The First Autumn

All is well with the Stewart clan with fall well under way. I figure it's been long enough that I should let y'all in on the latest happenstances & goings on.

The family is continuing to bond, a process that will take the better part of many years. Amissa & Galyna get along pretty well most days, although there is some friction between (rules-oriented) Tierney and (still-learning-the-rules) Galyna. We look at it as a great opportunity to teach Tierney grace & compassion while continuing to help Galyna adapt to her new family/culture. It's been a wonderful thing to see how the bigger family has led to growth in all the kids, not just Galyna. Seeing Tierney & Amissa, for instance, get upset at the local water park when some boys were teasing Galyna showed a deep compassion and love for their sister. (And seeing Tierney NOT deck the boys showed a growing patience on her part; there was a time in daycare - years back - where she hit a boy who was teasing Amissa. She was promptly put into a timeout. Later that afternoon, the daycare provider came along to see Tierney once again in the timeout spot. When asked why she was sitting there, Tierney said something along the lines of, "I hit again for teasing Amissa and then put myself in a timeout." I probably shouldn't have been as proud of her as I was.)

School continues apace, and Galyna is starting to pick up some reading skills. Her verbal English has long been ahead of her written English, which is natural. It's fun to see her starting to catch up. She's also popular at school and we see her giving (and receiving) many hugs from classmates when we pick her up at day's end. The only downside is she's on phy-ed & recess restrictions while the implants are in. It's a blessing to have teachers willing to be creative in helping her remain engaged anyway. Her favorite subject is art, and she's said a few times now she wants to be an art teacher. (Heh - as I type this she's pulling out colored pencils and paper. Call me Nostradamus.) If patterns hold, we'll have Tierney as our dramatic/performing arts daughter, Amissa as our gymnastics/swimming daughter, and Galyna as our visual arts daughter. Which should make logistics fun when they're all involved in actvities.

Galyna's treatments continue to progress. Her last hospital appointment went well, and it looks like the surgery to remove her implants will be December 28. That lines up well as it allows her to get through Christmas, as well as to recover in time to not miss any school. Of the four implants, we've finished filling two, and the other two are 1/2 - 2/3 full. To my untrained eye, the net result of this should be an improvement of hair coverage of 50%+. She's tolerating the saline injections much better now that we're finished with the two ports on her neck, which were always the painful ones. What I find myself wondering about is whether she'll want to go back for a second set of procedures when she sees the results of this one.

This is not to say there aren't still challenges, although things are smoothing out. The experts tend to agree that after 6 months you start to see real breakthroughs in bonding and we certainly have. She is starting to feel more comfortable, although there are still times it seems she's not sure of what's going on (or what's expected of her.) We have managed to work through some of the ... "survival habits" she picked up in the orphanage. As we come up on the one-year anniversary of the trip to Ukraine to bring Galyna into our family we remain grateful for the opportunity God provided.

As always, we thank you too for your prayers and support.

God bless,
Ron

Summer Wanes, Procedures Continue

The past few weeks have been full of more ups than downs, and I'm sure some of you are curious as to how Galyna is dealing with both first grade and post-operative procedures.

Since we last spoke (ha!) here we've had a few new experiences for Galyna. Aside from the needles and saline (more below) we introduced her to the following:

• Camping: Okay, she's been camping before, but this was our annual family camping trip to the Wisconsin Dells' Jellystone Campground. Yeah, it's campy (pun intended) but it's fun. Also, when you go over a September weekend you pretty much have the joint to yourself. On a side note, Tierney appears to be getting too "old" for this campground. I've been doing a bit of photo labeling and sorting of late, and watching how much the girls have grown...better stop now before I get eye moisture on my keyboard.


• First Grade: this is Galyna's first year in everyday school. Last year she was in a couple of school-based programs the days she wasn't in kindergarten, but this year she has all-day/everyday class with the same teacher and classmates. Conferences come up Thursday evening, so we'll see how she's doing. She was fairly nervous about homework, although why that would be we don't know; her sisters rave about homework and want to get lots. Maybe she's hearing things from other kids!


