I think the problem is, they are caught up with the aesthetic aspects of
having a plastic surgeon near by.  It has nothing to do with the aesthetics,
go with a functional angle.  If they had to cut on your face, they would let
you have a plastic surgeon close it correct?  For my friend, the plastic
surgeon wasnt' there for reconstruction, he was there to close so that once
she's cleared she can have recontruction later.  It's a real head banger of
a situation for you isn't it?!!


Beth T.
-----Original Message-----
From: St. John's University Cerebral Palsy List

To: [log in to unmask]
Subject: Re: Hey all


Thanks, Beth.  Yeah, I already approached my surgeon with that one and he
said that he would only cut the bare minimum.  He's a really good "Joe", and
I trust him on this one.  Laura had surgery about ten years back and he was
the cutter.  I was really impressed with his bedside manner and suturing.

I've been fighting with "peer review" already at the insurance co.  At best,
these folks are LPNs, most don't have any formal medical education at all.
The doc is as frustrated as I am about their reticence to have someone else
close. He admits that a plastic surgeon could close better, even with no
reconstruction.  They are pretty adamant about the whole thing--because "the
book says it's not 'medically or psychologically necessary' for men to have
reconstruction."  If it ain't in the "book", they ain't payin'--pure and
simple.  Our benefits administrator said to me that I have to be careful
when deciding whether to fight or stand-down as the carriers are becoming
"hip" to all of the arguments.  She said that I've already become a
statistical liability to the carrier, so I need to pick my battles
carefully.  Still, the "breathing" angle is one I hadn't considered.
Thanks!  I'll call my cutter today and run that past him.  Who knows?  Maybe
he can plead the case that with my spastic CP, a second pair of experienced
hands might be cheaper in the long haul.

Kyle