April 15, 2008

The Nitty Gritty

We're at the stage where some of those nitty gritty decisions we all gloss over in light discussion or make "notes to self" to finalize or confirm eventually actually need to be finalized or confirmed now. Things such as:

1) A pediatrician
2) Maternity leave
3) Post-maternity leave child care
4) Dietary preparations that address the age-specific needs of the child as well as needs specific to possible health concerns, and developmental concerns for that matter

Don't get me wrong - we all read, question, and prepare a lot during the dossier prep and wait process, but preparing yourself and actually signing on with a doctor and agreeing to a health plan and letting your HR department know more than just an approximation of when you'll be out on maternity leave and arranging all of the details...well that part is starting to require quite a bit more attention. Again, don't get me wrong - I LOVE the amount of attention we finally get to pay to this sort of stuff. As I put it in an email to our adoption consultant today: Is there a cloud 20? We passed #9 & #10 long ago!!!

#1: Pediatrician
We've covered the basics of having a trusted pediatrician review the medical documents and make knowledgeable assessments and identify any potential areas for concern. Check. However today we met with the doctor who will likely be our child's primary pediatrician and now need to decide if this is the man who's hands we're going to place our child's health in or if we need to expand our options. We both like him, feel as though we could trust him, and appreciate that he has a history of working as a doctor in other countries. Unfortunately all of these countries (and the families he's worked with) are primarily caucasian and he admitted that he's never worked with children adopted from Ethiopia before, not that that's a surprise. At least he's honest. I suppose I should mention that we're looking for a pediatrician in New Paltz which is where we spend most of our time and is about 2 hours north of NYC which is where we spend some of our time. Our options for pediatricians in NYC are obviously much larger, however we feel it important to have a local pediatrician where we spend the majority of our time- right? I guess we could have two, one in the city and one in the country...that seems like it could get unnecessarily complicated though. We like this guy, he made some good suggestions (as if I could tell the difference between good and bad medical advice...the expert that I am) and honestly I'm sure he'd be fantastic. So we should go with him, right? Of course we'd really love to have Dr. Aronson as our primary physician (the famed orphan doctor) and will likely have her do the initial examination once we're home, but the fact that she doesn't accept insurance is kind of a bummer.

#2: Maternity Leave
This ones got me in a bind. I can take 6, 8, even 12 weeks if I want thanks to the Family and Medical Leave Act (FMLA). My company is very generous (I think, at least in comparison to the limited exposure I've had with other company's regulations) so at least some of this will be paid leave, however not 100% and certainly not for the full 12 weeks. Yes, we thought about this ahead of time and yes, we've been saving and yes, we would both LOVE to just use the full 12 weeks. But nope, still not 100% sure how much time to take but are leaning towards 8-12 weeks.

#3: Post-Maternity Leave Child Care
I will return to work and although am fortunate to work remotely from home most of the time we all know that chasing after a 1-2 year old is not something one can do while remaining a productive employee. So, in-home babysitter for peak hours? Daycare? Find other families and combine in some sort of modified daycare/babysitter routine? Au pair? We're leaning towards a babysitter who can arrive after the morning nap around noon and stay until about an hour after the afternoon nap, so let's say a 12-5 schedule when we're working remotely. Because he's definitely going to abide by a strict morning/afternoon nap schedule, right? (Oh come on, I'm not that naive) When we're in NYC we're going to need all-day care so that's a whole other bridge to tackle, but at least there we have friends with children (and the all important thing that goes along with that - EXPERIENCE!) so are confident we'll sort out the right option.

#4: Specific Dietary & Developmental Preparations
I'll be honest, he's going to be over a year by the time we bring him home and let's just be real - his first year of life was no walk in the park. There are many early intervention programs we can take advantage of and I have a masters in early childhood education so in theory should know a thing or two, but sitting with the doctor today while he pointed out all of the things we should be considering and preparing for based on an actual medical report for our actual real life child kind of turned the whole topic on it's arse.

I love the nitty gritty, in fact I often thrive on being a bit OCD with the Nit and the Grit. This is just me coming into the realization that this is happening - I have a face and a name and a medical history and a zillion questions and...well, no amount of preparation could possibly be sufficient at this point, at least not for someone who requires a 16 x 16 matrix to map the most simple of projects.

Over analyze? Me? No...


Jill said...

Maybe you could ask your pediatrician if there is someone that he could suggest in NYC that he works with and feels comfortable referring his pts to if things are out of his league. My pediatrician is related to an infectious disease pediatrician who adopted from Ethiopia. When my ped. doesn't know something, she emails her cousin (even took a picture of Mari's rash to send her).

There are probably docs that your pediatrician prefers to work with and this will save you in the long run...it is a lot easier to get an appt with a "bigger" doc when the "little" doc has worked with them before.

Amanda & Andrew said...

Overanalyzation and over-preparedness (word?) are much preferred to underanalyzing and under-prepared.
At least, that's how I see it.

There's a face, a name, a life! A true, honest to goodness boy that belongs (well, soon will!) to you and your husband. :) This nit and grit has to be even better than most nit and grit you thrive on!

Good luck finding a pediatrician you feel you can count on be confident with also good luck with day care. I'm sure you'll have no problem getting something to work out exactly the way you need to! :)

Jodi said...

Good luck with all these decisions. I always think the daycare one is the hardest. Honost advice: take as much time off as you can. They are only little once and it is time with your child you will NEVER regret. I am not saying I always followed that advice, but wish I had. Good luck! Congratulations - I can't wait to get that call.

Brooke said...

Jo, you make me laugh :) I love that you are OCD about the "nit and grit". I am too.

I think your on your way to being very prepared and that will make the transition a lot smoother.

Anonymous said...

I think the most important thing is finding a doctor who cares, good "bedside manner," gives you as much time as you need when you have questions, is sensitive about stuff like interracial families, and knows his/her doctoring. I don't really know what I'm talking about, but I think after the first few months or so, any lingering health issues that derive directly from Ethiopia are likely to be general developmental things resulting from nutritional deficits or whatnot, things that a child from anywhere (even NYC!) could come in with. Country or even continent-specific experience seems far less important to me than knowing how to ask the right questions and answer your questions completely & caringly. I learned something about what I seek in a doctor firsthand when I switched from an awful female gyn to a much better male gyn... my assumptions about who could help me most were turned upside-down.