• The Great Minnesota Get-Together: I'm not sure Galyna has yet recovered from the incessant over-stimulation that is our state fair. From games and rides to food and animals, she saw more of pretty much everything than she ever had before.


• Church: Yeah, she's been going since we adopted her, but this summer she was in the service on Sunday mornings since children's programming was a "one hour or the other, but not both" option for us. It'll be interesting to hear, as she gets better at expressing herself, how she perceived this.

I'm sure there are other things I'm missing, but this is already looking to be one of my (in)famously verbose posts.

On to the medical portion of our show. We've had the opportunity (challenge? distress? stress?) of a lifetime, twice since our last hospital visit, to inflate Galyna's tissue expanders. It can't be a good sign when she starts crying hard and tightening up long before I even pull the needle out of the packaging. What is hardest for her is the inflation of two ports on her neck (which inflate expanders on the sides of her head) and the discomfort caused by her stretched skin over the two days or so subsequent to each expansion. All of which I completely get. The last time, she even said she wanted to have them removed and forego hair for the rest of her life. Fortunately, the two ports on the top of her head don't cause her as much trouble, so by the end of the procedure she's generally calmed down.

Aside from the obvious pain/discomfort, there are also starting to be some aesthetic concerns. The expanders lift the scalp tissue, which makes Galyna's head look very "lumpy" and not round. She sees this as "gross" and "ugly." Which, again, I understand. It has to be so very hard for her to see what we do, which is the end game. Her immediate pain is the hard part, and knowing she won't fully grasp the benefits of this until months (or years) from now is difficult on all of us. But. We persevere.

We do this because the procedure is a blessing from God; Shriner's care has been excellent, and the gift of free procedures is humbling. We're not "fixing" a broken doll, but Shriners is helping us heal a hurt child. We don't minimize the pain she feels now, but we know she'll at some point have part of her past healed from this. We also persevere because we want for her the best life possible, and although we'd like to think she'd always be treated normally despite having physical differences we're not so naive as to believe that's reality. She's always been beautiful to us; we want her to be beautiful to herself too.

So as you go through your Thursday evenings these next few weeks, please remember us in a prayer. I'm sure Galyna will appreciate it, even if she doesn't know it's happening.

God bless,
Ron

Post-Op Update

Lots going on, so it's probably about time for an update. Medically, we took a big step today when both Shannon and I were taught how to inflate Galyna's expanders. That's interesting. I spent some time working at a plasma donation center when I was in college, and as part of that job stuck needles into many people. It's a different experience sticking a needle into your own daughter. But I marvel at the creativity of medical researchers who came up with this entire process for dealing with trauma-induced hair loss on children.

Galyna was not thrilled, to say the least, with the whole needle part of the experience. She hung in there, though, and the tears flowed more slowly (and quietly!) once she realized it wasn't as bad as she feared it might be.

The process is to add more saline to her implants each week, then revisit the hospital in a month to gauge progress. Then we'll discuss when to finish the procedure by taking the expanded tissue and using it to cover the areas of her scalp which are currently covered by (non-hirsute) skin grafts.

In the meantime, she's on full restriction of physical activity at school. Both gym and recess will have to be monitored for her as she can't do anything to risk head injury. The playground, anything involving objects flying through the air, running, jumping, etc. That could very well be the hardest part for her, and it will last 2-3 months. Fortunately, the teachers at the local school are great, and will be helping to give her options that keep her engaged with the rest of the class, yet protect her head from injury.

Speaking of school, last night was open house night. Galyna (and her sisters) met teachers, hugged people not seen in months and displayed a bit of apprehension at the thought of homework. Well, Tierney and Amissa weren't at all nervous about that, but Galyna is. Her speaking is coming along well. She's to the point we understand what she's trying to say, but are correcting grammar and vocabulary. Her reading is behind, and she still struggles with focus on certain words and letters. But even there she's further along than she was before the summer. (Honestly, with a pseudo-writer/avid reader/grammar geek for a father - not that you can tell from this blog - and avid reader mother and sisters, Galyna has zero chance of getting through life unable to read and write. Whether she likes it or not!) We're looking forward to seeing her blossom this year as she gets into the swing of things.

