Which prosthetic / rehab company to use?

[mike5plus5]

 I don't know how to select who fits/adjust etc. my prosthetic arm and leg which I should get the order for from my ortho dr on April 9. My traumatic LAE amputation was 11-6-14 and surgercal amputation of my RBK Was 1-15-15. I was injured in a wreck that also broke my back. So I  spent 1 1/2 months at the trauma hospital and then was transferred to a nursing home to recover. I'm still living at this nursing home and they want me to use the prosthetic and rehab companies that they recommend. I used the in house rehab service that the nursing home has contracted with until the time allotment ran out for that first stage. I am the only amputee here. I was happy with the service in general but I found out that they have very little experience with amputees. I would imagine that there are certain techniques etc. that are specific to amputation rehab cases. Is that right?

 And I've been very dissatisfied with the incompetent medical care / case management that I've received here so far and I feel like I would rather have my prosthetic care managed by just about any company other than who this nursing home recommends.
  My insurance is Medicare/Medicaid and I suppose I need to call them to get more information about if I can stay here but use an outside prosthetic company and rehab service of my choice and still have the nursing home provide a room, food and transportation to and from wherever I need to go for the service I choose if need be  I asked my ortho doctor to advise me on a good service to use which is the one I will possibly choose but hat's only because I don't really know an accurate way to find out exactly what service I will need and also a source for their companies reputation, previous clients experiences, and if there is some sort of grading system used in this feild.
 Thanks for any guidance and suggestions on this!
Mike

[cherylm]

Mike, I'm not an expert on Medicare/Medicaid coverage (so yes, I think you should call them), but I don't think there's any way a nursing home can specify your prosthetist and technician services. If they have so little experience in dealing with amputees at all, I can't imagine that they have any type of relationship with prosthetists at all...it's probably just the closest place they know of. What they "might" be able to do is to fight transporting you to some other service, but I'd definitely challenge that, if it does come up.

There are some particular physical/occupational therapy processes that are especially helpful for amputees, but some of them can't really be addressed until you actually have your prostheses. Until that time, they ought to be working on strengthening your core muscles and your remaining limbs, as well as making sure you maintain a good range of motion in all your joints. Beyond that, they really, really need to make sure that you are properly trained on falling and how to recover from a fall, wheelchair, crutches, or other mobility aids or general living tools that might apply to your personal situation.

When you do settle on a prostetist, make sure that you are very comfortable communicating with them. Your prosthetics team will become some of the most important folks in your life...make sure you can tell them amything, ask them anything, and feel that they are actually answering your concerns in ways that make sense to you!

[mike5plus5]

Thanks for responding cherylm. I've contacted Medicare but the person I talked to was not much help and the prosthetic provider I think I'm going to use, Hanger, but as you said, both tell me that they can't give me much information until after I get the order from my doctor.
After the time ran out in January that was allotted for therapy here at the nursing home in order to strengthen remaining core muscles and residual limbs , I have not been able to do any further exercising or training because they won't allow me to use the facility un-attended and the therapist don't work for free. I do what I can alone in my room and have kept my remaining limbs strong and my knee on the stump side flexible and able to straighten completely. We never got to cover any fall training so I've had to have help to get back up after 2 falls I've had since.
Also, I injured my left rotator cuff on 2-18-15, in my bed of all places lol, and could not get care for it until I re-injured it falling out of my wheelchair on 3-17-15. I only was able to get medical attention then because there were witnesses and because it happened on nursing home property. It still took until yesterday for a therapist to evaluate my shoulder and she won't return to give me therapy until next week, 4-14-15. She did comment yesterday that I have lost a lot of muscle mass in that shoulder as compared to the other.
I haven't really found an accurate way to judge which prosthetic / therapy provider to use based on feedback provided by former or current patients, so I have decided to try Hanger Prosthetics in Memphis TN. They are nationwide with a location closer to this nursing home than any other and they also have a location in Ocala FL, where I will possibly move to when discharged from this nursing home. Does anyone have experience dealing with Hanger or have any pros / cons info about them?

[cherylm]

Mike,I hope you can get OUT of that nursing home! This truly sounds like a less-than-competent place and you may find yourself better off working on your own. (Note: there's nothing wrong with you working out on your own in your room...just be careful with it.)

As for Hanger...they are HUGE in the world of prosthetists. I am a Hanger client myself and I have been very pleased with the folks I've dealt with at my local Hanger office. They've fitted me with three lovely, beautifully designed legs over the years. I will say, though, that since Hanger is an immense company, the quality of your service can vary based on who happens to be working at your particular Hanger office. I've met folks who swear that "Hanger saved my life" and nearly as many who claim that "Hanger ruined my life." So go into your relationship with the staff knowing that you need to be a "full participant" in the fitting process. Tell your prosthetics team exactly what you're feeling and how well you're able to move in your various trial fittings...and listen closely to make sure they are truly hearing you.

Keep us posted on what's going on!

[mike5plus5]

My problems with being the victim of healthcare mistakes continues. At my last appointment with the orthopedic clinic the doctor wrote my prescription for arm and leg prosthetics on a Hanger form which I viewed while in the exam room. Then the nurse took all the paperwork to do whatever they do with it. Then when I checked out the lady put my paperwork in an envelope to take back here to the nursing home. I assumed she had included the prescription but found out it was not in the envelope when I got here. I called and she apologized and sent the prescription through the mail. That was 4-9-15. Well, you guessed it. It has not shown up here.
 My appointment with Hanger was Thursday 4-16-15 at which time my prosthetic order was supposed to be faxed to them by the ortho clinic. That didn't happen either and I have again contacted the clinic with no return call yet. I'll get back on that chore Monday.
 But the silver lining is that I was very satisfied with the service I received at Hanger. Two prosthesis worked with me and answered all my questions and gave me some good information. I go back for castings next Friday 4-24. According to what I was told, it is good that I have medicare / medicaid. They said it will be a much faster process with less limitations than if I had it through certain insurance companys. They said I should do very well and be walking really quick but the arm will take more time. I had already figured on that since my leg is almost pain free with very little phantom pain too. My arm on the other hand is still very painfull to the touch in certain spots and has really nagging phantom pains. Tearing my rotator cuff in February on that side doesn't help either. But my desire to conquer this challenge is strong and if the first impression with Hanger continues I should be a happy camper real soon.

[cherylm]

Well your "silver lining" sounds like a good one, Mike...and I hope the paperwork mess gets straightened out soon!

[mike5plus5]

Thanks cherylm.

[mike5plus5]

 LOL. Well, I got the prosthetic prescription order thing solved by finally having a new order faxed to Hanger Clinic. That happened last week. So yesterday I got the original order from the orthopedic clinic in the mail, dated 4-9-15 and postmarked 4-27-15. Gee, it only took them 18 days to find it and mail it.