Tricare Prime - Any Military Hospitals experiences?

January 10, 2006

Hi Everyone,

This all new to me! But I know that you have all been here too.

I am 6 months pregnant and know that my son has at least one

clubfoot, possibly both. I'm researching on the web about the

different treatments. I'm really interested in the Ponsetti method.

My biggest hurdle is being a Navy wife we are enrolled in Tricare

Prime and we are currently stationed in Guam. I don't believe that

the baby will be treated here as the hospital isn't really able to

deal with things like this. I'm hoping to find out in advance if it

will be possible to use a Doctor that does the Ponsetti method. I'd

also like to know about anyone else's experience with military

doctors. I emailed Dr. Ponsetti and he said he knew of one child

that was " poorly treated in Hawaii " but he didn't know who the

Doctor was. This worries me as we will most likely be sent there or

Okinawa for treatment if it is available at either place.

I was also told there is a list of questions to ask a physician

to help me assess his experience and qualifications on this

website. But I don't see it. Can anyone tell me were to find that?

Thanks for any help!

Gretchen

January 11, 2006

>My daughter was on tricare when she was born w/bilateral clubfoot.

Please understand that you DO NOT have to use military Drs although

tricare will try to pressure you into doing so. My daughter began

treatment w/a military Dr that was supposed to treat paratrooper

injuries. He told me he had experience in treating clubfoot and I

was new to dealing w/insurance. I assumed I had to stay w/in

the " network " or military facilities. However EVEN if they do have

the correct Drs at the military clinics you have the right to get

another opinion.

In order to use a Dr of your choice you have to use the chain of

command at the hospital and get referrals. It is a hassle but soooo

worth it. It really pays off in the end. I was able to take my

daughter to anyone and for the most part everything has been payed

for. While stationed at Ft Bragg I got a 2nd opinion and treatment

then paid for at another hospital because my girls feet were not

being corrected. The Dr we went to although on the Ponseti list was

not able to correct w/out surgery. We then got a 3rd opinion which

was approved by Tricare and treatment in Iowa by Dr Ponseti was then

payed for. Afterwards her followup care in Baltimore maryland was

also paid for . Recently we ended up having to switch Drs again and

tricare approved that as well. I will admit it was alot of work but

in the end my daughter got the best care possible. Feel free to

email me if you have any questions. > Hi Everyone,

> This all new to me! But I know that you have all been here

too.

> I am 6 months pregnant and know that my son has at least one

> clubfoot, possibly both. I'm researching on the web about the

> different treatments. I'm really interested in the Ponsetti

method.

> My biggest hurdle is being a Navy wife we are enrolled in

Tricare

> Prime and we are currently stationed in Guam. I don't believe

that

> the baby will be treated here as the hospital isn't really able to

> deal with things like this. I'm hoping to find out in advance if

it

> will be possible to use a Doctor that does the Ponsetti method.

I'd

> also like to know about anyone else's experience with military

> doctors. I emailed Dr. Ponsetti and he said he knew of one child

> that was " poorly treated in Hawaii " but he didn't know who the

> Doctor was. This worries me as we will most likely be sent there

or

> Okinawa for treatment if it is available at either place.

> I was also told there is a list of questions to ask a physician

> to help me assess his experience and qualifications on this

> website. But I don't see it. Can anyone tell me were to find

that?

> Thanks for any help!

> Gretchen

>

January 11, 2006

Gretchen,

Hi and welcome to the group! Congrats on your pregnancy too! I'm

almost certain that the child who Dr. Ponseti was referring to was

Gabe, Faith's son. Faith is an active member of this group so I'm

sure she will respond quickly with a lot of information for you,

sounds like you are in very similar situations.

Best wishes to you!

>

> Hi Everyone,

> This all new to me! But I know that you have all been here too.

> I am 6 months pregnant and know that my son has at least one

> clubfoot, possibly both. I'm researching on the web about the

> different treatments. I'm really interested in the Ponsetti method.

> My biggest hurdle is being a Navy wife we are enrolled in Tricare

> Prime and we are currently stationed in Guam. I don't believe that

> the baby will be treated here as the hospital isn't really able to

> deal with things like this. I'm hoping to find out in advance if it

> will be possible to use a Doctor that does the Ponsetti method. I'd

> also like to know about anyone else's experience with military

> doctors. I emailed Dr. Ponsetti and he said he knew of one child

> that was " poorly treated in Hawaii " but he didn't know who the

> Doctor was. This worries me as we will most likely be sent there or

> Okinawa for treatment if it is available at either place.

> I was also told there is a list of questions to ask a physician

> to help me assess his experience and qualifications on this

> website. But I don't see it. Can anyone tell me were to find that?

> Thanks for any help!

