PT/OT/insurance

[cotton1958]

Hi again. I have a question. It's kind of a tricky one. Home therapy (physical, occupational, nurse) just called. I will have a 75.00 copayment for each visit. So I need to figure out how to economize my visits and when to pool my money in for the most important time/s.

For example, I had a visit by an occupational therapist (I didn't order it, I guess the hospital did). She was very nice, but I think I got a lot of these issues covered in the hospital, so I could cross this off my list possibly??

The nurse came out yesterday to take my stitches out. I guess I could have gone to the Dr.'s office and had them out for free, but that would have been very inconvenient.

So that leaves PT. I wonder if my husband, who has offered, should help me do my excercises? He's pretty good at stuff like this...he excercises regularly. Or should I pool my money for 2 weeks out when therapy changes course? If so.

I'm really at a loss. I didn't anticipate this. I have insurance but had to leave my job in May. So money's not coming in, just going out at this point.

Thanks for any ideas as to helping me plan if anyone out there has any. :skp:

 

[loggon]

That is pretty high for home PT. Did you call the insurance company and check on it? Usually home pt falls under the deductible and the Stop Loss. Meaning you have reached your limit as to having to pay out anymore money. With knee replacement you usually reach your limit.

Some folks don't do PT and some only do it a couple of times to learn what to do and then do it on their own. If your husband watches what the therapist does and he needs to ask questions and write down notes, I bet he can do it and it will take the stress of the copayment off your mine.

You do not have to get aggressive in your PT and you are already doing great.

Good luck and post with any questions and we all can give you some exercises to do and there is a great site that is listed some where on here in the post.

 

[cotton1958]

Thanks for your fast response.

I do need to call the insurance company.

My deductible was 10K and 3 million max. Of course that 10K has been met and I'm out-of-pocket on ambulatory and 4 visits now, and meds.

I guess I need to let my husband help me on these early excercises, as you suggest. I was hoping to get out and do therapy out of the home when I was more mobile. I'm having some fear now of being sure I'm at the right place at the right time when it comes to doing/going where I need to be to learn to walk again. I know these are all steps to make the legs stronger.

 

[Doug]

Cotton, since my Dr. knew I would do my own rehab, he released me at two weeks post op.
You can research on-line the types of post-op exercises you need to do.
If you can, get access to a stationary bike and work with that. Start with the seat high and lower it a little at a time.
Later, if you have a mall, it is fun to just go for a walk. They usually have plenty of seats if you wear out.

 

[Judles]

I never had any out patient PT therapy either once the home PT ended after 2 weeks! I diligently kept up with my exercised r times a day and like Doug said....walked as much as I could.....a little more every day!!! Don't be discouraged! (0)

 

[Jamie]

Cotton, these are all great suggestions. Just be honest with your PT at the first visit and they can design a program that you can do yourself (with hubby's assistance). Then you would only need to see the therapist maybe once a week or so.

I can't imagine why you would need additional OT.

As for the nurse, you need to make the call as to whether or not you are able to go to the doctor's office for anything that the nurse might do.

Just make yourself a plan for the next couple of weeks based on how much in co-pays you are willing to spend. You can always change it if you decide you need to add or subtract something. And post here....you'll always be able to get advice from folks who have gone through recovery just like you. Good luck!!!

 

[Josephine]

Here in the UK we rarely have any PT at all, just a list of exercises to do on our own. PT only comes into play if there are any problems. And our results are pretty good. OT is unnecessary, specially if they covered it all in hospital.

 

[skigirl]

Cotton,

You should order the book Knee Replacement and Rehabilitation by Bruglioni and Falkel--there are an otho doc and a pt who had a bilateral knee replacment.

there are so many exercises in that book and they are listed specifically for the week of your recovery.

I would not waste money on home pt--the book is $20 on Amazon .com, arrived two days later. But, I think pt in a gym is well worth the moeny and the pt will help you design a program that targets your specific weaknesses.

