Father’s Day…

By TAO

This is a post I wrote three years ago, about a time before how medicine is practiced today, when people relied on their family doctor for just about everything.  I figured it was worth reposting today.  Now it’s time to head out and pull a few weeds and get some fresh air.

 

Ted Talk – Aditi Shankardass: A second opinion on developmental disorders

Very short talk compared to the very long title but worth every second…

From the Ted website:

Developmental disorders in children are typically diagnosed by observing behavior, but Aditi Shankardass suggests we should be looking directly at brains. She explains how one EEG technique has revealed mistaken diagnoses and transformed children’s lives.

Aditi Shankardass is pioneering the use of EEG technology to give children with developmental disorders their most accurate diagnosis.

 

Dr. Oz your “Transformation Nation Million Dollar You” excludes adoptees

From the website: Dr. Oz’s Transformation Nation: Million Dollar You

Here’s how it works:

You’ll join Dr. Oz, Weight Watchers, Sharecare and a powerful team of health professionals to tackle the seven key steps to weight loss and healthy living. The new, healthier you could even be eligible to win a $1 million prize!

Kick off the program with our Ultimate Health Quiz, where you’ll get an overview of your health. Next, conquer the seven steps:

Tell a Friend

Official Weigh-in/Calculate Your BMI

Connect with Your Doctor

Learn Your Family’s Health History

Get More Sleep

Assess Your Stress

Start New Fitness Habits

Then show off your knowledge with the Final Health IQ Quiz. The public will vote for the participant it finds the most transformed and inspirational. The winner will receive $1 million and appear on The Dr. Oz Show.

(bolding and font changes mine)

They even have two helpful videos and family health history forms…

http://www.doctoroz.com/videos/learn-your-family-history-pt-1

http://www.doctoroz.com/videos/learn-your-family-history-pt-2

http://www.doctoroz.com/videos/family-health-history-worksheet

Here is what I would say to Dr. Oz…

Dear Dr. Oz,

You say knowing your family health history can save your life.  Having knowledge that your family has a history of early age heart attacks and stroke can save your life and prevent events.  Well of course I agree with you, that knowledge would have changed my life.  If I knew that my family health history included multiple close relatives who had early age heart attacks and strokes, my doctor would have made different choices.  But you see, I am just an adoptee, and therefore not worthy of having that knowledge, or even the right to seek that knowledge.

Furthermore, you and most of the medical community at large, have not stood up and demanded better for us adoptees.  I doubt you even realize there are millions of adoptees in the US, who have no information that could be used to save them from events, that can take their lives in a heartbeat. 

If you cared, you would talk about it on your TV show.  You and the entire medical community would petition the government to change the laws.  You would stand up for us, because you deem it crucial to our health and future.

All I hear is the medical community telling those who have access to their family to do it.  For adoptees, all I hear is crickets…

Sincerely,

An adoptee whose life was changed forever, because no one did the right thing for all adoptees.

 

Life goes on…

I had to take mom in for day-surgery this week and then make sure her post-op time at home went okay.  I was completely drained by the time I got home, and yesterday I was still tired and my thoughts weren’t translating into words and still aren’t the best, but I am glad I went and everything turned out okay.  Mom needs me more and more and that worries me, in case I let her down because of my health.

But getting back to taking her for surgery – she got checked in and organized and were told both the surgeon and anesthesiologist would stop by in a few minutes.  The anesthesiologist arrived first to talk about her health history and family health history asking a variety of questions.  She is forgetting some things so I was glad I was there to fill in the blanks, and others she just doesn’t see the importance of mentioning – things that are important – like the health of your lungs when you are going under anesthesia.  I don’t know if she has lost this knowledge, or never absorbed it from dad like I did, yet we all were at the dinner table when dad told us about his day and explained how things worked and answered questions.  I guess I am worrying that she is losing information she once had, but I also question if she ever really listened and learned.

Anyway, one of the questions was whether she had ever been under anesthesia, and if any of her relatives ever had a hard time waking up from anaesthesia.  That triggered me all over again, and made me realize that question must be asked by all anesthesiologists – that mine wasn’t just being overly careful – because he asked the question after finding out she had been put under before.

The whole experience triggered me that as adoptees – we aren’t entitled to that knowledge – knowledge that everyone else has and asked about.  I know this is harping on the subject of family health history, but when are people going to wake up and start talking about the very real risks to all adoptees? 

