Thursday, July 17, 2008

Money concerns...

I have no health insurance and very little savings. OHIP covers the cost of surgery, but as far as I know physio and all other associated costs are my own problem. I emailed a guy I know to find out about his expenses during the same surgery a few months ago.

Here's the response I got:

1) Costs of Rehab
Typically physio would cost $90 for an initial assessment, and then $55 for subsequent visits. Typically just after the surgery, you would be going to the physio twice a week, and then at some point that goes down to once a week, or once every other week. During the early stages, the physio is working with you to rebuild some of the muscle that you are losing on your involved leg, and work on your ROM (range of motion), and to get your swelling down. They'll probably be hooking you up to some electro-stim and carefully monitoring your post-op progress.Once the first month is under your belt, then you are getting into more advanced rehab, at which point physio becomes more of a supervised exercise regime, which you continue on your own at home on the other days of the week. I probably spent upwards of $1400 on physio, but I have health coverage that covers me for most of it.So if cost is a concern, you can explain that to the physio. So in that respect, you can ask to do more stuff at home (of which you'll be doing plenty of anyway) and only come in for status updates and corrections to your physio regime. Physio in a hospital is covered by OHIP, but I am unsure about the details of how you actually get that. It would be worth talking to surgeon about that one, because perhaps he/she can write you a script for it.

2) Knee Braces
Custom-made knee braces are very expensive. They cost in the $1400-1600 range from my experience, and my health coverage doesn't cover it. Whether or not you get a knee brace depends on a few factors: the outcome of the surgery, the types of activities you want to resume post-surgery, the cost. My surgeon and physio recommended that I did get a knee brace if I was to return to activities that require quick start/stopping or rotations. Things like: skiing, soccer, squash. However, at this point I'm OK with being able to do the more knee-friendly activities: swimming, walking, cycling, hiking. I've decided to postpone the decision of getting a knee brace for now.

One thing to remember is that typically people get measured for a custom knee-brace BEFORE surgery because post-surgery your measurements are off. First because of swelling, then because of muscle atrophy. So if you don't get measured before, expect to wait at least 4-6 months so that your muscles get back to regular size before getting fitted for a knee-brace.There are non-custom knee-braces that cost in the $400-600 range. As well as simple over-the-counter ones you can buy at Shoppers for $40 that can also help, but won't provide the same kind of support as a thin space aged custom deal.

3) Other costs
I've heard of some people being hooked up to ice-machines or machines that passively exercise your ROM post-surgery. I didn't do either of those things, so I can't really speak to that. What I did buy at Shoppers is a simple ice-pack that has a velcro strap and you can swap in soft ice-packs. I highly recommend one of these puppies, they only cost like $20 and I still use it to this day after a lot of activity.I did spend a lot on taxi's. But I was rehab'ing in the winter, and petrified of falling on ice/snow. Also, thankfully, my company paid for taxi's to/from work. ;)

4) Pre-surgery
Doing physio to build up the muscles pre-op can help with your recovery post-op. You will lose a lot of muscle on your involved leg in the weeks after the surgery. Even though it doesn't seem all that intuitive to build up muscle just to lose it, the more you have, the less you lose.Let me know if you have any other questions, and I'll do my best to help out. I can also give you more tips/advice for the days/weeks immediately post-op too, so let me know when that date approaches.

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