I'm going to be an Aunt

My emotions ran from excited, to sad, to ok, to depressed, to numb.  I had a feeling that was the news we were going to be getting.  I appreciated they told us in person and it was an understated announcement.  I did my best to push out the excitement.  I'm happy for them I really really am.  I'm sad for me.  I know its not about me its about them.  I'm glad they dont need to deal with infertility.  I'm broken that I do.  Lifes not fair- nope not fair.

I think I did an OK job at exuding my happy feelings for them and suppressing my sad feelings for myself.  I'm not sure how I did with that.  In the process of being happy for them I asked them their due date: Sept 19th.  Will you share names?  yes.  Want to share?  Sure we like BabyGirl2 its the name we heard a parent yell at their child in the mall.  I went numb.

BabyGirl2 is the name we had picked as it is my Grandmothers name.  Not overly old fashioned but we like it.  My other grandmothers name is the middle name we have picked.  We have two male family names for the boy name.

I didn't say anything because what do you say?  Thats MY name!  We had it FIRST!  I waited until we were in the car driving away before I cried.  A release- not sad, not happy, just numb.

So tonight I wrote this letter which I plan to include with a small gift for my neice/nephew to be:

Dear Sister In Law,

I wanted to write to you to about the amazing news you shared with us.  I want to first say that I am so happy for you both and I know you will make fantastic parents.  Its not always an easy job but seeing how you and Brother- In-Law work together I know you are up for this life long challenge.

With that said I also wanted to share with you that fertility is bittersweet for me.  I never would wish our journey on another family while at the same time our not so easy path lead to an amazing little girl.  Its often said in the adoption world that adoption is not a fix to infertility and I continue to mourn not getting the chance to be pregnant.  I put on a strong front but pregnancy is something I still grieve.  I don’t expect anything different from the two of you and I’m so excited to finally get to be an aunt.   Just please do know that I just might need time to outwardly show that I truly am excited for you guys.

It is extremely likely that your bundle of joy will arrive before our second child.  We have no control over the order of life.  Your oldest and our youngest will likely be somewhat close in age and look forward to that cousinly bond that I got to have with my cousins.  We had planned on keeping the names we chose a secret just like we did with Baby Girl.  I want to share with you the names we chose:  BabyGirl2 after both of my Grandmothers and she would go by Girl2, and Baby Boy after Grandpa and both of our dads and he would go by Boy.  I come from a big family with multiple people with the same name (we have two Ps; three variations of A, two Bs, and a M and L).  I didn’t know how to react when you told me you guys liked BabyGirl2 for a girl because we love it as well (and do a ton of other people given that BabyGirl2 is in the top 10 girls names).  I wanted to let you know our intentions.  Neither of us know the gender of our baby so for all we know we could have two boys.  I’m sure if you guys pick BabyGirl2 and we both have girls that there will be some fun way to differentiate between the two and I’m sure would bond them even more.

I don’t write requesting your sympathy but just understanding.  Becoming a mom is the most rewarding experience of my life and I can’t wait to share in this with you. 

With Love-

Sister-In-Law

Books!

So I have been sicker than a dog as has everyone in our house.  Its a revolving door between the stomach bug and the not so common cold.  We did get a chance to leave the house briefly to go to the library so I thought I'd give a quick review of two books that we found during our last two trips to the library.  Promise I'll get back to my NAS posts once I can sit at a computer long enough to do the research I feel like this topic deserves.  Until then... enjoy!

Do you love me?
This was our find last time we went to the library.  Written and illustrated by Joost Elffers & Curious Pictures.  I was initially not a fan.  It seemed overly needy, soft and uncomfortable for me.  Baby Girl had me read it over and over and unlike many books that I can now recite by memory the more I read it the more I grew to appreciate it.  Short and simple.  "Do you love me?  Always, dear.  Do you need me?  Ever near.  Would you leave me?  Never ever."  In the facebook group I am a part of many of the moms to older adopted children have discussed their childrens insecurities and fears.  I think this book addresses those questions of loving, needing and leaving.  Since this book is not an "adoption book" I think it also shows that it is not just children that are adopted that experience these questions.  Children are so complex and deep that at times I think their simplicity is hard to realize.  Having Grandma come and visit but then leave may leave any child wondering if you will do the same.  Other major life events such as death, divorce, or a friend moving away may lead the child to question our permanency in their lives.  Adoption clearly heightens that fear but I think this book has helped me realize that sometimes maybe us adults look too deeply into simple questions about our permanency as a question about adoption.

Shades of People
Another adoption find by Baby Girl (She has great taste in books my I add).  This book again not adoption specific but pertinent to many families that grow via adoption.  This book helps children see that skin is just a persons wrapping paper and we are all the same on the inside.  It also discusses how in the same family there maybe different skin tones.  Baby Girl is more interested in the pictures then the words but I'm always surprised at when I don't think she is listening to the words I'm saying how much is sinking in.

