Status Quo

Andrew had his monthly eye appointment with Dr. Mazow. While the very optimistic(we love this about him) Dr. Mazow believes Andrew is still improving he is still testing at the same acuity as a month ago, 20/60. We are continuing with the patching for another month to see if he will improve or if we have reached a plateau. Likely we will begin talking about surgery options at our next visit. We ask for your continued prayers as we trust the Lord to lead us through this decision making process to help give Andrew the best possible vision. He is such a trooper! While he does not like to wear his patch...he does and he never complains. It is as if he knows how important this is for him to wear...he has an amazing attitude about it that we believe could only come from the Lord. So we proceed for the 3rd consecutive month of patching all waking hours everyday.

Kathlena did not have her appointment as we had scheduled. A series of scheduling issues on our end and Dr. Mazow's had us postpone Kathlena's appointment until next month...perhaps a blessing in disguise. Although, Kathlena was trying to help Andrew see some of the pictures by calling them out while he was being tested...we quickly assured her that her time would soon come. Big brother appreciated the gesture though :)

Now our usual after our appointment routine is to head over to the Museum district since we are already downtown and have a picnic lunch before heading to the Zoo. We are making good use of our Zoo Pass. We were disappointed though since it was cloudy and threatening to rain the 11 day old baby giraffe was not visible for us to see nor the baby Safica Lemur. Fortunately, though we were able to watch via YouTube, but it would have been great to see them in person. Well maybe we will get to see them next time. We also spent quite a bit of time seeing the Primates. We started a new BFIAR book called Caps For Sale by Esphyr Slobodkina. It is an adorable little book about a peddler who sells caps and gets them snatched up by some curious little monkeys. We had fun monkeying around and watching the Mandrills, Lemurs, and Orangutans.

Here are a few pictures Emily captured for us at the Zoo.
Mom reading our new BFIAR book, Caps for Sale



Resting under a big tree like the peddler in

Caps For Sale!

Andrew loved watching this funny Mandrill, he had quite the
personality.


With the threat of rain looming over us we decided to check out a tip a friend gave me that The Museum of Natural Science has free admission to it's permanent main exhibits on Tuesdays from 2pm-8pm. It was fun since Andrew and Kathlena have not been before and it has been ages since Emily and J.Michael have been so it was like a first for us all. We were able to see how enormous dinosaurs would be standing next to us. We spent most of our time though touring the Energy exhibit. It was really informative and we even rode in a Geovator, which is a simulator that lets you experience what it would be like to go hundreds of feet below the surface on a drilling expedition to find oil. We also toured the Gem and Mineral exhibit...this was a favorite for Emily and I. It was so neat to see all of these huge pieces of rock that encased some of the world's most beautiful gems. We also went into the vault to see the collection of precious jewels. There were two pieces from St. Petersburg, Russia that were once worn by royalty.

It was a good day...almost all fell asleep on the long ride home in traffic, but it was so worth it! We will have more on our visit next month until then we will keep checking on those Zoo updates and plan our Butterfly Exhibit trip. Spring is such a wonderful time of year!

Andrew's Eyes Update

Today, we went to see another ophthalmologist, Dr. Mazow of Houston Eye Center. In mid October under the advice of the optometrist we were seeing we stopped patching Andrew for his amblyopia. Once we concluded all of the testing with the optometrist and had our parent consult with the her we felt we needed to go back to an ophthalmologist as surgery is imminent (the one common thread through both dr.'s) and we were uneasy with the direction the optometrist was going. It would seem too much emphasis was being placed on his previous circumstances as empirical evidence was likely not reliable as a result of his English skills at the time of testing. So, we began patching again while we waited to get in to see Dr. Mazow as we were quite certain we would be going back to this. The more we read it seemed that in order to correct the amblyopia patching was the only way. I think this was our number one problem with the optometrist (even though we all wanted it to be true that there was another way other than patching) in that she said patching would not help him. It could be that she was willing to accept his acuity where it was and seek to improve other areas such as peripheral vision, but we were not ready to give up on him improving his acuity just yet.

