Rare Disease Day and Osteogenesis Imperfecta Type IX (Type 9)

Today, February 28, is Rare Disease Day – and so it seems fitting to share with you today that we’ve received some new information about the specifics of FangFang’s diagnosis of osteogenesis imperfecta.

With osteogenesis imperfecta (OI), it is possible to receive a clinical diagnosis or a genetic diagnosis or both. A clinical diagnosis is based on observations made by a doctor of features that are associated with osteogenesis imperfecta. FangFang has had a clinical diagnosis since the early days of her life. It was made in China and confirmed in America. There are a number of different types of OI, each associated with a different genetic mutation and each having slightly different effects, and a type can only be determined with certainty via genetic testing, but guesses can be made based on clinical presentation. Because of the specifics of her presentation, FangFang has been clinically assumed to have osteogenesis imperfecta Type IV, which is generally moderate in its severity.

Osteogenesis imperfecta itself is a rare disease. The current estimate is that approximately 25,000 – 50,000 people in America have the condition. The geographically closest person to us who has OI and whom we know lives 2 hours away. That means I rely heavily on Facebook groups and connections I’ve made online within the OI community for my learning and information about how to best parent FangFang in light of her diagnosis.

Even within the umbrella label of osteogenesis imperfecta, though, different types occur with differing frequencies. And yesterday I received a phone call informing me that, while we had all assumed FangFang’s genetics tests would yield a result of Type IV osteogenesis imperfecta, that is not actually what they showed. She, in fact, has Type IX (Type 9) OI.

There is no one else in our 2,000+ member Facebook group of parents of children with OI whose child has been diagnosed with Type 9 OI. When I asked in a larger group that is open to adults with OI, as well, the responses were the same – interest, for sure, but no one else is reporting having that same diagnosis. That’s a bit of a lonely place to be!

In a worldwide database tracking reported cases of OI, there are a grand total of 16 cases ever reported of this type 9 osteogenesis imperfecta.

This is the face of someone with a truly rare disease.

We don’t really know yet all of what this means. To be honest, we probably won’t ever know. Research into everything about osteogenesis imperfecta is still so new. The bisphosphonate treatments that FangFang receives quarterly to strengthen her bones have only been around for 20 years or so. Sometimes one drug or another works better for people with a certain type – but if there is no one else with your type, there’s no way to know until you try it. FangFang’s type is so rare and newly discovered that it isn’t even listed specifically on the OI Foundation website. Really, I expect that no one knows much about it.

I have an e-mail out to the doctor who is the most likely person in America to know anything about Type 9 OI. He is no longer officially part of FangFang’s care team in Omaha (he took another position at another hospital a few months ago), but he is a good guy, and I hope he may have some information for me.

Until then, I have resorted to consulting Dr. Google – and even Dr. Google has failed me. I spent about 2 hours yesterday searching and found next to nothing available publicly. I’m aware of its rarity, its inheritance pattern, and the gene it affects. That is all. There simply is not general information about this condition available in an easily accessible form.

And so, this week (and beyond, I’m sure), I’ll be scouring medical journal articles, to which we, thankfully, have access through Matt’s position at the university. Not being a doctor, trying to read medical journal articles is not really my preferred pastime, but I want to arm myself with all the information I can find, so I can do everything possible to obtain the best care for my daughter. I hope we’ll do alright. And I hope we can be a resource for anyone coming after us.

Another Trip to Omaha, Another Surgery

Later today, my mom and FangFang and I are heading to Omaha again in preparation for another surgery for FangFang. This time the plan is to do bilateral tibia rodding – inserting rods into both of her tibias (the main bone between the knee and the ankle). We’d talked with her surgeon last winter and spring, and he’d hoped that once her femurs were rodded, her tibias would do alright on their own, but since then she has fractured both tibias, with one of the fractures being quite significant. With that, the plan has changed. For her to continue to progress safely toward walking and other gross motor skill developments, which she very much wants to do, it will help her tremendously to have her tibias rodded. Those rods will straighten and strengthen her tibias, hopefully preventing them from fracturing so frequently, and when they do fracture, the rods will act as internal splints, lessening the severity and effect of the fractures.

I’m very much looking forward to having the surgery done. I’ll stop holding my breath and hoping not to hear that tell-tale crack every time she pulls herself up to stand on the couch and starts cruising along or scoots herself up into a low chair or tries to go up or down the stairs by herself.

I think it’s going to be safer for her, better for her ability to continue to develop her gross motor skills, and better for how her legs feel for her.

