the medcom group, ltd

As the popularity of the Continuous Passive Motion Machine (CPM) continues to grow, we here at The Medcom Group, Ltd. have increased our inventory to match that demand.  Most of the CPM devices prescribed in the United States continue to be for patients who have had or are about to have knee surgery.  There are a few of reasons for this.  Knee surgery is the most prevalent type of orthopedic surgery performed these days.  The knee CPM has the longest history, being the first type of continuous passive motion machine invented and produced on a high scale.  Therefore, the knee CPM can also claim to have had the most studies performed regarding its medical efficacy, and as a result, is the most likely form of continuous passive motion machine to get paid for by insurance companies.  The knee joint is also the most replaced joint in orthopedic surgery, and CPM machines are typically used for patients after total knee arthroplasty.  Hence, the popularity of the Knee CPM, when compared to its rivals (shoulder CPM, ankle CPM, hand and wrist CPM, elbow CPM) may never be challenged.

But continuous passive motion machines for these above mentioned joints do exist and are becoming increasingly popular themselves.  Very few companies have any of these “specialty” CPM machines…The Medcom Group, Ltd. has all of them.  And we have a lot of each of them.  The shoulder CPM helps patients recover more quickly from rotator cuff surgeries, shoulder replacements, and shoulder manipulations.  The elbow CPM makes life much more comfortable for patients who have had contracture releases.  Ankle and hand problems?  The continuous passive motion machine designed for those joints work amazingly well and help to regain the motion that physical and occupational therapists have had a hard time getting back manually.  We have had countless physical and occupational therapists tell us that patients who use a CPM, regardless of which joint they injured, are far easier to work with and are able to work on their strengthening exercises much sooner because they have gained their full range of motion in a much shorter period.  Remember, insurance companies only pay for a certain amount of formal physical therapy visits per year.  A home CPM rental can assure you that you will get the most out of those P.T. visits, and that you shouldn’t need to pay out-of-pocket for further physical therapy visits that aren’t covered by insurance.

Feel better sooner with a continuous passive motion machine after your orthopedic surgery.  Make sure to ask your doctor if your recovery would benefit from a CPM machine at home, because with certain types of procedures, a CPM would not be a good idea.  Your physician will know, but don’t be afraid to ask.  And once you have the OK from your doctor, call us here at The Medcom Group, Ltd. at 877-301-4276 to arrange the delivery of your CPM.  The Medcom Group, Ltd. – Your one stop shop for all of your continous passive motion needs!

Surgery Hurts!  If you are about to have surgery, have had surgery in the past, or know anyone who has had surgery (which should include most of us), you know that an operation is no picnic.  Of course, depending on the type and extent of the surgery needed, and the skill of the doctor, some precedures hurt more than others…but they all hurt!  Most surgeons will want patients to use some form of cold therapy after the operation is over for a period of time.  Icing after an injury (surgery is an injury that is designed to heal a greater issue) is the standard of care, but there are very different ideas of HOW to ice after an injury.  Some doctors will suggest a plastic bag full of ice, or perhaps a frozen bag of peas.  While these versions are certainly cheaper, they are the least effective forms of cold therapy.  In other words, ice bags don’t eliminate pain and swelling nearly as much as some other forms of cold therapy.  So if you can make surgery hurt a lot less, and in some cases, eliminate pain altogether, wouldn’t it be worth a little extra expense?

There are a couple of cold therapy devices that have really made a big impact on the market, both of which are carried by The Medcom Group, Ltd.  First, the Cryocuff by Aircast is a very popular purchase item for patients post-operatively.  The beauty to the Cryocuff is its simplicity…just fill the cooler with ice and water, attach the appropriate wrap to the injured part of the body, and let gravity do the rest.  The wrap will fill up with cold water, which often stays cold for 30-60 minutes, and really helps take away your pain.  The water inside the wrap also provides some compression, which helps to reduce the swelling that post-surgical joints experience.  The list of Cryocuff wraps available is extensive, covering all the major joints that a patient could injur.  The Cryocuff can disconnect from the wrap without any water spilling out, so you are not stuck to the machine.  There is also an electrical version that continuously circulates water (Cryocuff IC) for even longer periods of cold and compression.

