Frequently Asked Questions About Our Services

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Pre-Adoption and Travel

What can we expect from a consultation with your clinic?

This is covered in much detail, with pretty graphics, here.

When should we schedule our pre-adoption consultation?

When you have adequate translated materials in hand. We've experienced enough cancellations due to delays in translation, agency promises not kept, etc, that we need you to actually have your referral in hand before we can schedule. We're happy to hear from you before it arrives, however, and to discuss what is "enough" useful information to consult with.

Will I receive a formal written evaluation after our consultation?

Generally, no. Our phone conversations are extensive, often lasting 30-45 minutes, depending on the complexity of issues involved. I think you'll find us to be patient, thorough, informative, and happy to answer questions that you have about the child, or the adoption process in general. We've chosen to spend our time in discussion with you rather than typing long reports about your child. 

You're of course welcome to take notes, or have other family members join the phone call if that helps. If you need later clarification of something that was discussed, just contact us. We do keep consultation notes for our own records, which helps when followup information or overseas requests come in. We are also happy to provide followup questions in writing for you and your agency.

What are your thoughts on "blind travel"?

When asked, our doctors routinely say they recommend the conventional referral process rather than blind travel (travelling to adopt without any information about a specific child). That said, if you choose to travel blind for whatever reason, we'd be happy to work with you and consult once you're in country. We can send you our "Blind Packet" if you'd like to see how it works.

The most difficult thing about "blind" adoption is the potential for surprises and the inherent pressure to make a quick decision, typically before you come home. For some families this is no problem; they're maybe the "quick to leap" type and/or they have been referred a child who seems relatively straightforward to them and we hopefully agree. But for others, the emotional and intellectual agony of meeting a child (or children), participating in one or several medical consults, and making a decision within hours of first seeing any information, is just too packed a process for their comfort. Add to this some cultural "pressure" (real or imagined) and the juxtaposed concepts of being a loving parent and declining a child who is certainly worthy of parents, and you can see how the process can be overwhelming for some folks. Not to mention truly unfortunate for the children involved, especially older ones that have some idea of what is going on.

So, your agency may not agree with us, but we tend to steer families to the traditional referral process if they ask. It's not that blind referrals don't work out, but it does seem to be a less frantic process for families, allowing for fewer surprises, etc, if you consult and make your decision while still at home. 

The cost for our consultation services is higher for blind referrals, as well. They're considerably more difficult and disruptive for our providers, since turnaround needs to be immediate, and families often see multiple children. The good news about the blind fee is that it covers you to consult on one or many children while on the trip. We hope (for your sake and ours) that it's just one terrific child, but if it's more, the additional reviews are included (I think the record is 6 children reviewed on one trip). We are also on-call for you for your return trip to bring the child home.

What special needs should I consider?

This type of "preparation" for medical issues in adoption is difficult to help you with, but it's a question we have been getting more frequently of late.

Here's the difficulty.  Only with decently clear info about a specific child can the doctors really give you clear guidance and preparatory advice.  For example, even if you were to say, "I can handle the care of a child with a birthmark," you might later consult on a specific child and find out that this particular birthmark is not just cosmetic but is associated with a genetic syndrome or disorder which includes many health care issues for which you are not prepared or able to parent.

If you must "submit a list of medical issues that we would accept", I would recommend that you speak candidly with your agency about the ultimate necessity to consider each child individually.  Please make sure the agency and the country will tolerate your need to do a medical consult to help you understand the individual child.  If you decline a child with a medical condition listed on your approved list, will this be held against you?

So, what do you do, short of going to medical school, to understand the enormous variation of special needs?  I would probably use the internet, even though we generally say beware!  Please remember that the internet is not always 100% accurate, nor without bias or hidden agenda, but you can certainly read informational websites which will describe the generalized course of care for children with specific conditions. I would start at our website as our doctors have written a lot here. Websites hosted by well-known national societies and associations would be a better mainstream resource for you than a personal blog, but if nothing else, the latter will give you hints into the variation of familial response to special needs children.

Sometimes a sense of whether a special needs issue may be right for your family is about gut reaction, too.  Would a possibility of heart surgery be affordable and emotionally possible for you?  What if there would likely be many heart surgeries?  Are you still comfortable?  Do you live in an urban setting with surgeons, therapists, and special educational programs or would there be excessive travel for all of your special needs care?

I hope this answer is helpful, even though it likely doesn't give you the answers you sought.  Perhaps after you have done some preliminary digging around, you might let us know if there are any issues that we could help clarify for you.

Do you prescribe medications for travel?

Yes. Families that consult with us will receive a page of prescriptions for the child they are travelling to adopt. We include a note to the pharmacist explaining the situation. Unfortunately, you will not be able to use insurance for these, since they are for a child that is not yet in this country, let alone on your insurance. But most of these are available in generic form. 

