NCP refuses to consent to son's surgery

[armydaddy]

Yeah she said she had to stay stocked up on popsicles and yogourt. Apparently her daughter had to be out of school 2-3 weeks until recovery but from what she states she is SO MUCH BETTER. She never complained about eating ice cream all the time either...lol I know it seems like a lot for a small child to go through but it is better in her sons condition to go ahead with it now so he can start this before he starts kindergarten.

 

[rmet4nzkx]

Yeah she said she had to stay stocked up on popsicles and yogourt. Apparently her daughter had to be out of school 2-3 weeks until recovery but from what she states she is SO MUCH BETTER. She never complained about eating ice cream all the time either...lol I know it seems like a lot for a small child to go through but it is better in her sons condition to go ahead with it now so he can start this before he starts kindergarten.

What ever your relationship to CP of this child. Please, Please, refer them for proper assessment without assuming based on other's experiences, that surgery is necessary! This child deserves appropriate assessment.

 

[Whyte Noise]

Enlarged tonsils do not always become smaller with age.

My 12 year old has to have her tonsils and adenoids taken out because of this same problem.

Her left tonsil is so large that it's at the midline of her throat, and that's WITHOUT an infection going on. Whenever she gets an infection (tonsilitis, pharyngitis, etc.) and her doctor looks in her throat his first words are always, "Oh my God." At that point, her left tonsil is completely across the midline and her right one is getting close.

She snores, stops breathing at night (undiagnosed sleep apnea her doctor said *because she hasn't been formally subjected to a sleep study*) and she mouth breathes, even while awake. Her Dr. in Missouri recommended the surgery, and so has her doctor here. She's waiting to see the ENT now.

And, most insurances will not pay for this without the proper documentation. In Missouri, my daughter had to have 3 documented instances of infection before insurance would even consider her for the surgery even though her tonsils were obstructing her breathing without an infection. We moved before we could get the third one in. If OP's insurance is going to pay for it, I'd be willing to bet that there's been more than one doctor that's documented the need for this surgery.

So, who is to say that there hasn't been appropriate assessment? After all, it's not like you can just walk into a hospital and request a tonsillectomy off the streets. At least ONE doctor had to say there was a need for it along the way somewhere, or the surgery wouldn't be scheduled.

How many doctors have to say the surgery is needed before you consider it an "appropriate" assessment, rmet?

 

[nextwife]

What ever your relationship to CP of this child. Please, Please, refer them for proper assessment without assuming based on other's experiences, that surgery is necessary! This child deserves appropriate assessment.

I agree that a second opinion is warranted. And even then, if they ultimately DO go forward, it is important to be certain of the capabilities of the entire staff for pediatric surgery, especially ask about the pediatric anesthesiologist and what type of facilities are there . Children's Hospitals have an entirely different environment, which helps reduce stress and fears, they also are better equiped to handle emergancies. ANYTIME a child goes under a general anesthesia, there is a risk. Bleeding risk is also a concern, withj all that is being done. Tubes is one thing (if actually needed), tonsilectomy is a whole other.

 

[armydaddy]

Child has been assesed by the state of KY and this is the only reason why he qualified to attend the preschool for speech therapy. This was set up BY THE STATE. Yes there are ways of dealing with ear wax beside tubes but thats not the main problem. The ear wax is building up because of fluid not being able to drain from behind his ears as to what I am told.
It was a school teacher/ speech councelor durring the assesment that has noted that many children that had this problem improved greatly after getting their tongue clipped. She is not solely going off what this teacher said. Two other doctors have said the same thing.
The tonsils are not infected they are just extremely large. Put it this way I saw this childs tonsils myself and you would have just enough room to fit a small tip of a pinky finger between it. The previous doctor's have suggested this surgery as does this one now due to problems this could cause.
As far as the NCP questioning these procedures, yes he has EVERY right. Once he refuses to act on those rights and expect that it just not be done because it is not in TN just shows his lack in helping his child. To me this just shows how he is trying to place an unfair strain on the CP to help assist their son in getting medical treatment. After all he was offered the doctors name and number and he has just as much right ot those records as the CP. He chose not to so here we are.
By the way he is only covered by KY Medicaid.

 

[rmet4nzkx]

Enlarged tonsils do not always become smaller with age.

My 12 year old has to have her tonsils and adenoids taken out because of this same problem.

Her left tonsil is so large that it's at the midline of her throat, and that's WITHOUT an infection going on. Whenever she gets an infection (tonsilitis, pharyngitis, etc.) and her doctor looks in her throat his first words are always, "Oh my God." At that point, her left tonsil is completely across the midline and her right one is getting close.

She snores, stops breathing at night (undiagnosed sleep apnea her doctor said *because she hasn't been formally subjected to a sleep study*) and she mouth breathes, even while awake. Her Dr. in Missouri recommended the surgery, and so has her doctor here. She's waiting to see the ENT now.

And, most insurances will not pay for this without the proper documentation. In Missouri, my daughter had to have 3 documented instances of infection before insurance would even consider her for the surgery even though her tonsils were obstructing her breathing without an infection. We moved before we could get the third one in. If OP's insurance is going to pay for it, I'd be willing to bet that there's been more than one doctor that's documented the need for this surgery.

So, who is to say that there hasn't been appropriate assessment? After all, it's not like you can just walk into a hospital and request a tonsillectomy off the streets. At least ONE doctor had to say there was a need for it along the way somewhere, or the surgery wouldn't be scheduled.

