Sunny on the Inside

By Erin Ruggaber Howard

At six-weeks-old, JD was a strikingly attractive baby boy with long, curling eyelashes emphasizing startlingly black eyes. When the nurses woke him so that I could pick him up, he lifted his head up and peered out from under a blanket with an endearing, tear-wet face. For one precious moment, we could see the sweet, calm, charming, little baby he was on the inside.

And then the withdrawal took over.

The sweating started first. Big beads of sweat, like those of a stylized athlete in a Gatorade commercial, stood out on his baby face. Then came the crying, a high-pitched cry that ended with a squeal like a dolphin whistle. Then he began to shake, his little hands clenched and his arms shaking convulsively as I held him for the first time, tightly, tightly, trying to help him calm down with the stability of my body.

I was no withdrawal expert, but I knew the basics. In the single day since we’d been contacted about adopting JD, I’d been on an information bender. I consulted social workers, pediatricians, friends with medical experience and, of course, the trusty internet to find out all I could about the long and short term effects of JD’s pre-natal opiate exposure. It wasn’t exactly comforting, as the best thing anyone could say about methadone addiction was, “At least it’s better than heroin.”

I knew that JD had been born addicted to methadone, a tightly-controlled, legal prescription drug used to help people, like his birth mom, kick a destructive addiction to illicit opiates. I knew that JD’s withdrawal symptoms had been so severe that he’d been heavily sedated with morphine in the six weeks since his birth. I knew that as the methadone passed through his body, the withdrawal effects would dissipate and eventually disappear altogether. It may not have looked like it the first time I met him, but JD was on the upswing. At long last, his birth mom—who had known for months that she intended to place JD with an adoptive family—could finally complete her adoption plan.

Far from being scared by our abrupt exposure to the intense world of drug withdrawal, my husband, Phil, and I were filled with compassion for this little guy. I was immediately stung by the fact that little JD had been doing this alone. I understood, as had our social workers, why his birth mom couldn’t be with him day after day. She was in a difficult position. I also understood why Phil and I hadn’t been contacted until JD was almost ready to be discharged: there were extreme emotional and legal risks to bringing the adoptive family into the picture too soon. And yet, my son—for he became my son the moment I saw him—had been going through this horrible experience without his Mommy.

After an exhausting four days during which Phil and I tag-teamed sixteen-hour stretches as the hospital, JD was stable enough to be discharged. JD had his first “episode” as our official son on the four-mile car ride home from the hospital. When we got home, we found that his carseat was soaked through from his panic-driven sweating. It took two hours in a darkened room to calm him.

At the nurses’ suggestion, we did what we could to mimic the dark, quiet hospital environment at home, but we couldn’t recreate everything. I found myself giggling with over-tired hysteria as the discharge nurse explained to me that JD had always slept on his tummy with a blanket over his head, and that they had used a washcloth to tie a pacifier to his face. There was no way we could help JD through the transition if that’s what he was used to! It was ludicrous! It was one thing to tie something to your baby’s face while he was attached to heart and oxygen monitors. It would be foolhardy—possibly even illegal—to attempt such a thing in our home.

The days weren’t so bad. Our two toddlers loved JD and, although we feared that his new siblings’ noisy play might trigger episodes, JD responded well to interaction with the “big kids.” Phil and I quickly learned to read JD. At times, I felt like Steve Irwin, the Crocodile Hunter, who used to say he could feel aggression rising in a captured croc. I could feel the tension rising in JD when his environment was about to trigger an episode. Once an episode began, JD would need dedicated attention in a quiet room for a couple of hours and, as the stay-at-home parent to three kids under three, I didn’t have a couple of hours to give. Whenever possible, we needed to get in front of the episodes. We walked out of restaurants, family gatherings, even JD’s own baby shower whenever JD showed signs of tension. Often, JD was what we termed “sleeping in self-defense”—that is, forcing himself into a non-restful sleep to escape the disturbing stimuli—so family and friends often couldn’t figure out why we were leaving. To the untrained eye JD appeared to be napping. In our knowing, parental eye, he was barely coping.

