Live Alone and Found Out I Need A New Hip

[Misty]

Hello!
I am new here; I just found your web site today. I am 57 and am a widow and have had a lot of challenges since my husband died. I have learned to become totally independent and it is just me and my doggie. I found out recently, after having pain in my left hip that I need a hip replacement. I have put this off because my insurance company will not pay for in house rehab after my surgery, and I don't know how to figure all this out. In the mean time I have done out patient physical therapy, and worked out at the gym, but I have had to stop because of the pain. I have also stopped dancing, bowling, walking; just to name a few. So, I have to do something. I take care of a house on my own and my dog, and am not used to not being able to do things. I wanted to know if anyone else has had a battle with the insurance company not wanting to pay for in house rehab after surgery so that you can take care of yourself when you get home? They seem to not believe me, and I feel like they are looking at me through the phone like I have 10 heads!! I have been a very active person and want to get back to normal. I have a lot of friends that work and can't always depend on them and believe me I have had to totally learn how to handle things by myself. The fact that I need to be have rehab after surgery to learn to get around and up and down steps and the battle with the insurance company scares me more then the surgery. I have had surgeries before, and some serious one and I bounch back quickly, but this situation scares me. Any advice I would appreciate. Thanks! Take care!
Jan

 

[aussie]

Hi Misty,

I can't help answer your pt questions but I do want to wish you all the very best for your operation.

I'm in the same boat, widowed and VERY independent, so asking for help and relying on other people was difficult for me to do, however, I soon learnt how.

Best wishes,
Chris

 

[Josephine]

I can't help with the insurance but as I'm in the UK but I can relate to the being on your own bit. I am single and have no local family except a sister who's worse than me waiting for a hip replacement. I'm waiting for a knee replacement and having to face the prospect of coming hom alone. We don't have much in the way of rehab facilities here but we do have visiting nurses and care assistants so will have to make do with their daily visits and just manage the best I can the rest of the time.

I'm laying up a big store of food and sundried like cat food and loo rolls! Also cooking quick meals so the freezer is full of heat-up stuff. For the rest I shall be shopping on line. I also have some friends but they also work and have busy lives. Hope you get an answer to this, Misty.

 

[golfer]

Jan: Insurance battles are cruel. if it were me, I would network my way to be able to talk directly with a physical therapist. I believe that they are good people who want to help. That person might just take you on (pro bono ... like the lawyers) or may know of a less expensive program.

Also, if you have a local YMCA call them ... get to the director ... and listen to what they have to say. Perhaps a call to your local health department may give you some help.

Where there's a will, there's a way. Keep fighting and have the operation. Don

 

[Misty]

Good Morning!

I am glad I see some replies. I don't live far from Philadelphia, Pa., and am looking for a surgeon in that area. I have had so much inconsistent information from my insurance company, I am going to write a letter to the Banking and Insurance Commission that handle insurance problems. My problem with my hip started very fast!!! I woke up one morning after being out at an oldies dance night and had a pain in my left hip and thought I pulled a muscle. After going to the chiropractor for several weeks he sent me back to my family doc and they did x-rays and that is when I found this out. But, I immediately started therapy, which is what probably has kept me going for so long. I just could not understand how I could be going down the shore and walking on the boardwalk 7 miles, and then could not walk my dog, dance or anything! How can it happen that fast? I am stubborn and take care of a big house by myself and my dog, but there is more and more I can't do. But, I still do some of my exercises with my legs to keep up my strength. I believe I have quit a bit of strength in there yet. I read some of the posts and how well some of you have done, and I have to persue this totally now. If I can walk normal again, wihtout the pain I am going to be kissing the doctor and the ground; when I can bend overLOL I am trying to learn all the questions I should ask when I see the surgeon. I go back to my family doctor next week, and I am getting my referrals and believe I have a surgeon I picked out in Philly at a big hospital. The one big question I have; I have a big two story house with steps. Since I didn't know this was going to happen I never had a problem with steps before. I have two rails coming up the steps; I had an extra rail put in. I have to go up the steps one at a time; good leg first. I am stubborn. I have carried up my vacuum cleaner LOL holding on to one rail, one step at a time. It's 12 steps straight up. And only a powder room on the first floor. I am worried as to when I will be able to do steps. I really want to work my tosh off in physical therapy after the surgery. I think I have a good attitude. I don't think I am scared of the surgery or pain; been there and done that with other issues; just scared of not being able to do steps and take care of myself and doggie for a period of time when I get home. I honestly asked the insurance company if they just plain to throw me out on a garbage pile after I have the surgery, since they want to do nothing. They called the care I am asking for, custodial care. I don't even know what they mean by that.
Have a beautiful day. We are having an unusual beautiful, sunny day here in New Jersey. Take care.
JAN

