Ezrael's Pregnancy and Birth Story

Ezraels Pregnancy and birth Story

I'll never forget when we found out we were pregnant with our second baby.
It was a MASSIVE shock and so much fear surrounded it.

I was still breastfeeding Hezekiah, and he was still just a little baby in our eyes - he was 13months when we found out. At that stage I was still recovering from our first pregnancy. I had only just started to resume any form of real exercise and was finally starting to feel stronger and like I was getting back to myself.

I did not feel emotionally ready for another baby - although I wanted more one day. Hezekiah's journey was a huge roller-coaster - as was the recovery.... I did not feel equipped or prepared when we first found out.
All I could hear in my head was the doctors saying - if you want to have more children - you must wait - probably at least 4 years...… and I could hear what my family would say.... their worry and concern.... if I'm honest there was a lot of fear... and very little excitement from me especially in those first few weeks.... and then the HG kicked in (hyperemesis gravidium) … I had forgotten how bad it was... but this time... I also had a toddler and a working husband..... from 4 weeks I was in bed all day... any time I tried to get up I would vomit large quantities and often end up on the floor...
it was a hard balance of trying to stay hydrated and keep anything down. The only benefit was that we'd been through it was before... so tried to get a head of the dehydration before it got as bad as the first time.
It was a really hard time... trying to care for myself and the growing baby.... and an active 13 month old... who had just had to stop breastfeeding almost overnight with no warning. My milk dried up almost instantly and Hezekiah could not understand at all what was happening - it broke my heart hearing him cry for me as Rob would try and soothe him in another room, while I'd be vomiting and so incredibly weak.
But the weeks went by somehow, around 7/8 weeks I started having some bleeding and cramping and was taken for another ultrasound - the sonographer knew us from our previous pregnancy and had seen what we'd gone through the first time. He said and wrote on the report - unlikely that this pregnancy will be viable. He sent us home with strict bedrest for the next 2 weeks and then told us to come back ( strange since I was already on bedrest completely with the HG) … we did as were instructed and shared the news with two friends in Australia, asking them to pray - pray for the baby, for me for peace and for our family and Dr's who we still hadn't told at that stage, pray that they would receive the news well.
After 2 weeks we went back for an ultrasound - and to the sonographers shock and delight  - the baby was doing well - he said - I didn't expect this but I shouldn't be surprised with the miracles we saw in your first pregnancy.
We went home happy, and trying to rejoice, in amongst the fear of what was to come and the chronic sickness.
We eventually shared with our family over video the ultrasound video.... I'll never forget my parents reaction - especially my mothers.... but, but Leah..... what about what the Dr's said.... our response was simply, " we guess God had other plans".
Telling my younger brother and his wife was really difficult. They were only a few months away from moving to Uganda - for what was suppose to be at least 12 months. They had given notice at work and started packing and preparing to come. They were very happy for us, and decided they would still come at least for a few months.

It was a difficult time, physically so weak from the HG, emotionally from feeling like the timing was terrible ( especially with wanting to stay and be with my bro and sister in law and nieces who were coming) and then with not knowing what this time was going to be like. With knowing what we'd been through the first time, we weren't sure if I would experience the swinging uterus again, and would I have to contend with the possibility of an incarcerated uterus again.
Wondering if we could we prevent it this time, because we knew now?

We eventually told our Doctors in Australia - who's recommendation was to try and get home before 18 weeks - 24 weeks ( where the biggest risk was for the incarcerated uterus) but they also knew I needed to be well enough to cope with the journey on my own.
Once again it looked like I'd have to go on my own - this time leaving Hezekiah to come with daddy, as I was not allowed, and was unable to carry him.
This was incredibly heartbreaking realizing I'd have to leave Rob and Hezekiah this time, and my brother and sister in law and nieces, who would have only been here a few weeks when it would be time for me to go.

At around 14 weeks - it became pretty clear that this journey may reflect the first one in many ways - I started to notice again that I would wake and have no tummy, then it would reappear. So once again I spent many hours hanging between two lounge chairs trying to prevent the incarcerated uterus from happening again. This became a normal part of the new routine again....

