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Thanks for those that responded to a previous post about questions concerning my wife's upcoming hip replacement surgery. Just a quick update and some brief info for those new to the group since September. Patsy (PD for over 10 years, now 55 years old), had total hip replacement on her right hip on Nov 28. That part went well. We reduced her sinamet dosage some to try and prevent dyskensia, BUT we overlooked a small factor. With her getting an epidural, she was talking to the recovery room staff 10 minutes after the surgery was finished, so started the sinemet again 1/2 a table of 50/200 CR ever 3 hours. Prior to surgery she was on 1/2 a 50/200 CR ever 2 - 2 1/2 hours. Well, a few hours of liquids and NO solid food produced what, in hindsight was a build up of sinemet in her brain, just waiting to get the lady in action. About 30 hours after surgery, she awoke to the most severe dyskensia she had ever had. Thanks to our daughter, a Family Practice Doctor, U.S. Army, who took 2 weeks leave to spend in the hospital, she grabbed the leg and held on for dear life while negotiating with Doctors of various types, insisting that a Neurologist get ther quickly, and paging me to get back to the hospital, and DEMANDING something be done quickly, kept my wife from dislocating the new hip joint. About 2 hours later the introduction of knock out medicine, an education of several nurses and a few doctors that had never seen a dyskensia PD person, Patsy would awake about ever 30 minutes, more knockout, repeat as necessary. About after 8 hours the cycle increased to ever couple of hours. It took about 22 hours before we felt safe to introduce more sinemet. Well by then Patsy is totally wiped out strength wise, is sore in ever spot. Well, that took 2-3 days to get back on track with the recovery theopary procedure. Of course, as she was in the hospital for a hip replacement procedure, the insurance manual says on the 7th day thou shall exit to a skilled nursing facility, even over the suggestion by at least 3 attending physician that she stay longer. The good side of this was observed by my daughter was, at least I will not have to train a new staff each shift as she had to at the hospital. The good side of the hospital stay was she had worked with all the doctors to allow her to order the meds as needed and not on the nurses trained rigid schedule that they are used to. Well, we are now at the skilled nursing facility, progress is being made with mobility, O.T. and P.T., but we are facing the fact that additional days are needed there before Patsy heads home, BUT again the HMO nurse and her schedule of services is dictating what is allowed. She has not admitted such to me, but asking questions and getting evasive answers or no comments tell me a lot. Now to the reason of this post, have any of you got suggestions of how to deal with the insurance company situation? Our other daughter, a interpreter for the hearing impared is now her doing the constant care at the skilled nursing facility and will be here 1 more week, then our son comes for his two week turn. Thanks to some great kids we feel like we are overcoming a lot of that would not have been possible with out someone there all the time. I appreciate the need to control medical costs, BUT when there are multiple complications such as surgery with PD, it seems like there needs to be another chart to look at or some other means to deal with those situations. We have kept detailed notes and hope to write up some suggestions for people who are faced with hospitalization while contending with the PD situation. More on all that later. Sorry this got so lengthy, BUT, the good part is Patsy has NO more hip pain as before. She was almost unable to walk at all the 2 weeks prior to the surgery, so good things are happening. Stanford Hospital, the doctors, nursing staff, skilled nursing facility and OT and PT have all been great, just flustered with the insurance situation. Thanks .. Have a great holiday season. Chuck & Patsy Niggley [log in to unmask]