How many doctors have to say the surgery is needed before you consider it an "appropriate" assessment, rmet?

Based on the limited information Armydaddy provided, there had not been appropriate clinical evaluation, this thread has developed into one of personal opinions, not one looking at the legal and medical issues which were already addressed.

At one time in history, T&A were removed routinely because it was thought that they were not needed and it would prevent illness, in fact the opposite it true.

I grew up in one of the most affluent counties in the entire country and only the poor kids didn't get their T&A removed. Now this was in the days when modern antibiotics were not available and strep and ear infections were not as effectively treated as today. What they found out was that while these children might have frequent infections and enlarged tonsils, that in children who did not have T&A removed, that they usually got better after getting through the usual exposure to infections upon attending school so that by say age 8 most children, because of their stronger immune systems, not only had tonsils that fit but also childhood asthma, ear infections were also better. Tonsils can also grow back.

While it may be easier to have surgery for a young child than an older child, it is better to only have it if necessary. It appears that your child has reached an age where it is clear that she needs the surgery and as you have noticed, it is not easy to get approved. My son, had frequent ear infections, an infection that was not cured until after he was 3 yo, his tonsils were huge, even when he was not sick, he also had asthma. His hearing was assessed, it was excellent, dispite scarring of his eardrums, he had no speach or learning disabilities, infact was talking early and reading by age 3 (not memorized materials, but novel materials) we discussed tubes and removing the tonsils but the doctor said wait because most children improve and he did improve on all accounts.

In this case NCP is justified in questioning all these claims that surgery is necessary, no matter their intent. This child has communication and behavioral issues that require specific assessment. That is why I suggested assessment and early intervention for DD and a GAL if there is a dispute regarding the necessity after appropriate assessment.

Preschool teachers are not the ones who reccommend toungue clipping. Tubes are not inserted to treat earwax. These are elective proceedures. There is something incongruent with the reported clinical reccommendations, that is why I asked Armydaddy who they are in relation to this child.

 

[rmet4nzkx]

Child has been assesed by the state of KY and this is the only reason why he qualified to attend the preschool for speech therapy. This was set up BY THE STATE.
OK then NCP should have no problems with preschool and if the child qualifies, most of their medical should be covered through state sponsered programs. This assessment is ongoing and may take time. In time there will be reexamination of the childs progress, it is too early to consider surgery unless several doctors/PED-ENT deem it necessary. Subjecting a young child with behavioral, learning and communication difficulities to surgery which may not be necessary could be seen as abuse.

Yes there are ways of dealing with ear wax beside tubes but thats not the main problem. The ear wax is building up because of fluid not being able to drain from behind his ears as to what I am told.
Then the earwax is removed by the doctor as needed and regular treatment/cleansing at home, supervised by the doctor can control the build up of earwax. The build up of fluid is treated by the doctor with medication if and or when this fails and the child has frequent ear infections sometimes tubes are inserted, sometimes these come out, but it is not the answer to initially to either problem. There was a time when ear tubes were all the rage and like the removal of T&A are not routinely inserted without considerable assessment.

It was a school teacher/ speech councelor durring the assesment that has noted that many children that had this problem improved greatly after getting their tongue clipped. She is not solely going off what this teacher said. Two other doctors have said the same thing.
Again, while many children with speach problems may be tongue tied and an observation of speach pathologists, unless a physician deems it necessary, it is questionable. Again a doctor may contifm this observation, that many children's speach improves, has any doctor actually made the clinical assessment that this child actually required this surgery?

The tonsils are not infected they are just extremely large. Put it this way I saw this childs tonsils myself and you would have just enough room to fit a small tip of a pinky finger between it. The previous doctor's have suggested this surgery as does this one now due to problems this could cause.
To the untrained observer, tonsils can look huge, yet they may be within normal limits. As I stated in a previous post my son's were huge, but in time they fit and at age 35 still has them! Has this child been examined by a ped/ENT?

As far as the NCP questioning these procedures, yes he has EVERY right. Once he refuses to act on those rights and expect that it just not be done because it is not in TN just shows his lack in helping his child. To me this just shows how he is trying to place an unfair strain on the CP to help assist their son in getting medical treatment. After all he was offered the doctors name and number and he has just as much right ot those records as the CP. He chose not to so here we are.
He aksed that the doctor call him, CP refused to relay that request. If NCP calls, they are still going to question if he has permission, if there is a waiver, if they have joint legal and before they call back. CP is playing the game here, no doctor is going to discuss a patient with someone who calls in and askes to discuss the patient without proper authorization. It would be simpler for CP to ask the doctor to call NCP sign HIPAA waivers.

By the way he is only covered by KY Medicaid.

OK, depeding of the eventual evaluation of the child and the reccommodended treatment plan. KY medicaid may authorize treatment elsewhere and I suspect if NCP is afforded their rights in making joint legal decisions re the best interest of their child, rather than CP trying to control the show, they may agree to treatment in KY. If CP moved to KY from TN, they knew, that would make such decisions more difficult.

 

[panzertanker]

And would anyone care to tell this poster the REAL answer based on the state in which they live?

No, BB. We are all waiting on the edge of our seat for you to offer your god-like knowledge.....instead of riddles, parables and posturing.
So where is it? What is the REAL answer???

 

[rmet4nzkx]

And would anyone care to tell this poster the REAL answer based on the state in which they live?

OP is unrelated 3rd party and has no bone(*) in this fight, their state of residence is of no relevance, furtheremore, since OP is AD military, their state of residence may not be where they reside