Edward S. Hume, M.D., J.D.: Chinadopt
updated 3/31/96
Health and Medical Information. The general page on the FCC Website.
Medicines to bring with you: My list. Medical books to bring with you to China.
Hepatitis A & B: Our own web page on these topics.
And this from the FCC Website :"Deborah A. Borchers, [M.D., F.A.A.P.] a pediatrician who has adopted from China, has made three excellent submissions about medical issues for those traveling to China, or just returned:"
An Open Letter to Pediatricians on Chinese Adoption Medical Issues
Suggested Procedures for Pediatric Examination After Adoption of Chinese Children
Helpful Medical Items to take to China for Your Child. [I would add this: Take the phone numbers of one or more pediatricians and family practitioners with you so you can CALL HOME FOR MEDICAL ADVICE! Your doctor can tell you what might be wrong, and what to try. Why more than one? Sometimes the doctor taking call for your MD might not be too eager to do a transoceanic telephone consultation.]
From Nancy Hendrie, M.D.: A pediatrician's view on the health issues of children adopted from China. Dr. Hendrie, is a pediatrician who has gone to China with a number of groups of adopting parents.
Health concerns in adopting children from China, by Jerri Ann Jenista, M.D.
Health Status of Adopted Chinese Orphans on Arrival in the US. A statistical study and summary.
Growth Charts for Chinese Children from the FCC Website
Scabies from the FCC Website
What We Wish We'd Read While Waiting from the FCC Website. Contains cites to medical information not available on the Internet yet. And: medical/pediatric advice book to take to China.
Rice Cereal and salt as a possible substitute for Pedialyte. I can't see dragging Pedialyte along: it's mostly water, which is freely available in China. So try this instead.
Making It Home: a personal story from FCC Website that can teach us something about our medical concerns.
Emporiatrics- An Introduction To Travel Medicine ( from Virtual Hospital, University of Iowa) Travelers With Special Medical Conditions
Immunizations And Chemoprophylaxis For Travel-Related Diseases (from Virtual Medical Center)
International Adoption Clinic: University of Minnesota.
International Travelers Clinic, University of Wisconsin
Pediatric Travelers (Virtual Hospital)
Stanford
Travel Medicine Service : Immunizations
and Patient
Information
From: owner-a-parents-china@shore.net on
behalf of Stroud, DF David (6923)
Sent: Thursday, March 28, 1996 4:18 PM
To: 'Richard Smith a-p-c'
Subject: Pediatricians
Good Day All -
I've not posed this question because it is so subjective, but here goes anyway.
We have been looking for a pediatrician, and not having much luck. We are in one of those <@$&%$> PPOs, and are limited to the Doctors that are on our "list".
We have interviewed two, and neither one impressed us much. The first one was in such a hurry, that I finally told him I would PAY him if he would just sit down and answer our questions! He was extremely egotistical, and brushed off all the medical info that I had gotten off the 'net. We decided before we ever left his office, that we weren't going to use him. He was the closest to where we live, too : - (
The next one was about 45 minutes from where we live. He was very personable, but was also pretty egotistical, although not as bad as the first one. He did not brush off the medical info from the 'net, but he admitted that he didn't put much stock in what he felt was "anecdotal information".
They both summarily dismissed any thought of "pre-prescribing" any drugs to take with us (probably fear of malpractice lawsuits).
Our "family doctor" was pretty miffed that we would even consider a pediatrician instead of him. We like him OK, but we both enjoy good health, so don't have that much contact with him.
How important is a pediatrician, as opposed to a GP that has a lot of experience with children? Has anyone had their doctor pre-prescribe the meds that are suggested by the posts on the FCC homepage? Are we being complete idiots for looking for the "ideal" doctor? Is this another one of those "new parent worries that will sort itself out?
yunqi, Dave
STROUDDF@gvl.esys.com (Stroud, DF David (6923))
[Ed here ---
A number of people wrote in to encourage Dave. One thing I can think of is either exercising a choice in getting into a different insurance plan; or, if your employer has no choice of plan, talk to someone about getting a choice due to the inadequacy of the PPO.