What do parents answer when they are asked that question when one of their children is going under anesthesia for surgery?  Are they really okay with not knowing an answer that could in reality have very serious implications?

 

Walk a mile in an adoptees shoes…

Hypothetical scenario that plays out more times than you would think…and for different diseases throughout life…

Karen age 25 is scheduled to go to the doctor today for her regular yearly examination, as she understands she has to be pro-active in preventive health care.

She and Dr. Jones sit and visit for a couple of minutes and the doctor asks her how she has been over the past year.

Karen answers that she hasn’t been sick other than the a couple of colds, but her monthly cycle has become more painful to the point that she is missing a day or two from work each month.  Dr Jones asks her if fibroids or endometriosis runs in her family and specifically her mother and then remembers – oh yes, you were adopted so you probably can’t answer that type of question.  So instead she offers suggestions on how to minimize the pain, and if none of those work then what they can try instead.

Then Dr. Jones goes on to ask her if she does monthly breast exams and if she has noticed any changes. Karens answer is yes, that is part of her pro-active preventative health care routine and that no, she has not found any changes or lumps.  Karen then asks Dr. Jones about whether or not she should get early mammogram screening as she has just turned 25, or perhaps even tested for the BRAC genes just to be safe.

Screening (right-click to open in a new window)

For most women under age 35, breast cancer screening is not part of their annual health routine. But for women with a family history of breast cancer, experts say screening should begin as early as age 25.

Memorial Sloan-Kettering Cancer Center recommends that women who have a first-degree relative diagnosed with breast cancer should begin yearly mammograms starting 10 years earlier than when the youngest family member was diagnosed. For example, if a mother was diagnosed at age 42, her daughter should begin annual mammography testing at age 32. For women in this risk factor group, experts also recommend clinical breast exams at least twice each year and monthly, self exams beginning at age 20.

Once again, Dr. Jones asks if that info was provided in the history she was given at the time of her adoption 25 years ago.  Karen replies that it was noted that a great-aunt on her mother’s side had breast cancer.  Dr. Jones asks if it was early age onset or later.  Karen replies she does not know, it wasn’t included.

The average American woman has a 12% chance of developing breast cancer in her lifetime; this figure can more than double for a woman with a family history of breast cancer.

According to the Centers for Disease Control, women with a “first-degree” relative — such as a mother or sister — who had breast cancer have an approximately 30% chance of developing the disease, too. If that first-degree relative is diagnosed with bilateral breast cancer (breast cancer in both breasts), the risk jumps to 36%.

Among those with “second-degree” relatives (grandmother, aunt or niece), lifetime risk is about 22%. For those with a “third-degree” relative (cousin, great-grandparent or great-aunt) who had breast cancer, the risk is 16%.

Dr. Jones shakes her head and explains that it is highly doubtful that her insurance will pay for either when she only has a known family history for breast cancer in a third degree relative.  That a great aunt’s diagnosis makes her risk 16% which is not much higher than the 12% risk all females in the general population have.  If there was a first or second degree relative breast cancer diagnosis info they probably would approve it, but without that info chances are insurance will not pay for early mammography screening, or genetic testing, no matter how hard they fight.

Karen gets home and ponders whether she could afford to get the genetic tests and the early screening each year.  Then starts to wonder if she should contact her adoption agency and decides on that as a first step.

Karen makes contact with the agency and finds out it will cost her $150.00 to get her non-id and medical info from the agency and does that, only to find out the medical info is the same 25-year-old info she already has.  Her adoption agency does offer a limited confidential search service that costs way more money with no guarantees so she wonders what would be better, search or pay out-of-pocket for the screening each year.

In reality Karen – you are just an adoptee – suck it up – medical history is only important for the non-adopted.  You just have to hope you won’t be one of the women who are diagnosed at an early age before the recommended screening age OR pay for early screening on your own dime because your adopted.

What would you do if you had no knowledge about whether or not breast cancer ran in your family and at what age?

 

November Adoption Awareness Month – Day Six

“F” is for Family Health History…

Far too many adult adoptees are finding out the hard way the consequences of living without family health history.  It’s effects are far reaching and do not just impact us the adoptees, but also our children and grandchildren.  Even if you have an open adoption we all know that some will close or you lose contact for a variety of reasons.  Add on the fact that some adoptions are done without even the knowledge of who the father is, let alone his family health history.

