Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 jagd41 wrote: > ... I would hope some of our local drs have learned about this > problem. > Be careful here. You don't just want someone that has just learned about it. You want someone that has done lots of Heller myotomies. There are articles written by surgeons that describe how their second fifty myotomies were better than their first fifty. There are studies that show two important factors in the outcome are, the experience of the surgeon with this surgery and the volume of myotomies the medical center does. Unless you live in a very large metropolitan area it is unlikely that there will be enough myotomies done in the area to keep volume up. The rate of new achalasia cases is 1 in 100,000 per year, and not all of those will receive myotomies. A center that serves a population of 500,000 would only have 5 new cases a year and less myotomies. Remember too that children have about a tenth as much of a chance of getting achalasia. So a population of 500,000 may go a year without even having a new case of a child with achalasia. Places like CC and Mayo keeps their volume up by taking patients from all over the world. For volume, few centers come close to what CC does. notan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2007 Report Share Posted September 11, 2007 In 1997, Drs. Vogt D, Curet M, Pitcher D, Josloff R, Milne RL, and Zucker K. of the Department of Surgery, University of New Mexico, Presbyterian Medical Center, Albuquerque 87131-5341 published a study on 20 cases of laparoscopic Heller myotomy for achalasia. They must have done many more since then, but you'd have to find out whether the surgeon(s) among them are still there. If you're determined to see a top specialist, Drs. DeMeester and Maish in Los Angeles, or Dr. Patti in San Francisco would be closer than Cleveland, with the same level of experience. in PA Drs out West > , I will be looking into drs at UNMH. Our insurance is > with > PHP. I would hope some of our local drs have learned about this > problem. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 > > ... I would hope some of our local drs have learned about this > > problem. > > > > Be careful here. You don't just want someone that has just learned about > it. You want someone that has done lots of Heller myotomies. There are > articles written by surgeons that describe how their second fifty > myotomies were better than their first fifty. There are studies that > show two important factors in the outcome are, the experience of the > surgeon with this surgery and the volume of myotomies the medical center > does. Unless you live in a very large metropolitan area it is unlikely > that there will be enough myotomies done in the area to keep volume up. > The rate of new achalasia cases is 1 in 100,000 per year, and not all of > those will receive myotomies. A center that serves a population of > 500,000 would only have 5 new cases a year and less myotomies. Remember > too that children have about a tenth as much of a chance of getting > achalasia. So a population of 500,000 may go a year without even having > a new case of a child with achalasia. Places like CC and Mayo keeps > their volume up by taking patients from all over the world. For volume, > few centers come close to what CC does. > > notan > Notan, thank you, I hear you loud and clear. My concern is just that I hope they have heard enough about it to realize what a special problem it is, and respond accordingly. Thanks for keeping me on my toes! Adam's dad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 > > In 1997, Drs. Vogt D, Curet M, Pitcher D, Josloff R, Milne RL, > and Zucker K. of the Department of Surgery, University of New > Mexico, Presbyterian Medical Center, Albuquerque 87131-5341 > published a study on 20 cases of laparoscopic Heller myotomy for > achalasia. They must have done many more since then, but you'd > have to find out whether the surgeon(s) among them are still > there. > > If you're determined to see a top specialist, Drs. DeMeester and > Maish in Los Angeles, or Dr. Patti in San Francisco would be > closer than Cleveland, with the same level of experience. > > in PA > > Drs out West > > > > , I will be looking into drs at UNMH. Our insurance is > > with > > PHP. I would hope some of our local drs have learned about this > > problem. > > > , Thank you for the info on the Drs in Ca. Adam's dad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 I also have PHP. I know that they use Case Managers and I'd request one. They can check with the docs, in the system, to help determine who has experience with Achalasia. If there is not one with good experience, then you can begin to work with the insurance company to go out of network. > > In 1997, Drs. Vogt D, Curet M, Pitcher D, Josloff R, Milne RL, > and Zucker K. of the Department of Surgery, University of New > Mexico, Presbyterian Medical Center, Albuquerque 87131-5341 > published a study on 20 cases of laparoscopic Heller myotomy for > achalasia. They must have done many more since then, but you'd > have to find out whether the surgeon(s) among them are still > there. > > If you're determined to see a top specialist, Drs. DeMeester and > Maish in Los Angeles, or Dr. Patti in San Francisco would be > closer than Cleveland, with the same level of experience. > > in PA > > Drs out West > > > > , I will be looking into drs at UNMH. Our insurance is > > with > > PHP. I would hope some of our local drs have learned about this > > problem. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 wrote: > ...published a study on 20 cases of laparoscopic Heller myotomy ... Notice that these 20 cases were selected over 4 - 5 years, so volume may be kind of small. notan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 > > , I will be looking into drs at UNMH. Our insurance is with > PHP. I would hope some of our local drs have learned about this > problem. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2007 Report Share Posted September 12, 2007 I'd be curious to know what you find out. Good luck! I'll also ask around; I know a Pediatrician and he may have some ideas. > > , I will be looking into drs at UNMH. Our insurance is with > PHP. I would hope some of our local drs have learned about this > problem. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2007 Report Share Posted September 13, 2007 I just spoke to the Pediatrician I know, and he mentioned a couple of ppedicatric surgeons he likes from Presbyterian: Dr. Hatch and Dr Buntain. He also mentioned a Dr. Lemon, from UNMH. I don't know how much experience these doctors have with achalasia, but these are the names he was familiar with. At least it's a place to start. > > > > , I will be looking into drs at UNMH. Our insurance is with > > PHP. I would hope some of our local drs have learned about this > > problem. > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.