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THR Hipster64's Recovery Thread

Barbaraj

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Fingers crossed, @Hipster64, that the short-term disability review will produce good results--we're all rooting for you! And, of course, it makes good sense to ease up on any exercise if you feel it's not helping and might even be contributing to discomfort. There are a gazillion of other exercises you can (or can not!) do, so lots of choices here--and, naturally, walking is always the best medicine for us as we heal. I say this knowing that it is my least favorite form of exercise but knowing that others don't feel that way at all. Hope your week is going well. Cheers!
 
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Hipster64

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Well, back to the OS today. I was walking outside this afternoon doing my laps, when I hit a patch of black ice....and fell. Of course, my left leg (the worse one) took the brunt of everything. My left hand is scraped and I have a nice contusion brewing on the left knee. My husband insisted I call the OS to let him know and to see if I can be checked out, so I did and was seen by the PA who has been very sympathetic to my situation.

Speaking of, CIGNA is up to their tricks again with requesting more documentation and more hoops for me to jump through for the final 3.5 weeks of my time which they are refusing to pay until received. That was another reason why we thought it prudent to go to the OS-to document this latest incident. Also, in case something develops over the weekend, I didn't want it to bite me in the you-know-where down the line. Well, it is Friday the 13th today after all! Hope everyone has a luckier weekend than me!
 
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leejaa

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I am sorry you had a fall. Sounds like no damage so that is great. Insurance companies are so much fun when we need them to pay for things. I hope you have a good week end and no increased pain anywhere.
 

Elf1

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Oh my, that fall had to scare the bejeebers out of you. Dang black ice! Sounds like you checked out ok for the most part, hopefully not too sure tonight or tomorrow. Hoping you get the Cigna hoops figured out and get your pay.
:fingersx: :xmas-wave-smiley-emoticon:
 

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Hello @Hipster64
I'm so sorry to hear about your fall. That must have been really frightening.
Thankfully your surgeons PA was able to see you right away. I hope you're not in more pain tomorrow and you're able to take it easy for the rest of the weekend. Wishing you comfort as you recover from the mishap. :console2:
 

Fit4Family

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So glad you didn’t do any damage to your new hip with that frightening fall @Hipster64 What a bummer. Ice works great for bruising too. Watch yourself. We had ice here yesterday and it reminded me of the new winter challenges that I didn’t have on my radar. Hope you are on the mend very soon. Take care.
 

Barbaraj

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Oh, my goodness,@Hipster64! A fall sounds very scary, but so relieved to read that you don't seem to have suffered any lasting ill effects. Seems like this should be even MORE evidence for CIGNA that your balance and gait aren't healed yet and additional insurance payments are critical for you so you can take the time you need to heal and strengthen up those muscles. Sheesh, those folks must think you're applying for lifelong payments instead of just a reasonable amount of time to heal after surgery! I hope you are feeling okay today, despite bruises and some probable soreness. You take care of yourself--no more falling allowed!
 
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Hipster64

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Thanks everyone for your kind words! Yes, I was petrified after falling-so afraid that I screwed up my replacement-and had to hold on to the rear bumper of my neighbor's parked car in his driveway to hoist myself up. My knee is slightly bruised as well as my pride, but otherwise and thankfully I am okay. Thankfully the weather has warmed up here-59 degrees yesterday in a New England December, can you believe it?-and I have continued to walk and do my bed exercises with no lasting repercussions.

Other thing I noticed is that I forgot to take my daily morning 1/2 a 50 mg Tramadol and 650 mg of Tylenol yesterday-and I noticed no real difference in my pain level. So I am trying to get off them completely, except for my days in PT. I still feel I should take something before I exercise. I am very happy about this because it means I don't need the pills like I did before, and to me, that's a good thing.

3 more weeks and I will be back at work. It's hard to believe I'm already at this point.

Enjoy the rest of your weekend!
 
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Hipster64

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@Eman85: That's a good point. If I'm feeling good off the pain pills, then I might as well go 100% off and see what happens. Why take something if I don't have to?
 
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Hipster64

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@Eman85: Thank you for clarifying; sorry for misunderstanding your comment. The PT has been helping me-my legs do seem to be tighter and more muscular. Honestly, I have the back pain all the time, not just after PT, and most of the time I feel better after leaving PT. I've been off all pain meds for three days now and see no difference from when I was on them. I am going to not take the pain pills tomorrow morning and will see what happens.
 

Layla

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Hi @Hipster64
Wow, 59F on Sunday must have been wonderful! We won't experience that in my neck of the woods for many months to come. Hope you were able to get out and breathe in some of that fresh air.

Best of luck with weaning off the meds. I think it's a good idea for you test the waters by abstaining from OTC meds before PT and also afterward if you're not in pain. Physical Therapy shouldn't hurt and if PT causes you any pain, you should step back from whatever you're doing that's causing you discomfort. Recovery from the major surgery of THR is not a "no pain, no gain" type of situation.

I hope tomorrow's therapy goes smoothly and you feel satisfied with your progress after your session. You've been doing well. Thankfully the mishap you experienced wasn't more serious.
Have a great week!
 

Barbaraj

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Glad to read that no permanent damage from your fall, but does hammer home the point that being careful out there is important for everyone, but especially recovering hipsters! I agree that PT shouldn't hurt. Sure, I often feel a bit stiff after my weekly Pilates class as I've stretched out my muscles pretty thoroughly, but it's a "good" ache, and quickly fades and I feel so much more limber. Good job on weaning yourself off pain medication. It's critical for awhile but the goal is always to get off it completely, gradually and as tolerated. Good luck at PT, with no pain pills beforehand. I hope you'll come out of your session feeling perhaps a bit tired but not in pain. If you feel it's helping you by stretching out and strengthening your muscles, then it seems like it's been overall a position experience for you. With the return to work in three weeks (wow, creeping right up there, @Hipster64, isn't it?!!) you will want to be in as good shape as possible. Keep up the good work--you're doing grand! Cheers!
 