The Game Ready cold therapy and intermittent compression system by CoolSystems, Inc. is another popular cold therapy choice.  The Game Ready can be purchased from The Medcom Group, Ltd. as a used machine, offering extensive savings over purchasing new from the manufacturer.  The Game Ready system can also be rented from The Medcom Group, Ltd.  Much like the Cryocuff, the Game Ready comes with a complete assortment of wraps available.  Unlike the Cryocuff, the Game Ready offers variable levels of intermittent compression, which really helps to milk a lot of the swelling out of the affected joint.  The higher levels of compression also promote deeper cooling, which greatly reduces the pain compared to the surface (skin) cooling provided by ice bags or a bag of peas.  The Game Ready connects to a wall outlet and can be set for a wide range of time options (five minute increments).  It also has the ability to shut itself off once your cold therapy session is over, helping prevent the frostbite that can occur quite easily with ice bags.

As with any cold therapy device, a prescription is required for both the Cryocuff and the Game Ready.  It is recommended that patients place the wraps over top of a thin barrier, such as clothing or a towel, and not directly against the skin.  This can help to prevent frost bite and enhances patient comfort.  Also, we always request that you follow your doctor’s directions on length and duration of use, as well as the manufacturer’s recommendations on proper use of the equipment.  Here at The Medcom Group, Ltd., we have heard countless patients tell us how much their Cryocuff or Game Ready helped them get through the worst part of their surgeries – the PAIN.  Let us help you recover more quickly…call us at 877.301.4276 and we can get you back on your feet fast!  The Medcom Group, Ltd. – Your Cold Therapy Experts!

When most people think about using a Knee CPM for their home use after surgery, they plan on renting one.  And for most patients, renting a CPM, whether they need it for 2 weeks or 8 weeks, is the most economical decision they can make.  Insurance companies are much more likely to pay for a Knee CPM machine rental than they are for a purchase.  However, there is a certain segment of the patient population that would benefit more from actually purchasing a Knee CPM, whether new or used, especially if their insurance wouldn’t cover either way.  Here are a few things to consider when asking yourself the rental vs. purchase question:

1.  Is this the only surgery you are planning on having where you might need to use a CPM at home?  Many patients have one knee replaced and then will have the other knee replaced later.

2.  Are any of your close friends or family members planning to have similar surgeries where they may benefit from using a CPM machine (always check with those patients’ doctors’ to make sure that a CPM is indicated for those patients as well)?

3.  Would the cost of renting a machine exceed the purchase price of used equipment because the rental period would be so long?

4.  Do you want to keep the machine and use it for extended periods well after your formal physical therapy has ended (many patients want to keep their machines much longer than the rental period typically covers…here at The Medcom Group, Ltd., we have heard countless patients who have said they never wanted to give their machines back)?

If you work at a facility requiring CPM machines for your patients to use on an inpatient basis, allow us to help you do your homework.  Many facilities still rent CPM machines from a provider like The Medcom Group, Ltd.  For facilities who don’t use CPMs very often, the rental option may be most cost effective.  But for many hospitals, rehabilitation facilities, and other skilled nursing programs, purchasing CPM machines can cut down on long-term costs by thousands of dollars per year.  The Medcom Group, Ltd. offers sales on new CPM machines throughout the year and we are contracted with some of the largest Group Purchasing Orginazations around.  In fact, we have the ability to save contracted facilities hundreds of dollars on each new Knee CPM purchased versus non-contracted providers.  For most facilities, who are purchasing 5+ machines at once, those savings are significant (thousands of dollars).  We also have the variety of options that facilities are looking for, because we have ALL of the major CPM manufacturers’ products on our GPO contracts.  If you are looking to upgrade your CPM fleet, chances are that The Medcom Group, Ltd. can provide them for you at a great discounted price, and you can earn the benefits of contract utilization.

Whether you’re a patient looking to buy a used CPM because you want to keep it long-term or you’re a purchasing manager at a major health system looking to save money on industry-best CPM products, The Medcom Group, Ltd. can take care of your needs.  Please call us at 877.301.4276 to discuss how we can save you money and Get You Moving!

The benefits of renting or purchasing a knee CPM machine are seemingly limitless, as long as it is used as directed by the physician.  These benefits include quicker recovery times, easier physical therapy visits, less pain, less swelling, reduced dependence on pain medication, decreased risk of further surgical procedures, and expedited healing processes.  Patients who use their knee CPMs typically have a much better overall outcome after their operation.  However, patients need to be comfortable in their machine in order to properly receive the benefits.  If the CPM is not comfortable, they will be less likely to spend the necessary time in the machine doing their important therapy.

