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PKR 4 months post TKR, 1 year post PKR

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Just make sure that your PT are very gentle . Congratulations on the new knee. Its too bad initially that the pain got out of control. Do keep track of your med intake!. Lets us know how things move along.
 
I just got home from my second appt with my awesome PT. Just did gentle ROM stuff and ended with 15 minutes of ice and ESTIM, which feels wonderful. I got to 110 degrees today with out any pushing, I think that is pretty good for 9 days after surgery. I am still having pain if I don,t keep on top my meds. I am spending the rest of the day iced and elevated.
 
Well..I did it. I fell into the over-doing-it trap. I have been reading and reading and swore I would be good and would be able to avoid that over-doing-it silly stuff. Well Sunday I cleaned up my kitchen and did some laundry. Monday at PT I was all ready swollen, ROM down around 104. But, somehow I was still in denial...I went to my upstairs (15 steps) and looked around...then went up there 3 more times. Not only that, I thought I would give my husband a break and did all the indoor animal chores. Well, my husband saw me doing so well, he went to work today thinking I could do all the indoor animal chores. So, my knee got mad..it was asking politely and I wouldn't listen till it screamed and threw a tantrum. So, after I got all the indoor animals fed, watered,cleaned and insulin in the diabetic cat I retired to my recliner with my elevating pillows and a bunch of ice. After 3 or 4 hours I was not getting much relief and I had larger swelling than in this entire process so I got out the giant ace bandage I came home in and wrapped it all up. It is finally feeling a little better and my husband now knows I am not recovered enough to take on daily chores. I hope I am better soon cause I go in to get my staples out on Thurs. I also hope I have learned my lesson!
 
I had my 20 staples out today. It didn't hurt a bit to have them removed, a little pinch here and there. I also got x-rays today and we talked about my meds. The doctor said everything looked great and he would see me in 4 weeks. I have to say it was instant bendy relief when the staples came out. I am gonna drive for the first time tomorrow, to PT.
 
[Bonesmart.org] 4 months post TKR, 1 year post PKR
Always a great milestone to pass---knee always feel much better--not so tight.

hbacres said:
I fell into the over-doing-it trap. I also hope I have learned my lesson!
Click to expand...

Don't count on not doing it again---we're all guilty, can't seem to help it when we are feeling good and thinking we can take on the world. Of course, Knee always makes us pay.

Take care and keep us posted. We care.
 
Staples out!:tada: Glad it went smoothly. It's a great feeling.
 
Howdy !
Finally found your thread :) Wanted to get in touch because it sounds like we've got a lot in common. I am in Maine, and fortunate that I'm literally a 3 minute drive to the hospital. I can not imagine your long drive to yours. Bravo for all you've gotten through to this point! !
I've yet to start pt...Tuesday is my first. I am hoping that by then my quads will be awake and I can do some leg lifts.
I was freaking out about the staples coming out too. It ended up being fine. I also had 2 that pinched, as they had scabs the nurse said. My incision is covered with steristrips now but I gotta be honest, it makes me a little freaked to see it lol.
I just got home yesterday and hubby has to return to work tomorrow. I am under explicit instructions to not over do it....I will take your words to heart and go slow.
Anyway...you're in my thoughts.
We can do this!!!
:) Caryn

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@glazed151
Hi Caryn!
I am so pleased to see you are home! It sure sounds like you had a rough time! I think you will feel much better on your home turf. Sometimes it gets a little old sitting in my chair, but it is a lot better than the hospital. I am sure your quads will wake up when you least expect it. My husband and I were talking the other day and he asked me if two weeks ago I thought I would be doing this well. I told him well two weeks ago I didn,t think I would live and wondered what a horrible mistake I made. Then, just this past Friday, I drove myself to PT and had a 124 rom. It seems once it starts heading in the right direction, it is dramatic! All the sudden yesterday I was able to peddle my bike the whole way around, it was like magic.
So, don,t worry about those quads, they will show up when they are ready and you will be amazed.
As for the steri strips....I was a little worried. I got on the floor today to fix something and I had to bend a lot to get myself back up....I thought oh no it is gonna split open...I checked..it was fine.
How is your pain level now? Once it was under control for me, it stayed pretty good. Now I am mostly on etodolac (which made a huge difference for me, I had to be off of it for the warfarin) and Tylenol and only using the oxy for break through pain. My doctor was pleased and we know now that when I decide to do the tkr on the other knee that I will need more pain management.
Enjoy being home! Keep me posted, I have been worried about you!
Robin
 
And now begins the endless phone calls to insurance and billing departments to get that all sorted out and correct. Atleast it can all be done while iced and elevated! On a happy note, I am pleased with my knee, it seems to be doing great. I am 19 days out with an ROM of 124 and I am getting around great......can drive short distances and actually went in the grocery store today for much needed cake mix and icing......had a craving so it must be what the knee wants, right? What the knee wants, the knee gets.....especially after today's PT workout!
Hope everyone is having a healing day!
Robin
 
