Choosing rehab hospital

[rider76]

Because I am considered "elderly" and live alone, my surgeon has told me that, after a 7 day stay in the acute hospital, he wants me to go to a rehab hospital for another two weeks. Due to many orthopedic surgeries, I've had enough experience with rehab hospitals that I want to choose my own this time.

I started with the medicare.gov site to check the ratings of facilities in my area and narrowed my initial choice to three. When I walked in the door of the first one, I was met with an odor of urine and cabbage - I turned around and left. The second one (with the highest rating in all categories) has 96 beds, but some are three to a room built for two beds. I visited after lunch and most of the patients/residents were dressed and outside with good supervision. Their physical therapy room is well equipped with modern machines. The facility is situated on a very busy highway and traffic noise is an issue. My own doctors don't have privileges there and I would be assigned a new one for day to day care, though my surgeon would be called if there were problems.

The third hospital is smaller and closer to my home. It has 56 beds - all in 1 or 2 bed rooms. It is set back from a city street, backing on parkland. The physical therapy room has no machines and depends on therapist-directed exercise. I met the director of nursing and she was very personable and described the personal services available. I was allowed to examine a room, including bathroom and the shower room. My internist is on staff there. This is the only one that offers a reservations system, meaning that if I choose it, my bed will be guaranteed. I don't like the last minute scramble to find available beds, sometimes landing in a less-than-desirable location.

My gut is telling me to go with the smaller hospital, despite the lesser-equipped PT room. I need to make my decision by Monday, when I have my final pre-op appointments. Surgery is Wednesday. Does anyone have suggestions that I should consider in choosing the rehab hospital?

Catherine

 

[Mentu]

Hi, Catherine, this is not a decision I needed to make but I helped my Mother to make a similar choice. I would definately go with the site near your home and for the following reasons. First and foremost, a few days after your surgery whether old or young, you are not going to be using a lot of machines. My surgeon and all of the others I have knowledge of, tell their patients that during the early weeks after surgery they should practice their breathing exercise and walk, then, as you begin to feel better start doing light chores around the house. Outpatient Cardiac Rehab doesn't normall start for 6 to 12 weeks after surgery when one may begin using mechanical exercise equipment. During those two or three months, regular walking is about all you should expect to do. You are not going to be "pumping iron" soon after surgery.

I think it is far more important to have a site where one can be as comfortable as possible because how one feels makes such a difference when it comes to getting out of bed and you will most definately need to get out of bed and walk several times a day. Having a skilled therapist could be very helpful with the little things. You may need to be shown how to move more carefully when getting out bed or out of a chair. You may need some encouragement doing your breathing exercises regularly. And, at first, you may feel more comfortable having someone with you when you go walking. But as for "machines", all you need are your lungs and your feet for those early weeks. Finally, I should mention that the oldest member of my Cardiac Therapy group was 82 years old. She started group therapy at 10 weeks and often walked us into the dust and some members of our group were in their 30s recovering from bypass surgery - I was 59 (just the basic AVR). I say go to a facility where you will be most encouraged to breath and walk, move home as soon as you are ready and, when your Cardiologist recommends, start Cardiac Rehab with a group where you will find a lot of support and, yes, some machines but that is for later.

Larry

 

[MrsBray]

I had an OT and a PT visit me in the hospital and at home. The OT was concerned with what I could do for myself, such as getting dressed, preparing food, taking care of myself in the bathroom etc. I used no machines with her. The PT was concerned with how I moved my body to accomplish those chores, ie stand up/sit down, in/out of bed, and walking. The only "machine" I used was a walker for my first few walks. I'm 5 weeks post op, and the only thing I've done other than walking and breathing has been very light weight lifting for muscle tone. VERY light, like 3 lbs. And I didn't even do that for 3 weeks! My advice is to choose the place you will be the most comfortable and get the most rest. It's not really "rehab" that early, so much as "rest and recuperate"! Good luck!

 

[epstns]

Larry (Mentu) reminded us of how it usually works after valve surgery. I would agree with his advice - the type of "rehab" you will need for the first couple of weeks is that which will enable you to become self-sufficient at home once again. That means lots of walking and breathing exercises, as well as learning new ways to do simple every-day things without pain or strain. The "heavy" rehab usually doesn't start for a couple of months, once you've had a chance to heal some more.

So, go with your gut. Choose the facility where you will be most comfortable while you continue healing. You can look into cardiac rehab when you're back home and ready for a new challenge.

 

[tom in MO]

Choose the facility where your internest can go and you get a reservation. Planning and your own doctor is what you need to feel secure. My cardio team starts rehab about 3 weeks after release thus not having machines is not a problem.

 

[river-wear]

I agree with everyone else - go with the 3rd one where you can reserve a room and have one less thing weighing on your mind. It sounds like it has everything you will need in the early weeks after surgery, while being the most comfortable for you.

Best of luck for your surgery and a speedy recovery!

 

[Jkm7]

Hi, Catherine, this is not a decision I needed to make but I helped my Mother to make a similar choice. I would definately go with the site near your home and for the following reasons. First and foremost, a few days after your surgery whether old or young, you are not going to be using a lot of machines. My surgeon and all of the others I have knowledge of, tell their patients that during the early weeks after surgery they should practice their breathing exercise and walk, then, as you begin to feel better start doing light chores around the house. Outpatient Cardiac Rehab doesn't normall start for 6 to 12 weeks after surgery when one may begin using mechanical exercise equipment. During those two or three months, regular walking is about all you should expect to do. You are not going to be "pumping iron" soon after surgery.

I think it is far more important to have a site where one can be as comfortable as possible because how one feels makes such a difference when it comes to getting out of bed and you will most definately need to get out of bed and walk several times a day. Having a skilled therapist could be very helpful with the little things. You may need to be shown how to move more carefully when getting out bed or out of a chair. You may need some encouragement doing your breathing exercises regularly. And, at first, you may feel more comfortable having someone with you when you go walking. But as for "machines", all you need are your lungs and your feet for those early weeks. Finally, I should mention that the oldest member of my Cardiac Therapy group was 82 years old. She started group therapy at 10 weeks and often walked us into the dust and some members of our group were in their 30s recovering from bypass surgery - I was 59 (just the basic AVR). I say go to a facility where you will be most encouraged to breath and walk, move home as soon as you are ready and, when your Cardiologist recommends, start Cardiac Rehab with a group where you will find a lot of support and, yes, some machines but that is for later.

Larry

Excellent post.
I totally agree.