On the pre-prescribing issue, there is a lot of help on various FCC-related websites in finding out what to take. We used antibiotic ointment, for example, to treat infected bug bites on our a-daughter, and we used a Bactrim clone to treat our b-daughter's bladder infection. Your doctor should, however, either "pre-prescribe", as Dave puts it, or simply give you some samples. If he/she won't get another doctor.
Remember, the doctor works for you, not vice versa. You have
hired her/him to provide services. Don't let a doctor boss you
around.]
From: owner-a-parents-china@shore.net on behalf
of Julie Watson
>Sent: Friday, March 29, 1996 3:51 PM
>To: a-parents-china@shore.net
>Subject: selection of child's doctor
>
>There have been many good suggestions on the list so far - I agree with them all! Two other points which I haven't seen discussed here yet:
>Consider asking other international adoptive parents - when I did this, I found the same 2 or 3 names coming up over and over - I interviewed them all and found they would all have been acceptable - one was just more 'my type of person'. The one recommendation I got from a friend (not adoptive mom) wouldn't have worked out well at all. Pediatricians (or GP's) who have a large adoption practice, are often more clued in to 'exotic' disease, malnutrition, bonding issues, developmental delays - all the things which may affect us disproportionately as a group. They are also going to be more aware of the normal development of children after they come home, and may be more laid back about some things which may worry other pediatricians lacking the experience. For example, many asian babies have smaller head circumferences than caucasian children - not only because of a different shape of skull genetically, but because many of our children have flat backs to their heads from lying on their backs so much.... at least 2 friends I know have had their precocious, active, obviously with-it children worked up for 'microcephaly' on this account. If you don't have a China support group close by - there is probably one from Korea or Latin America who may be able to provide you with references.
Also think carefully about suggestions from well meaning friends that going to an Asian doctor may be a good idea - it might - but on the other hand, remember that it is possible an Asian doctor *may* have prejudices related to Asian culture we are not aware of. Not all cultures are pro-adoption for instance.
Take care - jwatson@mail.bcpl.lib.md.us
From: owner-a-parents-china@shore.net on behalf
of Myers, Leslie
Sent: Thursday, March 28, 1996 5:21 PM
To: 'Dave'
Cc: 'China Mailing List'
Subject: RE: Pediatricians
>We have been looking for a pediatrician, and not having
much luck. We are
>in one of those <@$&%$> PPOs, and are limited to
the Drs that are on our
>"list".
So are we.
>We have interviewed two, and neither one impressed us much.
RED FLAG!!! You don't have to love your pediatrician, but you
should trust him/her.
>They both summarily dismissed any thought of
"preprescribing" any drugs to
>take with us (probably fear of malpractice lawsuits).
Then, hopefully, someone in the group you travel with will
have meds.
Not all of the children will need perscription strength meds, if
any. Be
prepared with the OTC meds. suggested on the FCC web site.
[Ed here --- for some things (e.g. --- antibiotics), OTC will NOT
do. Find a doctor!]
>Has anyone had their doctor preprescribe the meds that are
suggested by the
>posts on the FCC homepage?
Luckly, my GP gave (yes, gave) us some antibiotics and syringes. The pediatrician that we chose (recommended by our GP) is going to prescribe everything else that was on the list from the FCC web page. He was very impressed with all the research I brought him from the Internet. He said it was all very practical.
My husband and I explained to him that we do not intend to diagnose illnesses. We will take the meds to the doctor that examines our daughter in China. If she needs anything, we'll tell the doctor, "These are the meds that we have. What do you recommend?"
>Are we being complete idiots for looking for the "ideal" doctor?
I don't think so. I did. After a ton of prayer and asking every parent I know who their pediatrician is, I went in to my GP for my first Hep. B shot and asked her. She's a new mom. (Why didn't I think of her first?) Anyway, she referred me to her pediatrician. He's well worth the wait.