 

[UTdave]

Misty,

I'm sure everyone's experience is unique, but I was sort of freaked out about stairs also. I had plenty of support when I got home. I live in a 1930's era house with "granny-killer" stairs (read- steep and slippery). It was actually not that hard getting around. I was pleasantly surprised. You will find the way you are doing steps now is the way you'll do them when you first come home. The time that I really needed help was 1. Driving - you just aren't allowed for a bit by law supposedly. I started after 10 days, but I could not have started at all in the first week at home. It depends on what leg, what car, etc. so think about that one. 2. TED hose. These things are Satan's creation. So hard to get on by yourself initially. It was about post-op week 3 that I could finally get them on myself without my mother-in-law (imagine that) doing it for me. As long as you have your raised toilet seat, walker/crutches, sock grabber (I just wore slippers) and shower chair (may I suggest a shower brush to reach your feet) you'll do well with the other stuff.

Remember that you'll have a physical therapy eval in the hospital and they will not let you go home if you are not ready - despite what your insurance company says. It's pretty typical for people your age to go straight home, however. I wonder if that's why they are giving you a hard time? Most insurance companies will offer home PT visits a few times a week. I would definitely do this.

Might I recommend you ask your surgeon about anterior approach, metal/metal bearing hip replacement if it's possible in you. Recovery time is pretty quick with those. I got a posterior total hip and was back to work in 5 wks or so. One of my colleagues got an anterior total hip at the same time and was back in 3 wks despite his extra 20 years age over me. I've been hearing about how weak I am! ;-)

Good luck!

 

[aussie]

Hi Misty,

Yeah mine came on that quick too. I have always had knee problems and knew eventually I would have to get a TKR or two. But overnight I woke with a pain down my left thigh, pulled muscle I thought, after a couple of weeks I had an XRay and nothing showed up so for the next 12 months (or more) I had every screen test known to man until eventually it was found it was my hip. I had to make a choice which I would get done first so Nov '07 I had my hip replaced and it was great from the minute I woke up properly. Of course there was the surgical pain, but the trauma I was going through every time I would try to transition from standing to sitting was gone, like magic. Then in Nov '08 I had my first TKR. So I am busy recovering from that at present.

Good luck for your op, I hope your results are great also.

Chris

 

[Jamie]

Misty, keep after your insurance company. Have your surgeon write orders for what you need and letters to the insurance company if necessary. Doctors are usually used to doing that for their patients. Get the approval BEFORE surgery if at all possible. You don't want to have this on your plate when you're trying to recover. Can one of your friends be with you on surgery day? That is really important to have an advocate there when you are out of it. Also, do you have some way for your puppy dog to be taken care of for a while? Have you considered going to a rehab facility after surgery? That's a great argument with the insurance company....that (because you are alone), you must use an inpatient rehab facility if they won't approve home visiting nurses and PT. May be just the argument you need. Or maybe it would be better for you to actually use a rehab facility if you could board your dog somewhere for a week or so. Don't hesitate to write the forum again if you have roadblocks or questions. And keep us posted!!! Hugs to you!!!

