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Our screwed-up heath care system

SEIOWA CLONE

SEIOWA CLONE

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Dec 19, 2018
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On Monday, my wife while at work, collapsed while walking, her right knee popped, and she could not put any weight on her knee. They had to wheel her out to a coworker's car in an office chair and took her to the ER. Do an X-ray and put her in a brace and send her home with crutches, telling her to set up an appointment with her doctor in a few days. Last few days she is struggling to walk around, brace is too small for her and keeps sliding down, holding it up with an ace bandage.

So, she missed work this entire week, sitting on the couch, struggling to get up the stairs at night and the rest of it. Today, I have to take a day off work to take her to the doctor, she cannot drive and hell, cannot get in and out of the car without help. Get right in to see the doctor, she says she should not be in a brace, promotes swelling in the knee, and since the X-ray showed no broken bones, it's a tendon or ligament that was damaged and we need an MRI to determine that. They can do the MRI today, if Blue Cross OKs it, so they send us back out in the waiting room, we hang around another 30 minutes, and the nurse comes out and tells us that "BC wants her to do physical therapy first, and then if there is still a problem, we will do an MRI."

So now she will be doing PT for a couple of weeks to determine if there is a problem in the knee, instead of just having the MRI, and then determining a treatment plan off the data from the MRI.
Welcome to the American Healthcare system.
 
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SEIOWA CLONE said:
On Monday, my wife while at work, collapsed while walking, her right knee popped, and she could not but any weight on her knee. They had to wheel her out to a coworker's car in an office chair and took her to the ER. Do an X-ray and put her in a brace and send her home with crutches, telling her to set up an appointment with her doctor in a few days. Last few days she is struggling to walk around, brace is too small for her and keeps sliding down, holding it up with an ace bandage.

So, she missed work this entire week, sitting on the couch, struggling to get up the stairs at night and the rest of it. Today, I have to take a day off work to take her to the doctor, she cannot drive and hell, cannot get in and out of the car without help. Get right in to see the doctor, she says she should not be in a brace, promotes swelling in the knee, and since the X-ray showed no broken bones, it's a tendon or ligament that was damaged and we need an MRI to determine that. They can do the MRI today, if Blue Cross OKs it, so they send us back out in the waiting room, we hang around another 30 minutes, and the nurse comes out and tells us that "BC wants her to do physical therapy first, and then if there is still a problem, we will do an MRI."

So now she will be doing PT for a couple of weeks to determine if there is a problem in the knee, instead of just having the MRI, and then determining a treatment plan off the data from the MRI.
Welcome to the American Healthcare system.
Click to expand...
Most knee situations want PT and if there is surgery it is best to do some ahead. Past experience says the PT will assess it and start the PT and get you scheduled with an MRI if they believe it requires surgery.

I’ve learned that it it’s not anything broken to hit PT immediately and it speeds the process up.
 
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You'd think if you are dealing with possibly ligament issue that they would need the MRI to determine the serverity of the injury and i if PT is even an option to rehab the injury. If it is a torn ligament PT isn't going to miraculously heal that.
 
CYdTracked said:
You'd think if you are dealing with possibly ligament issue that they would need the MRI to determine the serverity of the injury and i if PT is even an option to rehab the injury. If it is a torn ligament PT isn't going to miraculously heal that.
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No they won’t, but study after study has shown people who did PT before surgery heal faster and more complete than those who don’t, for tissue situations.
 
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#fakenews. We don't have a health care SYSTEM. There's health care out there but there's no system. The business model of insurance companies is to put as many obstacles in the way of paying claims as possible.

Sorry about your wife. I hope she recovers quickly.
 
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That exact situation happened to my sister recently. She did PT for a few weeks before she was referred back to the doc for the MRI and potential surgery.
 
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BCClone said:
No they won’t, but study after study has shown people who did PT before surgery heal faster and more complete than those who don’t, for tissue situations.
Click to expand...
You may be right, but I really struggle with the idea that we are doing PT first, and then maybe an MRI, instead of doing the MRI, and then determine the best course of action after they know the extent of the injury. She starts PT on Monday, so we will go from there.