> Gretchen

>

January 11, 2006

Gretchen,

I know that Faith will post to you as soon as she sees your note. I'm

pretty sure she was in Guam, also, when her son Gabe was born with

clubfoot! About the list, you can find it at

http://members.tripod.com/ponseti_links-ivil

There's lots of info there.

Congratulations on your pending arrival!

We're glad you're here!

& (3-16-00, left clubfoot, switched to Ponseti method at 4

months old)

http://ponseticlubfoot.freeservers.com/

January 11, 2006

Gretchen, I believe he was probably, almost definitely, talking about us. Gabe

was born in Guam with bilateral cf. At 6 weeks we were sent to Tripler in HA and

treated by Dr Burkhalter. He's a good surgeon, and to his credit, the tenotomies

he performed on Gabe were done very well. The problems arose when we were

" ready " for shoes and bracing at 3 months. Even I as a layperson could see that

Gabe's feet were not completely corrected. His feet were fat little sausage

rolls w/ very high arches that I know now are referred to as complex clubfeet.

Incidently, there is a new theory that this brand of clubfoot is caused by

improper initial casting. After the tenotomy casts came off, he looked at Gabe's

feet, said " eh, I don't hate it. " then sent us home. WE were supposed to go get a

brace within the next couple days. Of course, this is a HUGE no-no because

newly corrected feet can relaspe in , literally, hours. It tookl us two days to

get the from the orthotics guys downtown. We put the

brace on immediately, but I have no doubt the feet had relapsed a bit already.

The first and second night Gabe screamed bloody murder over the shoes and bar.

He pulled out of them several times. His feet were red and blistery. WE went

back to Dr Burkhalter to ask if this was normal. He told us, yes, " it's normal.

Unfortunately, some kids..and their parents simply can't take the bracing and

opt for surgery. " I new that according to Ponseti, this was an erroneous

statement, but we were TRicare Prime. I had just separated the Air Force to take

care of GAbe... WE couldn't aford to argue. WE sent us back to Guam with a

screaming baby and no recourse. A week into full time... torture... with GAbe's

brace, in tears and at my wits end, I found this group. They told me to call

Ponseti himself in Iowa. At 90 years old, who knew he was still seeing/would

talk to just ANYONE! Anyway, I called him and sent dig. pics to him of Gabe's

feet. He told me Gabe would probably never be able to waer the

shoes that had been forced on us due to his aypical/complex clubfeet. Gabe's

feet indeed were left uncorrected...by quite a few casts. He convinced me to do

whatever I had to do to get Gabe to a doctor who had experience with treating

feet like Gabe's. He told me NOT to return to give DR Burkhalter a second

chance. WE withdrew GAbe from Tricare Prime; put him into Tricare Standard, then

I left my hubby in Guam and moved in with my parents for SEVEN months. WE saw a

ortho in Atlanta that was on Ponseti's list of approved orthos, but got pretty

much the same result. Turns out the guy actually trained DR B.! Talk about bad

luck! WE had been bad-mouthing him for weeks!HA! Anyway, finally at 7 months, we

scraped together enough to go to Iowa to see Ponseti. He corrected GAbe's feet

completely, for the first time, in 7 casts, and we've been in a special

hand-made brace ( brace- you're new so I won't inundate you with too

much info). Anyway, we've been problem free since. No

surgery...no pain...just beautiful feet.

If you child has typical clubfoot, who knows... DR B may correct them without

drama. However, the man is Chief of Pediatric Orthopedic Surgery at Tripler. No

one sees his patient but him. He is soooo busy. You;ll never wait under an hour

to see him..then you see him for casting and he disappears. The mistakes he

made treating GAbe's feet were huge i.e. leaving GAbe uncasted or unbraced for

days (huge, huge no-no), he told us that the brace would further the feets

correction. WRong!BRacing is for maintenance not correction! If the feet aren't

100% corrected when they go into the shoes there will be undoubtedly discomfort

and they will NEVER correct themselves! Lastly, the feet simply were never

corrected. It's just my opinion, but such huge, glaring mistakes made by Chief

of Surgery is a bit scary, ridiculous.

You have time to find out if your child can be treated sufficiently by him. If

you get the results we did, you can always be referred off-base. There is, I

think, one guy off base that is on Ponseti's list though I don't know anything

about him. The only problem with trying DR B. is like I said, his casting may

have resulted in Gabe's compound deforities..

Anyway, that's our story. Should you have any questions at all. Don't hesitate

to call (801)782-9347. We have flat rate long-distance; we could call you. I

know that the Guam telephone authority has a seriously crappy long-distance

program.We never had long distance (always phone cards). WE're on mountain time,

but keep odd hours, so don't worry about time zone issues. Hope we can help you

...

okdoake wrote: