Rachel is fully recovered from her surgeries and doing extremely well!

Rachel is completely healed from her de-tethering surgeries.  She has started Physical Therapy to improve her balance and stability when standing, walking, and running (a by-product of her scoliosis).

Dr. Mapstone referred her to a pediatric urologist as a precautionary measure (to make sure that she is able to properly empty her bladder).

Several weeks ago, Rachel started using the potty by herself.  Since then, she has been successful with that about 95% of the time.

Rachel is home again!

Rachel came home Friday afternoon. Today is Sunday. The place where her lumbar drain exited her back has remained dry. She goes back to Children's Hospital on Tuesday to get some of her stitches removed.

Please pray for her continued healing.

Updated update

Steve is with Rachel right now and just now called and said that they are moving everything up to now.  I am not sure why, but I am glad.  So they are getting ready to take the drain out, do a pressure test, and do a ct scan under sedation.   Please pray it goes well and her body is healed, and healing. 

Still in the hospital ...

UPDATE (Wednesday morning):

There has not been any observed leakage of cerebral spinal fluid (CSF) through the incision since they installed the lumbar drain 7 days ago.  This is good and we are hopeful that the incision from the initial surgery has been able to fully heal as a result.  However, there has been some CSF leakage at the point where the drain itself exits Rachel's lower back.

The most recent plan (as of Wednesday morning) is to remove the lumbar drain on Thursday, then wait an additional day or two to make sure there is no CSF leakage through the incision or the drain site before allowing Rachel to go home.


Please pray for no more leakage today, tonight, and after they take the drain out.  Please pray for the normal process of csf re-absorption to happen.  Please pray for wisdom for us and for the doctors.  Also, please continue to pray for peace of mind, traveling mercies, and efficient and restful sleep as we juggle having one of us at the hospital 24/7 with Rachel and the other trying to keep things halfway sane at home.  We are so thankful for Sarah's brothers and their families helping us and for several people at church who brought meals.  It has helped so much! 

Rachel is still in good spirits, but tired of being at the hospital ...

All the nurses have fallen in love with Rachel and her sweet personality.  She is doing well, especially considering how active she likes to be and the fact that she can't get out of bed and run around because of the CSF drain.

They initially were draining off 20 cc of CSF every hour.  They dropped that down to 15 and also started adjusting the height of the drain outlet relative to her body so they could slowly but continually drain off 15 cc per hour rather than draining it down all at once each hour.

Today (Saturday) she had some CSF in her bandages around the incision, so they are going to increase the target drainage output from 15 to 17 cc per hour.

Also, Dr. Mapstone mentioned a couple days ago that they want to do a pressure study wherein they monitor and record her internal CSF pressures over time.  That will require her spending a day in ICU.  We are guessing that might happen Monday or Tuesday.

Yesterday (Friday) morning, Sarah's brother Michael was sitting with Rachel while Sarah and Steve were transitioning a switch in responsibilities for the day (Sarah going Stillwater, Steve staying at the hospital).  Rachel had a dirty diaper that got her pants dirty.  After Michael changed her diaper and started to put clean pants on her, Rachel started screaming "buckey, buckey" and pointing at her diaper.  Finally, frustrated by Rachel's persistent and loud exclamations, Michael called Sarah for an interpretation of what "buckey" might mean.  Sarah informed Michael that "buckey" means "pockets".  Rachel sometimes fusses over wanting to wear pants with pockets.

Later in the day, she decided to take off her pink shorts (with pockets) and wear them on her head:

Surgery went well ... Rachel is resting.

After the surgery, the neurosurgeon said that they found a hole in the dura (the outer covering of the spinal cord).  They are fairly confident that her problem is related to overproduction and under-absorption of cerebral spinal fluid (CSF) and that her body just needs time to adjust.  They decided to use the existing hole in the dura as the temporary drain site, but snaked the drain though intact muscle tissue so they can remove it without creating another incision.

So, she is back in her regular hospital room and resting.  The valve on the drain line has to be opened hourly to allow the excess CSF to drain out (about 20 cc per hour).  Now it is just a waiting game -- waiting for her incision to heal and for her body to reach equilibrium in terms of CSF production and absorption.

Dr. Mapstone had previously mentioned a possible connection between her tethered cord and the enlarged ventricles in her brain -- due to the cord pulling down on the base of the brain and not allowing the CSF to flow freely, thus requiring her body to produce excess CSF in the brain in order to force enough CSF into her spinal cord.

It is possible that the release of the tether freed up some of that restricted flow (which, if so, would be a good thing), but that her body is still producing extra CSF and has not yet recognized that it is okay to slow down production.  This is all conjecture, but seems to be a plausible explanation.

Please pray for her body to quickly reach proper equilibrium in this area of CSF production, transport, and absorption, and that once she becomes more active, she will be able be mobile without damaging the drain location.

Also, all the boys start school this week and next, so please pray that we are able to coordinate all that needs to happen to get them started off well.

Surgery tomorrow (Wednesday), then another week in the hospital ...

It's not as bad as it sounds, but it looks like Rachel will be spending another week here at Children's Hospital.

Her incision is still leaking cerebral spinal fluid (CSF) and the neurosurgery team has decided the best course of action is to re-open the incision first thing tomorrow (Wednesday) morning to find and fix the leak and also to install a temporary drain in her back.  The drain will allow any excess CSF to leave in a controlled way so that it will not be trying to exit the incision.  That will give the incision a much better opportunity to heal.  It also means that she will not be restricted to staying horizontal -- a huge plus.

Dr. Mapstone said that the recovery from this surgery will be much easier than the surgeries two weeks ago.  We are hoping that she will be able to stay in a regular room after the surgery and not have to spend time in ICU.

She has to stay in the hospital until they are able to remove the drain (then probably another day to monitor the healing process at the drain site).  So that's why we are expecting her to be here another week or so.

Rachel is in good spirits and is being well taken care of here.  We are so-o-o-o thankful that there are no signs of infection.  At this point, the doctors are just trying to clear away the obstacles that are keeping her body from performing the normal healing process that God so amazingly designed into it.

At least 3 more days in the hospital ...

UPDATE (Monday evening):

The doctors came in early this morning and saw a small amount of fluid leaking out of Rachel's incision.  Later in the morning, as the neurosurgeon started pressing around the incision site, quite a bit of additional fluid came out.

Although the fluid was clear, they were concerned about a possible infection.  So, they ordered a CT scan of her head and spine and decided to keep her NPO (no food or water) in case they needed to do emergency surgery.  Getting a CT scan of her head was a major ordeal for her.  It took two separate trips to the scanner.  During the first attempt, she would not stay still enough, even though she was highly medicated.  So, they had to try again later using conscious sedation, and that worked.

The results of the CT scan showed no obvious signs of infection and thus no need for emergency surgery.  Once she was able to have food and drink again, she was mostly calm and peaceful.  She finally fell asleep around 18:30 (after being up since 5:30).

They have tentatively scheduled her for surgery for Wednesday, in the event that the incision does not stop leaking before then.  They are hoping to stop the external leaking by physical means (they added a couple additional sutures and have applied a pressure bandage and are "requiring" that she stay horizontal as much as possible) so that natural healing can take place on the inside.  If her body isn't able to shut down the leak on its own, they will reopen the wound to try to find the exact location of the problem to attempt to fix it.

Apparently, the brain and spinal cord rely on a fairly complex fluid flow system involving the production of cerebral spinal fluid in the brain, transport of the fluid through ventricles in the brain and along the spinal cord, and absorption of the fluid into the surrounding tissues -- with the body regulating those three subsystems to keep them all in balance.

The neurosurgeon said that she might be experiencing excess fluid pressure as her body attempts to adjust to the changes associated with the dethering.  If the leak does not stop on its own and if it cannot be stopped by reopening the incision, she might need a temporary shunt (in the back of her head) to reduce the fluid pressure, to stop the fluid from wanting to escape through the incision, to allow the incision to properly heal.  If they have to go that route, there is also a risk that the shunt might need to be permanent.

Quick update ...

UPDATE (Sunday evening):  Rachel's incision was leaking again this morning (with a yellowish tint to the fluid this time) and she was running a fever.  The neurosurgeon was concerned about infection, so they started her on IV antibiotics.

The incision did not seem to leak at all throughout the rest of the day, though.  Our understanding right now is that she needs to be leak-free and fever-free for 24 hours before they will let her go home.

Rachel is in good spirits, but she is once again saying she wants to go "bye" (go home).  She did have the IV in her hand go bad today; getting a new IV started was a traumatic event for her.

Thank you for your continued prayers!

Home for a week ... then back to the hospital.

Rachel was moved from ICU to a normal room around noon last Friday (8/1).  She was doing so well, that they discharged her the next morning.

She had a good week at home.  She rarely complained of any pain or discomfort.  She was pretty much normal, sporting her infectious smile most of the time.  The only medication she needed was ibuprofen a couple times per day.  We did let her spend extra time just lying around watching movies (she watched Lady and the Tramp what seems like 15-20 times).

Yesterday (Friday) afternoon, however, she had a slight fever and was kind of mopey.  Sarah took her to the walk-in clinic to see if she might need antibiotics.  The PA at the clinic would not prescribe any antibiotics without first getting a urine sample, so they sent her home with a cup to collect a urine specimen to bring back in the morning.

This morning, Sarah noticed that the lowest portion of Rachel's incision (just below the waistline) was leaking clear fluid (cerebral spinal fluid, CSF).  So, instead of going back to the walk-in clinic, Sarah took Rachel to the ER at Children's Hospital in OKC.  The neurosurgeon there said they need to re-suture the place where it is leaking, keep her overnight, then see if that stops the CSF leak.

So, this afternoon they gave her a Lidocaine shot, then put in a couple extra stitches.  Other than the initial pain of the shot, she got the new stitches without incident and the external leaking has stopped for now.

Please join us in praying for God to heal her at the source of the leak.

Recovering in ICU, trying to rest and be calm ...

