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Thread: Can anyone relate to this?

  1. #1
    Junior Member
    Join Date
    Jan 2004
    Boothwyn, PA

    Can anyone relate to this?

    Bill, T-6 since 11-02 has not been to rehab yet!! because of many fractures including a shattered wrist that had to heal before he could be weight bearing and be accepted there. Developed a bed sore while still in the hospital which got worse, needed a vac pump which didn't work, after 4 1/2 months, got a few opinions and the flap surgery to heal it. He was evaluated 3 times at 2 diffrent rehabs, they alwyas said, get the decub healed, then come back. We did as told, 6 weeks flat on his back, got blood clot, and other complications, finally got well, and guess what, the insurance co. figures he doesn't need inpatient rehab since it has been so long since his accident. As he was in bed for almost a year trying to heal the frigging thing, he has not learned to do any of the normal functions alone. I still dress him, take care of condom caths, we still do the bowel thing with me using an enema, or disimpacting him in our bed. He has not learned these skills yet, we think he needs at least 2 weeks as in inpatient, then he can do the outpatient thing. I work three 12 hour days, leave the house at 6:30 am. He stays in bed all day, as he doesn't get into the wheelchair completely alone yet, and definetly couldn't get back into bed alone. Are we wrong to want him to be an inpatient? Seems mandatory to me for him to be in there while learning to use a commode, or whatever they do. We don't know, been waiting to go to rehab for 14 months and learn all that stuff. Anybody been there, know what I mean? Thanks. Hope

  2. #2
    Senior Member Jeff's Avatar
    Join Date
    Jul 2001
    Argao, Cebu, Philippines
    This is an absolute travesty. There's no substitute for inpatient rehab after an injury like this. At T6 he should be totally independent and kicking butt. How is his weight? If he's not heavy he might be able to get stronger and begin transferring with or without inpatient rehab. But definitely fight the ins co for an inpatient rehab stay..... he deserves his chance at this. It will give him a huge boost.

    Wow....this is terrible. He should be so much further ahead. Staying in bed all day...that breaks my heart. I think KLD or the other nurses will have good advice. Something needs to be done.

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  3. #3
    Suspended Andy's Avatar
    Join Date
    Jun 2003
    Chicago IL
    Going back to inpatient rehab months/years after an accident is NOT unheard of. I was speaking with someone who's son went back to inpatient a second time about a year after the initial inpatient stay to learn new skills. Never getting rehab due to complex medical issues finally clearing up under the excuse of 'its been so long' is not right. Appeal, contact the state insurance commission, become a squeaky wheel.

  4. #4
    I am a t-4 complete for 23 years, travel around the country alone in my truck, fly on planes no problem, ride a arm powered cycle for 40 miles in a day. I just wanted to illustrate to you all that a person can do at this level of injury if they learn how to live again, to learn how to live a life again requires intensive rehab, there is no substitute. I attribute much of my success to the great rehab I got for two months after my injury in 1981. I see you are in Pa, not far is Rusk institute in New York, as I recall they have a great rehab center, you should check with them. I am sure they can give you ideas on dealing with the insurance company. This is very important, do this asap.

    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  5. #5
    I don't think you are far from Magee Rehab. in Philly, one of the regional SCI centers. My advice is to call for an evaluation. They will work with whatever insurance is available. They will make recommendations regarding inpatient or outpatient treatment, as necessary. I strongly recommend inpatient. Bill will learn a great deal about being independent and get some perspective on his disability.

  6. #6
    The others are right! You MUST appeal. Ask Magee to help you. This is so below even the minimal standard of care that it is not believable. You may need to get a lawyer to fight this, but he needs at least 4-6 weeks of inpatient rehab.

    If you have not obtained it yet, you need to get this FREE book right away, read it and follow through:

    Legal Rights of the Catastrophically ill and injured: a family guide


  7. #7
    I to am a T6 as of 7/03 and i will be out of outpatient rehab next week and i must say, rehab is the best way to move forward from the spot he's in. i believe what i can do now is because of rehab then. i am now kayaking and fishin, being fully independent except for driving, which im in that therapy now. i feel bad for whats happened to him, but it will get better by the day. i saw great improvement every day and it kept my mood and motivation strong. the rehab should help you with your insurance battle. good luck

    Josh Stevens
    T6 para as of 7/17/03

    "Nobody's perfect...til you fall in love with them!"

  8. #8
    Senior Member
    Join Date
    Jan 2003
    Madison,Wisconsin, USA
    oh man, you guys must be so frustrated! I sure know how hard it is when you have to hassle with each thing. Do you have a good Physiatrist? They should understand the importance of rehab and write out a script. Model Centers should be able to help with insurance. My brother was refused by private insurance, but I took him to Sheperd anyway after guaranteeing private pay. Sheperd managed to get the insurance to pay, although they would only take him on an outpatient basis. Although that was not the best solution, he was afforded three weeks of learning. It is very disheartening, but keep up with appeals to insurance company, squeeky wheel gets the grease. At Sheperd they had a list of caregivers if family was not able to be there. Best of luck to you.

  9. #9
    I pray for yall. I can only imagine how hopeless you feel. I was in the hospital four months and they never helped me with a bowel movement. I went nine days without having one finally the last two weeks a resident came in and stemed me so I kinda had and idea. When I got out of the hospital I didnot go into rehab for six weeks and I didnot know how to even sit up in bed or again bowel movements just happened whereever.
    So, if I were you I would call my state representative, congressman and climb the latter. American Association of People with Disabilities 1-800-840-8844. National Council on Disibilities in DC. National Council on Independent Living 703-525-3406. National Organization on Disability in DC 202-293-5960. Spinal Cord Injury Info Network 205-934-3283.NSCIA 970-726-1540. Now, tell your state officals that you may have to drop your insurance and get on Medicaide and they will help you. Just remember, be humble, but say what you mean and mean what you say. Even insurance companies have to answer to someone. Don't stop calling because no one is going to just come to your rescue. I hope this helps.

    Mary Sibley

  10. #10
    You have received some GREAT advice here. You have to fight this. My daughter was injured in March 99; she went through rehab and came home in May. She was inpatient again in Aug. 2000 for a month (second car accident ). BUT...we live in WV, and last Feb. she went to Craig Hospital in Colorado for two weeks of inpatient rehab, specifically to conquer her bowel program. (She did some other things too, but that was her main goal, since they didn't teach her that in her original stay.)

    Our insurance covered all this. We had to get letters of medical necessity from her docs, which was no problem. Hang in there...Bill DESERVES this!


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