But I am sad that in order to gain all of those things, she has to endure yet another surgery. And we haven’t had great luck with fractures this last month or so. FangFang broke her right humerus just over a week ago.

And then the next day, she hurt her left arm. We weren’t sure whether it was a fracture or not, and she alternated between wanting to use it and wanting to have it splinted, and we have followed her lead on that. She seemed more confident that it was alright yesterday, so we’re hoping that’s a good sign and she’ll continue to be able to use it without issue.

Mostly I’m hoping that she won’t have all 4 limbs incapacitated at the same time. Two arms at once has been really hard, so I’m really hoping her left arm continues to feel alright!

Would you pray for our trip and for her surgery please? You could pray for these specific things –

  • Safe travels to Omaha and back.
  • My kiddos and Matt at home – Miranda, Madeleine CaiQun, and Atticus are staying home with Matt, who still has his regular teaching responsibilities this week, so the kids will be hanging out with various friends for many hours this week. Please pray for them (and for our friends), as this will be far from their normal routine, and pray for Matt, who will be working and parenting on his own for several days.
  • Successful bilateral tibia rodding – that the surgery would go well, that her surgeon would feel confident in the placement of the rods, and that she would have no complications. If you’re feeling particularly ambitious, you could pray that her surgeon is miraculously able to place FD rods, which are the type she has in her femurs, and which expand with the bone as it grows. He thinks her tibias are probably too small, and he’ll likely have to place a different type of rod, which he’d then have to replace sooner, but he still thinks that’s better than no rod. But we’ve heard from other parents that even when he expects not to be able to place FD rods, he’s sometimes able to do so, and that would be amazing.
  • Pain management – The Omaha Children’s Hospital pain management team is great, which is huge in terms of post-op care. Apart from making sure we avoid infection or actual surgical complications, pain management is really the biggest focus after surgery – and it’s a huge factor that plays into my next prayer request…
  • Discharge – We don’t know how long we’ll have to be inpatient after surgery. Assuming there are no complications, once we can get FangFang transitioned to oral pain meds, we should be able to leave and head home, and all of us do so much better here, so I’m hoping we won’t have to be in the hospital very long.
  • Emotional support in the hospital – FangFang is our ever-friendly, always joyful extrovert. But even she has a hard time after surgery. She’s hurting and sad and wants me to hold her and stay within her sight at all times. Please pray that my mom and I can care for her well not only physically but also emotionally.

And, while it feels a bit silly that I’m asking for prayers for myself as my daughter heads into surgery, would you please pray for me, too? I think it’s important to be real and honest about what my life looks like, and for those of you considering adopting a child with special needs, what life parenting a child with special needs looks like. Friends…I’m tired. We’re coming off of a week of hosting my family for Thanksgiving and caring for our 4 children, which is a lot normally, but add to that the fact that one child, for large portions of time, had zero arms available so needed an adult (mostly me) to do nearly everything for her, and I have a cold, and I have not been sleeping enough or sleeping well – it’s a lot. Physically, I’m tired. And beyond that I am emotionally weary. This will be our 4th trip to Omaha and our 3rd surgery in less than a year. I’ll be, again, leaving my other kiddos home while I travel, over Atticus’s birthday, no less, which is so hard on my mama heart. I’m tired from arguing with insurance companies; I’m tired from coordinating to get all the documentation we need for everything we pursue; I’m tired from reassuring jealous siblings who view a trip to the ER as a special “Mom date;” I’m tired from not having gotten to worship with my husband for nearly a year, as one of us is always in FangFang’s and Atticus’s classroom at church; I’m tired from coordinating logistics for all things; I’m tired from the ordinary demands of motherhood and friendship and life in general. I’m just tired. All around, I’m tired. I’m tired as I head into a week in which much will be demanded of me as a mom. Please hear me when I say, this is the life I want. Parents who knowingly adopt kids with special needs sometimes, when they express that things are hard, hear, “Well, isn’t this what you asked for?” Yes, yes it is. This is the life we’ve chosen; this is the life we want; and we wouldn’t trade it for anything. That doesn’t mean it’s always easy. I’m pressing on and persevering in the midst of all we have going on in our lives. I will continue to be the Chaos Coordinator and the Mama Bear that my kids need. But I would so appreciate your prayers for my energy, my stamina, and my heart as I do that.

I’ll keep you updated on how surgery goes and how we’re all doing as I’m able.