Thank you everyone for praying for us!  Right now Rachel is resting and has eaten half a container of yogurt and drank a lot of apple juice throughout the day.  We are in ICU so that they can manage her pain and keep her sedated, primarily because she is supposed to lie flat for the first 48 hours -- to limit the buildup of too much internal fluid pressure at the incision locations (as her body works to replace the spinal fluid lost during surgery and also to heal the incisions).

After the surgery this morning, Dr. Mapstone said that both surgeries went very well.

Also, they were using a special monitoring system throughout the procedures wherein a neurologist remotely monitors her synaptic responses.  This helps alert the neurosurgeon if he starts getting too close to any nerves.  Dr. Mapstone said that Rachel's synaptic responses were better after the surgery than they were before.  This means that her spinal cord was indeed being stretched and stressed by the tethering and that she would almost certainly have experienced long-term nerve damage without the procedures.

We thank God for his watch-care over this precious girl and for allowing us to witness firsthand His grace and mercy over her!

Please continue to pray for peace and rest.  Each time she wakes up, she is agitated and anxious and upset.  She just doesn't like having so many restrictions.  Thankfully the night nurse let us take off one arm restrictor around her iv.  We just put gauze around it, so she had more movement.

Update Wednesday morning:  She has been awake a couple of times since about 3 and she is remarkably less angry.  She is not smiling yet, but she ate more yogurt and talked to me more like her normal self.

The next step

It has been a long time since I have updated the blog.......I guess we have been a little busy!  I have been constantly thinking of things to add, but haven't had a chance to actually write them down!

Rachel is doing so well in so many ways and we are so thankful to have her as a part of our family.  I can't imagine not having her with us.

She loves to hang with her brothers! 

 
And she loves loves loves to play in the water.  Every day she asks to go out to play in the pool.

On the more serious side of things, yesterday we had an appointment with Rachel's neurosurgeon, Dr. Mapstone.  This was our first appointment with him after having an MRI of her spine and brain, and a CT of her thoracic spine (all of which was done 3 weeks ago....).  They never called with the results (which they said they would) and the first thing Dr. Mapstone said when we sat down with him was that her situation was too complicated to discuss over the phone (Ahhhhh!).

So, basically he talked about four different problems she has.

The first is that she has enlarged ventricles in her brain (due to spinal fluid not draining properly), but that everything seems stable.  He described it like a clogged bathtub that lets some water out, where the water going in and water going out has reached equilibrium, but the water never drains all the way out.  So, he does not believe we need to address that issue right now.  He basically said that as long as she doesn't show any symptoms of pressure building up (headaches, learning difficulties, etc.), then no intervention is necessary.

Second, she might have a chiari malformation (this is not confirmed, just suspected; he said the images weren't clear enough for a definitive diagnosis; but this could be the reason for the spinal fluid not draining properly).   This is basically a problem with the way the brain is connected to the spinal column; the brain is sitting down in that funnel too low.  Or it is being pulled down.  (When I looked up chiari malformation, there were different types; the doctor did not tell us what type it might be).

The third issue deals with the location of the scar on her back.  (Actually, this is two separate issues; one being bone related, which we learned about a couple months ago from x-rays and meeting with a pediatric orthopedic surgeon, the other being spinal cord related, which we just learned about).  This is in the thoracic (upper back) region.  The MRI showed that, at that location, her spinal cord divides into two, then it comes back together again below it.  (I have no words for this.........other than I believe God has protected her.)  Dr. Mapstone believes that her spinal cord might be tethered or "hung up" with scar tissue or adhesions in this area.  Surgery is required to release the tether.  Without surgery, there is a 50% likelihood that she will suffer permanent nerve damage as she grows (due to the spinal cord stretching rather than moving freely).

The fourth issue is that her spinal cord also seems to be tethered at the lower end of her spine.  This also will require surgery.  The dangers of not addressing this problem are the same as above.

So we have both surgeries planned for Wednesday, July 30.  Dr. Mapstone will release the tethered cord, both locations, in one day.  He will start with releasing the lower portion (which he said is the easier of the two), then as long as everything is going well, release the thoracic portion as well.  (There is a possibility that Problems 1 and 2 might be due to the spinal cord pulling down at the base of her neck, due to the tethering.  If this is the case, then the surgeries might alleviate those problems.)  The combined surgeries will last about 3 hours, and she will be in ICU for 1 day and then probably 3 days in a hospital room.  She will have to stay on her back or stomach for the first 48 hours.  (Then, at home, she is not supposed to be overly active for 4 weeks......hmmmm).

So this feels like a bigger deal than we were hoping for.....although we had discussed all of these possibilities.  It just seemed that because she is doing so well, that I was hoping there would need to be only minimal intervention, if any.  And, it does seem difficult for her to have to endure this surgery, when she is doing so well physically and developmentally; but, Dr. Mapstone said that if we do not do anything, she will progressively get much worse, maybe even being wheelchair bound eventually.

We still don't know exactly what the scar on her back is from.  He said maybe they just removed some cartilage, or fatty tissue, or maybe it was a repaired meningocele (which was the diagnosis given by the orphanage physician), we just don't know.   

We are so thankful that we got her when we did -- a year later and she might have had nerve damage that was permanent (or more damage, we still do not know if she is going to have ongoing deficits).

We are so thankful for her!  She is so endearing and charming.  I am praying the hospital staff gets to see that side of her personality, not just the mad, "stop restraining me" side.

I have also gone from being a little mad at the orphanage because they did not seem to have fed her well enough, to now being very thankful that she is still so small.  Growing is what would make this tethered cord problem get worse, so God was protecting her by keeping her small. 

We are thankful we are at a location where the care she needs is only 1 hour away (and at a hospital campus where I used to work).   The travel part does not seem hard.  And I feel that it is a good children's hospital.

So I am still processing all this and will probably have a few freak-out moments over the next month, but I am mostly thankful.

Sarah

Our final day in China and the long trip home.

So it turns out that I am not very good at updating everyday on the blog.  But I did want to write down a few things, partly to remind me of things and partly to help others to know what to expect. 

Thursday we stayed at the hotel to pack and rest and for Silas to work on homework.  We had to wait for the babies' visas to arrive about 4:30 pm.  Thankfully our guide was able to get us a late check out so we did not have to wait around from noon until 4:30 in the hotel lobby.  At the right time we all met in the lobby, said goodbye to each other and the guides, received our visa and immigration package, and loaded up in our own private, nice, new minivan.  We were on the road by 4:45.  The driver must live in Hong Kong because his steering wheel was on the right side of the van.  It was a quiet ride. 

After a couple of hours we got out at the customs building.  We had to get out and go through the building on foot and meet the driver on the other side.  The agent at our line kept looking at me and at my passport picture.  I was starting to get nervous, trying to think what they could do with me and 2 kids.  She called another person over, who also kept looking at me.  They talked a little, and I got more nervous.  She finally asked me if I had any other documentation. Thankfully I had my wallet with my drivers license in it.  She looked hard at it and finally decided it was ok and let me go.  We met the driver on the other side and continued on about another 1 hour to the hotel.

On the ride to Hong Kong, I was struck by how many people live in this country, more than a billion, and I get to take this one little person home with me.  I do think it is a miracle that God put us together so that Steve and I get to be her parents.  How could we have found this one precious little soul in the midst of masses of people?  I was feeling so thankful and overwhelmed. 

The next morning we went plenty early to the airport which is connected to the hotel.  I was glad we had plenty of time because it is a huge building and we had to wait in line to check in, and then through security, and then again through customs.  The airport is a mall too.  There were dozens of shops.  I succumbed to a Piglet purchase from the Disney store. 

Our plane left late.  But we had a full night's sleep at that point so we were doing ok.  And I was so impressed with the staff at the airline.  They took the initiative to come tell us that we were leaving late and also came to me to ask to help me get the stroller packed up for the flight.  They also came and invited me to board ahead of the long line. 

The very long trip home does not need to be written about.  I have no meaningful advice I can give.  I would rather give birth multiple times rather than repeat that ordeal.  Rachel hates seatbelts and confinement and she and I both got super tired before it was over. 

Then we had issues with flights leaving Chicago, but we made it.  I was very thankful for a 5 minute visit with a family from our adoption group that we happened to see in the Chicago airport (even though they had left from Beijing and we left from Hong Kong).  I needed that hug! 

As expected (see seatbelt comment above) Rachel did not appreciate the safety of the car seat.  She screamed until we stopped at McDonald's and got her some ice cream.  Then she was ok until about 10 minutes before home.

I will save the home blog for another day, hopefully tomorrow.  We are doing well. 

We're finally home!

Glad to be home.  Now it's time to figure out our new normal.

Rachel has been smiling at Caleb (her 16-month-old brother) and her cats (Snickers and Abby) and her dogs (Cali and Haley).

Now it's time to try to get some much-needed rest!

Headed home!

We are at the Hong Kong airport.  Our bags have been checked.  We made it through customs and security.  We are at the gate waiting to board our flight home to the U.S.

UPDATE #1:  The flight left Hong Kong an hour and twenty minutes late.  Sarah, Rachel, and Silas are en-route to Chicago, but they will only have about an hour to get through customs and immigration and then catch their connecting flight.  Please pray for some restful sleep on the long flight and that everything goes smoothly through customs and immigration.

UPDATE #2:  The connecting flight from Chicago to OKC was canceled.  (Wouldn't have made the connection anyway because it took so long to get bags from baggage claim before going through customs.)  Then the next flight to OKC was canceled.  We finally (after hours on the phone and/or waiting on hold with reservations agents) got them booked on a different airline.  The flight is supposed to leave at 20:10 and get in at 22:25.

UPDATE #3:  Got on the 20:10 flight.  Plane left the gate about 30 minutes late.  Should arrive OKC around 22:45.

Final days in Guangzhou: Shaiman Island, toy mall, riverboat cruise, consulate appointment, and a walk in the park ...

Travel tip: Some families have great wifi in their hotel rooms, but mine is spotty.  I discovered if I stand in the doorway of our room or out in the hallway, it works really well most of the time.

As Silas has already said, on Monday we went to White Cloud Mountain.  It had a paved road going gently up the mountain and there were many local people there out walking.  The students were on a break for the upcoming spring festival (Chinese New Year), so there were quite a few students walking in groups being silly, pushing and teasing each other, just like our students.  There were also a lot of older people walking and some were dancing together in some of the little areas off the main road.  It is so nice to see the retired people out doing community activities and exercising.

The weather was perfect for the walk.  Rachel fell asleep in the stroller for most of the way up.  This is a tropical region, so there was an abundance of trees and flowers.  It was lovely.

We spent the afternoon in the hotel again.  That afternoon Rachel had a fever so we stayed in for the rest of the day.

Tuesday we went to Shaiman Island which was an English and French Concession.  I don't exactly know what that means, and am too lazy to look it up right now, but basically I think it was under English and French control.  It has western architecture and was interesting to walk around.  This is where the famous White Swan hotel is, where many adoptive families in the past have stayed.  The consulate used to be there but moved a few years ago.  This is also where the famous statue is with the children walking behind each other.  Again, the weather was perfect for this outing.

We also spent about an hour at the "International Toy Wholesaler."  This was another large mall, about 6 stories tall.  The stores are little, more like booths, and just packed next to each other.  Sometimes you could not even walk down the aisle because the store had boxes and packing material and products out.  It was a whole mall of stores that were all like the little carts we have in the middle of the walkways at our malls.  There were cell phone cases, toys, novelties, clocks, purses, glittery things.  (Travelers tip: there were some inappropriate things, so don't let kids go off on their own!)  I hear that the higher up you went the nicer things are.  We only made it to the 2nd floor but found gifts for the boys back home.

Tuesday evening we went on a beautiful dinner cruise on the Pearl River.  The dinner was good, the view of the city was spectacular.  The city lights up all the bridges with colorful lights in addition to all of the tall, lit-up buildings.  There was also a performer who was like a clown.  She juggled oranges and knives, spun a soccer ball on peoples fingers and in general acted silly.  See Silas' blog post for more pix.

This morning (Wednesday) we had our very important consulate appointment.  I got teary eyed when we walked up to the building and saw lines of people waiting to get in.  We did not have to wait in that line, though, because we had an appointment.  I was just so grateful to be so blessed to belong to this country.  And the babies our group had with us are so blessed to get to come to the U.S.  (There are just so many left behind......).  I am not saying my family is particularly special, but just that so many people want to come to the U.S., and these few get to.  We truly have a great country.   Anyway, that appointment went well, and we took an oath on behalf of our children.  They will become citizens when we land on the ground in the U.S.

We are now just waiting on Rachel's visa, which we will get tomorrow (Thursday) afternoon.  As soon as we get it, we and another family who has been with us the whole time will travel by bus 4 hours to Hong Kong.  We will spend the night there in a hotel and get on the plane about 11:45 am Friday morning and land in the U.S. about 12:20 pm Friday afternoon (35 minutes later on the same day).  There are a lot of hours in between though (with the 14-hour time change)!  We are flying through Chicago, then we arrive in OKC late Friday afternoon.  Praying for good weather for all of this!  I am ready to get home and start figuring out our new normal.

Rachel has had a fever on and off.  Thankfully my pediatrician let me take some antibiotics just in case, so I have been giving them to her.  When she is happy, she is so fun.  We went for a walk in the park this afternoon and she was walking around watering the plants with her sippy cup.   It was so cute!  But right now she is tired, and doesn't feel good, so she is fussy.

She definitely is preferring me to everyone else.  She doesn't mind having others around, but she holds her arms up to me if she wants something.  Sometimes she lets me kiss her head, other times she lets me, but then she wipes them off.  However, I still have a hard time comforting her when she is upset.

I can't believe we have had her a week and a half already!  Thanks for praying for us, we are doing well.

Silas: A riverboat ride along the Pearl River at night!

Tuesday night, we went on a night cruise on the Pearl River here in Guangzhou.  Each of the bridges there were lit up with different colored lights.  For the dinner on the cruise we had rice and cookies and duck and chicken and other stuff.  We had an entertainer that had balloons in her hair.  She juggled oranges and knives and did cool stuff with a soccer ball.  There were also a lot of buildings with a bunch of lights along the river.  The best one was a giant tower called the TV tower with colorful rainbow lights going around.

The riverboat we road on.

One of the many colorful bridges we went under.

Live entertainment!

TV Tower

Silas: A souvernir mall and a river island in Guangzhou

Tuesday, we went to a mall with toys, games, jewelry, phone cases, small plants, and even head bands.  We got my brothers souvenirs, too.  There were a lot of people selling horses because it is the year of the horse. We ate dumplings, rice, cake, spring roles, etc. at a Cantonese restaurant.

We also went to an island on the Pearl River called the Shamion Island.  I played badminton with a short elderly Chinese man on the island.  There were a lot of statues of people on the island.

Silas: A temple/museum in Guangzhou and White Cloud mountain ...

Sunday, we went to a temple.  The decor is very awesome.  There were a lot of shops there.  The temple is also a museum.  I got a crystal bead like thing that is about 1 inch in diameter with a dragon and my name on it.  We also got to see someone paint a hand painting with only his hand, not even a small brush, just his hand.

Monday, we climbed White Cloud mountain.  I went up to the very top of the mountain with another family.  There was a lot stuff at the top of the mountain.  We even got to see a dragon dance.  My mom didn't go all the way to the top even though she was close so she didn't get to see the dragon dance.

Silas: The museum and beef noodles in Lanzhou, and Traveling to Guangzhou

On Thursday, we went to the Lanzhou museum.  There were dinosaur bones, Buddhist art, and pottery that we saw.  My favorite thing was the dinosaur stuff.  My favorite part was the elephant bones.  The elephant bones are said to be the best preserved skeleton in the world.  They found the bones near the Yellow River in the sand dunes. The skeleton is about twice as large as a normal African elephant.

The main dish is beef noodles in Lanzhou.  The noodles are very skinny.  You usually only get one slice of beef, though.  The broth that the noodles are in is very soupy and brown and it is clear not creamy.  They eat it any meal including breakfast.

The flight to Guangzhou on Friday was about 3 hours long.  It was a normal airplane without TVs.  It seated about 250 people.  It took an hour just to get from the hotel to the airport in Lanzhou.  It took an hour after we got to the airport in Guangzhou to get to our hotel there.  So it took a total of about 6 hrs.

Guangzhou has about 13,000,000 people in it.  A lot of people here speak English.  They speak Cantonese as their main language here.  In Lanzhou it was a desert.  In Guangzhou it's a tropical place and it is very warm.

Packing list (for future travelers) ...

This post is more for those coming behind me than for people just keeping up with our trip.

This is a list of things I am glad I have with me and also things I wish I had brought.

Things I'm glad I brought with me:

• snacks!
• keyboard for the iPad
• crystal light packets (I ran out after 3 days, though)
• vpn number (can't access the blog or facebook without it)
• did I say snacks!
• a fels-naptha laundry bar of soap
• toys (bubbles, books, crayons, travel doodle pro)
• cash (not able to use a credit card as much as I thought)
• hot chocolate packets
• Skype and FaceTime on the iPhone and iPad
• AT&T Global Data plan. (Steve set this up for me before I left.  The cost is $30 for every 120 MB of data we use.  When we talk via FaceTime audio, it uses about 0.5 MB/min, or about $0.12/min.  FaceTime video uses about 2 MB/min, or about $0.60/min.  We can use Skype or FaceTime for free whenever we have good wifi, but being able to switch to cellular data when the wifi is slow has been a big help.  In fact, Steve and boys back home would have missed out on Gotcha Day without it, because we weren't able to get connected to the hotel's wifi service beforehand.  This has also allowed us to exchange iMessages at very little cost, no matter where I am.)

Things I bought here:

• dish soap
• more snacks
• diapers (there are diapers here, even pampers and huggies, but they are not cheap)
• a fork
• a knife
• chopsticks for the room
• water bottles for the room.

I thought I would be able to buy a stroller cheaply if I needed one, but the cheapest one was about 50 or 60 U.S. dollars, and it was not a style that I would use at home.  The hotel in Lanzhou did have one to borrow (actually our guide borrowed it from somewhere.)  And the hotel in Guangzhou has one we can rent for about 3 to 4 U.S. dollars per day.  I ended up taking Amanda's, she is such a good friend!  I really ended up needing one, because Rachel does so well riding in one.  I have an ergo also, and it works with her on my back, but it is difficult to get her into it.  So we have been using the stroller mostly.  Other families are using carriers more, I think it just depends on the momma and the baby and their preferences.  I think it might be worth it to bring one from home even though it is an added difficulty on the plane rides.

What I wish I had:

• actually, more snacks that could be meals, like protein bars or pb crackers
• sharpie to mark whose open water bottle is whose
• a hobby, like knitting
• snow-pants for Rachel. I brought a heavy coat for Rachel, but I wished I had warmer snow-pants type things for her in Lanzhou.  It was very cold there and I really did get yelled at by the grandmas in the park.  (I live in Oklahoma, we don't buy snow pants unless we are planning a trip to the Rocky Mountains to go snow-skiing...)
• I wish I would have downloaded more movies or entertainment for Silas on the iPad and iPhone.  I assumed we would be able to stream shows or download additional videos from iTunes or ultraviolet once we had access to wifi, but the wifi was just too slow at our hotel in Lanzhou and also there was a restriction on video downloads once we were outside of the U.S.

Hanging out in Guangzhou: Breakfast at the hotel, the temple/museum, the mall, the park ...

