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My Story...and countdown....

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brs0660

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Seems strange to be starting a thread on this side. For the new folks that are browsing or those who are anticipating Knee Replacement, I decided that this was the appropriate spot to post.

On Feb 14, I will be celebrating my 10 month anniversary of Right Total Knee Replacement:wahey:. On the same date, I will be one week into the recovery from Left Total knee replacement. Wow...what a Valentine's celebration.

I started having major knee problems about five years ago. I have been overweight all my life which has been a major contributor to osteo-arthritis in my knees. The first time I saw the orthopedic surgeon (OS) he x-rayed my knees and diagnosed me as 'bone on bone'...the unwanted diagnosis. My OS gave me cortisone injections in both knees and sent me to physical therapy (PT). This was very helpful for about year as the bones continued to rub ruthlessly on each other. We then tried five injections of Supartz (about six monts). This gave a little relief, however, again the relief was short lived. After a couple cortisone shots (these were actually the most helpful) I reached the six month point and we tried three injections of Orthovisc. These provided little relief. These injections and physical therapy got me through about three years. I remember the day, I had an appt with my OS...he looked me in the eyes, shook his head...and said, "I think you know that the time to replace your knees has come. Which one is the worst?". I was surprised, but not surpised.

Soon after the decision was made, I went to a Joint Replacement Class to begin preparing myself mentally and emotiionally for this surgery. Class was informative , but I had to know more...I found a couple of videos on line of the entire knee replacement surgery (If you are weak of stomach...DO NOT do this). Then a Cardiac Clearance was required before surgery could be scheduled (rules are rules). This can vary from a conversation with the cardiologist to EKG's or Stress tests depending on your heart health and history. Once cardiac clearance was obtained, the date was set.

The preop visit was interesting. My hospital has online registration and health history. This is wonderful because you can complete the information with the resources you need (telephone numbers, drug names and dosages, surgical history etc etc). I first went to the OS office where the the physician assistant (PA) went over all the risks of surgery, anesthesia etc. This included a paper to authorize transfusion if necessary (TRANSFUSION!!...this is knee surgery). Then proceeded to the hospital for registration, visit to the IMPACT clinic (they oversee in hospital medical care) and the anesthesia interview. I think the thing that really got me in this interview was the questions about do you have an advanced medical directive or a living will. (This is knee surgery!!!). This took about three hours. I ended up needing to take some potassium which was called to
my pharmacy. Then the countdown began...six, five, four. On day four, I began the bacterial decontamination process. Four three days, I showered with antibacterial soap and washed my knee with special soap (betasept). I washed the knee...twelve inches above and twelve inches below...front
and back. Allowed the soap to sit on the skin for several minutes and then washed the area with water. On the day, I was to wash my entire body with the special soap. I was VERY clean!!!!

(To be continued)
 
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brs0660

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It is now Saturday...four more days til Left Knee Replacement. Out early this am picking up a few needed supplies...baby wipes, altoids, a buff puff and some dark chocolate M&M's. I'm ready now...I have chocolate to go!!!!:whis:

Now where was I in my story. Ah yes...day of surgery. My surgeon starts surgery at 1pm. My surgery time or rather arrival time at the was 6:30pm. Okay...my I say that is a LONG time to be NPO (nothing by mouth). I was to keep myself distracted. I went to bed very late and slept until about 10:30am. That was a good plan. Then I leisurely was getting my suitcase ready and the phone rang. "How quickly can you get here?" We have a surgery that has been delayed." Okay, I threw the rest of my stuff together and and out the door we flew. Got to the hospital in about 35 minutes...not bad|! Went to the waiting room, they took me to the presurgical area. First the usual questions..who are you, who is your doctor, what are you having done today, have you had anything to eat or drink since midnight, what medications have you taken today, etc etc. Next stop bathroom. Changed into hospital attire (sexy gowns..can hardly stand it). Another nurse came in and asked the same questions again. They then bathed my to be operated knee again (already done this am). Then I waited and waited and waited. (Did I mention that my dear sweet husband is hospital phobic!!!). Seems that an emergency came in and they bumped me from my new time. 2 came and went...3 came and went....4 came and went....5 came and went....6 came and there was a bit more action. The anesthesiology came to visit. Checked my lungs and oral passages, asked if I had questions and then explained what they were going to do....(They would do a femoral block and give general anesthesia). Next my doctor came in asked how I was doing and then he initialed my knee to indicate the knee to be replaced. Now somewhere between 2 and 6 they started my IV. You can take a lot of fluid in four hours...so of course I had to go back to the bathroom. You guessed it...while I was gone they came to take me to surgery!! Got back to the room and they loaded me on the gurney and off we went to the OR. It was now around 6:30pm.

