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Old 03-08-2018, 10:59 AM
 
468 posts, read 351,148 times
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Do what your mother wishes and that is she would rather recover under professional care than having you try to take care of her at home....Knee replacement is serious and painful surgery and recovery and she must know that and she also knows as well as your intentions are you will not be able to give her the care and comfort that she will require.

Back in the late 70's I became friends with now former NY Jets quarterback Joe Namath....he suffered every day from bad knees...when he signed with the Jets the team orthopedist told Joe and the team owners that due to his bad knees he would not be able to play pro football for more than 4 years. He played for over 13 but says he suffered pain on every single play in every game in his career.

Years after retirement and at the still young age of 48 he started to fall down...so he decided to have both knees replaced...and he said the replacement surgery and recover was more painful than any hit or injury he suffered during his entire NFL career..and Joe was one very tough individual.

He had his done in 1992 so maybe with all the medical advancements today is not as painful as when Joe had his done but if his pain was worse than anything he ever received playing football than I suggest you listen to your mothers wishes and allow her to go to the facility she wants to go too for her recovery...

Best of everything for your mom.

Last edited by NY 915; 03-08-2018 at 11:36 AM..
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Old 03-08-2018, 11:37 AM
 
50,107 posts, read 35,754,801 times
Reputation: 76078
Quote:
Originally Posted by lchoro View Post
In order to assess the situation, you have to describe what she is going to the hospital for. All you have described so far is her condition. They won't do two knee replacements at the same time. There will be a rehab stay associated with each surgery. Medicare will cover only the first 20 days of each nursing home stay, and you have to pay 20% afterwards up to the 100 day limit. There is also a limit to how long they'll cover the home rehab. They may also cut her off if she's not making progress. The best choice is to start her off in a nursing facility and then go home to rehab some more. The clock on Medicare benefits resets when you're discharged for home care.
Yes they will if the patient is in good health otherwise. Some people prefer to get it done at the same time and get it over with. Elective knee replacements rarely result in weight bearing restrictions so there is no reason not to.


Most people with Medicare have a supplemental policy, that covers the 20% between days 21 and 100. Most patient's with knee replacements won't need more than 20 days even with bilateral replacements, unless they are morbidly obese, frail elderly, or have some other limiting factor.


The benefits clock resets after the patient has been out of the hospital and rehab for 60 consecutive days.


I want to add for OP, your mom is going to be quite helpless early on. This includes help toileting. if you take her home from day one you may very well be wiping her butt for her. Mom probably knows this and may not want a child and especially a son to have to help her with things like this. With getting both knees done, she may need 2 people to help her transfer. She may need equipment on a temporary basis like a sliding transfer board, a commode, a tub transfer bench, a hospital bed, a CPM machine.


You do not have training in these things and it will take so long to get these devices via home care your mom would be recovered before anything was even delivered. When I did home care through a big hospital system, one of my patients had to straddle the toileting to urinate because she couldn't stand from the low toilet and weeks went by before they could get her a commode. If she is in rehab, they can get the equipment needed delivered before she even gets home.
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Old 03-08-2018, 12:03 PM
 
12,022 posts, read 11,472,111 times
Reputation: 11136
Quote:
Originally Posted by loves2read View Post
The choice to have both knees replaced at one time depends on the patient and the surgeon--
People do have both knees replaced at one time
I know someone whose husband had one knee done and had a bad job--
The surgeon was obtained through workman's comp because he was driver for FedEx and damage was related to his job--so they didn't get to choose surgeon through their health insurance w/wider choices like they would have if he had been injured by accident or been in different job category

Surgeon was mediocre --did sloppy job--and the guy overdid the rehab exercising so he contributed to the negative result
Tried for about 9 mo to live w/that surgery result but was too painful

Needed the other knee done anyway and went to different surgeon--also w/workman's comp but better choice
Did both knees at once
He listened to what he should/should not do during recovery and had better end result because both the surgeon and the patient did their jobs...

So people do have both knees done in one proceedure
Thanks.

I've also been told by the doctor that full function won't return if a rehab isn't successful in two months.

Her first rehab took about 2 weeks in in-patient rehab + 4 weeks at home.

The second fall took nearly 3 months in rehab and 2-3 weeks at home before it was called off.

Quote:
Originally Posted by ocnjgirl View Post
The benefits clock resets after the patient has been out of the hospital and rehab for 60 consecutive days.
They probably won't go back and do an in-home rehab. Medicare provides benefits for 100 days of in-inpatient and then benefits start for in-home therapy. That's why the original poster is recommended to use the skilled nursing facility while it's available for each surgery (unless the doctor recommends otherwise).
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Old 03-08-2018, 12:25 PM
 
Location: Southern California
29,267 posts, read 16,557,815 times
Reputation: 18901
Quote:
Originally Posted by Eastern Long Island Tom View Post
Do what your mother wishes and that is she would rather recover under professional care than having you try to take care of her at home....Knee replacement is serious and painful surgery and recovery and she must know that and she also knows as well as your intentions are you will not be able to give her the care and comfort that she will require.

Back in the late 70's I became friends with now former NY Jets quarterback Joe Namath....he suffered every day from bad knees...when he signed with the Jets the team orthopedist told Joe and the team owners that due to his bad knees he would not be able to play pro football for more than 4 years. He played for over 13 but says he suffered pain on every single play in every game in his career.