I am having trouble with my insurance payout. Apparently if I was an Inpatient the insurance would cover the entire cost of my knee implant, the device. I was an outpatient and so I have to pay 30% of the cost of the implant, around $3000.00. It seems my hospital arbitrary gives all knee replacements a status of outpatient even for a total. They said this was for insurance purposes before my surgery. Now they tell these are medicare rules that they follow, even though I have Blue Cross. They told me that they can not change my status for insurance payout, when they arbitrarily gave me the status in the first place. I told them I should have been an inpatient since I was released too soon and ended up in an ER within 4 hours, was refused re-admittance at their hospital and went on to be admitted to another hospital. Well the lady on the phone was alarmed to see what I went through and took notes and there is a big meeting this week. I don't know if they will change my status or if the meeting is concerning my poor care at their hands. Anyway... I wondered.. is everyone else being taken in as an outpatient for these surgeries, or is this just something my hospital is pulling. I am really not handling the stress of reliving the situation and telling it over and over to these people and trying to save us $3000.00...... Any advice out there from those who might have experienced this???
Thanks
robin:hissy:
 
Robin, I was an inpatient. I stayed about 29 hours the first time and the second time, I stayed two days. There are some folks here who went home the same day, so I assume they were outpatient.

This discharged you early because if you were outpatient, you have to be discharged within 24 hours. Since you obviously were discharged early to save the hospital money, I think you may have a case. Were you discharged within 24 hours of your surgery? I cannot believe that they sent you out with uncontrolled pain. I am going to tag @Knitter4444 who seems to know a lot about medicare questions. Also @Jamie there used to be someone on the forum--Merry? who knew a lot about insurance--do you remember her name?
 
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Yeah..knitter4444 is me. Merry.. I will answer this in tomorrow. New rules now and most insurance companies follow Medicare rules. Never occurred to me to post them about this because most people stay more than 2 midnights. They probably had you "labeled" as observation. Totally BS. Give me til tomorrow but in the meantime, do you have copies of your paperwork that you signed when admitted? The hospital should have told you before your surgery about your financial obligations. Look at your paperwork and try to tell me if there is anything on it about how you were admitted. Will try to help

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Hi @Knitter4444
I have all my papers in a folder and I know I signed electronically a ton of stuff at my pre-surgery appt, but they did not give any of the copies to me. On my discharge forms, the only place it even lists me as an outpatient is under if I was given a flu vaccination and is says NO, reason why:outpatient. I was actually hospitalized from Jan 8th at 10 AM.. discharged the 9th at 3 or 4 PM and then home 4 hours, in the ER for 7 Hours and then admitted to another hospital at 4 AM on the 10th and stayed almost 24 hours there. My brother, who worked at a large hospital, told me that I had what is called a Sentinel Event and that is why they would not take me back the night of the 9th as they were trying to hide the fact they released me too soon. I am planning to get my records, but I pretty much have to go in person and sign and give my ID to get the copies which since I am not really driving that far yet, it is going to be a week or so till I feel I can drive an hour each way. When I get my records I will ask for copies of everything I signed at Pre-surgery.
I feel so stupid abut this.. I thought i had it all figured out and that when I spent the night I would be an inpatient and it would be covered. Obviously, I was wrong. They could have kept me 72 hours as an outpatient...
Anyway, I guess I can't answer any of your questions until I can get copies of what I signed.......
Thanks
robin
 
Robin..let me know when you have your paperwork. And ask your doctor what his plans were as far as how long he planned for you to stay.




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I remember the doctor's office telling me that they have to have you as an outpatient or insurance would approve the procedure. Come to find out I didn't need pre-approval anyway. But, they planned to enter me as an outpatient... then they said the doctor would write the orders for me to stay overnight. I guess I thought if I stayed overnight I would be an inpatient... I have since been told I can be in the hospital for 72 hours before changing to an inpatient.
I am going to try faxing forms and seeing if I can get my paperwork mailed to me.. Thank you for your help.

robin
 
So it was the doctors orders. Did you express to your OS that you wanted to home ASAP? Is this what he does with all of his patients? Yes..there is now a new rule but he "admitted" you as an outpatient and you didn't stay more than two midnights which sometimes can be extended. Lesson for everyone. Get something in writing that you are being admitted as an inpatient. And for Medicare patients..you must be inpatient for three days (not including discharge day) in order to qualify for Medicare to cover rehab.

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Thanks so much @Knitter4444 you are such an asset to the forum. I cannot believe the OS listed you as an outpatient for this surgery. Probably you need to go to him first and let him know what happened to you. I find that a letter which is factual, not emotional is the best way to address this type of thing so that he knows about it for future surgeries if for nothing else.
 
And don't pay the $3000. Please talk to supervisor in billing office and negotiate price to the Medicare reimbursement. I don't know the price but I bet it is at least 50% or more. Probably more.

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I agree with Merry----when you talk to the hospital, point out how badly you were treated . . . discharged too early . . . not informed of your financial obligations . . . how it would have been paid if inpatient, etc.

She is right if the bill is $3000 then the Medicare disbursement is probably less than $1000.
 
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