Saturday, February 25, 2017

After the Adoption Order - The Medical Stuff

Last month we had an appointment at Manchester Children's Hospital to see the Immunologist again about Birdy's allergies. It took us about an hour to drive there, through what seems like a perpetual rush hour these days, and more time to find a place to park, and then a very cold walk across campus to the right building. On arrival, I tried to check us in on the automatic machine in the foyer, but it didn't work.

This was my first inkling that something was wrong.

As we made our way to out-patients reception to try to check in again, I wondered about the confirmation of appointment letter I had tried and failed to find that morning. Had I actually been sent one? I had made the appointment using the choose and book website but, come to think of it, had I actually heard from the hospital?

We queued up for quite a while. Our appointment time came and went. Finally we got to the front of the queue and it was confirmed - there was no appointment.

There had been. The hospital had received the referral from the GP and written to me inviting me to choose and book. But then the hospital had got confused. The GP's letter said that Birdy had been seen at that clinic before. The hospital checked their records. No record of Birdy. So they wrote back to the GP suggesting she had made an error and cancelled the appointment. Nobody had thought to tell me.

I was not surprised, because I had predicted it. Birdy's first appointment at the hospital had been a year ago, in her old name, using her old NHS number. When a child is adopted, they receive a new NHS number and new records are started. It's a blank slate. It takes time for this new number to be issued, and time for the GP to make summaries of old records and append them to the new ones. So for a while, there is a limbo land.

It was during this limbo land time that I approached the GP for the referral. Prior to that appointment, I called the hospital immunology department myself, explained Birdy's situation and told them to expect the referral. I knew from the tone of voice of the person I spoke to that she didn't really grasp the significance of what I was trying to tell her. When I saw the GP, I explained it all to her very carefully. At that point Birdy was going under a new name but didn't have her new number.

Somewhere between that GP appointment and the referral being made, Birdy switched over to her new number. The referral obviously went off to the hospital with the new information and the confusion was complete.

Thankfully they still saw us, we got our allergy testing and added sesame to our list of foods to avoid. And if that was the end of it, I'd be happy. But, of course, it isn't.

Birdy has a moderately lengthy medical history. She has been seen by the GP, the asthma specialist nurse, the eczema specialist nurse and two different hospitals. At various times she has had prescriptions from all of these people. Most of these prescriptions need to be put on repeat, yet it has taken me repeated requests for each medicine to actually make that happen.

When her records switched over, it apparently threw all that for a loop again. I asked for a printout of her complete prescription list this week and three items were missing from it. One of these was her anti-histamine medication that we have to carry everywhere with us. The others were eczema creams. The receptionist said there was no record of her ever having been prescribed these things, despite the fact that they issued a repeat prescription on the anti-histamine at the end of last year. I now have to go back to the eczema clinic and the hospital and get some proof so that the GP will put them on repeat.

This is something that adoptive parents need to prepare themselves for. At no time, during the adoption process of either child was this explained to me. It didn't matter for OB as he had virtually no medical history anyway and the GP's surgery we were with then seemed to manage it fairly seamlessly. 

Birdy is a different matter though. For various reasons, it's important that an accurate medical history is carried through. For instance, the immunology consultant plans to call her into hospital when she is around four years old to do a supervised peanut challenge. This won't happen if she's disappeared off the system!

And we can't assume that everybody involved understands the procedure either. When I called my GP's surgery to tell them she'd been legally adopted and ask about procedure, the receptionist I spoke to offered to just change her name on the system. Let's be clear, that would link her new name (changed for security reasons!) to her old NHS number allowing anybody that can search that database to find her new name in a moment just from looking up her old NHS number - a number that her birth mum undoubtedly has a record of.

At least I know Birdy's medical history though! For people adopting a child who may be four or five years old, with a lengthy and now inaccessible medical history, this must be a minefield. Yes, it's been a bit of a slog for us, but six months down the line and it's mostly sorted out now - apart from those pesky repeat prescriptions!

Saturday, February 18, 2017

The Perfect Age Gap

There's quite a large age gap between me and my sister. It doesn't matter now, of course, when we are both rushing madly towards middle age (one of us six years nearer than the other of course!), but when we were children, well, six years was a long time.

So I had thought to myself that maybe when I had children, I'd try to have them a bit closer together. I imagined that with, say, a two-year age gap, they'd have interests and friends in common, play together without one having to come years down to the other's level, go to the same birthday parties and kids clubs. I thought that would be nice. 

When you adopt your children, it's not so straightforward. If you adopt a sibling group, you get what you're given in terms of age gaps. I know adopters who have children less than a year apart in age. And if, as I did, you adopt two completely separate children at different times, the agency is likely to insist on a minimum age gap - in our case, at least two years.

Having experienced a few different combinations of children over the last six years, I can see why. Having toddler boys nine months apart in age was a lot of fun, and yes, they did play together and were very close, but basically it was exhausting for me, and there was a lot of screaming and fighting too.