Wow that operating room was huge and cold!! I glanced around and there on the table near by they were preparing the instruments for surgery..making sure all was ready. There was the drill, the hammer, the templates etc etc. Everything was right in place. Of course, all this time they were talking to me...asking my name, what surgery I was having, who was my doctor, which leg they were working one etc etc. I answered but was far more interested in my surroundings. The anesthiologist came and we talked about weather and a variety of topics as he wired me for sound, hooked me up to the monitors and prepared for administering the anesthesia. So after a while, he asked if I had questions...I said no...only one comment..:"please know that everyone's hands that will be part of this surgery have been prayed for!!!" And about then, I drifted off into a peaceful sleep. I remember very little about the recover area. I remember some voice calling my name...opeing my eyes...and then pretty quickly drifting off into sleep again. My next memory was arriving in my room...I think it was about 11pm I believe. It was quite a flurry of activity as I was moved from the gurney to the bed. They hooked me up to new monitors, the Personal Controlled Analgesic (PCA), got me comfortable. I visited with family and friends for a few minutes and then feel off to sleep again:zzz:. I have large calves, and they were unable to use antiembolism stockings. So I was hooked up to a foot compression unit that helped to keep the blood circulating in my legs to prevent blood clots. I was awake several times because they monitored my vital signs about every 15-30 minutes. I sent my husband home soon after I got to the room, but had a friend stay with me during the night to help if I needed it. Morning came early....the lab came for blood, vital signs, spit bath, brushed teeth etc.

Interetingly food at my hospital is room service. My first meal was soft diet. I choose apple sauce, soup, and "gummy worms". The gummy worms were the best!!! Then each meal was ordered. I must say that the food was good, but at times my appetite was great. I found that things that were very flavorful were most satisfying. I also had a few snacks squirrelled away for hungry moments.

There was no laying in bed very long. About 10am, the physical therapists came to get me out of bed and on my feeet. This was an interesting experience also. They placed a band around my waist to hold to keep me from falling. I used a walker to get up. GET UP:shk:...you want me to get up. I could not lift my surgery knee enough to get it off the bed. This is perfectly normal. They assisted me in getting turned around with
my feet dangling from the bed. The walker was placed in front of me and they taught me the proper way to stand. YOU WANT ME to STAND:shk:???. But stand I did. Only one small problem...the femoral block had not totally worn off...I could not feel my leg. (Ever tried to walk when one of your legs has fallen asleep??) I swear to you...I sweating just doing this much. They then helped me get back in bed and reminded me to do my bed exercise...ankle stretches, gluteal squeezes, and the exercise where you try to press your knee back into the surface of the bed....10 of each three times an hour. And oh...by the way dot NOT forget to do your respiratory therapy exercise too!!! Needless to say...I was exhaused and quickly used the PCA and fell asleep. PT came in two times on the first day..we tried A step the next time...still could not feel my leg. Had all kinds of visits from doctors, staff, friends etc. So ended day one on the other side..... (to be continued)
 

Josephine

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You have a nice way of telling a story, Barb! Almost as good as me! :wink:
 

Yamhillnancy

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So...what happens next? I am on the edge of my seat waiting for the next installment. I am having knee replacement (partial or total, but if it were up to me it would be total) on Feb. 26.

Nancy in Los Angeles
 

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Nice story Barb. I had those foot things after surgery that felt like plastic bubbles that squeezed my feet on and off for a few days. I never saw the darn things come to think of it. It felt weird though. Also, I found my gait belt in my closet the other day. Memories for sure. I haven't decided what to do with it.

