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New Hip - 6 Month Update
Old 01-02-2015, 01:21 PM   #1
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New Hip - 6 Month Update

I haven’t updated about my progress since July and I realized that it’s been 6 months since my hip replacement surgery on July 1st.

First, I’m feeling GREAT! I used the cane through August and even into the first week of my school crossing guard job. It was mostly for security and a little help getting in and out of the car. By September I was just using it for getting out of bed in the morning for the first trip to the bathroom and kitchen and then I’d park it for the rest of the day. I knew I didn’t need it much anymore when I would forget it and realize I had left it in another room.

Early on I had been walking up and down my own block, first with DH or one of our sons with me, then alone. Our street was getting new gas lines and some of the sidewalks were torn up so I started walking at a local indoor track. At first I could only walk 1/4 of a mile with the cane and needed to take a break halfway, but very quickly I progressed to half a mile without the cane and no breaks. I try to go walking at the track 3 to 5 times a week and I’m now doing a mile easily. I’m aiming for increasing to 1.5 miles and then 2 miles.

I feel completely recovered except for steps. My hip pain had been so bad since about January of 2014 that I had been unable to do steps with both legs, I had been just using the left leg. After the hip replacement I can lift the right leg just as high as the left but climbing a step with the right was feeling like I was straining muscles. So I kept using the cane on steps at home or found an elevator when out. I’ve been working on this, using an adjustable exercise step at home, starting at about 2 inches and I’m up to 5 inches now. I practice a couple times a day and I can feel a difference. A normal sized step is about 7 inches so I will be there soon. Another thing I haven’t been able to do is get my right foot all the way up to my knee to put my sock on. So I still use my sock tool that I got for the recovery period. Not a bad compromise and like the steps, I think I’ll eventually be able to do this, too.

Once I accepted that I needed the hip replacement I was interested in how all this would turn out insurance-wise. I knew we’d reach our high deductible health plan maximum out of pocket limit, so I knew what our costs would be but I had no idea how much something like this costs in total. Is the retail cost 20K or 50K? What’s the negotiated rate on something like this? So here is a rough break down. Keep in mind we live in a low cost of living area and all our providers were in-network.

Here is the billed amount and the negotiated rate which we paid until our MOOP and then the insurance paid 100%

Initial evaluation and X-rays and radiologist reading - 1373 196
Pre op testing 911 438
Anesthesia 931 931
Hospital costs 30,119 25,534 (approx 85%)
-Private Room 2 nights - 2914
-Pharmacy - 619
-Ancillaries - 2068
-Implant - 13,357
-Lab - 168
-Radiology - 259
-Operating Room - 8724
-Physical Therapy - 1216
-Occupational Therapy - 794
Surgeons fee 7223 1463
Daily visit from hospital physician 272 161
Purchase walker 116 79
Home visits by RN (2) and Physical Therapists (7) 1735 990
3 week follow up visit with surgeon 120 15
3 week X-ray 576 36
3 week X-ray reading 55 19
7 week follow up visit 100 14

Total = 43531 29876

The anesthesiologist bill rate and negotiated rate are the same. I called to ask about this and they told me that they bill for the same services with the same insurance companies so often that they know what they will be paid and don’t bother with the retail vs negotiated amounts. That $931 was worth every penny!

All the hospital related costs seem reasonable, I was surprised by how low the negotiated amount was for some office visits and X-rays, etc. Not to worry, I drive by the surgeons office all the time and they just did an addition that doubled their office space and a major renovation.

Overall, I’m very glad that I did this. I didn’t realize how much my hip situation was holding me back. I’m very appreciative of little things like being able to reach my toes in the shower and just simple things like WALKING. The recovery was tough at times but my DH took very good care of me. Before the surgery we went to a “Hip and Knee Class” where you learn what to expect in recovery. The patient and their family member go together and a nurse and occupational therapist explained so much about what we needed and how it would all progress. It took a lot of the mystery out of the whole process.

So I'm looking forward to a much better 2015. I'm enjoying my walking and appreciate my shiny new hip every single day.
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Old 01-02-2015, 01:34 PM   #2
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Hi Sue: Glad to hear the recovery is coming along fine.

If you ever need to get the second one replaced, take a look at the anterior procedure that I and member HaHa (Mike) had done. Very short recovery and no cuts of muscles, etc. I was out of the hospital in two days and walking around the neighborhood in less than two more. I was back to driving a car and getting around with no cane in 10 days. Full recovery was a couple of months with no restrictions.

Medicare and my supplemental policy paid for mine completely.

Here is the Doc that did mine and there is a video clip on the procedure on the web page:

Anterior Total Hip Replacement Video - Minimally Invasive Hip Arthritis Surgery, Houston Texas
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Old 01-02-2015, 01:58 PM   #3
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Sue, thanks for posting this. A new knee and possibly a new hip are probably in my future so I'm very interested in how these replacement parts work out.
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Old 01-02-2015, 02:30 PM   #4
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Delighted to hear how well it's going, Sue. Financial data are very interesting. Your biggest single cost was the implant, followed by the OR (which covers equipment, supplies, setup and a lot of nursing care). Based on what your physicians (surgeon and anesthesiologist) earned, they certainly did not make out like bandits. I mean, $14 for a follow up visit? It's no wonder they want to ER!
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Old 01-03-2015, 03:45 PM   #5
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Sue, very glad to hear that new hip is is working well for you. As Aja mentioned, I got new hip 10 months ago. I got the same operation that he had, the relatively non-invasive anterior replacement. I spent 6 months at least attending presentations by every hip replacement surgeon that I could get to. I also talked to a teams from California. So I arrived at the idea that for me, the anterior approach was more suitable. My surgeon was also like Aja's, a regional expert with a very limited practice. In my case, he and his team and associates do only anterior total hips, total knees, and revisions that they take on. An entire floor of the orthopedic institute is for only their hip and knee replacements. So the nurses are tuned in to these cases, the whole floor is relatively easy to keep infection free, and dedicated PT and OT teams are right there and specialize in hip and knee replacements. The only people that I have talked to who were not happy with their hip replacements are people who went to community hospitals where perhaps the teams was not as drilled and trained in this specific thing.

