first couple days on this laxative were hell for our daughter. The first day left her with severe gas, and a belly bloated like a starving Ethiopian child. Day two (yesterday) left her on the toilet most of the day, even while we were at preschool. Last night after the "flood" came out from within her, a new child emerged. A miracle has happened. Or at least I feel that way. And my family seconds that vote. Including our 4yr old.

Last night, our 4yr old said she has always been in pain, as long as she can remember. She described it as "feeling like she had to throw up", belly hurting, back hurting. Always. Yesterday she was pain-free for the first time in her memory. She is a loving, hugging, running, dancing, affectionate, laughing, giggling, silly little 4yr old girl. She went to bed last night saying she wants to change her name. She legally has two middle names, and now she would like that to be her first & middle name. At birth she was named "x" "yz". Now she wants to be known as "y" for her first name, with "z" as her middle name. She says she hates that "x" person and doesn't want to be that person anymore. So we are calling her "y", although it's hard to remember.

She is loving being a new person. And we can tell.

I went to bed crying last night. Tears of joy. Pure Joy.

As an added perk, she has gone from the girl having trouble attaching to me, to the girl who thinks I'm the miracle worker for taking her to the hospital. She is on me like white on rice. And I'm loving every minute of it.

I'm off to make Gingersnap cookies with her. This is something special on her new diet. An approved snack.

Have a great weekend everyone!

To Answer Some Questions.........& Preschool

Today I signed my baby up for preschool. OK, she's not a baby, but she seems like one to me! She will have a visit from her teacher next Wednesday afternoon, and start school Thursday. School will be from 12:30-3, M-Th. I will be providing transportation. We have skipped her nap the last two days in a row, and she's been in a complete meltdown the last two evenings. My thought? She's too tired. I moved her bedtime to 7pm. Perhaps it needs to be earlier while skipping a nap? She wakes up about 7-7:30 no matter what time she goes to bed.

I really like the teachers. Each class has three teachers and 11-20 kids. So, good ratios. They provide lunch there as well, so I have to get the diet info requirements signed off by Children's Hospital so they will give her reasonable substitutions.

I'd like to answer some commenter questions:

Children's Hospital feels she doesn't have ANY control of her pooping at this time.

A kid only has control of this if they are fully functioning and have no medical problems. That would be a defiance/control/noncompliance issue to run into encopresis at that point. The doctors don't feel this applies to her. But more specifically for her, her upper and lower intestine are stretched out so far that they aren't functional. Laxatives will have to push the poop out for her for months while her intestines heal. Once she is pooping soft poop once or more times a day, her intestines will take an additional three+ months to heal and begin to function on their own. In my daughter's case as well, the doctor feels she became so constipated either thru developmental delay and/or her brain not telling her "it's time to poop/pee". Then her upper and lower intestines were so stretched with holding all the poop that her upper and lower intestines lost their function to move poop. Even if she wanted to, she has no ability to move her own bowels at this point. Sorry to be so gross. You have no idea how grossed out I was Wednesday hearing all this for hours on end! Blechk!

She has no muscle control at this point over her bowels. Her sensations aren't working either. So, two strikes against her body.

I did ask the doctors "so, what is her responsibility in this? I mean, it's her body after all. She needs to take control of it." This is when they explained at this point and age she has no control of this situation and it would be medically impossible for her to have any control over it. They said it would be like an adult trying to control a charlie horse. Not gonna happen.

So, I at least feel at this point she's not emotionally or behaviorally playing out aggressions, control, problems, etc. thru her pooping.

The doc did say that her responsibility in all this is to 'obey' me on everything I tell her. All the toilet sitting, drinking all water, pushing more water all day than she would like, accepting "no" when I tell her she can't have something on the "no" list, eating what I give her to help her stomach (food, drink, meds) without giving me a fit, temper tantrum, crying, etc. She just has to buck up and do it all to heal.

By the way, this laxative is giving her a rash. Any suggestions? I think I'll give it a couple days and see if it goes away. She is only on the high dose for 48 hours, then goes to a reasonable amount daily from there on out.

Thanks for all your support! It really helps this journey to know there are so many interested, caring, supportive people like each of you!

Poopsicle

This is a post about poop. If you can't stomach that, please come back in a day or two and there will be something new for you to read.

I spent an 8hr round trip with our 4yr old yesterday on a trip to Children's Hospital Urology. I've had this appt since September to see if we can help her in the peeing/pooping area of her life.

She did a urine sample (in a "hat" in the toilet). Then an ultra sound, which showed she still has 4oz of urine left in her bladder after she goes to the bathroom. We then saw a 20 minute Power Point presentation on pee/poop (fun). Our 4yr old then cried. She said she hates this place because they talk about her peeing. We then moved onto the doctor appt. They interviewed me about her health, background, peeing/pooping issues. Off to radiology we went to get an Xray of her stomach. Then back to the doctor's office. The Xray showed from her colon to her stomach, she is severely constipated. It is so severe it has stretched out her upper and lower intestines to the point where they are not moving poop. She is so full of poop, her bowels are pressing on her bladder and spine, giving her pain in her back.

This is called encopresis.

When she moved in, I knew she had been constipated living with the foster parents. So I immediately put her on a high fiber diet. Within 24 hrs she was pooping every day or two, and has been ever since. So I erroneously thought she wasn't constipated any more. Apparently, her body only signals that she is "full", and she poops until that full feeling is gone. Same for peeing. She doesn't empty out the rest.

So, to make a long story short, I pressed them on why she would have this condition, especially at such a young age. After they danced around it a while and avoided my question, I kept pressing to know why so that we can deal with this and keep it from happening again. Finally they asked me if she has had a neuro eval. I said no, but I've been working on that referral all week. They said they want her to have a neuro eval because they feel she has encopresis due to either developmental delay and/or a brain problem where her brain isn't signaling her to pee/poop. I told them Friday the neuro dept is giving me our appt date. They want the results of the neuro before urology sees her again in three months.

We have to give her an even higher "high fiber" diet, which includes many drinks & foods that she cannot have, and many drinks foods we have to add. Also she is on an extremely high dose laxative for 48 hours, then she will be on a regular dose of this laxative for a year or more. Urology wants to see her every three months for at least a year, since the state SW's DSHS office won't pay for her to go to the Encopresis Clinic.

After she is pooping soft poop at least once a day regularly, then her intestines can start to heal. They said too that once her bowels aren't pressing on her bladder, that should help with the peeing/wetting issues.

In addition to the special diet, we have to put her on a peeing/pooping schedule. Called '2-2-2', for every two hours she sits on the toilet two minutes and has to pee twice in that two minutes. This is to get her to learn to empty her bladder before she feels full, and to teach her to fully empty her bladder each time. Additionally we have to put her on the toilet every morning for 10-20 minutes for mandatory pooping time.

What fun.

We have to log (no pun intended) her peeing and pooping.

I've been given a list of websites to check out, a urology folder, and a list of books I'm supposed to read. I'll keep you posted on that after I check out the books and websites.

On a positive note, our daughter has been accepted to EACAP preschool and will start in the pm class in a couple weeks. The preschool rep will visit our home next week to assess our daughter and interview me. This pm preschool will completely interfere with nap time, little sister too. Little sister will get a very short nap, and big sister will get none. Both girls usually take a 2.5-3hr nap. To help combat this I will be putting them to bed 60-90 minutes earlier each night. I've never put kids to bed at 7pm on a regular basis, but maybe this will work well. If the girls are just too crabby, I'll pull her out of pm preschool and wait for an opening in the am class.