 

[Troweltalk]

Bluecross / Blueshield insurance:

In-home nurse to come in and draw blood and change and check bandages three times a week for two weeks.

In-home physical therapist to keep me on task that began at the hospital and to monitor my progress and offer guidance for next steps, literally.

Hospital said they would have referred me to a convalescent care facility if I didn't have anyone at home that could helpout with cooking, bathing, medications, and in the event of an emergency. Remember, although we see it happening less and less, we take blood thinners for a reason after joint replacement surgery -- to prevent blood clots which can be life threatening.

Thank God for my loving and patient wife (and for all those great foot rubs)!

I would ask about the convalescent care facility for your first 2 - 3 weeks. After that things get much easier to deal with.

 

[Josephine]

My problem with my hip started very fast!!! I woke up one morning after being out at an oldies dance night and had a pain in my left hip and thought I pulled a muscle. How can it happen that fast? I am stubborn and take care of a big house by myself and my dog, but there is more and more I can't do. But, I still do some of my exercises with my legs to keep up my strength. I believe I have quit a bit of strength in there yet.

Been there, done that, Jan. Mine went from 0 to about what you describe in 4 weeks! Man, to see your life just flusing down the pan like that is scary!

I read some of the posts and how well some of you have done, and I have to persue this totally now. If I can walk normal again, wihtout the pain I am going to be kissing the doctor and the ground; when I can bend overLOL

You and me both!!

I am trying to learn all the questions I should ask when I see the surgeon. I go back to my family doctor next week, and I am getting my referrals and believe I have a surgeon I picked out in Philly at a big hospital.

I have this post where (almost) everything you need to ask is listed plus some other advice How to choose a surgeon and a prosthesis

The one big question I have; I have a big two story house with steps. Since I didn't know this was going to happen I never had a problem with steps before. I have two rails coming up the steps; I had an extra rail put in. I have to go up the steps one at a time; good leg first. I am stubborn. I have carried up my vacuum cleaner LOL holding on to one rail, one step at a time. It's 12 steps straight up. And only a powder room on the first floor.
JAN

You were very wise to have the extra handrail put in. In my house, the previous owner had put in an extra rail and I am now blessing him at least once a day!

As far as there only being one powder room and on the first floor, why don't you invest in some Travel Johns to make the first few days easier? They are very hygenic and non-smelly. My sister used them and I'm going to get some as I already have - ahem - 'problems' in that area!

broken link removed: https://cgi.ebay.com/Disposable-Urinal-Travel-John-Urine-Bag-3-Pack_W0QQitemZ220348557419QQcmdZViewItemQQptZLH_DefaultDomain_0?hash=item220348557419&_trksid=p3286.c0.m14&_trkparms=72%3A1205%7C66%3A2%7C65%3A12%7C39%3A1%7C240%3A1318%7C301%3A0%7C293%3A1%7C294%3A50

 

[Laurie]

Hi Misty, Greetings from a hippy friend north of you in NJ. I had TRHR Aug 26 and have my life back. I am your age, 56, and really do think that age and good health made for a great recovery. I did request going to subacute rehab after the hospital to give my hubby a break and because we have lots of stairs. Even though I couldn't wait to get out of there (was there 5 days and would have left earlier but was labor day weekend and would have been considered AMA), having the PT every day and OT support was great. At my hospital the rehab could not be approved til after the surgery, but was glad the Saint Clares medical staff took care of all the red tape. You may want to ask your hospital's joint education contact about all this. She was very helpful at St clares and your hospital probably has same?

I found that the stairs weren't as daunting as I expected. I used a crutch at first, for a very short period, with rail, and did ok as soon as I was shown the technique by pt.

I do have to admit, that for the first couple of days, would have been worried about being alone. Was good to have hubby there when I got into and out of the shower, b ut bet you can make do with a sponge bath during that time. For me it was getting clear from the narcotic meds that made me feel logy (sp?) and a little off. Didn't even fill the percoset prescription because it gave me such a sick headache. (tylenol exstrength was all I needed, the aches were so minimal, esp compared to before surgery).

