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the cost of an EKG is around eighteen hundred dollars.

I do not know of a parent who wouldn't pay that amount of money in order to make sure their child was safe.

"And the states often face conflicting priorities when determining their budgets. For instance, a state may face a choice between expanding newborn screening and ensuring that all expectant mothers get sufficient prenatal care. Of coarse, this is little comfort to parents whose children have a disorder that could have been found through a screening testbut wasn't." (Bartoshesky 3)

There are at least two solutions to this overwhelming problem. Tests to ensure an infant does not have a heart defect such as ASD and VSD should be required, or at least explained and offered to the parents at their discretion. Most insurances cover anywhere from 50%-100% of the cost and they only

take about 15-20 minutes, so doing these scans ~ij~Dld?mI['i5"~?~~ptqli1~m~ ..

Lauren Haas

Evaluation/Proposal Paper

March so" 2011

English 1102

her heart. This condition, called Atrial Septal Defect (ASD), required a trip to Georgia to the best ~

\\tttV

-. ~ .;:> ... ~cfv' pediatric hospital in America and a pain-staking open-heart surgery for this little second grader. He~~" '. W ~ o:.-~ ~ ~

, '\ ." v v'(l~

'V ~V~ \~ t-t i' v .. ;" chest was cut open and her sternum broken. She was very strong about it ali:. the tubes that were ~4c;:_~ ;5!?

coming from different parts of her bod , the bad hospital food, the fact that moving just the slightest bi~~5 \.Ie (t -\

~_ b r (0 l\ <.\, cJcc;..l.

might completely rip out the drainage tube placed through a hole in her chest and around. ··r heart. It ~'i<2.('J~\i\~'\..cl

~ D\~~VQV.P

was the hardest thing to see her so helpless and not the lively little girl we had come to know ~,~d I~ve '. Lth r ~u.~~: . \ .J 0 i1'\ e 0-} w \.-'-'l c..V\

Although she made it out of the operation fine and everything was going great, she will always ~." .......

remember this time of her life as a traumatic one and she will always have a five-inch-Iong scar in the

middle of her chest.

tJ) Atrial Septal Defect and Ventricular Septal Defect are "congenital heart defects in which the wall

that separates the upper heart chambers (atria) or holes in the wall that separates the right and left

ventricles of the heart do not close completely." Both of these conditions are present from birth and can

be detected at or before birth. If not detected at birth, children, like Sidney, who are lucky enough for

their ASD/VSD to be detected, have to endure the traumatic experience of an open-heart surgery. If not

detected during childhood, this condition can kill a mother giving birth or a high school soccer player on .' .1 the game field. "Early diagnosis and proper treatment can make the difference between lifelong 1 'I ~y{::> '.

impairment and healthy development." (Bartoshesky 1) __.,

'\ Q'l\ -e.. i~ i~ P a. r-e r fl""C7d. .-10 f c. t+- 0 LLe «r» u{-ctA'1kt (';'1 ~:5

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So if this condition can be detected and corrected at birth, why is it the cause of so many

&

unexpected deaths? At birth, newborns are given a standard screen test that involves taking blood and

-'~ (,k:>r (~e. o-vd WGYcGV1_ /-c,l/11J checking for many diseases and disorders. These in~Ongenital Hypothyroidism,

Galactosemia, Sickle Cell disease, Biotinidase Defic"ency, Congenital Adrenal Disease, Tyrosinemia,

/

Maple Syrup Urine Disease, Cystic Fibrosis,@Deficiency, Toxoplasmosis, Muscular Dystrophy, HIV

and nueroblastoma. Out of these, 1 in 80,000 live-birth newborns have Galactosemia, and 1 in 120,000

have Biotinidase Deficiency. Both of these occur very rarely and when they do, symptoms are easily

treatable and are detected within the first few months whereas ASD/VSD symptoms will never be

noticed unless checked or until that person dies. In this case, it's too late. 8 in 1,000 newborns are born

with Atrial Septal Defect and 43 in 1,000 newborns are born with Ventricular Septal Defect. These

numbers are significantly higher than those of Galactosemia and Biotinidase Deficiency. My question is,

why not check for ASD and VSD at birth when the rates are as high as they are?

