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| From BambiniPt2 |
Unfortunately the Doctor only shows up for clinic one day a week and he had just been on a three week vacation so ended up waiting an hour and a half. Since we were not covered by any insurance we negotiated a $100 fee. By the time we were done everyone had gone home so it was not collected. I was waiting to see if they had the nerve to ask for it, but so far they have just apologized.
The staff was very nice and the examination the doctor performed was at a whole new level. He made observations and felt things that no one else had done. It was clear he was very specialized. He is not only the head of the department and chief surgeon, but he is also the professor and runs a research lab.
He explained the procedure he would probably do would be a single operation. The Kaiser Doc wanted to do a two stage operation with six months in between each surgery. We asked him about his complication rate and seemed to think it would be about 5% with Nico. The most common complication is a simple 25 min fix that is usually the result of a stiches coming apart.
The most illuminating comment came on the way out when we asked if we could be with him before he went under and when he came round. His answer was of course. "We want the parents in the recovery room". This was music to my ears because we had a very tense phone call with the Kaiser Doctor on this subject and he was doing everything possible to avoid answering that question.
As you may recall, this was an issue when Barbara had her procedure done. They kept me out of the recovery room until she had fully recovered (probably to eliminate an eye witness should there be complications) despite my request to be there when she recovered. Obviously Kaiser is trying to limit their liability in case something goes wrong.
Next he mentioned that the anesthesiologist uses a mask to deliver the gas. Now this may seem obvious, but good old Kaiser insisted the only way to do this was by inserting a tube down his throat. Barbara had this done in her procedure and her throat was torn up so badly she needed to suck cough drops for days. It took almost a full week to heal. In fact it was the biggest issue of her recovery.
I could not understand how so much damage could be done with today's technology, but they assured us there was no alternative. It was like she had a bad cold. She was in pain and her throat was raspy and very uncomfortable. This is not something a baby would be able to do anything about. He cant suck a cough drop!
It is likely that this would cause him so much irritation that he would not be able to sleep. Since healing is the most important part of this procedure, and sleep is key to healing, the tube down the throat is something I wanted to avoid at all costs. When the Doc said they use a mask we were overjoyed.
In preparing to take on the Kaiser machine, I contacted a few people from anti Kaiser sites like The Kaiser Papers with an appropriately named section "PATIENT HORROR STORIES - BY CATEGORY" and Just Health. They are a little militant but it never hurts to hear what they have to say. In one letter from Vicky, who has some experience in dealing with Kaiser, she points out that suing Kaiser engages mediation with DMHC that all members agree to when they sign up. She continues:
Kaiser is a private company and while DMHC ( Department of Managed Health Care)
is supposed to be helping patients they do appear to be controlled by Kaiser. Kaiser has a terrible track record for a lot of things but it does not matter to them nor does it matter to
any government agency that only cares about data. Kaiser provides data and
government agencies are hard pressed to obtain data from many other sources.
The government incentive is to not find wrong doing.
Here is what Kaiser Administration assumes you will do and they are probably
correct:
1. You will waste time with appeals that they will consistently deny because
they have a doctor on staff that they claim can do the job.
2. You will become frustrated and desperate. Kaiser administration counts on
that happening.
3. You will contact government agencies and be strung along and eventually will
be told that their hands are tied.
4. You will continue to be frustrated and your desperation to help your son
will increase so greatly that you will consent to the Kaiser surgeon and you
will be grateful no matter how he performs the surgery.
Since Kaiser just got fined $3m for poorly handling member complaints, we are going to give it a shot. I think we have a reasonable case mostly because their surgeons do one or two of these surgeries per year and the specialists do at least 150 per year.
We have also been courting the specialist in Dallas. While the Doc in San Francisco is good too, he is difficult to reach and should there be a problem, I suspect he will become unavailable. The Doc in Dallas emailed me his cell phone number and we had a great conversation. If he was in this area he would be the obvious choice. His published complication rate is 4% over the last ten years, and I get the feeling he would go to bat for us if a problem arose.
Barbara and I have discussed this at length and because so much is riding on this first surgery, I am going to fly to Dallas to meet him next week. I will ask him a few more technical questions about his procedure to make sure I fully understand what differences there are between him and the UCSF Doc, find out about his anesthesiologist and also check out the hospital.
If there are no red flags, then we will have a difficult choice. The flight to Dallas is not without its stress for the babies, but it may be worth it if the surgeon is better. Either way we have to decide in the next week and schedule it because there are a lot of things happening in October.
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