Medical Care for the Uninsured

If you don’t have medical insurance and you’ve ruptured your achilles tendon, here’s some information that you may find useful:

  • Tom’s post on Cost of Medical Care for the Achilles Tendon Rupture in the US: Cost of Medical Care for the Achilles Tendon Rupture (Also, be sure to read Jim’s comments where he was able to negotiate with the hospital to lower the cost of care. He was uninsured at the time. Since he is a nurse, he knows how the hospital system operates and was able to save a lot of money. Daveleft also has some helpful information.)
  • (I bought this book, and I’ve learned a lot about health insurance. For example, it really makes a difference which state you live in.)

24 Responses to “Medical Care for the Uninsured”

  1. Doc Ross,

    Did you wear the Achilles Train Pro SUpport on your hike? Are you using it anymore?

    I am 10 weeks post op, adn ready for two shoes June 16th!!

    I take my boot off at night, and walk around my house (and office) all day without the boot, barefoot (I work out of my house). I am hoping to surf again on 4 more weeks.

  2. I thought I would share this with my fellow ATR breathren.

    When I did my injury, I, like many of you, thought why did this happen to me? I am a good guy, have coached every sport for the last 17 years, volunteer for everything, etc. etc. Why me, and why now?

    I am divorced, and a single father to three, including a 4 1/2 year old. I have an almost 18 year old son,
    who has had problems with drinking, pot, etc. A good hearted boy, but going down the wrong path.

    I wasn’t even sure if he was going to graduate this
    year.

    Well, when the injury happened, I was really concerned about running the household, taking care of the young one, and how the heck was I going to handle my installation business? I climb on ladders for a living!

    In the past two months, Shaun has not only taken over all household chores, but taken over my business, worked his ass off at school, (yes, he is going to graduate next week), stopped smoking pot, and barely drinks.

    He has grown up BECAUSE he had to step up (well, he didn’t have to, but he certainly did). He has really matured, and I think because I can be overbearing at times, but could not with this injury, that we have become much closer as father and son.

    I could not be more proud of what he did for me and our family.

    So, there was a reason for this to happen! And I would do it again if I knew that the outcome would be this great.

    It’s a cliche, but everything DOES happen for a reason!

    Mike

  3. Mike R. - That is a GREAT story. You must be extremely proud of your son, as well you should be. It’s funny how a single event can have such a strong impact on our lives. Keep working hard and soon you’ll be back on those ladders.

  4. Hi Mike,

    This is a great story, and certainly a silver lining. Make sure to tell your son you are proud of him and appreciate all he has done for you during this process.

    Craig

  5. Awesome strory!! I have found a few silver linings with this myself..make the most if your downtime…kevin

  6. Anyone–can you get these compression socks at any store or do you need you need a prescription?? Any ideas on a good brace, I think I may wear one when I go back to work(UPS guy)…doctor hasn’t said anything about it and pt said I would use it as a “crutch” if I got one now..but I think for a good one I will need a prescription….thanks Kevin

  7. kev - i never got a pair of the compression socks, but looked at a pair in a pharmacy a few weeks back. they were right on the rack near the braces/supports and no script was needed.

  8. What are the solutions to problem of providing adequate health care for the uninsured?

  9. My husband and I are self employed and have no health insurance. What we have found is that if you pay cash they give you deep discounts, just ask. The hospital I was in takes 40% off the total. Most of the Doctors and related services will take at least 15% off. we were sent a form to apply for a further reduced or forgiven bill from a thing called Med Pay. We came out far better than if we had been paying on insurance all these years, since we’ve never been sick or injured before. We have been looking into getting health insurance with a $5000 deductible, because we aren’t getting any younger!

  10. Check out my blog for the new evidence (post-2007) that skipping the surgery can produce outcomes just as good as having the operation, same strength, same range-of-motion, same re-rupture rate — and LOTS less expense!

    The evidence is in FOUR randomized prospective studies, all producing the same shocking results. The info hasn’t worked its way “through the system” yet, and lots of surgeons and PTs (and coaches, insurance companies, teammates, friends and relatives, etc., etc.) haven’t read the studies or “gotten the memo” yet. When they do, I think the WORLD will save a lot of money on ATR surgery, not to mention saving some pain and suffering, too.

    BTW, the modern non-surgical protocols do NOT much resemble the traditional “conservative” protocols, that involve long periods in a series of casts. We’re talking about an orthotic walking boot (preferably hinged) from the start, non-weight-bearing (NWB) for only TWO WEEKS, fully WB from FOUR weeks, and out of the boot at EIGHT. And starting Physio at TWO weeks, too. This is not your Grandfather’s non-surgical protocol, and the results aren’t like those, either.