Much luck on your next surgery and I'll be thinking of you down this way in the ATL. Take care and will pray for those surgical hands taking care of you.
 

doug62

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Barb,
Great story! My "event" is coming up on 3/8 so I'm VERY interested in your account of events. By the way, thanks for your tip about Lane recliners. You were right about those being the smoothest operating.
Doug
 
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....or should I say...I THOUGHT that ended my day. Why was I wide awake and conversing with my friend at 2AM....4AM.....ah at last sweet sleepppp about 4:30AM and guess what....5am the lights come on and the blood sucking phlebotomist comes in and bleds me dry :hissy:. Now I am really awake. But you know what, I have a feeling of discomfort??? or is it pain??? hmmmmm.....punch the PCA and the discomfort begins to fade away. My nurse comes in to check on me....."we'll be taking your catheter out this morning dear". No NO you cannot do that...this is such freedom. I do not have to get out of bed to pee....If I get out of bed I will have to stand up and WALK. I only took one step yesterday...please don't take it away!!!!!!!...or at least so thought my mind. Actually they did leave the catheter in one more day...probably because I was not walking too well yet and they had to order a "large sized port-a-pottie".

Breakfast time arrived and I was ready to eat a great breakfast to ordered my favorite oatmeal, fresh fruit, toast, coffee. Nice healthy breakfast. Not to complain, but the was okay, the toast was cold, the and the coffee was definitely NOT Starbucks!!! (So just as a suggestion...ask the staff for recommendations for your food--you are in trouble if they say order take our or bring your own from home).

I had a constant stream of visitors. Some I recognized, some I did not. The anesthesiologist stopped by to see how my pain levels were. The IMPACT doctor stopped by to see what my pain levels were. The nurse came in and did vital signs and wanted to know my pain levels. All I can say is know what your pain levels are. I was now about 36 hrs post surgery, so they discontinued the antibiotics. They frequently checked this weird looking drain that was coming from my dressing. It was the drain line that drains blood or other fluids that might be accumulating around the knee.

Then the physical therapist drops by and warns me that I am next. So IV still in place I give myself a last dose from the PCA about fifteen minutes before they got there. Started by doing bed exercises and then it was stand up time again. I still could not feel my leg but this time I actually made it to the door of my room....but you did not hear me say I made it back. They had to wheelchair me back to the bed. They thought I had done pretty well. They tucked me in and it was definitely nap time.....zzz:zzz:.

After nap, they removed the IV and PCA pump and started me on oral pain relievers. They monitored me frequently to be sure I was not having a reaction. My OS dropped by..read my chart asked what my pain level was and seemed very happy with his handy work!! And the day dragged on and on and on. I was now bored:sigh:!!! Respiratory therapy stopped by to see how I was doing with my breathing exercises. I must admit I missed my PCA because that pain relief was pretty quick. So ended a pretty uneventfuly day......

Things to to make you stay more enjoyable....know your caretakers names including the people who empty waste cans. Treat them respectfully. Always try to smile....even if you are gritting your teeth. Find out about your caretakers...take an interest in them. Just know there is someone down the hall that is being ugly...and they will want to come see you because you are pleasant to them!!:whis:
 
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Surgery was on Tuesday, I made it thru Wednesday and was now ready to begin Thursday. A really odd doctor stopped by and asked if I wanted to go to rehabilitation? I said whatever was best for me. He left and I did not hear anything more until much later that rehab was denied. Whatever, I had no idea what to expect either way..home or rehab.

Woke up on Thursday morning with the usual wonderful arm stick. At least it was a good looking young man this time (ooopppss...sexist I am). So I snoozed until breakfast. I suddenly realized that I was in P A I N :shk::shk:...as in number 8 or nine. I had not been diligent at keeping up with it. And better still, can you guess who showed up and my door and said "Time for PT!!!" Oh my I was a real mess. My therapist immediately went and got the nurses to bring me pain meds and she decided to give me a few minutes get my pain under control. (I actually think she did a couple of patients before me). The moral of this story is DO NOT let your pain get out of control...it is not a pleasant experience!!! I actually walked from my bed into the hallway on this day and was really proud of myself. I and so was the therapist. Now I believe that most people would have been in the PT gym by now...but because of my being overweight...I do not think that I progressed as quickly as most folks.

