Any doctors here-why aren't echocardiograms routine?

[Disney Doll]

Let me pose another question to you parents:

If your insurance wouldn't pay for it, would you be willing to pay out of pocket for an echo for your child, as part of their routine check-up?

 

[meshmar]

That's the real question ... isn't it.

To paraphrase the FBI agent in "National Treasure" ... someone has to pay.

 

[NJBlackBerry]

Why stop at an echo? What other tests should be done? Let's go for the whole thing!

No one should have to bury a child. But it will continue to happen, as sad as that it. And all the preventative and diagnostic medicine in the world won't help.

 

[meshmar]

I can see making non-invasive testing more affordable and available, but I would draw the line at invasive testing. Unfortunately, there are a lot of problems that only show up with invasive testing ... and a lot of times have no symptoms until someone dies.

So, what would you do if something did show up on testing? Let them enjoy what life they have ... or be overly protective and possibly make there short life a relative hell?

 

[Simba's Mom]

this is for Simba's MOM Hi my son to has Tetralogy of Fallot where do you live and how old is your son? I live in Jupiter , FL and my son is 4 yrs old

Hi, shanfl! Check your PMs.

 

[RachelEllen]

Newborn intensive care is what I do, so I can try to answer this....

The issue is both financial and practical.

I believe the cost of an echo is going to be in the 1000 dollar range. I'm wondering if the lower cost posted was that of an EKG. A thorough pediatric echo requires about an hour of time of a pediatric cardiologist. In the nursery where I'm working today, we are discharging home 10 well babies. This is a small community hospital. So you'd need pediatric cardiologists who did nothing but read echocardiograms on well babies.

There are also many cardiac defects that can't be seen on echo at all. Many conduction defects would be better seen on an EKG. Some of these would be found on a routine EKG. Some come and go and need a 24 hour EKG to find.

You also have to remember that every test will have false positives. A general rule in medicine is that the more careful you are about not missing someone with a disease, the more likely you are to think you have found the disease in someone who doesn't have it. If you do complete cardiac workups on everyone, you may end up misdiagnosing so many people, that you will create anxiety, unneeded restrictions in the lives of well children, and side effects from unneeded testing. You may end up creating a bigger problem than you solve.

The test that someone mentioned before with pulse oximetry is a good way to pick up a constriction in the aorta. It's quick and easy and many people advocate doing it rountinely before a baby goes home. This is a specific defect that causes no problems at birth, but can be fatal before a baby even returns for their first check up. So, its an ideal condition to do a test for. To test for the entire range of cardiac problems, however, would be impractical.

 

[JVL1018]

Let me pose another question to you parents:

If your insurance wouldn't pay for it, would you be willing to pay out of pocket for an echo for your child, as part of their routine check-up?

I would. I believe my son's echos were $475 each. If it was something I was really concerned about, I'd do it.
I wonder though, if everyone was doing it, would the kids who really need it have to wait even longer for care?

I would book my son's cardiology appointments a year in advance. He had them yearly, so when I was finished with one, I'd book next year's..and even then, I'd sometimes get a call a week before saying it had to be changed to another day/time.


ETA I am sure my son's echos were not near $1000 at his cardiologists office, the hospital I don't recall, I am sure they were jacked up there because the bill for his 24 hour stay was ridiculous.
($50,000 not including surgery and anesthesia).

I just pulled up his bill from my health insurance online from this past Feb and total was $890 for his checkup after his procedure.
$100 for the office visit, then $65, $375, $175 and $175 for "diagnostic services" I am guessing the EKG was $175 and the echo was $375.

I don't recall what else he had done so not sure what the others are.

 

[Horseshoes]

Why stop at an echo? What other tests should be done? Let's go for the whole thing!

No one should have to bury a child. But it will continue to happen, as sad as that it. And all the preventative and diagnostic medicine in the world won't help.

I agree, why stop there. What about a brain anuerysm? That could be present at birth also.

 

[CF'er]

but few hard answers.

Let's start with newborn screening tests that are done routinely on every baby born. They do a heel stick and send it off to a lab. Depending on where you live depends on how many tests are screened for. The sooner some of these diseases are treated the better. Cystic Fibrosis is one of them. It is the #1 genetic killer of caucasian children yet not every state screens for it. The only way to know if you are a carrier is to have a child born with it. (In simple terms.)

What about the breast cancer gene? If you're tested and positive what then?

I agree with other posters who said if the echo comes back positive what do you do? Wrap the child in bubble wrap and sit them on the couch? Do you try to let them live a normal life and then if something happens blame yourself because you "knew"?

I don't think there are any "easy" or "right" answers here.

 

[RachelEllen]

ETA I am sure my son's echos were not near $1000 at his cardiologists office, the hospital I don't recall, I am sure they were jacked up there because the bill for his 24 hour stay was ridiculous.
($50,000 not including surgery and anesthesia).

I guess we have an office vs hospital difference in billing perspective
I was saying 1000, as you can't really have an Echo without a cardiologist to read it. So if you gave every well kid an echo, you'd have to include the cost of consultation and reading.

 

[JVL1018]

I guess we have an office vs hospital difference in billing perspective
I was saying 1000, as you can't really have an Echo without a cardiologist to read it. So if you gave every well kid an echo, you'd have to include the cost of consultation and reading.

That's true. With everything done for the routine checkup it was close to that!

 

[Alicia87]

I think the other piece of the answer is what you would *do* with the test results if you found out about an abnormality. Do you raise the child never letting them run, never letting them play, never letting them go on any rides, never letting them do anything that would put stress on their heart?

If test results found an abnormality, then you do whatever anyone does when they have a test that goes wrong.....you take care of it. Thank Heaven we live in a day and age when these procedures are much easier than years ago. In 1991 when my daughter was born, her cardiologist explained to me that "fixing" a child with a congenital heart defect was as simple to them as what the "common cold" is to me. Of course, that was easy for him to say....it wasn't his two day old baby lying in that isolette in PICU!! Thankfully, her open heart surgery in March 2005 will be her "last open heart". Next time she needs her pulmonary valve replaced, it will be done through a cathetarization See what I mean about medical advances?!?!?!

Remember, having a heart abnormality doesn't mean you will die as soon as you put stress on the heart, it just means you are more likely to.

Thankfully the above statement is no longer true. Someone who has never had open heart surgery to repair the heart is more likely to die than someone who has because as my DD's cardiothoracic surgeon puts it...."her heart is perfect now because it has been fixed."

 

[Alicia87]

So am I now officially considered a thread killer?

 

[julia & nicks mom]

My son recently had an EKG - and it showed an abnormality so we are going for an echocardiogram

any child under 4 who has one has to be sedated - I tried to have them do it without but from what I hear - they have to lie still for 1/2 hour to an hour - and they can't be sure that a child under 4 will stay still - and then the resutls will be difficult to read

so while it might be easy to have it done -it is not always a non-invasive procedure

 

[bicker]

It's frightening! Probably start with the insurance companies. Are they going to cover any part of it financially on a child for it to be done routinely?

If we were all willing to pay for it, they would. So, no, DON'T start with the insurance companies. Start with the people. Make the people see the value you see. If you cannot get passed the people, then going to the insurance companies won't help.