We could have handled the days better if the nights hadn’t been so bad. Phil and I found ourselves reluctantly called upon to be the washcloth that had held the pacifier to JD’s face in the hospital. He couldn’t calm without it. Many nights, we found ourselves half-asleep on the floor, one hand by JD’s face to keep the pacifier in his mouth as he whimpered..

I don’t know how many episodes JD had in the six weeks before his withdrawal symptoms ended. I do remember being gripped with fear about two weeks after JD came home, panicking in the middle of the night with the horrible what-ifs. What if the episodes didn’t go away at three months like we’d been told? What if it was going to stay this way for months and months, or longer?

In my semi-lucid daytime moments, I didn’t have that fear because I knew at that the episodes were a surface issue. From the very beginning, Phil and I could see that JD was actually a sunny, easy-going guy. The withdrawal was something that was placed on top of him. It wasn’t who he was on the inside.

At three months old, just as predicted, JD became that sunny kid full-time. We began to get compliments from strangers about JD’s calm demeanor. It was hard not to laugh or, worse still, launch into a description of his wild early days. “Thanks,” I would try to make myself say, “he’s been that way since he was a tiny baby.” After a year or so of physical therapy to get his muscles stronger and more coordinated, JD emerged strong in heart, mind and body with nothing to hold him back.

When JD was almost two years old, Phil and I returned to our adoption agency to begin the adoption process for our fourth child. During one of the classes we were required to take, we were encouraged to think about what kinds of prenatal conditions and special needs we would be able to handle as parents. Our social worker passed out a handout to everyone in the group listing the dozens of children who had been placed through the agency in the past two years. The chart listed all the risk factors for each child, so that prospective parents could start thinking through the realities of these issues. Some babies had no risk factors at all, but one had entries in every category. The risks looked stark and horrible on paper: Methadone. Morphine. Withdrawal. Hospitalization. In half a second I realized that this, the most dire of all the babies placed that year, was my son JD.

“He’s so much more than that!” I wanted to cry out. “This has never defined him! It has never held him back! You don’t need to be afraid of a kid like JD!”

Sometimes I want to shout those words not just to an adoption class, but to the world. On the inside, JD was never the person that the drugs caused him (at times) to be. All he needed was a little help to get through the first three months. Now six , JD is the same sunny, affectionate, easy-going guy that Phil and I loved from that hospital bed. The only difference is, now the whole world can see it.

Erin Ruggaber Howard is a full-time mom and part-time museum curator. She loves to share her experiences in parenting and adoption and has been published in Chicago Parent, Adoptive Families, Adoption Today.

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By Erin Ruggaber Howard

There are lots of words I would use to describe my seven-year-old son “Ben.” Sturdy comes to mind. Solid also gets thrown around a lot. And yet, after Ben’s recent well-child appointment, I had to throw out Solid and Sturdy and replace them with two far less pleasant adjectives—Overweight and Obese.

The pediatrician flashed her electronic tablet at me, pointing to the Blue Zone—the healthy BMI range—and following my Ben’s line up the chart as it shot straight into the White Zone. The Danger Zone. She tilted the screen away from Ben so he couldn’t see. Almost guiltily, she made a few brief suggestions about healthy foods and increased activity, and we moved on. Quickly. I guess she didn’t want to embarrass him. Or me.

Ben just doesn’t look obese. Not to me, anyway. I’m sure a trained eye would detect the slight pudge around his middle, the thin padding that smooths over the ridges of his rib cage. To me, he looked healthy, and that’s scary. Normally, I’m pretty on top of this Mom thing. I’m quick to pick up on symptoms—the wheeze that denotes an allergy trigger or the rash that’s our first clue of Strep. I’m observant, darn it! How could I miss this one!

Looking back, there were clues. When he was a toddler, Ben’s sister found some of my banana scented Burt’s Bees hand cream and fed it to Ben with a doll spoon. He ate it. All of it. He’s always been a big eater like that. It doesn’t matter if he’s hungry. I guess it doesn’t even matter if it’s food—he seemed happy enough with hand cream.

