Food is not the enemy...Food is NOT the enemy...

So I'm recovering from a sinus infection...after 3 really hard, stressful weeks my body just basically finally gave me the big ol' middle finger and shut down business. It happens every time this year (beginning of a new school year), so I should expect it and know its coming...
I'm trying really hard to NOT take medications, as a lot of OTC stuff can screw with your thyroid and inhibit absorption of your thyroid meds...so, I'm just trying to stick with the netipot, hot/cold compresses on my face, etc.


I also made a visit to Dr. Magic-Hands Michelle today...which is always a welcome treat, but even more so when I'm not feeling well. I was telling her about not feeling well, but how I still forced myself to do the elliptical and do an hour step aerobics class and an hour weightlifting class earlier in the week (fever included). I felt great afterwards, actually...weird, considering...but Michelle brought a good point...how the frick do I exercise as much as I do, eat as healthy as I do, and still not have a rock hard body? Well, First, I'm not genetically engineered that way...I've always had meat to me, and I'm ok with it, I'vemade peace with it. I've been bigger than I am now, and I've been skinnier than I am now. It's my main goal to just stay where I am. Second, my thyroid condition makes it pretty impossible to lose weight, and makes it pretty easy to put it on. I have to really watch everything I put in my mouth or else it can get out of control very quickly, metabolic disorders suck!   
 In the lowest of my low days when I'm not feeling good about myself (we all have them...) its one of the things that pisses me off the most.  I do everything right, yet my body always seems to betray me...
Now, Dr. M also brings up a good point too - what would I be like if I DIDN'T make so much effort towards health?  Would I be a bedridden, 400 pound mess?  The thought terrified me. It also pissed me off a little bit because, ho-ly crapola, I'm in this for LIFE! I will be doing back to back cardio classes until the day. I. die. I'm never going to rest again. Good thing my motto is "If you're bored, you're not doing it right"....

So, Michelle and her magic hands got my sinuses moving and after an afternoon of sneezing fits Ryan and I decided to let Jillian stay at school a little longer while we went to a mommy and daddy, kid-free happy hour.  It was nice to regroup, especially since he's been travelling so much, and I've been running around like a crazy person taking care of 500 other families (literally) and pretty much neglecting my own in the process.  Houlihan's has a gluten free menu, but I pretty much said F-It.  I ate the most amazing chicken nachos, loaded with sour cream, cheese, and more salt than anyone should eat in an entire year. I also had a giant beer, and two margaritas.  It was amazing in my mouth!  I am so careful with what I eat every other day of the week...I sometimes just don't want to nit-pick, and just eat what sounds good.  I've barely eaten all week, F-it. Chicken nachos it is!


OMG! why do I do this to myself? Where is my brain?! I am currently sitting here unable to sleep,  in pain and misery, not only because of the sinus issues, but now my body and every joint and appendage is on fire with pain and inflammation (EVEN MY LIPS ARE SWOLLEN!!!)  from my poor food choices.  I'm not looking for sympathy, I'm pissed at myself! I know better than this! 


So here's the thing... THIS IS FOR LIFE. I'm officially the freak at the table who holds everyone else up and has to special order everything.  It is what it is, I guess. I don't want to be the 400 pound, bedridden mess. So I guess it's worth it...it could always be worse. Just bear with me if we're eating together and I have to ask a bajillion questions...trust me, its better than the alternative!

That being said...I'd like to share two new foods I've found that are amazing - they taste good, don't aggravate any of my symptoms, and are gluten/soy/dairy free.  They are great for breakfast or quick snacks.  Try 'em! you might like 'em!

Lara Bars - my version of a Nutri-Grain bar only waaaaayyyy better for you with only 4 ingredients, and NO CHEMICALS!  (By the way...it is my new goal to only eat things that have 4 or less ingredients) 
they make me extremely happy at 630am when I'm sitting at my desk starving (because who has time or desire to cook breakfast at the crack of dawn?), or at 3pm when I'm having a blood sugar slump.  YAY Lara Bars!  My favs are Apple Pie, Cherry Pie, Pecan, and Lemon...they are on sale right now at Hy-Vee for 10 for $10.  They are normally $1.59 each, so I've been going every week and stocking up while the sale is going on.  If you want to know what to get me for Christmas - Lara Bars in bulk would be awesome!!!! haha!