Later, with a 5-year-old, a 3-year-old and a baby, I saw a different dynamic. The two older children were in competition the whole time. Any idea I had previously held that having children with similar interests would be lovely quickly went out of the window. For these two, similar interests meant similar needs, and therefore intense competition to have these needs fulfilled. Twinkle and OB never gelled at all. It was such hard work that, despite copious amounts of comfort eating, I actually lost weight.

This experience confirmed to me that I needed a decent-sized age gap between OB and any sibling. I began to understand that it was vital that other children living in our home had different needs from his. OB has never minded when I have taken time out to, say, feed a baby, but if I had to help Twinkle on the toilet I could bet my bottom dollar that he'd have a sudden urgent need for the toilet too - and vice versa. I can do things for other children, as long as they're not the same things that I'd be doing for OB.

Birdy and OB are just about exactly four years apart. Is it the perfect age gap? I don't know, but it really works for us. I had worried that the difference in age would be too much, that they would never play together and miss out on shared experiences. So far I am glad to have been proved wrong. Now that Birdy is fully ambulatory and into everything, they play together a surprising amount. As she still has a nap every afternoon, I can get some quality OB time in there too.

But more than that, Birdy's adventurous character has been a real boost to OB's more timid nature. She will have a go at anything, and OB finds it easier to pluck up the courage to attempt new things if he's 'helping' her or just 'going with' her. Last time we went to CentreParcs, OB was ready to throw himself down the water slides as long as he was 'just helping' Birdy. In previous years it's taken hours of patient work to get him to even try them.

Birdy has brought out a truly caring and compassionate side to OB's character too. He knows all the food she is allergic to, and looks on cafe menus for things she is safe to eat. He looks out for her, calling me if she is hurt. He is so willing to get on her level to play silly games that have them both roaring with laughter. I couldn't ask for more.

As for Birdy, well, she looks up to her older brother, seeks him out when she doesn't know where he is, and cries for him when he is not there. She copies everything he does (sometimes I wish she didn't!) and tries so hard to play his games. Today they were building marble runs together. She was thrilled with the run that OB made for her, and he was relatively calm when she later trashed it!

It's not prescriptive, I know. My children are not birth siblings, so they don't carry shared baggage from their early experiences, which helps us. Every family set up is different. Every child is different. But I think that, although I would never have planned it this way, our four-year age gap is working out just perfect for us.

Saturday, February 4, 2017

Interrogation in the Supermarket

Years ago, back when I lived a carefree, non-parent life, I used to go about my days relatively unmolested. I could walk down the street and nobody would pay me any attention. I could spend as long as I liked (preferably not too long!) in the supermarket and nobody would speak to me. I quite liked it.

As soon as OB came into my life, all that changed. Having a gorgeous, wide-eyed, cheeky-looking toddler in the trolley seat apparently attracts all kinds of attention. There were comments about his cuteness - I appreciated all of those! - and questions. Lots and lots of questions. What's his name? How old is he? And, as he got older, does he go to nursery? To school? (He's very tall!) To be fair, these were far more innocuous than the questions I got asked at the Sure Start Centre tots group, which often centred around unpleasant-sounding birthing experiences. 

All of that was fine, though. OB was (and is) fabulous and I never minded answering questions about him or accepting compliments on his behalf.

Since I've had other children alongside OB though, I've noticed a major shift. I don't get asked questions any more. Suddenly, I'm invisible, and all the questions about the babies and toddlers are directed at OB.

Is this your sister?
What's her name?
Is she good?
Does she cry at night?
Does she share your toys?

And so on and so on. Poor OB. It's torture for him. Firstly, the answers to some of those questions are not always so straightforward. Is this your sister? Or brother? Until a few months ago, none of the children that have accompanied us to the supermarket have been OB's sisters or brothers. I used to step in to save his awkwardness but, to be honest, I would struggle to answer the question too. Do I lie? Or do I tell the truth and say "No" - an answer that really feels as though it requires further clarification that I'm not sure I want to give to the stranger in the supermarket.

Secondly, OB is shy around strangers. Actually, he's shy around people he knows. When we go to his best friend's house it takes him a while to work himself up to taking off his coat. He has a hard time answering people's questions. It puts him under pressure. If a stranger even asks him what his name is, he practically turns himself inside out. A supermarket interrogation is the last thing he needs.

And for some reason, so many of these curious strangers seem to take his non-response as a personal challenge. They keep going, determined to drag some answers out of him. I assume they're trying to show him they're friendly and establish some sort of connection but the longer it goes on, the more gnarled up OB gets. If he does answer, it's barely audible, which the interrogator takes as a signal to get him to repeat his answer over and over again, resulting in five more whispers and then one strangled shout. Cue the interrogator backing off in alarm.

So do I intervene and answer for him, thus giving everyone the impression that I'm an overbearing mother and that's why he's so shy? Or do I explain that he's shy and risk shaming him? Or do I just stand there and let it happen, hoping he'll 'toughen up'? (Hint: it won't be the last option!)

I've started ordering online!