One month home.

If you're still reading our blog, it's certainly not to follow our adoption process, because that is over!  It must be because you're interested in seeing how our little boy is doing and how our family is adjusting.

Joshua has been home just over a month (I'm late by a few days).  Obviously, coming home during the holiday season can be stressful for any family, and so we haven't scheduled all of the doctor and therapy appointments we might have otherwise.

Physically, Joshua has gained at least a pound since being in our care.  This was after he gained more than seven pounds since we received his original medical information in February.  And this is because of the care he received from his Baba and the improving conditions in Pleven.  (Note I said improving, not improved.  It is an evolving process).  In fact, he is (barely) on the growth chart now!  His diaper rash, which was the worst I've seen, improved within days of him being home with us from being changed regularly and using high quality diaper rash cream. I saw what they used in Pleven.  It is not their fault, but when the diaper rash cream streams out of the tube much like white colored water, chances are it won't be a terribly effective barrier cream.  I also know his Baba changed him more frequently, but when diapers are at a premium and there are so many children, it is obvious why they wait in dirty diapers so long.

Joshua eats.  Oh, how he eats.  We feed him generally 4-5 times per day.  He doesn't request to be fed, but when he sees me beginning to prepare a meal, he gets very excited. It is hard to keep him safe around hot food when he is constantly at my feet, doing what we call the 'food hum'.  Since he's non-verbal, he sometimes hums (or mimics the intonation of what we are saying).  The 'food hum' is one I only hear when I am preparing a meal for him, a rhythmic, three beat hum.  We are teaching him the sign for "eat".

His diet is still very limited.  We have experimented with foods and have had mixed results.  Josh appears to chew, though not effectively.  He knows how to use a spoon, but is so messy with it that sometimes I have to discourage him from feeding himself.  We've had great success with a mixture of mashed potatoes and crushed up sweet potatoes.  He eats this often and really loves it.  Puddings, fortified with additional calories, are also good.  We've modified soups to be more like what we had in the orphanage, using broths and small noodles and breaking up 2 pieces of whole wheat bread into the broth.  He has no taste for vegetables.  He enjoys overcooked spaghetti noodles in mild red sauces and applesauce with rice cereal.  Yesterday we tried baked beans.  He ate, though not in the quantities he normally does, and then refused the remaining half of the bowl.  He recently tried oven baked potatoes that were soft and seemed to enjoy a few of these as well.  He is eating oatmeal in the mornings, with additional calories added.

Drinking is problematic.  He cannot drink independently and seems to want nothing other than water, and not much water at that.  We try to include applesauce and broths to boost his liquid intake.  He has gone through brief bouts of constipation because of this.

Our visit with the doctors about his eyes was incredibly encouraging.  The reports from Bulgaria were simply inaccurate in many ways.  The risk of his vision being dramatically decreased is gone; in fact, his eyes have been declared structurally correct.  This is in contrast to his medical information, which suggested a pale colored optic nerve, indicative of serious vision impairment.  Instead, his optic nerve is pink and healthy.  He does have strabismus and, though the doctors in Bulgaria didn't believe he had nystagamus, he does.  I suspected this too.  Beyond that, he is very healthy.  We have neurology appointments in a week to determine if there are underlying issues related to his external hydrocephalus.

Behavior-wise, he is exactly what we expected.  Mischievous!!  He knows right from wrong in many cases, as evidenced by the smile he gives us when he tell him 'no'.  It's a different smile from the genuine smile we receive when we come into his room in the morning.  He has learned the gentle concept of "time out", which for him is not the same as it is for our daughter.  We do not leave him or sequester him to a part of the house.  Instead, we sit him in the room with us and explain in very simple, repetitive terms.  "No.  No touch.  No.  No throw."  Over and over we use these words and we can tell he is comprehending them.  When told "No throw" he will often put a toy down.  He is also very friendly and loving.  He enjoys being held and rocked.

Verbally, he is non-verbal.  He mimics the intonation of many things we say.  He was non verbal in Bulgaria too.  However ,he has learned the signs for "more" and "help" and we are working on "eat" and "drink" and "me".  He uses the sign "more" very often when bringing us toys or things he wants.  He still reverts to the 'easier' behavior of crying or dragging someone to an object he wants, but he's making good progress.

An interesting thing is how he reacts when Jon comes home and greets me.  If Jon and I embrace in the kitchen and he sees that, he will run from wherever he is and scream and hit us.  He is sometimes quieted when we pick him up and embrace all together.  For a period of time, even this didn't help.  He was very attached to Jon and if I even patted Jon on the arm, he would get very angry.  Some of this is dissipating.  Generally, when we embrace and he gets upset, we pick him up and put him between us, give him kisses and hugs and then Jon and I will kiss each other or hug each other while he is with us.  We like to show him that we all have love for each other, and just because Daddy and I love each other doesn't mean that we don't love him too.  Interestingly he doesn't seem to care if we kiss, hug, or hold Chelsea. It's only the adults (primary caregivers!).

He is able to sleep in his own bed now.  Co-sleeping did not work for us.  Our bed was too small and after a nasty spill, we realized it was just not possible.  Thankfully, he was able to transition to his own bed easily.  He still does not make much noise when he wakes; a sad reminder of his institutional stay.  But he has begun to "bang" a little bit on his crib to alert us.  Of course, we come as soon as possible so he knows that when he cries out, we will be there for him.

He smiles and blows kisses.  He seems to know when we are with him and looks for us, though he will just as easily go with others at this point.  This gives him the impression that he is friendly (and he certainly is!) but also that he does not yet truly "prefer" us and know that we are his Mommy and Daddy, provider of all of his needs.  His eye contact is poor and we have concerns (which we had in Bulgaria also) that he may end up with a diagnosis of autism.  However, he demonstrates some very good skills that give us hope.

Love is not enough in adoption.  It is not enough to love a child when you adopt them.  LOVE IS NOT ENOUGH!  No, children don't "just need love".  They need stability, commitment, resources, and many other things.  PATIENCE, oh dear heavens, patience!  But it is doable and worth it.  He is definitely worth it and overall, after exiting his orphanage just over a month ago, doing as well as anyone would hope.