The one joy I had to focus on and keep me motivated was my little brother, and SIL and nieces arrival and thankfully when they arrived, I was 18 weeks, the HG while still there, but had subsided enough for me to be able to at least get out of bed and function with medications to help with the vomiting and nausea. We got to spend a few weeks showing them around and these are memories I really treasure. It was also a gift, because for Hezekiah he had the constant distraction of his two nieces to play and entertain him when mummy was gone.

But that day at the airport was one I will never forget - the screaming of Hezekiah as they walked away as I went through security - was a real breaking of the heart. He had no idea what was going on - or where mummy was going.

When I returned to Australia I was quickly put back in under the same team at John Hunter Hospital and thankfully I had almost the identical team as the first time, which made a huge difference with not having to explain things and having that understanding from them.
As with Hezekiah, I had the swinging uterus, so spent a lot of time on my hands and knees - or resting between two chairs to prevent the uterus from becoming incarcerated again. It became clear around 24 weeks again that the swinging was stressing the baby again, as there had been very minimal growth in between ultrasounds over a period of time. I was put on more medication to try and stabilize the excessive pain, which they hoped would calm the baby and help with the growth.
The further a long we went, the more excruciating the pain was becoming - the pain was bad the first time, but it doubled in the second pregnancy's because my body hadn't healed completely from the first pregnancy.
As with Hezekiah I had issues with my hormone levels ( a part of the condition I was born with) so was in and out of hospital and on ever increasing medications to try and stabilize my cortisol levels etc etc.
Numbers of times throughout the pregnancy the doctors stating what a miracle it was that this little baby had survived that first trimester with all the issues I had again, and with my uterus so traumatized from the first one.
Finally Rob and Hezekiah joined us in Australia, which brought so much joy and relieve, and help.
By the end of the pregnancy I was very heavily medicated, it was the only option to help stabilize the pain and to stabilize the hormones. They continued to monitor Ezrael's growth and found that while the medication was helping, it was highly likely he too would suffer withdrawals when born for the amount of medication I was on.

The day he was born ended up being much less straight forward then our first C-section.
After trying around 15 times to find a vein for the cannula they finally got one ( had that same issue first time too, and often too - I have my grandma's tissue veins)  , then it took multiple times to get the spinal block in the correct place. By the time the actual surgery even started I was already feeling very weak - but it was going to get a lot more difficult.
About 20 minutes into the surgery I said to Rob - they are taking a lot longer than last time, our beautiful surgeon ( who' also been there for Hezekiah's birth) said, "I'm so sorry Leah - there is just so much scar tissue from all your previous surgeries - we are having a difficult time getting through it all".

That's why the pressure was so much worse this time - the pulling and pushing sensations that you get were pretty intense this time.
Finally after about 35minutes - she said -" Finally" and then there was a little cry and we heard her say - "oh you are a lot smaller than your brother" ( I was thinking - smaller? really he was suppose to be bigger! Hezekiah was small enough)
Here he was and he was a he..... we had known he was going to be a boy - but I had questioned that a few times - but here he was.
They held him for a few minutes over the top of my abdomen and allowed for delayed cord clamping as I had asked. Then they whisked him off to check on him.
Rob went with him and I lay there waiting for them to insert the pain blocks they give me into my abdomen before stitching me up.

Struggling to get through all the scar tissue from multiple abdominal surgeries I've had over the years. 

Finally they got him out

They bought the TV screen close to I could see him being worked on, with Rob watching over him closely. At that stage we still didn't have a name.
Finally our midwife bought him over for me to have a look at and they to have a little skin on skin contact, after a few minutes I said, " I am feeling a bit strange, you may need to take him" they took him away and Rob followed them.