My second favorite new thing is "Amazing Grass - Amazing Meal"...now this is going to take a minute for some of you, but hear me out.... it is a meal replacement powder that you mix with either rice or almond milk to make a shake out of.  It has Acai, Wheatgrass, a Probiotic, Hemp Protein, Flax Seed, etc and all ingredients are from an organic farm in Kansas! Now, this has way more than 4 ingredients...but...they're good ones at least!

Benefits:

Confluence of Functional Foods Hemp Protein Powder can supply any diet with a vegetarian source of essential fatty acids, antioxidants, vitamins, minerals, fiber, chlorophyll and a complete, balanced gluten-free source of the essential amino acids. Rice Protein is an excellent source of vegan, hypo-allergenic protein that is an alternative to soy, without the animal products of whey. Organic Wheat Grass Powder ' One of the most potent green vegetables available. Wheat grass is an excellent source of natural vitamins, minerals, amino acids, and enzymes. Wheat grass is known to be highly alkalizing and will help detoxify the body. Organic Kale - Kale is rich, calcium, and iron. Kale has seven times the beta-carotene of broccoli and ten times more lutein. Organic Barley Grass Powder ' Part of the cereal grass family green barley grasses contain a multitude of enzymes. It appears that there may be thousands of active enzymes in barley grass, especially superoxide dismutase (SOD), a major detoxifying enzyme sometimes recommended in combating arthritis. Organic Alfalfa Powder ' Roots grow very deep to absorb many minerals and nutrients from the soil. Contains eight essential amino acids, is a rich source of vitamin B12, natural fluoride and chlorophyll. Organic Açaí ' This berry is grown in the Brazil rainforest by our friends at Sambazon. It packs more antioxidants than blueberries or pomegranates, plus an abundance of omega fats, protein and fiber. Organic Carrot Powder ' Excellent source of vitamin A from Beta Carotene. Carrots are believed to be very beneficial for eye health. Organic Blueberries - Blueberries are concentrated in anthocyanins and other health promoting antioxidants, plus they add to the great taste of Amazing Meal. Organic Goji Berries ' This healthy berry shows off its phytonutrients in bright red colors. Goji berries are one of the most nutritionally dense fruits on the planet and have been long revered in Tibet for its health promoting effects. Organic Maca 'This amazing adaptogenic root enhances your ability to deal with stress while boosting energy, endurance and performance. Organic Rose Hips - Natural source of Vitamin C. Promotes good health with bioflavonoids and strong antioxidant and immunity support. Organic Banana ' We added organic banana to Amazing Meal so it would taste like you just stepped out of a smoothie shop, only healthier. The great taste it not overmatched by its excellent source of energizing B vitamins and potassium. Organic Flax Seed Powder ' Organic flax seeds are a great source of Omega 3's and fiber.

So I was skeptical because I was pretty sure it was going to taste like complete crap.  My naturopath had given me a drink powder to try and it was HORRIBLE! But this one got amazing review throughout several websites, so I decided to give it a go.  I mix with rice milk, a banana, and ice.  If I know if I'm not going to be able to eat again for a while, I mix some almond butter in with it too.  It really is amazing!!!! sooo good, balances my blood sugar, and I don't have to eat 3 morning snacks to get through without passing out.  It is definitely a new favorite on my list of "weirdo foods"

I would also like to ask for a "Magic Bullet" for Christmas...because it would be awesome to make up my morning shake faster and with a built-in "to-go" cup.  Plus, our blender sucks...



Ok, so I'll admit, Amazing Grass and Lara Bars don't taste like chicken nachos...but...they also don't make me want to jump off a bridge at 2am either...just sayin'

That dead tree in the back yard was probably the one the money grew on...

I'm having cash flow anxiety with this adoption!  Ryan and I have been very fortunate in our 5 years of marriage to not always have to worry about where the bacon is coming from...

