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Thread: Mom has new C6 incomplete injury Help!

  1. #1

    Mom has new C6 incomplete injury Help!

    My mom fell on Dec 4, 2014 and broke her neck she was immediately operated on. She spent a few weeks at Chandler Regional Hospital in Chandler AZ then was moved to a LTAC where they were able to wean her off the ventilator. She does still have a trach collar but does not use any assistance to breath. We have had a lot of setbacks in her recovery; C-dif infection, pneumonia, a 2nd surgery because the incision did not heal properly and reopened. She was finally moved to a rehab facility on Feb 6. She has good shoulder strength and is able to move her arms the right one is better than the left. she can turn her wrists at times and has some movement in her fingers but cannot always control her movements. Her arms always curl up and she has the neck collar on so it is hard for her to see what her arms are doing so she doesnt always know when they curl up. She can wiggle her toes on command and has recovered some feeling all over but Doctors have told us that this is pretty much as good as it will get. They say she will never walk never be able to sit up on her own and never be able to move herself from the chair to the bed or be able to go to the bathroom normally. She has the best attitude and works really hard at therapy but is starting to get a little discouraged they changed her wheelchair to one that she blows into to make it go because she cant get her arms straightened out enough to move it. She will be at Health South until April 1 then she will come home.

    My questions:

    Health South is a great hospital we have no complaints about the care she is receiving but they do not work with many spinal cord injuries should she be at a facility that specializes in spinal cord injurys and if she should does anyone know of a good facility in the Mesa Az area or in Nebraska. My parents are snow birds and live in Arizona in the winter and come home to Nebraska in the summer.

    My mom loves to read and play games on her ipad but obviously has not been able to do either Are there devices that she can use to be able to use the ipad or to help her be able to read a book and where do you go about finding such devices?

    Any help would be greatly appreciated we are all new to this and want to hep mom the best way we can

    Thanks

  2. #2
    Senior Member
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    I had HealthSouth and still do. Lately, after breaking leg, doctor there told me my plan is better than theirs. I suggest, do NOT, let mental like, "she never will." ever get in the way. They told me I will never move ankles. 12+ years later, I now do have ankles moving. Even toes in 1 foot. Have not worked on other foot yet. Do not allow therapy to dictate what can or cannot do. If CAN do, then do it. Keep doing it and make sure this is communicated to Therapy cannot see your brain. Therapy I think does far too much work solely based on what they see you physically doing. That is only part of the process.

  3. #3
    I would try to get her into Craig Hospital in Denver . Also closer to home .

  4. #4
    In your area, I would much prefer Barrows in Phoenix over HealthSouth. As you say, they are not very experienced in SCI, and we have had major problems with some of our patients who received their inpatient rehab there. Craig would also be great if you can get insurance to cover it (and the transportation to get her there).

    How old is your mother?

    (KLD)

  5. #5
    My mom is 69. The surgeon that operated on mom was from the Barrow Neurosurgical Associates. I did not know there was a Barrows rehab facility. Our other issue is that my dad drives over to spend time with her every day so we were trying to find someplace that was closer to their home so he didnt have to drive into Phoenix every day. My brother and sister and I do not live in Arizona and have been taking turns going to stay with dad but there have been times when one of us hasnt been able to be there. What is the average length of stay in a inpatient rehab facility for someone with this kind of injury?

  6. #6
    For iPad usage there is something called tecla that you can buy that works with the switch controls on an iPad. It can be operated by various methods, one of which is sip and puff. Your mom would be able to have access to almost everything on the iPad with this device. It can also be set to work with an iPhone if she has one. I found a decent article about how this helps quad that you can look at http://gettecla.com/blogs/news/13884...an-ipad-iphone

    disclosure: I work for verizon and this is my personal opinion and recommendation and has no affiliation with verizon

  7. #7
    In Lincoln, Nebraska there's Madonna Rehabilitation Hospital. The SCI medical director is board certified in PM&R and SCI. http://www.madonna.org/patient/rehab/spinal-injury/

    She's been at the HealthSouth Facility for about a month now. Determination of remaining length of stay depends a lot on what's discussed in weekly team conferences where PT/OT/Nursing and Physicians review her progress from the past week and set new functional goals for the following. At the same time, the social worker and case manager are documenting some rough idea of how much longer the stay is going to entail and where patients are going to go after discharge. If you are thinking of transferring her to Barrows or to Nebraska, you should talk with with her doctor and case manager as soon as possible. They'll have to make a referral to the other hospital requesting transfer for a more specialized SCI program. Acceptance for transfer from one acute rehab unit to another is never a sure thing.

  8. #8
    What is her insurance? If it is only Medicare, she is unlikely to get funded for more than 5 weeks of inpatient rehab; sometimes less unless the team is really doing a good job of documenting increasing functional gains.

    Yes, Barrows has a specialty SCI rehabilitation program: http://www.thebarrow.org/Neurologica...ervices/204476

    The program at St. Joseph's Hospital (Affiliated with Barrows) is the only CARF accredited Spinal Cord System of Care in the state of Arizona:
    http://www.dignityhealth.org/stjosep...s-and-programs

    In Nebraska, the following are CARF accredited as a Spinal Cord System of Care:

    Mandonna Rehabilitation Hospital (Lincoln): http://www.madonna.org/

    CHI Health Immanuel Rehabilitation Center (Omaha): http://www.chihealth.com/immanuel-re...mpaign=phrehab

    While it is nice to be close to family, at this point the most important thing is to get her the best possible quality rehabilitation program. Otherwise she is very likely to end up in a nursing home. HealthSouth is not CARF accredited for any of their rehabilitation programs in AZ.

    If they are planning to send her home as she is now on April 1, who will provide all of her care? Have they done a home evaluation so you and your family can get the home modified as necessary to make it fully wheelchair accessible? Has her wheelchair, bathroom, and bed/mattress equipment been ordered? Are you and other family members being taught how to do her care? Has she been taught how to manage her health, including management of things such as skin breakdown, autonomic dysreflexia, urinary tract infections, etc.?? Is she on a functional bowel program that is preventing bowel accidents and constipation?

    (KLD)
    Last edited by SCI-Nurse; 03-05-2015 at 01:35 AM.

  9. #9
    She does have additional insurance not sure what it is. They have done the home evaluation and everything was good except for the bathroom and dad has someone coming this week to start the repairs. She does have her wheelchair but I dont believe the other stuff has been ordered yet. They haven't spent much time teaching us about her care but i think dad was going to hire a nurse to help out at first. As far as the health management that is something that I am not sure about I will be back in Arizona next week. If we are thinking of trying to get her in at Madonna in Lincoln who do we need to contact can I just call them directly or is that something a case manager would have to do? Thank you so much for your help.

  10. #10
    Hiring a nurse will be VERY expensive for home care. Do that have those types of resources?? Medicare will not pay for homecare for the things they judge to be "maintenance" care such as bathing, bowel care, bladder care, skin care, range of motion exercises, transfers, etc. Medicare is likely to only cover brief skilled nursing care such as catheter changes or wound care for home care. Medicare does not pay for bathroom equipment, so that will need to be paid for by your parents.

    A good rehabilitation program would be intensively teaching both her and your father right now about every aspect of her care.

    Call Madonna directly. They will help you with the referral process from HealthSouth.

    (KLD)

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