Anschlussheilbehandlung (AHB) nach Endometriose-OP

Anschlussheilbehandlung eine Frau wird massiert

Eine Anschlussheilbehandlung, kurz AHB, oder Anschlussrehabilitation, ist ein etwa 2-4-wöchiger Aufenthalt in einer Rehabilitationsklinik direkt im Anschluss an einen stationären Krankenhausaufenthalt. Auch für Endometriosepatientinnen gibt es in Deutschland die Möglichkeit so eine AHB in einer auf Endometriose spezialisierten Reha-Klinik zu beantragen.

Nach Gesprächen mit Ärzten und Physiotherapeuten auf dem 12. Endometriosekongress in Berlin, möchten wir euch die Teilnahme an einer AHB wärmstens ans Herz legen.

Vor allem für das frische Narbengewebe ist die fachgerechte Behandlung durch einen spezialisierten Physiotherapeuten die beste Voraussetzung, neue Verwachsungen zu vermeiden! Und die Kontakte mit EndoSchwestern und die vielen Tipps fürs tägliche Leben sind nicht mit Gold aufzuwiegen!

 

Ziele einer Anschlussheilbehandlung

Freiheit

 

  • Informationen über das Krankheitsbild der Endometriose vermitteln
  • Therapiemöglichkeiten aufzeigen und ausprobieren
  • Psychologische Hilfe zur Krankheitsbewältigung leisten
  • Umgang mit Sexualität und Partnerschaft
  • Schmerzminderung
  • Entspannungstherapie
  • Steigerung der körperlichen Leistungsfähigkeit, Muskulatur und Haltung

 

 

Angebote einer Anschlussheilbehandlung

  • WellnessKomplexe gynäkologische Anamnese und Untersuchungen
  • Ausführliche ärztliche Beratung
  • Schmerzanamnese, -therapie, Neuraltherapie
  • Optimierung medikamentöser Therapien
  • Endometriose-spezifische Krankengymnastik und Rückenschule
  • Körperliches Konditionstraining
  • Rhythmische Bewegungstherapie
  • Massagetherapie
  • Ernährungsberatung, Lehrküche zur Endo-spezifischen Kost
  • Kreatives Gestalten
  • Psychologische- und Sozialberatung

Zusätzlich bieten die Reha-Zentren eigene, spezifische Therapie- und Freizeitangebote. Bad Schmiedeberg bietet zum Beispiel monatlich einen dreistündigen Kurs für EndoPartner an. Den können EndoPartner besuchen, auch wenn ihr nicht in Behandlung in Bad Schmiedeberg seid. Aktuelle Termine findet ihr immer hier.

Informationen zu den individuellen Angeboten bekommt ihr auch auf den Webseiten der Reha-Kliniken (siehe unten).

 

Wie man eine Anschlussheilbehandlung beantragt

Die AHB kann nur vom sozialen Dienst des Krankenhauses/Endometriosezentrums beantragt werden, in dem du operiert wirst – und auch nur, während du dort Patientin bist!

Das Krankenhaus überweist dich quasi direkt in die Rehabilitationsklinik. Die Behandlung soll dann innerhalb von 14 Tagen nach Entlassung angetreten werden und geht je nach deiner Krankheitsgeschichte etwa 2-4 Wochen (je mehr Zeit du selbst mitbringst, desto besser).

Wenn du berufstätig und bei der Rentenversicherung Bund versichert bist, entscheidet die Reha-Klinik über den Antrag, gezahlt wird die AHB dann von der Rentenversicherung, mit einer Selbstbeteiligung von dir von 10€/Tag. Mehr dazu in der Tabelle weiter unten.

Für bei anderen Rentenversicherungen Versicherte, Studenten oder Beamte zum Beispiel, geht der Antrag an die Krankenversicherung und wird hier entschieden.

Für die Genehmigung einer AHB müssen gewisse Voraussetzungen erfüllt werden, die, laut Aussagen der Ärzte und Reha-Verantwortlichen beim 12. Endometriosekongress, bei Endometrioseoperationen in über 90% der Fällen gegeben sind. Der soziale Dienst sollte diese Voraussetzungen kennen und kann sich bei Unklarheit jederzeit an die Reha-Klinik zur Unterstützung wenden.