I do not think it is uncommon at this point of recovery to feel blue and to feel more pain. Usually day three post surgery, for whatever reason, we feel like we should be back to ourself and then we start having a major pity party. This is a great day to have a friend or two drop by to keep your spirits up. (This will not be the last time you will see me having a bad moment.....).

Catheter came out the first thing this morning. It was a real accomplishment to walk to the pottie. The drain from my knee came out as well. My OS came in and was really pleased that things were progressing so well. He really felt that I woppuld be going home the next day. I was really ready to be home with the familiar. By afternoon, I think I had made it over the bad spots of the morning. The hospital e chaplain stopped by..that was pretty cool. Got up several times (ANY time you get up...you need to have someone there to help you) and went to the bathroom, or moved to the recliner in the room. I snoozed a lot but was feeling more aware of what was going on around me on this day. I believe that I played Yatzee handheld games and maybe tried to do a Soduku puzzle (was not quite ready for that). Daytime TV is poor and evening TV can even be worse. I think I most enjoyed my Ipod because I could listen to music that I enjoyed.

When my husband came today, he brought special treats for the staff. I think he brought either a cake or cookies. Although this sounds manipulative, a full staff is a happy staff. Happy staff take good care of patients. (Forgive me if I am offending anyone).

Tomorrow I get to go home................:flwr::wow::ch-w:
 

KM253

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Thanks for sharing Barb. I'm overweight too, so I worry about the additional baggage we have to overcome. I will be having surgery sometime this spring. Starting with the right knee, because it's worse than the left, but the left is bad too. I wanted them done at the same time because I'm afraid it will hurt so much I won't want the other one done, but you give me hope.

Kathy
 

Yamhillnancy

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Thanks, Barb. I am interested in your story since my RKR is on Feb. 26th. The doctor is considering a partial, but I think that I am going to convince him to do a total. My gut is telling me that it would be a mistake to do a partial. I have rheumatoid arthritis and lupus and I am afraid of what they would do to my knee in a couple of years. No way am I going to go through this ordeal again. I also have a granddaughter; she is just 3 months old. I can't do much with her at all, as far as carrying her around, sitting on the floor with her, etc. We get her two days a week while my daughter is working and I was unable to care for her. We had to hire a full time housekeeper to take care of the baby, the house, me, cooking, driving, etc. We had no other choice since I am totally unable to do these things.

Nancy in Los Angeles
 
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brs0660

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(Please Note: That this was personal experience and is not typical of most people's experience)....Friday came and I was so excited because the doctor said I would go home today. I had a few, no alot of concerns. I love my husband, but he is in his own world shall I say. If I had to get up was he going to be able to help me or better still would he help me. The day started as usual, EARLY. Had breakfast and early morning meds. Doctor came in and said I was going home. About 10am the physical therapist came in and said we need to see if we can get you to walk before they come and get you. I was like are they transferring me to the psych ward...what?? Did they not tell you, you are going to rehab!!!!!!!!!!!! I think my jaw dropped to the flooor. I was going home what is this about rehab? First I told mty therapist that I had had no pain medication since early morning. She told the nurse and we started walkng down the hall. I was doing really well. I felt pretty confident except what was with rehab. We were about half way down the hall when the elevator door opened and it was the ambulance service ready to take me to rehab. I was rushed back to my room, all my possessions were thrown together, I was put on the ambulance gurney and off they took me to rehab. Just as a reminder, I had had no pain meds since early morning!!!! I was panicked. Where was I going? Did my husband know where I was going? Did my doctor know where I was going??

The ambulance ride was aweful. I swear to you that ambulance had no form of suspension at all. Either that or the driver hated me because for the next 15-20 minutes (it seemed like hours) he hit every pothole and bump in the road. The ambulance was swealtering hot....and did I say I had had no pain medicine since early morning!!!

