Nurse Grace

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Grace Chimene Pediatric Nurse Practitioner. I am interested in the health and safety of children. BSN RN University of Texas School of Nursing 1983 MSN University of Texas Medical Branch Pediatric Nurse Practitioner 1987
Showing posts with label Medical Home Portal. Show all posts
Showing posts with label Medical Home Portal. Show all posts

Monday, July 21, 2014

OMG, Why My Child; What to do After a Diagnosis

My friend called. Her grown son was just diagnosed with a rare brain tumor.  The tumor of the pituitary gland was a benign (not cancerous).  This type of tumor increases the amount of growth hormone and  causes acromegaly or gigantism. Her son’s, very on the ball, GP noticed symptoms, large hands and feet, growing facial features and referred him appropriately for the correct tests that confirmed the diagnosis.  Now her son is making plans for surgery and his mother is frantically checking online for all the information she can get.  

What I did when I got the call to help research this rare disorder for my friend, I started with Google and I looked on the  Medical Home Portal, which collects medical information  about rare medical conditions, and The National Organization for Rare Diseases NORD.

I looked for the specialists for this disorder:

I checked for the disorder's patient and family support organizations:
In this case the support organization based in Australia.

I checked for the experts in the field (who writes the papers on the rare disorder).

And finally I found medical guidelines:

That is what I did as a nurse practitioner.  Now consider what should a family do when a diagnosis is made.  

Find the specialist for your child’s diagnosis.  If the diagnosis is very rare.  There is some doctor or group of doctors in the world who takes an interest in your diagnosis.  Most of those doctors are associated with a medical school. Look for who writes the medical articles on the diagnosis and who is on the board of the patient support groups for your diagnosis.

Be careful of online quacks and the scary worst case personal stories.  Try to learn as much as you can from respected medical persons and from persons and families who have helpful advice from personal experience.  Find helpful resources through your doctor or the agency who supports families with your diagnosis or disorder. 

Consider a second opinion, especially if an operation is called for.  My friend’s son is living in Australia at this time.  Sometimes second opinions can be offered by review of charts, lab and MRIs.  John Hopkins has neurosurgeons who offer long distance second opinions after the patient or patient’s family gathers the required forms. Of course the John Hopkins neurosurgeons are specialists for adults.  Other medical schools offer the same type of second opinion services.  

If your child needs a surgery for a rare problem ask if the surgeon has performed this surgery before.  Sometimes older surgeons have seen more rare diseases, on the other hand, sometimes the younger surgeons know the new surgical techniques. Find a medical school with specialists, the latests equipment and of course the nurses who love to take care of children with special needs.

The Medical Home Portal has a page entitled When your Child has Been Diagnosed with a Disability or A Special Health Care Need. Read the whole article.  The following are the suggested topics to consider:


  • Take a deep breath and remember your love for your child and family
  • Educate yourself about the diagnosis
  • Beware of the Internet
  • Find resources and support in your area
  • Start lining up services
  • Understand the laws that may apply to your child
  • Take care of yourself
  • Take care of your family
  • Educate your child about the diagnosis
  • Take another deep breath.



Let me know if you think of some other ideas for the time after that first diagnosis.  Of course always hug your loved ones, call on your friends for help and take deep breaths. Remember that each loved one handles problems differently.  Be respectful and tolerant of those differences and if needed get counseling by a professional to help your family through the difficult times.  

Monday, March 24, 2014

Medical Home Portal; My Favorite Website for Special Needs Children

Grace's Note:  The Medical Home Portal is by far the best web site for special need children, their families and health care providers.  I have been trying to get Texas to participate in the Medical Home Portal, but alas they have their own plans.

This is a page that introduces folks to the Medical Home Portal.  Go and see what else they have to offer.  A medical web site treasure.

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A page from: the Medical Home Portal 


Our goal in this section of the Medical Home Portal is to help you learn how to better care for your child with chronic and complex conditions, and become a more effective partner in your child’s care. Effective partnering with physicians and other health care professionals are the foundation of the Medical Home approach to care (see About Medical Home to learn more).
The following “For Parents and Families” areas focus on various points in the journey and aspects of assuring the best outcomes for your child.
Before a Diagnosis
This page provides an introduction to the processes involved in recognizing a problem and then seeking its cause or diagnosis.
After a Diagnosis or Problem is Identified
This section of the Portal has content for families of children with a new diagnosis. We hope to help with information, including: knowing you are not alone, working with healthcare providers and Medical Homes, and Caring for Children with Special Health Care Needs. Filling prescriptions, working with the insurance company, or simply keeping up with your child—dealing with daily life is often overwhelming. Find tools and suggestions for getting organized and Managing and Coordinating Care, advocating for your child, planning for the future, and taking an occasional break from it all. This section also includes information on adoption, foster care, complementary and alternative medicine, and advocacy.
Responding to a Diagnosis
Whether your child has been recently diagnosed, or you are looking for the latest information about your child’s care, this page will help you find reliable resources and information.
Early Services, 0-5 Years
Research shows that early discovery, diagnosis, and treatment of children with developmental delays or disabilities lead to improved outcomes in developmental skills, academic performance, and social skills. This section provides information on the Early Intervention Part C program and services, additional government and private services, and home visiting programs for children 0 – 5 years with special health care needs.
Education and Schools
Schools can provide necessary services and support for children with special health care needs. Learn the terms, laws, and processes so you can work more effectively with schools to provide the best educational experience for your child.
Navigating Transitions With Your Child 
Children, youth, teens, young adults, and their families will find answers to some of their questions about growing up and becoming independent, as well as suggestions for preparing for these changes. A School Transitions section is included to help students and families anticipate the challenges and get the most out of each phase of education.
Financing Your Child's Healthcare 
Caring for a child with special health care needs can be financially overwhelming. This page may provide some information and resources that can help with your child’s health care costs.
Assistive Technology
Children with special needs or disabilities may benefit from a variety of assistive technology. On this page we offer an overview of available types of AT, information to guide selection of AT, and resources to help you find what you need.
Taking Care of Yourself and Your Family
When a child is diagnosed with a disability, chronic condition, or special health care need, it can be difficult to accept and understand. It can profoundly affect the whole family. This section offers information about the reactions, feelings, and needs that are part of this process for family members.
Legal Issues
There are a variety of laws and legal situations that families with CSHCN should be aware of. This section provides some brief direction on guardianship, estate planning, special needs trusts, and divorce as well as laws that protect and extend benefits to children with special healthcare needs.
Diagnoses & Conditions - FAQs
This section is written for parents and other family members of children with the disabilities and diagnoses listed in our Diagnoses & Conditions section. It provides answers to some of the common questions that parents have about these conditions, along with links to other relevant high quality web sites.

Resources

Information & Support

For Professionals

A Request for a Letter of Medical Necessity(PDF Document 33 KB)
A simple, one-page form for parents to fill out that helps the physician write a letter of medical necessity.

For Parents and Patients

Care Notebooks (AAP)
Instructions, ideas, and templates for building your own care notebook; American Academy of Pediatrics Medical Home Implementation.

Authors

Compiler:Information compiled by Medical Home Portal authors and staff
- See more at: http://www.medicalhomeportal.org/living-with-child#sthash.A3zCv9KG.dpuf