Ella's surgery went well and she's recovering as well as can be expected. I'll write more about that later. For now, I wanted to post an update on Ella from the medical side of things since that part has been a little complicated. I tried to post this the night before we left for the hospital but I wasn't able to upload photos at that time. The first photo is the day after I received Ella, our first full day together, and the second is from Christmas Eve.
Ella’s medical issue was thought to be a brachial plexus injury before we traveled to China but it would take several months once she was here to obtain a definite diagnosis. My info from Bethany had it listed as "left arm deformity." Her medical info in her referral called it "functional limitation of left arm" and "nerve injury of left arm." Two international adoption doctors reviewed her file and agreed that it sounded like she had a BPI but one of them said there was also the slightest chance that she’d had an in utero stroke, a stroke before she was born. She said the overriding factor was that her brain sounded intact and was encouraging about that possibility.
Ella’s medical issue was thought to be a brachial plexus injury before we traveled to China but it would take several months once she was here to obtain a definite diagnosis. My info from Bethany had it listed as "left arm deformity." Her medical info in her referral called it "functional limitation of left arm" and "nerve injury of left arm." Two international adoption doctors reviewed her file and agreed that it sounded like she had a BPI but one of them said there was also the slightest chance that she’d had an in utero stroke, a stroke before she was born. She said the overriding factor was that her brain sounded intact and was encouraging about that possibility.
Within minutes of meeting Ella it was clear that she could use her arm much better than I’d expected. The first time I set her down to walk, however, she was dragging her left leg. Her shoes were way too small and she was wearing jeans and thick quilted pants. Once she had new shoes and wasn’t quite so layered, she was able to walk much better but her leg was significantly bowed. She loved to take off running down the halls in the hotels but would fall almost every time. I’m not sure if she’d ever been able to run like that. By the time we left China she would limp after walking a lot but was able to walk normally.
Ella’s affected arm and leg are both on the left side. The first doctor that examined Ella thought that she may have indeed had an in utero stoke. During the first few months home during appointments and her therapy evaluations things like “hemiplegia” or “mild cerebral palsy” were mentioned, which could be caused by a stroke. There could have been risks involved with these or a cause that was an issue in itself (such as an undiagnosed heart defect or clotting issue). It was important to rule out the stroke to obtain the correct treatment for Ella and to rule out other risks. These things could have been scary but thinking about them in this amazing little girl, MY daughter, made me realize how managable they could be.
Ella’s leg improved tremendously over a period of months so it seemed like maybe the arm and leg issues were unrelated after all. Ella had an MRI of the brain under general anesthesia in September. By this time it was expected to be negative and it was! She was "officially" diagnosed with BPI of her left arm and had an MRI of her shoulders in October. She's had physical therapy and a tendon transfer was recommended by the orthopedic surgeon who has been following Ella for her BPI.
A second orthopedic surgeon at Shriners has been following Ella with her leg issue and is calling it either Blounts disease or simply a nutritional issue. He really can’t explain it for sure. What I was told might require a brace or surgery has healed without any intervention. It can only be attributed to a better diet, well fitting shoes, and a lot of prayers! This has made me realize how much we take for granted. There was the possibility of a leg length discrepancy that could have required a lift in her shoe but the doctor feels it’s so slight that it won’t be necessary. At our last appointment in December her leg had improved about another 8 degrees. I remembered to bring a photo of Ella in China so that they could see the difference. Both Dr. S. and the resident said “Wow.” The nurse said that “someone” must’ve been looking out for us- that’s for sure! ;)
I'm thankful for the way that God has worked things out and what He's shown me along the way. There are always a lot of unknowns in international adoption and special needs adoption. There are lots of leaps of faith. Ella is from an orphanage that only does special needs adoptions internationally- this was the only way I would've found her! I recently saw a video of a child available for adoption with my agency that has left hemiplegia and I can see why there was concern that Ella had this. I'm thankful that the Chinese doctor who examined her in China didn't see what the American doctor saw here. She might have been given a different diagnosis in China and I wouldn't have been matched with her. Almost two years ago I declined the possible referral of a little girl with mild CP because I thought that might be something that I couldn't handle as a single person, even as a nurse... I certainly didn't forget that when I heard those words mentioned about Ella.... and I was thankful that God knows better than I! In the end the diagnosis was what I'd hoped and prayed for... but if it hadn't been, then that would've been OK too. I wouldn't want to have missed out on my Ella Qin Qin for anything.
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