The Least Annoying Hospital Ever

On Monday we had Fiona's Hemangioma checked out at Seattle Children's Hospital in the Vascular Anomalies Clinic. While I would never want any child to have a health condition requiring this level of care, if you did happen to have one, this is the place to go. It was such an interesting experience, and so seamless! I was amazed at the paperless convenience of it all.

The appointment was made after multiple phone calls by me to our pediatrician's office for them to get the damn referral made already. Two weeks before our appointment we received some information by mail. Confirmation of the date, time and place, where to park and where to go. So useful! They also included detour routes because of viaduct repair closures.

Kevin and I left town about 6:30am for a 9am appointment. We HATE being late, and would rather wander the hospital for an hour than stress over traffic and directions. I would take Fiona to her appointment and Kevin would entertain Patrick somehow, either at the hospital or at University Village, conveniently close by. We made it in plenty of time, and the correct parking lot was super easy to find.

As I walked in the entrance I was immediately greeted by a Greeter. "Do you have an appointment today?" She then directed me to the end of the line for the initial check in desk. They confirmed the time and location of my appointment. Kevin and I were given ID badges with our pictures. Then we were shown the registration desk for the Vascular Anomalies Clinic. We took our number and waited a brief time for our turn. (I'm thinking Monday mornings are a great time for health care appointments). She took our insurance information and got our paperless paperwork in order. The paperless part was so cool. No useless piles of info, even my signature on the consent form was computerized! We got a pager like the ones you get when waiting for a table at Olive Garden. It would buzz when ready and tell us what door (there were three options) to go to when they were ready for us.

Five minutes later, the nurse was taking Fiona's measurements and asking the standard questions about medications, allergies, and the like. It didn't take long for the doctor, Dr. Robert Sidbury (dermatology) to come in. This is where I thought it got very interesting. Another woman came with him. She sat down at a computer. As we started talking and the examination began, she typed. She was dictating his notes as we spoke! The convenience of this became very clear at the end of the appointment.

His assessment was in line with my research: a 6x7cm mixed tissue hemangioma that was not interfering with vision, breathing, or growth. There was no apparent growth into her internal organs. Then we discussed options. We both agreed that further exams (like an MRI) were unnecessary because the risks of sedation far outweighed the benefits at this time because she didn't have any other symptoms. Surgery for the same reason. Dr. Sidbury explained that deeper hemangiomas would eventually fade, but there was a possibility that her skin could look distorted as it shrunk, rather like the stretchy skin we get on our bellies after having babies.

So here was the struggle. We had the option to do nothing. Her birthmark fell into a real gray area, the doctor said. Any problems in the future would be cosmetic, if there was anything left at all. And I felt that I wanted to do everything we safely could to help her skin to look as normal as possible as she grew up. I didn't want her to feel angry because we could have tried an instead did nothing. Dr. Sidbury said he would probably do the same thing if it was his kid.

So what to do? Dr. Sidbury talked about the newest treatment: propranolol. It's a beta-blocker for those in the know, normally used for cardiac patients or high blood pressure. It's only been used for the past two years after a pediatric cardiac patient in France used the medication and subsequently had her birthmark shrink. The goal is to stop growth and start shrinking it. We will have a consultation with a cardiologist before starting treatment. Fiona will also be monitored for about six hours with her first dose to make sure she doesn't have issues with her heart rate, blood pressure, or blood sugar. While it all sounds a bit freaky, I like it better than steroids, the other treatment choice.

This whole conversation was relaxed. I never felt rushed and all my questions were addressed. We spoke for about 20 minutes. I got his card with an email address on it for any further questions or concerns. And when my appointment was over, I was give two sheets of paper from the medical assistant who was typing throughout our visit. She had already sent via computer Fiona's records to the cardiologist. When I call to make her appointment, they will already have the necessary information. On the first sheet was a summary of our appointment, instructions for follow up, and contact information. All very clear and easy to understand language. I was also given some basic information on hemangiomas. So terribly efficient.

Overall it was a good experience. If there were any hang ups, I never saw them. This was a well oiled machine with good structure to support the great care provided by doctors, nurses, and the admin team. Hopefully I'll feel as good about them when I start receiving the bills.