Genetic tests are not the answer and I doubt they ever will be because they have only isolated a few genes or genetic combinations for some diseases.  And even if they isolate all the bad genes for all known diseases, how the disease plays out over successive generations provides valuable clues to your risk level.    And insurance companies don’t pay for genetic tests if there is no family health history of the disease.

So many diseases have similar symptoms so when your doctor does not know what runs in your family he is taking care of you with one or both hands tied behind his back.  Treating a disease early is always has better outcomes than treating it late.

In October I wrote two posts that I would encourage you to read that explains why family health history is so important and how even the best family health history taken at the time of adoption fails us, the children you want so badly.

The first post to read is titled Family Health History is important…so why are adoptees left in the dark?  Then come back and read Testing knowledge based on age…

It’s time to stop this but prospective and adoptive parents are the only ones who can do this…

 

He was “Dad” to me and “Doc” to all…

Dad was simply “Doc” to many people in our community.  He was “Doc” 24/7 literally.  He did not have days or nights off except for 2-3 weeks in the summer when another doctor took his care of his patients and then dad took care of his patients in return so each could take a well-earned rest or the odd long-weekend to go visit family. 

Dads day (generally) started with breakfast with the family and sometimes we were able to get through the meal without a phone call or two from a patient.  After breakfast dad would grab his doctors bag and head off to the hospital for morning rounds and some mornings he would visit both hospitals or stop by a nursing home as well, seldom did he not have at least one patient to visit.  After the hospital, hospitals, and/or nursing home he would return in time to be in the office by 9 or 9:30 am and the steady stream of patients (and performing the lab tests as well) he would see that day (some scheduled / some not) and his day (in the office) ended when the last patient had been seen and we thought 6 pm was an early day for dad.  Dad would climb the stairs, wash up and we would then have our second meal of the day together as a family, each describing their day, what they did, what they learned, and that included dads day (minus identifying info of course).  Dinner together was mandatory but it was also shared with dads patients, and if we got through a meal maybe only 3 or 4 phone calls from patients it was amazing. 

After dinner dad would watch the news and read the paper for maybe a half hour and then if he did not have any home calls to go on and it was summer time, he was out tending the yard, flower beds, or his precious vegetable garden until it was too dark to see what he was doing.  Dad produced the majority of the food we consumed which mom preserved for the long winter months.  But dad loved gardening and provided him with his only real chance to get excercise and reduce his stress and to refresh his soul from a world filled with sorrow and sickness.  Too often though that world intruded and the phone would ring, mom would call for him out the window and he would come up from the garden to take the call.  Sometimes those calls were just calls for advice but other times it turned into someone arriving to be seen after hours in the office or dad grabbing his bag hurrying out on an emergency home call. 

Some nights dad got to go to bed and sleep till morning, other nights he would get a phone call and would either get up and in head off to the office to patch up whoever had been in an accident, head out to the patients home usually to deliver a baby or head into the hospital to deliver a baby.  Dad did not practice medicine 8 hours a day, he practiced medicine 24 hours a day – and that included weekends – people don’t get sick or have babies on a schedule.  It was normal for dad to be seen sleeping in church, especially if he had delivered a baby the night before.  Dad was his patients “Doc” and people relied on him to be there for them when they needed him, regardless if they could pay their bills, paid with cash or what they had to trade. 

Todays Doctors (heaven help you if you use Doc instead of Doctor) just don’t seem to measure up to dad, a shallow comparison at best. 

Dad also managed to always be there for us kids and if we needed to talk to him during the day he took the time between seeing his patients.  On weekends I would go with him on his hospital rounds, depending on who the patient was and why they were in hospital I would either go with him into the room or waited for him in the waiting room but those trips to the hospital was ‘our time’.  Nursing home visits were also part of our routine if he had not managed to squeeze them in his rounds during the week.  Once his doctoring duties were taken care of we returned home and I could usually be found playing near where dad would be digging, planting, weeding, tilling, mowing, trimming, harvesting, pruning and at the same time teaching me, being my dad, schooling me in the wisdom of just being the best human being you possibly can and that included helping people when they needed help – not just when it was convenient…

Doctors and Dads of today could learn a lot just by trying to follow in the footsteps of this man I knew only as Dad…

I miss you dad.