Bitte lasst euch vom sozialen Dienst (und auch euren Ärzten!) nicht abwimmeln, mit der Aussage eure OP wäre zu klein für eine AHB – das kann immer noch die Reha-Klinik (bzw. Krankenkasse) entscheiden. Viele Anträge werden gar nicht erst eingereicht, weil der soziale Dienst manchmal nicht gut über Endometriose informiert ist (das kann leider auch im zertifizierten EndoZentrum vorkommen).

Eine Auswahl der Voraussetzungen

  • Ausgeprägte Verwachsungen und aufwendige Adhaesiolyse
  • Viele peritoneale Endometrioseherde
  • Hoher Blutverlust
  • Beteiligung des Darms
  • Wundheilungsstörungen, Zweiteingriffe zur Wundrevision, etc.
  • Postoperative Probleme wie z.B. Blasenentleerungsstörungen, Lagerungsschäden, neurogene Probleme
  • und viele weitere…

Was ihr selbst tun könnt, damit es mit der AHB klappt

Im Idealfall wird euer behandelnder Arzt den sozialen Dienst im Krankenhaus informieren, damit dieser mit euch in Kontakt treten kann. Bitte verlasst euch nicht darauf. Sprecht die AHB selbst an und kümmert euch notfalls selbst um den Kontakt mit dem Sozialen Dienst, damit eure AHB beantragt wird, solange ihr Patientin seid, sonst habt ihr die Chance verpasst.

Zertifizierte Endometriose-Rehabilitationskliniken in Deutschland

Was ist der Unterschied von einer Anschlussheilbehandlung und einer Reha-Maßnahme?

Papierkram

Das Reha-Zentrum und die Angebote sind bei AHB und Reha gleich, wobei ihr natürlich frisch operiert einige Angebote der Klinik nicht oder nur eingeschränkt wahrnehmen könnt, wie z.B. Wassergymnastik oder die Moorbäder in Bad Schmiedeberg. Das Zentrum ist aber darauf eingestellt und prüft individuell, was für euch wann in Frage kommt.

Es gibt aber große und gewichtige Unterschiede in der Beantragung. Die einer AHB ist um ein vielfaches einfacher und öfter erfolgreich, als die einer Reha-Maßnahme.

 

 Anschlussheilbehandlung (AHB)Reha-Maßnahme
Wer schreibt den Antrag?Der Soziale Dienst des behandelnden Krankenhauses.Du, gemeinsam mit deinem Gynäkologen. Über die Endometriosevereinigung Deutschland könnt ihr Formulierungshilfen für den Antrag bekommen, wenn euer Arzt sich unsicher ist.
Wann wird beantragt?Der Antrag ist zwingend während des stationären Aufenthaltes einzureichen.Antrag jederzeit möglich, wenn ihr die Voraussetzungen erfüllt (siehe unten).
Wann beginnt die Maßnahme?Direkt, bzw. idealerweise spätestens innerhalb von 14 Tagen nach der Entlassung aus dem Krankenhaus.Nach Bewilligung des Antrags.
Wer entscheidet über meinen Antrag?Für Versicherte der Rentenversicherung Bund entscheidet die Reha-Klinik über den Antrag.
In allen anderen Fällen geht der Antrag über die Krankenversicherung.
Es entscheidet ein Sachbearbeiter deiner Krankenversicherung
Wie hoch ist die Erfolgsquote meines Antrags?Etwa 95% werden bewilligt.Etwa 60% werden bewilligt.
Warum ist das so?Die Endometriose-Operation selbst genügt in den meisten Fällen als Grund für eine AHB. Nur bei sehr kleinen Eingriffen oder fehlenden OP-Berichten kann es sein, dass der Antrag abgelehnt wird. Für die Reha ist weniger die Diagnose "Endometriose" entscheidend, sondern die täglichen Funktionsstörungen und die Beeinträchtigung eurer Erwerbsfähigkeit. Außerdem müsst ihr beweisen, dass die Therapie ambulant nicht oder nur unzureichend möglich ist.
Der Nachweis ist wesentlich komplizierter und wird dadurch häufig abgelehnt.
Widerspruch gegen eine Ablehnung einlegen lohnt sich!
Was kostet das?Wenn die Rentenversicherung zahlt: Zuzahlung von 10€/Tag für max. 14 Tage pro Jahr (inkl. Krankenhausaufenthaltstage).
Wenn die Krankenversicherung zahlt: Zuzahlung von 10€/Tag für max. 28 Tage pro Jahr (inkl. Krankenhausaufenthalt).
Zuzahlung von 10€/Tag für max. 28 Tage pro Jahr (inkl. Krankenhausaufenthaltstage).
Wie oft kann ich die Maßnahme in Anspruch nehmen?Nach jeder Operation.Alle vier Jahre.