>Is this another one of those "new parent worries that will sort itself out?
It will only sort itself out if you are persistent.
Leslie
lesliemyers@mmd.com
"Myers, Leslie" <lesliemyers@mmd.com>
From: owner-a-parents-china@shore.net on behalf
of LuceMV@aol.com
Sent: Thursday, March 28, 1996 11:53 PM
To: a-parents-china@shore.net
Subject: A Pediatrician's Two Cents
Hi all! My wife and I *love* this list! We are planning to adopt someday and are now in the info gathering stage. Thank you to Richard and all who have contributed so much! This is such a wonderful resource!!
Here goes my first post...
I am a pediatrician in a large children's hospital in Philadelphia, and I thought the following brief (yeah right) notes might help.
[He discusses hepatitis A and hepatitis B]
Take-along meds:
If a parent came in to my office as well-informed and intelligent as most of the people on this list, I would have no trouble at all writing prescriptions for a several take-along meds (like those suggested on the FCC web page). Unfortunately, I can definitely see how many of my colleagues could become very obnoxious and paternalistic when it comes to dispensing these take-along meds. Can't offer much advice here if you run into trouble, other than to try another doc.
The best doc for kids:
I went into pediatrics so I could specialize in the care of children. All I do is help parents take care of kids. I, personally, was intimidated by the goal of Family Practice, to deliver health care to all members of a family, be they young or old. Actually some family practitioners develop areas of interest, and like to spend more of their time taking care of kids, or delivering babies, or taking care of elders, or practicing sports medicine, etc. Just like some pediatricians like to spend more of their time with adolescents, or handicapped kids, etc.
I think there are two areas of expertise my wife and I will look for in the doctor we choose for our kids. On the one side, we want to be very confident in her "book smarts" and that she is keeping up to date with the latest medical advances. On the other hand, if she or he doesn't know how to listen to us, or talk to us, or understand us, what the heck is the use of all their "book smarts?" The best trained bozo-doctor is *still* a bozo! In the end, I'm sure we'll pick one of my colleagues, a pediatrician. But, if your general practitioner or family practitioner is keeping up with medical advances in pediatrics, and is someone you can talk to and trust, *stick with her or him!*
How can you tell if your doc is keeping up to date? Do they have books in their office? Do the books look older or newer? Can you see if they are reading several medical journals? Are they reading one or two of the main journals in pediatrics ('Pediatrics', 'Journal of Pediatrics', or 'Contemporary Pediatrics' to name a few) Are the immunization guidelines - or cheat sheets - we doctors all use kept up to date? ( the latest guideline sheet is dated January - June 1996)
Please confirm what I've said above with what your own doctor advises if you have questions. My babble above is intended merely as info, not as formal medical advice. ( my lawyer will be so proud of me, for that little disclaimer! :-) )
I can be reached at <rescuebird@aol.com>
-Geoff
LuceMV@aol.com
[This guy is my kind of doc! All emphases in color are mine.
--- Ed]
Rice Cereal and salt as a possible substitute for Pedialyte
from Dr. Borchers' article, Helpful Medical Items to take to China for Your Child
Using rice cereal and salt it is possible to make up a less bulky substitute for Pedialyte. Use 2 cups water, add 1/4 teaspoon table salt and dissolve the salt in the water. Gradually add 1/2 to 1 cup infant rice cereal to the water until the mixture is as thick as is drinkable. Mix well. You can offer the solution to your daughter after each diarrheal stool, giving infants a half cup and older children a full cup. It should be discarded after 6 to 8 hours. If your child is vomiting, offer the mixture in amounts of 1 teaspoon or less. If your child fails to urinate, she does need a medical evaluation.
[The standard recipe for Pedialyte is one level teaspoon of sugar and one pinch of salt in eight ounces of water. I have been told by a pediatrician not to use this because getting the proportions even a little wrong could have deleterious consequences. Hence the recipe above. --- Ed][Another thing: Pedialyte tastes so awful I don't see how anyone --- even a sick kid --- could stand to drink it.]