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I've had a bad hip for about the last 15 years. Never saw anyone about it because there's never much they can do and it cost more money than I could spare to get it treated. I just dealt with it.

Recently it's becoming more of a problem because I have almost no range of motion in my hip anymore and it hurts more and I limp more. I don't even stand right at this point.

So I go to the doc on Monday and he says... there's nothing I can do for you, you need total hip replacement surgery. The joint is severely degenerated, there is essentially nothing at the weight-bearing part of the joint. The ball of the femur is becoming misshapen because bone is grinding on bone, and he showed me where the "bone dust" that used to be part of my femur is accumulating. Nice

I'm told it will be 3-5 days in the hospital, and then an 8 week recovery before I can think about going back to work. Minimum of 4 weeks of no driving. Lots of physical therapy. Blah blah blah.

Anyway... I have good health insurance. But- I have no disability insurance because my employer doesn't provide it. So I would have to take all of my vacation for the surgery and still would be without an income for 5 weeks. I would have to continue to pay child support out of pocket whether I had an income or not. $1k deductible for the health insurance, plus co-pays. All told, I figure that I will need about $6500 in cash to cover expenses during that period, over and above what health insurance will pay.

On top of all that, I live alone. In a house with the bathroom on the second floor. No family in the immediate area except my sister. My sister has offered for me to come stay with her for a few weeks, but I have a dog, and she has two young daughters with autism and a husband I would kill with my bare hands if I had to spend more than a couple hours with him. So no.

So I won't be having total hip replacement surgery any time soon. I can buy a lot of Aleve with $6500, and I can live in my own house and keep earning money. Nuff said.

Just a thought (and I live in Canada, so I don't know about US)...but can you apply for unemployment insurance for the time you are off work?

Or, can you get welfare benefits for that period?

This is from Canada:

Employment Insurance Sickness Benefits

Employment Insurance (EI) provides Sickness Benefits to individuals who are unable to work because of sickness, injury, or quarantine.

It's doesn't say "surgery" but I'd think that would fall under sickness or injury.

[This message edited by JanetS at 11:13 AM, August 21st (Wednesday)]

(((Eranda)))

I would encourage you to re-think everything and consider having the hip replacement. I fear you will be in more pain and more time off work if you don't do it. My father had his hip replaced and his recovery time was actually a lot faster than any of us expected. And after he was healed he felt no more pain anymore.

I understand the stitch you are in but re-think and see if there is actually a real possibility you can get this done.

Just had another thought...you say you have to pay child support (can you double check that???). Maybe you can make it back up AFTER you're back at work.

And since it sounds like you don't have a convenient place NEAR you to convalesce, it is possible you could go to parents or other friends/relatives who live further away. This might involve having the surgery elsewhere, closer to where you'd be healing, but that might work???

I agree with click....to wait may make the situation much worse, and the recovery longer. And, as click stated you MAY heal quicker than you think. Are you at a desk job? Perhaps you could get back earlier, using a walker to help you around?

[This message edited by JanetS at 11:43 AM, August 21st (Wednesday)]

Insurance may pay for a rehab facility until you can return to your home. There are home health services that can help you once you return home. Many hospitals have classes about the procedure with case managers that can give you more info about what to expect, recovery, services available, etc.

Keep wearing that hip down and you risk additional damage to other joints because of compensating for this hip.

Assuming you work in PA employers are not required to provide temp disability insurance. However you can get it for yourself through your employer at a group rate. I pay $12.05 every 2 weeks and it's taken out of my pay check before taxes.

honestly, i would check with social services at the hospital or see if your doctors office has networking with any social services.

The hospital I worked with had TONS of help for those that needed it. They had tons of volunteers that woudld help patients. (granted this is for achildrens hospital, but still, i am sure programs are everywhere)

I remember one story, the parent was in Indy for vacation when their child was hurt very badly.

The social worker here found the mom a rental and worked with the owner to get a better price to help with cost, then turned around and worked with community networks to get that paid for.

She mobilized a few more to go to this woman's house and take and foster her animals here, gather needed things from her house, and to close up her house in another state.

the SW went above and beyond, they ended up being here for about 4 months.

Don't give up on it, ask around, see if there are programs that can help you out.

Just a thought (and I live in Canada, so I don't know about US)...but can you apply for unemployment insurance for the time you are off work?

Or, can you get welfare benefits for that period?

The US has no unemployment unless you are actually unemployed. We have FMLA but that is UNpaid leave.

Just had another thought...you say you have to pay child support (can you double check that???).

Yes, I have to pay it by court order unless there is a modification. Temporary disability is not considered a modify-able event because I will be going back to work.

it is possible you could go to parents or other friends/relatives who live further away.

My family is across the state, across the country. I can't take my dog with me, or leave her somewhere for months. My parents are older and live in Florida. And my kids are here.

Insurance may pay for a rehab facility until you can return to your home.

I don't know about that, it's possible. But in the meantime I still have no income, which is a huge problem. I'll talk to the insurance company though.

