The Medical Conditions Check List and What We Know We Can’t Do

I never wanted to be a nurse. It’s not that I have anything against nurses. They are wonderful people who do a very important job. It’s just not a job that I ever wanted. Sticking needles in people? Yeah, just didn’t think I could do it. And then came children and I found myself doing things I thought I couldn’t do.

Children who are born to us can surprise us with medical complications. I certainly wasn’t expecting to take my one week old fourth-born into the hospital for out-patient surgery. Nor was I planning for my first-born to have two separate knee surgeries. These experiences weren’t a lot of fun, but we all survived and life went on.

But adopted children come in a different category, especially if they are older. Anyone who has gone through the process of completing a medical conditions check list prior to adopting is well aware of the discomfort in having to decide which conditions… and the children who have them… one is ‘open to.’ On the one hand, no one wants to have a child end up in a family who is not prepared to care for their medical needs. On the other hand, how can a family really be sure they are capable of dealing with challenging medical needs?

For our first adoption, we did check things on the list, but were referred a healthy three year old boy. Our healthy boy may not have had any physical issues, but his emotional ones left us all reeling for many years. (“Healthy” referrals, to me, seem entirely misnamed, but that is a topic for another post.) Frankly it would have been a relief to take him to the hospital, have a surgical procedure, and bring home a recovering, but well child. The experience of dealing with emotional special needs was formative.

When it came time to think about our second adoption, we were in a different place. We had survived some tough stuff and we were ready to consider a much wider range of medical conditions. A child needing surgery didn’t seem so scary anymore. You could see what was wrong. There was something that could be done to fix it. Other people understood physical ailments.

We were referred a seven month old baby boy who had a cleft lip and palate. His adoption took so long, his lip was corrected in Vietnam and so we thought we would still be facing a palate surgery when we came home. When we met him, we discovered that his palate was intact and that all we were dealing with was a cleft alveolar ridge. In the interim, since he has been home he has had a lip revision surgery and we are still waiting for him to grow a bit more to have a bone graft done. I’m not looking forward to it, but I’m not dreading it either. For our son, outside of the surgeries, his clefting is something so negligible that we forget it entirely.

Then came adoption number three. We weren’t planning to adopt again, but when you fall in love with a child and the child desperately needs a family, what are you going to do? This time around would challenge my position on not being a nurse, though. This daughter has had quite a few surgeries, and will need quite a few more. While she hasn’t been through as many surgeries as other people’s children I know, it is still rough. Her surgeries all involve facial reconstruction, with the most recent being tissue expansion. She has skin that needs to be replaced both for aesthetic reasons and to avoid possible future cancer. In order to do this, the surgeon places expanders (essentially fancy medical balloons) under her good skin. For the next 12 weeks we slowly fill these expanders by injecting saline through ports under her skin. As the expanders stretch the skin stretches and expands, too, essentially growing new skin. When enough new skin is grown, the surgeon then removes the expanders, cuts out the damaged skin and replaces it with the new skin. No one enjoys this, neither the child nor the parent.

I’m thinking a lot about this because this past week has been filled with doctor’s visits and unexpected surgeries as we fight to keep this round of expanders. I find myself changing drains, poking needles into my daughters temple, and changing bandages and dressing. I do this while remaining incredibly calm and upbeat so as not to distress my daughter further. I am doing things I absolutely never imagined myself being able to do, much less doing competently.

I don’t think it’s any surprise that many families start out adopting a ‘healthy’ child and gradually move on to raising and loving children who would have never made the cut on the first medical conditions check list. Those check lists do not even begin to tell the whole story. Behind each of those conditions is a real child with a real personality. As we live in the adoption world, we meet some of these children and the parents who love them. We see ourselves being stretched in ways we didn’t imagine. You just never know what is going to happen… you may find yourself sticking needles in your daughter’s head and be glad you have the chance.