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TKR So much harder than I expected

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@MissNoodle , thank you so much for such a great reply!! :) I still will have about 100 hours of PTO left and still qualify for short term disability IF the OS felt I should not return to work yet. At the very least, I will ask for reduced hours the first 2 weeks back because of my very long commute every day (up to 2 hours) plus a 8-9 hour work day. I have only been taking about half the vacation time I could for about7- 10 years in order to build up my time in the event something like this ever happened, since I am the sole suporter.

In my hospital, I am not even accruing PTO while I am off on short term disability, so I doubt that FMLA would be building up again. I also was supposed to get a raise effective July 1 and a small bonus, however I was told by payroll, that I would not get it until I return to work.

The position I hold at my job is above a staff position and is very specific to a specific specialty. There is only 1 other nurse that knows the same type of info that I do and can fill in fully for me. (It's a 2 nurse position that we share.) I filled in for her when she was on maternity leave. Other nurses can barely cover the essentials, but not the full job, so I don't think they would just get rid of me due to this, as a lot of training would be needed to replace me. But, I guess you never know. I might make some calls, just to find out what the policy is.
 
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Ladies, I'm reading these posts and really hope everything works out with yours disability and FMLAs. When I told my employer last year that I would be taking about 2 months off ( I did give exact number of days) and that I would be using 49 of my 180 sick days ecrued they wanted me to take an FMLA, which would've meant I wasn't getting a pay check. I respectfully denied the FMLA after conferring with my union president. As a single woman I had saved those sick days for this very purpose. I ended up using 60+ days and will start next year with about 132 sick days.
 
@KarriB , we don't have a union at my hospital and we must apply and take FMLA or our job is not protected. We'd be fired. I could have chosen not to use my disability pay, but I had paid the premiums for 22 years and initially only wanted to use the 30 days of PTO during the waiting period before it kicked in. However, we also had an option to take an additional 30 days of PTO and still receive short term disability. I chose to do that for the extra money due to my medical bills, so I have used 2 months of PTO time as well. Since I also am single now, I completely understand how you feel about saving up as much PTO as possible. Our PTO stands for paid time off and we don't have separate sick time. Every time we take a day off, even for a holiday, we must use our PTO time.

Thank you for your kind thoughts! ;)
 
@KarriB , luckily, the right knee has only had minimal pain, for all these years. They told me 7 years ago that the arthritis in the right knee was not nearly as severe as the left. I have had increased pain in the right knee, however lately, but I think it's because it has had to work so hard in trying to compensate for my left knee for so long. (The arthritis in the left knee got so bad because I had a skiing accident many years ago and tore my meniscus really badly and they could not repair it.) Hopefully, if I ever need a knee replacement on the right knee, it won't be for a long time. I honestly can't imagine going through this again.......
 
@MidwestTKR I'm hoping to hold off until next spring for my left knee. It hurts often, even when moving it in bed. But I really don't want to take off work until spring. That way I don't have to come back to a sub after being gone and have summer to recuperate as well.
Glad you don't have to entertain the idea of another TKR, I originally said this spring, then moved to next spring. I'll think about it another day...
 
@KarriB , boy do I ever feel for you having read you need to do your other knee too. I am sorry....... I completely understand wanting to put if off as long as you can.....
 