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Hipster64

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@Barbaraj: I did not take the pain pills this morning and am proud to say that I noticed no difference after my PT session, so I am making the decision to stay off them unless the pain becomes insurmountable. I have the same pain level on pills as I do off them right now. The PA was kind enough to give me another prescription today. I told him about my plans to "go commando" with the pills and he was pleased, but suggested I take the new prescription just in case. I have 7 pills left and if I split them in two, can make them last two weeks. I think I'll be pretty good with what I have on hand for now but it's nice to know I can get more if I need them.

Of course the main reason I was in there was to ask if they could fax over to CIGNA the 12/13 office note documenting my fall. They still are not paying me past 12/10 and when I called today, the claim is still under medical review. After playing extensive phone tag last week, I was able to present my facts and progress to a nurse case manager yesterday morning. The supervisor that I have been dealing with took yesterday and today off and will be back tomorrow, and she has been extremely communicative with me about updates, so hopefully I will hear something by Friday. Like you said before, I'm just looking to get this squared away to 1/3 and am not looking for long-term disability payments for life. I will laugh if they set me up for an independent medical exam because I am definitely returning to work 1/6, so for CIGNA to pay a company $800-$1000-almost 1/3-1/2 of what they would owe me- to put me through an examination to argue 3.5 weeks of disability when my returning to work is pretty much written in stone, is a waste of money, counter-productive and futile. But as a longtime employee in this business, lack of logic is just about what I would expect.
 
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Barbaraj

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Oh, my goodness, @Hipster64, I really do hope those dolts at CIGNA really DO think this through and decide to simply go ahead and grant the small amount of additional time needed and not order an independent medical exam. That would just be crazy! At least you work in the insurance business so you can probably navigate a lot better than so many. And if you are having these kinds of problems, just imagine how difficult it might be for others who aren't as knowledgeable as you. I am just shaking my head right now!

Nice that you've been able to wean off the pain pills pretty much fully, it sounds. I think having a few pills and a prescription in reserve in case you need medication is a sensible approach, a little insurance plan of your own. Glad that PT isn't triggering pain for you--I always felt a bit tired after a session, but more stretched out and limber than when I went in for my workout, and that faded quickly. As you get more flexible and stronger, it will be a huge boost physically and mentally. Good for you--keep up that excellent work!
 
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Hipster64

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Well folks, I got the word today from CIGNA.....THEY CUT ME OFF. No more payments as of 12/10. I figured it was a denial because they left two messages with no status, just a callback request. No one would dare to leave bad news on a voice mail.

When I called back the supervisor, she said that since my 12/13 note said my gait was normal, my incision wasn't split open, and I had no pain to speak of, that this was the needed proof to cut off my benefits. However, they took that note completely out of context and used it against me because the note related to my condition after my fall, not my overall condition. I also find it completely ironic that the opinion of a CIGNA registered nurse/employee, who has never seen me and only talked to me on the phone once for 20 minutes supersedes the medical opinion of a physician assistant and an orthopedic surgeon who not only formerly ran an orthopedic clinic in Tennessee, but is currently the director of the Joint Replacement Program for the entire health system I use, which encompasses three hospitals and three orthopedic offices. And both the OS and PA have seen me and examined me multiple times. So my going to the OS on 12/13 after my ice fall and having the PA see me and document the visit inadvertently threw me under the bus.

I challenged her to set me up for an independent medical examination which I would be more than happy to attend and reminded them how it would not be cost-effective and would basically make them look foolish, but she did not take the bait. And it just hit me....since they believe that my 12/13 visit clears me from disability, shouldn't they owe me payments until at least 12/13?

I do have the right to appeal the decision so since I have nothing to lose at this point, I might as well do so. They agreed to look at my upcoming 12/31 office visit notes and 12/26 PT re-evaluation. And upon my return to work, I plan on notifying our VP of Human Resources about this. Since my company demands the highest customer service standards from its employees, shouldn't it demand the highest standards from the providers it contracts with? I think the VP-who used to be our branch claims manager-would be especially interested in knowing that I had to do the representative's job for most of the claim.

Oh well, it could be much worse....they could have cut me off on 11/5 which is what they wanted to do in the first place. But I am NOT going to let this ruin my Christmas. I will get through this and in 2.5 weeks I will be back at work and earning my paycheck. Meanwhile, I will continue to make the most of whatever recovery time is left, paid or unpaid!
 
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CricketHip

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Oh no,, I am sorry to read this. It all seems so unfair. Especially since you've spent so many hours doing all of the paperwork and calls yourself. It's very difficult not to be cynical with insurance companies these days.. again, I am so sorry.

Glad to hear you won't let this ruin the remainder of your time off and your holiday.

The good news is that you are mending nicely and the fall didn't set your back, thank goodness!

:flwrysmile:
 

BruceH

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@Hipster64

You have one option if all else fails. Your state Insurance Commissioner.

I've been in a similar situation involving FMLA and an insurance company contracted to administer it for my employer. It was very unsettling until it was finally worked out.

It was a month of high anxiety and took two appeals to straighten out. I hope yours gets resolved sooner rather than later.

Sometimes it seems like insurance companies automatically deny a certain percentage of claims hoping that some people won't follow through after the first denial. I hope I'm wrong because it would be so wrong if that theory was right.
 

leejaa

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So sorry for your issues with insurance. Not something anyone needs in the midst of recovery. I wish these people remembered that their customers are already under stress from surgeries/illnesses and were more compassionate and helpful. I have my fingers crossed that you win on the appeal.
 

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