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    #16
    I want to thank everyone for their helpful posts. Brian had surgery on Thursday everything went well. He still has the respirator in his throat so he can talk. The pulmonary doctor checked Brian this morning and found that his right lung had partially collapsed so they inserted a tube in his chest to reduce the stress on the right lung. He said that the sooner that they can remove the respirator the better. Hopefully Sunday they will be able to remove the respirator. Brian is asleep now so I can home my wife and daughter are with him.

    Yesterday, I spend a lot of time dealing with issues but by far not the most important. I found out that Brian’s company will continue him on medical leave for 6 months. He has Blue Cross of CA PPO medical insurance. The person I talked to at BC was very helpful. Brian is at the Barrow Neurological Institute at St Joseph’s Hospital in Phx and that is in the BC network. So for the time being that’s good. The company Brian works for also provides both short term disability and long term disability insurance. The medical insurance and the disability insurance are paid 100% by the company. So I think that's all very good. Brian was a passenger in a car driven by a friend. They were at Rocky Point Mexico. The driver had purchased Mexican insurance but that only provides $2000 for medical injuries. That’s probably only a concern for Blue Cross.

    The social worker at Barrow talked to my wife and I for quite a length of time on Friday. Soon we need to make a decision on where Brian will have rehab. A new Neuro-Rehab Center is opening at the Barrow Neurological Institute on Monday. With the increased facilities Brian could get right in. My wife thinks having friends close by is more important and thinks staying in Phx would be better than going to Shepherd in Atlanta or Craig in Denver. My son also has a several college friends in LA. So that raises the possibility of a therapy center in LA. I don’t really think we should count on college friends giving Brian the long term support that he will need during Acute Rehab that's why I’m leaning toward staying in Phx. In Phx he might not have as many of his college friends but he has family and old friends from when he was growing up here.
    Last edited by Roger; 17 Feb 2007, 8:31 PM.

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      #17
      Don't go to a new center. The staff will be very green. I know...I opened a center 18 years ago, and I shudder to think how little my staff knew, and how I had to be there every minute to be sure that the most basic things got done right. Being close to family is great, but don't ship going to a leading center if you can. It is sort of like skipping a scholarship to Harvard Law School so you can stay close to your family and go to XYZ Night Law School. Many things that he will learn in rehab, and the advice of EXPERIENCED professionals in the field will determine the course of his life for the next few years, and prepare him with the skills he will need for his life.

      I would only consider Rancho Los Amigos in Downey, CA, but you would have to understand that it is a county hospital, and that the realities of staff shortages and budget cuts may impact the quality of the program. The only other center I would even consider is Casa Colina in Pomona.

      I assume he is not a military veteran, correct??

      (KLD)
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        #18
        KLD

        No, Brian is not a veteran. Perhaps it would be more precise to say that the Barrow Neuro Rehab has moved to a new larger facility. It's not a new center in terms of operations. Our surgeon Dr. Theodore told us that the procedures developed at Barrow are the basis for the MODEL system.
        Do you think that Blue Cross would agree to transport Brian to Atlanta for therapy?

        Roger

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          #19
          Shepherd Center is a great program, but comparable to Craig.

          Barrow's is NOT a model System Center, although they are CARF accredited as a SCSC. They don't see the numbers of patients with SCI that are seen at Model Systems Centers, so their staff are not as expert or experienced. I would not consider sending a member of my family there or to Good Sam for SCI rehab.

          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


            #20
            KLD

            Thank you for your comments. This is the type of dialogue that I was hoping for.
            Do you have any thoughts on the transport from Phoenix to Atlanta issue.

            Roger

            Comment


              #21
              KLD,
              I rehabbed at Good Sam and thought I got pretty good care. I have nothing to compare it too.What would have been different if I had gone to Craig or Sheppard?

