fat biker

Greetings All,

I have several surgeries fast approaching and will be unable to drive my car, ride my bike or walk very far.

I have local friends, who, under better circumstances I could call on for a ride in a pinch. As fate would have it, some of these same friends are experiencing challenges of their own.

I have available rides to and from medical appointments as an insurance benefit. This service has been less than reliable.
Boy Scouts taught me to Be Prepared. Having backup transportation as near as my phone would be smart.

Then, the questions...

Uber?
Lyft?
Other, SF Bay Area - quick search gave a bunch of names I had never heard of.
Any gotchas I need to be aware of?
The internet suggests tipping 10-20% is appropriate, big enough tip?
Anything else I should have asked?
Any other advice you can offer?

Thank You All,
fat biker

tyrion

I've had a procedure where the hospital insists on a personal contact of mine to drive me home (I guess hospital assumes I'd be too loopy to navigate Uber or taxi - you know how hospitals can seem overly cautious). Hospital calls my contact before procedure to make sure ready and available. So maybe check with hospital and see if they'll allow Uber/Lyft ride home.

Other times I just take Uber. I think Lyft is equivalent to Uber but I use Uber. I usually tip 20% if all goes well with the ride (still cheaper than taxi usually). If you're new to Uber/Lyft, install it on your phone and take a practice ride.

fat biker

Thanks tryrion,

Great suggestion on the practice trip. I will add that to my to-do list.

I may run afoul of hospital policy, regarding having a family member there at pick as my wife will most likely not be available for thtat duty.
Looks like I will need to be in touch with the hospital in advance of my scheduled pre-op visit to work this out.

Thanks,
fat biker

fat biker

Surgery #1, left hip replacement
Surgery #2, cataract, left eye
Surgery #3, right hip replacement

I will likely not be able to drive for a month after the hips and there will be considerable physical therapy.

fat biker

CliffordK

It may be convenient to have your wife participate some, as she will have to aid with some of the followup care, assuming you are living together.

Are the hip replacements day surgeries, or overnight stays? That could give more flexibility for the discharge.

Don't forget a good old Taxi system. They are pretty good at coming when scheduled.

fat biker

Should have included, my wife is presently not in good health, has poor mobility and not able to drive our car.

CliffordK

Do you have any children that are within 100 miles away that might help out some?

The two of you may have issues if you both need recovery care.

An option would be in home nursing care, or checking one or both of you into a nursing home for a week.

fat biker

No kids, nieces & nephews have moved away.
One of the dogs was probably smart enough to drive the car, unable to reach the pedals though.

fat biker

Iride01 

I just had my gall bladder removed. I've only ever had one other surgery where they put me completely under anesthesia. My wife said I was lucid and talking to everyone right after I got to the post op recovery room. And supposedly doctors and nurses came in and had conversations with me telling me what to do and all sorts of other stuff.

I remember nothing but fleeting memories till getting home. So beware if you are using others that aren't your family or personal friends. Maybe even prepay or arrange billing for any services Uber, Lyft or any other provides you. Post surgery and still under the effects of anesthesia you shouldn't be doing stuff that requires making decisions including paying people money. Probably at least for the remainder of the day do nothing that requires you to have your senses about you.

fat biker

For the hip surgery, I will be hospitalized no less than overnight, I would expect no lingering effect from anethesia.

gobicycling

Please be sure and check with the hospital regarding their release procedures. Our hospitals around here will not early release a patient to a Uber driver or taxi.

DiabloScott

Absolutely true, and you have to tell them who is coming to get you before you even check in.

@fat_biker I propose you have your wife be your responsible contact - she can take Uber to pick you up and you can go home together in Uber too. The responsible party has to be able to understand the discharge instructions and make sure you follow them - that's about all.
Alternatively, you could contract with a home-health aid ahead of time for these services... likely $$$.

As for tipping Uber - I use the service frequently for work, the boss says $2 tip per ride max... so that's what I do - the drivers don't know how much you tip until you're long gone so there's really no shame in cheaping out... unlike other tipping scenarios.

canklecat

This is such a common problem the NY Times did an article about it within the past few months: Older folks skipping necessary or beneficial day surgery and procedures because they can't find a reliable person to accompany them throughout the procedure.

