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Old 04-03-2008, 12:10 AM
lovemybaby lovemybaby is offline
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Question H on forhead treatmetn options

Hi all,
My 9 wk old Collin has a compound H on his forhead (about 1.5 cm long and a few mm high) and I have a bunch of questions right now. If anyone has any input for me I would sure appreciate it. We saw the ped derm at Kaiser HMO Nor Cal (San Fran Bay Area), Dr Beets-Shay, today. She trained at UCSF with Dr. Frieden. It is my impression that they take a relatively conservative approach (compared to Waner or Rienisch). We talked about doing topical steroids cream (Clobetasol) for 2 weeks and then possibly a steroid injection and or V BEAM pulse dye laser in about a month if the H is still growing or has not improved. She said the steroid cream or injection can casue thinning of the skin and that the laser can cause ulceration. She said the ulcer is more likely with a thicker H that has thinned the skin already. She said the ulcer would scar. She said she uses a low setting and that the red part may ligten to pink from the laser. She is in the laser clinic one time per month and does mostly PWS. I am wondering if this is enough experience to work on my baby's face. How do I know if she is experienced enough? Dr. Freiden's nurse Crotwell said Beets Shay was very good. How do I know I am in the best hands I can get into in my area? I am sorry if I seem like a hysterical parent...but I want the best outcome for my darling baby boy!
If the H persists I am considering surgery in the future with Dr. Reinisch in LA, but I am not sure if that would be "extreme". Right now the H is causing no complications. I do not wnat him to have this big red bump on his face until he is 5yrs plus though! What kind of a scar might we expect from Dr. Reinisch's surgery? Is there a chance that Kaiser HMO would ever cover that? What if the Kaiser Ped Derm wont write a letter to request it (I dont think she would). Could our pediatrician do that instead?
Well, thanks for any help.
Mariah
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Old 04-03-2008, 04:26 AM
EJsMommy EJsMommy is offline
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Default Hi

I don't know what the procedure is with your particular insurance, but just keep in mind there is always a way. If your daughter's doctors won't refer you to a Hemangioma specialist, you can request Authorization from the insurance with a letter explaining your situation, and some photos of your child (well, that's how I had to do it, because I could not get a referral either). But, I'm not insurance expert, but I thought I'd share how I got authorization.

My daughter has a large H on her head too, it's raised, looks like she bumped her head or something. I am scheduled to see Dr. Waner in May for surgery. I do not believe surgery is extreme, and babies heal very well and scar less than older kids and adults. Surgery for the excision is usually better to do when they are young, rather than years down the line. Of course, it depends on what the specialist recommends for your individual child's H.

We'd love to see photos of your baby if you are able to share.

PS - The sample appeal letter on this site helped me... maybe you could get some ideas from it for requesting Authorization from your insurance company.
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Old 04-04-2008, 12:27 AM
lovemybaby lovemybaby is offline
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Hey Christine,
Thank you. Yes, if there is a will there is a way...I cant post photo now because the file is too big. But Missy did post one for me on the Kaiser Surgery thread a couple of weeks ago. The H has grown since then, particularly the deep part. I will get some updated pics up soon. I am going to send them to Dr. Reinisch hopefully tonight. I have not heard back from Waner or Leviine on ask the expert. It has been two and and half weeks. I will try again...
Congrats on your success with your insurance.
Best,
Mariah
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Old 04-04-2008, 06:05 AM
EJsMommy EJsMommy is offline
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Good Luck... I hope it goes well!!!
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Old 04-28-2008, 08:08 PM
mjwrw mjwrw is offline
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Hi Mariah.
I am not sure what point you are now at, but I just read your post today.
My daughter had a large forehead hemangioma and she had surgery to remove it with Dr. Reinisch when she was 13 months old. He was wonderful!! We sought opinions from doctors all over the US and we could not be happier with the result.
This is such a scary and stressful process, but I agree that where there is a will there is a way. Your child's face is very important you want to be sure to get the best. I would be happy to email with you on more details regarding the financial end if you like.
Also, attached are some before/after pictures of my daughter. The before is on her first birthday and the after is a few weeks ago.
Good luck and please let me know if I can help.
Rory
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File Type: jpg Birthday girl1 Tiny.jpg (36.8 KB, 54 views)
File Type: jpg Tiny Ears.jpg (72.3 KB, 47 views)
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