              I also think it's important to have a strong support network close. Due to the circumstances of my injury, I was completely alone during my rehab, almost no friends or family contact until my release. I think that was the hardest part of my injury.
              My blog: Living Life at Butt Level

              Ignite Phoenix #9 - Wheelchairs and Wisdom: Living Life at Butt Level

              "I will not die an unlived life. I will not live in fear of falling or catching fire. I choose to inhabit my days, to allow my living to open me, to make me less afraid, more accessible, to loosen my heart until it becomes a wing, a torch, a promise. I choose to risk my significance; to live so that which comes to me as seed goes to the next as blossom and that which comes to me as blossom, goes on as fruit."

              Dawna Markova Author of Open Mind.

              Comment


                #22
                I can understand the thought process your going through. My son was injured out of state and we had similiar decisions to make. We decided to transfer him closer to home during a small window of time we had after he was stabilized. The hospital he was being transferred to was comparable to the one he was leaving. Both were large university hospitals. We thought it would be good for all of us if he was closer to home.

                Your son is obviously farther along with his recovery and transferring him should not be a problem. The company my son worked for, had additional insurance coverage for that transport. My son was airlifted and the additional insurance policy through a different insurance carrier, covered it. So, you might want to check with your contact at his company, to see if they do have a policy that covers transporting him to another facility.

                I think the decision to move my son closer to home was a good one. During rehab there were countless friends that lifted his spirits. The rehab was good and we were pleased with how well it went.

                At 5 months post injury, after he was stronger, he did another course of inpatient rehab at a facility that set the bar a little higher for recovery. We live in Ohio and went to the Rehab Institute of Chicago for further therapy. The time was right for more rigorous therapy and the results again, were good. I would think that the RIC and Craig are comparable. A Model SCI Center offers so much more. If you don't think the time is right to go to Craig now, try to go later. Don't feel pressured to do it now. Initially, rehab will consist of daily living skills which can be addressed at any good rehab center.

                At a Model SCI Center the therapies are so much more comprehensive and the doctors are so much more knowledgeable. After all, they treat SCI on a regular basis. With his PPO insurance, this should not be a problem. You will have to justify the additional therapy and I would be happy to share with you what we did to get it covered.

                I'm not sure how long your son's cobra will last. I would check into that and try to get as much therapy as you can during that time period. My son's cobra started 6 months out and lasts for a couple years after that. It's not cheap by any means but, it offers him options for treatments and rehab.

                Good luck with your decision and if you have any additional questions don't hesitate to PM me.

                Donna
                "Our lives begin to end the day
                we become silent about things that matter."
                - Martin Luther King Jr

                Comment


                  #23
                  Roger,
                  While it would be nice to have family close by it is much more important that he be in the best SCI specialty hospital/program he can get into, be craig or shepherd. He will be busy with therapy most of the day so time for family will be limited. The quality of acute rehab care will directly impact the long term prognosis. I can’t stress this enough,

                  The quality of acute rehab care will directly impact the long term prognosis.

                  It’s much more important to get to the correct facility than it is to have family nearby

                  Comment


                    #24
                    transport+insurance

                    I made a 4 hour trek from hospital to rehab and it was brutal. Just make sure he's got plenty of pain meds for whatever the duration is.

                    Your son should also have a death & dismemberment clause with his work life insurance. He will be eligible for a lump sum disbursement for quadraplegia/paraplegia depending on his injury level. quad pays higher than para. helped me out considerably when it came to buying an accessible home, and could give your son housing options as well.

                    Comment


                      #25
                      I also vote that the quality of the rehab is the most important thing in this short term. I base this on a few things which are actually assumptions, and the knowledge that rehab time is far too short. Family time is forever. Time with family during the crucial rehab days is a luxury, not a necessity. We were 25 miles apart, I saw my family 2 or 3 times a week. I lived for it but I wouldn't have died without it. (I was a grown woman.)

                      The MOST important thing you get in rehab is education. I'm assuming the education and information will be most complete if one is in the best rehab possible.

                      The 2nd most important thing is creative problem solving. I'm assuming that the best OT's (best imo meaning most creative) will be employed at the best rehabs.

                      PT-very important. Presumably the best staff and equipment, and the most cutting edge techniques, will be found at the best rehabs.