Our visit with Dr. Mazow was as predicted and he concurred with our first ophthalmologist in that patching is what is needed and extensive patching in Andrew's case. So, we are back to patching all waking hours now for a month then we will go back to Dr. Mazow. He wants to keep a close check on him for signs of improvement. In Dr. Mazow's office he also had an orthoptist evaluate Andrew. She determined that he also has nystagmus in both eyes...it is very slight though. We both felt like we got a very thorough evaluation with Dr. Mazow and he is very experienced with strabismus and amblyopia. The trip to see him was not so fun as we were stuck in traffic for almost 2hrs to get to the appointment...you got to love Houston!

Please pray for Andrew...patching is hard. He is such a little trooper though. He is very compliant and knows that it is to help him see better, but it is still very hard. He tested at 20/100 at Dr. Mazow's office. When we began in July his vision was 20/50 then, 20/70 in October at the optometrist and now 20/100 so, it has doubled in 4 months. We only stopped patching for about 6 weeks. Even when we were patching it was getting worse...not sure why. We just continue to pray for wisdom and for healing for Andrew's eyes. Thank you for lifting him up to the Lord with us.

Sorting things out...vision issues update

We have completed the testing through the optometrist. While the optometrist believes that the patching will not produce better acuity and that perhaps this is lost and will not be regained, however she believes through therapy his eyes can be trained to compensate in other ways for it. She has recommended extensive therapy for both vision and a host of other issues. Unfortunately, we are not sure how accurate the findings are as much of the test weighs heavily on a concrete understanding of English. It would seem she is relying more heavily on his background and statistics in the recommendation for extensive therapy as she also commented on the English issue to the reliability of the testing. We continue to pray for wisdom and have decided to consult with a second pediatric ophthalmologist who specializes in strabismus and amblyopia...in fact if you do not have strabismus the Dr. will not see you. We have an appointment scheduled for Dec. 9th. We are so grateful for the Lord's provision as each time we "hit a wall" the Lord directs us to the new door of opportunity.

We continue to trust the Lord...believing his Word for all situations. Proverbs 11:14 tells us that "Where there is no counsel, the people fall; But in a multitude of counselors there is safety." This has been our prayer as we have sought Dr. after Dr. and test after test. Perhaps in all of these visits and "feeling" like we are doing something what we needed most was more time.

"You will guide me with Your counsel, and afterward receive me to glory. Whom have I in heaven but You? And there is none upon earth that I desire besides You. My flesh and my heart fail; But God is the strength of my heart and my portion forever. For indeed, those who are far from You shall perish; You have destroyed all those who desert You for harlotry. But it is good for me to draw near to God; I have put my trust in the Lord God, that I may declare all Your works." Psalm 73:24-28

Patching continues...surgery on hold

Today was our follow up visit for Andrew with the pediatric opthamologist. I would be lying if I said I am not completely shocked at the results of our visit today. I was so sure that Andrew had regained most of his vision as he seems to function so well with his eye patched...even riding his bike "no fast, Mom!" as he whizzes by me. I must admit that I am taking this really hard because he has had little to no improvement and we have been so diligent to patch everyday except for 2-3 times in the entire 2 months as well as keeping in the 8hr+ range a day. Dr. Coats is now recommending another 2 months of patching only now it is every waking hour. This breaks my heart as he was so ready to have no more patches and since we were so shocked we had ill prepared him for this possibility(nor did we know of this possibility-thought surgery was imminent). He is a trooper though and willingly has resumed patch wearing. For now we have been advised to schedule surgery again in 2 months following his next follow up appt. and that if no improvement is made we will move to a chemical blurring of the good eye to force use of the weaker eye. Dr. Coats said that for some reason when a patient doesn't respond to patching sometimes they will to the drops and vice versa. We are trusting the Lord to give us wisdom in all of these matters to make the best decisions regarding Andrew's health. Perhaps like many things simply more time is needed for his body to heal. Everyday he is getting stronger and healthier with good nutrition so I have to think there are additional factors in his vision improving.