KarriB, FMLA is not something that has anything to with pay. It is always leave without pay; it is really a misnomer to call it leave at all. Where I work, you MUST apply for FMLA designation for a significant health-related leave, and the feds absolutely do audit this. Not frequently, but they do. The definitions of a significant leave are pretty standard. Sounds like you technically did not opt for an FMLA designation, but I can't figure out why you would not. Again, it does not affect your pay, your leave balances of vacation/sick leave. What it does do is this: if you had told your employer, "I plan to take all this sick leave, and all this vacation for my upcoming surgery. I have the time accrued." Without FMLA designation, they can decline to give you leave, subject to your collective agreement. Or, they can demand that you come back based on "regular," i.e., unprotected leave criteria.
@Midwest TKR; you said "In my hospital, I am not even accruing PTO while I am off on short term disability, so I doubt that FMLA would be building up again. I also was supposed to get a raise effective July 1 and a small bonus, however I was told by payroll, that I would not get it until I return to work."
Based on my experience with FMLA, my first response is "yes, you are still accruing FMLA, because you are still an employee/meet the definition of an employee." But I am not 100% positive of that. Your raise--they may have you on that one. Arguably they should give you the bonus on July 1, because it bonuses are for past performance. But make sure the delay in the raise doesn't change your eligibility date for any future bumps. IOW, let's say your raise was due July 1, but because you were out on protected leave, you don't receive it until Sept 1. (And I would not cave on that one without squawking). If some sort of annual bump comes your way, make sure it is based on the original July date, not the Sept date. You should not be penalized in a compounded way, if you follow me here. As for accruing regular PTO, this can vary by state. Some states enable full accrual if you work (or have accrued leave to cover) X number of hours in a month (usually 80.) If your employer is a certain size, blah blah. Just make sure you get your answers from HR/Payroll/the Pope in written form. Save those emails!
 
@MissNoodle I belong to the teacher's union at my school, PSEA and NEA, I have been confused about FMLA and sick days. My Union president didn't advise doing both because she said I didn't need both and didn't think it was necessary to dip into the FMLA days as well as my sick days in case I would run out of sick days and need FMLA. My school has (with a vote from the school board) allowed teachers to donate sick days to a particular teacher requesting days, so that could have been a possibility if needed. Not sure if it's different in PA or if I'm confused, but I used just sick days. There are teachers in my district who have applied for FMLA to care for parents or children. Some have sick days, others do not. But technically (at my school) sick days are only used for your own illness, not a family member. My job was protected by the bargaining agreement, so even when I had to extend my sick leave a letter to the board was all I needed. I did need a notice from my dr upon requesting the sick leave and again when I was allowed to return, first part time, them full time. Our contract stated a written excuse from a dr is needed when missing 5 days or more. Guess I'm still confused, perhaps we thought the FMLA time would not accrue while I was out. But my school made it easy for me to be out and upon my return asked where I'd like a handicap spot etc. to make my return smoother.
 
My PTO I'm accruing is based strictly on the PTO I am using to have my paycheck equal my full -time status (66% short term disability + 33% my PTO), so it's about 1/3 of what I would regularly accrue. I was told I wasn't accruing anything on what was being paid for the disability. I chose to supplement with PTO because a) I still have a ways to retirement b) my PTO was close to being maxed out and c) hubby wanted the full paycheck!

sent from my Galaxy 4
 
Interesting! Both of you! @tigz--this type of arrangement makes sense to me, and the loss of 2/3 of your accruals is a little more bearable. @KarriB: I see your Union's point, and now i understand what you mean by not dipping into FMLA until *after* you've exhausted your leave. Yes, at that point it would be leave without pay entirely. But my understanding of the law, and it is a understanding limited to Oregon, is that FMLA must run concurrently with whatever sick or disability leave you're taking. This may be one of those state-by-state things I alluded to. If the protection you've been afforded your employer is greater than what FMLA affords, then perhaps you can use FMLA exactly how your union rep laid it out. Nice! This stuff can make your head explode. Combine it with oxycodone and you have QUITE the recipe for bewilderment.
 
Hefty conversations at this time in the evening...its 12:17 am on the east coast. I'm watching extra innings of a baseball game. :yawn:
 
I would immediately request a copy from the PT of any information that was provided to your insurance company. I have done this regularly lately as it seems that more and more claims are denied for spurious reasons. I have a notebook and have kept my records there.

I would also request a letter from your OS stating that the July date holds firm for your recovery. get a copy of that too. A lot of times, the insurance company will claim that they did not get the paperwork---since I have a copy myself, I can fax a copy to them within a hour of that claim. I got to a UPS store, have them fax it and receive a receipt from them that the fax was received.

This is standard practice now in the insurance world. As a patient, I get a copy of each dr.'s report before I leave the office. I also get copies of any tests that are done, right there and then. I need the info to fight the insurance company.
 
