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Cost of Potential s Arthritis Greater risk for developing arthritis due to orthopedic injuries. Arthroplasty $26,800 - $29,000 Replacement of hip joint due to bone disease. Autonomic Dysreflexia (exaggerated autonomic response to painful stimuli) Autonomic dysreflexia results from noxious stimuli, which causes too many signals to overload the autonomic system, which may increase blood pressure and causes severe headache, goose bumps, sweating, flushing, even stroke or heart attack. Autonomic Dysreflexia (exaggerated autonomic response to painful stimuli) Autonomic dysreflexia results from noxious stimuli, which causes too many signals to overload the autonomic system, which may increase blood pressure and causes severe headache, goose bumps, sweating, flushing, even stroke or heart attack. Baclofen Pump Implant for treatment of Severe Spasticity See comment National Average for Baclofen Pump complete procedure $30,000-$40,000 Baclofen Maintenance, Programing, Refill per year $10,000 - $15,000 (depending on medication use) page 33

Cost of Potential s Baclofen Pump Implant for treatment of Severe Spasticity See comment National Average for Baclofen Pump complete procedure $40,000 to $50,000 Baclofen Maintenance, Programing, Refill per year $10,000 - $15,000 (depending on medication use). Bone Fractures Balance deficits could contribute to frequent falling, which puts this person at a higher risk of fracturing a bone. Bone Fractures Balance deficits could contribute to frequent falling, which puts this person at a higher risk of fracturing a bone. Botox Injections for treatment of spasticity $6,000 - $7,000 per series 2 series of injections per year for life, if injections successfully reduce spasticity and contractures Bowel Obstruction Secondary to chronic constipation. page 34

Cost of Potential s Bowel Obstruction Secondary to chronic constipation. Bowel Transplant $403,070 - $404,680 The estimated cost includes evaluation for transplant and transplant. Cardiac Problems Secondary to Electrical Shock Examples of cardiac injuries secondary to electrical shock are pericarditis, persistent left ventricular dysfunction, cardiac arrhythmias, electrocardiographic changes, myocardial necrosis, tachycardia, arterial thrombosis. s Related to Diabetes s can include cardiovascular disease, kidney disease, impotence, ocular disorders, etc. Contracture Deformities Inappropriate or lack of range of motion exercises. page 35

Cost of Potential s Contracture Deformities Inappropriate or lack of range of motion exercises. Corneal Transplants $6,450 - $7,450 per eye Corneal transplants are done when the clear front of the eye is damaged, such as with corneal ulcerations that can develop during comatose state. Dialysis s the Infection, hypertension, cardiovascular events such as myocardial infarction and stroke (females ages 20-44 average 15.8 days in hospital/year). End Stage Renal Disease See s Requiring dialysis and/or renal transplant. Dialysis: $63,000- $75,000 year; Transplant: $54,000- $150,000. Further Deterioration of Vision Due to Retinopathy Laser surgery to treat retinopathy. page 36

Cost of Potential s Gastrostomy Revision Maintain feeding access. Hearing Impairment $50,955 for surgical implant. Placement of a Cochlear Implant to imporve ability to interpret sound. Once implant placed therapy, programming, monitoring and supplies will be needed through life at an estiamted annual cost of $6,500 - $8,500. Hemorrhoidectomy Can result from chronic constipation. Hemorrhoidectomy Can result from chronic constipation. Heterotopic Ossification Excessive bone development in joints. page 37

Cost of Potential s Hydronephrosis the Secondary to repeated urinary reflux, which could ultimately lead to End Stage Renal Disease. Hydronephrosis Secondary to repeated urinary reflux, which could ultimately lead to End Stage Renal Disease. Hypertension Chronic hypertension can be a side effect of electrical shock. Impaired Cognitive Functioning Greatest potential complication for this individual involves problems resulting from his reduced cognitive functioning and impaired decision making capabilities. A structured environment must be provided to maximize his capabilities. Locomotor Consequences of Electrical Shock Examples include: bone demineralization, reflex dystrophy, periostitis, osteomyelitis, osteonecrosis, pathological fractures, degenerative joint disease, and limb dystonia. page 38

Cost of Potential s Lung Transplant $265,900 for pre and post transplant care in 1st year; $25,100 / year thereafter. Replace damaged lungs with an organ transplant. Major Depression Inactivity and low self-esteem. Major Depression Inactivity and low self-esteem. Major Depression Requiring Hospitalization Inactivity and low self-esteem. Megacolon Colon stretching resulting from prolonged and repeated stool retention. page 39

Cost of Potential s Megacolon Colon stretching resulting from prolonged and repeated stool retention. Morphine Pump Implant to Control Chronic Pain Estimated cost depending on the specific needs of this patient. Morphine pump implant at the estimated cost of $32,308 to $35,758, which includes trial, surgeon s fee, hospital charges, equipment, medication and anesthesia. Morphine pump will need to be replaced every 5 years at an estimated cost of $32,308 to $35,758. Maintenance and refill of Morphine Pump is an estimated $12,000 per year. Nervous System Conditions Nervous system disorders secondary to electrical shock: progressive motor neuron disease, acute lateral sclerosis, and seizures. Neuropsychological Sequelae Examples of neuropsychological/ psychological problems secondary to electrical shock are: emotional disturbance, post traumatic depression, relationship difficulties. Ocular s s Ocular complications frequently develop secondary to electrical shock. Examples include cataracts, reversible maculopathy, optic neuropathy. page 40

