Wednesday, August 31, 2011

The Hospital Chart

Ok first,
let me say thank you for all of your wisdom about our "custody papers" issue yesterday.
Ya'll are all fired up right alongside me and you had such a great point that we have already "proved" he is our son by the fact that he is enrolled in our insurance.
The office had been sent a referral for him, from our insurance.
This knowledge that we had already submitted 800 papers to prove his adoption when we registered him with our insurance months ago eluded me in that moment.
That is exactly where the burden of proof has been met.
I appreciate your advice and I will let you know what happens on Friday!

In other news,
I've been obsessively planning the details surrounding John's trip to China.
He should be leaving next week!
Hold on.
That sounded really good.
I just have to say that again.
He should be leaving next week!!

I've been going over and over and over the details of everything involved with them coming home
with Joshua being in the hospital
the oxygen delivery
the Ronald McDonald house reservation
where the nearest coffee stand in the hospital is
You know.
The important stuff.

And one thing that I have been hung up on is that it is going to be quite challenging trying to communicate with JJ when he is in the hospital.
It's hard enough when these kids first come home.
But coming off of a 15 hour flight,
being handed to a stranger(uhhhh, that'd be me)
and going straight into the hospital is going to ratchet up the difficulty level a notch or 12.

Are you hurting?
Need to go to the bathroom?
You want to watch that crazy yellow sponge named Bob show?

These are the things I will need to know.

And if we learned anything with Jacob and Joey's adoption it is that those translators,
though good in theory
are slighty impractical.
They are too slow.
They are too tempting for little boys to touch while it's thinking about the translation.
Additionally we found that it would often make an error.
"Do you want to take a bubble bath?!"
Could easily become
"Do you want to put the duck head in the dishwasher?!"
I dunno.
They have their place.
It just didn't work for us.

So I decided to kick it old school and make him a little picture chart.
With a picture, kinda like this
of a drink.
With the Mandarin character for "thirsty" under it.

And this:

With the character for "hungry".

And so on.
I'm going to keep it small.
One page.
And he will be able to just point at whatever he needs.
Which, when you are recovering from a heart cath and {hopefully} major surgery,
not having to play charades and pantomine everything with your new mother in order to get your needs met
has got to be a relief.

So I need your help!
What am I leaving out?
Get away from me you crazy American woman.

What else should I put on there?
Bring it.

In other news,
Day 872 waiting on TA
Just kidding.
It's been 3 days.
It just feels like 872.


  1. I found this page that seems to have some good info. on preparing children for a hospital stay. It has sections for different age groups and a nice chart for showing pain. I hope this helps! Hugs ~ Jo

  2. I also found a PDF that you can Print for your boy! I think it's pretty universal!

  3. i like the crazy american woman one-- gotta see that!!!!!!
    ok- so definitely go get your hunger game trilogy. also, The Help, The Good Earth, Snow Flower and the Secret Fan( can you tell i like to read???)

  4. The pain scale picture set is often used in hospitals and I think it would be very useful! Maybe you could also include other emotions he might be feeling? Like happy, sad, scared, with the characters, of course.
    So excited for you!

  5. The chart is a brilliant idea! Sure helped when ordering McDonalds when in China! ;) I'd add a hug (although he may not want one, at least he'd see it as something you'd like to provide him) , t.v., and book or toy. SO exciting that your hubby is leaving next week. Just fun to say. NEXT WEEK!!

  6. Here's another for potty questions! : )

    This is a great site for nonverbal needs, although this page is specific to Autism. here's the link:

  7. LOVE the idea. I agree maybe tv/movie...maybe next to thirsty put water or juice or two choices so he can pick easily. Also I know you said translators didn't work but (not to put anymore on your plate) could you find out if a college by you has a student who could come say everyother day or whatever you choose. Not only would it be comforting to him to speak to someone else but he could let him know things he couldn't communicate with you and maybe they could play a game or two. I would think there has to be an exchange student that has been in the US a while that was fluent in both. I work in a hospital and can say when you have the translator there in front of you is 1000x better then when they are on the phone. It is also sooo much more comforting for the patient. They seem to feel much more in the conversation and do understand a great deal more. I am praying for your entire family

  8. I would like to be just like you! You rock!!

  9. YEah!! Love it! What about itchy since some of the drugs can do that to him. Also maybe a picture for walk (when he first needs to get up & walk) sleep - so he knows you want him to be still or nap, cold or warm, maybe emotions like scared, love, and not sure of the hospital you are going to but if they either have a playroom or the portable video games then a picture. I think the hardest will be when he is feeling better but not quite ready to come home.


