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Jenniferne

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Feb 18, 2009
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65
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I am having my surgery (TKP) this Friday and I still don't know where I am going after I leave the hospital. My surgeon wants me to have in home therapy for the first two weeks and then go to outpatient therapy. Sorry to say in my home town Columbus Nebraska we don't have in home therapy.I mentioned this to my surgeon and he said to talk with my family doctor and have him help me . Now my family doctor wants me to go straight to the rehab unit when I get out of the hospital in our home town for 10 days. I had told him that I need to make sure our insurance will cover this. Our insurance is Golden Rule which is being taken over by United Health. Calling the insurance company is a joke as I keep getting different answers everytime I call. Seems like no one knows what is going on while this transaction is taking place. My doctor told me not to worry about it . He said the day after my surgery a counsler will come and talk with me. I am suppose to mention to them that my doctor wants me to go to the swing bed unit and they will do all the work with my insurance company. I just don't want to find out that it was not covered and end up paying this off for the next 15 yrs. I am so confused.....Also how important is the CPM machine. Seems like my surgeon doesn't use this machine.
 
Jenn,
I can't help with the insurance issue but, from my own experience, I went home after four days in the hospital. I used the CPM twice a day while there. Once home, I had a visiting therapist for three weeks. Usually, I had already done the exercises prior to them getting there. In fact, I was having my wife drive me to the gym so I could get on a stationary bike.
The Dr., whom I have known since he was a kid, released me from therapy since I was steadily improving from my own workouts.
I mention this only because the ball for recovery is mostly in your court.
The first few weeks, are tough but you'll make it...
By the way, my mother, at 74 had her knee replaced. She had a home CPM for one month. She also, once the staples were removed, use a pool to exercise, bend and stretch the leg. She has excellent ROM.
Best of luck and let us know how it goes.
 
Jenniferne,
Some surgeon believe in the CPM and some do not. The jury is still out on if they do any good. Your doctor is correct on your counselor; they will handle your insurance company. They will get the approval before you go to the swing bed unit. So please don’t worry and I pray that you will have an easy time with your surgery.

God Bless,
Rick
 
Jenn, try contacting the social worker at the hospital where you will be. They are used to working with all the insurance companies and hopefully they will be able to find out BEFORE your surgery if a rehab center is covered. It sounds like a good option for you if it will be covered. Also....if you have a written copy of your policy, it should be in there. Or you could go online to your current company (not the one you are transferring to) and see if there is a copy of the coverage document there. I'm not a lawyer, but I can't imagine the company would be allowed to change your coverage in the middle of the year. So whatever coverage you have under your current policy, you should have the same under the new company until your insurance calendar year is up. For my insurance, that's January 1st of each year.

Also, I see that Columbus is kind of near Omaha and Grand Island. It is possible that home care could be provided out of one of those larger cities to your location. Here in Kansas City, the nurses that came to see me frequently drove 45 minutes to an hour out to smaller towns. So you might also ask about that when you talk to the hospital social worker.

Good luck and let us know how things are going. I understand completely that you'd like to know about the options available before you go in for surgery....peace of mind and all that.
 
Jenn -- that's excellent advice from Jamie. My surgeon does not believe in a CPM machine so I didn't have one. It was sort of up to me to do my exercises, bends, pulls and stretches. PT counted for one set of everything and then I had to do 2 or 3 more sets of everything on my own.. I went home on day 3 and had in house PT 5 days a week for 2 weeks, then out patient. The idea being to keep you moving as much as possible and walking as much as you can. You break it up with a lot of rest periods. But if there really is no way you can get home PT -- then many people go to a rehab facility where they give you PT twice a day -- which is good!!! So however it works out for you as long as you're really motivated you'll do fine. But like you -- I would want to know where I will be BEFORE I go to surgery.
 
I had no CPM machine with either knee, but did my exercises, PT (lots) and exercise bike. I did just fine :)

Good luck!
 
Most insurance companies have requirements about who qualifies for rehab stay and many rehab units also have to follow regulations about case mix. In most cases they don't approve a rehab stay if you are having a single TKR unless there are some other circumstances.

I had a BTKR and live alone with no family in town and new to the area so no friends to help out. Even with this, we could not get approval till I was 2 days postop. Also the standard stay for BTKR is 7 days and I would suspect it is less for a single TKR. I had additional problems and original the insurance company refused to pay for the additional 4 days but in the end they did pay it.

As other suggested you should call the hospital patient discharge unit, social work or call the rehab unit. Make sure you get everything in writing.

The CPM issue is up in the air. Research has shown that it helps in the short run but after 6 months there was no difference between groups. The main thing is to make sure
you exercise at home and bend the knee as much as possible

Simon
 
Thanks to all of you who responded. I got a call from the hospital where I will be having my surgery and they said that a counsler will be visiting with me on Saturday to help me set up my therapy for when I leave. I really don't want to go to a rehab unit after my surgery and am hoping that they can find someone to come into my home and help with the therapy for the first 2 weeks. I know my doctor wants the best for me but he doesn't have to fight with my insurance company or pay my bills. If it wasn't for my knees I would be considered in excellent health. Everytime I called my insurance and asked if Columbus had home therapy they would say no but I never thought of a different town having it and coming here so I will make sure the counsler checks that option out. My sister had two tkp and said that on her first tkp she did not use the cpm machine but on her second she did. She doesn't notice any difference between her two knees.
This site has been such a help for me and when my surgery is done I am hoping that I too can help someone here when they need questions answered.
I'll be back on when all is done.
Thanks again....
 
At least someone had the decency to call you, Jenn! I'm sure you will get all the details straightened
Out before your surgery! All the red tape was the very last thing you needed to deal with! The best part is, the surgery will be over before you know you know it and will be well on the road to recovery!! Prayers are coming your way! Best of good luck to you! :)
 
Thanks Jenn! It sounds like you are on the right track now to getting things resolved. And your plans to come back to BoneSmart later and help others is WONDERFUL!! I think that's the thing that makes this site so amazing....people are like a caring family and help lift others up when they need it! THANKS!!!
 
Well, I'm pleased you got some reassurance even if it's not yet completely settled. Simon was right about the CPM - no data to show it's effective/not effective. My surgeon doesn't use it either.
 
Just a word concerning the CPM machines. I realize that there is no positive data one way or the other. I can offer that my husband had no CPM with the first knee, but he did with the second. The second knee seem to re-hab much easier than the first maybe because of the consistant motion. I personally think from watching/ helping him do his exercises, that the second knee was more flexible and gained in strength at a better rate. Although the end results were the same. He just always said that he was glad he used the CPM with the second knee because it helped him quite a bit with the pain level. Just as we've always said; different things help different people in different ways.
Come to think of it... when he did the first knee... the CPM wasn't even in use in this area at the time! LOL that might have been the difference?
I wish you so much good luck in what ever you decide to do. You will be in my prayers for your quick recovery and hope your rehab comes out as painless as possible. Let the counselors handle those insurance companys. Much less stress for you and right now you don't need any more. Blessing your way in ALL ways!
Love and Prayers~~
 
You're right of course, my friend. And my surgeon did impress that his opinion was based upon the long term outcome (would these guys ever look at anything else!
[Bonesmart.org] Oh my!!!!
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