Adoption Times Two

My sister and I were both adopted in a closed adoption facilitated by a home for unwed mothers in New Orleans, LA. The adoptions were four years apart and we are not related biologically. Our parents always let us know that we were adopted—even before we could fully conceptualize the meaning of the word. Over the years, I have grown increasingly thankful to my birth mother (who I do not know) for choosing to place me for adoption and to my parents for choosing to welcome me into their family. Obviously, these choices made before I took my first breath have impacted me for the whole of my life.

One of the very few negative consequences of being adopted has been the blindness to elevated health risk factors based on family medical history. Neither my sister nor I have the information needed to be proactive with regard to preventative lifestyle, dietary, or other medically relevant actions that we might otherwise consider. Nor have we been able to aggressively monitor conditions to which we might have a propensity that might otherwise be known to us.

Both of us—my sister and I—have experienced medical situations for which the absence of family medical history has placed us at a relative disadvantage, compared to individuals with detailed family medical histories.

When I was 11 years old, my parents and I learned that I had a problem related to one of my kidneys. It was a blockage in my left ureter that resulted in hydronephrosis (a painful swelling) of the affected kidney. I was at a summer camp when symptoms of the condition developed; my parents were notified and had to rush me home from camp to our family doctor. After further testing, the specific cause of the blockage was determined and the attending physicians indicated that this specific type of blockage was transmitted genetically to male children.

It was necessary for me to have two corrective surgeries to address this problem: the first when I was 11, and another surgical procedure while I was in graduate school. Although having foreknowledge of the possibility of this blockage would not have prevented its manifestation, it would have reduced the anxiety of not knowing what was wrong when the symptoms presented. (I also may have chosen not to participate in a contest at camp to see who could drink the most Cokes!)

While I don’t know if my biological father had this condition, my wife and I watched attentively for symptoms, similar to mine, as we were raising our son. Although he never exhibited any such symptoms, he is now married, and he and his wife have the potential to pass this genetic trait to my grandchildren.

Another challenge that I have faced as an adult adoptee with an absence of a family medical history has been a diminished ability to address medical conditions as they develop. For example, when I was diagnosed with high cholesterol, one of the first questions from my physician was something like: “Do you have a history of this in your family?” Because family medical history is often used by physicians to inform how aggressively a medical condition will be monitored and treated, not having this point of reference has removed that tool from the physician’s toolbox in their treatment of any medical condition that I encounter.

My sister has experienced some very dramatic medical situations, the most significant being multiple occurrences of cancer. In her early 40’s, she was diagnosed with hormone-receptor positive breast cancer. She underwent a bilateral mastectomy, along with radiation and chemotherapy. Through frequent monitoring, she was considered “cancer free” for several years.

However, within the last year she was diagnosed with hormonally-based bone cancer that is distributed throughout much of her body. She is currently undergoing further chemotherapy at a nationally-known cancer treatment facility. She has been told that the current bone cancer is frequently encountered by those who had the type of breast cancer for which she received treatment previously.

It would have been advantageous for my sister to have undergone earlier and more frequent mammograms before her initial...