I started in the gym on day four post surgery---I wanted to get out of the house, did not want any home pt. I think you would benefit from a few visits with a professional pt---but $75 each---I could afford about four of those!! Kelly

 

[cotton1958]

Thanks Kelly. I was just sitting here(well duh), thinking of what to do. I have a post-op appointment tomorrow... hopefully will be seeing OS, and will ask what I should do.

I am just trying to figure who ordered my 4 visits thus far. I only got one good PT session and stitches out for 350.00. I know this is a drop in the bucket considering what surgery cost, but it's money flying out the door too, and it's my money.

 

[cotton1958]

I'm going to bump off my own thread to ask another question.

I called the OS surgeon this morning. The nurse said my appointment for tomorrow stands, although I thought the home healthcare was in place of my not going in. Anyway, I asked how I was supposed to get up to the office. She said use crutches or walker.

I don't have crutches...and I use a walker all the time. Problem is, I have not walked far enough to think I am ready to walk through an office building although I would have someone to drop me off out front. Getting out of the car is something I only did once, arriving back home after surgery, last week. So I have visions of being swarmed by a busy place and getting on and off an elevator with not so steady knees yet.

Can anyone tell me their experiences at 17 days as far as what I should trust my body to do? I certainly don't want to fall.

______________

BTKR 8/25/09

 

[loggon]

You will be fine I had to go in a Huge office and up the elevator and just walking in the office is huge I was doubtful.

You may want to try riding in the back seat if you have one.
Just slide across the seat so you can rest your leg in the seat.

You will be fine.

Also, home PT is not a waste of money if you get a good therapist. Mine was great and my doctor and the center PT when I went to one was impressed with her.

It is not where you have PT it is the therapist that you have.

 

[cotton1958]

Thank loggon. Maybe things will get more into perspective tomorrow. Trying to wing things myself for 6 days, I need some guidance.

Frustrating afternoon. I got stuck in the shower 2 flights up. My chair was too low and shower got too slippery. I thought I had it all planned out. Stairs were harder than I thought they'd be too. Back in my chair in the basement. Will ice soon. : /

Oh, I got my scars/wounds wet. Hope it's okay.

 

[Josephine]

Well, after that experience, if it was me, I'd cancel the appt and rebook it a couple of weeks later. Or more. It's stupid of him to expect you to cope with the office and all. In such an establishment, I suppose having wheelchairs for people to use is out of the question!

As regards getting in and out of cars, try this: get to the back door and pearch on the edge of the seat with your feet on the ground. Taking your time, wriggle yourself back on the seat until you're sitting with your back against the far door and both legs are stretched out on the seat. When you have to alight, just wriggle yourself across the seat until you can lower your feet onto the ground again.

As for using escalators - don't! Use the lifts (elevators, I think you call them). You could have a nasty accident trying to get on and off an escalator.

 

[brs0660]

Sometimes office staff are so empathetic...they need to experience this surgery...then they can smart off!!!!!!!!!!!!

All suggestions for getting in and out of the car are great. The medical office building where my doctors practice, have wheelchairs available. If check with your local church or veterans group and see if they have one that you could use.

When I went for my first appointment, I ambulated pretty well (me and my walker) that is! However, it was a single floor..and lots of chairs. You will need to do what makes you most comfortable.

Another thing is ask for a temporary handicap permit. It will help as you have to get around more.

Barb

 

[skigirl]

Dear Cotton,

I can't even imagine having both knees done at once!!! My doc won't even do them that way[---although there are lots of folks here who have had both done at once.

I think that you need to practive walking alittle more--although it seems that your house is on many levels, which makes things harder. I live a small two story--but have bathroom and living room and bedroom on first floor. By three weeks, I was taking walks outside--not long walks, but walks. I would guess that with two knees you might be a week or two behind the folks with one knee and balance is probably the issue. So, I would take walks outside with a walker---just walk out 100 years, turn around and come back. someone here suggested putting alawn chair outside, so that you could sit when you needed to do so.