  10. We did this when we went to to pick up our 7 yr old in Feb. It was hugely helpful. I got a small photo album from Micheals and put the pics in there. Our daughter still likes to talk about the book. She caught on immediatley how it worked and would use it daily. I think it gave her a sense of control. Here is what we did...

    potty, PJs, brush teeth, bedtime, doctor, car, food, jacket & shoes, coloring, TV


  11. what about pictures for emotions? Sad is a big one they feel coming home.
    have different options for food, so he doesn't feel so limited, though I doubt he'll have many options in the hospital. :(

  12. So creative - I would like to see the one with a crazy American woman .
    My kids just want to be quite and sleep - how about a picture of a kid sleeping in a bed.- just a thought

  13. Maybe something like "do you need a hug" or "do you want me to sit by you/snuggle you?" I know he's on older boy and all, but hospitals can be scary.

  14. I've been a lurker on your blog for awhile. I'm an adult who was internationally adopted and a professional who works with children who have a range of special health and developmental needs.

    So setting up picture communication systems is something I do often. Your list is a good start.
    In addition to the ones you already listed some picture icons we typically might include: help, more, want, play, yes, no, please, thank you ...

    The website below is great. If you scroll down (about halfway), you'll find pages with picture icons for a ton of common objects, foods, toys, videos, activities, etc. This may he useful for both communication and teaching English vocab.

    This site is also good. The icons on this site are more like line drawings than photos like on the other site. I'm guessing these are far more than you'll need but options are always good. :)

  15. I don't know if you have access to an iPad, iPhone, iTouch, or similar such device (or know someone you could borrow one from) but have you looked into any of the Augmentative and Alternative Communication (ACC) apps that there are out there to use. The possibilities with this would be just about limitless with picture to word communication. (I'm sure you could point to a picture as well to show him what you want to communicate). Here is a blog with a list of programs.

  16. Isn't it true that most reputable hospitals
    provide translators (human) for those patients
    who are not English speaking? Often times, you
    meet a hospital employee who may translate.
    Your little boy and his situation will just
    touch many peoples hearts. Blessings on your
    husbands trip to China. mm, vancouver,wa.

  17. I posted about this a loooong time ago:

    They worked great and Ivy walked around holding them on a cute key chain. Congratulations on being a mom again.

  18. Hi Sonia--we met in China when you got your boys. My son, Landon, is from the same orphanage as Joey and Jacob. Anyway, Landon had to have surgery just a few days after we got back to the U.S. and the hospital arranged for a Mandarin translator for us. She was amazingly helpful and a lifesaver when he woke up after the surgery. Take care, Amy

  19. I have a picture icon book that I made for my older kids when I adopted them. It is a 5x8 binder with velcro and all the icons for anything I could think of, tortillas and beans when we were in Guatemala and noodles in China!!!

    Anyhow I would be happy to send to you and add any hospital type ones that you may need to it.

    I used the front cover to make a visual schedule of what was the plan for the day. We needed this with our little one that was so obsessed with getting food. We were able to show her when she would eat again.

    It's your if you want it!

  20. Sonia...this may be a really dumb question, but did you check to see if the hospital has a translator. I know, I know...not likely, but worth a try. Also, check with your insurance, because they could possibly cover for a translator under the circumstances. I know a pain in the rear, but it might be terrifying for this little guy if he doesn't know what is really going on...just a thought! Miss you & praying for you always!

  21. PS...the picture idea sounds great for when it is just you and him in the room...trying to get his basic needs met! I just meant a translator for the big stuff!

  22. I am a pediatric nurse and think this is a great idea. Call the hospital and ask to speak to the Child Life Specialist, they should be able to give you more ideas. This will also help them to prepare for this special patient who is coming! Prayers for healing and peace being sent for your son and family.