The surgeons were still busy at work, and the anesthetist was busy chatting with them and monitoring the machines and the midwives were busy working on Ezrael and Rob was with them.
I started to feel even more strange - (I've had a lot of surgeries and its not unusual for me to have some weird feelings or side affects from all the medications)

As time went I started to realize, it was not just pressure I was feeling now - it was pain, the pain of a needle or something pushing through me, and then pulling, the pain increased, I tried to get the attention of those around me, but I was struggling to talk, both my arms at this stage were strapped down as I had medications going in both arms, I couldn't wave for anyone. I kept calling - but not much sound was coming out and there was a lot of noise going on in the room, the pain was increasing, I could feel them stitching up my insides... the pain was excruciating, I started to feel like I was going to blackout, this went on for what they suspect was about 10 -15 minutes. My body started to shake and my beautiful midwife happened to glance over and saw and she left Ezrael with the rest of the team and she leaned down and said "whats going on Leah, how are you feeling?" and amidst the shaking I said, " I can feel everything..... I'm going to blackout". ….. she got the attention of the anesthetist who was nearby - he came over, and read the other machines, looked at me and gasped, " oh my goodness she's feeling them, and he instructed the Dr's to stop...… they injected more medicines and eventually the machines and everything levelled and they began again …. it took quite some time, I kept feeling like I was going into shock, poor Rob stood by concerned and wanting to help, but didn't want to get in the way.
He tried talking to me and tried to distract me from the excruciating pain I was still feeling - waiting for the medication to kick back in.... after some time the pain subsided -  now it was just back to the pressure feeling, the Dr came over and apologized profusely, " I'm so so sorry Leah, since the c-section has gone a lot longer, the anesthetic had started wearing off, we just didn't expect the amount of scar tissue that they found today - I'm so so sorry you were suffering there", he wiped my tears and I could see how sorry he was.

Feeling very alone as the pain kicked in and anaesthestic wore off

Finally got their attention and able to share what I was feeling

After being wheeled to recovery I was incredibly weak and they placed me on oxygen as I just wasn't doing well - I slept in and out while my midwife tried to express my milk for them to give to Ezrael - he was stable at this stage so was in recovery with us.

The anesthetist came and checked on me in recovery and apologized again, he said he'd never had that happen before and he was so sorry. For me and Rob despite how horrible it was - the whole C-section had gone very differently to how they had thought and planned, so it was no one's fault it was just what it was. 

Later after recovery they took me down to our private room on the ward, the plan was the same as with Hezekiah that Rob would stay the whole time to help care for me.
Once we got down to the ward, our specialist and midwife started to explain the care management for me to the nurses on the ward - they all looked at each other, it was clear that it was going to be too much here.
Our specialist and midwife did some ringing and before too long we were being taken back upstairs - I slept and when I woke I was in a large room - I had no idea where we were - the midwife said, they had decided to set up a critical care room for me upstairs at the back of the delivery suite unit - near NICU, as Ezrael was going down hill and they believed he would be going there soon.

I had my own nurse and midwife for the next 3 days - who's sole job was to care for me and all the machines I was attached to.
Not long after they bought my mum and dad in and Hezekiah to meet Ezrael - it was a special moment seeing the boys together for a few moments.
Mum and dad had some time to say hello to Ezrael and then he was taken to NICU where he would spend the next 2 weeks.

Inside our high-care maternity room - we had such an amazing team caring for us

I didn't see Ezrael again till the next day - Rob and my nurse would help to express my milk while I was very heavily medicated, and they would take turns taking it to the NICU.

The next day, they wheeled me through the back corridors between the delivery suit and NICU and I saw ezrael - he wasn't doing great at that stage - they wheeled my bed as close to him as possible, I wasn't able to sit up very much so it was difficult, but I had a few moments with him. They hooked up my oxygen to his oxygen machine, and the nurses smiled and said " you guys are sharing oxygen together still, even after birth :)

Sharing oxygen together on my visits to NICU

Over the next few days the nurses would go to the huge effort of wheeling my whole bed from one ward to the next often through the middle of the night, whenever I got upset that I wanted to see him, they'd unhook all the machines and go to all the effort to try and give me those few moments with him a few times a day.

