Revision TKR Still having difficulty .... from Amberpep

[Jozilla]

Abby - from what I have read here lots of members here care about you. When you feel down remember that! It is what convinced me to go ahead with my tkr. So many positive people who share their stories good and bad. I also wish I was closer to help you out. Just don't give up. We are here to support you and we do care!


RTKR - 9th December, 2013

 

[kneeper]

Tell your son he can either drive you or fund the cab ride.

 

[Pumpkin]

I hope you can make the appointment, if you cxl, you will just go through this all over.
Visiting Angels, you had mentioned them, can drive you in your own car, it is cheaper than a Taxi. They will also go to the appointment with you. We used them for my Mom when she needed to go on a 100 mile day trip, I was laid up, and my brothers could not take off that day.

 

[amberpep]

Thanks so much for your kind replies ..... I really do appreciate it. I found out that going by taxi to the BWI airport costs $100 one way so that's not going to happen. And my friend Pat and I figured out how much it would cost to have Visiting Angels come 3 mornings a week and wow, that gets very pricey too. So, it will work out somehow. I'm just too tired tonight to think about it.
abby

 

[ravenwood]

Oh, Abby, let those kids whine if necessary! Insist on help. They will be better people for it. If you give up on this you are at risk of suffering more. It is too bad they can't read this discussion. Hugs coming your way...Stay strong,
Raven

 

[amberpep]

Hi friends .... Well, after all the hassle of finding a good revision surgeon (I don't even know yet if I need that), I got a call today from the new doctor's office. It was his Receptionist and she was asking me insurance questions, who did the original surgery, where and when. Then she told me that they would "prefer" if I went to my original surgeon first as he was also excellent at revisions IF I need one.
I'm so tired of all this yanked around that I just want it over. So, I see my original surgeon next week. I'm sure he'll x-ray but I don't know if he can send me for an MRI or not since there's metal in there.
And so it goes .............
abby

 

[Jamie]

Abby....you call that doctor's office right back and tell them you are not going back to your original surgeon first. You do not have to do this and certainly not on the suggestion of one of the doctor's administrative staff. It has been 3 years since your surgery. There is absolutely NO reason you would need to see the old doctor first. I'm sure this new surgeon is perfectly capable of evaluating your situation by himself. The whole point of seeing someone different is to get an independent opinion! If you see your old doctor and they forward the results of that exam to the new doctor, you have totally defeated that purpose.

But, this does raise a possible issue. Are these doctors practicing at the same hospital by any chance?

 

[Pumpkin]

Abby,
I am so sorry to hear they are putting you through the ringer so to speak. It is bad enough you have to live with a swollen painful knee, and to be told to see the orginial OS first sounds so frustrating.

This posted after Jamie's post and I agree with what she said.
The challenge I had is all the surgeons I saw knew each other, or of each other even though they were 200+ miles apart.

Yes, you can have an MRI. I had an MRI at 6 weeks on my left foot, no problem.

Some things he may order are, blood tests for infection/inflammation, he may aspirate your knee for infection, he should check for ligament instability, bone scan for inflammation, CT scan, MRI, and of course an x ray.
If he only takes an x ray and says everything looks fine, stand your ground and ask for the above testing.

No matter what, you have the right to have a second opinion, what ever he says.

(((((HUGS)))))

 

[amberpep]

Hi Jamie ..... I normally would agree with you ..... no they don't practice at the same hospital, but what we're all finding down here is that many doctors are no longer taking Medicare patients and some of them are actually dropping the ones they have. Stinky, I know, but it did happen to me with one of my doctors. I'd been with him for 12 years, got the letter the end of January and it was effective February 1. Oh, he was willing to give us referrals, but at that point I was so upset I didn't want anything else from him. This can happen to individual doctors practicing in the same hospital individually. Some do and some don't. It makes it rough on the patients, almost ashamed that you've got Medicare. So, we're all pretty much at the mercy and decision of the individual doctors. I'll see my old one next week, and go from there. Maybe they'll just replace my leg with a 2 x 4!
Hugz,
abby

 

[amberpep]

