Because there are so many unknowns about L, Mr. A and I thought it was important that we take her to the local Children’s Hospital International Adoption Clinic. It was a big commitment: two days of appointments and and six specialists (infectious disease/pediatrician, developmental specialist, nutritionist, psychologist, hearing screening, vision screening).
The first day of visits was brutal. They tried to take L’s bloodpressure and it just freaked her out. They tried to take it about 10 times and the only reading they got was very very high. They also had to draw about four vials of blood to run lab tests. Holding her down while they tied off her arm and collected the blood was NOT fun. I didn’t mind meeting with the nutritionist, though she looked like she was only 22 and that made me question her credibility a little.
L crashed and slept through the developmental assessment, so I just told her what I knew. Though L only looks a little delayed in a few areas (fine motor and gross motor skills), this earned us another Early Intervention screening in a few weeks. I am a huge fan of EI. I figure even if L doesn’t need EI services, the two hour evaluation will be pretty useful and will help me figure out what areas we need to be watching. I also suspect they can suggest some simple activities to help L catch up.
On Monday, we went back to have L’s tuberculosis skin test measured. It came back borderline at 10-11 mm which means she was either reacting because of her BCG vaccination or was exposed to TB. The borderline result meant we needed a chest Xray to rule out active TB. It also means that L has to take an antibiotic called Isoniazid every day for the next 9 months. When I heard this, I quickly called a friend whose daughter also had to take this medication to find out what I should be asking the doctor. I was very VERY reluctant to sign up for nine months of any medication without a real diagnosis.
I think the doctor was surprised that I wasn’t hopping right on board the Isoniazid train. After she answered all my questions and also mentioned “tuberculosis of the nervous system” and death, I took the prescription. I am still not thrilled, but further research at Google University demonstrated that this is the standard protocol, unfun though it may be.
We still don’t have L’s labs back yet. (Did I mention we had to collect her poop and mash it up with a little spoon so it would fit in a test tube – Yuck!) Besides the TB thing, she looks very healthy and weighs in at a solid 8.6 kilos and 69.4 cm (19 lbs and 27 inches). I am really glad we took her to the International Adoption clinic, even if it was very stressful. The more information we have, the better, if you ask me.
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For what it is worth, despite my initial skepticism, we are 100% on board with the TB medication. The odds that L could develop active TB after the positive skin test appear to be about 10%, but that 10% isn’t a chance we are willing to take. Also, the doctor we met with is in the Infectious Diseases department and works in the TB clinic, so we believe she knows what she is talking about.
You can find a little more information about TB and adoptees from China here:
TB and Adoption: What Parents Needs to Know
Internationally Adopted Children Need Evaluation for Tuberculosis
Ahhh…I remember it well. We had to take Meia back twice to get enough blood for the tests. Good thing, they did find out she has beta thalassemia trait. No big deal, but good to know nonetheless.
And the poop thing. Good times…
Oh, scary, stressful. I’m glad it’s over for you, and hope only good things come out of it.
I am also a big fan of EI. We had our daughter screened even though we were not concerned about her development. The evaluation was very informative (they evaluated in seven different areas), and the therapists provided helpful suggestions on how to further our daughter’s development.
We are currently on the Isoniazid train…our last TB screen popped up irregular (very boderline, but after doing the same research you did we went for it). Not fun, but also not going to kill us.
And, after our EI eval we qualified for Speech, and it is going so well. Our experience, thus far, has been pretty great.
Take care.
My daughter reacted too, it was the BCG VACCINATION. That causes positive reactions! I cannot believe your doctor was all about medicating! I can’t remember how or why medication was ruled out beyond the BCG VACCINATION on her health history, but a chest xray is considered diagnostic in most cases. The scare tactics were so beyond unnecessary. So are infant blood pressures. They are notoriously unreliable. What a nightmare for you both!
I had a positive TB test..I had to take medication. It sucked. And I didn’t have a choice. Then they told me it was probably just because my arm was thin. Um?
Hope the results turn out fine.
Emma went through the 9 month TB treatment. Like you, I wasn’t sure about it, but after doing some research, speaking at length to our doctor and chatting with a few parents whose kids had been through it, we decided to go ahead with it. The main reason we opted for the treatment was that while Emma did have a BCG shot which can in turn lead to a positive TB test, all the other kids in our group had had the same BCG shot, but none tested positive for TB. During the 9 months, we did bring her in for blood tests twice just to check her liver. Once we figured out how to give her the medicine, it wasn’t a big deal at all. It turns out our little Miss Independent (she was around 11 months when we began treatment) liked to drink the medicine all by herself so we just poured it into a plastic medicine cup and let her drink her “Emma juice” and she loved it so thankfully it all worked out pretty well. Nine months sure is long though!! Otherwise, sounds like L is doing great. And like you, I found that things got better in increments and it wasn’t until we’d been home about 6 months that I could say that life with 2 kids now seemed like a doable norm!
Julie
Would you remind me how old L is?
[...] Today was the day L took her last dose of Isoniazid (aka INH), the antibiotic she has been on since she had a 10mm Tuberculosis skin test. [...]