One of the common complaints about using a knee CPM is that many patients find their legs rub against the rails of the machine.  Some machines have orthoses that are too narrow for the patient’s leg and many CPMs have the proximal ends of the bars that protrude near the patient’s groin.  These issues are supposed to be solved by the CPM pad kit that is affixed to the rails of the machine.  This pad kit is designed to hold the leg in position and support the leg as it runs through its range of motion.  Most pad kits, however, have a couple fatal flaws that can help lead to patient discomfort and apprehension.

The first issue most pad kits have is that they sag.  A pad kit works best when it is applied to a CPM machine in a tight fashion and acts almost like a trampoline.  Most pad kits have their Velcro straps, which wrap around the bars of the orthosis, sewn on at the outermost edges of the pad.  Once they are applied to the machine, regardless of how tight, the weight of the leg begins to put pressure on the Velcro straps and the entire pad kit sags.  Once the pad sags, the rails become exposed, and the leg drops between the rails, greatly increasing the risk that the leg will rub against the metal.  Remember, the leg is very sensitive after surgery anyways, so any other impetus for pain, like rubbing against hard metal, should be avoided if possible.

The second problem with most pad kits is that the proximal end near the patient’s upper thigh is far too short.  Many pad kits don’t cover the protruding ends of the metal orthosis which can allow the rails to come into contact with the patient’s sensitive upper thigh or groin area.  This can cause patients to move the machine further away from them, taking the knee out of proper position.  The machine won’t bend the patient’s knee where it is designed to bend and can cause even more discomfort.

There is a simple solution to both of these problems – use a universal pad kit offered by The Medcom Group.  Our pads are made of soft, comfortable fleece and are hypo-allergenic and latex free.  The Velcro straps are inset an inch from the edges of the pad, so when they are wrapped around the CPM’s rails, the metal stays completely covered.  This design feature also prevents sagging which keeps the patient’s knee joint in better anatomical alignment.  The Medcom Group’s pad kits have a longer proximal tail which covers the protruding ends of the rail that are left uncovered by other pad kits.  This way patient’s who use our pad kit don’t have to worry about the bars poking them in the groin or inner thigh area, increasing patient comfort and compliance.  The longer proximal end of our pad also prevents an improperly fit machine from migrating away from the patient.  All of The Medcom Group’s knee CPM pad kits are universal, so they fit every stand-along CPM on the market, including all of the ones we rent and sell.  Facilities can receive great discounts based on contracted GPO rates.  Interested facilities are encouraged to contact us for a sample.  877-301-4276.  The Medcom Group…Your CPM (and pad kit) experts!

A Sequential Compression Device (SCD) is one of the best therapies that a patient can use to help prevent Deep Vein Thrombosis (DVT, or blood clot).  Clots that form, especially in the lower extremities, can potentially be very dangerous.  If that clot were to break free, any number of bad consequences could follow, including pulmonary embolism (PE).  Know your risk!  Here is a helpful guide published in the April, 2004 edition of AORN Journal that shows the risk factors for DVT:

* age (ie, 40 years or older);

* fractures, orthopedic reconstruction, or total joint arthroplasty;

* heart failure or myocardial infarction;

* history of previous DVT;

* leg edema, ulcers, varicose veins;

* lower extremity trauma;

* malignancy;

* obesity;

* pregnancy;

* prolonged immobilization or paralysis;

* sepsis;

* stroke;

* surgical procedures using general, spinal, or epidural anesthesia lasting more than 30 minutes;

* use of oral contraceptives; and

* venous stasis.

Patients can be categorized into low, medium, and high risk categories. Patients in the low risk category have a less than 10% chance of calf vein thrombosis, less than 1% chance of proximal vein thrombosis, and a 0.01% chance of developing a fatal PE. Low risk patients have only one risk factor including

* being bed bound for less than 24 hours,

* being older than 40 years of age,

* being pregnant,

* having a minor medical illness, or

* having minor surgery that lasts 30 minutes or less. (1,2)

Patients in the moderate risk category have a 10% to 40% chance of calf vein thrombosis, 1% to 10% risk for proximal vein thrombosis, and 0.1% chance of developing a fatal PE. Moderate risk patients have two to four risk factors, including

* being older than 40 years of age,

* being pregnant with varicose veins or having a history of thrombosis,

* having a fracture or history of thrombus and being younger than 40 years of age,

* having a malignancy and being 40 to 60 years of age,

* having surgery that lasts longer than 30 minutes, or

* having trauma with no fractures.