Post-Surgery and Travel Update

Thank you so much to all of you who prayed us through our travels to Omaha for FangFang’s oral surgery and our return trip back to Missouri!

We left early Thursday morning and made it to the hospital just in time to meet the dentists who would be performing FangFang’s surgery the next day and do our pre-op consultation with them. After that we had the evening to ourselves, so we went and checked into our hotel…

…and then went out to dinner at Block 16, a hipster sandwich shop downtown, which all of us enjoyed! We tried to get FangFang a good last meal with all her teeth 🙂

She went to bed pretty well, and she actually did better than I thought she might with not being able to eat or drink after 8:00 AM. I woke her up around 7:45 to give her a clear liquid breakfast (jello and apple juice were her choices), and then I let her play with an iPad as a distraction while Catherine and I took turns getting some breakfast. We had a 10:00 AM check-in time at the hospital, so the morning was actually reasonably leisurely, and it wasn’t long before we were playing in the hospital playroom with brief breaks to consult with our nurse, a nurse practitioner, the dentists, and the anesthesiologist.

She was pretty happy right up until surgery. I actually declined Versed, and everyone seemed to think that was a good choice, because she seemed so comfortable and happy interacting with everyone, but as soon as she got about 10 feet down the hall from me, she started wailing, and they said I could come back with her. Her oral surgery was taking place in the procedure suite, which apparently has a lower standard of sterility than the OR, so I was allowed to walk into the room with her. I really wish all hospitals would do that for all procedures, whether they’re in the OR or not. FangFang is going to need a number of surgical interventions over her lifetime, and I’d prefer that, as much as possible, she see hospitals as places that help her, as opposed to the locations of traumatic experiences. Nurses seemed very concerned that it might be overwhelming to me to see her go under sedation in preparation for the procedure or have her throat suctioned afterwards, and they didn’t want me to feel uncomfortable. I assured them that I’d witnessed my husband experience cardiac arrest, so nothing they were going to do that day was going to make me uncomfortable, and if I needed to get out of the way, I’d do it. And most importantly, this is about FangFang, not me – if she’s more comfortable with me there, that trumps all else. They let me hold her and sing to her while she went to sleep, and I was so glad.

Catherine and I grabbed some lunch at the hospital cafeteria and then headed back up to our room to wait for FangFang. The dentists came and talked with us and said they’d pulled 5 teeth – the offending back molar that had the deep cavity giving her so much pain and her 4 front teeth, all of which had significant cavities. Because they’d pulled so many, they hadn’t needed to cap any teeth, but the crowding in her mouth will continue to make brushing and flossing a huge priority. They do not believe she has dentinogenesis imperfecta but that it’s more likely that we’re playing catch-up from her years in an orphanage, plus the crowding of her mouth, which is good news, because it means there’s some chance she won’t continue to have such serious dental issues.

It wasn’t long before I was allowed to go back to FangFang in recovery, and I walked in just as she was starting to open her eyes. She was in pain and angry. We got her Tylenol right away, and she wanted to leave that area, so we got to go back to our room right away, but she was still mad. We gave the Tylenol a bit of time to work, but it didn’t seem to be taking the edge off at all, so it wasn’t too long before we requested something stronger, and once she had a dose of Oxycodone, she started to calm. She cried for the mouth pain and cried in hunger and cried from her sore throat every time she had to swallow (she’d been intubated for the procedure). We started gradually introducing some clear liquids – apple juice and water and then jello, and she handled that well (no projectile vomiting!), and just before 4:00 they said we could go!

We weren’t sure how FangFang would do on the car ride home, and I was so thankful to have another adult with me who could help monitor her while we drove. She was pretty content watching Frozen and Daniel Tiger, though, and slept just a bit. She was even happy enough to try on goofy hats at a truck stop where we stopped to give her more pain meds and get gas!

We made it back home just before 11:00 last night, and she was very happy to be back, as was I!

Honestly, the trip itself went pretty well. That was really largely due to Catherine’s presence with us. I so enjoyed getting to chat with her on our drives – it was so much more fun than just driving by myself – and as a mom to four, it almost never happens that I get 10+ hours to hang out with a friend! And she was so helpful in assisting me with everything FangFang needed, getting juice or jello or washcloths to wipe up blood, and entertaining her while I talked with the doctors and dentists. I’m so, so thankful she came – such a blessing and encouragement.

And I’m so glad to be done with the procedure. FangFang was in a fair amount of pain yesterday but seems to be feeling a million times better today. She’s really been in pain for almost a month, and I’m so glad we were able to get this dental work done quickly and be done with it.