If you have a friend to come over after work, bet she would be more than happy to visit---know it is hard to ask. I found this a great time to reconnect with my sister and friends--now that I am back to work I kinda miss those 8 wks.

I hope your experience is as good as mine. I have biomet metal on metal, was supposed to be minimally invasive posterior, ended up with 6 inch incision. At 5 months out, scar is already fading and I note that there is more definition in my right hip--amusingly thought I should have same on left for the more "buff" look (LOL) Of course it helps that I am going to gym regularly and can do my routine on elliptical and treadmill with no pain...a joy.

Take care,
Laurie

PS: Josephine, a weird question for you, do surgeons ever combine liposuction with hip replacement?????

 

[Jamie]

As far as there only being one powder room and on the first floor, why don't you invest in some Travel Johns to make the first few days easier? They are very hygenic and non-smelly. My sister used them and I'm going to get some as I already have - ahem - 'problems' in that area!

broken link removed: https://cgi.ebay.com/Disposable-Urinal-Travel-John-Urine-Bag-3-Pack_W0QQitemZ220348557419QQcmdZViewItemQQptZLH_DefaultDomain_0?hash=item220348557419&_trksid=p3286.c0.m14&_trkparms=72%3A1205%7C66%3A2%7C65%3A12%7C39%3A1%7C240%3A1318%7C301%3A0%7C293%3A1%7C294%3A50

Wow, Jo....now there's product I never knew existed!! It's so amazing what we learn from each other!

 

[Josephine]

PS: Josephine, a weird question for you, do surgeons ever combine liposuction with hip replacement?????

Certainly not! Lipo comes under plastic (cosmetic) surgery and is way outside an orthopod's expertise!

 

[1jt@atime]

n
PS: Josephine, a weird question for you, do surgeons ever combine liposuction with hip replacement?????

Wouldn't that be nice!!!! :'D

 

[Mr.T]

I can only speak from my own experience.I had Blue Cross/Blue Shield insurance.The insurance would only pay for a 4 day stay in the hospital,for my hip replacement.My Dr. wanted me to stay 2 more days buy the ins. said no.The ins. co. won. The ins. would not pay for any in hospital therapy.But they would pay for a nurse and a therapist to make house calls.
If you don't have any friends or relatives to stay with you,when you first come back home,you might consider hiring someone just a short while.I would also consider renting a hospital bed,and putting it on the first floor for awhile.I would hate to know that I had to climb stairs while I was still weak.Just one fall and you might have to start from scratch again.Good luck.

 

[PRGal]

Certainly not! Lipo comes under plastic (cosmetic) surgery and is way outside an orthopod's expertise!

Maybe so, but I can attest that my operated hip has a really nice "30-something" curve while the other one sadly looks its age! (and I'm nearly 3 months post--can't credit or blame swelling!)

 

[Laurie]

PR gal, Thanks for validating that I am not imagining things. Have to say that I do like the new hip curve b etter than my "natural" left side. Guess it is just an unexpected "side" benefit. Don't think anyone notices but me, but .....interesting (only to me) to note all the same. I will comment to my Dr when I go for my 6 month check next month because I think he will b e amused.

More importantly, had to run all over Trenton today in the bitter cold for work. The hip was working great.
Laurie

 

[Judles]

I felt the hip really doing a marvelous job. I have more ROM than ever! I don't think i'll ever take putting on socks,shoes or tying laces for granted again! But now I can even pull up boots! I am so happy I can cry!
Miserable weather is coming our way! Please ALL Hippies & Kneesals, just take those few extra minutes to be safe!

 

[mvo]

Hi Misty,

It is nice to have someone at home, so if you have a friend who can stay for a week or so when you get out, that would be great. It was my first surgery and I had quite an easy recovery, and looking back I Could have coped at home alone if I had to, but am glad I didn't have to, if you know what I mean.