Wenn ihr zwischendurch auf AHB wart, zählt diese nicht in die Verlängerung der Frist.

 

Weitere Infos

Natürlich könnt ihr euch während eures Reha-Aufenthaltes besuchen lassen. Bitte sprecht mit den Kliniken über verschiedene Unterbringungsmöglichkeiten. Auch das Mitbringen von Angehörigen und Pflegebedürftigen zur Reha ist möglich. Da der Aufenthalt in der Reha-Klinik mit einem Krankenhaus-Aufenthalt gleichzusetzen ist, ist das verlassen der Klinik über Nacht für gewöhnlich nicht möglich.

Über die Anschlussheilbehandlung haben wir auch gesprochen in unserer Podcast-Folge zum dritten Tag des 12. Endometriosekongresses in Berlin! Hört doch mal rein, hier oder auf iTunes “EndoHilfe”.

Wir freuen uns immer über Feedback und eine tolle Bewertung unseres Podcasts!

 

Hast du einen Erfahrungsbericht zur AHB und möchtest einen Beitrag schreiben? Melde dich!

51 Gedanken zu „Anschlussheilbehandlung (AHB) nach Endometriose-OP

  1. Schade…
    Jetzt erst, nach der zweiten Entfernung von Endometriose am 11. August 2017 erfahre ich hier, dass es sogar eine Anschlussheilbehandlung gibt. Hm, darauf hat mich bisher noch niemand hingewiesen.
    Im September 2015 wurde mir zum ersten Mal Endometriose entfernt, als mir meine Gebärmutter entfernt wurde, weil ich seit 2013 die ersten zwei Tage während der Menstruation noch stärkere Schmerzen und Blutungen als zuvor hatte und der 10-15 minütige Schmerz nach dem Stuhlgang unerträglich wurde. Ich denke, schon 2013 hätte mein Gynäkologe wohl eine Bauchspiegelung anordnen müssen, doch man wird ja nicht ernst genommen mit seinem Schmerz. “Ja, dann nehmen sie jetzt für zwei Jahre die Pille durch und dann entfernen wir die Gebärmutter mit 40!” waren seine Worte im Jahr 2013…
    PS: Auch habe ich jetzt erst erfahren, dass man ja für Endometriose sogar einen Anspruch auf einen Grad der Behinderung hat.

    1. Hallo Ilka,
      Absolut, da besteht noch ganz viel Redebedarf. Leider weisen die Sozialdienste der Krankenhäuser nicht immer darauf hin – und wenn Frau es nicht weiß, kann sie nicht fragen. Ich lade dich herzlich ein alle Infos, die du auf dieser Seite findest mit allen zu teilen – und dich wenn du magst daran zu beteiligen mehr Infos auf die Seite zu stellen. Dazu haben wir jetzt auch eine Facebook Gruppe “EndoHilfe”. LG, Sarah

  2. Bin gestern operiert worden und neben den Zysten sei auch Endometriose an Gebärmutter, Eierstock und Harnleiter entfernt worden. Die behandelnde Ärztin meinte, dass es keine AHB gäbe, da ich keinen Krebs habe. Das verunsichert nun, da ich die Beiträge anders verstanden hatte.

    1. Hallo Catrin, da ist die Ärztin leider falsch informiert! Mit einer so großen OP hast du absolut Anspruch auf eine AHB! Bitte wende dich an den Sozialdienst des Krankenhauses und lass nicht locker!

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