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  1. #1
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    Ice machine/CPM: Insurance cover, cost, worth it?

    Sorry for new post, but looking for quickish specific answers on two post surgery devises

    Having knee surgery #2 today. See my kneecap dislocation thread for the background. I have asked a lot more questions this time to try and get things sorted before the surgery and this time they have recommended a game ready ice machine. Unfortunately things still aren't totally sorted, but I'm working on it this morning. I remember reading mag's digging this or similar icing devices.

    -How was it paid for? Totally out of pocket, HMO pay, PPO pay, Rent , Buy???
    -How much did these puppies cost you?
    -Worth it?

    CPM:
    Same questions, although I'm questioning this one as initially he said it wouldn't do anything for me at this point and now his assistent is saying he recommends it...
    He who has the most fun wins!

  2. #2
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    Ice thing is definitely worth it - mine was completely paid for by insurance. if not, the non electric one is $100 or so. The electric one is way better and stays cold all day before needing re-fill. I iced my knee 24 hours a day for the first few days after surgery.

    The cpm machine was also paid for by my insurance. I used it for the first few days and I think it helped me. I had my knee in there bending for 6 hours a day. I think you can do without it though, but you need to make sure you move your knee on your own then. For me, it was good because I am lazy and probably wouldnt have moved it so much without it.

    Good luck with your surgery and recovery!

  3. #3
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    cpm is paid for by insurance ...but its is spendy....My opinion is that it is much more valuble than the Game ready. the game ready is great ,however you can get the same results from the cryocuff or a good gell pack that you can rap around your leg with a ace bandage. The CPM machine...(I am on now as we speak...day 5 for me on ACL repair) is invaluable! ROM is everything...you can control swelling as mentioned and maybe save some $$$. Again,j ust my opinion.....good luck.

  4. #4
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    I used both. Insurance paid.

    My doc had me set the CPM on 90 degrees through full extension the very first night. When I started weight bearing PT four weeks later I already had full range of motion -- better than I had before the surgery. Definitely worth it even if I would have had to pay.

    I boiled my thermometer, and sure enough, this spot, which purported to be two thousand feet higher than the locality of the hotel, turned out to be nine thousand feet LOWER. Thus the fact was clearly demonstrated that, ABOVE A CERTAIN POINT, THE HIGHER A POINT SEEMS TO BE, THE LOWER IT ACTUALLY IS. Our ascent itself was a great achievement, but this contribution to science was an inconceivably greater matter.

    --MT--

  5. #5
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    Ok, heres another question. If there are a few ice machine thingy's, any preferences??? Anyone have one they want to lend me for a week or two?
    He who has the most fun wins!

  6. #6
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    Quote Originally Posted by comish View Post
    Ok, heres another question. If there are a few ice machine thingy's, any preferences??? Anyone have one they want to lend me for a week or two?
    I wish! I'd like to secure one myself too! I just went to Target and got a few gel packs for the freezer. I'm lucky that my mom's coming in town for the first few days of surgery so I she'll do the switching out from the freezer.

    If I wanted to spend like $60-100 I'm sure I could get my paws on a Cryocuff, which is the icer that uses gravity to keep it cold. I'm sure it would be worth it but I'm trying to save money and get rid of stuff. Good luck to you though!

  7. #7
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    CPM machines- My rental was ~40/day for this and paid for by insurance. Some docs like em and some don't. Last year I thought it helped me a good deal; this I used it this year (cut May 9) for a week and it probably helped a bit. Part of the hang up on the CPM machines is that they spend ~80-90% of time moving through the ROM you already have and only a little time at the full extension / flexion. The one I had this year had was nice in that I could set a variable amount of time to pause at the ROM in range.

    The cryocuff cooler has been my best friend- I use it ~3-4 times a day still (4 weeks out this Friday) and right after exercise. The one I got was ~$120 last year. I recommend it if you can get a hold of one.
    Move upside and let the man go through...

  8. #8
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    The cryocuff is worth its weight in gold. I refuse to operate on anyone who don't have it.