That hasn't always been the case, however.  When we first got married we were in collective credit card debt to the tune of about $17k.  It sucked, it was scary, and it was NOT an awesome way to start out married life.  We did some re-managing, refinanced Ryan's house (now MY house too) and were able to pay off all of our debts, and keep them away for good, and we have impeccable credit to show for it. We undoubtedly know how blessed we are to both have good, stable careers, and to have amazing health insurance through Ryan's company.  Make no mistake though, we have WORKED OUR ASSES OFF to remain financially stable.  It's not easy, and we've cut things out over the years to be able to have the things we really want (I don't really like cable tv that much anyway...and Ryan LOVVVES driving a beat up old Ford pickup with no AC, especially THIS summer - but its totally worth it to be able to take that yearly trip to Florida!)

Suddenly though, I find us at a crossroads of  - we'll be ok, to HOLY SHIT WE'RE GOING TO BE IN THE POOR HOUSE!  Adoption is freaking expensive y'all, and I'm not sure how we're going to cover it. 

Here is breakdown of the costs:
$300 application fee
$52 per person fingerprinting fees
$2500-$2900 Adoption Home Study fee
(remember all that paperwork? someone has to process it...)

$20,215 Korea Program Placement fee
(Korean children basically live in the Waldorf-Astoria until they are adopted...its one of the reasons we picked the program. You will not find 14 babies crammed in one crib in a sad looking orphanage like you see on Dateline in Korea...these kids are well taken care of! It's a perk to know your child is getting amazing care...but you pay dearly for it)

 $500 Parent Escort Service Fee
(Holt-Korea charges a Parent Escort Service Fee of $500 for parents who choose to travel to Seoul to escort their own child home. We DEFINITELY need an escort! I don't know how to speak Korean and pretty sure I'd end up in Timbuktu if I tried to navigate the train system by myself. Plus, we have to go to Korean court...I definitely need help with that!)

Post placement Fee $1,200 - $1,400    
(There will be follow-up visits with your social worker and reports for the overseas office. This is required by foreign countries and offers families an opportunity to receive support while the child and family are adjusting to each other. The same agency provides both the adoption study and post placement services)

Unknown $$ - TRAVEL TO KOREA
(1 plane ticket could cost $800-$3k, depending on the time of year we get called to travel. Cross your fingers its not December! that is the biggest holiday travel time for Koreans. I want to be able to have me, Ryan, and Jillian travel. But really only one adult has to go.  I really don't think I could bear going alone, or even going without Jilly. I feel its important for her to be there and be a part of it)

Other Expenses to Anticipate
Additional expenses which are paid to various service providers. Including:

• Obtaining copies of legal documents
• Finger printing
• Visa filing fee
• Medical exams
• Travel expenses
• Phone calls to Holt
• Postage
• Legal adoption

I want to throw up just thinking about it.  We could get a loan, but no bank right now is giving $30k worth of loans with less than 10% interest.   We could get a 0% credit card, but the adoption agency wants cold, hard cash.  There are grants and things available for adoption, but so far we have not found one we qualify for.  Most of them are if you are devout Christians, Jewish, adopting a child with special needs, or if you are Korean-American adopting a Korean baby.  We have not been able to find anything special for just regular people wanting to adopt a healthy baby.  We can expect about a $13k tax refund from the government when the adoption is complete...but that law is always changing, and who knows what it will be by the time everything is final for us.  We cannot count on that as an absolute.

Its quite discouraging. I feel like we do everything right, but keep getting pushed back down. We're financially responsible, but we're going to go into debt over this. That is hard to swallow, especially since we work so hard to stay OUT of debt.  We have savings, but don't want to drain entire bank accounts either...
I try very hard to be extremely healthy - eat right, exercise, don't eat fast food, don't smoke, etc, but yet my body won't allow me to have another biological child.  If I were having a total pity party here, then I would say that the universe is throwing out all the signs that we should just be happy with the one child we have. 

