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Choosing an Inpatient Rehab Center!

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jduda01

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Hello everyone. I'm getting a BTKR in August, and am planning to check into an inpatient rehab center after surgery. Any advice on choosing a center would be greatly appreciated. If people could give advice about what I should look for in a center, and maybe point me toward some resources to help me with my search, that would be wonderful. Wishing everyone the best with their recoveries!
 
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jduda01

jduda01

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I'm right outside the Boston area, but would be willing to travel (not too far) if I hear good things about rehab centers that are a ways away. How was your inpatient experience?
 

Lmarshall

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Maybe there is a bonesmart member from that area that could recommend someplace.
 
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Besides recommending a specific place, if anyone can tell me just about their experience, that'd be great. I'm really nervous and I don't want to make any mistakes :/
 

Kavan

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I was in an impatient rehab for 13 days after BTKR. My first advice is talk with your doctor or his RN or PA and ask very frankly which rehab they’d pick. My OS’ PA recommended three but when I said which one would you pick he unequivocally suggested one. When I went to the hospital for me pre-visit they suggested two other places but when I named where I was going they were handled getting me a bed and making the appropriate arrangements with my insurance company.

The big thing I think is you need to have an idea of what kind of experience you want in rehab. The rehab I went to was like boot camp-you had PT twice a day every day but Saturday and Sunday. Now for me that worked because I needed to be out of the bed doing stuff, but I can see how for some people that would be a nightmare. So you want to ask about their daily routine and expectations. Also my rehab had a lot of one on one therapy and that is so necessary especially early on.

You also want to ask about RN ratio to patients etc. I had a medical issue arise and had two RN’s not been there it could have gone badly. You want nurses and good medical care even for little things like ice packs when you wake up at three in the morning in pain.
 

Lmarshall

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I went to an acute care rehab center for 10 days after bilateral total knee replacement. Acute care consisted of 2 hours of p/t and 1 hour of o/t every day. I was told with bilateral you should go to an acute care, while with uni lateral, you could go to a sub acute care center (ie. Skilled nursing facility). There you have less therapy daily.
 
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welcome cat 2.jpg
jduda01, so pleased that you have joined us here on the forum. Do you have a date for your August surgery? If so, please let me know so you can be added to the August surgery list.
I have some reading for you! The first set is essential reading, the second and third are useful and the fourth is just good information, but you will need it all.

Group A
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Group B
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Constipation and stool softeners
Sleep deprivation is pretty much inevitable - but what causes it?

Group C
Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

Group D
MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

Please don't be overwhelmed by the list. The articles are not lengthy and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish; giving you a place to vent, whine, complain if you need to; sharing experiences with one another; and having fun and some laughs along the way.

Take care and keep us posted. We care. hugs 10.jpg
 

gazelle7777

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Where would someone chose to go to rehab and not just home? I could see if you live alone. Is that mostly who goes to rehab? Also,I would suppose in cases where there may be other medical issues going on during the healing process. I had BTKR on June 4 and spent three days in hospital and could not wait to just go home!, My husband stayed home the first week, then I was home alone. I did fine, got about with my walker etc. Now three weeks into it I am pretty much walking unassisted and I even vacuumed the house yesterday! I have a way to go, but I do not think rehab would have made the process go any better.
 

Lmarshall

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I loved being in rehab. I was by no means ready to go home. Honestly, I still miss it and wish I could put myself on a routine like they did. I am now looking into outpatient rehab and hope it helps me.
 

Kavan

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I am grateful I went to inpatient rehab. I had a post surgery complication-excessive blood loss that the hospital totally missed. Had I not been in rehab and had I not had top notch RN's caring for me I think things could have gone badly. And bear in mind I'm 37 and the type of patient who was expected to have no complications. But I had one. My doctor pushed for rehab because as he said if problems arose they'd be likely to catch it and they did.

Most of the patients at my rehab had terrific family support as in spouses and or kids who visited daily. Most doctors seem to prefer it for bilaterals or individuals who have medical issues.

And as much as I wanted to go home-in hindsight it was fantastic to be in that setting where you hit the call button and got ice or pain pills or assistance 24/7. I also think it was good to be around others who were going through the same thing. We could give and receive support. And I do think the PT I received was so top notch because they did knee and hip replacements all the time and had a lot of experience.
 