Ezrael was suffering hypothermia, and was really struggling with breathing - so was on oxygen for a number of days and also placed on CPAP. He struggled to keep down his feeds and was weak for a long time. We heard a number of times the Dr's saying, he is acting more like a 34 weeker than a 36weeker - at the time I didn't think anything of it - more on that later.

Finally getting a real hold after 5 days

After about 2 days - after a lot of praying on our part (mostly Rob as I was pretty heavily medicated) we came up with the name Ezrael. Ezrael meaning God is my strength/empowered by God
Amani (Swahili - meaning loyal, faithful and peaceful) Colin - meaning Victorious - after my dad.

Both our boys names meant something to do with strength from God - because we knew we would not have them in our arms today - if God hadn't strengthened and empowered them. We also chose middle names with the characteristics we prayed that that little one would have.


After 3 days in high care maternity, Rob and I were taken back down to the ward - I still wasn't walking but no longer on as many machines so was able to have a nurse who cared for other patients also.

We spent the next 2 weeks there. Rob would go back and forth between me and NICU, helping to care for Ezrael, helping me express, helping with my physio etc etc.


They are weeks of great physical pain for me, but also feeling greatly blessed to have such a wonderful husband, and feeling blessed at the gift of being a mum.
Most days I only see Ezrael once when they wheel me up to NICU, Rob takes photos and videos for me to stay connected to him.

As Ezrael gets stronger they bring him down for little visits, and eventually he got to a stage where he was able to sleep with us, while still being monitored by the NICU team.

Ezrael suffered medication withdrawals ( as did Hezekiah), so they are monitored closely for all the signs of opioid withdrawal. Its not a nice thing to see your baby shaking, having tremors, in pain and struggling to feed from the medications you've had to take - but I am so thankful for the amazing team who journeyed through the whole process with us.

First night sleeping in with us at hospital - Rob on pull out bed next to his little boy

All tubes finally gone

After our few weeks stay in hospital - we were finally released home. And then the recovery begins.
5 weeks in a wheelchair, months on a crutch as my body was really struggling to recover this time.

home with our boys - the journey to recovery begins

First sunday at church - 6 weeks old

The original plan was that we would all try and return to Uganda together before Rob's 6 month visa ran out. It became pretty clear when ezrael was about 3 months old that that wasn't going to be possible - I was still struggling with recovery and on a lot of medication, and Ezrael was still very little and struggling with feeding, so we hadn't even begun the process of weaning off the medications.
When ezrael was 12 weeks old - Rob flew back to Uganda..... it was going to be an incredibly difficult 6 months apart.

When we finally did start the withdrawal process, it became clear quickly, that Ezrael was struggling with the rate we were coming down off the medications. He was constantly having tremors, diarrhea, crying in distress (a unique cry that is hard to describe unless you've been around a baby having withdrawals), and unable to sleep ( he would wake 7 times within an hour) ….
So they had to slow it down even more.
It was an exhausting process - for us both.
But with God's miracles - we got there ( another post )

Hezekiah was a wonderful big brother and support to mummy - who was also experiencing the same withdrawal symptoms as Ezrael. I am so thankful as I look back for all those around us who supported us during that time.
It is incredibly difficult for people to understand chronic pain, or any of my conditions, and then to try and understand what opioid medication withdrawals are like, when they've never been through it, but I am grateful that people supported us and surrounded us, and stepped in to help and showed great compassion, even when it was hard for them to understand.

7 weeks old

Finally after 6 months apart - I returned to Uganda, with our two beautiful miracles.

It was only when I was back in Uganda - that we would realized why Ezrael was more like a 34 weeker - when I had originally returned to Australia I had accidently left my original scans.
At my first antenatal appointment in Australia - they asked me what the due date was - I was already pretty heavily medicated - and jetlagged, and had pregnancy brain, I said.... umm... and I said its either, this date or that date.... she said ok - and wrote one and said get rob to check.
I completely forgot about it, and because, although Ezrael was small on the scans, he was measuring bigger than Hezekiah did the whole way, so no one questioned.
So with the actual dates - Ezrael was born at 33 weeks and 4 days which explains the extra issues he had, compared to Hezekiah.

