doctor Recommendation - Great! Like I don't have enough on my plate...

Discussion in 'The Watercooler' started by DaisyFace, Mar 1, 2011.

  1. DaisyFace

    DaisyFace Love me...Love me not

    Good news is - DS had a great follow-up with the Rheumatologist today.

    Bad news is - she has some concern about the flexibility of his knees and ankles. The joints are not quite behaving the way they should.

    So...the doctor said that she wants DS to start swimming laps in the pool on a regular basis.

    OK - great!

    Well, we don't have a pool. Don't have a friend/neighbor with a "swimming laps" kind of pool.

    Which leaves me thinking about swimming programs at public pools (I'm not sure what's here in town - not much, for sure) and/or signing DS up for a health club membership.

    And how in the world am I going to pay for that?

    Would it make sense to contact Medicaid to see if they will cover something like that?

    I hate being poor.

    And I hate feeling poor and stupid...
    (cause if you're poor, you're obviously a moron and ask dumb questions like about getting a kid into a pool program for "therapeutic swimming". Ugh!)
  2. DaisyFace

    DaisyFace Love me...Love me not


    Looks like the YMCA about 30 minutes away has therapeutic swimming...

    That might be a possibility!
  3. AnnieO

    AnnieO Shooting from the Hip

    The Y is a great idea!

    We have one close to us, and actualyl had a membership for a couple of years, until I let it lapse because it wasn't being used. Originally, it was so the kids could go there after school, but that was a nightmare. They promised "fun, educational activities" - which came down to letting the kids watch cartoons all afternoon. And I'm sorry, but Phineas & Ferb and SpongeBob aren't my idea of "educational".

    Otherwise, we only went to the pool maybe 3 times in 2 years - I actually only went once. So I said forget it - we aren't wasting money on this anymore.

    HOWEVER - if DS is getting use out of the pool - it's more than worth it.
  4. susiestar

    susiestar Roll With It

    I am sorry he is having a problem that needs the help of a rheumatologist at all - esp at his young age. Are the joints too mobile or not mobile enough, do you know? Or did she say they just were not moving properly? I ask because I had to see a rheumatologist for years and even though I was misdiagnosed the exercises and therapy I did made it so that I retained a lot of mobility in my joints that most with my problems lose early on. Regardless of the specific problems, unless he is extremely hypermobile, range of motion exercises done on a regular basis now can make a big difference in his adult life.

    What the doctor wants him to do is physical therapy. Some PT places have lap pools, at least here. Others just have smaller pools for stretching, aerobics, etc.... You will need to call around. If there is not a PT place with a lap pool, are there exercises he could do in a smaller pool that would help? The doctor needs to write a rx for PT that states what she wants him to do and also includes an evaluation. Often docs do not have a real clue what the PT (and/or Occupational Therapist (OT) if that would help, likely not in this situation) can do, so you will need to ask the PT if there are other things that can also help.

    If there is a YMCA in your area, they WILL let him swim. Most likely for free after you call and explain that you cannot afford membership but have a child who needs to swim regularly to treat a problem as recommended/prescribed by his specialist. They may want a letter from the doctor (both to see that you are truthful and to be sure he is healthy enough to swim and it won't hurt him). You will likely need to be there to supervise. They may not have open swim times, but if classes are not using the entire pool or if it is adult swim time and he will mostly leave them alone (under your supervision), they will usually let you use the facilities.

    They don't advertise this kind of thing, largely because a ton of people would take advantage of them, but I haven't heard of one that is unwilling to help in this kind of situation. When the docs said swimming would help thank you with Occupational Therapist (OT) stuff and help his muscles work up stamina (he couldn't do exercises, PE, etc... without tiring much sooner than his peers - part of the Sensory Integration Disorder (SID) problems according to the Occupational Therapist (OT) and PT people we saw) - our Y let us come in so he could do exercises and walk in the shallow end of the pool while the adult exercise and lap swim was going on as long as an adult was in the water with him.

    If you have an indoor public pool run by your community chances are that they will also allow you to use the facilities for free or a much lower cost. Otherwise medicaid MUST work with you to provide the care he needs. It won't be easy if there isn't a contracted PT place that has a pool, but they should.

    DON"T FORGET to search the website AND to call them to see if they pay for transportation. Here they do NOT come out an tell you this, NOT EVER unless you say something to them about not being able to get to to the doctor or whatever because you don't have a car, but they have a transportation program. With notice they will provide rides to and from an appointment or the pharmacy or they will give you an authorization number nad will reimburse you for your mileage. 24 hours notice is needed for most rides, but authorization numbers can be given the day of the appointment, though they like you to call ahead a day or two.