List of prescribed medications:
Zithromax suspension (excellent oral antibiotic for a variety of bacterial infections)
Bactroban cream (for skin infections)
Elimite cream (scabies cream)
Erythromycin ophthalmic ointment (for conjunctivitis)
Polyvisol with iron (a multivitamin with iron)
Sterile syringes/needles (just in case)

How do I measure head circumference?

Bring a non-stretchable measuring tape, and practice a bit first. Wrap the tape snugly around the widest possible circumference - from the most prominent part of the forehead (often 1-2 fingers above the eyebrow) around to the widest part of the back of the head. Try to find the widest way around the head. Remeasure it 3 times, and take the largest number.

Can you write a letter supporting my leave from work?

We're happy to ... just send us a request, after you've had your consultation, with some details: your name, child's name, employer, the reasons you're providing for leave (we've got our own list, but would like to be in sync with yours), how much time you're asking for, and roughly what your employer's policies are about adoptive parent leave.

Post-Placement

Can you see our child in clinic?

If you live anywhere near Seattle, or are willing to travel, we'd love to. To schedule an appointment at the clinic for your child, call our clinic schedulers at 206-598-3000. They're the quickest draw in the West - we reportedly have the fastest call pickup time at the UW, so you may not get to hear as much soothing Muzak as you're used to.

Can you recommend an adoption-savvy pediatrician near us?

Maybe - contact us for ideas, see this list of international adoption specialists, consider asking your agency for ideas, or get in touch with local adoptive families or support groups for the skinny on your area's adoption-friendly providers.

When should we schedule our post-adoption appointments?

As soon as you have travel plans, give the clinic a call at 206-598-3000 if you'd like to schedule a post-placement evaluation, as those appointments do fill up well in advance. We like to see new arrivals 1-2 weeks after they get home, to give you time to recover, nest, and get to know each other. If there are urgent medical issues you can call when you get home for an early visit at our clinic.

Following the initial clinic visit (it's a doozy), we like to see children every 2-3 months at first. Some families who live far away transition to a local provider after the 6-months-home visit, and we're happy to help.

What will happen at our post-placement appointment?

We have two good articles that cover this: "Our Post-Placement Evaluations" and the "Welcome Home Guide".

Can you write a letter supporting my leave from work?

We're happy to ... just send us a request, after you've had your consultation, with some details: your name, child's name, employer, the reasons you're providing for leave (we've got our own list, but would like to be in sync with yours), how much time you're asking for, and roughly what your employer's policies are about adoptive parent leave.

Website

Is your content accurate, evidence-based, free of bias, and up-to-date?

Probably not all of these all of the time.

We strive to make sure our content is accurate, but this is not a peer-reviewed medical journal, and inaccuracies may exist. 

As for evidence-based, adoption medicine is more of an "expert opinion" field at this point, in the sense that our advice regarding preadoption evaluation, necessary tests, parenting advice, and so on has probably not been tested by rigorous randomized placebo-controlled trials. Of course, that would apply to much of pediatrics at this point, as well.

As for free of bias, it should be free of commercial bias. We do not receive income from any medical products or treatments that we mention here. There is no paid advertising on our site. We don't allow drug company reps in our clinic, except for stocking formula samples for our lower-income families. We do get a paltry sum from Amazon if you purchase a book through our links; said income defrays our website hosting costs. Being human, however, we do have our biases and assumptions, but we strive to make those clear in the content. 

As for up-to-date, we do try to revise our articles as new evidence or recommendations emerge. But the pace of modern medicine pretty much guarantees that new information will be available that may not be reflected on the site. 

If you note anything on our site that you find questionable, do please post a comment or let us know. For more information about our content, please see our disclaimer

May I link to, quote, or reproduce your content?

 

Yes, if you follow the guidelines in our copyright notice. There are no restrictions on linking to us, of course. If it's a small quote from the site, we ask that you please link to the original article. If you'd like to reproduce, distribute, or display a whole article, we ask that you follow our guidelines, and please let us know. No commercial uses or derivative works are allowed without our prior express permission. Thanks!

 

Would you please link to us?

Maybe ... but not if you're hawking foot powders, all-natural miracle cures for wrinkles, or other non-adoption non-pediatric commercial ventures.

But if you have a legitimate, non-hucksterish resource, feel free to let us know about it

Who does your website?

That would be Dr. Davies. He's nerdy that way. 

The website is created, edited, and hosted on Squarespace.com. We HIGHLY recommend it for creating and maintaining a website, blog, or both. Feel free to tell them we sent you.

The lovely artwork is from Kittenchops. We &hearts Kittenchops.

Where's the new content?

 

You can pretty clearly date my becoming a father by the "freshness" of this website. Now that I'm a dad of 2 young kids, my obsessive blogging days are over. 

But rest assured that we do periodically update/refresh content on our site to match evolving recommendations. And in general, adoption medicine is not such a rapidly-evolving "science" that content from 2006 is no longer applicable in 2015.

If you do find any content on this site that feels erroneous or out-of-date, please do let us know, and we'll address it.