When Michelle* went through the two-year adoption process, one of the many reasons she chose Audrey* to be her daughter was because the little girl was born with a congenital deformity called cloaca; Michelle knew she could provide Audrey with the kind of medical care her daughter would never receive while living as an orphan in Asia.
Audrey's cloaca—a condition in which the vagina, rectum and urethra all join into one common channel with only one skin opening—was discovered at birth, and a doctor created an opening for her colon through her abdominal wall and skin (known as a transverse colostomy) as a short-term fix to keep her alive so that the stool emptied into a bag rather than through the common channel. They then created a new anus for her and reversed the colostomy leaving her with an anus and a single opening for her urethra and vagina. But the now-4-year-old needed definitive reconstruction surgery to have a hope of thriving into adulthood.
Upon adopting Audrey, Michelle began searching for a health institution anywhere in the nation prepared to tackle this complex surgical case. She found Grace Mak, MD, director of the Pediatric Colorectal Reconstruction Center, and immediately knew Mak was the right person to trust with her daughter's care.
"The knowledge Dr. Mak and her team have is amazing," Michelle said. "They had a game plan before they had even met Audrey. They knew what cloaca was and were able to explain so clearly how they could help her."
Most congenital anomalies are discovered and corrected at birth, but because of Audrey's adoption, her treatment took place later in life than most children, making her case a more challenging one. In addition to the delayed timeline, the physicians knew little of Audrey's medical history other than what they could perceive from scars on her abdomen and sparse medical records.