Today (Sunday) has been a pretty good day.  We started out at our giant breakfast buffet.  I have found what she loves to eat, congee, which is basically soupy rice, I think.  It is thinner than oatmeal, like almost watery.  When I give her a piece of bread or bun or muffin or anything, she puts it in the congee to soak.  Then she likes to eat it.  I saw some adults doing this in Lanzhou, so I think they must have done that in the orphanage.  Breakfast is where she eats the most, all soaked in congee.

Then our group loaded in the bus for a temple visit.  It was a museum that had all kinds of amazing carvings in all different forms, ivory, wood, and a paper-mâché type design.  They had painting demonstrations, some very impressive silk embroidery, and calligraphy.  It is so amazing how skilled and meticulous they are!

Rachel did very well riding in the stroller.  As long as she has a snack in her hand, she is basically happy.

Then we went to a 5 or 6 story mall filled with jewelry wholesalers.  I bought some pearls for Rachel for later.  There were children in this mall riding scooters and rip sticks and little kids riding toys right in the mall.  I guess this is what happens when everyone lives in apartments and no one has yards or suburban streets.

We spent the afternoon in the hotel room with Silas working on homework and me just hanging out with Rachel and reading.  We did go down to the park that the hotel has and, let me tell you, Rachel is fearless and she likes to have fun!  She did not shy away from the play area and went on the slide and the swing like she had been doing it all her life.  She loved it and of course Silas played with her.  She just giggled and laughed and had a great time.  It is even more impressive because when we got to the room I thought she felt warm, and she did have a fever.  She certainly did not let it slow her down.  So she fell asleep drinking her bottle and is sleeping.  I am really hoping and praying that this fever is just some weird transient thing, because we are supposed to go see a mountain tomorrow.  I get a little restless being in the hotel room all day, I don't want to miss the mountain visit!

Did I mention that she has been wearing only orphanage clothes for the last several days?  She will not let me take them off.  But they were filthy after today's outing where she fell down several times on the very dirty ground.  She found her other orphanage shirt in the drawer, so she let me take the dirty shirt off to wash it.  Then her pants got wet, so I washed them too.  So it feels like a victory that she is at least wearing something different, but she still is not wearing the very cute pink things I brought.  Someone at the play area thought she was a boy :(.

Two seemingly small, but very enouraging, occurrences during our first full day in Guangzhou

Yesterday (Saturday) a couple of very encouraging things happened.

The first, we were getting ready to go out walking around and I told Silas to get his shoes on and to find Rachel's shoes.  I did not look at the shoes or point to them or anything and a minute later Rachel brought me her own shoes.  Maybe she saw Silas putting his on but either way, there was communication there.

Also, she was upset at bedtime, pretty upset, but when she started calming down, she let me hold her and give her a bottle and a banana.  She was very relaxed in my arms.  She has always let me hold her, but doesn't usually relax enough to fall asleep, and she did last night.  And then she let me lay her down in her crib and she stayed asleep all night.

Some details about our final day in Lanzhou and the trip to Guangzhou

Well, I will try to catch up and describe what and how we have been doing.   On Thursday morning we went to a museum in Lanzhou.  It was a very nicely done, modern museum with exhibits about dinosaur bones found in the province, Buddhist art and history, and relics from the Silk Road.

After the museum we had beef noodles at a nice little restaurant.  It is interesting that the restaurants have like only 4-5 tables in them.  The beef noodles are long skinny noodles like spaghetti only thinner and longer.  At this restaurant they were in a beef broth soup with one piece of beef in the soup.  They also brought out several different plates of different vegetables to add to the soup.  They also serve this for breakfast at the hotel.  I had it once for breakfast, very yummy.  These beef noodles are the famous food for the Lanzhou region.

Thursday morning we saw the first of Rachel expressing her own opinion.  When we were leaving breakfast she was not ready, so she cried a little.  Amanda and I were so surprised by the tears welling up in her eyes and spilling over onto her cute little cheeks that we tried to take a picture, we missed it though.  I was so glad that she finally expressed some opinion.  She seemed to finally trust us enough to tell us what she liked and didn't like.

Those tears were just the beginning of many more to come.  Thursday evening we were at Pizza Hut and she dropped a cracker on the floor.  We picked it up and threw it away and she just lost it, even though she had more crackers in front of her.  She cried and cried loudly, so I took her outside and let Amanda stay and pay.  Outside, I am sure everyone passing by thought there was a crazy white lady trying to abduct a screaming cute Chinese girl.  Several stopped to try and help me.  But it is hard when I can't talk to them and explain what she is going through.  Amanda finally was able to pay our bill, and we got Rachel back in the backpack and started moving.  She felt better about that and quieted down.

Since Thursday she has had a harder time sleeping also.  I put her orphanage clothes back on to see if that would make her more comfortable and she has not let me take them off since.  So much for the very cute clothes I brought for her, maybe we will get there.

One of the big things that causes her anxiety is food.  She always wants food in her hands.  If she has to let go of it, she gets very upset.  We went to a grocery store and got m and m's and she kept putting the package up to my mouth because she knows that you have to open these packages with your teeth.  She would not let them go nor would she stop putting the package in my mouth.  I finally opened them and she about went crazy eating them!  She loved them so much!   She did not want to share.  Raisins however, she shares.  She finds a raisin mixed in with the cheerios in her little cup, and she feeds it to me.