When I think back to Ezrael birth, it was certainly more traumatic than Hezekiah's actual birth, the excruciating pain of being without the anesthetic and the weakness I felt for months after - it was a long recovery.


While so much was similar to Hezekiah's pregnancy and birth, each had their own challenges and complications and both held so many miracles.

When our team ask how the miracle boys are - I am always reminded of just how blessed we are to have our two little boys.

And what a beautiful addition Ezrael has been to our family.

Culture shock - through the eyes of a child

Culture shock is something that I am fairly well versed in, or at least thought I was pretty well acquainted with.
I remember experiencing it after my first trip to Africa as an 18 year old - more so when I came home then while in Africa. And I have seen others experience it when they've come to Uganda or gone home and tried to re-adjust. But for me it hasn't been too hard going back and forth, so I completely underestimated what it would be like for my children - or even for me now watching the changes through their eyes.

Its really hard to explain what culture shock is like even from one adult to another, if you've never experienced it - but its even harder to try and explain to someone what culture shock is like for a child.
I am super thankful for a recent friend - who experienced this with her children who was able to help me process my thoughts and for my Dr who just happens to be South African. She raised her children in both places at certain times and was able to reassure me that what we've been experiencing it perfectly normal and natural, and while super hard now - one day our kids will thank us for the amazing life of having two cultures.
She also assured me that I should forget what anyone else says or stop caring about what others may think about my kids behavior - because others will never understand unless they've actually walked in your shoes.

The difference in our boys here has been..... NIGHT AND DAY! The way our boys have behaved since coming - is behavior I have pretty much NEVER seen in them before.
My normally co-operative, socially happy, sharing, caring and gentle (well one has a wild streak), good eating boys, have become loud, aggressive, shy, disruptive and non eating boys.
They are quick to snap at anyone (other than me), they refuse anyone else to help them and get anxious when I'm not around (that is when I even go to the other room!)

For a pregnant mummy who is tired, experiencing rare complications and pain, who is also experiencing more culture shock then I have before and who is missing her normal life in Uganda and my husband too.... its been an incredibly hard season.

I can say I didn't handle the first few weeks very well - mostly because I couldn't figure out why my kids were being what others would consider "naughty".... I could see the way people looked at them and judged them or me ….. and I couldn't work it out....the horror of having our 2 1/2 yr old bite other kids at playground or at their cousins house etc....until the Dr and that friend shared how culture shock affected their kids, did I realise what was going on, and that its pretty normal behavior - so I can take a deep breathe and not worry my kids have turned into aliens from another planet and can stop worrying what other people think. ( why do mum's care so much about other people's opinion - so frustrating - I'm going to work on that in 2020!)

One of the suggestions my Dr had was to take the time to sit and write down all the differences I could think of, and then that would allow me to see just how those differences may be affecting me.
I wrote down a lot! More than I've written here but here a few that I've come up with,

FOOD - a bit of an obvious one
-  Food is so different - there's so much variety here ( so many fruits and vegetables) so many dairy choices and snack choices and meat choices etc. Its overwhelming.
And the foods that are the same here actually taste different. Our boys normally eat numbers of banana's everyday - its a Ugandan stable.... eaten savory or sweet depending on the variety …. here they are very disappointed in the bland taste of bananas. No fruit and vegetables taste as fresh as the ones we pick from the market. Milk tastes different, honey tastes different (different flowers for the pollen, makes different tasting honey) .... everything tastes different.

SPEECH AND LANGUAGE
- Australians speak FAST ( actually we do everything in a rush/walking/shopping/playing/talking) - which is the complete opposite of the take your time, enjoy life culture of Uganda. Even though yes we speak English at home mostly, and the boys are surrounded by English speaking people - we speak a slow English - and use different words from here in Australia. Often our Yes means no or our no means yes.
We say sorry instead of 'are you ok' when you hurt yourself or share something painful.
My boys have struggled to even understand people when they speak here - this particularly has manifested in Hezekiah - who will snap back or reply completely wrong to what the person has said or asked. Particularly when it is a male speaking - males have much stronger Australian accents and except for the video call conversations they really haven't been around male Australian accents much. And in Uganda I personally speak with less of an Australian accent, so that people can understand me more.

