Evaluation at Vanderbilt

6-1-2011

Our evaluation began with a detailed ultrasound. There were no changes to report from Thursday's ultrasound. Rachel's heartrate was 142 and she now weighs 1 lb.
We met with 3 different doctors, the financial advisor, social worker, a genetic counselor and fetal surgery coordinator. All of them were very good at explaining the surgery and the aspects that pertained to their jobs. I think it was very helpful that we had researched the surgery and the different aspects of spina bifida before attending this evaluation- I think for the parents who did not- it would be very over whelming. They are very strict regarding their criteria for surgery- especially with the mom's medical history and the mom's BMI (thank god for all of the lettuce I ate for the last 3 weeks as I was already overweight when I began this pregnancy. At this point (22 1/2 wks) I have gained 8 lbs but it looks and feels like a whole lot more than that.

We were approved for the surgery and will be the second case scheduled for Tuesday the 7th. One of the hard things for Steve and I to think about is the level of intervention and possible DNR status of Rachel should something go wrong during surgery or the first few weeks following surgery. I will have preop labs drawn on Monday. The surgery is done in the labor and delivery wing at the adult's hospital. The operative team consists of several different doctors, along with an ultrasound tech that continually monitors the baby and the usual anesthesia and nursing team that accompanies surgeries. It is expected that I would need to hospitalized for 5 days following the surgery. The entire surgery takes 3-4 hours.

On a crappy note our insurance company UMR has denied coverage for the surgery- stating that it is because we have no out of network benefits but yet no one in our network is qualified to perform this type of surgery. The estimated cost of the surgery is $68,000. They have a financial advisor at Vanderbilt that is going to continue to try to negotiate with UMR. It is sad that in some cases Medicaid (title 19) has covered this surgery but yet UMR whom I pay a lot of money for will not. Makes you wonder . . . .