Re-entry is always rough, at least for me. I’m so excited to see everyone, but I’m also worn out. I really just want to have some quiet, alone time to read a book and relax. But there’s unpacking to do, and I’m behind on my work week since I was gone for 2 days, and kids need to be fed and cared for, and things at the house are just a little out of sorts any time I return from being gone. It always feels overwhelming to me, and I get snippy. There’s nothing that reveals your selfishness like parenting – and I think that’s doubly true when you add in any special needs. I do feel stretched, and I do feel tired, and I do feel overwhelmed at times, but that’s not a license to be unkind to anyone else, and I definitely fail at living that out.

I’ve tried to spend some time helping everyone settle back in. FangFang and I snuggled and read a book this morning, and a bit later Madeleine CaiQun and I got some one-on-one time reading on the couch together. Miranda and I had some chats, and Atticus came and snuggled with me for a while.

Matt has the kiddos out at a park right now, and I’m hoping to use this time well, doing some catch-up on all the tasks I need to tackle, but also to recharge and be prepared to love well when the rest of the family returns. I spent some time reading my Bible and praying and journaling, which has helped to settle my heart. I’m hoping that when everyone comes home, we can have an evening of enjoying being together, both in cleaning up the house some but also in just spending time together. These people have my heart, and I want to live that out, day by day, moment by moment.

Homeschooling 2016-2017 – Mid-Year Update

It’s been rather a while since I’ve written about our progress with homeschooling this year, so I think we’re due for an update! I wrote in detail about our curriculum choices for this school year here, and we are in large part finding that those are working well.

Our curriculum outline lays out a pathway for getting through all of its materials in 180 days (36 weeks). By the time I left for China in December, we’d made it through 11 weeks of curriculum, something about which I sometimes felt a significant amount of stress. I knew life was only going to get crazier once FangFang came home, and I was worried that we’d never finish “on time” if we couldn’t even get through a third of the material before I left. Fortunately, there actually is no “on time” in homeschooling, particularly in these early elementary years. It doesn’t really matter if you read about the fall of Rome 10 months or 14 months after you start with Creation. And actually, we’ve been moving faster post-adoption than we did pre-adoption (go figure). In the 4 months between starting this school year and heading to China, we made it through 11 weeks of curriculum; in the 2.5 months since Christmas, we’ve accomplished 8.5 weeks of study. Phew! We will eventually finish 🙂

We’ve definitely had to revise our routine since our homecoming, though. I’ve found that math has to happen first thing in the morning, or it doesn’t happen at all. It’s my girls’ biggest “workbook” type subject, and they don’t have the focus or the patience for it later in the day, whereas if they start with it, they work through it pretty quickly and do a good job. We’ve actually made some changes in Madeleine CaiQun’s math curriculum. I’d started the year with Singapore grade 1 math for her, and I’d known within a few weeks that it might not work for her for the whole year. The program is very heavy on mental math and on grasping numbers as abstractions, and she just doesn’t see things that way right now, so nothing was sticking. Right now I have her doing some Rod & Staff workbooks to really solidify basic addition and subtraction facts in her mind, and once she finishes those I’ll make a decision about what to have her do next. I love that we can investigate and find resources that work well for each child as needed!

After we tackle math, we usually have a bit of play time, and then we move on to “reading school,” by which I mean Bible, History, Geography, Literature, Science, Language Arts, and Reading – all of the subjects whose focus centers around my reading out loud to the girls. I always envisioned us snuggling on the couch and reading together, but it turns out that small children’s vision does not always coincide with mine, particularly when the littles are incorporated into the day 🙂 Usually I bring out some toys with which all the kiddos can play while I read, and it’s been a process to learn which toys work best. Trains still require my assistance to build a good track, so those work only if we build the track before launching into school.

Wooden blocks, Duplos, Whittle World, and Magna Tiles are all good options for us. The general rule for the big girls is that as long as they can play without talking and interrupting while I read and they can talk with me about what we’re reading when I ask questions, they’re welcome to play during reading time! We obviously do a lot of parenting-everyone-mixed-with-school, but we’ve found that it works well for us. We’re usually done with our school day before lunch, and in the event that we’re not, we just pick up whatever we have left to do in the afternoon, either after lunch or after rest time. Then I leave our literature reading for bedtime, which is a much more relaxed, snuggly atmosphere in which to get through those longer portions of fun reading.