Dr. Coats has given us a few other options to work with Andrew on over the course of the next two months that I am going to check out and see. Dr. Coats assured us that even with his current vision he would still be eligible for a driver's license which was something I had not even thought about. He is not giving us glasses as an option as it seems to be a brain to eye issue. I have some researching to do and hopefully will have more to post soon.

Opthamology Report

Our really cool glasses we got to wear after

having our eyes dilated. Andrew has huge

pupils...I have never seen any so large!



Kathlena with her eyes nearly fully dilated. I think it

made her feel a little funny.


Look at those pupils! I can hardly see anything else except

for that adorable Andrew smile!



Beginning patch therapy right away.


What a trooper...this is hard but Andrew is doing so well.



Well today was like letting out a deep breath for me. We have known from the beginning that Andrew has vision issues, but we have only speculated about Kathlena's multiple issues all being related to vision. Today confirmed what we were thinking. PTL!

We had a great visit with Dr. Coats from Texas Children's. He confirmed what we suspected about Andrew that he has Esotropia (eye drift to the middle and up), mild hyperopia or hypermotropia (same thing) and as a result developed amblyopia in his left eye. The great news is that he has 20/20 vision in his right eye and was reading his letters very well in English. He did so well throughout his exam. He didn't seem nervous at all but interested in how everything in the office worked. His left eye is at 20/50. At this time the Dr. would like for us to do patch therapy where he wears a patch over his "good" eye (right in his case) for 2 months to begin strengthening the left eye. He must wear the patch 6-8hrs a day...he is not liking it but he has been persuaded to wear it. ;) Now, the Dr. thinks that surgery is unavoidable and has asked us to go ahead and schedule it for 3 months from now. We are praying that the patching helps strengthen his vision thus correcting the amblyopia, but in order to straighten the muscle (hypertropia), surgery seems to be the only option-we continue to pray for healing without surgery, Lord willing, and if the Lord chooses to heal him through surgery we will trust Him in this also. We go back in 2 months to see the progress with the possibility of pushing back surgery at that point if patching is making improvements along with his weight gain and overall health improvement.

For Kathlena this was a home run day for us to find out what we have suspected all along. All of her issues were related. No CT scan needed nor neuro follow ups. She did so well in her exam. The Dr. was amazed at how she would sit still and allow him to look into her eyes. We have often attributed this to all of her Dr. visits she has had in Russia, but usually kids who see many Dr.'s and have lots of tests done tend to fight it more. I definitely think we are beginning to see the fruit of lap training. She sat in David's lap the entire time. Even when she and Andrew both had to have their eyes dilated they both did well, no screaming or squirming. While we waited for their eyes to dilate they got to watch Monsters Inc., which was so funny since Andrew has not seen it in quite a while, but still loves it all the same.

Kathlena was diagnosed with nystagmus (her eyes bounce, difficulty tracking). Dr. C ruled out the Spasmus Nutans even though she has the head bobbing. His best explanation of how this could be related to the "birth trauma" we were told at the orphanage is that oxygen was restricted during birth to a particular area in the brain that effects vision, including the pigment for the eye color. He also ruled her out as having albinism (ocular or otherwise) even though her eyes are very light. He did not see the other characteristics that usually mark this. He did say that she could be on the spectrum of it though due to the birth trauma. For now, we wait and see how much good food and activity improve her situation. It is expected that eventually she will also have to have surgery, and providentially it would be the same surgery that Andrew will have. Is that not amazing! Two biologically unrelated children placed in the same home who will have the same surgery...the Lord knew and placed together for His glory. It may sound strange, but I am thankful that I have already gone through surgery with J.Michael when he was young (again, providentially when he was 6yrs old just like Andrew will be if we do have surgery). I know it will not be any easier to have Andrew wheeled out to surgery, but the Lord is so good to prepare us and strengthen us through these times. Here is what to expect from the surgery and recovery stage. I have lots of reading up to do and will post more soon. Thank you for your continued prayers.