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                                        Dr RICHARD's Desk - February 2010

                             Thinking of Adopting a Child This Year ?

OUR EXPERIENCE with children adopted from various AsianBrad Pitt & children countries is variable. If you have thoughts of adoption the strong suggestion is to prepare thoroughly. Seek legal advice about the bureaucratic procedures involved and follow them carefully. We suggest you do not attempt shortcuts or use hearsay advice.

Make absolutely certain what regulations apply if you wish to take the child from the birth country to Australia. As far as I know this regulation still applies - a child adopted in Indonesia cannot be taken out of Indonesia for 12 months post adoption and the birth mother is able legally to reclaim the child at any time during those 12 months.

Your posting may not be long enough to comply with these time frames.  The regulations might seem onerous but they do protect the child and you have probably noticed most countries have tightened their adoption procedures after bad experiences.
Madona & child
Another essential consideration is to remember that many of the health issues of children living in orphanages in developing countries are the health issues of children in general in those countries.  For example with 23 million births each year in China  there are obviously limited financial resources with  consequent  health issues  affecting children daily whether living in or out of an orphanage.

Malnutrition, rickets, anemia, lead poisoning, asthma, tuberculosis, hepatitis B, bacterial and parasitic intestinal infections are common medical problems for children living in these institutions and in developing nations generally. Clearly documented investigation and treatment of these diseases plus using the Australian Vaccination Schedule may be expensive but essential if applying to return to Australia.

Simple things such as age can be a problem: An adopted patient of ours was obviously small for his formally documented age with language delay, mobility delay and so on all indicating a serious medical problem. The poor child was subjected to all manner of blood tests and investigations to try to determine the cause of his developmental delay. Nothing found!  Mum happened to go back to the country where she had adopted the child. In casual conversation it was discovered the child was actually 18months younger than documented - birth mother was an illiterate very poor villager. Problem solved !

We felt pretty stupid, but this prevented school problems and the like on return to Australia.

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                             Well, What did the Doctor Say . . . . ? ?
HOW OFTEN have you had a medical consultation, walked outside  and realized you can't really remember what on earth the doctor said . . . . so you assume he did not tell you anythingWhat did he say?, or it must have been unimportant!  Believe it or not doctors usually do attempt to provide patients with the relevant information.

About 50% of information provided by healthcare providers is retained but 40-80% is forgotten immediately. Of the information that is recalled, about half is remembered incorrectly. So about half is forgotten immediately and half of what is remembered is wrong. That may leave a very misunderstood message which could have medical consequences.  Curiously about 70% patients cannot remember the medical diagnosis that was made - even when the condition is serious. So if you can accurately recall 25% of the details of a consultation you have done very well!

For some reason patients do remember unrelated details such as the colour of the doctor's shirt, his dreadful tie or the geriatric magazines in the waiting room.

Total Recall Many things work against remembering what doctors tell you e.g. you have been comprehensively reminded you forgot your wife's birthday again, you are stressed at the time, you answer your hand phone during the consultation. Denial is  another powerful defence mechanism which can interfere with recall of the most obvious diagnosis - patients frequently forget a diagnosis of excessive smoking and obesity.

Recall of information is dependent on many factors, some related to the patient, some related to the mode of presentation of the information, and some related to the clinician.

So much for medical consultations . . . but have you ever tried to recall what was said in a meeting with somebody else outside your profession? What did your accountant tell you, or the structural engineer ? ?

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                              Rabies in Bali is Getting Worse
WE MENTIONED a few months ago Rabies had just appeared in Bali. The Rabies problem is getting worse with about 20 deaths to date. Currently only dogs carry RabiesMonkey bites woman  in Bali but it is inevitable monkeys will become infected. Rabies uncommonly occurs in other rural parts of Indonesia.

There is no curative treatment for Rabies. Avoid touching or being licked by any furry animal in Asia. Visitors are strongly advised to have the very effective Rabies vaccination before travel to Bali or anywhere in S.E. Asia, especially Thailand.

If you are bitten  - bites may be totally unprovoked - then seek medical attention as soon as possible. First aid is to wash the bite with soap and running water for 10 minutes. Within seven days of the bite you  need treatment which may be life saving. This involves a series Dog gets rabies shotof injections.

The  first injection may not be available in Bali or if it is may cost up to $2,000 and may be of questionable quality. For that injection travel to a third country e.g. Thailand where very expert Rabies treatment is available or back to Australia.

Remember the stakes are very high with Rabies and post – bite treatment time is short.

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Hand phone
     Is there any hope for humanity ?
A GENTLEMAN tripped and sat down very heavily on his lounge chair. His daughter's hand phone accidentally left on the chair promptly disappeared up his fundamental orifice. The phone partly unfolded so removal was difficult. The phone rang three times during the surgical procedure!

The ring tone? "Where the Sun Don't Shine".    True story !

If you have any suggestions or topics you would like discussed please contact me:
Dr Richard Tomlins
rjtmedical@gmail.com


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      Dr Richard - Stress                             Dr Richard - StentNext
Reviewed    10  December   2017    
If you have any suggestions or topics you would like discussed, please contact me:
     Dr Richard Tomlins
   rjtmedical@gmail.com Dr Richard Tomlins


Contents

Thinking of Adopting a Child this year?

Well, What Did Your Doctor Say ?

Rabies in Bali is Getting Worse

Is there any hope for humanity ?