JACKSONVILLE, Fla. (AP) — When Adam Paulraj sets his mind to do — or not do — something, he's unstoppable. Whether it's using his entire body to block his baby brother Elliot from grabbing his toy or refusing to go on a bike ride with his parents, Adam is determined to get his way.
You might call him a little stubborn. But his resolve has helped him through what would be considered anything but an easy first 20 months of life.
"He definitely has a resilience that's pretty remarkable," his mother, Jessica Cooksey Paulraj, said.
Adam was born in September 2011 in India with Bartsocas-Papas. When his biological parents saw the severe deformities caused by the rare syndrome, they abandoned him.
Raja Paulraj was working as a doctor in the hospital. He quickly introduced his wife, Jessica, a Stanton College Prep graduate, to the infant. They adopted Adam soon after meeting him.
Adam's young life has been filled with 10 surgeries. There have also been illnesses and infections. Between the tough times, there have been plenty of laughs with his brother, cuddles with his parents and extended family, and amazement over the small things he's constantly discovering.
Now the Paulrajs are back at UNC Hospitals in Chapel Hill with Adam, waiting for his next round of surgeries to start in a week or two. He has already had surgery on a cleft lip. Now he's getting surgery on his cleft palate. And after surgeries to give him eyelids, doctors may need to do some repair work on his left eye.
Doctors may also change the size of the opening for his tracheotomy tube, or possibly even remove it in a few months, said John van Aalst, a plastic surgeon at the hospital. He said doctors will meet with the Paulrajs over the next few days and determine Adam's immediate needs.
Jessica is hoping when the tube is out, Adam might start talking. For now, he's learned a little sign language, including the signs for "please" and "thank you."
Also while the Paulrajs are in North Carolina, they will discuss creating prosthetic legs for Adam. He was born with his legs fused together. They were later amputated just below the knees.
So far, Adam's $200,000 of medical costs were covered by family, friends and strangers from around the world. Doctors estimate his medical care this summer will run about $150,000. So far, the family and hospital have raised about $12,000 for these next surgeries.
Van Aalst coordinated Adam's care after he heard about the boy from one of Jessica's friends. He's also helped spearhead the fundraising effort through The Medical Foundation of North Carolina. He assures donors that all of the money raised is used exclusively for Adam's treatment.
After Adam's surgeries, the Paulrajs will return to Jacksonville, where Jessica's parents live. Then in the fall, they'll return to India.
It's in India where Adam learned to get around mostly by crawling. But he loves to pull himself up to his knees to play with a table toy.
And even though he was born without fingers, it doesn't stop him from picking up anything he sets his sights on. Once he's holding a new toy, he can play with it for 30 minutes or an hour.
Even when he's had a fever or pneumonia, he uses every ounce of energy, Jessica says, until he's worn himself out. And when he wakes back up, he just keeps going.
"It's like he wants to make the most of every opportunity," Jessica said.
And he knows what he wants and doesn't want. About six weeks ago, Adam made it clear he didn't want to go on a bike ride with his parents and Elliot. So they headed out without Adam, leaving him with friends.
Five minutes after they left, Adam scooted himself over to the front screen door and sat there while he waited for his family to return.
On the family's blog, Jessica said her heart swelled when she got home.
"To know he knew we left and maybe he even missed us?" she wrote. "Love him so."