But... I'm not a quitter and I never back down. I always find a way to get what I want. We'll figure this out...
let me get out my little change bucket...

HAPPY NEW YEAR!

Seeing as I have either been in, or worked in a school since 1985 (with a brief hiatus from the years 2003-06) I have always considered the beginning of my "year" to be mid-August...not January.  So for me, next week (August 16th to be exact) is the beginning of a new YEAR for the Creeden household.  Instead of getting the typical warm fuzzies and reflective feelings like the rest of you do the last week of December...I'm getting them now...

So this past "year" was one of great discovery and change for me. 

I changed jobs (within my job) and changed my work schedule.  (Can I just tell you that, yes, even though I do get off at 3pm, getting to work at 630am IS ROUGH!  ESPECIALLY in the dead of winter.  Getting to work that early also means my alarm goes off at 430am...I snooze it until 445, then I'm up and at'em...)  But I'm happy and grateful to have a job, and job I really enjoy with people I really love, no less. 

This "year", Jillian also turned 3 and started coming to school with me.  She is now almost 4 and has just grown and flourished more than I could ever imagined or hoped for.  The other day at school I was working away when I looked at the clock and realized it was her classroom's lunchtime.  I said outloud "I'm going to take a little break and go sit with my daughter while she eats". How fortunate am I to have that luxury?!  I love having her in the same building... but at the same time, hearing the words "my daughter" sometimes still sounds so surreal! How in the world am I old enough to have kids already?!

Which brings me to Kansas City....last night Ryan and I were walking around downtown on our date night and I realized that next weekend I will have lived in Kansas City for 12 YEARS!!! I was 19 when I moved into my first apartment - it seems like a lifetime ago, but at the same time, seems like it was two seconds ago!  Before you know it "my daughter" will be 19 and moving away, and then I might throw up...

My health...blah blah blah. It's all been said before.  I had a *YEAR* in the health department! But you know what? That year, I'd never want to do it again, and would never wish it on anyone.  It sucked. Plain and Simple.  But, it needed to happen.  I've learned so much.  And after being on new medication for almost two months, and being gluten/soy/dairy/allergen free for 6 months, I have to say I feel pretty damn good!  There are still bad days, and I will be conscious of it every day of the rest of my life.  But I feel pretty comfortable saying that I will no longer STRUGGLE with it every day of the rest of my life.  That is an amazing weight lifted off of my shoulders....(now if only I could get the weight lifted off my ass and thighs...that'd be great too! damn thyroid and metabolic disease!)


And the biggest change of all - deciding to adopt a child from Korea! Everyone we tell says "wow, that's a really big decision"...well, isn't deciding to have a biological child a pretty enormous decision as well?!  I'm hoping by the beginning of next "year" we will have our little one home and adjusting.  Time will tell. I'm trying not to think too much about it in day to day life, because if I do I will become a mess of anxiety ridden goo. Someone really smart recently told me "let go, and let God".  I'm really trying to apply that concept to this situation.  I have complete control over pretty much everything in my life, I have got to try to remember that I cannot control the Korean government. 

Anyways, HAPPY NEW (SCHOOL) YEAR everyone!!!  I wish you much success and happiness in the up-coming year!!! BRING IT!

To support International Adoption - you must also support deforestization = HOLY PAPERWORK BATMAN!!!

The paperwork. is. exhausting!  When we first met with our social worker, she warned us that we would be knee deep in it. However, she also said that if we were organized people then it would be tolerable.  At that point, Ryan and I did a mental high five, because if you didn't know this about me already - I pride myself on being highly efficient and organized
(however, DO NOT look at my desk at work...THAT is a perfect example of organized chaos!...but it makes sense to me.  I'm not bragging - I just learned very early on how to keep my shiz together - how do you think I had a 4.0 in HS and a 3.9 in college?! It's not because I'm particularly smart or anything...I also really, really enjoy office supplies!  I think I'm the only one who gets excited about hi-liters and binder tabs!)