Totally screwed up system
 
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BCClone said:
No they won’t, but study after study has shown people who did PT before surgery heal faster and more complete than those who don’t, for tissue situations.
Click to expand...

I'd guess there's times when it depends on the severity but what gets missed in talking about PT is that it's often about strengthening areas around the injury to provide a base and help it...in that, PT helping with healing makes sense.
 
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CYEATHAWK said:
No..........they don't. It's the entity that sets forth all the regs that is the problem. Sorry......my MIL just had a stroke, has the best BCBS insurance money can buy.....and they were not the problem.
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The regs that say insurance companies can't do things like discriminate against people for pre-existing conditions and things like that? The problem is its a for-profit system. Just like oil.
 
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SEIOWA CLONE said:
You may be right, but I really struggle with the idea that we are doing PT first, and then maybe an MRI, instead of doing the MRI, and then determine the best course of action after they know the extent of the injury. She starts PT on Monday, so we will go from there.

Totally screwed up system
Click to expand...
If at a smaller clinic/hospital, which most in Iowa are, scheduling what they consider non life-threatening MRI (which you have to do an Xray first in your wife situation per guidelines -- regulation since they thought too many people were getting needless MRIs) will be out close to a week. Then it can take a day or two to get the results back since a specialist has to read it. It is during this time that PT is to start. We have an Athletico location 10 miles from us and a hospital PT in town, we go to Athletico. I feel they are more thorough, effective, and accessible. We have been able to get in either that day or the next day at latest, and the head person there can analyze the injury and get you on the right course quicker than we ever could by going to the local ER.
 
Perhaps it is difficult if there is a lot of swelling, but I'm pretty sure a doctor can make a reasonable judgement on whether there is a tendon tear based on some movements and checking for stabilization. It needs to confirmed by MRI of course.
 
SEIOWA CLONE said:
On Monday, my wife while at work, collapsed while walking, her right knee popped, and she could not but any weight on her knee. They had to wheel her out to a coworker's car in an office chair and took her to the ER. Do an X-ray and put her in a brace and send her home with crutches, telling her to set up an appointment with her doctor in a few days. Last few days she is struggling to walk around, brace is too small for her and keeps sliding down, holding it up with an ace bandage.

So, she missed work this entire week, sitting on the couch, struggling to get up the stairs at night and the rest of it. Today, I have to take a day off work to take her to the doctor, she cannot drive and hell, cannot get in and out of the car without help. Get right in to see the doctor, she says she should not be in a brace, promotes swelling in the knee, and since the X-ray showed no broken bones, it's a tendon or ligament that was damaged and we need an MRI to determine that. They can do the MRI today, if Blue Cross OKs it, so they send us back out in the waiting room, we hang around another 30 minutes, and the nurse comes out and tells us that "BC wants her to do physical therapy first, and then if there is still a problem, we will do an MRI."

So now she will be doing PT for a couple of weeks to determine if there is a problem in the knee, instead of just having the MRI, and then determining a treatment plan off the data from the MRI.
Welcome to the American Healthcare system.
Click to expand...

Have had a similar situation, cost me months of recovery but at least the billion dollar insurance company didn't have to shell out for an MRI right away. Good luck to you both.
 
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BCClone said:
If at a smaller clinic/hospital, which most in Iowa are, scheduling what they consider non life-threatening MRI (which you have to do an Xray first in your wife situation per guidelines -- regulation since they thought too many people were getting needless MRIs) will be out close to a week. Then it can take a day or two to get the results back since a specialist has to read it. It is during this time that PT is to start. We have an Athletico location 10 miles from us and a hospital PT in town, we go to Athletico. I feel they are more thorough, effective, and accessible. We have been able to get in either that day or the next day at latest, and the head person there can analyze the injury and get you on the right course quicker than we ever could by going to the local ER.
Click to expand...
That was not the problem today, the doctor had contacted the gal about a time for MRI today at the hospital, she said she was free all afternoon if BC approved it.
 
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