                      Nursing/support staff-Maybe this should be first. We need to get healthier and stronger in rehab. Bad staff when one is vulnerable will waste the precious few days of rehab, doing things like healing sores and uti's. I have seen some bad staff at a model sci center.

                      Much of rehab is simple gutbucket labor, that can be done anywhere. The expertise which is so important can't necessarily be found at any rehab on earth.

                      Good luck with your choice.
                      Blog:
                      Does This Wheelchair Make My Ass Look Fat?

                      Comment


                        #26
                        I would vote for the quality of a major rehab center also. Not only are the skills better, the peer support is a major advantage. The short duration allowed by insurance for rehab really dictates concentration on the task at hand and becoming self-sufficiant. Family and friends will be there when he's done but rehab and extended SCI education is usually a once only deal with many insurance companies. Best of luck.

                        Comment


                          #27
                          Choosing a Rehab Facility

                          Roger, I'm not sure how old your son is, but when my son was injured at age 18, we chose Shepherd Center in Atlanta as the best possible place he could be. We live in NJ and had a facility closer to home that the insurance company would have preferred that he go to, but we thought Shepherd offered the best care. It is a HUGE decision, but will affect SO much later on down the line. We (immediate family and some friends) were able to make the trip to GA from NJ quite frequently, but having friends around is really not the most important thing at this point. The support is wonderful, yes, but there is a lot to do and learn, and it is crucial that you learn the best care, techniques, etc. from the best staff available to you. As his mom, I stayed with him the whole time with just one short break at home. Shepherd has a wonderful program, as I'm sure Craig does, but I am not personally familiar with it. Do your homework and make the decision on where to go for the best reasons.
                          I am sorry you and your son and whole family are in this situation, but you will find wonderful support and good information here.
                          Any questions, please ask!
                          Oh, and just be sure to keep in touch with the ins co on a regular basis. You should be assigned a case manager and they can make all the difference in the world. But they need to know what you're doing - BEFORE you do it! Good luck.
                          Cynthia

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                            #28
                            Rehab Decision

                            Brian is much better. He's alert and can speak faintly. We're trying to get things arranged to send him to the Shepherd Center in Atlanta for physical therapy. We're getting some pressure from the case worker at the hospital to make a decision quickly. I was shocked Tuesday with Brian showed substantial improvement that the case worker really started pressuring us. She said we had to make an irrevocable decision on rehab almost immediately and if Brian went to the Barrow Neuro Therapy even for a day to get off of the expensive ICU floor he wouldn't be allowed to move to any other center for physical therapy. The thing that really shocked me was that just a day earlier they were telling us not to make plans ahead of where we were. Take it one day at a time. Fortunately the case worker at Blue Shield of CA was a lot more tolerant of our need for more information. She even said that she was flying to Phoenix to meet with us and Brian to help us through this whole process. I was surprised that she was going to come from somewhere in California to Phoenix rather than doing it over the telephone or internet.
                            When Brian is at Shepherd my wife and daughter will be with him. What kind of vehicle do we need to allow Brian to get out of the Center on Sunday when he wouldn't have rehab. I have a Ford Expedition but I'm not sure if Brian would be able to get into this vehicle. The seats are pretty high. I'm thinking that I'll either drive the car to Atlanta or have it shipped. The other option is to buy a car in Atlanta and then bring it back to Phoenix after the therapy at Shepherd is completed.

                            Comment


                              #29
                              Some people have mentioned this to you, but insurances are sort of weird while you are in the acute rehabilitation phase, they do not allow you to leave the hospital (on your off days). I.e. if you are capable of leaving the hospital on your off day, you are capable of going home.
                              Daniel

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                                #30
                                I had the same situation Dan has mentioned. He needs max number of rehab days. Don't endanger it with a day off!

                                During my initial rehab stay I was allowed to go home a few times. They discharged me for 2 months, waited for the c-collar to come off, then re-admitted me for 2 weeks. During the 2 week re-admission I wasn't allowed to go home at all. 2 of the longest weekends of my life...

                                During the first admission, there is so much to learn and do that I kept myself fully occupied. I barely had time to sleep.
                                Blog:
                                Does This Wheelchair Make My Ass Look Fat?

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