Requesting Feedback on Dr Nath and mod quad

[Sema]

Hi,
My son, Evan, has incurred a bpi during delivery. He's now 11 months and so far the Dr's have taken a wait and see approach along with physical therapy. He still can't raise his arm over shoulder level or bring his hand to his mouth in a natural manner. I feel now we have to be more aggresive about his treatment.

I spoke with Dr Nath and Evan is scheduled for evaluation on 3/1 and mod quad surgery on 3/2. I am interested in getting some feedback from parents who had this surgery done. What's the evaluation procees like? Do they do an EMG or Nerve Conduction Velocity test? Have you found these tests to be useful in determining in your course of action? Evan only had an MRI so far.

Since we live in the East Bay area in CA, I'm also taking Evan to see DR. Hentz at Lucille Packard Children's Hospital at Stanford for an opinion on surgery. If you have any feedback on him, I'd be interested in hearing it as well.

[Francine_Litz]

Hi Sema - my daughter Maia has had 4 surgeries with Dr. Nath. Mod Quad gave Maia the world - it's the one surgery that we call Maia's miracle surgery.
It gave her the ability to reach overhead and behind the head and much more. (Of course you have to have the innervation to be able to do that.) We don't regret it for a minute.

The surgery is very short so there's much less anesthesia risk. They are put in a removable splint so there's much ease in caring for your child and it breathes. TCH is a great pediatric facility. And well Dr. Nath - he's on our angel list.

If you have specific questions I'd be happy to talk with you about them.

francine@injurednewborn.com

http://www.injurednewborn.com/maia/homepage.html
I have a lot written up about the mod quad...and pictures of it.

-francine

[admin]

Hi -
I'm so very sorry to hear about your little boy, Evan. I know what you are going through.
I'll play cheerleader here for Dr. Nath. The man is a miracle worker. Our son had the mod quad when he was 10 months old. He had about what your son had, as far as function, before the surgery. Afterward, he finally got external rotation and abduction. Those guys at TCH are so good; they could tell just by Danny's lack of function what exactly needed to be done, and they were right. It is an incredibly miraculous surgery, and I cannot recommend Dr. Nath or the mod quad highly enough. I am sure they will conduct whatever tests are necessary to ensure the surgery is the right choice.
One thing that should comfort you is how many hundreds (thousands?) of these surgeries they've done successfully - they know what they are doing. I would trust Dr. Nath all the way. He is the only doctor I've ever said that about.
Anyway, good luck to you and your little boy. God bless, and keep us posted on what you decide.
Take care,
Janet

[Clint]

Hannah had both the primary and secondary surgeries by Dr. Nath. His bedside manner isn’t the best, but he is a tremendously talented surgeon. He has done wonders for Hannah and we trust him with her life.

I don’t recall them ever doing an EMG or nerve conduction tests in evaluating for the secondary surgery. However, in our case they did an intra-operative EMG to measure the results of the primary surgery. In general, the secondary surgery is not designed to repair nerve function. The muscle releases and transfers are intended to increase the range of motion of the shoulder. I say generally because one part of the Mod Quad is to decompress the axillary nerve in the arm pit. But I have never heard of them doing any nerve reconstruction in this surgery. But anything is possible.

I agree with Francine that TCH has an incredible facility and from the janitors to the nurses they are extremely caring.

Good Luck.

[claudia]

We have done 3 surgeries at TCH and would go nowhere else.

Drs. Laurent and Shenaq did primary and Dr. Nath did mq and biceps lengthening.

We would be nowhere without primary, as Juliana's injury was severe, however, mod quad gave us the stuff that was more noticable...shoulder movement and better sensation. The axillary nerve decompression helped alot.

As for Dr. Nath, he and my husband and I have a wonderful relationship. I find him to be direct without being rude or callous. He always makes me laugh when Juliana asks a question like "are you done yet?" and he turns to me and says "are we?"
By the way, I have learned to listen to my kids reactions to doctors. Juliana is very relaxed when we go to TCH. It is as if she knows they are caring.

Second opinions are important, so get one if you can.

My experiences at TCH are excellent.

claudia

[admin]

I live in SF, my daughter has seen Dr. Hentz and had the mod quad at 2 and 3 months with Dr. Nath. I'd be happy to talk with you on the phone about the experiences, or email me directly.
Lisa

[admin]

That is, at age 2 years and 3 months (not at 2 months and 3 months) ha ha ha

[m&mmom]

If we had it to do over again we would have skipped over mod quad at TCH and had Dr. Kozin's transfer/release instead. It would have saved on a surgery and his approach makes more sense to us. Matthew's pec muscles were cut during mod quad to help relieve internal rotation and it didn't help at all.

If you'd like more specifics please feel free to email me at cpfranklin@psualum.com

Cindy

[CathyY]

My son Matthew is 4 now and had Mod Quad with Dr. Nath when he was 18 months. I can't speak highly enough about the Mod Quad and Dr. Nath specifically. Since the Mod Quad, Matthew can reach overhead and behind his head, as well as out to the side. All were motions he could not do at all before surgery. We also view this surgery as the "miracle" surgery due to the huge gains he got from it. We are so grateful to have Dr. Nath in our lives; my personal opinion is that he is a remarkable man and a gifted surgeon.

Good luck with your decision...it's a tough one but for us it turned out better than we could have hoped!
Cathy Y.

[Sally]

My son had the Mod Quad at 15 months. His surgery was done by Dr. Shenaq. He will probably be having an additional surgery in the near future - performed by Dr. Nath.

The MQ made a huge difference for Michael. He couldn't lift his arm above shoulder height (he could barely make it near shoulder height) and he had no external rotation at all. Now he can do both.

We had our surgery at TIRR, so I can't say much about TCH (although, at clinic, everyone was soo nice).

Looking back, I have NO regrets about this surgery at all. It made a world of difference for Michael. I know how scary it is to make that final "go ahead" decision - but I am very glad that we made the decision to go ahead with this one.

Also, if it makes a difference, I have heard that Dr. Nath won't do surgery if he doesn't feel that it is warranted (we haven't been in that situation yet, so I am going on what other people have posted here). I know that that sounds like it should be a no-brainer, but I found it comforting that even if everything is scheduled and pre-certified, blah, blah, blah, he'll simply not do it if he doesn't feel it is in the best interest for your child.

As far as the doctor himself goes, I have found him easy to talk to (we've seen him at 3 or 4 gatherings/picnics now).

Good luck with all of your appointments. I hope that you'll post about your second opinion visit and that it makes your decision easier.

Sally and Michael (ROBPI - will be 3 in April!)