PT after Surgery

[schoust]

Ok there Ladies and Gent's I just got off of the phone from the insurance company after inquiring about my benifit's after TKR. They told me a couple of things that I was unaware off. The first thing was I can bring the CPM machine home from the Hospital for a total of 21 day's. The secound thing that I was told which I don't know if it is normal or in the middle or great?? They told me that I am aloud 200 hundred visits at my home for PT. They women who is in charge of my case told me flat out to use every day and I asured her that this would be the case! The last thing which I was not very happy with was they said that when I am able to move about and drive I will have to pay my copay of ten bucks each and every vist ? This to me stinks! IMHO they are basicly forcing me to do somthing that I do not want to do that is use all of the PT atr home! You know these insurance company's never siece to amaze me! Can they not figure this out?? I would much rather be at an outpatiant facility than continue to be (Home Bound)? Any and all coments are appriciated.

Thanks Ralph

 

[Simon]

Ralph

From my experience the home PT was ok but not nearly good enough to be useful long term. You are better off once you can get out to go to the outside PT. You are lucky the copay is only $10 for me I pay 30% of what they decide is reasonable but I was ready for that.

My biggest problem at the moment is the insurance company approved 7 days of inpatient rehab and I was there for 11 so I thought I would only have to appeal 4 days. Well I just found out they are rejecting the entire claim so at the moment I need to find $22,456 dollars ouch.

Good luck

Simon

 

[Sandy R]

I can tell you from my husband's TKR recovery experience, his home PT visits were fine from the time he left the hospital until he was 2 1/2 weeks post-op. But, once he started his outside PT, his recovery really began. Home PT visits are completely different from outside PT... more equipment, machines, ultra-sound, a wide range of exercises. He couldn't have progressed as well, with only home PT. Balance the $10 co-pay for outside PT, with a far better and probably faster recovery in the long run.

Also, you might check with your insurance company to find out if those 200 home PT's are for each year or for your lifetime. If so, the $10 co-pay for the outside PT's might sound even better to you.

Sandy

 

[Josephine]

Simon! oh! ouch! ouch! in sympathy!

 

[schoust]

Wow Simon what a rip! I swear you absalutly need to dot those I's and cross those T's with these insuance company people! So the vedict is as soon as I feel capable go to outpatiant Pt? Or should i just start imeadiatly? I will have to see what the Doc recamends. What about the machine? Should I take one Home and use it? It is avaiable so why not.

 

[ship4]

Ralph,
You have said nothing about the availablity of going to a rehab facility post op. This is what I did after my BTKR on 6/18/08. I was in the hospital 2.5 days and transferred to the rehabilitation hospital on day 2.5 and stayed there for another 6 days. I came home following the rehabilitation hospital where I learned to walk with a walker, shower on my own, walk with 2 crutches (forearm type, Canadian), learned to climb 13 stairs and eventually use only one crutch. When I left the rehabilitation hospital I was at 100 degrees ROM with my left knee and 102 with my right knee.
At home PT we walked outside up and down the street, reviewed exercises to help increase my ROM, measured ROM on each visit, removed the staples, and continued with increasing my walking, foot strike on the floor (heel, toe) along with an even stride length. I continued to work on the stairs. After about 9 home visits (my incision also split open during this time and had to be steri-striped together for a longer period of time) I was discharged with a ROM of 125. My PT told me I should be able to increase it to 135 with no problem continueing to ride my stationary bike at home.
I have unlimited home PT as an insurance benefit and only 25 out patient visits yearly. I am not using any out patient visits at all.

Simon,
You need to call your insurance company and review the bill. They should pay for 7 of the days since they were pre-approved! If they do not, threaten to go to the State Insurance Commisionner....... They most likely will pay for the first 7 days if you appeal their decision.
Best,
Crystal

 

[schoust]

Hmm I did not think that I needed to go to a rehab facility because I will have my wife there to care for me and the theripist comming alsoome to think of it I think that they did ask me if I would be interested in going to a facility. I'm not sure that rehab is what I want anyway! I went through a lot worse than a Tkr and had no issues at home. IMHO if you are alone and have know one to help you and are older then you should find a facility to help you out in the short run. Besides I could not stand to be away from my wife and kids......

 

[ship4]

Ralph,
The recovery at rehabilitation is more intense than you will receive at home. Home PT is usually 2-3 days per week for an hour at a time. Rehabilitation consists of intense PT for 5-11 days where you have PT for 3 hours daily. They put you on the CPM machine, work with you on a PT table doing exercises with your legs, and walking with you with a walker, crutches, and eventually one crutch. You also receive PT regarding getting in and out of a car, doing stairs, using a home bathroom, working in a kitchen, and how to do general household skills.
I am 58 and very glad I went to rehab for 6 days. I do believe going to rehab since it is available to you thru your insurance would be beneficial to you and your family. JMO
Best,
Crystal

 

[schoust]

Thank you very much Crystal. It is very nice when total strangers are willing to help others based on there experience and I commend you for that. Crystal I know that you are right without a doubt because I have been in this position before. I suffered a very severe accident on a motorcycle which almost cost me this leg. The reason that I have to have the Knee replaced is due to the severe deformity that I have been left with. I understand the value of PT and I also understand the difference between at home Pt and Pt at a place where they have all of the things that are needed for recovery and rehab. I think one of the most important things that I have experienced about PT is the kind of therapist that you get. The woman who I ended up with was in a word INCREDABLE! She saved my life her and the surgeon of course(I have to give him some credit LOl). She worked me incredibly this came at a time in my life when I was being lead to the Or every other weak for debridement and other vascular issues. I ended up with significant lose of Rom and my ankle ended up fused. But through it all the Pt is what made me able to continue my life for 23 years after the accident. I work very physically every day and I knew at some point because of the gross misalignment that the knee would need to be replaced. So I thank you for the advice and I have it in my mind exactly how I will deal with this my only hope is that I end up with another dedicated person as I did the first time....

Thanks Ralph

 

[ttlncsc]

Hello Ralph,

I agree with the tone of the answers to your question. Outpatient PT is superior to home visits. Both are good. However, more machinery, more time, and a little more aggressive approach while balancing your progress is my take on it. I had both and even though I've done extremely well for being 7 wks post op, I requested a note from my OS to allow me 3 visits per week for an additional 4 weeks in the Outpatient rehab area. I have progressed nicely and flexion is 120 and extension is improving with just 3 more degrees to go for completely straight.

Talk with your insurance case manager. Outpatient services (I pay a $25 copay) have been more than worth it.

Good luck, Tom

 

[schoust]

Yes Tom I am in complete agreement. I actually had no idea that I could have Pt at home when I had my accident so it was a new thing to me and I was unaware that it was not effective. I have already set up my own Gym so to speak I have Gym pack and a recumbent bike so that is a good start. I think that as soon as I am able I will begin the Pt at the outpatient level. I have a 10 dollar copay so this will not be to bad on the wallet. Tomorrow is my last pre op visit before surgery I am beginning to get a bit nervous but this does not change my optimism!
Thanks Ralph