W States and hospitals decide which tests to conduct by: weighing costs against benefits, the risk of a false positive result, the availability of treatments known to help the condition, and financial costs.

Weighing costs against benefits speaks for itself, but what could be more beneficial than saving

iL-<Vl-,i\

someone's life from a condition they would have never j5.D.e_w_they had, no matter the cost? There is

only one treatment for ASD/VSD which is an open-heart surgery which the insurance mostly covers. The

only aspect left to think about is the EKG scans used to detect ASD/VSD and their costs. In most states,

the cost of an EKG is around eighteen hundred dollars. I do not know of a parent who wouldn't pay that

amount of money in order to make sure their child was safe.

"And the states often face conflicting priorities when determining their budgets. For

instance, a state may face a choice between expanding newborn screening and ensuring

that all expectant mothers get sufficient prenatal care. Of co~\se, this is little comfort to

'I

parents whose children have a disorder that could have been found through a screening

testbut wasn't." (Bartoshesky 3)

©There are at least two solutions to this overwhelming problem. Tests to ensure an infant d~, not have a heart defect such as ASD and VSD should be required, or at least explained and offe~ to the

parents at their discretion. Most insurances cover anywhere from 50%-100% of the cost and they only

take about 15-20 minutes, so doing these scans should not be a problem.

-] ,t~"'1t, J~ Q elro../a- <f Irv'(!"" 'f' ~pe.r IS IJO~

bv.t tr:: Q_ ccQ?i} q_ d cl s 0 J1f1 e (Yj/O'/f ~ <rll~ I~ s I {-(JYVI ",he

flU' SGA cJ_ S t d e_ oJ J+ 61-0 c:_ q -r /Al, ~ c<JF eel- dO7_.( r SJ' 5f-e-/

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_!0V .e I c;._ ·nA.l t~ '56 f CA r ' r. _

._ toVL-~ C CL-il )"f 'S 'h-e cia ~..Q_ TO ~h£s C/[:5~c<2 e _

Yo~ c: cu~ td~3 13 'l () c l '-Lefe V\J Vu:Lk lU(,lj;te_ c. aUld

l\_o>-'-tl2. \oJ:l__e_ V\ tllLQ. t} «!A.'l, s ti.o: d hee.i1 d_801 e a.f; b,\rI-0 ~

Lauren Haas

Evaluation/Proposal Paper

March so" 2011

English 1102

M\~

To whom it may concern:

On May 3rd, 2010, my family and I found out that my eight-year-old sister, Sidney, had a hole in

her heart. This condition, called Atrial Septal Defect (ASD), required a trip to Georgia to the best \J.~~\'{\~---pediatric hospital in America and a pain-staking open-heart surgery for this little second grader. Her

~\)

chest was cut open and her sternum broken. She was very strong about it all: the tubes that were

coming from different parts of her body, the bad hospital food, the fact that moving just the slightest bit

might completely rip out the drainage tube placed through a hole in her chest and around her heart. It

was the hardest thing to see her so helpless and not the lively little girl we had come to know and love.

Although she made it out of the operation fine and everything was going great, she will always

remember this time of her life as a traumatic one and she will always have a five-inch-Iong scar in the

middle of her chest.

Atrial Septal Defect and Ventricular Septal Defect are "congenital heart defects in which the wall

that separates the upper heart chambers (atria) or holes in the wall that separates the right and left

ventricles of the heart do not close completely." Both of these conditions are present from birth and can

be detected at or before birth. If not detected at birth, children, like Sidney, who are lucky enough for

their ASD/VSD to be detected, have to endure the traumatic experience of an open-heart surgery. If not

detected during childhood, this condition can kill a mother giving birth or a high school soccer player on

the game field. "Early diagnosis and proper treatment can make the difference between lifelong

impairment and healthy development." (Bartoshesky 1)