Neonatal Abstinence Syndrome (NAS)

Neonatal Abstinence Syndrome (NAS) is a general medical term to describe infants that were prenatally exposed to narcotics.  BAbies with NAS have their digestive, respiratory and nervous system affected.  During pregnancy drugs are passed from the mother to the fetus via the placenta and surpass the blood/brain barrier.  Exposure to the fetus cause the unborn child to also become addicted to the substances they are exposed to.  The baby is then born addicted to said substances.  Not all babies born to women addicted to illicit substances go on to experience withdrawal symptoms.  According to Standfordchildrens.org "Opiates, such as heroin and methadone, cause withdrawal in over half of babies exposed prenatally. Cocaine may cause some withdrawal, but the main symptoms in the baby are due to the toxic effects of the drug itself."  

Symptoms often do not present at birth but take 24 hours to days later to present.  In Baby Girls case it was a few days after her birth that she experienced symptoms and D was lead to believe that she was out of the window of risk when she presented with symptoms (I believe she presented with symptoms on day 3).  Accordin to Standforchilderens.org symptoms that an NAS baby may present with are "tremors, irritability, sleep problems, [a distinct] high pitched cry, [high] tone, hyperactive reflexes [specifically the startle reflex], seizures, yawning, poor feeding/suck, vomiting, diarrhea, [diaper rash], dehydration, sweating, and fever or unstable temperature."

NAS is diagnosed based on their symptoms which are scored using the Finnegan NAS Score.  According to http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004566/ a toxigology report can be obtained from the first stool.  A verbal history and toxicology report of the mother also can be used to monitor the baby for symptoms of withdrawal.  Though several sources reported that mothers are likely to underreport exposures.  D's verbal report was inconsistent between the medical chart and her adoption paper work.  The symptoms that Baby Girl presented with were not consistent with the verbal report from D provided the medical staff; which likely means Baby Girl had more exposures than we initially were told about.

There is also questions in the literature if it is appropriate to state the baby is born "addicted" as the fetus was subjected to an exposure and was not a willing participate.  "Prenatally exposed" appears to be an accepted term.

http://www.stanfordchildrens.org/en/topic/default?id=neonatal-abstinence-syndrome-90-P02387

Two Years Ago

Two years ago tonight according to Facebook my baby girl had a good day.  She had PT and OT that day which was my favorite part of her stay at the hospital.  My memories now are highly dependent on the photos I posted on Facebook which I did daily giving a general update since I wasn't able to use my phone in in the NICU.

Two years ago on Feb 2, 2012 I was thrust into an unknown world.  I had been in a NICU once when I was an OT student and was there for approximately 5 minutes.  I had been exposed to drug culture in my upbringing.  I thought I understood methadone treatment.  I had researched drug exposures and the long term effects.  We were comfortable checking off almost all illegal exposures and chose to try to avoid as much as possible legal exposures (cigarettes and alcohol) though we were willing to discuss.  I learned really fast that I knew NOTHING.

I dont know that I have ever stated that Baby Girl was an NAS (Neonatal Abstinence Syndrome) baby.  This is a general name given to babies that are born exposed.  Exposure can mean that the mother took illegal drugs or was a part of a methadone program.

Though I still dont plan on sharing exactly what exposures Baby Girl experienced I do think I am finally read to share my experience in the NICU.  I wish I really understood what I was getting myself into.

Baby Girl is exceptional.  She is at or above all milestones socially, language, fine motor and gross motor.  She loves brussel sprouts more than pasta.  She is funny.  She is compassionate.  She is totally potty trained (except for at night).  I couldn't ask for anything more.  She is 2 and thus wants to do things on her own, has her own mind, and chucks food she doesn't like (still figuring out how to break that habit).

She did take me on a ride that first month that I honestly was not ready for.  I was a new Mom.  I was in a city where I knew not a soul.  I was new to adoption.  I was new to NAS babies.  I was a mess.  My friends and family often comment on how impressed they were with what I did, but they didn't see me crying at her bed side, the desperate phone calls to DH, the sleepless nights, or my poor diet.  I was a mess.  I held it together because this girl that I had just met was worth fighting for but without her needs I would have fallen apart.

So over the next month I want to address a few topics:
- NAS babies
- Exposures and what they mean
- Working with/communicating with a substance user
- NICUs
- Occupational Therapy, Physical Therapy, Speech
- The Finnegan Scale
- The experience of Weaning
- Being an "outsider"
- DCF and Private Adoption
- Aftercare
- Outcomes
- Opening an Adoption with Drug Exposures (my experience)
- Jail and Adoption
- How I explained a month in the hospital
- What I gained from my experience

Some of these I will pull together resources that will be helpful sprinkled with my own first hand experience.  Other topics I will address more from my own perspective.  None of the posts should replace doing your own research or consulting a pediatrician regarding your exposures checklist.