I pay $12.05 every 2 weeks and it's taken out of my pay check before taxes.

You are very lucky, you must work for a union. Where I work we just had the enrollment period for STD coverage and for my age and income it would have been about $54 a pay period. I could wait until next year and enroll, then wait another year until the waiting period is up and I can draw benefits. I still haven't gotten a straight answer on whether this will now qualify as a pre-existing condition- because most STD plans don't cover pre-existing conditions. In fact I've read that they will refuse you coverage entirely if you have one, although I haven't tested that obviously.

I do understand everyone's concern that not getting the surgery will make my hip worse. I asked the doc what I should or shouldn't do in the meantime and he said that nothing I can do or not do will make the surgery more difficult or less successful since they will be basically replacing everything anyway. He said if I can manage the way I am and I can't make the surgery work he at least wants to see me back in a year to take another x-ray.

The problem really is that I cannot go two months (or even one month) with no income. I am the sole earner in my household and I have to pay the bills.

In January I will have three weeks of vacation again but that still leaves me with 5 weeks of no income- that's too much, especially when I have to pay child support out of pocket even with no income.

I'm not thrilled about this. But I have to be realistic

Well, the good news is that the Dr. said you aren't risking future health by delaying.

Maybe over the next year you can save as much as you can so that you can get this surgery done down the line.

In the meantime I do hope that you can find a pain med that works for you.

My hip acts up from time to time. My Dr said that down the road I will probably need a replacement, but not yet.

You are very lucky, you must work for a union. Where I work we just had the enrollment period for STD coverage and for my age and income it would have been about $54 a pay period. I could wait until next year and enroll, then wait another year until the waiting period is up and I can draw benefits. I still haven't gotten a straight answer on whether this will now qualify as a pre-existing condition- because most STD plans don't cover pre-existing conditions. In fact I've read that they will refuse you coverage entirely if you have one, although I haven't tested that obviously.

I do not work for a union. The place I work employs around 50 total people. The disability coverage they offer us is 100% employee funded. Our benefits here are horrible. Medical is $3000 deductible with huge co pays and no dental.

Errands, not sure what kind of work you do, but you may want to talk to your boss about working limited duty or from home for part of that time. Most people who I know have had this done are within 3 to 4 weeks walking much better than they did before. They may still be tired a lot and have to rest some because it is a big procedure. Although there are some procedures now for this that are much less invasive.

I think you are selling yourself short by not exploring every option before you make a decision to ignore something like this. Chronic pain will wear on you (and likely your job performance) as surely as that hip keeps grinding down.

Also, kudos on the stop smoking!! You will heal much quicker post op if you are not smoking.

Eranda - You probably don't have to do this immediately but it is time to start planning.

As far as the bills and cost of surgery, if financially you are strapped you need to let the hospital, and all your Dr's know that they can't get blood from a stone, and they need to work with you on a payment plan option of some sort.

Next after surgery- Depending on your insurance you most likely have a benefit that includes rehab. That does not mean you get to stay for the full 6 weeks, but it does mean that they will pay for it for a period of time until you can be independent again at home, usually someone who is still working would be about 2 weeks. The bathroom on the second floor is not a huge issue, by that time. You get a commode, and you get home care, with PT/OT coming to the house a few times a week.

Most folks say recovery from a THR is much easier than a knee. Also if you work for a larger company you need to talk with them about coming back at "light duty" status once you are up and around, and off pain meds.

Most employers will work with employees on this.

Lastly if you just say never, and don't prepare for it, you may end up caught completely unprepared, when one day you bend the wrong way and snap. And yes it happens. Then you won't have a choice.

Is there anyway you can save your vacation time, from the end of one year, and the beginning of the next, so say in 2014 you get 3 weeks, you save that until November, have surgery, and then bridge it with the 3 weeks of vacation you get again on 1/1/15. Just an idea.

I just had surgery and hospitals will work out payment plans for ya. I might be paying for 100 years though

I would check on any loans you might have to see if they offer a temp suspension. Some places will let you suspend payment for a couple months (but you still gain interest).

Once you have a list of what you HAVE to cover during that 2 months, can you get a loan for that amount? Granted, you would be paying on it for a long time but it is usually a lot easy to pay a little amount on a loan for years than to save up 6500.

I understand all the consuming obstacles, but limping and not being able to even stand right are huge.

PS - how many more years do you have left to pay CS?

[This message edited by EvenKeel at 1:35 PM, August 22nd (Thursday)]

Walt, sorry to hear that :(

Luckily I have very GOOD insurance- deductible is only 2k and employer pays half of that. After that insurance pays 100% aside from co-pays which are reasonable.

So the cost of the actual surgery is not my concern. I could come up with the 1k for my part of the deductible but the co-pays for all the physical therapy might be a problem on top of that. But I would figure that one out, it's not undo-able.

The biggest problem is not having any income for the duration. We cannot bank vacation time at my employer, it's use it or lose it. So 3 weeks is the most I could use in any given calendar year. That still leaves 5 weeks unpaid.