We arrived at rehab. They rolled the gurney into the area, and there was no one there to ask about where I was to go. Finally they located a nurse who took us to a room. They rolled the gurney to the bed and literally said 'get off onto the bed'. YOU WANT ME TO DO WHAT??? I had no cane, no crutch, no walker!!!! I literally rolled off the cart onto the bed...everyone just stood and watched. By this time I was a basket case. The nurse got
settled in (she was my angel)...I was sobbing by now. They could not give me any pain meds until they got the orders for the medications...and did I say I had had no drugs since EARLY morning. After about an hour (my guess because I have no since of what the time period was) they arrived with pain medicine. It took forever for those meds to work. I was so out of control. Finally, my husband found me (he had gotten some pretty good directions). I was so glad to see him...I cried so more. It was not until late that night that I finally began to settle down and rest, AND my pain was finally under control. So was my first day at rehab!!!!!

Lesson to be learned: When you have questions, you must ask them and be an advocate for your own care.
 

KM253

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Barb,

See this is part of what I fear. I'm a single mother of an 11 year old with Down Syndrome, diabetes and asthma. I have no family support. Not everyone can take care of him. I have to know ahead of time whether I'm going to rehab or not. I'd like to be able to plan on it, but I keep hearing that insurance companies are not approving it. I wish they'd give us a break and let us know what to expect.

You're probably a nice person. I'm a screamer. They'll want to medicate me to shut me up! I hope rehab treats you well.

Kathy
 

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Well, sometimes no matter how hard you try the system screw up. I spent the week prior to admission trying to arrange delivery of my aids from the social worker - all to no avail. Then, Wednesday, the day after my op, I had to bug the nurses to get onto them which they eventually got around to on Thursday but got no reply until Friday. Even then the chap rang back irate wanting to know why had they left it so late? Now it's Friday, what did they expect him to do on a Friday!!! And they had wanted to send me home on the Saturday! So because they couldn't send me home without, I had to stay in until the following Tuesday until social services got their act together. They'd actually said they couldn't deliver till the Wednesday but I wasn't having that! I went home anyway!
 
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Two days to go before my second knee replacement. :wub:

Day Two & Three of Rehab......Things were much brighter after day one of rehab. Since it was the weekend, there was not a lot of busy-ness going on. Today, the physical therapy department came and got me to do an assessment of my condition. They checked leg strenght and ability to walk. They also gave me some exercises to continue doing until Monday. The rest of the weekend was resting and doing my exercises. It was nice to down time.

Day Four of Rehab dawned a NEW day. Sunday evening, the schedule for the next day was delivered. It looked daunting. Up at 6 am, for occupational therapy....BEFORE breakfast!!!! The OT came in and we talked and she taught me how to take care of some basic needs like a REAL shower. It was awesome. To have clean hair was such a gift. Seriously, she taught mie how to manuever getting in and out of the shower safely. Then it was breakfast time...food was good. Meds came because in about an hour PT would be coming to get me. We began with simple things like moving leg in and out of the bed. Then we took a wheelchair ride to the PT suite. We started on the table. The tables were adjustable so that they fit you height needs. It was here that
I met the straight leg raises for the first time. I believe that I lifed my leg about an inch off the mat. I did about five and was totally exhausted!!! All the mat exercises were structured to strenghten the quadricep muscles. After the mat exercises, we started doing some longer distance walking....across the room!! It was an hour in lenght....when I got back to my room I was out like a light. When I awoke, it was lunch and med time again. The doctor dropped by to check on my progress and make some medication changes. Then it was back to the PT suite for OT. Started by doing arm cycle exercises. (Upper body strengh is very important as you prepare for surgery). We played games with bean bags, and had to retrieve them from the floor. We did more upper body exercises and THEN it was time for PT again. More of the exercises done in the morning but I think I could lift my leg 1 1/2 inches this time...that was improvement. Then it was back to the room for afternoon nap and dinner. It seems like there was a lot of time....but healing is a very time consuming process.

