Capers of An Almost Two Year Old in a Cast

I am enjoying a moment of peace as Eli plays outside, on a warm winter day, and the rest of the Johnson’s nap. At last check, he was in the neighbor’s fort saving the United States. It is never a dull moment in the Johnson household, and last night was no exception. We ventured down the street to my good friend Jill’s house with an offer of chili for supper. As Jill and I carried on chatting and laughing, Sidney appeared out of the corner of my eye. I did a quick assessment and realized something was missing. Her cast!

Over the last day or two, the cast became looser as swelling decreased. We felt it needed to be taken care of Friday; however her thumb was still out. A resident advised it was ok to try to get through the weekend. Her cast is not to actually come off until February 1st.

As she came bounding across the room, proud of her recent freedom, my friend Jill jumped to the call. I was in a full panic mode, thinking about how gruesome the grafts might look uncovered too early. Jill had already swept Sidney into her arms and was assessing the situation. My morbid curiosity took over, and I looked at the grafts which as a side note look great. It was so strange to see her little fingers separated.

Everyone agreed keeping her hand out of any dirt was the most emergent task. Jill quickly devised that a Dixie cup would serve to keep the fingers protected but not allow anything to touch the grafts. We first put the whole hand into a medium cup then realized she might start digging at the sutures with her thumb. The larger cup was quickly replaced with a smaller cup and her thumb left out with band aids holding them on. Jill quickly found a clean tea towel and wrapped it around, using packing tape around the outside. The look was completed with some form of princess sticker.

After a tense hour waiting for a resident to call, we were on our way to Iowa City. It was already close 9pm. This actually worked well, because Sidney was asleep and not moving the fingers as much. The orthopedic resident advised to have him paged. This made the entire trip a bit shorter. There was a plane crash in Cedar Rapids the same night, so we were warned it was busy.

We were back by 2am, and my friend gladly kept Eli overnight. Their home has become an extension of our own, so I was relieved she was the one keeping Eli. Eli was thrilled with staying at his friend’s house.

Sidney no longer has her hot pink cast and was forced to get a white cast. Two residents worked to get the cast on her small arm. When the first cast was put on, the resident advised her did not think was going to stay on, so he cut it off and made another attempt. This seems to be much tighter, and we are optimistic it will stay on, because much of the swelling is down.

Sidney was a trooper through the whole thing. As she sat sucking on a Tootsie Pop at 11pm and watching old episodes of Rosanne on TV Land with Tom and I, she acted like nothing was out of the ordinary. Even as I sat in the ER, knowing our drive home was over an hour, I felt like the luckiest person in the world. While we were waiting for the resident to come in to cast her arm, I walked back into the room to see Sidney propped up on the bed with dad sitting in the chair at her bedside. She looked at me and took her free hand to pat the spot next to her on the bed, saying come sit by me mom and take a load off. These are the moments that erase three years of waiting.

Surgery Complete

Tom and I woke up bright and early Thursday morning and left for Sidney's surgery from my sister-in-law's house, in Iowa City. My father in law voluntarily slept on an air mattress the night before and easily navigated the snowy streets with 4x drive. Of course this easy navigation happened after we scraped the side of my sister-in-law's car backing out of the driveway. Sorry Steve, my laughter is, again, at your expense. I should have mentioned that Tom's dad was a very calming presence and made the experience much easier.

Surgery started at 7:15am, and we were there an hour early. This time in preop included all the bells and whistles sounded by the anesthesiologists. Most interesting were the six residents who came through to look in on Sidney and discuss the procedure. Iowa City deals with a lot of children, from all over the world, however I am certain Sidney's hands were quite unique. Sidney was given an oral sedative and taken off to surgery.

Surgery took about four hours. It took longer than anticipated, because the surgeon had to replace the original and much tighter sutures on the separated fingers with looser sutures. This was the area where a skin graft was taken from Sidney's hip and placed on the newly separated area. Looser sutures were used to increase blood flow to one of the fingers which was a bit too purple. Three hours passed after surgery while Sidney had a small fever and threw up apple juice in recovery. The fever passed, and she had a fairly uneventful night and simply waking up for pain meds. Her fingers were a perfect pink hue by the time we left this morning.

We returned home to my mother and Eli who had spent the entirety of the surgery watching the blizzard.

Sidney is fast asleep on a muscle relaxer and codeine with her very pink cast. More to come when I have had some sleep but wanted to give a quick update and to say thank you for everyone's prayers and kind thoughts.

On the Path to Healing

As the scent of pine remains in our house, I am reminded our family experienced an amazing Christmas. It was such fun to watch the kids excitement. Sidney is obviously too young to fully understand the concept, but it did not take long to get into the spirit of diving into a pile of packages. Eli was quick to follow up with his standard line of, "you know gifts are not the real meaning of Christmas." We had several occasions to experience this. I am happy to report we made it through four family Christmases unscathed and will round out the season with our last family Christmas today. Thirty people will converge on my father-in-law's house, chaos erupts, and we will have a great time!