I still don't have all the info on what would or wouldn't be covered (and when) under STD if I enrolled next July. I'm working on gathering that info.

I did speak to the insurance company about short term rehab or visiting nurse type coverage, and I DO have that if the doc gets pre-authorization. I spoke to the doc's office about how that works and they told me that the hospital caseworker arranges it after surgery. Of course... I can't get surgery not knowing whether it will be approved- I can't put myself in a position to have to leave the hospital and come home alone with no help. So I left a message for the caseworker, she should be able to give me an idea of what criteria they use to determine whether it's considered necessary and would be covered. Even so, it's a risk because they could decide after the surgery is completed not to cover it and then I'd be screwed. But at least I can get a better idea of my chances.

I've already paid most of my deductible for this year, so if I could manage to get the whole thing done before the end of the year I could potentially do it with little cost to me, which would be ideal. However I only have 7 days vacation left for this year so that would leave me with 7 weeks unpaid and that doesn't work.

I'm working on collecting all the information I can so I know what my options are. They are pretty limited at this point, though, I can say that.

I'm trying. I am scared of being alone in all this and ending up losing all the financial groud I've gained since the divorce, but I'm trying here.

Eranda: Check out a joint surgeon in your area who does ANTERIOR APPROACH CERAMIC TOTAL HIPS. This is a minimally invasive Total Hip. These are far different from your run of the mill TJR hips that take two months to recover from and months of therapy. Trust me here. I just had both of my knees replaced using minimally invasive surgery. I was off work 9 days for the first one and 2 weeks for the second one. There was a gap of 5 weeks between the two surgeries. Anterior totals are only done in a few centers in each state because they take special equipment and special training, but they don't cost more, and they offer you, a MUCH faster healing because they don't go cutting threw muscle, a smaller incision, and far less of a rehab. From what I have heard from patients, especially females patients, they can go back to work in 2 to 4 weeks depending upon their job. With my knees, I had a stand up job, and I did fine with the standing and walking, it was the sitting that killed me. Rising from a sitting position was painful for a while. But if you are not in a rush, you can do it. That was KNEES though. I would do some research and see what you come up with. See if there is anyone in you area that does anterior total hip replacements, and then make sure they do a fair number of them and have good success. And go talk to that surgeon. I work in the operating room, and i can tell you, that the patient satisfaction with these in comparison is quite high. I need a hip done in the next 10 years, and that is definitely the way I'm going to go. I am the sole support of my kids as well, and I cannot afford to take off more than 3 weeks for anything. As far as disability insurance. Call AFLAC now, and see if you can afford insurance. There is also a policy that is fairly affordable from American Family i think. It does pay some for this kind of thing. Check in to those. Best of luck.

I don't think you understood. Save your 3 weeks in 2014 until there are only 3 weeks left. That way you run your 3 weeks from 2014 into your 3 weeks in 2015. Yes it will suck to have surgery through the holidays but you will be able to add in those holidays into your 3 weeks. Therefore you get paid all 6 weeks. If your plan truly pays 100% after deductible then you are in good shape.

You will be able to go to rehab and insurance will pay for it. As long as you participate in therapy like I said that will be about 2 weeks. Your home therapy wil also be covered and I believe you don't have to pay copays for each therapy session as an outpatient when it is under a surgical deemed necessity.

Now as far as finding out what insurance will pay you need to look into what your "skilled nursing" benefits are and what facilities participate with your plan. Your insurance most likely WILL NOT pay for acute rehab ( in hospital) rehab for a hip unless you have a secondary issue like a stroke.

Talking with the hospital case manager for the orthopedic section is very smart that's what they do all day every day. I did case management in the hospital setting and those are the rules and tricks I know of.

Eranda: Lots of good advice here. Time to fact-gather and figure it out.

Do you have many years of CS left?

Any chance that you can do part of your job from home on a laptop?...maybe getting at least a "part" salary.

15 years of pain does not sound fun. And now it's getting worse. I hope you are able to figure this out and can get this done in a year or so, if not before.

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just read Tushnurse's suggestions (she's good). Sounds like that might be do-able.

[This message edited by JanetS at 6:43 PM, August 22nd (Thursday)]

Tushnurse, you're right... I didn't understand. I see what you mean about getting six weeks from one year into the next.

Yeah it would suck to have surgery two weeks before Christmas but... but but.

And that means no vacation time at ALL for two YEARS. That really sucks :(

Only problem there is that I would have one deductible in 2014 and then another would start two weeks later in 2015. That would double my out of pocket costs... but it might be offset by using my vacation time and getting paid- I'm not sure I have to think about that.

The insurance rep did say that any inpatient PT is covered as part of the hospital stay, and it would be covered as part of the inpatient short term rehab stay... but once I'm released it's $35 a pop.

AFLAC doesn't sell STD individually, you have to buy it through your employer. And as far as I know, any STD plan has a waiting period, most of them are a year I think.

Your only bathroom is upstairs and you live alone. You are going to be covered for some rehab and at home pt.