    With regular therapy needed, esp if you have to go to a nearby town, this could really add up.

    If the doctor doesn't want to do a PT referral, you will have to push her. Usually docs would give this to you on a prescription form during the appointment but the doctor may not be aware that if it isn't then medicaid won't cover it.

    There is no reason why medicaid would NOT cover this, as long as the doctor says it has to be done.
  5. Star*

    Star* call 911

    DF -

    This may be a longshot - but....worth asking because I also HATE being poor (I shall never admit to being stoopit) ---spellt wroung on purpis.

    Call Medicaid and ask them if they can write a prescription FOR therapy in a YWCA pool and then contact a local therapy place that has a pool -some doctors /rehabs have pools - and see if they will allow you to take DS there for 30 mins a day and have Medicaid cover it? OR....

    See if Medicaid will cover a Jacuzzi if a prescription is written by your doctor - and see if an in-home medication place will rent you one - covered under medicaid.

    I know Medicare paid for one for my mother in law to have in her home when she was disabled when the doctor wrote the prescription for it up to (years ago) like $5000 - maybe they'll pay for that pool thing?

    Or check with that pool place and see if they have any year end sales?

    I'm really out of thoughts past that.
  6. Star*

    Star* call 911

    Ohhhhh kay - I see Susie* beat me to this - so yeah - What she said. lol (she types really fast huh?) heheh
  7. susiestar

    susiestar Roll With It

    The Y will probably give the entire family a free membership with a letter from the doctor, but they could only do it for DS or for him and 1 adult to supervise him.

    There is NO REASON for you to bear the membership expense for this. Y's can be really expensive esp if your family is on a tight budget. The Y has scholarship programs already and when the services (like swimming) are needed for medical reasons they usually waive the fees. It is part of their national philosophy to be there for all families, not just the ones hwo can afford them.
  8. DaisyFace

    DaisyFace Love me...Love me not


    His ankles are too mobile and his knees are too stiff.

    I didn't think quickly enough to ask for an official PT referral...


    That's a good idea! I will have to call Medicaid and see what would be covered under a doctor's orders.


    Yeah, I hear ya! Memberships are very expensive if nobody is getting any use out of it...
  9. slsh

    slsh member since 1999

    Another thought would be Easter Seals and/or Shriner's (if there's one in your area).
  10. susiestar

    susiestar Roll With It

    The doctor can do the rx and referral if you call. medicaid will likely tell you that they need a doctor's rx before they can tell you if it is approved - at least that is how it works here.
  11. DammitJanet

    DammitJanet Well-Known Member

    I know for a fact that medicaid will pay for PT. Now I am really interested if Medicaid will pay for a I have done PT several times. Normally health clubs are also associated with some sports medicine or orthopedic doctors so they have a PT dept there. At least the larger health clubs will. Look for one that is associated with the hospital. You will need the rx though.
  12. shellyd67

    shellyd67 Active Member

    Good Luck with the Y .. I hope it works out !!!!
  13. DaisyFace

    DaisyFace Love me...Love me not

    A jacuzzi? Whoo-hoo!

    Seriously though - I hadn't thought in terms of "Physical therapy" in the doctor's office....because those were not the words she used. She said that she wants him to start doing laps in the pool - regularly.

    So my brain went "Pool? Kiddies pools I got....Pools for 'laps' ? Not so much..."

    So I was focused on "Pool" instead of "Therapy".

    I'm going to discuss this all with husband tonight....probably check out the Y....and then call the doctor back and see if we can get an actual 'script' written for PT.

    I'd be happy with just some assistance paying for DS to have access to a pool - whether that means Medicaid pays or the Y drops the fee - either way, I am happy.

    However, if they offer a jacuzzi or one of those 'endless pools' - I'd be happy to accept! (Though I won't be holding my breath in the meantime!)

    Thanks for the great suggestions!
  14. JJJ

    JJJ Active Member

    How about the local high school pool?
  15. HaoZi

    HaoZi Guest

    I had a family membership at the local Y last year. They do have a financial aid program, my ANNUAL fee was I think about $218, which I paid in full using tax return. Couldn't do it this year because my truck ate the last of this year's return, but hey, brakes are important, and I can work out at home if I can get my happy hindquarters motivated even if I don't have anything but free weights.