Part of this season has been spent thinking about this coming week. Sidney will have surgery on Thursday, Jan, 7th, in Iowa City. This surgery will separate the webbing between two fingers as an outpatient procedure. Our surgeon let us know they will call with times the night before, but she will likely start surgery around 7am. Good thing mommy likes coffee, because we will have to be there around 5:30am. If all goes according to plan, surgery will take about 3 hours. With an army of family, friends, fellow adoptive parents, and fellow church members praying, we are very optimistic about the days ahead.

Separating Sidney's fingers involves taking a skin graft from a donor site on her upper thigh which will be used to cover the inside area between the two webbed fingers. A cast will cover the full length of her arm, to prevent it from slipping off her small arm. We are unsure of what the skin graft will entail as the tissue from the donor site is quite deep. This depth aids in the healing process.

When I look at Sidney's hands I am quickly reminded how differently her hands might have grown without surgical intervention. This particular procedure would not have been available to Sidney in the orphanage. Under the governments medical care, a few procedures are covered. For example, procedures 1-25 are available, leaving anything else up to a person to pay privately. Obviously, funding a major surgery is out of the question for many people. This is well known by the average Chinese person, so when Americans are spotted with special needs children the reaction is many times very positive. Sidney is only one example of socialized medicine. Why, again, are we begging for socialized medical care in the United States?


I asked the hand surgeon what happens to a hand with webbed fingers without surgical treatment. She advised Sidney's two webbed fingers would continue to grow at different rates, causing the hand to become disfigured. This is also true on the other hand which does not have webbing but bone growing incorrectly over the growth plate. Without correction, the base of her finger would actually grow wider.

This is such a simply thing to do which will completely change Sidney's life. We could not be prouder to be the parents facilitating this care!

December Past and Present

Another Christmas season is upon us. I find myself going through the motions of a traditional Christmas, in my warm and comfortable home, contemplating Sidney's life last December. During these moments I am lost in thought, only to come out of my revelry at the sight of Sidney dancing to Jingle Bells. Like a popular adoption song says, "what has been is lost in what will be."

Thinking about Sidney's life in China, I think not only of last December but of her first six weeks of life, in an environment so different from anything by Western standards. This period of time will remain a mystery to all of us. If I had to guess her life would likely have mimicked what I saw the day we flew into her province. On the approach for landing, air blew across the the rice paddies below from the power of the landing plane. People stood below, planting rice, as the water rippled around their legs. Statistically speaking, the majority of abandoned girls are from rural areas.


As adoptive parents, we are given medical reports which give some clues. Nothing specific is given about about day-to-day life other than to say she lived a routine life. We sent a disposable camera in a care package to the orphanage. From what we could see, it was sparse but appeared clean and new. Sidney likely moved into a new facility last December. Construction of the new orphanage facility was completed around this time. Prior to moving into the new facility, Sidney lived in a much older building next door. We did not receive any photos of her caretakers. These are the people who taught her to hold herself up when being held walking around, allowed us to make eye contact on her first day with us, and did the best they could with the minuscule resources available.

We believe some of Sidney's routine might also have revolved around contact with the U.S. based organization Half the Sky. This organization provides children with extra care and medical treatment. For children staying in an orphanage their entire life, it is the closest they will come to a family. They can provide us with additional information if they had contact with Sidney. We are faxing a questionnaire in. Our referral information indicates Sidney interacted with "grandma's." This particular organization hires elderly women from the community to come into the orphanage and interact with the children. This could also explain why Sidney did so well interacting with Tom and I on those first few days in China.


It is the hours when she was not being fed, bathed, spending time in her crib, or sleeping that we wonder most about. This question comes to mind, because Sidney is finally to the point where she is content to simply be. Meaning, she is able to simply hang out and know it is OK to get out of our laps and play or explore. Before she mixed between playing for short periods and coming back to Tom or I, looking for the reassurance that we had not gone anywhere. She understands if we are holding her, we will hold her again. She went through a period where putting her down to do something else was not an option. I have learned to do many things like unloading the dishwasher or making a batch of cookies for the school bizarre with Sidney in the carrier. After my back was breaking, I remembered reading that you should start all over and put her back into the carrier, if a child was regressing. I did this and two weeks later, she is secure in allowing me to put her down. Consistency is the best thing in her routine. This has caused me to say no to things and understand that what Sidney needs right now is time.