So Ryan and I were like, WE GOT THIS! (or, Erin has this, rather) Then the packets started rolling in...ooooh, wait. Holy Cow! We haven't even started our home study yet! This is just pre-home study stuff. A lot of it takes what seems like FOREVER (I told you I wasn't good at waiting!) because we are relying on and waiting on other people to fill out their portions (If you also don't know this about me - I sometimes would rather just do things myself!!)

 I think this is all pretty standard for ALL adoptions, even domestic -  but we've never done it before, so it's new (and somewhat daunting)

So far, this is what is in process:

*Initial Application - this was about 6 pages (more on this later)

*Holt International Contract - this was about 6 pages of legal stuff that we had to agree to and get notarized

*4 separate Non-Family Referrals, at about 4 pages of questions each (BIG thank you to the friends we chose to fill these out!) I took a look at one of them and there are some difficult questions on there. Thanks guys! we owe you one!

*1 family reference - haven't seen it, but I think its probably the same length as the non-family references

*Financial Statement - One page spreadsheet outlining every single dime we have to our name.  Let's rub it in how much this is REALLY going to cost!

*PIP Training Paperwork - there will be more on this later. We missed this month's training, so we have to wait until the fall for the next session.  It is an 8 hour training on a Saturday that goes over adoption issues and how to handle them.  It is also where you meet other adoptive parents and make contacts throughout the agency. I'm looking forward to it!

*Pregnancy Policy - if I get pregnant then all bets are off, I have to sign saying I know that

*Corporal Punishment Policy - We have to agree to never spank our kids

*Medical - All three of us have to have complete physicals, and then also have our doctors write letters saying that we are pillars of health and that we are fit enough to be parents.  Some countries have pretty strict requirements - such as, in China - you cannot adopt if you have been on antidepressants within the past two years.  Or - in other countries, you cannot adopt if your BMI is over 25!!!  I get why they do that, but come on! My BMI is like a 23! and I consider myself pretty(fairly) fit!  I am interested to see what they say about my Hashimoto's...my endo. wrote a pretty nice letter (she is from China herself, so she is intrigued by our adoption stories) so I'm hoping it won't be too big of an issue

*Background Checks - Fingerprinting, Sex Offender Registry, and MO/KS State checks, and a Fed Check.....update: got the results back, and we are not criminals!!!! HAHA!

Personal Data - this is about 20 pages, and Ryan and I have to each fill one out.  It asks everything from - "what would change about your own childhood?" to, "what do you like most/least about your spouse"....it is some pretty thought provoking stuff!  I've changed my answers AT LEAST 3 times each! 

*Employment Verifications - gotta prove we have jobs to pay for this!!!

One thing I find particularly fascinating about all of this is the fact of how easy it was to have a biological baby.  I spent a lovely evening with my husband, waited 9 months, went to the hospital, and 5 days later they sent me home with a baby - NO. QUESTIONS. ASKED.  They were more concerned with trying to sell me the newborn photos and birth announcements than they were with making sure I was ready to take home a living person!
 I completely understand why the adoption process is so involved, and I would question it if it were any easier. But now I'm questioning why its so easy for anyone to just pop out a biological kid?  There are some really dumb people out there who don't deserve to be parents!!! it's not a right...it's a privilege.  I've said it before - you have to have a license to drive, you have to have a license to catch a damn FISH! but any ol' idiot can become a parent! 

*sigh*

oh, another thing we had to send them was a family picture!  Here is the one we chose...look how cute we are! Won't a little Korean baby look beautiful sitting in our laps too?! LOVE!

About Korean Adoption...straight from the people who invented it

So, I don't know yet what we can "legally" share with others according to our contract with our adoption agency.  I know there are some industry practices and insider information that they like to keep to themselves and that they don't want shared via the internets or blogs (They ACUTALLY have an "internet police" that surfs websites searching for information...if we violate this policy then we can be terminated from our contract! they mean business!!!) We will learn more what the stipulations are when we attend our PIP (Parents in Progress) training.  For now though, because I have had questions from others about it - I will share what is directly posted on our agency's website:

http://www.holtinternational.org/

A Legacy of Love in Korea

Holt’s legacy began in Korea when Harry and Bertha Holt adopted eight beautiful children in 1955. The Holt’s understood that children need families more than anything else, and they could not forget the thousands of children who remained in orphanages. In 1956 the Holts established an adoption program in Korea.