And of course Ben’s swimming in my husband’s gene pool. Phil is the very definition of a Big Guy. We have to order his Size Sixteens from a website called “BigShoes.com.” No joke. When I do laundry and pull out a pair of pants that is almost bigger than I am, I think, “Wow, these are ‘Big Man Jeans’.” Then I chuckle to myself, because my husband has both “Big Man Jeans” and “Big Man Genes.” I get really bored when I do laundry.

Just like his Dad, Ben has “Big Man Genes.” Undoubtedly, he will someday also have “Big Man Jeans.” Does that mean I should throw up my hands, throw out the BMI chart, and go on as I’ve been? So. Tempting.

Since that fateful doctor’s appointment, I’ve taken a good look at our family’s eating and exercise habits, and the truth is we aren’t perfect, but we aren’t doing that bad. It’s not like I handed Ben a bag of Cheetos and a six pack of Coke with a cheery “Enjoy your video games, Dearie, I’m off to Bingo.” We’re an active family who eats home-cooked dinners around the kitchen table. It’s all very Rockwell-ian. Those “Big Man Genes” must be a big part of the equation because Ben’s three siblings (who all happened to have joined the family through adoption) are perfectly balanced. The three of them are nestled comfortably in the healthy Blue Zone on their own nicely curving growth lines, while Ben’s chart shoots straight up into the Danger Zone like a profile of Mt. Everest.

I could shrug this whole BMI thing off. Ben’s a Big Guy and that’s the way it is. After all, I’m sure Phil went through his whole childhood hearing, “Oh, he’s just big boned” and he turned out all right. Ok, not exactly all right when it comes to this issue—it’s a struggle for him to stay under the 300-pound mark now that his football and wrestling days are behind him—but he’s got low blood pressure, low cholesterol and normal blood sugar. And he’s charming, well-adjusted, spontaneous, and a great Dad. That has to count for something.

But from long years of experience watching Phil’s battle to stay under 300, I know it is much easier to maintain a healthy weight than to try to shed unhealthy extra pounds. Even if Ben is “big boned” I need to teach him how to make healthy choices—now.

No more hot-and-ready pizzas when I’m running late. No more ice cream every sweltering afternoon. No more granola bars for breakfast. But the biggest change needs to come from Ben himself.

When we were out to lunch a couple of weeks ago, Ben and I split a club sandwich and tomato soup. For the first time, I noticed that we ate the exact same amount—me a grown woman and him a seven-year-old boy. As soon as his food was gone he glanced over at his little sister’s plate. There was half a grilled cheese sandwich, just sitting there, all tempting. “Are you going to eat that?” he asked casually, already reaching across the table.

“Are you still hungry?” I asked. He thought about it for a second. ” I’m not really hungry anymore … but I’m not full either.” Ah-Ha! Breakthrough! Still holding his hand gently, I looked him in the eye. “This is what full feels like”, I said. “Right now. ‘Not hungry anymore’ is the same as ‘full’. You don’t want to eat until you feel sick, do you?” Sadly, I think he had to consider it. Eventually he shook his head, and I quickly removed little sister’s temptingly half-empty plate. One small victory.

It’s a weird balance—teaching Ben to make healthy choices without getting carried away. I feel a sadness that Ben is now a national statistic—one more of those 31% of American kids who are overweight or obese—and it would be easy to get carried away trying to “fix” him. But doubling down to reduce his BMI percentage? That’s the wrong goal. That BMI thing is just a tool. It doesn’t tell the whole story. It’s not a one-size-fits-all proposition. Like those black knit winter gloves I naively bought home for my ham-fisted hubby when we were newlyweds, the BMI chart is at best one-size-fits-most.

The goal has to be a healthy Ben—whatever that is—and not a dot on a chart. I’ve got to let go of my Mommy Guilt and admit that healthy Ben might never be a Blue Zone kind of guy. But healthy habits, healthy choices for the whole family, will go a long way toward making sure those “Big Man Jeans” never get too big.

Erin Ruggaber Howard is a freelance historian and writer, and a SAHM to four children. She has written for Adoptive Families, Adoption Today, Chicago Parent, and Brain, Child exploring issues of parenting, adoption, and racial identity.

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Sunny on the Inside

More Than a Stat: My Son is Obese