There are other concerns we're dealing with, naturally, due to the nature of adopting a previously abused, different cultured, institutionally raised child into a family like we've done. The good news is the issues are new, meaning many have been resolved. Life continues to be an adventure, and even in the tougher spots (squabbles with sisters, etc...) we wouldn't change a thing. The blessings outweigh the pain, and even the pain is a blessing at times.

I could go on about how pain can be used for evil, or it could be a necessary part of restoration, healing and redemption. But that's a bit deep for an 11:00 pm post. As always, thanks for prayers, support and love.

It's greatly appreciated. Always.

God bless,
Ron

Surgery Day

So today was the big day! Well, one of many big days for our little Ukrainian dochki. I'll assume you have read (if not, please do!) the back story in prior posts, so let's sum up and zoom ahead.

A few months ago we found that Shriners accepted Galyna's case. The procedure they would perform is called tissue expansion, which is basically the placing of saline-filled "balloons" under the scalp in areas where she has hair coverage. The amount of saline is increased over time, which stretches the skin. After a while, there is sufficient extra skin, with hair follicles, to cover areas on her scalp where there is no hair currently.

It's genius, really, and especially effective for this type of situation.

We showed up at the hospital today ~ 8:00, and the two-hour pre-operative process was fairly straightforward. There was a quick shower (did not see that on the pre-op prep instructions, or we'd have done that at home last night), the taking of vital signs and the ceremonial (or not) shaving of her head. After that we went into pre-op, where she was allowed to select her own scent (strawberry-kiwi) for the happy-sleepy gas, as well as the color for her bandages (pink.) From there the surgical team took Galyna into surgery, Shannon took Tierney & Amissa to their cousin's for a few days and I headed to the waiting room. Just under three hours later, Shannon returned and Galyna came out of surgery. The timing was propitious; they waited until Shannon and I ran down to the cafeteria for a quick lunch to let us know we could go see her:)

They placed four tissue expanders in her scalp, and clipped off one smashed fingernail (another trauma from her prior life.) As I type this, roughly 4 hours after she came out of surgery, she is just now starting to awaken. She's nibbling on crackers, watching cartoons and coloring her very own floppy hat. She's also going to color a baseball cap for her bear, Ashley, who kept her company through surgery. Loyalty like that must be rewarded.

The rest of this evening will be some more clear foods, rest, cartoons, rest, visits from my folks and maybe another friend or two, followed by more rest. They have placed Galyna on a PCA drip, which allows for her to get a boost of pain killer if she needs it, but so far she's been showing no signs of pain. Post-op narcotics and residual anesthesia seem to be taking care of that. Her energy will return in fits and starts, and in about 48 hours she should be back to completely normal.

The next event in the process is a follow-up appointment in early September where we learn how to add saline to her expanders. That will be interesting. My prior experience at a plasma donation center will come in handy, although I never had to stick a relative before. I just hope to earn some good brownie points by not having my wife do it.

Thanks, as always, for the thoughts, prayers and support. They are definitely felt and appreciated. With the way we've seen God work through all this it's obvious they are effective too.

God bless,
Ron

Surgery Day

Hello again -

Thought I'd catch you up, albeit briefly, on today's goings on. We take Galya down to Shriners hospital today ~8:00, and she goes in for surgery ~10:00. The procedure should take a couple of hours, and she'll be in the hospital for at least one, possibly two nights afterwards.

I'll be back again later to let y'all know how it goes:)

God bless -

Ron

The Latest From the Good Doc's

Today was step two in the process over at Shriner's. Galyna had a physical and a surgery consult. The surgeon took some more pictures, measured her scalp and walked Shannon through the procedure. Looks like Galyna will have four tissue expanders inserted the first go around.

We're still fairly sure that Galyna doesn't understand what the procedure will be like. Primarily because we haven't given her much detail yet; we want her to enjoy as much of summer as she can without a fear of another surgery in her too-young-for-this life. (Actually, nobody's ever really "old enough" for what she's been through.) You can tell she's nervous, though, as she gets squirmier than usual, and giggly. I'm not sure what her memories of surgery in Ukraine were like. We trust her experience here will be better, but if she has no memories of the past operations, or if those memories are bad, she'll have added fears going into it.