Today Holt International Children’s Services in the United States and Holt Children’s Services of Korea continue as partner agencies assisting the homeless children of Korea, until they can go home to loving, permanent families.

Holt’s foster care program in Korea is an international model for loving, temporary care of children. In addition Holt has an extensive array of programs such as a world-class center for the care and development of disabled children, a highly developed post adoption services program and Heritage Tours for adoptees and their families.

Holt International has over 50 years experience placing approximately 60,000 children from Korea with adoptive families in the US.

• Children are young, many of them infants.
• All of the children live in foster homes, not orphanages
• Excellent medical and social information available.
• Experienced staff both in the US and Korea who respond to the needs of children and families.
South KoreaThe Need The Korean War ended with the signing of an armistice in 1953, splitting the peninsula along a demilitarized zone and leaving, in its wake, many orphaned and vulnerable children. The war also devastated the Korean economy, causing widespread poverty. Unable to provide for their children, many families saw international adoption as a way to give them a better life – a belief shared by many unwed Korean mothers who, fearing the stigma of out-of-wedlock birth, chose to relinquish their children. Also facing a lifetime of discrimination were the many mixed-race children born during the war to Korean mothers and American GI fathers. For these children, international adoption often seemed preferable to a life of poverty and prejudice.
Beginning in the 1960s, South Korea experienced rapid economic and social change, emerging during the last decades of the century as one of the “Tigers of Asia.” As the nation grew more prosperous, so grew the role of the Korean people and government in the welfare of their children, including greater cultural acceptance of domestic adoption.

Traditional Confucian values, which place great emphasis on bloodline, nevertheless remain entrenched in Korean culture. Although more unwed mothers are choosing to parent their child, discrimination makes life extremely difficult for them. For many Korean children, social stigmas still create barriers to having a permanent, loving family within their birth culture.
Holt’s History in South Korea Moved by images he saw of malnourished war orphans, Harry Holt embarked on an historic voyage to South Korea in 1955. That year Harry and his wife, Bertha, urged an act of Congress enabling them to adopt eight Korean children, generating considerable media coverage and public interest in international adoption. Guided by Christian faith, the Holts quickly returned to Korea on a mission to unite every homeless child with a permanent, loving family in the U.S. They established the Holt Adoption Program in 1956, enabling thousands of children to be nourished to health and placed for adoption in the ensuing years.

Concerned about the children who weren’t adopted, especially those with profound medical and developmental conditions, the Holts built a long-term care facility near the village of Ilsan in 1961. The Ilsan Center has since become a world-renowned residential facility specializing in the care of people with disabilities.
Holt developed its philosophy of care in Korea – a philosophy of affectionate, attentive care to nurture children’s growth and development while they await permanent placement. In 1965, Holt introduced a foster care program founded on this philosophy. In this more family-like alternative to an institution, children thrive in the loving embrace of trained foster parents. Holt proceeded to replicate this model of care in countries we serve throughout the world.
Holt broadened its reach in later years, establishing community centers to serve low-income families in several Korean cities. Here, families receive free meals and medical check-ups, as well as opportunities to gain employment and other life skills. Holt also founded the Family Welfare Research Center, providing a forum for collaborative research on social welfare.

In the 1970s, Holt Children’s Services of Korea (Holt Korea) became a legally separate entity from Holt International. They now serve children and families in Korea as two separate but closely tied organizations.
Current Projects Since 1955, over 150,000 Korean children have joined families through international adoption. As adoptees grew to adulthood, many expressed the need for continuing support, such as counseling and assistance with birth searches. To meet this growing need, Holt began offering these post-adoption services, as well as adoptee summer camps and motherland tours – enabling adoptees to explore identity and adoption issues as well as connect with fellow adoptees.