    The randomized trials say that you do NOT get what you pay for with ATR repairs!

  11. Just came back from the Doctor, and he said I need surgery.

    My achilles tendon got injured. I am trying to obtain information on recovery without surgery. If anyone has more information on this topic, please send me email at: rrt.raf17@gmail.com

    I would love to learn about how to heal the tendon, without surgery if that is even possible.

    Many thanks
    rrt

  12. Look up normofthenorth’s blog.

  13. Thanks, Ifixteeth. Haven’t heard from you recently, have we? Hope that’s because it’s going well. Post an update, pls.

    Rafael, I’ve just sent you an e-mail, and I plan to post it on my blog for future reference — as “The case for skipping ATR surgery”.

    Good luck, and Good Healing!

  14. It’s posted now, newest page of my blog, at achillesblog.com/normofthenorth .

  15. Norm, I am doing just fine. Coming up to 8 months, post rupture and no surgery, I am back to my usual activities. Can’t do any one leg heel raise yet, but I think in my case, I have not been consistent in doing all the strenghtening exercises that my physiotherapist has advised. I am back to the gym now that the gardening season winds down so I am sure that will help.
    I am very happy that I avoided the surgery and I want to thank you once more for all the information and advice.

  16. Glad you’re happy, Ifixteeth, and sorry your one leg heel raise is still elusive. Mine (at 10-ish months) is better than nothing — and better than it was at 8 months — but still way wimpier than the other side. Several of the other non-ops here are building strength faster, though I don’t think anybody’s close to keeping up with post-op elsurfer.

  17. TO THE UNINSURED…

    This post will probably make a lot of fellow rupters feel better, which is my hope. Full rupture Jan 26th, 2012. Even though I’ve never felt that “Bat to the ankle” feeling before, I kind of knew something was serious when I went down in a game of basketball. Just felt wrong and I did the typical “Look around for the person who stepped on my ankle” thing. I tried to walk it off but it felt like I had just put on those hideous Sketchers curved fitness sneakers. No pain really, just weirdly uncomfortable. I had the peg-leg, flat-foot walk.

    I was laid off in July of 2011 so I had no insurance. I was freaking. AND, to top it off, my wife and I were moving from Chicago to NJ in 3 days w/ enough stuff to fill a 16′ truck and 2 cats, one of which likes to sh!t in various places. I was in honest shock by what had just happened. I came home and we did the research, leading me to this blog. I was trying to crunch the numbers to see what type of set back this was going to create (financially and mentally.) It was just the worst possible timing for all this. That first night I cried for the first time in years. Like many of you I’m sure, I kept thinking about a life without active sports. A $10K+ bill, confinement for 10 weeks, depending on my wife for all the little things and so on. It was overwhelming.

    I’m glad I didn’t head to the ER, which would’ve been costly for nothing more than the slightest peace of mind. I knew what I did. I wasn’t in pain. A therapist would’ve been more effective that first night :).

    I had no choice but to put off this injury until we arrived in NJ in 5 days. I helped where I could, but the heavy stuff we moved was left to my good friends. I still hobbled fairly effectively, but no progress in the heel (Which was only wishful thinking.) Pretty much stayed the same until we arrived. I did buy a pair of crutches off Craigslist ($15) and an ankle brace at Walgreens ($32.) Did the trick. But doing this move while being on crutches for the first time in my life (37 years) was a humbling experience.

    We arrive in NJ, had help to unload and was now focused on this friggin heel. I decided that heading straight to the Ortho was my best bet as an uninsured citizen. Called around, read reviews and set something up w/ a $250 initial visit doctor in Linden, NJ (Follow up visits are $75.) I was also looking for docs that were known to be conservative in their approach (within reason of course - I still want to do this the proper way.) I was assigned to my man Walter Pedowitz, who has accolades that rival the best. Great guy, and his easy-going personality kept me at ease (I asked what to do if my leg itches, and he said to scratch my nose.) He’s a big proponent of the non-surgical route and said most of his colleagues are doing the same these days. Not much of a difference in the re-rupture rate plus no complications of surgery. That’s good and all, but to be honest, I was only concerned w/ the final tally if you know what I mean. He put me in a hard cast, NWB, crutches etc for 6 weeks. This will be followed by 4 weeks in a walking boot. 10 weeks, which is normal.