Years after retirement and at the still young age of 48 he started to fall down...so he decided to have both knees replaced...and he said the replacement surgery and recover was more painful than any hit or injury he suffered during his entire NFL career..and Joe was one very tough individual.

He had his done in 1992 so maybe with all the medical advancements today is not as painful as when Joe had his done but if his pain was worse than anything he ever received playing football than I suggest you listen to your mothers wishes and allow her to go to the facility she wants to go too for her recovery...

Best of everything for your mom.
On this subject of replacements, many athletes and those who have the money will try PPR/Stem Cells to try to avoid the replacements. Many of the athletes have gone this route both going to Europe and here in the states. If you are not familiar with this therapy here is a link:

Find Regenerative Medicine Doctors - GetProlo.com

It's big in So Calif. If money were not the barrier for me I would go for the injections above before invasive replacements. After a hip replacement, I'm left with 3 major complications and it's 7 yrs post op.

MY Belief is that if these regenerative injections were covered by our great insurance world, MANY more would go this route first. This is what holds me from them.

Last edited by jaminhealth; 03-08-2018 at 12:34 PM..
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Old 03-08-2018, 12:27 PM
 
Location: 49th parallel
4,593 posts, read 3,240,903 times
Reputation: 9556
Quote:
Originally Posted by ocnjgirl View Post
its not assisted living, but subacute rehab in a skilled nursing facility, which may or may not have an ALF attached, but your mom would be in subacute rehab not assisted living. I work in one of these as an OT, and we have many patients 10 and even 20 years younger than your mom for rehab. Why not give her a week to recover there?

Home therapy is not even close to the same, you'll have a OT/PT for 20-30 minutes 3 times a week who has very little equipment, a walker and a few exercise bands, versus 2+ hours a day in a facility, where we have all the equipment needed for rehab. Home therapy is for old frail people who are home bound, a younger person is better off with short intense rehab for a week or so, then just polish up the edges with home therapy once she's discharged. Why does it bother you, it sounds like you may be taking it personally?

I want to add, family members often caretake the person, wait on them. As someone else stated, in the nursing facility she'll have an entire staff carrying over what she's learning in therapy, whether it's getting dressed with assistive devices or walking to meals.
This is excellent advice. I suggest you put aside your outdated ideas and let the professionals help your mom get better faster and with less stress than if she were at home or at your home.
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Old 03-08-2018, 01:38 PM
 
50,107 posts, read 35,754,801 times
Reputation: 76078
Quote:
Originally Posted by lchoro View Post
Thanks.

I've also been told by the doctor that full function won't return if a rehab isn't successful in two months.

Her first rehab took about 2 weeks in in-patient rehab + 4 weeks at home.

The second fall took nearly 3 months in rehab and 2-3 weeks at home before it was called off.



They probably won't go back and do an in-home rehab. Medicare provides benefits for 100 days of in-inpatient and then benefits start for in-home therapy. That's why the original poster is recommended to use the skilled nursing facility while it's available for each surgery (unless the doctor recommends otherwise).
Yes, I recommended it also. I was correcting a post that said the benefits clock resets once the patient is discharged from inpatient, but it is actually 60 days past that. Medicare pays 100% of days 1-20 and 80% of 21-100, but very few people actually get 100 days for one incident. Once our notes show the patient has plateaued, they have to be discharged whether it's 10 days in or 60.
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Old 03-08-2018, 02:13 PM
 
468 posts, read 351,148 times
Reputation: 1457
Quote:
Originally Posted by jaminhealth View Post
On this subject of replacements, many athletes and those who have the money will try PPR/Stem Cells to try to avoid the replacements. Many of the athletes have gone this route both going to Europe and here in the states. If you are not familiar with this therapy here is a link:

Find Regenerative Medicine Doctors - GetProlo.com

It's big in So Calif. If money were not the barrier for me I would go for the injections above before invasive replacements. After a hip replacement, I'm left with 3 major complications and it's 7 yrs post op.

MY Belief is that if these regenerative injections were covered by our great insurance world, MANY more would go this route first. This is what holds me from them.
Thank you for the information and for the link..Extremely interesting and informative....I read 2 of the articles there and have bookmarked it. Thank you.

Unfortunate indeed that the injections can not be available to everyone.....
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Old 03-08-2018, 02:45 PM
 
Location: Southern California
29,267 posts, read 16,557,815 times
Reputation: 18901
Two pretty well known MD's who do this work are:

Marc Darrow, MD - Los Angeles
Ross Hauser, MD - Midwest and FL I believe
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Old 03-08-2018, 03:14 PM
 
Location: Raleigh
8,168 posts, read 8,456,672 times
Reputation: 10141
Failure to follow rehabilitation protocols is the major cause of failure of any orthopedic surgery, especially knees.
It is somewhat unusual to do both knees at once.
Social Security will pay nothing.
Medicare may pay something. Work with her surgeon and the facility.
Something is dodgy here.
Who owns the ALF, her doctors?
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Old 03-08-2018, 03:55 PM
 
Location: Southern California
29,267 posts, read 16,557,815 times
Reputation: 18901
It may be somewhat unusual...from others I've heard one knee and then months later or year(s) later the other one if it's that bad. Two at the same time...yikes the more I think about it.

And if she does two at the same surgery, intensive rehab is a definite.

It almost sounds cruel to do 2 at the same time.

Last edited by jaminhealth; 03-08-2018 at 04:05 PM..
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