I had to cancel a procedure for my chronic neck pain back in December for the same reason. The plan was for three injections *outside* the spine to numb some nerves that were causing pain from my cervical spine stenosis. If the procedure helped, the plan was to "burn" the nerves on the next visit if the pain returned. But the clinic requires the driver to wait in the waiting room throughout the procedure. They would not accept an arrangement in which a driver would return to pick me up.

My Medicare/Medicaid provider claimed they could arrange for a driver to accompany me, wait in the lobby, and drive me home. I called the week before to confirm. But on the morning of the procedure the driving service said they cannot provide someone to wait in the waiting room throughout the procedure.

After weeks of wrangling with the insurance carrier and driving service I gave up.

The VA was my primary health care system before I turned 65 and switched to Medicare. The VA used to arrange for this kind of transportation and accompaniment. But things changed during the pandemic, the VA health care system had a huge turnover in staff, budget cuts, etc., and no longer provide this kind of transportation in my region unless we meet a higher threshold for disabled combat or service connected disabilities. Mine is fairly minor (neck injury in training at Coronado, but not enough for significant disability until the past few years).

My only alternative at this point is to hire someone for the day at my own expense. I figure it'll cost at least $200, estimated based on the market value for what a rideshare driver could earn during the same time, roughly 4-8 hours.

As a long shot I could try to get an ortho doc to cite this procedure as medically necessary, rather than just for "lifestyle improvement," in which case it might be possible to have the procedure done in a hospital with an overnight stay covered by insurance. But I doubt the health care system assigned by my Medicare replacement program will go for that.

My ortho doc said some other ortho specialists will do it in their own private practice clinics, and won't require someone to accompany me and stay in the waiting room. I haven't called around yet to see whether another ortho clinic might be okay with this.

PITN. Literally.

canklecat

Those hip replacements should be done in hospital with overnight stays, at a minimum, followed by discharge to a qualified physical therapy rehab center. I've never heard of a hip replacement on someone age 60 or older being done as day surgery with discharge to home. That would be incredibly irresponsible of the medical and insurance provider.

Before I got older, I was caregiver for two grandparents and my mom. I accompanied them to almost all medical appointments. Their joint replacement surgeries -- knees, shoulders, hips -- were always done in hospital with at least one overnight stay. In some cases they were discharged to home only because I was there to assist them, including with physical therapy. In some cases they were discharged to a rehab center for a few days or longer, since special lifting apparatus was necessary to move them safely.

It's effectively a denial of health care coverage to require patients to jump through hoops for the convenience and economy of the insurance carriers.

gobicycling

They're doing drive-thru hip and knee replacements now. From the Mayo clinic:
https://www.mayoclinichealthsystem.o...rgery-possible

canklecat

And it's dangerous and irresponsible. It's just a cost savings push by insurance carriers.

I'd need to check my notes for a reminder of the number of times we had medical emergencies and needed an ambulance to return my grandparents or mom to the hospital because they'd been discharged too soon. This was an era before any responsible medical provider would even consider day surgery to be suitable for a hip replacement for older folks.

Another bit of false economy was when hospitals cut or totally eliminated staffing for social services, which included making sure a patient had essential care at home before discharge. Now they just dump patients on the curb at any time of day or night. My cousin's daughter died that way after being irresponsibly discharged in the middle of the night without any effort to be sure she had transportation and care at home.

njkayaker

Both are fine. Often, drivers will be on both.
Lyft is (by my experience) often cheaper. Lyft might have more deals.
I’ll often check the prices on both.
You should also check the price of the local cab company.

GhostRider62

The test injections are painless. Why do you need a driver?

I've had the RF ablation w/o anaesthesia although I do accept it now because it freaks the neuro out (pain doc).

The test injection feels like a mosquito bite, call another medical factory.

Leisesturm

I don't know about all this. My wife is blind, but otherwise very, very independent. Still it has freaked several Uber and Lyft drivers completely out because they have to get out of their car and guide her to its door. Or get out of the car and guide her to the door of her destination. She gets bad ratings (not an issue for the o.p. but a huge issue for someone who needs open ended service) that she has to contest with Lyft otherwise future drivers may not accept her for rides. Given the variability of experiences, the o.p. must not, and cannot, leave themselves at the mercy of a rideshare service when they have just had a hip replaced.

