THR On the other side of surgery

[barbloki]

Yes, our insurance covers in-home nurses and we called every agency on the list that the insurance company gave to us but none of them have any nurses available for wound care so I'm stuck doing it. We found one agency not covered by insurance that has nurses who will come to the home for $150/visit. That's a little too expensive for us. I definitely feel like this is a little too much for me at this time in my recovery but there's no other option. At least the infection isn't as bad and the redness and swelling are completely gone. I just wonder how long I'll have to do this. Bending over the bed really bothers my hip. I'm just grateful we are renting this hospital bed for me because he is using it for dressing changes and can raise it up high. If we didn't have the bed I don't know how I would do this. Speaking of the bed, it's time for me to get into it. I've been sitting up long enough.

 

[barbloki]

Thank you @Jamie . I will call them tomorrow. I don't believe Visiting Angels is covered by insurance but I think the VNA is.

 

[Jamie]

That was @djklaugh who gave you the recommendations. You might check with your GP’s office to see if they have any additional resources for you to try. That’s disgraceful that the agencies your insurance recommended have no nurses to do wound care. That’s a primary reason people need home care! I’m so sorry you are dealing with all this.

 

[myglasshalffull]

Just unbelievable all this that is going on when you are in your own recovery.
Hope you can find some nursing assistance.

 

[Layla]

I wonder if the expense of every other day professional care, or even just a few times a week at $150 a visit will take some pressure off of you? It's sad to imagine you doing this without any support. It's a lot of emotional weight to be caring for a loved one, while you're healing from a recent major surgery yourself.
Depending upon the size / depth of his wounds this will likely take weeks. It may be worth it also to have a few professional visits early on in the healing process to assess the wounds and offer reassurance hubs is healing properly. My heart. goes out to you, Barbara, each time I read your updates. You're a trooper, that's for sure. Hugs
@barbloki

 

[barbloki]

Well... my first outpatient PT appointment got cancelled last week so I'm supposed to go today. They just called and said my PT called out sick so they asked if I could arrive later and see someone different. I was kind of looking forward to seeing the same guy I saw for Pre-hab but I can adjust. I need to get this evaluation done so I can start actual PT next week. I need their machines and devices so I can start getting stronger. Since I've been doing everything around the house, I've been ditching the walker and cane so I have both hands available to cook, put away laundry, and deal with redressing hubby's wound incisions. I think all the limping is hurting me. My left thigh is starting to hurt and of course the right thigh and knee has been getting all the work so now I hurt on both sides. I finished the bottle of antibiotics on Wednesday but there's still a scab on the top edge of my incision where the surgeon thought it might be infected. see attached.
Hubby is asleep in his chair so that gives me time to sit here and write this and place an online grocery order. So thankful for online grocery ordering. Just order, drive up, and they bring it to the car.

 

[benne68]

I need their machines and devices so I can start getting stronger.

Oh, please stay away from the strengthening machines for now. You are much, much too early in recovery. . Your muscles and soft tissues need 10-12 weeks to recover from the trauma of surgery.

At this point, your "exercise" should be focused on stretching and activating the muscles. Strength training needs to wait; it is counterproductive right now and could delay your recovery.

Take a look at this article for more: https://bonesmart.org/forum/threads/bonesmart-philosophy-for-sensible-post-op-therapy.37103/

 

[barbloki]

Have you looked into the possibility of having Home Health

Yes, we looked into it. Before the hospital would release him last week they required someone at home who could do this for hubby. They called every agency on the list and none of them had availability so I was trained to do it even though it's hard for me. I think I wrote in another post that all we could find was an out-of-network out-of-pocket agency that charges $150/visit. We just can't justify that expense. We'll get through this somehow. I take naps when I can. I think I'm going to extend the hospital bed rental for another month because it's has rails which help me get out of the bed and it can be raised up for him so I don't have to bend so far to deal with his wounds. It's worth the extra $200 in my mind.

 

[Jamie]

Boy, that’s interesting….and not in a good way. I wonder what their next move would have been if you told them there was no way you could do this because of your own recovery. Or what if he lived alone? I frankly don’t think they should have put this on your shoulders. They have a responsibility to patients to be sure they are adequately able to obtain required aftercare.

It’s hindsight, I know, but your own recovery is suffering with this arrangement. It’s not something that is going to just take a few days and it’s over. Maybe it would have been better for him to have been transferred to a skilled nursing facility for this support. I know that’s not ideal and probably not what either of you would prefer. But I’m very worried about your hip recovery with you on your feet a lot of the day and limping around all the time on a hip that’s trying to heal. You are young and you don’t want to jeopardize the future outcome of your hip like this.

Perhaps you should have a discussion about all this with your hip surgeon and your GP. With their support, you might be able to get your husband a few weeks in a rehab facility and greatly ease the burden on yourself.

 

[barbloki]

a few weeks in a rehab facility

A rehab facility was one of the options before he was released from the hospital last week and he refused. He was convinced he was coming home and going back to work. Once he got home and realized how painful it is to sit, he realized he couldn't work. Then Monday he ended up back in the hospital for another surgery so now he's off work for at least 2 more weeks. I agree that a rehab facility would have been better but he refused so it falls on me. He knows it's hurting me and keeps apologizing. I just wish the home health agencies had adequate staff to help us, especially since our insurance would cover it. We go back to his surgeon on Tuesday and I'm going to ask the question about how long this is supposed to last. Then I'm going to call all of the agencies on the list again and see if anything has changed where they can send someone once or twice per week. I just need a break. I too am worried about my recovery.