We arrived in Guangzhou yesterday (Friday) and the trip basically took all day because of driving to the airport on one end, the flight, and getting to the hotel on the other end.  We were exhausted,  especially after very little sleep the night before.

There is a McDonald's next door to the hotel, a bonus.  This is a very nice hotel, the Marriott.  The internet is much better.  The beds are very nice.  It has a great big tub and it has English TV stations.

This morning (Saturday) was the medical exam, which went smoothly.  We went shopping a little then home for the afternoon.  Rachel has just been happy and playing all afternoon.  I gave up on making her take a nap today, she made it yesterday without one, and I just didn't want to fight it.

Overall she is still about the cutest little person I have every seen.  I am very thankful for her and she is worth all the effort.  But it will be good to get home!

David: Mom, we need you! Please come home soon!

Dad keeps burning the grilled cheese and we have exhausted all of our pizza reserves!  Please come home, soon!

Roses have thorns ...

This update is from Steve, based on recent phone conversations with Sarah.  Sarah was too exhausted after a long travel day, so she asked me to write this for her.

Rachel has had a couple episodes over the past couple days where she has cried inconsolably for 1 or 2 hours straight.  This is in stark contrast to her first couple days with Sarah and Silas -- during which time she was extremely quiet and contented.

Sarah is uncertain what has changed and how best to try to comfort her during those times.  Please pray for wisdom for Sarah, for adequate rest for both Sarah and Rachel, and for Jesus' peace that surpasses understanding to fully envelope all the adoptive families in Guangzhou this week.

During my conversation with Sarah this morning, she commented, "I am so ready to be home and for things to get back to normal."  I reminded her that, with two toddlers at home, things will never be back to "normal."  We will have to figure out our new normal.  Rachel is probably thinking/feeling the same way -- take me back to my "normal."  Even the Israelites wanted to return to the "normalcy" of slavery in Egypt when faced with uncertainty about the plans and the future God had prepared for them.  It is inconceivable to us that they would prefer slavery in Egypt to freedom and prosperity in the promised land, but they had spent 400 years in Egypt -- it's all they knew and all they had known for almost 10 generations.  We have removed Rachel from her Egypt, but she is now traveling in what seems like a wilderness -- where all things are unknown and unfamiliar.

LORD, teach us to depend wholly upon You so that our cravings for normalcy disappear in the midst of our deep yearnings for You and for seeing Your plans and Your purposes accomplished for Your glory!  Amen!

Sarah, Silas, and Rachel have arrived safely in Guangzhou

Safely at the hotel in Guangzhou, but exhausted from such a long travel day.

Just the pix ...

Here is a collection of select photos of this adventure thus far, in rough chronological order.  Enjoy!

Sarah's favorite of all the referral pix.
(NOTE: They shave all their hair off because they
believe that it will grow in thicker if they do.)

Silas watches a movie on the iPad
during the LONG trip to Beijing.

Silas at the Great Wall.

Silas and a stranger at the Forbidden City.
(NOTE: Lots of people keep stopping Silas
asking to have their picture taken with him.)

Sarah and Silas at the Forbidden City.

Silas with another stranger at the Forbidden City.
(Actually, it's a statue.)

Gotcha Day!
Rachel with the Qingyang City orphanage director.

Gotcha Day! Rachel with Mom.
With Dad, Caleb, Jonathan, and David (not pictured)
watching in via FaceTime.

Gotcha Day! Rachel with Silas.
With the boys back home watching in via FaceTime

Rachel and Mom ride in the van to go to Civil Affairs
in Lanzhou to get Rachel's passport photos taken.

Sarah and another family fill out all the adoption paperwork in Lanzhou.

Silas entertains Rachel while Mom takes
care of all the adoption paperwork.

Sarah has her thumbprint affixed to the adoption paperwork.

Rachel prepares to have her footprint taken.

Rachel's footprint is placed on the adoption paperwork.

It's official!
Rachel Xiaolan Trost.

One of Rachel's nannies from the orphanage holds Rachel
before saying goodbye.

Silas teaches Rachel to drive a tank at the mall in Lanzhou.

Rachel sleeps in the crib with her Scentsy stuffed lamb
and Gymboree blanket at the hotel room in Lanzhou.
(NOTE: Sarah purchased this blanket about 10 years
ago in anticipation of this day!)

Rachel feeds Mom at KFC at the mall in Lanzhou.

Mom gives Rachel a bath at the hotel room in Lanzhou.

Rachel plays on the floor of the hotel room in Lanzhou.

View of Lanzhou at night from the hotel room.

Silas "ice skates" on a pond at the zoo in Lanzhou.

A Buddhist temple in Lanzhou.

Silas and Rachel at the museum in Lanzhou.

Rachel likes traveling on Mom's back.

Sarah has her shoes shined in Lanzhou
while Rachel waits contentedly on Mom's back.

Rachel's first airplane ride, with big brother at her side.
From Lanzhou to Guangzhou.