There is another way. I don't know what it is, but I know that there is. It probably starts with explaining the situation to the hospital! They may have volunteers on staff that can accompany the o.p. home. When I had significant eye surgery that required my being put under for three hours, a volunteer kept my wife company, and helped her get around the hospital and to a meal while it happened. We stayed in a motel near the hospital and as it happened there were some very important post-op drops and dressings that HAD to be performed on a strict schedule and I was in so much pain and woozy from medication that I was unable to do them and she couldn't help me and a doctor from the hospital came to our hotel and helped us! Totally above and beyond the call of duty.

The o.p. is thinking only of transportation. Transportation is the least of it. The o.p.will need help. Support when they will be fragile and vulnerable. That is not Uber's or Lyft's responsibility and might possibly be beyond their ability. So, in this case, being prepared means laying in the support they will need ahead of time. Good luck.

gobicycling

Check with your county aging services or Senior services. Ours has a multitude of services they will provide. This includes transportation homemaking and a variety of other free support services. It's worth a shot. And the important thing is it's not just getting home it's not understanding that you are still under the influence of an anesthesia for at least 24 hours and you need someone there for safety and medications etc. Also check out your local Senior center. Good luck

CliffordK

Dad got bilateral knee replacement a while ago. The hospital didn't want to do both knees at the same time, but Dad didn't want two recovery periods. I don't know how many days in the hospital, but he was discharged home.

However, unlike the OP, Mom was healthy at that time and was very strict with his rehab routines. One of the issues was Dad's tendons had shrunk, and needed to be stretched which required a lot of work to get him back to 100%.

With the knee surgeries, they try to get the person walking as soon as possible.

CliffordK

Find out about what assistance programs are available. Perhaps go into the hospital early and ask to talk to a social worker.

There are wheelchair van services that could be available. In home health care and checkups. Help showering. Physical therapy, either in home, or in a clinic, etc.

You can also get a hospital bed for at home if needed.

Getting people home as quickly as possible saves them money.

Don't cheap out when there are better alternatives. Get a licensed Taxi if that works better that Uber/Lyft. My only experience with Uber/Lyft was being stuck with a vehicle that wouldn't start. Rides were scheduled, but nobody would come for a pick up.

DiabloScott

It's really difficult to get a decent price comparison. The way these companies calculate fares doesn't lend itself to shopping around. Same trip but different time of day, different traffic conditions, different day of the week, different amount of rider demand; different price. You can't account for that except by doing the same trip multiple times and keeping track.

njkayaker

I run both at the time I need it.

(You get the cost before you are required to book it.)

canklecat

My thoughts as well. The ortho doc at the clinic I was originally assigned to suggested the same thing.

A few years ago at the same clinic I had injections of anti-inflammatories deep in the muscle tissue for my injured shoulder. No need for any topical or subcutaneous anesthetic. I think the doc asked if I wanted it and I said nope.

Same with colonoscopies. The clinic won't do it without anesthesia and the same requirement for family or friend to accompany me throughout, including waiting in the lobby during the procedure. But my last colonoscopies were during the 1990s -- day clinic, no anesthesia, drove myself there and back home. No problems. It was a little uncomfortable but nothing bad enough to need anesthesia.

I'm not a fan of unnecessary and avoidable pain, but anyone who's played sports or engaged in athletic activities seriously, long enough, amateur or pro, has already experienced much worse pain from injuries than anything we'll feel from a few injections. When I was hit by a car five years ago, breaking and dislocating my shoulder, the ambulance crew offered fentanyl. I declined because the ER was less than five minutes away. The ER offered morphine. I declined and just asked for a single hydrocodone or tramadol. I knew the pain would kick in a couple of hours after the injury, but I also knew from my many previous injury that my body seldom experiences serious pain immediately from injuries. The next day, sure. The next week or so, oh, yeah. But the worst immediate pain I've experienced was from cracked ribs, which didn't occur during this particular collision.

Long-term chronic pain has been a problem, due to many injuries, age and arthritis. And lifelong migraines, cluster headaches or trigeminal neuralgia -- my neurologists never agree on what it is. Those are by far the worst pain I've ever experienced. But I'm fortunate to rarely experience severe pain immediately from injuries.