@skigirl , Thank you for the advice! I actually just read your post. Thankfully, however, The insurance adjuster told me that my benefits were reinstated and are in place until July 13, the date the OS originally had said I should be off until. After that problem occurred, I decided to be proactive in a different way. So yesterday, when I had my PT note, I informed that PTA what had occurred and that I wanted to make sure that every symptom I am still having is documented in her note that day. I also said I wanted to make sure she documented that I still walk with a cane outside of my home. She said, that was fine, as I was due for a monthly progress note. She then documented each symptom in front of me on her computer note. In addition she read me what her previous notes had documented regarding neurological function and ADL and thankfully they clearly documented issues I am still having, even though my ROM is so good.

That just proves to me that the ROM is NOT the most important thing at all in the recovery! My flexion was measured at 132 yesterday and my extension was - 1 1/2 the week before. I can see that every week, my knee/leg feels a tinge stronger and my endurance is better than it was a few weeks ago, thank goodness. I still have pain when trying to walk up a few stairs normally, so I have stopped that for now. I don't want to flare up the tissues that are still healing. My other symptoms are the hypersenstivity on the side of the knee, pain in the middle of my knee if I do too much, that stiff band feeling that we all talk about, difficulty in sleeping some nights, and decreased overall energy, although improving!

I go to see the OS on July 6. I am due back to work a week later. What is the best way to go about judging if I am truly ready to return to week. I thought I should tell him all the symptoms I am still having and then advise him that I know there is no way I can work in a very busy clinic that requires lots of walking for at least another 4-6 weeks, maybe more. (I can't walk in clinic with a cane.) I was going to ask him to please write a note to limit my activities to desk work. I didn't know if I should ask him for a gradual return to work hours, since I have up to an hour commute each way and then work a 8 1/2- 9 hour work day. (So, up to 11 hours in one day.) Is that something typically people have to tell the OS, would the OS just do that. I would imagine you have to be pro-active in asking them what you need. Is that correct? What do you and everyone else advise based on your experiences returning to work?
 
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Of course you should be pro Active---otherwise you will have to push yourself too hard at work---then ask for more time off. Much better to take more time at this end. Here is an article from our library

Phased return to work

Yes, of course speak to the doc---he will need to know how you are doing. If you are concerned at all about working, it is better to be take more time off now.
 
tHi Everyone,

I thought I'd give a progress report. I am now 11 weeks left TKR. I saw the surgeon yesterday for a FU visit and was released to go back to work on Monday, July 13 as scheduled. I feel OK with that. I did however explain to him that there is no way that I can do my full job yet and explained what that entailed to him and he restricted me to light duties, (deck work) for 8 weeks after my return and then told me to progress as tolerated. He would like me to continue outpatient PT until both the PT and I don't feel it is needed any longer. I still walk with a cane when I need to go to a store, etc, unless I can lean against a grocery cart for support. I am fine walking inside the house without the cane, but do fatigue if I do too much, however I am able to make it though the day without needing a nap every day now!!!! :)

I notified my supervisor and she is OK with my being restricted to light duties and can accommodate me. I just didn't feel right about asking the Dr. for less working hours initially as I am feeling better in the last week or two and we are understaffed at work. My sleeping is better this last week. I am going to have a day off in the middle of the week, since my job entails a 4 day work week and my supervisor asked if I'd prefer a day off in the middle of the week to give me a break. That sounds perfect since my energy level is still not normal yet. Getting the note from the Dr. has eased a lot of the anxiety I was feeling about returning to my full duties, which would have required me being on my feet for long hours and a lot of walking.

For all those still recovering, I can tell you that each week, gets a tinge better!!! I feel l have really seen that light at the end of the tunnel in the last week. The PT did tell me that when I return to work, I will probably feel like I have taken a step back initially, but it will get better. I am planning on bringing my cane and ice packs to work and elevating on a box if I need to! The end is finally in sight! :)
 
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Great report, @MidwestTKR! What are you doing for ice packs? I've been wondering what works best since the end of my short term disability ain't to far away!

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@tigz, I have only used the plastic type of ice packs that you put inside a cloth wrap that goes around my knee and stays on with Velcro straps. I have 2 sets of ice packs. I will either bring one set to work, or look into an instant ice pack. I think I read about a type somewhere on this site for when you return to work.
 
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