The littles have completely given up napping for me, and I’ve decided to embrace it. I could keep fighting for it and block off hours of every afternoon for my generally-fruitless attempts to get them to sleep, which produce high levels of frustration for everyone, or I can just accept the fact that for whatever reason, this is our new reality, and we need to make our choices in light of that fact. It actually frees up our day quite a bit. It means we have more room for walks and park outings. We don’t have to finish school before lunch. I can let the kids play longer when things are going well. I’d dreaded this milestone, but I’m actually enjoying it, though I am pretty wiped out by the time Matt gets home in the evenings.

Anyway, in terms of school itself, we’re enjoying what we’re learning. I appreciate the early exposure to some topics I don’t remember covering until much later. We’ve learned some Greek and Roman history and read some mythology, which was a lot of fun. Most recently we are learning about ancient China, reading about the Great Wall, and enjoying some stories set in China, which has obviously been a great connection for our family! The girls are learning about nouns and verbs and memorizing some poetry. We finished a long unit centered around animals and are now studying the human body. We’re talking a lot about the Holy Spirit right now as we study the Bible, and we’re memorizing some Bible verses related to things we’re working through personally right now. Most recently, Miranda and MeiMei and I memorized Psalm 103:8 – “The Lord is compassionate and gracious, slow to anger, abounding in love,” reminding ourselves of who God is and how He calls us to follow after Him in acting in compassion, grace, slow-ness to anger, and love, but He also makes it possible for us to do so. Right now we’re talking about how God has a different path for each of us, but we can all follow Him in the individual things we’re doing, and we’re memorizing Ephesians 2:10 – “For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them.” It’s fun that the littles also ask to have turns repeating the Bible verses as we work on them, and I enjoy including them in those small ways as we go through our school days! We also do just a few things that are truly centered around them, singing songs together, reading simpler books, and working on shapes and colors.

The big girls have continued to do gymnastics, with Miranda in particular starting to develop her own goals there – namely to climb the rope all the way to the top of the ceiling and ring the bell. She’s been working hard, and last weekend she was able to accomplish her goal!

Additionally, we try to take advantage of opportunities that present themselves for us to take the kids out to special events. A few weeks ago, the big girls and I went to see the ZuZu African Acrobats with some friends from church.

And last weekend, we went to a Mandarin for Tots activity at the library. We attend a number of art-related events, as well. Obviously most of our social interaction occurs within the context of our family, but we’re also attempting to teach our kids how to engage with our community, too.

We’re also embarking upon a new adventure in schooling – we’re officially enrolling FangFang in public school. However, she won’t actually attend school outside of our home. In our efforts to do everything possible to make sure she has every chance to grow and develop to her potential, we went ahead and had her evaluated by the local school district, and her delays are significant enough that she qualifies for services. However, given the current fragility of her bones and the fact that we are still very much working on building attachment, everyone agrees that the best place for her right now is at home. I’ve heard horror stories from parents pursuing and working through IEPs for their children, but honestly, we’ve had an incredibly positive experience. It’s pretty awesome to me that in these assessments and meetings we’ve had to evaluate her development and discuss the best possible situations for her, there have always been at least 3 adults (usually more) from the school district involved and offering their input and expertise. Everyone has been happy to answer my questions and to listen to what I had to say – whether about the effects of osteogenesis imperfecta or our focus on attachment – and thus far, it has been a very positive experience. The current plan is that a special education teacher and a physical therapist will come to our home (or we can meet at a park or someplace where we can work on some of our PT goals) once a week for 30 minutes, and an occupational therapist will join them every other week. I’m excited to get started working with them and see how they can add to our efforts to help FangFang grow and develop!

Overall, I am really enjoying our school year, and I love getting to work with the big girls on formal school activities but also give them hours of time to play and enjoy being kids. I am thankful for the opportunity to homeschool and look forward to continuing to learn together!

FAQ: Home Almost Six Weeks! How’s FangFang adjusting? How are you?

At times it feels longer and at times shorter, but we’ve now been home with FangFang for almost 6 whole weeks! Some of the questions I get most frequently these days, in my few interactions with people who are not medical professionals or grocery store employees, are about the big picture of her adjustment and ours.

Attachment and bonding are always processes, processes with many variables and unknowns, processes best examined in retrospect. However, they are of such paramount importance for adoptive families that we adoptive parents are constantly on high alert, watching for indicators of progress (or lack thereof). We wonder to what degree our children are really getting it, that this is what family is; we wonder if they are really beginning to trust us; we wonder to what degree to indulge and to what degree to push; we wonder if we’re making the right decisions for our new children and for our families as a whole.

