So you're sick...thoughts on illness from an adoptive mom

A while back my cousin posted a family photo of our tribe on Facebook. Since the word "tribe" was used, my ever witty brother asked if he could use his Native American name "runs with scissors". Of course, there was opportunity for other names to be suggested. (And yes, I'm sure this whole conversation is entirely politically incorrect. Just take it at face value and know I have no intention of insulting anyone. Names with meaning are great regardess of ethnicity; names that are fictious and silly are just that-fictious and silly.)

As of right now, if I had to invent such a name for Kenson it would probably be something along the lines of "nose of the running snot" or "hacks up a lung." We are still dealing with sickness for him. He has honestly not been 100% healthy since October. In his case, it all starts with what appears to be allergy symptoms (clear runny nose), then develops into a cough that will not go away on it's own. I usually let the cough go for about a week before taking him into the doctor. From the end of October to the beginning of January, I had taken him in three times. Usually we followed the pattern of runny nose, cough, doctor, antibiotics, feel better for about a week after antibiotics, then back to a runny nose, etc.. At the end of January, I had kind of had it with this whole cycle so when he started coughing, I let it go a lot longer than I usually do, thinking maybe I was taking him to the doctor when he just needed a chance to get better on his own. By February 4, we were getting ready to head out of of town for Conleigh's birthday and I was worried about going out of town with him being sick so I made an appointment. When I picked him up from preschool that day, he had actually started running a fever and when we got to the doctor, she diagnosed him with near pneumonia.

And he has been coughing ever since then. We've since seen an ears, nose, and throat doctor who didn't feel like he could be of any assistance, and we will be headed to a pediatric allergy/asthma specialist in the next week or so. And while I know my child's medical history is completely riveting, my real point in writing was simply to share the experience of what it can be like to have a child who comes from a hard place who is sick.  I know it may like I'm coloring such a simple thing as a childhood illness with complex adoption issues.  That's not really it.  It's more about how your child's adoption sneaks into the everyday moments, about how that adoption impacts even little stuff like stuffy noses and chest congestion.  So here's my list of things that have popped into my head while doctoring with our kids.

"Is my child sick?"
Just like any family, when your kiddo starts acting differently or starts coughing you ask yourself what is going on.  But having a kiddo who is adopted, specifically from a third world country, means a couple of different things. In terms of the child, it means that you most generally do not know he is sick unless he is presenting with symptoms that you can physically see. There is a good chance your child will not tell you about stomachaches, sore throats, hurting ears, or a headache. (There's a chance of that with a younger child regardless of past history. But if you add in a possible language barrier, that chance increases. And then if you consider that your child has spent a good portion of his life in an institution where medication may not have been available, the nannies were too busy to notice that a child wasn't feeling well, etc., the chance goes up again as your child has not been taught to share when he is not feeling well.)

On one trip to the doctor, when he came in with a fever well over 100, had oxygen saturation levels that were at 90 (and lower than 90 usually means hosptialization) and a case of almost pneumonia, Kenson was literally jumping off of the step up to the exam table while we waited for test results. He never acts sick. He has starting telling us if he doesn't feel good but that has taken at least 12-18 months for him to do that, and even then I'm not sure how often he shares.

Conleigh's a different kiddo and she is more apt to communicate about not feeling well. But her English was better when she came home. And she is also more of a smarty pants; she notices if someone else is getting medicine for a particular symptom and will quickly develop that same symptom so she can have medicine. (Way too smart for her own good! Something we have been told by several previous caregivers.)

"If my child is sick, will he come to me for comfort?"
For those of us who grew up in pretty traditional settings, who is it we want when we're sick?  Our mom.  Who holds your hair while you puke?  Who tucks you in and brings you popsicles?  Who knows what toys to bring you or what song to sing to you?  If you have grown up without parents (or if your memories of your parents are from long ago, prior to orphanage care), who does those little things for you?  If you are lucky, you might have a caring nanny who notices you are ill.  If you are very sick, you might have a caring nanny but she is probably responsible for other things as well and you do not receive her undivided attention.  Of course, once a child comes home, his life changes.  But it take time for those old patterns of behavior to change.  For some kids, it can mean laying in bed, feeling terrible, but not saying a word to anyone because the child doesn't believe that the adult can or will fix the problem.

"Is there important medical history that I don't know?"
The other aspect of parenting a child who was adopted and is now sick (third world country or not) is that you have access to limited medical history. You do not know family history to share with a doctor. You have no way to know what the mother's pregnancy was like, if your child met developmental milestones like walking and talking at certain points, or if your child has had things like RSV, chicken pox, etc.. (You almost always feel a tad bit inadequete when you have to fill out health history questionaires for your child.) With both of our kids, we have known about them for the bulk of their lives. So we have a general idea of what sicknesses they have had. But it is just that: a general idea. With Kenson, we were told at 4 months old that he had asthma. Most pediatricians we consulted with said this was too early for such a diagnosis. And we didn't really ask more questions than that because we figured it was just an err and that there wasn't much information available on why asthma was mentioned. We also know that he had a chronic cough since infancy, which was pretty common at his orphanage.  And we know that the air quality in Port Au Prince is terrible.  Now, we have a child who is having some chronic respitory issues. Knowing the full medical history related to those issues would be helpful.

"Will our doctor consider past medical history even though it's incomplete or not up to American standards?"
It can be difficult regardless of a child's history to determine exactly what is going on.  Then take a child who is missing pieces of his early history, who does not act sick, and who does not complain about feeling sick, and treating him has some added dimensions.  Most doctors are apt to focus on the things that are known for certain ie what he is presenting with currently. I don't want them to just treat him based on today; I want them to treat him based on his entire medical history which is incomplete and I want them to treat him not based on if he appears to feel badly.  My personal feeling is that when he gets any type of bug that is related to coughing, his lungs, or breathing, that something is easily irritated and due to his past history of chronic cough/poor air quality, he is unable to get rid of the irritation. (But I am obviously not a doctor.)  But I haven't seen anyone get real excited over his past history.  (Other than our current nurse practicioner feels like it's out of her area so she has referred us to some specialists.)