But, at this stage, I think you will need to walk more so that you develop better balance on your knees. Walk a little, lie down and ice--then, walk a little more. My doc told me sitting was my worst position--I should be up and walking or lying down icing my knee after walking!!!

One thing that you will face is that the rehab needs lots of activity=-=lots of folks have led sedatary lives prior to surgery--but, that is all over now---you have new knees and a new life of activity===you will have to exercise those knees to keep them functioning properly.

So, ditch the chair and open the door to your new life. Kelly

 

[Josephine]

So, I would take walks outside with a walker---just walk out 100 years,

Kelly, I know you talked about over-achieving but really .... 100 years??

 

[Judles]

I was wondering the SAME thing,JO!!! LOL!!! (0).

 

[BigRed]

I also had both knees replaced at the same time. I rented a wheelchair with leg lifts for $100 for the month. I used it to get to places like the doctors office and I also used it to get around the house when my legs were tired or aching.

Also, I have found that several doctor offices and other places you may not expect have wheelchairs you can use while there. My church has one when I go to Mass as does a local department store. You might want to make a few calls to see if a wheelchair is available.

 

[Josephine]

Oh - and supermarkets like Walmart (well in the UK, anyway) have electric 'mart-karts' you can use to get around the store. Have I ever been grateful for them!

 

[Motherofmany]

Thanks for your fast response.

I do need to call the insurance company.

My deductible was 10K and 3 million max. Of course that 10K has been met and I'm out-of-pocket on ambulatory and 4 visits now, and meds.

I guess I need to let my husband help me on these early excercises, as you suggest. I was hoping to get out and do therapy out of the home when I was more mobile. I'm having some fear now of being sure I'm at the right place at the right time when it comes to doing/going where I need to be to learn to walk again. I know these are all steps to make the legs stronger.

Am I understanding you had to pay the first $10,000 then the insurance pays 100%? Our total max out of pocket was $5000 then they are paying 100% with in network expenses. Including all meds, pt, etc.

If you are saying you are paying $75 each time the pt comes out, I would have your husband watch and duplicate. Most exercises done at home are easily done on your own. I would invest in a gym membership with a pool. Walking in the pool with gentle stretching will do you wonders. This helped improve my ROM and gait more than anything else. Most gyms will give you a discount if your OS will write you a note stating it necessary for physical therapy from surgery. We were able to join with our entire family for about the cost of 4 visits and my co-pay was $20. This allows all of us to work out and swim when we want to, so I don't feel so selfish because everyone benefits.

With our gym membership, they offer a physical evaluation and 2 sessions with a professional trainer to learn what equipment to use and how to use it safely. My professional trainer has been instrumental in helping me be safe and get maximum benefit. Also there was an aquatic aerobics class, free with membership that was amazing. Many of the members where hip and knee patients and we had loads of fun getting in shape together.

When you call your OS office, ask if they have a wheelchair available for you to use to assist from the car. Your husband can park out front and go in and get it then wheel you up and come back out to park. If you have your husband go by the DMV (where you get your tag) and pick up a temporary handicap form, your OS can fill it out and then you take it back to the License Plate agency and pay $5 for a 6 month temporary tag that hangs from your rear view mirror. You can get multiple tags for $5 each. I recommend 2 if you have 2 vehicles. It is so worth the price and you will need it for a while to come.

Also take advantage of the riding carts in the stores as much as you can. This will help you not be so exhausted. I only walk in the store if I am picking up a few items and will be in and out.

Hope these suggestions work for you. Remember to shop around and find what works best for you and your budget. Whatever you are able to do will help you be healthier. The book recommended above was very helpful and also available at my local library. There is a section on pool therapy that was wonderful and helped me gain 20 degrees in ROM the month I committed to going everyday.

Wishing you a pain free/ uncomplicated recovery.

Blessings,