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You may remember that FangFang did not exactly appreciate my presence or attempts at caring for her in China. Having spent our time in China telling myself just to stay calm and positive and keep pursuing her in love regardless of what she did, I’ve needed to make sure I have been doing things to cultivate the warm, fuzzy love feelings for both of us. I’ll sometimes wrap her up in a blanket and rock her back and forth and look into her eyes, taking advantage of the oxytocin bump for us both. I’ll hold her on my lap while I read out loud or offer a hug or a kiss or a smile as we pass by each other. I try to take advantage of those 3-minute lulls in activity to do something relationship-building with her (and the other kiddos). We’ve incorporated more loving rituals into our lives as a family as a whole to build connections between all of us; for instance, before we begin our “reading school” time each day, the kids and I all sing the “Twinkle Twinkle Little Star, What a Wonderful Child You Are” song together. And as our time as a family of six grows, the love between us all is growing, too.

FangFang had actually decided pretty quickly after we left Sharon and Daniel that I was her person now, and that has been consistent, for which I’m thankful! The Ergo or Tula carriers, which she despised in China? She would now love to spend hours being worn and often protests when I tell her she needs to get down and play.

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She looks to us in new situations, and she frequently asks to be held – she’ll scoot up to me and put her arms up and ask, “Baby FangFang?” multiple times a day! She’s a pretty snuggly little girl. One night one of us casually mentioned something about love, and she, sitting next to me on the couch, looked up at me and put her hand on my cheek, and announced, “FangFang love.” Cue heart melt!

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She has continued to warm up to Matt more and more. She still prefers me, but she allows him to put her to bed, and if I’m unavailable, she’ll let him hold her, and she asks about him when he’s away from home.

She is generally a happy little girl, for which I’m very thankful, since that was the impression we got of her from the photos her foster home shared. I was worried that it would take a long time for her spark to come back after leaving them and coming to us. She does have occasional sad moments whose reason we can’t entirely discern and for which her English is insufficient to explain, which is very sad but is also very typical for kids adopted internationally. We try to hold her close and reassure her that we love her and she is safe, and eventually something (usually food) brings her back to her typical happy state!

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She also loves the other kiddos, and they love her, though there is certainly a large amount of interpersonal drama between any and all of them, too. We’re trying to cultivate kind, generous hearts and develop good relationships, but everything is a work in progress!

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I’m not entirely sure how to read her interactions with others outside of our family. Thus far, we have kept her with either Matt or me at all times. We haven’t exactly cocooned (a common adoptive family bonding strategy, keeping your child’s world small for a period of time after they come home, staying home as much as possible), largely due to the necessity of medical appointments and evaluations – in addition to our visit to the Omaha clinic, so far she has seen our pediatrician, had a local X-ray, a CT scan, a private PT evaluation, a private OT evaluation, an evaluation by the school system, and met with a local orthopedic surgeon. We’ve also been going to our church worship gatherings on Sunday mornings and just keeping her in the sanctuary with us for the entire time, and we’ve had a few people come over for dinner since we’ve been home. She is definitely more of an extrovert than most members of our family – she loves interacting with others. For the most part, she warms up to people pretty quickly but still continually looks to us for reassurance and generally behaves appropriately with them, which is encouraging. However, we do notice some overly affectionate tendencies, and there was one night recently on which some friends stayed for dinner, and within minutes of their arrival, she was reaching out toward the guy for him to hold her – the return of the mommy shopping! We weren’t sure that she initially realized that he wasn’t Matt – but it was still a little disconcerting.

We’ll continue to take things slowly. In the grand scheme of things, 6 weeks is not very long, particularly for a child who has lived for over 3 years outside of a family. There are definitely moments during which Matt and I yearn for a date night by ourselves, or we think about being able to go to our missional community group meetings, or I wish it were easier to go hang out with friends. This is just a stage, though. Laying the groundwork for healthy, secure attachment is so important, and we want to respect that and take the necessary time to do it right, so we’ll hang in there, keep reading the signals, and do what we believe we need to do to facilitate bonding and attachment.

Overall, we are so glad that she really is settling in pretty well. She seems to be increasingly understanding that we are her family and that this is her home. She seems happy. She’s learning English and increasingly able to communicate her needs and desires. We’re all getting to know one another more and establishing these new family dynamics, and everyone seems to be doing pretty well with that. We’re worn out, both mentally and physically, and we know we still have a long way to go, but I don’t think we could ask for much more at this point in our journey!