Lauren Haas

Evaluation/Proposal Paper

March so" 2011

English 1102

~,&--- Ti't-I-€',

On May 3,d, 2010, my family and I found out that myeight-year-old sister, Sidney, had a hole in

her heart. This condition, called Atrial Septal Defect (ASD), required a trip to Georgia to the best

pediatric hospital in America and a pain-staking open-heart surgery for this little second grader. Her

chest was cut open and her sternum broken. She was very strong about it all: the tubes that were

nIle coming from different parts of her body, the bad hospital food, the fact that moving just the slightest bit

tl')lyo O.

might completely rip out the drainage tube placed through a hole in her chestand around her heart. It

was the hardest thing to see her so helpless and not the livelv little girl we had come to know and love.

Although she made itout of the operation fine and everything was going great, she will always

remember this time of her life as a traumatic one and she will always h~ve a five-inch-Iong scar in t,he

middle of her chest.

Atrial Septal Defect and Ventricular Septal Defect are "congenital heart defects in which the wall

, . _", '.. ~

that separates the upper heart chambers (atria) or holes in the wall that separates the right and left

, --::, ,. " ,- -"._

/7 ventricles of the h,eart donot close completely." Both of these conditions are present from birth and can

be detected at or before birth. If not detected at birth, children, like Sidney, who are lucky enough for

their ASD/VSD to be detected, ha"e to endure the traumatic experien~e of an open-heart surgery. If not detected during childhood, this condition can kill a mother giving birth or a high school soccer player on

the game field. "Early diagnosis and proper treatment can make the difference between lifelong

. . . i I _ -., . . _-. _" •

impairment and healthy development." (Bartoshesky 1)

So if this condition can be detected and corrected at birth, why is it the cause of so many

unexpected deaths? At birth, newborns are given a standard screen test that involves taking blood and

checking for many diseases and disorders. These include: PKU, Congenital Hypothyroidism,

Galactosemia, Sickle Cell disease, Biotinidase Deficiency, Congenital Adrenal Disease, Tyrosinemia,

Maple Syrup Urine Disease, Cystic Fibrosis, MCAD Deficiency, Toxoplasmosis, Muscular Dystrophy, HIV

and nueroblastoma. Out of these, 1 in 80,000 live-birth newborns have Galactosemia, and 1 in 120,000

have Biotinidase Deficiency. Both of these occur very rarely and when they do, symptoms are easily

,

treatable and are detected within the first few months whereas ASD/VSD symptoms will never be

noticed unless checked or until that person dies. In this case, it's too late. 8 in 1,000 newborns are born

with Atrial Septal Defect and 43 in 1,000 newborns are born with Ventricular Septal Defect. These

numbers are significantly higher than those of Galactosemia and Biotinidase Deficiency. M'i question is,

. -

why not check for ASD and VSD at birth when the rates are as high as they are? ..,.-vteSfS ~

States and hospitals decide which tests to conduct by: weighing costs against benefits, the risk

of a false positive result, the availability of treatments known to help the condition, and financial costs.

Weighing costs against benefits speaks for itself, but whatcould be more beneficial than saving

someone's life from a condition they would have never knew they had, no matter the cost? There is

. '

only one treatment for ASD/VSD which is an open-heart surgery which the insurance mostly covers. The

only aspect left to think about is the EKG scans used to detect ASD/VSD and their costs, In most states,

the cost of an EKG is around eighteen hundred dollars. I do not know of a parent who wouldn't pay that

amount of money in order to make sure their child was safe.

"And the states often face conflicting priorities when determining their budgets. For

,

instance, a state may face a choice between expanding newborn screening and ensuring

that all expectant mothers get suffident prenatal care. Of coarse, this is little comfort to

parents whose children have a disorder that could have been found through a screening testbut wasn't." (Bartoshesky 3)

There are at least two solutions to this overwhelming problem. Tests to ensure an infant does

_ not have a heart defect such as ASD and VSD should be required, or at least explained and offered to the parents at their discretion. Most insurances cover anywhere from 50%-100% of the cost and they only take about 15-20 minutes, so doing these scans should not be a problem.