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rehab-beware sign.jpg
jduda01, just kidding with the sign, but you do want to find a facility that works with joint replacement patients frequently and in reasonable numbers. Do get a look at the kind of rehab exercise program they have. The exercises should be easy and gentle. There should be NO "no pain, no gain" philosophy of rehab. You will be healing and all exercise should just be to help you maintain and improve mobility slowly and without pain.


I had both knees replaced two days apart and went to a rehab facility on my OS's recommendation. he knew I had a semi-invalid hubby at home. He said without at least a week of inpatient rehab, I wouldn't be any good to anyone. I think I could have gone home, but I have never regretted that I went to rehab. It gave me 6 days to think only about myself and to take care of only myself. By the time I went home, I was ready to continue recovery, but was also able to do what I had to do for my hubby too.

I had no complications of any sort---my left leg was super from the beginning; my right leg was very swollen for a couple of weeks, and it was about a week and a half before I could raise it without assistance. You just never know until after surgery how well you'll be able to manage for the first week or two. So unless you have someone who can wait on you hand and foot and with great patience---rehab is the best!
 

BeckyR

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jduda01, If you are in the Boston area, there is nothing that can compare with the Spaulding (Spalding?) Rehab, but I don't know whether they take post-knee replacement people. Some places that are also hospitals (like Spaulding) only take trauma cases. Spaulding is the facility that took care of all the people who were injured in the Boston Marathon bombing recently. They are just incredible, and the facility is brand new and state-of-the-art. I'd look into them before anyone else. Stay strong!
 

BeckyR

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jduda01, I just checked, and Spaulding Rehab -- www.spauldingrehab.org -- does accept post-surgery patients. To be accepted into their main facility, in Charlestown, you need to be able to participate in three hours of rehab a day. (That covers all kinds of rehab -- not just PT.) They also have their own skilled nursing and outpatient facilities. They are affiliated with Mass. General Hospital and are an official teaching facility for Harvard Medical School. If I were having a BTKR, and still lived in Boston (where I lived for 27 years), that's where I'd want to go. Good luck in finding the right place, and keep us posted! I'm "visiting" from the hip forum, because I may need knee surgery later on.
 

BeckyR

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jduda01, Sorry to pepper you with info, but I dug deeper into the Spaulding site. They also have a facility on the North Shore (Salem) if that is closer to you. They specifically mention rehab from total joint replacement as one of the reasons people go there. Hope this helps!
 

referee54

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here would someone chose to go to rehab and not just home? I could see if you live alone. Is that mostly who goes to rehab?
After a few days of in the recovery area of the hospital, I was moved to the rehab floor. IT was great---my wife would come visit me after work, and I would get two sessions of OT and PT a day---after my BTKR, I was not quite ready to return immediately to home. It was a big help to me.
 

WyrDachs

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After both of my TKR's, I was transferred to acute care inpatient rehab. Honestly, i was glad to go. We had 2 hours of PT & an hour of OT daily. Saturdays where only 1 hr each, with Sunday rest. I'd call my husband and tell him what foid to bring me for dinner.
I
 

skigirl

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I suppose I could see someone with bilaterals going to rehab, but for a single tkr, I don't understand it at all. when I was post surgery and in my own comfortable bedroom, I did not want or need two hours of pt every day!!! I was busy lying down with my knee elevated on three pillows to decrease the swelling in my knee. I went to outpatient rehab at 3 weeks--when I could drive myself. I would never want pt and Ot for hours of the day when I was first post op---and I wanted to be in my own comfortable house. To each his/her own.
 

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Well skigirl,

Remember, I had inpatient rehab 3 different times (1 for left knee, 2 for right knee) and I must say that I think it helped me tremendously. Dr. Maale, the revision specialist, insists on inpatient rehab before he agrees to surgery. He has two rehab centers he recommends, and from what I have learned since,I picked the best one for knee replacements! Inpatient rehab requires 2 hours of PT and 1 hour of OT but in my mind it was worth it! I was with others who were facing similar challenges, and it lifted my spirit. Rehab gave me the momentum to move to outpatient therapy.

So, mark me down as one of those one knee operations who benefitted greatly from rehab! :happydance:
 

skigirl

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Yes, Sonja, but you were dealing with a problem. I totally understand your need for rehab with your revison. But, for me, with an uncomplicated knee---home was a welcoming and comfortable place. I had my things there too!!
 
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