In early January 2006 I walked out of a meeting and noticed I had a voice mail message. It was from the agency director. "Aimee, call me back when you get this". Saturday afternoon, hmmmm, her voice didn't sound celebratory and we weren't due for any case updates. I had a sinking feeling in my gut. I returned the call. "Aimee, there is a medical concern with Lucia that I want to talk to you about". Adrenaline kicked in as I desperately tried to listen carefully and write down all the details. There wasn't much to go on. The foster mother noticed that the baby had uneven gluteal folds. What? Apparently our fabulous, on the ball, foster mother had experience with this condition before. She brought it to the pediatrician's attention and now the agency was calling me. Fortunately I was scheduled to leave in a week to visit Ana Lucia in Guatemala. She was going to come and stay with me at my hotel in Guatemala City for four glorious days. I now had a few days to do some research, make some calls to physicians here in the US, and make an action plan for how this baby could best be diagnosed and the situation addressed. I kicked in to high gear. For any of you who know me - are you surprised? ;)
I took the worst possible action on that Saturday evening. I turned to the internet and began researching "uneven gluteal fold". Basically I learned this can be a sign of hip dysplasia. Ok, I was getting somewhere. However, everything I read stated that if a baby had hip dysplasia it should be addressed as early as possible. The possible treatment ranged from possibly wearing a brace to hip surgery. The surgery was most successful if completed before six months of age. The truth is, if my baby needed hip surgery, I did NOT want it completed in Guatemala. I called our pediatrician, he called a pediatric orthopaedist friend of his, and they concluded it would be beneficial for me to get either X-rays or ultrasound of her hips. At this point I didn't know if this involved both of her hips, if she was in pain, or really any details. Thank goodness I was headed to be with my sweet baby in just a few days.
As I arrived in Guatemala for the visit trip I headed to my hotel from the airport. Shortly after my arrival Pedro arrived with Ana Lucia and her foster mother. We went over some instructions regarding her care from the foster mother and headed directly to the pediatrician. I was armed with a list of questions from my pediatrician and the motivation to be this little girl's advocate without being the demanding American. I was walking a tightrope. The developing-nation physician recommended putting two diapers at a time on her and exercises. As a side, this is the exact way the situation was handled in the United States years and years and years ago. I thanked him for his attention to the baby and his obvious attention to detail. I then took the easy way out and communicated that the pediatrician I consulted back in the states asked if it was possible to get X-rays or ultrasound of her hips. I didn't demand it - I just used the American doctor as my excuse. Wanting to prove to the American doctor that he was willing and able to meet American standards the pediatrician quickly agreed to send Ana Lucia to the "best" orthopaedic physician in Guatemala City. Yeah!
I spent the next few days cuddling Ana Lucia and getting to know her. It was heaven on earth. It was also comforting for me to observe that she was not in any pain. As a funny side note, when Ana Lucia's foster mother brought her to me at the hotel, she undressed her to show me some details I should be aware of. First of all, Ana Lucia had an umbilical hernia. It looked horrible. The foster mother wrapped a band around her body to hold the hernia in and I needed to do the same. Now, around the band (which was actually a simple hair scarf folded) was a red bag attached. The foster mother informed me it was to protect the baby and give her good luck! After she left Pedro let me know that the foster mother was very superstitious and possessed some old Mayan beliefs. Truth is, the red bag was probably to protect the baby against the crazy American woman coming to take care of her for 4 days! The bag contained some herbs...I think. ;)
At the end of the visit I returned home and Ana Lucia returned to her foster family. She was taken to the orthopaedist. It was determined only one of her hips was affected and she was placed in a brace which she had to wear 23 hours/day. It wasn't until she was home in the United States that it was determined the Guatemalan doctors had made a wise choice in treating her and she would NOT require surgery. She had to have her hips checked every 3 months for her first two years home and now has been given a clean bill of health. Thank you God! She may always have a bit of a wobbly gait, but otherwise we expect no problems.
It was very difficult to be separated during a period of medical uncertainty. Once again we were reminded that God is in control. No matter the outcome she was still destined to be our daughter. If we had brought her home and she had to go right in to surgery we would have done so. Uneven gluteal folds - I can just about guarantee you I would not have detected this. Our foster mother rocks - red mysterious bag beliefs and all!
Sweet baby girl
Pink hernia band and red mysterious bag!
Sleeping angel
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