    OK, so to summarize at this point in this journey::::::

    I’M RELIEVED! Yes, 10 weeks is a long recovery time. I will probably never be the same on the court again. I’m already a little set back by the isolation this has created in my life. We are moving into an apt in the Lower East Side Manhattan at the end of Feb. I will still be on crutches and that doesn’t seem practical in a city like NY. Not at all actually. BUT, I may come out of this being better off WITHOUT insurance. If all goes as planned, I may be in for under $600 total (PT not included.)

    Cast and Initial Visit: $250
    A few follow up visits: $225
    Boot: >$100.
    Crutches: $15
    Shower cap: $12

    Sh!t happens, and I just experienced it first hand. It’s been two weeks and I’m trying to feel better about my situation. At least it’s the middle of winter and not summer. Thank the lord it wasn’t my driving foot. It’s all about the positives right? Thanks for letting me share my experience.

  18. Bells, if you can convince your Doc to follow the somewhat faster non-op schedule in the very successful “UWO” study, you can be walking in a boot (FWB) just about when you arrive in NYC. If your Doc’s results are better than theirs, he should publish them. Their ~75 non-op patients had 3 reruptures (pretty close to the irreducible rate of accidental falls, IMHO) and strength & ROM that were statistically equal to the surgical group — i. e. very good!
    The full UWO study is on this web-site, with a link to the protocol near the bottom. I’ve posted a bit.ly link to it many times, but I don’t have it in the iPod — maybe bit.ly/UWOProtocol ?
    I’d print them both out and share them with your nice Doc. (If he resists, roll them up and hit him with them!) ;-)
    Especially on the non-op track, going relatively fast seem to produce better results. UWO introduced FWB starting at 4 weeks post-non-op, and exercise and PT start at 2! They also saved the cost of a cast by starting with the boot, BTW.

  19. Wow. Thanks Norm. I’m going to call my man up and discuss this b/c it’s only been 10 days or so and I’m dying over here w/ this cast. Would rather be doing something practical like PT. Appreciate the advise.

  20. hey Norm of the North
    email me please
    djh232@hotmail.com

    I tore my AT fri night, cast sat morning.
    it is monday night the 5th now.

    i am going NON Surg route and need some tips ASAP

    thanks,
    DJ

  21. Tore my AT exactly 2 weeks ago today. Went the non surgical route too. I’m getting my cast changed on Thursday. Based on the good results I’ve been hearing about , I’m glad I went the non surgical route.

    For me, there really doesn’t seem to be much to do for now outside of elevating my foot, icing it. and being careful Here’s a few tips from my fist 2 weeks:

    The outside of my cast is pretty coarse so when I go to bed, I stretch an over-the-calf athletic sock over it. It keeps my other leg from getting scratched by the cast. I’m on a blood thinner to prevent clots from forming from being in the cast so I sure don’t want to do anything that’s gonna break the skin.

    Learn how to use your crutches. There are some good videos on YouTube for that. I’ve been able to drape some bags on my crutches so I can carry stuff.

    To wash up, I’ve been sitting on the floor of the shower using a hand held shower head. The foot is elevated with a waterproof cast protector around the cast and a towel over that to make sure the cast stays dry.

    Hopefully you have some people close to you that can help you out with chores. Live one day at a time and have patience. Trust your doctor. Yet do as much research as you can and this site is a great source for it.

    Hope this helps. Good luck.

  22. i wish for your healthy life……….

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  23. I ruptured my Achilles three weeks ago but I got my cast just two weeks this wednesday I have a visit to the doctor to take the hard cast I choose non-op and I’m Ok with that just very anxious about how long take the recovery =(

  24. johanna - I see that you are quite anxious about the recovery and that would be normal. If you hang around this site long enough you will come acorss Norm. He will give you some good advice regarding non-op rehab but essentially it will take the same amount of time to completely heal. You will have to start thinking of the long term and not this intitial healing stage which seems like a long time but in fact it is only the beginning. You will have to be careful for at least 12 weeks. That is when the risk of re-rupture subsides (not goes away). You will most likely be locked in a cast or a boot for a couple of months. Much will depend on the approach you doctor takes and how much you want to advocate for yourself once you have learned a bit more. There are some links on this site to many papers written on this injury and I also have some useful links on my site (xplora). I always suggest people understand how tendons heal as it is different to other soft tissues. Barring any setback, you should be back to doing most of the things you did before by 12 months but life will become better much sooner than that. It is important also that the people closest to you understand how slow this injury heals. Visit normofthenorths site for further reading regarding non-op protocols. I am an advocate of early weight bearing and movement and the use of boots instead of casts. I went the surgical way but my father was non-op and in 2 shoes at 7 weeks (using a boot). He was also weight bearing for the start.

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