This consistency is what has allowed me to watch her relax in my arms. Those first few days in Changsha, it was obvious she had been carried around but never cuddled in someones lap. She sat in my lap but not next to my body, closer to my knees and straight as an arrow not really relaxing. She allowed me to feed her bottles but kind of gave me a deer in headlights look. As the trust and understanding grew, she started to move back, first to simply rest against me, then allowing her head to fall back. I remember the first time she did this, she let out a sigh. Kind of like, is this what life is really supposed to be like? She now trusts so fully that she falls asleep all the time in my lap, and once she is out, she is out. She no longer startles awake, she knows where she is and does not bat an eye. These are the small triumphs that make three years of waiting seem like a walk in the park.

We could obviously go on forever about the differences. What counts most is what is happening now. We are witnessing a triumph of the human spirit. But just when I have forgotten there was a time when Sidney was living her former life, I look into those soulful eyes which have certainly seen enough for a lifetime.

Pre Op Blizzards and Palpable Joy

Wednesday we will have the opportunity to go to Iowa City for Sidney’s pre op exam. Her surgery is not scheduled until January 7th. After our pre op appointment, we go in for a genetics appointment. The hospital was excellent about working us in for a double appointment. Genetics must be a specialized field of expertise? I am saying this facetiously of course. Our pediatrician’s office placed us on the waiting list for an appointment in August. We scheduled the appointment a couple of months ago, and from what we understand only three appointments take place per day.

I saw on the news that Wednesday is supposed to be a blizzard. We might wait another six months to unravel the mystery, so I say for the millionth time as an adoptive mother, “I am releasing control!” Luckily, the hand surgeon’s nurse had the foresight to give us all the information necessary for Sidney’s surgery on January 7th. During Sidney’s last appointment, we went through all the information necessary for the anesthesiologist, all of her information was taken, and we were given pre op directions. It is an outpatient surgery and takes about three hours. I think I have told almost everyone, but she will have a full arm cast for three weeks and a split for two more. The full arm is because she is so little it will fall off. The other hand comes six months later. We plan to wait until after summer, next September. No fun being 2 and not able to be outside running around and getting dirty. I believe strongly in letting my kids wallow around in the dirt outside.

We are anxious for the appointment with the geneticist. If I had to venture a guess I would say something environmental caused Sidney’s condition. After seeing the rice paddies and fields surrounding Changsha and knowing rice paddies are also everywhere in Changsha, I believe her mother could have been exposed to a pesticide of some type in agriculture. Changsha is the capital of Hunan province, and Hunan is the second largest rice producer in China. I could be totally off base about Sidney’s condition however have done a ton of reading to come to this conclusion. I have also made conclusions about agriculture or a pesticide based on the high percentage of girls who are abandoned from rural areas. After seeing rice patties with huts sitting in fields, I can almost imagine the desperation of her parents when they saw a condition which was certainly insurmountable by western medical standards.

Onto something not so heavy….we went and cut down our beautiful 7 ½ foot Christmas tree! No, it is not the most magnificent Frasier Fur I have ever laid my eyes on which was a whopping $70. It is the garden variety Christmas tree, and we love it! Eli is old enough to remember tradition, and he and I had so much fun getting the decorations out. We could not get it finished before bedtime Sunday night. He made it clear that no more ornaments needed to go on unless he was there; telling me he thought the tree had plenty of ornaments. He promptly woke up this morning and asked to continue decorating.

Sidney’s reaction was great! Who could resist lights and the fun! She was fond of taking them off the tree and has finally learned they belong there. What kid should not have the thrill of enjoying Christmas? This is literally worlds from where she was last year at the same time.

Over the last week, we have witnessed a transformation which is palpable. Sidney is smiling! Not just smiling her small tiny, I am barely going to curl up my lips, because I have never smiled before and don’t really know how to express myself when I am happy smile. This is a full faced, eyes lit up, kind of smile. This melts my heart! Other transformations are her physical appearance. She has grown over an inch and gotten 6 teeth. Four are molars. Amazing what a little nutrition will do for catch up on growth. What has been even more amazing is the thickness of her hair.

When we first bathed her on the first night we had her in Changsha, I was horrified at how far back she had physically scratched the hair off her head. We know now this was likely the rash which was caused by giardia. This has now cleared, and her hair has completely filled in. This is also certainly due to better nutrition. We assume she got vegetables but question if meat was ever in her diet. She is still not fond of meat, but we give her a lot of eggs and peanut butter, in addition to other foods with obvious nutrition like fruits and vegetables.

OK, enough musing on the part of this adoptive mom, I could go on forever!

Drumsticks and Fevers

I realized I have been neglecting my blog. I picked up a couple of writing contracts, so by the time I am done writing for pay, my ambition is minimal.