Only negative thing I have noticed is that I lost a fair amount of conditioning prior to surgery, since I went around for long time before I got scheduled and had the surgery done. During this time I was first on a cane, then full crutches, for more than a year. Even my back became weaker. If I had to do this again, I hope I would bite the bullet and get to the surgery quicker. This should be unlikely for me, since my other hip and knees look normal. The hip I had operated was the site of an old injury.

My girlfriend said that losing this constant pain makes my face look more relaxed, and it sure is nice to be able to get up and down from a chair or bed without pain or unsteadiness.

This doesn't really apply to you, since you have completed your successful surgery and rehab, but if I were to comment on anything that might be generalizable from my experience it would be 1) get skilled opinion fairly early on and 2) favor a very specialized center for the particular type of surgery that you want.
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Old 01-03-2015, 04:34 PM   #6
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Haha,

Where I had mine done is a dedicated orthopedic hospital like you described. My floor was hips and knees, they have another floor for spines and shoulders. I agree with you that this makes a difference as all the nursing, PT and OT staff were very in tune with our specific needs.

Another thing I liked was that all the nurses worked 12 hour shifts. I don't know if that's common now as I try my darndest to stay out of hospitals. But as a patient I found 1 shift change and 2 sets of nursing staff easier on me as a patient.

Here's where I had it done - Crystal Clinic Orthopedic Center - Summa Health Systems Partnership
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Old 01-03-2015, 04:35 PM   #7
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Thanks to all of you posting your hip-replacement experiences. DH is just starting to consider a new hip, after 2-3 years of increasing pain/decreasing activity. He is very doctor-averse so it will most likely take months for him to decide to do it. But at least he has started considering. His orthopedic referred him to a surgeon who uses the anterior approach.

I was really interested in the OP's cost of surgery. One of DH's reasons to not get the hip yet is that he can wait until he is on Medicare -- but he just turned 61! I hope I convinced him that four more years of pain is not worth saving $5000 (my guess at what our 20% copay would be -- glad to know that I was at least in the ballpark), and even if it costs $10,000 out of pocket we can afford it. If he decides not to get a replacement yet it shouldn't be a financial decision.

I really want him to get a new hip so we can enjoy activities together after I ER this spring. I have hopes of biking and hiking with him but it's not possible in his current state. But I definitely want him to come to the decision without any pressure from me -- no blaming me for the pain during recovery! My only input was that any surgery should be after my ER date so I can take care of him while he's recovering.




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New Hip - 6 Month Update
Old 01-03-2015, 04:40 PM   #8
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New Hip - 6 Month Update

<quote>thing I liked was that all the nurses worked 12 hour shifts. I don't know if that's common now as I try my darndest to stay out of hospitals. But as a patient I found 1 shift change and 2 sets of nursing staff easier on me as a patient.<\quote>


12-hour shifts are very common here. DD is a new RN, and she informs me that "all hospital nurses work 12's". Like you noted, continuity of care is a big benefit. The benefit to the nurses, at least at DD's hospital, is they get full-time benefits with just three shifts per week.



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Old 01-03-2015, 04:45 PM   #9
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Quote:
Originally Posted by Sue J View Post
Haha,

Where I had mine done is a dedicated orthopedic hospital like you described. My floor was hips and knees, they have another floor for spines and shoulders. I agree with you that this makes a difference as all the nursing, PT and OT staff were very in tune with our specific needs.

Another thing I liked was that all the nurses worked 12 hour shifts. I don't know if that's common now as I try my darndest to stay out of hospitals. But as a patient I found 1 shift change and 2 sets of nursing staff easier on me as a patient.

Here's where I had it done - Crystal Clinic Orthopedic Center - Summa Health Systems Partnership
Sue, sounds like a very good setup that you used. I had my op on a Monday morning, and I went home on a Wednesday morning, so I really didn't figure out the nursing schedule, but I did have very pleasant nurses. Nurses make a huge difference!

Ha
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Old 01-03-2015, 04:45 PM   #10
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Originally Posted by Philliefan33 View Post
12-hour shifts are very common here. DD is a new RN, and she informs me that "all hospital nurses work 12's". Like you noted, continuity of care is a big benefit. The benefit to the nurses, at least at DD's hospital, is they get full-time benefits with just three shifts per week.
I dunno, I have mixed thoughts on nurses working 12-hour shifts. If they're on board with it and young enough to not have issues with fatigue I guess it is okay but having done both I know when you get past your mid to late 30's fatigue on long shifts becomes an issue.

I don't want to be looked after by exhausted nurses who just want their shift to be over so they can go home and sleep.
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Old 01-03-2015, 04:52 PM   #11
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I dunno, I have mixed thoughts on nurses working 12-hour shifts. If they're on board with it and young enough to not have issues with fatigue I guess it is okay but having done both I know when you get past your mid to late 30's fatigue on long shifts becomes an issue.

I don't want to be looked after by exhausted nurses who just want their shift to be over so they can go home and sleep.
You also don't want your surgeon or anesthesiologist to have been up all night before your operation, if at all possible.
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