  23. Crazy American woman..heehee! :) I don't know if this is possible when a child is buggered up in all those tubes and cords but what if he wants you to hug him, love on him, hold his hand? I'm a total sap so those things come to mind. :) Travel next week sounds AMAZING! Can I sneak into your hubby's suitcase to go see my little man...? ;)

  24. Love it! You have some great suggestions. I just want to tell you that I will be praying for your precious new son!!

  25. I think you have it covered as far as the basics. Also, a picture of an ipod (JP LOVES Angry Birds) and a computer/movie if that is what he wants. I also let him pick out movies at the DVD store and he knows every word to the Power Ranger theme song. ANYTHING character seems big. Our smaller hospital in Portland, Maine also said they would find a Mandarin translator.

    JP says "hungry" and understands potty and frequently asks for a drink. Definitely sleep. It would be good to have a way to let him know it is TIME to sleep. JP is pretty wired with the excitement.

    By the way, our guide came to our room and mentioned how cold it was. She asked JP if he was cold and he told her he feels much better here in the AC. He has had a lot of energy the last two days.

    Maybe you already know the words for hot and cold but I wish I had signs/words for those.

    Also, I wished I had a better way to do a pain scale. JP will not admit anything especially to a guide. They are programmed to be respectful. We have to go on mama's intuition which I am sure you have in abundance so you will be fine.

  26. I'm just tapping his little face on the screen saying Your.daddy'!!! This is just so exciting. My only suggestion is a heart so you can tell him you love him about 20,000 times a day. I'm so excited!!!!!!!!
    Donna O.

  27. I didn't read through all the comments so perhaps someone has already mentioned this, but a lot of hospitals have people to translate. I would definitely recommend asking for one! They will come and explain everything and answer questions. One thing for the chart you might want to add is: scared, sad, go for a walk.

  28. Can I just say you are brilliant?!

  29. I taught special ed. and that is exactly what we did for kids who were non-verbal but still could communicate some. That and flash cards with pictures (if you find you want something more extensive - maybe with a few medical type pictures to explain to him what is going to happen to him, although he's probably pretty familiar with hospital procedures at this point - poor boy!).

  30. Love it Sonia! I would add "afraid" to the list. You might consider a plate full of potstickers or rice and veggies rather than a burger for the "hungry" page! (or chicken feet! :)) And for "thirsty," they do not drink water directly from the tap in China, so the pic might be a little confusing to him...maybe a bottle of water. you might also had "nauseous" or "tummy hurts" in case you need to grab a basin for him! (not sure what pic you want for that one!) Call me if you want some pronunciation lessons to be able to say a few of these basic things... So excited the day is coming soon!

  31. I'm a medical social worker and also an adoptive Mom. Your hospital should be able to provide a Mandarin interpreter. I don't know where you live but if you are in an area where there are not Mandarin speaking interpreters they can access them on the phone through special interpreter agencies that can provide interperetation that way. As far as communication I would learn some basic Mandarin for commonly used words, that will help immensly. Then for what you don't know do what travelers and people all over the world have to do when they don't speak the language, you do pantomime. For eat you pretend to eat for drink pretend to drink, learn the ASL sing for toilet you make a T, thumb between your first two fingers and shake it back and forth. It's easy and understood, probably better to know the word in Mandarin, but trust me, acting it out will work very well. All your son will need is to see the love and kindness in your eyes, he will "get it", that you are there for him. Not its not the start you would want for him, but you will learn as you go.Both of my kids are deaf and came at ages 5 and 6 with no language of any kind, but they understood a lot. Keep paper and pen around and you can draw a lot with stick figures, you don't need to be an artist, kids will understand even rough drawings, its quicker and easier then trying to have pictures of every possible thing. It will all work out in the end, hang in there.

  32. Sonia,
    My only suggestion would be from a pro-active side with the hospital. It would be a good idea to check if they have a Mandarin interpreter with them now before he gets there rather than scrambling when he arrives. It will hopefully put your mind at rest a little. All hospitals are supposed to have phone interpreters but it is clumsy at best, especially for this little guy!

  33. You have already received a ton of great advice. I double the Child Life Therapist advice. Also, if you can get some pics of the hospital room ahead of time and pics of doctors in scrubs etc. he will not be so surprised when he sees them in real life. Kind of like sending the family photo album to prepare a child--since this will be his first "home". Pics of the head doctor he will see etc.

    Sending prayers multiple times a day.

    Oh, and yes, you should be able to get a Mandarin translator by phone almost any time--they have "banks" of translators they can contact. We have never been charged for having translator services.

    Ann at CrazyforKids (who for some reason cannot post comments except as anon)