Patients in the high risk category have a 40% to 80% chance of calf vein thrombosis, 10% to 30% risk for proximal vein thrombosis, and 1% to 10% chance of developing a fatal PE. High risk patients have more than four risk factors, including

* having a complex medical illness,

* having a major trauma including fractures,

* having a malignancy and being older than 60 years of age,

* having extensive general surgery,

* having a history of thrombosis or fracture and being 40 to 60 years of age, or

* undergoing total joint arthroplasty

If you are planning on having surgery, ask your doctor about your risk factors and whether or not an SCD machine would be right for you.  These machines require a prescription and are available for rent and for purchase.  Please give The Medcom Group a call if you would like more information or to place your order.  877-301-4276.  We are your SCD experts!

CPM Best Practices

When utilizing a CPM machine, it is extremely important to follow the prescription set forth by the ordering physician.  These directives include:

• The duration of use.
• Amount of time the CPM should be used each day.
• Amount of time the CPM should be used per session.
• Range of motion parameters.

Knee CPMs should be placed on a flat surface, such as a bed, couch, or floor, and specialty CPMs (shoulder, elbow) should be placed in an open space to allow for ample room for the patient.  Do not set a knee CPM near the edge of the bed for fear that it could fall off the bed with a patient leg inside.  Keep power cords out of the room’s traffic areas and unplug the CPM when it is not being used.  Keep hand controls out of the reach of children, if possible, so that the settings do not get changed unknowingly.

CPM Machine Troubleshooting

Problem – no power:  It may sound silly, but make sure the machine is plugged in to a working outlet and the power switch is on.  Check your circuit breakers and try the machine in a different outlet.  For any other power issues, it is recommended that you call the manufacturer or the provider.

Problem – squeaky machine:  Most machines run very quietly and smoothly.  Always be sure to place the knee CPM on a flat surface.  Machines are more likely to make noise it they are on an uneven surface.  If your machine begins to squeak, check to make sure the patient’s leg is not internally or externally rotating.  A rotated leg can put uneven pressure on the track, causing the components to grind.  If the CPM is noisy without a patient leg in the machine, apply WD40 or a similar agent on the propelling track both behind and in front of the connecting piece.   With the patient’s leg OUT of the machine, adjust the CPM’s range of motion limits to run at full extension and full flexion and allow ample time (usually 20 minutes) for the lubricant to take effect.  If your machine continues to squeak, it may need to have its track components or belts thoroughly cleaned.

Problem – not running proper range of motion:  Many CPM machines have a lock function which prevents patients from changing the range of motion beyond certain set parameters.  Always heed the directions given by the physician and DO NOT exceed any range of motion limits which were prescribed.  Check your owner’s manual or call your CPM provider if you are unable to unlock the range of motion on your hand control because all machine lock functions are different. If your machine appears to be calibrated wrong, it is recommended that a professional Biomed technician re-calibrate your machine to the proper angles.  Do not use a machine which appears to be out of calibration for fear that the patient may be exceeding the prescribed range of motion.

Problem – machine is migrating:  If you feel or see the machine migrating away from the patient with his or her leg is in the CPM, it may not be fit properly.  Try lengthening the distance between the knee joint and the hip joint.  If this distance is too short, the back of the can actually push on the pad kit as the machine heads towards full extension which pushes the machine away from the patient.  Without the patient’s leg in the machine, loosen the knobs which allow for this length to be adjusted, and make this femoral measurement longer.  Be sure to tighten these knobs down again to keep this length set properly.  Some patient CPM pads come with a longer proximal pad which is designed to rest under the patient’s upper leg/hamstring area (including those provided by The Medcom Group).  If comfortable, have this piece of the pad kit rest underneath the patient to prevent the machine from migrating.  Finally, check to make sure the surface upon which the CPM is resting does not slant downward.  Patients who place their CPM on a firmer, more level surface will have fewer migration concerns to deal with.

Problem – patient’s lower leg is lifting out of the cradle and not bending as much as the machine is bending:  Try shortening the femoral length.  Loosen the proper knobs and shorten the length of the orthosis between the hip and the knee joint, being sure to tighten the knobs once this distance has been adjusted.  You may also try lengthening the distance from the knee joint down to the foot plate, and also strapping the foot into the foot cradle tighter.  Finally, consider moving the strap that typically runs around the patient’s thigh down toward the shin area to help hold the lower leg in place.

We hope this helps.  If you have any further questions about CPM machines or would like to place an order, please give us a call today!  877-301-4276.