Days 5-7 were very much like the above day. In OT I learned cooking skills, dexterity skills, self care skills....oh did I mention that one day I did bowling using the Wii. Amazing how that teaches balance. In PT I continued with strengthening exercises as well as exercises to increase range on motion (ROM) and walking abilities. I learned to go up and down steps and ramps. One day (a beautiful spring day) we walked into the patio area of the rehab unit. It had been constructed by volunteers with different walking surfaces--pebbles, bricks, stepping stones etc--to help manuevering in different walking environments. The very last day, they focused a lot on home safety. I went to the demo bathrooms Tiwork on getting in and out of tubs/showers safely. We also talked thru the skills that would be needed to get in and out of cars/trucks.:thmb:

One week after I arrived, I got to go home. It was wonderful...but there were more challenges to face.......(to be continued)

I can honestly say that even though the beginning was tough it played an intrigal role in my good recovery. I have already told my doctor that I want to go back.
 
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......The car ride home was uncomfortable. Car riding stayed uncomfortable for awhile. Getting in and out is a bit challenging because that new knee just does not want to bend as easily as the other. Then the front or back seats of cars do not have a lot of leg stretch room. But home I was at last.

A new adventure! All the things I learned at rehab were so helpful. How to do steps. How to get in and out of the shower. How to get up from the toilet. But the one thing that was continually a problem was the height of the chairs in my house. I had no idea they were so low. My creative husband actually added six inches to our recliner sofa by using 2x6's. The other thing I found was that I really needed to start to the bathroom at very first inkling because it takes a few minutes to get there. I had several accidents...and they were humiliating to me. But many others here have had similar experiences.

Out patient physical therapy began Monday after I got out of rehab and continued for eight weeks. I had a wonderful therapist, who set reasonable goals and was always reasonable. Some times therapy can be painful...but in my OPINION it should only be the exception instead of the rule. Therapy does not end the door of the facility...it becomes your life. You want to be able to do all those things that you have not been able to do for years or months. So you work at improvement everyday is some way...walking, riding your bike, etc.

One final thing that OS never tells you is the depression that you may experience. I am a very independent, strong-willed person. It was extremely difficult to be dependent on my husband for almost everything for about four weeks. I got sick of having to wait for him to bring my walker around to my side of the car, having to ask for ice packs etc etc. The other thing was the boredom. Before my surgery, I worked about 60 hrs a week. You can only look at four walls for long before they begin to bore you. It was at this point that I found BoneSmart! It saved my mind for sure.

I want to thank Jo & Jamie and every member of BoneSmart for your encouragement. Now begins chapter two of my journey. I know that my friends will be here as I recover from number two surgery. I hope that this will help someone as they start on their journey to a new life.
 

reneee

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Wow, Barb I loved your story. I am new here, but I feel like I already know you. Love your sense of humor

God Bless
Renee
 

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To try to answer KM's question/s, just want to poke in here a sec. Not everyone goes to rehab, not everyone's insurance will pay for it (that, you can check on yourself now). It really cannot be prescribed until after surgery and it's indicated it is needed. Your surgeon should have a good idea if you will need it. Mine did. His PA poofed it off. Listen to you OS.

To know where to go, find out where is possible and look at the places and ask around. I do understand your dilemma in planning in that you have a family. Push the OS office a little more. But again realistically they cannot set you up in a rehab unless it's needed. I asked the same questions and never knew anything until the day came after my bilats where I would go. The social workers do that. So that's why it is kind of hard on them to let you know what to expect, until THAT phone call is made to your insurance co. So again, that's why I am saying, what your OS has hinted on would probably be your outcome. They are smart folks. Their office people who I know are heroes and help us out so much, don't know about where you will go and can only tell you what usually occurs. Hope I helped somewhat.
 

Texas

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Hey sweetie See I remember I cold never forget ya....Good luck Ill be thinking about you.........You will be fine........) Please let us know how you are doing......) xo........prayers your way!!!!!!!
 

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Yay Barb! You have waited so very long. Prayers being sent up! Let us know how you are when you can.
 
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