The skinny!

March 2, 2011

Ok, all. We are in HI, and have internet, and meds, and time, and a sleeping ningning. Here's what's going on:

The doctor who did Sky's well baby exam checked for TB, though Kwaj does not require it that young. Good thing he did though, because it is a large concern. As we were going through the adoption we were hearing that Sky was having appts w/ the doc. We heard they did the TB skin test, but Sky scratched it and screwed up the reading, so the doc was going to do an xray. We didn't need the TB, but figured if they were doing it, why not.

Not 4 hours after the adoption, we were being handed medical results w/ a diagnosis of positive "active TB." To fill everyone in, you can carry TB, and it isn't until you have a compromised immune system that it takes hold. The skin test you've all had w/ the little bubble of stuff they read 3 days or so later is a sensitivity test. It just means if your body reacts to some harmless TB, you've likely been in countact w/ TB and could be a carrier.

When TB goes active, it attacks mainly your lungs, but other organs are possible. It grows in your lungs and when you cough, sneeze or spit (some debate on all that) you can spread it.

So, we immediately got w/ Kwaj docs about what our options are and got the company line of it's your problem, don't come home. Next we went to the doc that diagnosed her and got his take on it. Apparently the skin test wasn't completely scratched off. There was a raised area, and he said it might have been a scratching. The raised area was larger than the US minimum for a positive diagnosis, but less than the international standard.

That doc ordered the xray and saw some stuff in her lungs. BTW, I came down immediately w/ a horrible chest cold...so there's some hope, its just that. TB causes some swelling of the lymph nodes, and Sky could again be diagnosed either way on that count, both in her lungs and neck.

The doc sat there and pretty well told us, look, his diagnosis is CYA and we need to get opinions. He did say she is not contagious (which I would have thought meant active) and that we would be ok to fly as she has no symptoms, i.e coughing.

It had already occured to me, if we're stuck not able to go home for 2 months, then it would be cheaper to go live w/ the folks and better to get American treatment. (Though, I must say I'm impressed w/ the dedicated TB work being done in Majuro.) The catch in that plan was contagion. We worried about getting family sick and taking her on a plane. I wrote to the family: "I'm tempted to bring her home, but I will not be that guy in a Zombie movie who brings his infected wife into the safe area, hiding the bite. You might be tempted to ask how many of my morals come from zombie movies. I would be tempted not to answer."

So next we went to the TB clinic and was told that they can't actually test there for active TB. (Sputum AFB, for those w/ similiar knowledge to Amber) In fact, she's too young to do the normal test, they have to take a sample of her stomach lining since her lungs aren't really big enough to go spewing stuff around. On the positive note, later we met the CDC ladies assigned there who said common thinking these days is that small lungs like that can't even spit out enough infection to be contagious. Anyway, 4 professionals told us we were good to bring her stateside. So we did hastily.

We did start her on 4 different medicines, whether it be prophylactic, or not. I don't know if we'll opt to test her at first, or treat her for a couple of months and then go for the test to make the Kwaj docs happy. I'd prefer to minimize those types of procedures, but more opinions will be forthcoming.

So, all in all, this is a huge hassle, but no more hassle than we signed on for being parents. Our personal mental health is great. We've both had a moment or two where we've had to step back and deal emotionally with this, but the rest of the time we feel this is treatable, surmountable and we really aren't stressing it...which is nice for us who tend to stress things. We're happy to have the chance to go back and see family. We're happy to have so much time to spend with our new little treasure. We feel very blessed that we could be a vehicle to take care of this girl in her time of need, and we feel super blessed to have her join our family.

I will have to wax poetic later on all her wonderfulalities. They are numerous, but I'm tired and all the TB writing took it out of me.

Thank you everyone so much for your support and can't wait to see all!
-d

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