    The CPM is unnecessary. We dropped it in 2003, and our patients have better early motion than every now. CPM also builds in a flexion contracture of the knee which is the kiss of death.
    drmark
    Mark Sanders, MD FACS
    Certified by the American Board of Orthopaedic Surgery, Subspecialty Certificate in Orthopaedic Sports Medicine
    Fellow of the American Academy of Orthopaedic Surgeons
    Fellow of the American College of Surgeons
    www.sandersclinic.net
    Houston, Texas
    713.907.6076

    Terms & conditions of use, as it relates to any and all information posted to TGR.com's discussion forums by drmark can be found at:
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  9. #9
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    I agree with Dr. Mark that ice machine is more important. CPM is great for a few days--once you have reached 90 degrees you should be actively moving your leg on your own. Moving it actively on your own from the beginning is the best--you just have to make sure you do it. for me. I think the cpm helped because i wouldnt have done it on my own. I used it for about a week, even though i had it for two weeks.

  10. #10
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    Just an FYI, if you ask nicely, the rep for the CPM company and Ice machine (same rep) will come to your house to set up the CPM and Ice. They prefer to do it at the hospital, but they'll do what you ask most of the time - they're paid on commission for each one they do.

    If there's an interest in a group buy on the ice machines, I can ask my gf about it. She is one of those reps and sells them as well. Last time I looked in her garage I think I saw 8-10 of those little coolers. I'll ask her about it when I see her tonight.
    **
    I'm a cougar, not a MILF! I have to protect my rep! - bklyn

    In any case, if you're ever really in this situation make sure you at least bargain in a couple of fluffers.
    -snowsprite

  11. #11
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    My wife has had 2 knee ops in the past two years. She went through several cryocuffs.

    The Cryocuff is worth its weight in gold, however, you dont always get a good one. I have gone through 2 myself in the past 5 days.

    The good soft gell packs are great if you have someone to change them out from the freezer for you. The game ready is best! But very spendy. A good PT will have the game ready when you go.

    The CPM machine is just to keep pumping fluid through your knee. If you can get one great. I agree, you need to move the knee yourself, but again if you are doing proper PT, you are already doing that. If you have miniscus issues it is even better. But again, you are going to get 10 opinions one way and 10 another as I am continuing to learn. Bottom line you are not doing PT 24-7, however a good portion of your day and when your just siting there typing on this damn blog, or just resting, sleeping, etc.....it allows for your knee to not get stiff and continue to keep it lubed.

    When you get surgury, a good Dr should give you a Crycuff....It does not cost that much in the sceme of things.

  12. #12
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    This pretty good....

    http://orthopedics.about.com/cs/knee...ment/i/cpm.htm

    Again just an opinion. You can go to 10 places and find good beta and 10 others that show the opposite.

  13. #13
    Join Date
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    Ditto here - ice machine is a godsend. Never used or felt like I needed a CPM.

    Honestly, I'd buy the cryocuff/iceman/whatever brand you want.... Hopefully it's your last knee surgery, but lets face it - you'll probably have another occasion in the future where you could make use of an extended ice pack. And you'd make yourself insane trying to keep fresh ice packs on your knee without one after knee surgery.

    Don't forget to buy some ice too unless you have a really good icemaker in your freezer. I've run out and it's easier to spend a couple bucks and fill up a cooler with ice to keep it going. Plus, in the middle of the night when you wake up and need more, you can have the cooler next to you, scoop some in to the cryocuff cooler from your big cooler and not even have to get up/disconnect from the machine/etc.
    "Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside, thoroughly used up, totally worn out, and loudly proclaiming, "Wow, what a Ride!"

  14. #14
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    I have a Donjoy Iceman and have used it through 8 knee surgeries, large and small. So nice not to have to mess around with ice or popcorn or peas or whatever. I just freeze a couple bottles of water, throw them in the container of water and I'm good to go all day. The game ready is the ultimate as it adds compression while cooling but it is indeed spendy. I think we're talking thousands here. I see Icemans on ebay for $80. Worth every penny in my book.

    I've also had surgeries where I used CPMs and didn't use CPMs. Had one for my 1st ACL in '90 but not the 2nd 10 years later, same doc. Then 2 debridement surgeries in Vail in '05 & '06, different doc, had me in one for 2 weeks! Uugh. Last surgery 2 months ago, new doc, no CPM. For me anyway it didn't make much difference. But, I've always recovered full flexion easily and quickly. Your situation is entirely different. If you can get one readily I'd say why not use it for a couple days and see how it goes. Good luck!

  15. #15
    Comish, I PMed you before I saw the thread. IMO, if you can get a CryoCuff/Iceman/Game Ready with a contribution from your insurance, do it.