UGANDANS MOVE A LOT 
We don't sit still a lot in Uganda - although life is simpler and quieter  - we are constantly doing something, we might sit and chat but we peel green banana's while doing so, we are washing clothes while talking, we walk to a lot of places. There are not a lot of moments where you just have to sit and be still. Before children actually start school in Uganda - all their days are filled with jobs and chores and playing  - they are constantly outside and doing something - using lots of energy up, jumping, climbing, fetching water, helping, playing etc - they are using all their muscles all the time and don't really have to sit still until they start school.

CHURCH IS SOOOOOO DIFFERENT 
I think the greatest difference for my boys is probably the difference in church environment. Church in Uganda is nothing like any church you would find in Australia. They are loud, active, busy, interactive and places where freedom of expression is encouraged and children are warmly welcomed.
When we started going to church here in Australia - my boys couldn't even sit through an hour and half length meeting - usually in Uganda - the sermon could be that long!
As long as I have food the boys can happily engage in church for 4 hours in Uganda ( not always but mostly)
Just a few of the differences from Australia to Uganda
- Our church in Uganda - is outside, dirt floor, sometimes we sit under a tent, other times we don't but its outside. Fresh air flowing, rain coming in sometimes etc.
- Our church is full of music and dancing- music not just at start and end, but constantly throughout - music is often a part of the sermon - one minute you are sitting, next you are all up dancing joining the pastor, everyone is dancing, jumping, moving etc etc.
- Our boys favourite place to sit in church is on robs shoulders - dancing around.
- Church is not a quiet affair in Uganda - there is no point in a Ugandan church service where people are all quiet and reserved - ( unless you attend maybe the catholic or traditional Anglican service maybe) but overall church is about shouting and praising. All through prayers people are shouting amen, hallelujah etc.... there's no point where I feel I have to keep telling the boys to shh be quiet we are praying now or whatever is may be.
- People wander throughout the service, Ezrael our youngest is an active boy, fairly normal I think for a lot of almost 3 year old boys but especially for Ezrael- so he has struggled especially with not being able to wander through church. I realized that in Uganda - even in sermon - adults are even wandering around, listening yes, but wandering up the front, down the aisles, showing their passion and expressing that as they move around. Children wander - engaged yes, but not necessarily confined to their seats.

PEOPLE LOVE KIDS - like really love them
People in Uganda, genuinely love kids, male and female, young and old, people love kids. They show them attention, they interact with them. Its not strange seeing teenagers caring for their baby or little siblings, its not unusual for a stranger to get down and play with your child on the floor or pick up your baby. Its not weird to have people smiling at your baby or kids in church who are running around etc. People in Uganda are very free in that they aren't worried about he noisy neighbours kids, they aren't concerned with a crying baby, they aren't worried about the mess on the floor from kids eating etc. They just love kids being around.

CHILDREN PLAY DIFFERENTLY 
A few weeks ago at a playground, I heard a mum say to her son to stop playing with Ezrael as he was naughty for being so rough. I hadn't taken my eyes off of Ezrael for a moment (he had started biting as a way of expressing all the changes since we had come so I was monitoring him closely)
I hadn't seen him being rough anymore than what I had seen most kids playing like in Uganda - he wasn't being aggressive or anything - he was just being.... tactile.
Now I realise not all kids like to play rough or in a tactile way but I realized in that moment ( and also from the conversation with the Dr, that African kids play differently) they touch a lot as they play, they hold hands, they push into each other, they naturally touch as they go past each other, they touch or gently push as they help younger children on the playground etc - they play in a very familiar way - even with kids they've just met.

They also dont' so much have the idea of 'taking turns' etc on the slide or something - its more - little ones go first. At a play ground ( not that we have many) or anywhere where kids play, older kids will often take charge of the little ones - not in a bossy way - but in a caring way - letting them go first, even if they just went, pushing them on the swing etc etc. So I think for our boys they hadn't really seen older kids at a playground not engaging with little ones, Ezrael will go up to older kids here expecting them to help him, or include him in their game. But that's not usually how things are done here in Australia.