Nearly all of the children who need families in Korea have been relinquished by their birth mothers, most of whom choose to keep their identities secret due to the social stigma of unwed motherhood. Children entrusted to Holt are placed in expert, loving foster homes prior to their adoption. Approximately 600 children are in care at any one time, most of whom wait an average of 11 months before joining permanent families. In the first five months in care, Holt Korea seeks families to adopt domestically, enabling the child to stay within his or her birth culture. Korea, in fact, requires a 5-month waiting period before a child may be placed for ICA.

Child sponsorship helps fund foster care, child care facilities and support for the residents of the Ilsan Center, which continues to demonstrate model care for people with disabilities. Ilsan provides short and long-term rehabilitation and medical care; apartment-style group homes overseen by housemothers; vocational training, such as pottery and sewing; and a K-12 school for children with special needs, including those living outside of Ilsan. Many Ilsan graduates hold jobs at the center or find employment in nearby factories and farms. They often marry and have families of their own.

To prevent child abandonment, Holt Korea began counseling expectant mothers and unmarried couples. Through guidance and support, Holt empowers them to decide whether to parent or relinquish their child. Many of the women who decide to parent stay for one year at one of seven unwed mothers’ homes throughout the country, receiving community housing, nutrition, support and skill development. If a mother decides not to parent, Holt provides her with additional counseling and post-natal care, and places the child for domestic adoption.
Strategic Directions As the country where our mission began, Korea holds great significance to Holt. Our role in Korea is, however, shifting. As national birthrates have declined over the past decade, fewer and fewer children are entering Holt care. And with greater acceptance and occurrence of domestic adoption, the profile of child available for ICA has changed. More healthy infants are finding homes within Korea. Children who now require ICA to have a permanent family frequently have some degree of special need.

Holt has adapted well to the changing landscape of international adoption, successfully recruiting families for children with special needs. But with the overall need for ICA diminishing, the Korean Government has considered bringing an end to the regular process. To maintain a viable adoption program should the regular process end, Holt is advocating for ICA to continue for children with special needs, as well as by Korean-American families – a placement option many consider equal to domestic adoption.

As the overall rate of ICA declines, our role as an adoption service provider will also diminish. But as a child service organization, our purpose in Korea will become more critical. In the coming years, we will help Holt Korea expand the scope of their work – looking beyond ICA to provide broader child and family welfare services through partnerships with local governments, social welfare agencies, educational institutions and hospitals.

Holt Korea’s services will not only expand, but also shift with the dynamics of Korean society, including increasing support for immigrant, guest worker and multi-cultural children and families. As more single mothers choose to parent their children, Holt Korea will provide greater shelter capacity and programs for single parents.

Holt Korea has also undertaken the complete renovation of the Holt Ilsan Center – a five-year project that will require significant fundraising. Holt will strive to underwrite the Ilsan project, work to expand the number of sponsored children, and explore new donor opportunities to support growing child welfare work in Korea.

This document is available as a PDF. Click here.

Some patients worse off with more-experienced docs

Some patients worse off with more-experienced docs

People with complicated medical problems more likely to die in the hospital under the care of a seasoned physician than with a newcomer, study finds

In a study that flies in the face of common sense, sicker patients turned out to fare worse under the care of seasoned doctors than when newcomers to medicine looked after them.   

