How do you make the tough decisions?

My heart has been heavy and my mind has been spinning the last few days.  As I previously blogged about, Jo, from Wacap, contacted me to let me know that Ramya, the four-year-old little girl in India that lit our adoption fire was now back up for adoption.  Great, right?  Well, sort of.  When we heard that she had a family, we then agreed to pursue Manasa, the one-year-old girl in the same orphanage that also has spina bifida.  We started our home studies, we took our classes, we talked to families, and we started to prepare ourselves... to bring home Manasa.  Of course, since our home studies and the such were not complete, and because there is another family now looking at Manasa, we knew she may never be ours, but we started to plan, unintentionally but also intentionally. 

I talked to Jo on Tuesday and asked what we do in this situation.  We now have two little girls who could both really benefit from joining our family.  Jo was not sure what we do because she has never dealt with a situation like ours before.  We cannot take both girls because 1- We do not think it is a wise choice considering their medical needs and the age of our children and 2- even if we did, India will not let us.  I asked if we are going to have to choose and she said possibly eventually, but not yet.  How in the world DO you choose, though?  We have been praying that God will make it very clear what we are supposed to do and who we are meant to adopt.  Here's the kicker, though.  Ramya is older and has more medical needs, so it is more important for her to find a family that is prepared to help her.  The problem?  She has more medical needs, and quite possibly very serious ones. 

I talked to Dr. Zuniga, Madi's urologist, about Ramya when we first considered her.  When I told him she was already having kidney failure, he told me that we can do a vesicostomy and go from there.  Ok, no biggie, we can do that!  Then David talked to his mom (who is a nurse) and she started throwing out things like kidney transplants and dialysis, as well as a short life-span.  Whoa.  Now that is a little scary.  I mean, if it was just David and I, or my children were grown, I would take her in a second, and love her for every second, as long as I could, whether that time frame was 3 years or 30.  But we have young children.  How do you explain to your children that their new sister will die, sooner rather than later?  I mean, we all face death, that is our reality.  We all have had people we love pass on, but how do you go through that with your children, and do you CHOOSE to go through that?  And how do you pay for those kinds of medical bills and keep food on the table?  But, on the other hand, how do you let her die without knowing the love of a family?  How do you look at her little face and say no?  It is SUCH a tough choice to have to make.  We knew that at some point we might have to make a choice like this, but it is so easier said than done.  We may be getting ahead of ourselves a bit, because we do not know if those are things she would face, but they have really made us stop and think and have sent us in to a tizzy. 

Dr. Zuinga has all of Ramya's medical records and is reviewing them for us.  I asked him to not just tell me what we would do now if we brought her home, but also what we would do in two years if she continues to get UTIs and her kidney failure gets worse.  We pray God makes our choice clear, and we ask for your prayers in that direction as well.  We know the right choice is not always the easy choice, but we don't know what that means right now. Though we are not sure what God has in store for us, or for the two little ones in India, we do have peace knowing that He knows and He has a plan.... a perfect plan.

Our fun today at a Hope Kids event that took place at Bumble Bee Ranch



Yesterday Madi had a urology appointment with Dr. Zuniga at Phoenix Children's Hospital. She had her 6 month urodinamics test, which looks at how much liquid her bladder can hold, as well as how it functions under high pressure. He was happy at how she functioned under high pressure and said that it indicates her bladder is not rigid, but has some flexibility. This is a good thing because she has renal reflux and a rigid bladder will push the urine back up the ureters instead of emptying. Hers, however, empties, which is great! Her bladder still does not hold as much as it should, though it did grow, which is good. He thinks we may see good long-term benefits from using dithropan. We are going to start her out very, very slow and see how she reacts to it. He said that dithropan is most important when they are little, though, because it helps increase the bladder size and will help it to grow normally. I talked to the naturopathic doctor and, unfortunately, there is no natural replacement for it, so we are not left with too many options. The reason to give it, though, is that if we can get the bladder to grow normally, she may be able to avoid a bladder surgery in the future, and of course, any surgery you can avoid is HUGE. Also, once you perform those surgeries, you are cathing for life. She may have to cath for life anyway, but at least we have a chance of changing that right now. 

Madi did a great job during the test.  I stay and talk/sing/play with her during it, which helps.  They turned on Finding Nemo for her, and she was fascinated by the fish.  I also brought a little bit of "baby bribery", aka organic chocolate chips.  She LOVES chocloate and it really helped keep her happy and in one spot.  Overall, it was a good appointment!

(Ceretta's Mint Chocolate Face)

The doctor says things look good!

This is an old picture, but I love it, so I just had to throw it in ;)

Last week we went to the Children's Rehabilitative Services (CRS) clinic and saw Dr. Zuniga, Madi's urologist.  They took an ultrasound of her kidneys and bladder (and I almost got in a fight with a nurse... long story, but let's just say, you don't mess with my child ;)) and things are still looking good.  Though she does not function perfectly in those areas, there is not too much pressure and we do not need to start catheterizing her, which was awesome news!  My prayer is, and always has been, that her bladder work well enough to not have to cath her.  We go back for another ultrasound in 3 months.  

Today we went to her normal pediatrician, Dr. Nemivant at Pediatrix.  Madi's weight is in the 5th percentile, her height in the 50th, and her head in the 55th.  Because of her hydrocephauls, her head has always been a bit larger, though it's not noticeable.  He was not worried about her weight, either, which has always been in the lower percentile.  I asked him to swab her diaper rash and see exactly what it is so that we can wipe it out.  We're waiting for the results back but he prescribed an antibiotic that is supposed to help in the meantime.  We have yet to Vaccinate Madi and I'm not sure if we ever will, or what we will vaccinate for, so our check was fairly quick.  He said Madi is looking great, though we already knew that ;)!