 

[Jamie]

That all sounds like a good plan. I hope something works. You might also explain to the surgeon on Tuesday the difficulty for you and your concerns about your own recovery. He may be able to convince your husband that a rehab facility is best for at least a little while until you are stronger and his wounds don’t require such critical attention all the time.

If it’s comfortable, the next time hubby mentions how sorry he is, you might try being honest with him about how this is hurting you and suggest the rehab facility again….just for a short period. It’s only temporary. He’s not going to be able to work for a while anyway and he’ll heal faster with the full attention of trained nurses. And you’ll be in a better position to help later if you’re allowed to have your own recovery right now when it’s really critical that you not overdo things with a hip that trying to heal. It’s okay to be truthful with him about the impact this is having on you and the risks it causes for your new hip.

 

[Pumpkin]

Can your doctor call your insurance company and explain the preferred providers do not have anyone available, and ask if you go out of network for your husband's home health wound care?

 

[barbloki]

go out of network

We already tried asking for coverage for out of network but they won't do it. Just like they won't cover the cost of any of these medical supplies we must buy like ABD pads, gauze dressing, saline solution, medical gloves, mesh underwear to hold the pads in place and let air circulate, bed pads to prevent leaks onto furniture, and more. We have a nurse assigned to us from the insurance company to help us navigate all of this and I think she's as frustrated as we are. She also is worried about my hip recovery. I just have to rest when I can and not overdo it. It's just all so frustrating. I want my normal life back.

 

[barbloki]

I had my first outpatient PT appointment today. The therapist I was planning to see called out sick so I saw a replacement. She was nice and did a thorough exam of what I can and cannot do. She gave me 2 exercises to do at home. One is standing at the counter and just shifting my weight back and forth from one side to the other. Sort of like rocking back and forth. Easy enough. The other one is sit to stand from a chair with arms but instead of keeping my left leg out straight and letting the right leg do all the work, she wants me to engage the left leg too. That's a little ouchie so I'll have to take that one slow. Overall I think it went well. Next week is Thanksgiving and there were no appts available so my next appt is Dec 3 and then I booked 2 times per week through Jan 2.

 

[barbloki]

I am completely satisfied with my surgeon. He has 46 years of experience, has a great personality and bedside manner. He thoroughly explains everything so there's no wondering. He did my right hip in 2022 so even though I have moved 1 hour away, I went back to him for my left hip. Dr. Gordon Kammire, Lexington, NC. His PA-C is also very good, Jason Romblad. I just read the reviews for Dr. K. He will be missed when he retires, for sure. https://www.wakehealth.edu/providers/k/gordon-charles-kammire

 

[Layla]

Good Morning Barbara,
I hope you slept well last night.
Since you provided a photo of your incision pinpointing the area your surgeon was concerned about, which appears a little inflamed, I suggest you call the office and ask to forward the image so your OS can give his thoughts on it. You need a medical professionals opinion. Be safe, rather than sorry for not checking on this.

I agree that you should have a conversation with your husband on how the care you're providing is negatively affecting your recovery which is important also. You've been a saint! My hope is he'll reconsider spending some time in a rehab facility, where he will be professionally cared for allowing you to concentrate on your own recovery for a time. This is more than you should have to deal with physically and emotionally at only five weeks post a major surgery yourself. Please thoughtfully consider...
@barbloki

 

[benne68]

Thanks for the information about your surgeon, @barbloki.

A question: you say he will be missed when he retires. Do you know if he is planning to retire soon?

 

[barbloki]

Hi Deb
I don't believe he plans to retire but he's in his 60's so I wouldn't be surprised if in a few years he does.
Barbara
@benne68

 

[Layla]

Happy Monday, Barbara
How did the weekend go for you and your husband and how are you feeling about the new exercises after a couple of days? I hope things are running smoothly and each of you is getting the rest you need to heal.
A peaceful day to you.
@barbloki

 

[barbloki]

The weekend wasn't that good. He's been out of breath, dizzy, and weak since he came home from the hospital on Wednesday. I took his blood pressure tonight and it was 83/69. If he falls, I won't be able to help him up. I haven't been getting good sleep either because he calls me for help or I have to get up to go pee. Constant interruptions to my sleep. It's starting to get to me. I had my first outpatient PT on Friday and it was pretty easy. Nothing too difficult. I went again today and it was a little harder. My therapist wants me to work on stepping up on a 6 inch step. I don't have anything I can use here at the house. I hate to buy something just to use for a short period of time. Hubby can't build me something because he's out of commission right now. Things are rough around this house. It hasn't been vacuumed in over 2 weeks. I'm doing the best I can with other cleaning. I'm starting to feel overwhelmed. But I'm happy to be going to PT because I know that will help me get stronger. The other exercise he gave me is sit-to-stand with a ball between my knees (or a pillow). That ones a little hard because I'm weak on the surgery side. My next PT is next Monday and then it will be twice per week. I couldn't get 2 appointments this week because of Thanksgiving. I think I'm going to need some Advil tonight after all that exercise today.