I am very lucky in that my husband works from home and was very helpful and supportive.

If I had to go through it again, and was on my own, I would arrange for some help during the day, or someone to stay, just for the extra peace of mind. And I consider myself very independent
Monica

 

[Stanj]

Misty
I lived alone when I was released from the hospital earlier than expected, at 9 days and was able to care for myself. the difference I am sure is that the hospital was in no hurry to release anyone until they could fend for themselves. The hospital in my case was so cheap, a lot cheaper than a 3 star hotel and I loved the staff so my normal intolerance of boredom was ignored.
If you have been very active and rearrange your living space to allow single floor living for a month you might have no problem at all. Looking back to June of 2008, I am not so sure I would have been so self sufficient at 4 days if that is the release period where you are having it done however. My pain was non-existent so there was no medication for that but I still had a drain pump at that time and changing bandages would have been harder. But when I was released on the 9th day, I walked to work on the 12th day, when dancing(with crutches) on the the next night on the 13th and just resumed normal, but slower life. Grocery shopping on foot and crutches turned out to be the hardest part, stairs turned out to be the easiest. A good backpack or better, a sling pack would have helped a lot for the shopping. You might be better off finding a temporary home for your dog, taking care of yourself will be a full time job if you are getting out so early. Your being released that early has no connection with what it best for you, it is a money issue only. If there is a rehab facility in the area, try to talk your insurance company into using that.
Dealing with insurance is the VERY worst part of medical treatment in the US. I was on Kaiser for 10 years before needing a hip replacement and they refused to even talk about it saying it probably started before I was a member, despite my first and only attempt to use any services was 10 years into my membership. After comparing notes, and recovery experiences I am very glad I had it done outside the US. Where money is not the primary care factor, I really believe the patients are better served such as anywhere in Europe, Scandinavia or where I had it done, St Petersburg Russia. No one wanted to rush healing to fit a schedule or was too busy for very personal and attentive care. I went home based on the only criteria that anyone was concerned with: Was I ready. As it turned out the longer hospital care period, which by the way cost far less than staying in a discount 3 star hotel per day, I am sure was the main reason I had such a fast return to normal life. I was back working full time at my office, and walking around the city miles every day by the end of my first full week at home. On the second week I took a trip outside the country, and at just under a month had forgotten to take my crutches one day and never used them again. My main therapy has been walking, normal home activities and a lot of dancing. Even during that month on crutches I went out dancing in rock or discos several times a week. Now, 7 months later, I can't even remember that I was in great pain for 5 years before getting the operation done. I've even forgotten at at time that I ever had the operation. Last week when I was getting out of the shower my GF commented how my scare had about disappeared. I was confused, I don't have a scare......then it dawned on me what she was referring to.

Your state insurance regulator is not going to help, no one can help fix a business model that give profits only when they do NOT give service. The head of United Health got a $1 Billion bonus for record levels of denials of coverage, not for providing good health care.
My whole hip replacement cost less than 5 months of Kaiser monthly payments. I recommend going somewhere the health care system is not so broken and get healthy as a long vacation and return only after you are fully back together. A month in France or Finland or even here in St Petersburg would do a world of good, be fun and you WILL get better care for less money, probably even if you have insurance. To cut their outflow some insurance companies even encourage going out of the country for treatment and cover procedures they would be reluctant to in the US because sending a patient and family member to another country for an operation is 1/20-1/5th the total cost than doing it at home. I talked to a back surgery patient recently in an English pub here who was from Dallas. She was allowed to bring 2 family members as helpers and her insurance covered all expenses, and was told they would require a substantial co-pay, above her contact co-pay if she wanted it done at home. That was a no brainer, paying $25,000 our of pocket for local care or having a whole family vacation and operation for free outside the US, in either way the insurance company wins.
Good luck Misty