  16. #16
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    The Gameready is $2500. I'm guessing you need to eat, so that might be a little expensive.

    I've given you my thoughts on the CryoCuff, which echo the sentiments above. My insurance wouldn't pay for it, though, but then again they also tried to get out of paying for the entire operation about two months after I had it done. Bitches.
    In the long run, we're all dead.- John Maynard Keynes

  17. #17
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    pm sent comish... anyone else who need icing as well. As long as I can get it back when I break myself again :fingerscrossed:
    but I know we can't all stay here forever, so I wanna write my words on the face of today...

  18. #18
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    Thanks dudes. Sitting on the couch now after round 2. Cryfcuff arriving tomorrow. Fuck me on the overnight shipping. Thanks for the offers Awake and DT, Really appreciate it.
    He who has the most fun wins!

  19. #19
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    Damn... I was thinking I had that thing gone

    EDIT: Heal fast buddy, ski season's coming fast
    Last edited by awake1563; 06-04-2008 at 10:01 PM.
    but I know we can't all stay here forever, so I wanna write my words on the face of today...

  20. #20
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    I had the DonJoy Iceman. Saved my shoulders when I was still in pain and couldn't take any more pain meds, and also when I was weaning off the meds.

  21. #21
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    CPM is alot like Teddy Ruxpin. (The teddy bear with the cassette tape player, circa 1980) You put it in the crib with you kid, and you let Teddy be the parent. CPM is no better a substitute for active motion, than Teddy Ruxpin is a substitute for parents.
    drmark
    Mark Sanders, MD FACS
    Certified by the American Board of Orthopaedic Surgery, Subspecialty Certificate in Orthopaedic Sports Medicine
    Fellow of the American Academy of Orthopaedic Surgeons
    Fellow of the American College of Surgeons
    www.sandersclinic.net
    Houston, Texas
    713.907.6076

    Terms & conditions of use, as it relates to any and all information posted to TGR.com's discussion forums by drmark can be found at:
    http://sandersclinic.net/legal_notice.html

  22. #22
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    I agree with Dr. Mark, NO CPM. It is not necessary, the more active stuff you do the better. I feel like it alows peeps to control what they are doing and sort of take charge of their rehab. Cryocuff/game ready are both awesome, if they will pay for game ready get that.
    fighting gravity on a daily basis

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  23. #23
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    I have this and it was the best thing I could have for my knee:



    CryoCuff costs $125.



    Played golf for the first time this year and knee swelled. 10 minutes on the cuff, good as new.

    And I am late to the ball game as normal..........

  24. #24
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    I had almost exactly what Buzz posted the picture of for one of my reconstructions, and after a week or two I went back to using frozen gel-packs, or whatever those things are.
    I found it a hassle to keep switching the water in the cuff every ten minutes or so to keep it cold, and it never got my knee as numb/cold as the ice packs. Cold/numb=very good when you have pain/swelling. I don't see any benefit to using the cryocuff over a few good ace bandages and several ice packs.
    And that surgery was the only time I was ever prescribed a cryocuff.

    So I guess I'm almost the only one to dissent from the cryocuff, but I guess a lot of surgeons don't see the need for it either.
    [quote][//quote]

  25. #25
    Quote Originally Posted by Dexter Rutecki View Post
    I had almost exactly what Buzz posted the picture of for one of my reconstructions, and after a week or two I went back to using frozen gel-packs, or whatever those things are.
    I found it a hassle to keep switching the water in the cuff every ten minutes or so to keep it cold, and it never got my knee as numb/cold as the ice packs. Cold/numb=very good when you have pain/swelling. I don't see any benefit to using the cryocuff over a few good ace bandages and several ice packs.
    And that surgery was the only time I was ever prescribed a cryocuff.

    So I guess I'm almost the only one to dissent from the cryocuff, but I guess a lot of surgeons don't see the need for it either.
    Actually, I agree. I know so many here swear by those type of things, but I only used mine for a couple of weeks right after the surgery (when I wasn't moving around at all). Since then, I've just stuck with the gel packs and homemade alcohol-water ice packs. I hated being tethered to the machine. I can strap on two gel packs, get up, walk around, take a leak, make dinner, then take them off. To each their own.

    [adult diaper commercial] In fact, I'm wearing mine right now. [/adult diaper commercial]

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