Medicals From Eastern Europe

My friend Stephanie recently posted an entry to her blog that discusses the issue of adoptive children's medical reports from their birth countries.  I want to thank her for that information and add our own experience with the matter.

When we reviewed the medical file for Rex, the two main conditions mentioned in it were congenital cleft lip and palate and moderately-severe hearing loss.  Otherwise, he was born a very healthy baby, around 50th percentile by US standards for height and weight with an APGAR score of 8-9.  He had feeding trouble for the first few months of his life and lost a lot of weight, but once cleft nursers were provided for him, he started to grow.  Rex's report also mentioned that he had significant developmental delays, especially after his cleft lip was repaired in Armenia.  Any and all of these delays could, theoretically, be explained by his hearing loss, CL/CP, and institutional life.

We did have Rex's file, along with many videos and photos, reviewed by a reputable IA doctor who is also an adoptive mom of three.  She was very concerned about his development.  Rex was more delayed than what she typically sees out of EE, but Rex was the first Armenian child she had ever evaluated.  She suspected that he had suffered brain damage under anesthesia and told us that in a worst case scenario he would be the proverbial vegetable, never walking, crawling, sitting unassisted or interacting with his environment.  We decided to bring him home anyway.

Now fast forward about a year and a half from that referral review and Rex was our son.  He had learned to walk, crawl, sit and stand unassisted, but his developmental delays were still significant.  He was evaluated by a variety of specialists and finally a genetics test revealed that he has a rare partial chromosomal duplication with an outcome that can not be predicted at this time with 100% certainty.  However, many people who do have this syndrome suffer from some or all of the conditions the IA doctor foresaw for Rex.  The doctor actually apologized to us for not recognizing a syndrome, but in essence, she did because what she described to us without calling it a syndrome, suspecting brain damage instead, is the nature of the condition Rex has.  Unlike many other children who share Rex's genetic anomaly, Rex has gained physical mobility and is, at least to a certain extent, communicative and interactive though it is a struggle for him.  The IA doctor was right in her own way, despite the fact that Rex has beaten some odds.

All that said, Rex's medical was completely correct in terms of all vaccinations he had received as well as his testing for infectious diseases.  It was totally wrong in diagnosing him with hearing loss.

When we received Emilia's referral, the medical was scary, especially in terms of her physical health.  We were open to heart defects, but here we had been matched with a little girl that was extremely small and had several red flags in her report.  We used the same IA doctor for evaluation and she shared our concerns.  She asked for additional information and videos which we received and which clearly dispelled some of what was in Emilia's medical.  It is very difficult to understand how and why some of the statements in her report ended up there. We again decided to take a chance.

Upon homecoming, Emilia underwent a thorough check-up which showed that she was malnourished and severely anemic.  She is a carrier for a congenital blood disorder and significantly developmentally delayed.  Later we discovered that she has a food allergy along with the feeding problems we'd already been combating.  None of this was in her report.  On the other hand, her heart defect was properly diagnosed, she was 100% on target with her vaccinations as stated and the testing for infectious diseases was completely correct as well.  From Emilia's medical, we could not have foreseen that she would still be largely non-verbal after a year home.

So what's the point of the long-winded post?  I suppose it is simply to say that medicals can be anything from accurate to dead wrong to both.  The thing is you cannot know for sure until your child comes home, has somewhat adjusted and been evaluated by medical professionals.  Plus, the medical report is most likely not going to address questions such as trauma, a child's true personality, a child's level of resilience or controlling/manipulative behaviors, RAD, etc.  You may find a few sentences here and there skirting those subjects, but, for example, we could never have anticipated Rex's capacity for joy and Emilia's incredibly loving nature based on their medicals.  We also had no warning about Rex's self-injurious tendencies or Emilia's deep and persistent need to feel protected.  You can prepare like crazy and tap into all possible resources to make sure you have the right child joining your family, as we did, but you can never be ready for all surprises, obstacles, and challenges that lie ahead.

Adoption is a leap of faith.  If you cannot leap - emotionally, mentally, spiritually -, this path might not be for you.