We also don't have as much concept of - this is mine, that is yours etc.
Most people do not have a lot of things, children especially do not have a lot, and overall share quite freely. They share food at a playground freely, we share food in our house freely, someone has a toy at the field, another child picks it up they let them play, knowing they'll get it back before they go.

Its only really been since we have been here that the boys have seen so many toys and things, and have learnt the concept of MINE, yours, taking turns etc. Not bad things to learn, but brand new for them even though they aren't babies.

PEOPLE KEEP TO THEMSELVES HERE IN AUSTRALIA AND ARE BUSY
People in Uganda while very busy doing everyday chores and working etc, take life a lot slower. They don't rush when they walk, they look people in the eyes, they greet people on the street, they shake hands with strangers at the shops, they are friendly and warm, they engage numbers after a brief conversation incase they work in an area of business that may help you one day, down the road. Our outgoing Ezrael is very much like this, talks to random people, etc and people are surprised by this here. I've already noticed he doesn't do it as much now as he realizes its not what people do.

WHEN WE SAY OUR MANNERS
In Australia - generally people say Please or thankyou in the first part of their request - in Uganda - its generally at the end - still there and not forgotten and my boys have always had good manners - but here people are often already correcting them even before they've had a chance to say it - every country seems to say their manners in a different place in a sentence ! Something I wish people would realise - for Hezekiah this has been especially frustrating - I can see he's about to say please or thank you and someone says - say please or say thank you or where are your manners - and he feels defeated so then doesn't even want to bother.

THE WHOLE WORLD IS A TOILET :) haha
Its perfectly culturally appropriate ( especially for a child) but sometimes even adults to pee wherever they may need to go. Thankfully most people here have found my boys peeing in public amusing and not bad manners :)

KIDS HAVE FREEDOM AND TAKE RISKS AND WE DO NOT OVERPARENT 
In Uganda - risk is encouraged and kids are kids, you do not here people saying, don't climb there that's dangerous, or be careful ( obviously if its crazy stupid maybe) but generally children are free to take risks and explore - parents do not over parent. I have had many concerned parents parenting my boys at playgrounds etc or looking at me strangely when I have been ok with some of the things my boys have done.

Its funny because there are some things in Uganda that when done here would be considered rude. And vis versa.
For example, my boys have walked into people's houses and before too long have wandered into the kitchen and sharing that they are hungry. Or they sit waiting for food to be served, even if we have just popped in for a visit.
This is culture - it is RUDE in Uganda to go to someone's house and to NOT be served something. Every time we go to anyone's house in Uganda, food, snacks or at least a nice drink would be served. And its considered rude not to take the time to stay and enjoy it. You never really just pop into people's houses there.
Here when my boys sit down waiting for food at someone's house or wander into your neighbours kitchen asking if they can have something to eat, it could easily be looked upon as that child has no manners.
People burp here ( even with manners) and have toilet humour… these are Completely inappropriate in Uganda  - I have probably never heard anyone burp in Uganda I don't think!
So the look on my boys faces when they encountered that here was quite funny!

There are so many other things I could write about, for myself just the overload of choices has been hard to get use to, the first few times I went into woolies, I came out empty handed because I couldn't choose something because there was just so many varieties and choices to choose from.
I go to a café and find it takes me forever to choose something because the options are endless!
The lack of 'God conversations' …. the negativity... parents yelling at their kids and talking in terrible tones to them ( Ugandan parents may discipline for sure - but yelling and demeaning is not a part of that) ……

I am thankful for those friends and my doctor who have helped me to see and understand many of these cultural differences, I pray that our boys will settle and learn how life works here, but also know the differences for when we go back. I'm especially thankful that they have started to settle especially now that their daddy has arrived.

While its difficult, I hold onto the belief that one day, these two cultures, while wildly different will help them to be well rounded and adaptable kids.