According to findings in the American Journal of Medicine, patients whose doctors had practiced for at least 20 years stayed longer in the hospital and were more likely to die compared to those whose doctors got their medical license in the past five years.
The results highlight "issues that we have as a medical profession in keeping up to date" with the latest medical knowledge, said Dr. Niteesh Choudhry of Harvard Medical School, who was not involved in the new study. It is "a quality of care problem that has been recognized for five to 10 years," he told Reuters Health.
Dr. William Southern and colleagues looked at records of more than 6,500 patients who'd been hospitalized between 2002 and 2004 at New York City's Montefiore Medical Center in the Bronx.
Montefiore is a teaching hospital where patients are first seen by a junior doctor who randomly assigns them to one of the hospital's six medical teams. Each team has a medical student, recent medical school graduates, and at the top, a senior doctor known as the attending physician.
Over the course of the study, there were 59 different attending physicians. The researchers divided them up based on how long they were practicing: five years or less, six to 10 years, 11 to 20 years, or more than 20 years.
Because the researchers thought doctors might behave differently with their own long-time patients, they confined the study to cases in which patient and doctor had never met before.
In comparing the most and least experienced doctors, researchers saw the most-experienced group had more patients die in the hospital.
At first glance, compared to patients with the newest doctors, those with the most experienced physicians had more than a 70 percent increase in their odds of dying in the hospital and a 50 percent increase in their odds of dying within 30 days.
However, when the researchers took into account how sick the patients were, they found that only the sicker patients -- those with complicated medical problems -- were at higher risk in the hands of the more experienced doctors.
Southern's group also found that while the doctor's experience played a role in how long patients stayed in the hospital, it also mattered how many hospitalized patients he or she was taking care of.
When doctors weren't very busy, they kept patients in the hospital for roughly the same average time no matter how many years of experience they had. But when they did have a lot of patients to see in the hospital, those with more than 20 years of experience kept patients there about half a day longer than their peers who'd been practicing for less than five years.
Previous research has found similar results across a variety of physician specialties. Earlier studies have also shown that physicians with more time in practice are less likely to adhere to practice guidelines.
"It's not quite as simple to say that as you get further away from training, your quality gets worse," cautioned Choudhry.
The problem, he said, is not with the capability of the more experienced doctors, but rather, their familiarity with more current guidelines and practices. The results suggest the need to rethink the way doctors are continually educated in the years after completing their certification, he added.
The authors suggest that physicians with more than 20 years in practice be required to recertify periodically. Most of the older doctors in the current study are presently exempt from having to take recertification tests, they say.
Most doctors do participate in "continuing medical education" programs after they finish their training. But much of it is passive, consisting mostly of attending lectures and reading articles by medical researchers. While these are important ways of learning new findings, said Choudhry, it would be better to develop educational programs that would actively engage the more experienced physicians.
Dr. Steven Weinberger, executive vice president and CEO of the American College of Physicians, cautioned that it is premature to make drastic changes based on the results of the study, which only looked at small numbers of attending physicians. He also came up with several alternative explanations for the findings.
For instance, the fact that patients were in a teaching hospital might have contributed to the different rates of death, since more experienced doctors might give the doctors-in-training more autonomy. And the different lengths of time patients stayed in the hospital could reflect a cultural difference in today's younger physicians, who are taught to focus on reducing hospital stays.
Despite his concerns about the study, Weinberger agreed, "It is important for physicians to stay as current as possible."


Copyright 2011 Thomson Reuters

Let's Learn a Lesson about Love and Acceptance from the "Dino Train"

One day, right after we put in the adoption application, I was having some major doubts...

then this came on the tv and Jillian knew the lyrics and was singing with them, and I really listened to the words.  I burst into tears and knew in my heart that we are doing the right thing.  I haven't looked back since. Please watch it and read the lyrics. It is so sweet and endearing, and so what I want our little family to be all about!

  I'm getting a little *verklempt* all over again watching it right now...

Dinosaur Train

Once upon a time there was a mom
Her name was Mrs. Pteranodon
Sittin’ on her nest she heard a stratchin’ and said
“Oh boy! My eggs are hatchin’”

One by one her kids popped free
baby Pteranodons one, two, three
“I’ll name you Tiny, Shiny, and Don”
But Tiny said “Wait, there’s one more, Mom”

Last little baby was a different size with teeth and a tail and big green eyes
He didn’t look anything like the rest
“What am I doin’ in a Pteranodon nest”

But dear old Mrs. Pteranodon said

“Oh this is your family and I’m your mom
you may be different, but we’re all creatures,
all dinosaurs have different features
Come on Buddy, we’ll take a vacation
I’ll get us some tickets at Pteranodon station
We’ll travel the world through sunshine and rain
And meet all the species on the…”

Dinosaur train, dinosaur train, dinosaur train, dinosaur train
We’re gonna ride, ride ride ride…
[Choo Choo]
ROAR!