Hi Pumpkin .... you're very right in all that. I've thought of the inflammation or infection part because it's swollen and hot. I've had, previously before this, the bloodwork, aspiration (a huge amount of fluid), and I've thought about instability and weakness in the whole leg since I have not been able to really exercise for so long. I'm going to go in there with a list, and he WILL answer them to my satisfaction. He really does have an excellent reputation, even though this doesn't show it. So, I don't know ..... I'll follow through with this and see where it gets me ..... if I'm running in circles again ....... well there are 2 other hospitals that my P.T. recommended and the doctor's names .... one of them is much easier to get to. I'll keep you all posted.
abby

 

[Pumpkin]

Glad you have a list of questions.
I would think the OS would want to get to the bottom of your swelling, pain, and inflammation.
In any case you will need second opinions to be sure you have the right diagnosis and treatment plan. A good OS will not mind, if they do you will want someone else.

 

[amberpep]

Hi Pumpkin ..... It's so nice to be able to chat with folks who have been through a TKR with varying results. This knee is just plain quirky. Today it only hurt when I got out of a chair or went down steps, or sat too long. But, the back of my knee it seemed the muscles and ligaments were hurting. Maybe they're feeling the effects of this too. And, of course, with the symptoms seemingly less today, I thought "maybe I don't have to go" ..... maybe it will heal itself. Maybe it's really nothing. My original OS is supposedly an excellent surgeon, and I believe he is, but he is totally lacking in bedside manner. If you ask him a question, he will answer it fully (and I've got plenty this time), but if you don't ask, he won't tell. Thus the note I'm taking with me. I need to lose some weight - I gained about 20-30 lbs. since this all started 3 years ago and I have simply got to get rid of it, but I can't do much exercising except walking, and then not a very long walk.
Well, I'll see what he says next week.
Take care, abby

 

[Pumpkin]

I thought "maybe I don't have to go" ..... maybe it will heal itself. Maybe it's really nothing.

I was thinking this up until the day before my surgery last week.

 

[amberpep]

That's funny ..... sounds like we have something in common. It's sort of the way you have a really bad sinus infection, make an appt. with your doctor, and the day of the appt., you feel better,your nose opens up, and you're sure you don't need to go! Always second guessing myself. Oi Vey!
abby

 

[Jamie]

Well that's really interesting about the doctors in your area. I had no idea that was going on for Medicare patients. What a sad, sad thing!!! I'm glad you're actively working for yourself, though. It's important!!! Please let us know how things go.

 

[skigirl]

It is interesting too---the Medicare payments have not been cut---there have been rumors but they have not cut the payments. So, why are they dropping Medicare patients? It sounds screwy to me.

 

[Jozilla]

Several years ago my endocrinologist dropped Medicare. Soon after she dropped my insurance. Luckily my GP was awesome and could handle me until I found a new doctor. Sorry to hear this is still happening. Good luck!


RTKR - 9th December, 2013

 

[Pumpkin]

When someone drops Medicare you can still see them, you have to submit the claim and Medicare will reimburse you. Just means the MD can charge you the difference in price. When the MD accepts Medicare they have to accept the Medicare payment, and cannot charge you the difference in price. Always ask about cash pay, you can receive up to a 40% discount if you pay the day of service.
If you are unhappy about the low reimbursement rates, write your congressperson, about improving reimbursement. Your congressperson is the one writing the guidlines that limit physician pay, not Medicare.

 

[amberpep]

Yes, a lot of doctors down here have even changed their codes so that the patients can't submit them themselves. That's what the other doctor that dropped Medicare and me did. And, down here, their payments have been cut way back .... that's why so many are dropping Medicare folks. Many doctors here are retiring, quitting practicing altogether, or going in with a hospital to work. Then the M.D. spot they leave open in the practice is filled by a Physicians Assistant. Right now, down here at least, if you're not in with a doctor already, chances are you won't get in with another if you're on Medicare. It leaves a lot of elderly who are new to the area really hanging.
Wonderful, new, healthcare system.
abby

 

[Pumpkin]

Doctors have always been able to opt out of Medicare, since it's inception, this is nothing new. As for reimbursement the only person who can change that is our representatives in congress, they have refused to change the formula since the 1990's.
Again write your congressperson, they are the only ones who can change this.