This week was one of maternal challenges. Eli and Sidney are recuperating from a bad cough and a fever. This is the first time we have gone through a fever with Sidney. As the digital thermometer ticked off, climbing higher and higher, I felt the familiar pit in my stomach. I have determined it is the loss of control that kills me. Of course, it didn’t help that mom was chiming into the chorus of coughs and wining with her own nasty cough. Getting sick alongside your children for lack of anything positive to say about the experience sucks! Sidney, Eli, and I are all on antibiotics.

I was unaware Tom could move so quickly as he did the night this all began with Eli loosing his lunch upstairs. Somehow Tom made it across the hall to the bathroom in a single leap when Eli gave the look of panic. Luckily, Sidney spared us the first step and went straight for the fever.

Tom and I made a joint decision not to drag anyone into the cesspool or to go anywhere. Instead we had Thanksgiving at our house. As the smell of turkey wafted through the house, Sidney, Eli, and I snuggled on the couch and watched the Macy’s Thanksgiving Day Parade. I could not think of a more perfect Thanksgiving. I found Eli especially fun this year. He was feeling quite a bit better and assisted Tom with preparing the meal. For those of you who have not been in our home, Tom loves to cook, grill, and generally play host when we have people over.
I was quite shocked at Eli’s level of genuine excitement and enthusiasm over an 8 lb bird. Tom’s meal was great. We have so much to be thankful for that we did not care about a little flu just about being together as a family of 4.

Unlocking the Mystery of Sidney's Hands

Today was the next step in unlocking the mystery of Sidney’s hands in Iowa City. We met with Sidney’s hand surgeon Dr Lawler, located at the U of Iowa Pediatric Clinic. Her fingers were examined to learn more about what is surgically necessary. Before coming into the office we were only aware of what is visible from the outside and had no x-rays prior to our visit. After learning more about what is possible, Tom and I sense overwhelming relief. This was the day we have been waiting for a long time.

After taking x rays, where Dad donned a large lead apron and Sidney a baby sized lead apron, Dr Lawler and a resident gave Sidney a sticker. After unpeeling an edge of the sticker, the doctor simply sat and observed her dexterity. It is fascinating for me to think about the years of medical expertise which allow a specialist to watch such a simple action and make a determination about medical care which will alter the manner, in which, she functions for the rest of her life.

After a few minutes of analyzing her dexterity, Dr Lawler showed us an x-ray of both hands. She was unaware that I stepped out with the x-ray technician and was able to see them on the computer screen. This was great, because I was prepared that both hands had extra bones. On her right hand, or the hand with syndactyly (webbing), there is an extra bone underneath the nail on one finger. This is one of the fingers which is webbed. This helps to understand why there is a ridge in the middle of her fingernail. I have always wondered why the nail was not flat in the middle until today.

For this hand, the doctor will perform surgery on 1/7/10 to separate them. She is unsure if they will take the extra bone, because taking the extra bone under the nail could change function in the finger. She said it is difficult when the fingernail is involved. Dr Lawler said she will make a decision on how to move forward when she is actually in the operating room. There could be other extra smaller bones which do not show up on the xray.When fingers are separated extra skin is necessary to fill the area on the inside which was fused together. A skin donor site will come from an area which is on the underwear line. For people who are easily grossed out, skip to the next paragraph. If you are like my mother and I with a morbid curiosity, keep reading. The skin donor site will be skin which is cut as deep as possible. For some reason the skin depth needs to be as deep as possible and is several layers. This aids the healing process and has a better appearance after healing. The doctor said there will be minimal scaring at the donor site.

Next Dr Lawler looked at the left hand or the hand with three separate fingers. If you look at Sidney’s fingers on the left hand, it is immediately obvious that the middle finger is quite wide at the base. There are bones which are misshapen and larger than needed in the middle finger. The bone is much larger than needed at the base of the middle finger. This bone is over her growth plate. If something is not done with this particular area, Dr. Lawler said the base of the finger will grow wider and wider, disforming the hand further. The doctor suggested doing the second surgery at least 6 months after the first surgery, so Sidney forgets. My comment was, “so mom forgets!”

At this point, Tom and I feel relieved to finally have answers to all of the questions we have had since we first opened the email with Sidney’s referral information. Nice to know what we are facing and that it is fairly uncomplicated for both procedures. Are we thrilled at the prospect of surgery, no, however we know God placed this child in our hands for a reason. It feels good to do this for her and know that she will grow up normally as a result of something which would have been impossible to do or done incorrectly in China.

One last note which proves how little we think about Sidney’s leg and hands. As the resident assessed Sidney’s hands (for those of you who have not gone to the University of Iowa or live out of state a resident always comes in before the doctor as it is obviously a teaching hospital). As he looked over what I am sure was an interesting case, he asked if Sidney had any other health problems. I confidently responded, “no.” Tom gave me a look like I was crazy, and I shot back, “what?” Tom said, “her leg.” “Oh yeah,” I said. “She has fibular hemimelia and is missing a bone in her leg.”