The Medcom Group, Ltd. has been in the business of renting and selling Durable Medical Equipment (DME) since 1988.  As a pioneer in home Continuous Passive Motion (CPM) machine rentals, The Medcom Group has thrived for over two decades by offering patients a wide variety of options to help with their post-operative recovery.  These options include everything from various CPM machines, including knee CPM, shoulder CPM, elbow CPM, hand and wrist CPM, ankle CPM, and great toe CPM, to a variety of pnumatic compression devices, such as SCD machines, lymphedema pumps, and foot pumps.  When The Medcom Group started providing these products to patients and facilities back in 1988, DME  suppliers dealt mainly with their local coverage area.  There weren’t a lot of companies that could provide these types of products, whether for rental or for purchase, on a national scale.  But with the explosion of the internet and the ease of online shopping, many companies who used to only deal with their local population have developed the capabilities to provide products on a national basis.  Also, similar to the growth in the mortgage lending industry prior to the housing bubble bursting, many new online equipment providers have popped up in an attempt to capture a share of the post-operative home health market.  This growth has led to some unsavory business practices that patients often don’t find out about until it is too late.  We want you to be aware of a couple of these practices before you find yourself in a bad way.

Get a Prescription

At The Medcom Group, we ask you for a prescription if you intend on renting or purchasing one of our products.  Most of our products are mandated by the FDA to include a doctor’s prescription before a patient uses them.  We ask for a prescription for YOUR safety.  There are a number of instances where your medical condition will preclude you from using certain pieces of durable medical equipment.  For instance, if you had a meniscus repair during knee surgery, your doctor may not want you to passively move your knee beyond a certain point, fearing that too much flexion could pull apart the stitches that repaired the meniscus.  This could lead to another surgery.  If there is a chance you may have a blod clot, you would not want to use a pneumatic compression device because these machines have the ability to break that clot loose, which could lead to a pulmonary embolism and possible death.  The ONLY person who knows if you are fit to use one of these machines is your doctor.  Doctors went to school for a long time to tell us what we should and shouldn’t do when it comes to our health.  Beware of the company that will provide you these products without asking for a prescription first.  They may be more interested in your money than your well-being.

Get a Price

Health insurance is a great thing to have, but it doesn’t pay for all of your medical bills.  Insurance companies typically pay for products and services that they consider medically necessary.  Opinions on medical necessity (i.e. what a particular insurance company will pay for) differ from company to company.  Some products, although prescribed by your physician, do not fall under the criteria of “medically necessary” for some insurance companies.  These products are often deemed “experimental,” and therefore aren’t covered under you plan.  The range of these products or services that are not covered is often quite large and can, at times, include some of the prodcuts that DME companies provide.  Herein lies the problem – some DME companies will claim that as long as you have insurance, the product WILL be covered.  Some will claim that if you have insurance, regardless of who your insurance carrier is, you will NEVER have to pay anything.  Other providers say that certain machines are almost always covered by insurance when, in fact, they RARELY IF EVER are covered by any insurance.  Be very careful of companies that provide these types of blanket statements.  They are looking for the opportunity to bill your insurance company, and if your insurance company does not pay for that product or service that you received, YOU will be on the hook for the balance.

Although we have the capability to work with your insurance, here at The Medcom Group, we offer a low cash-pay price if you would prefer to avoid involving insurance.  We clearly post our prices on our website for all of our rental and purchase options.  Most other companies’ websites ask you to call them to receive a price for their products.  We also have the experience to help you make a decision that is best for you.  For instance, we are not going to push you into billing your insurance for a product that, experience has told us, won’t be covered.  Instead, if the cash-pay option is best for you, that’s the direction we would suggest, even though we would be leaving money on the table.  If your insurance is likely to cover the machine, we will go through the process with them to gain authorization.  Remember, authorization is never a guarantee of payment.

Finally, beware of hidden costs.  Some of the national companies hide the cost of the soft goods (CPM pad kit, sleeves for pneumatic compression devices).  Some of them will hike up the cost of shipping a machine to your door and not include that in the original quote.  The soft goods and the shipping (to and from your home) are typically included in The Medcom Group’s rentals and purchases, and if they are not included, we tell you in advance so that you can make an informed decision.  We are more interested in patients having a positive experience with our company than any other DME provider out there.  You can count on an honest response from us that is geared towards you having the best outcome available, even if that means our company doesn’t make as much money as we possibly could have had we been less forthcoming.  Referrals are the key to any successful business, and we value our referral sources.  You deserve the best from your provider – choose one that you can count on…The Medcom Group.  877-301-4276.