Adopting a Child with ARM

One of the questions here is from a family that is considering adopting a child from another country where the child has a known interectal malformation and a couple of general things here, if you're in the process of adopting a child, then it is important that you gather as much of the medical records from the country of origin as you are able to. Um, sometimes the orphanage may not have all those records. Going to the local hospital where the child was treated before they were brought to the orphanage might enable you to find those records, but whatever you can find about the child's healthcare to the point of you taking care of that child and bringing them back home to the United States with you is going to be critically important for the healthcare team here, uh, even if it's in a different language, we'll get it translated so that we can see what was done. Uh, and oftentimes these children have already had surgical interventions done in the country of origin. Knowing what that surgery was and what was removed, what was replaced, is going to be really important for us to formulate a very personalized specific care plan for your child. Um, one of the things is that a parent is saying is that their child that they're adopting has a urostomy bag, and what does that mean? A urostomy bag is basically an external collection device. That enables you to collect urine, so it's kind of like a colostomy bag that you've seen patients who have problems with their intestinal tract where they've been either temporarily or permanently diverted to the skin on their abdomen, and then they wear a bag that collects all the secretions from the intestine into the bag and then the child empties that bag and drains all those fluids out. The same thing for a urostomy bag is when it's put onto the urinary tract, and it might be that it's put on. Uh, or an ileal conduit. Um, without knowing the specifics of what else was done at the time that they created the diversion that requires the urostomy bag, it's going to be hard for us to be able to give you any more specific answers, but um, it might be and hopefully is just a temporizing diversion that they said, you know, your child's urinary tract is too complicated, too involved, and your child's too young at this point for us to do anything more permanent, so we're just going to protect the kidneys and drain the urine out in a low pressure manner into a bag. Um, but I would strongly urge that once you bring the child to the United States that you have them meet with a pediatric urologist, and, uh, it'll be important for that pediatric neurologist to have access to as much of the medical records as you can, um, and then simple tests like an ultrasound of the kidneys, make sure your child has 2 kidneys, blood tests to see what the function of the kidneys are, and then based on that initial assessment, they will formulate what are the tests are required to understand what's going on with the child.