Cost of Potential s Orthopedic Problems with Shoulders and/or Elbows Shoulders and elbows not designed to be weight-bearing joints. Orthopedic Problems with Shoulders and/or Elbows Shoulders and elbows not designed to be weight-bearing joints. Osteomyelitis Related to Pressure Ulcers $59,600 - $115,635 (average cost excluding surgery charges.) Treatment can include inpatient hospitalization, surgical debridement of pressure ulcer, bone biopsy, culture-specific antibiotic therapy, and surgical flap surgery to close the wound. Osteomyelitis Related to Pressure Ulcers $59,600 - $115,635 (average $ except surgery charges.) Treatment can include inpatient hospitalization, surgical debridement of pressure ulcer, bone biopsy, culture-specific antibiotic therapy, and surgical flap surgery to close the wound. Osteoporosis Lack of weight bearing; may result in bone fractures. page 41

Cost of Potential s Osteoporosis Lack of weight bearing; may result in bone fractures. Post Bowel Transplant Care See comments $55,498 - $67,498 the first year; then $17,152 - $29,892 to include care outpatient care, anti-rejection medication, pathology lab work, and diagnostic studies. These estimates are based on good results from transplant with no rejection. Post Concussion / Migraine Headache Disorder Requires frequent visits to physician and medication Post Surgical s If post surgical complications, such as infection, develop the cost could be significant. Post Surgical s If post surgical complications, such as infection, develop, the cost could be significant. page 42

Cost of Potential s Pressure Ulcers Lack of pressure relief in bed or in wheelchair. Pulmonary s Respiratory complications secondary to reduced mobility. Pulmonary Embolism (clot that breaks loose and travels through veins to lungs) May result from thrombophlebitis. Pulmonary Embolism (clot that breaks loose and travels through veins to lungs) May result from thrombophlebitis. Renal s Chronic infections; incomplete voiding; urinary reflux; inadequate fluid intake; hypertension. page 43

Cost of Potential s Renal s Chronic infections; incomplete voiding; urinary reflux; inadequate fluid intake; hypertension. Renal Transplant s the Stroke, myocardial infarction, renal disease, chronic hepatitis, cataracts, diabetes mellitus, bone necrosis, malignancy. Respiratory s Lack of mobility. Respiratory s Lack of mobility. Revision of AV Fistula $19,949 - $23,000 Arteriovenous anastomosis for renal disease. page 44

Cost of Potential s Revision of residual limb Maturation and complications associated with the amputation site. Revision Tracheostomy Revision to allow continued ventilator access. Scoliosis Curvature of the spine. Seizure Disorder See $600-$750/Year for Neurologist to include EEG. $235-$310/Year for lab work. $708-$1,068/Year for Anti-Seizure medication. Seizure Disorder Requiring Hospitalization Escalation of seizure disorder which requires inpatient care to monitor. page 45

Cost of Potential s Shunt s Shunt malfunction requiring shunt revision. Spinal Cord Stimulator / Dorsal Column Stimulator $22,500 - $23,732 Surgically implanted device used to control chronic pain. The cost is estimated as it varies with specific client needs and location. Replacement of stimulator batteries are required every 4-5 years at an approximate cost of $9,800 - $10,700. Spinal Fusion Slipage at the fusion site requiring a repeat of fusion surgery. Syringomyelia A chronic progressive disease of the spinal cord characterized by the development of cavities and gliosis of surrounding tissue. Surgical placement of a shunt could be necessary. Syringomyelia A chronic progressive disease of the spinal cord characterized by the development of cavities and gliosis of surrounding tissue. Surgical placement of a shunt could be necessary. page 46

Cost of Potential s Temporal Mandibular Joint Dysfunction (TMJ) TMJ can be associated with a traumatic injury to the face or jaw, or simply from a significant jolt to the head and/or body. Typical treatment can range from construction of a mouth splint to surgical replacement of the TMJ. Thrombophlebitis (blood clot or deep vein thrombosis) Results from lack of movement and swelling in lower extremity. Thrombophlebitis (blood clot or deep vein thrombosis) Results from lack of movement and swelling in lower extremity. Total Parenteral Nutrition (TPN) due to malabsorption by the bowel $210,000 - $250,000 per year TPN requires monitoring by skilled nurses, infectious disease specialist, surgical insertion of catheter, pathology lab work and an infusion pump. Uncontrolled Bacterial Overgrowth Requiring 2-5 days in hospital. page 47

Cost of Potential s Uncontrolled Bacterial Overgrowth Requiring 2-5 days in hospital. Urinary Diversion Surgery $18,205 - $29,338 depending on what procedure is done Several procedures are available to divert the urinary system and allow catheterization through the abdomen or placement of an ostomy type opening to maintain bladder functions and alleviate the need for catheterization through the urethra. Urological Infections Lack of mobility; inappropriate catheter techniques; inadequate fluid intake. Urological Infections Lack of mobility; inappropriate catheter techniques; inadequate fluid intake. VP Shunt Placement Secondary to development of hydrocephalus. page 48