She is, as we know, healthy. She survived a blood draw, although there was much crying before the needle was even brought out. Promises of ice cream and the ever present toys were enough to calm her down.

Tierney and Amissa joined us for the excursion, which likely won't happen again. Delays led to a four + hour visit. We wanted them to see, and be somewhat familiar with, the hospital environment. They enjoyed the toys and games in the lobby, as well as the not-so-horrible cafeteria food. But it ended up being a long day.

So surgery is scheduled for August 24 ~ 10:00 a.m. There's one more physical, but that's the big day. Between now and then we have to also come up with the optimal way to get her to a better understanding of the procedure and the short-term impact to her life from it. She'll have to deal with no hair for a while, some discomfort when the expanders are filled and some obvious bulges in her scalp as the expanders, well, expand. This is an awful lot for a pretty little girl to deal with, but if there's anything we've learned about her it's that she's a survivor.

Thanks as always for the prayers and support. It is so very good to know we're not in this alone.

God bless,
Ron

June-ish Update

Greetings loyal reader, stopping by once/fortnight to see if I've gotten around to actually posting any updates hereabouts. We have some news related to Galyna, some of it more timely than others.

I'm currently in the midst of an experiment. Take Shannon out of the country (to India, to be precise) for 15 days. Add one mama's girl who has yet to spend a night away from both her adoptive parents. Stir in a daycamp for her sisters and a need to work from home for her father. Observe how she handles the relative alone-ness and quiet of the house.

So far? So good. She's handled it with aplomb, although there has been some help in the form of Grandma and Grandpa O'Malley visiting Sunday through Tuesday of each week so I can get some office time. I think she likes the time alone with us too.

She survived the school year well enough, although she will need summer school. Her focus is more sporadic than that of her sisters, so she still doesn't have her letters down. Her verbal English is far ahead of her written, which doesn't surprise. She also seemed to enjoy being at school - although her dinner conversation usually related about recess and lunch more than the three r's.

Her general behavior has improved as well. Galyna seems to be getting better about understanding "the rules" and is conforming to them better. There are still a few side-effects of her background and delayed development we need to work through, but progress is definitely being made. Early on (as I think I mentioned) it seemed she was working her way up the developmental ladder in two-week increments, pushing new boundaries pretty regularly every 14 days. In the past couple of months, that has leveled off quite a bit. One of the things we were told often was that there was usually a big step forward in stability ~ 6 months in. That seems to be right on track.

We also took her on the first road trip to Chicago so she could meet my Mom's side of the family. She very much enjoyed that, and even got along famously with Grandpa's dog. Galya's not been much of a fan of dogs at all, so that was good progress to see. Overall, her skittishness and propensity to flinch away from movement have decreased. I count this as a growing comfort level.

Oddly enough, another sign that tells me I think she's growing more comfortable with us is that she's started talking about her life in Ukraine more. She speaks of how she misses her friend Katya, how she wants to go back and visit, and how she wants to see pictures. This past weekend, she even started talking about her "mommy and daddy" (really, her guardians since she never knew her birth parents in Ukraine) and how her mommy mistreated her. Even this story had new elements as Galyna spoke of being put in very hot water, then being put with the pigs. I have no idea if this is memory or if this is just her repeating what she heard others say about her story. The hot water is a new element, but it would make sense to this medical layman; her scars never seemed quite consistent with just animal bites to me. But again, I'm no expert.

Either way...still ticks me off to know how she used to be treated. And, we'll likely start her into counseling sooner than originally thought so she can work through these in a more healthful way. I also see some new work in helping her understand the concept of family, and what it means to have a mother and father. She still seems to think that those are the people taking care of her. That too will come with time. Really, though, I look at this as a positive. She feels comfortable enough with us and her stability that she can talk about Ukraine again.

Progress is coming in unpredictable fits and starts, but it is coming. Next big milestone is the July 2nd visit to Shriner's. I'll update for sure then, if not sooner.

Thanks for your patience!

God bless -
Ron