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Venting: Injury Care in Modern Medical System

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Venting: Injury Care in Modern Medical System

Unread postby Olaf » Fri 18 Jul 2008, 13:22:58

I've mentioned on here a time or two about how I particpate in a form of armored sport stick fighting. Just over 4 weeks ago, I was doing my fighting thing and suffered a thumb injury to my left hand (dominant). It hyper extended sideways, causing a shock and vibration sensation in my hand. After checking it out, I tried to fight more, but quickly realised that I could not continue. The thumb felt very unstable to me and was very painful to try to do anything with the hand within several minutes. Went home, iced it up for a good long time and took some ibuprofin, hoping for the best.

Well, the next morning it showed no improvement, was swelled up nicely and the base knuckle on the thumb seemed twice the normal size. I had full range of motion, but no strength in the thumb and it continued to be unstable, so off to Urgent Care I went. I have insurance and a primary care physician.

At urgent care they took x-rays and proclaimed that I had a sprained thumb, with no breaks or dislocations. Not confident in this diagnosis, I asked if I could be scheduled with a sports doc or specialist. The earliest specialist they could get me in to see was an appointment two weeks out, but they could get me in with a sports nurse practioner that day while also scheduling the appointment with the hand specialist.

So off I went to see the sports guy, who spent no more than 4 minutes with me and confirmed the sprain diagnosis and set me up with Occ. therapy. He said to try to use the thumb, but to be cautious with it. Ok, for the most part, so far so good.

The Occ. therapist appointment was for the following week. I went in, and he had me go through some exercises, and did a couple of different treatments on the thumb and tested range of motion, etc. At this point the thumb still had significant swelling. The therapist confirmed what he thought to be a sprain, and gave me some exercises and said to work on those, use the thumb to try to strengthen some and scheduled me for a follow up the following week.

Now two weeks into the process, the pain in the thumb was down significantly, but the knuckle still looked out of whack and still no real strength in the thumb. Simply trying to grab a bottle of shampoo would cause the entire thumb to simply bend down with no grip. I went back and after running through some more exercises the therapist declared that he believed I had a torn UCL and fitted me with a hard plastic molded brace for my thumb. I still had the appointment with the hand specialist for the next day and he recommended I keep it.

The next day I went for that appointment, and after another 5 minute session during which he played with my thumb for a few seconds, he declared that I did have a torn ligament that would require surgery. Unfortunately, he was going on vacation the next day, and would be unavailable to do the surgery until after he returned. He suggested that I try to track down another surgeon that may be able to do it sooner. He said that if I was unsuccesful, he could do the surgey when he got back. Well, I tried to do this with an incredible lack of success. First, the surgeon leaving on vacation neglected to do his write up, and one surgeon flat out refused to even consider me without his write up. Sending back to me in the mail all the other records I had forwarded to his office along with a note declining to take me as a patient, stating he had nothing further to offer. The next surgeon I tried to contact could not even get me in for a consultation for several weeks.

By this time, it was more than three weeks since the injury, and the other surgeon was back from vacation. In the week that has followed since then, I have tried to contact the surgeon I saw on two separate occassions, leaving messages with his nurse, and several phone numbers where I could be reached. He has not called me back.

Additionally, I continue to believe that I have not received a full diagnosis for what is wrong with my thumb. Frankly, I strongly suspect that I may also have other damaged ligaments, as well as perhaps an at least partial tear in one of the tendons. Since the other doctor apparently feels no need to return my phone calls, I have gone ahead and scheduled that consultation with the other surgeon and contacted my primary to get my x-rays and a referral. Mind you, everyone I have talked to has declined to do an MRI to this point. The appointment for just my first office visit with him isn't until the middle of August.

I have found the service I have recieved so far (with exception of the therapist) to be entirely sub-standard. I am now a month into the injury with the likelihood that I will be two months into it before I even get scheduled for surgery, which will be reconstructive now due to the time it has taken for me to get anything done with it. This means they will have to take a ligament from somewhere else and put it in my thumb (assuming that is the only damage).

This has been frustrating beyond belief. I had no idea how difficult it would be to get good medical treatment for something of this nature. I am now faced with a delay for surgery, which will be followed with six weeks in a cast, and many more weeks of therapy. I'm told not to expect to be able to use the hand as I'm used to for at least 3 months after surgery, and quite likely longer. In general everyone has been either uncaring, unresponsive, or unhelpful, and I HAVE insurance. I've had to do virtually all of the leg work and feel like I am beating my head into a wall. If I may, WTF is going on here!!??

Thanks for listening to me b!tch.

Olaf of the busted hand
Last edited by Olaf on Fri 18 Jul 2008, 14:08:33, edited 1 time in total.
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Re: Venting: Injury Care in Modern Medical System

Unread postby Ludi » Fri 18 Jul 2008, 14:00:20

Oh my god. 8O

Reconstructive surgery?
8O


My best wishes are with you for full recovery. Scary stuff.
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Re: Venting: Injury Care in Modern Medical System

Unread postby Olaf » Fri 18 Jul 2008, 14:16:56

$this->bbcode_second_pass_quote('Ludi', 'O')h my god. 8O

Reconstructive surgery?
8O


My best wishes are with you for full recovery. Scary stuff.


Yup, reconstructive. As far as I see it, due to their complete lack of attention to detail and promptness in properly diagnosing it. My understanding is that if surgery is done wtihin two weeks of the injury, the ligaments can generally be reattached. After that, they begin to atrophy, and don't take well to being reattached. So now they'll have to take a ligament from somewher else (isn't it needed in that 'somewhere else')? I realize we've got some redundant organs and such, but the ligaments are in places because, you know, they're sort of needed there.

My biggest worry is that they've missed damage that will extend or complicate the process and reduce my chances for a moderately full recovery.

I mean, does this sound like standard practice to folks out there? Any docs on board or folks with similar experiences? The medical staff doesn't really seem to give a sh!t.

Olaf
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Re: Venting: Injury Care in Modern Medical System

Unread postby mgibbons19 » Fri 18 Jul 2008, 14:28:42

I thought somewhere else was dead guys.
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Re: Venting: Injury Care in Modern Medical System

Unread postby holmes » Fri 18 Jul 2008, 14:37:59

It does not help your cause that the medical facilties are booked solid and overwhelmed. I have had to wait months to get an appointment for a physical check up and a teeth cleaning. Overpopulation and over demand does not help anyone. I have cadillac benefits as well. yet I get the same treatment or worse than the illegal that can walk right in and get seen by law. The days that a LEGAL citizen can get immediate attention are over. That died pretty much in the 1970's.
I wish you luck and a total healing, Olaf.
If you can get a good doctor then it can be fixed. I had surgery on my toe and they lenghtend the tendon and took off a peice and attached it. My toes is fine now. Better then before. It is routine for a good doctor. try and get one of these young hot shot doctors that do advanced cutting edge stuff.
Last edited by holmes on Fri 18 Jul 2008, 14:42:00, edited 2 times in total.
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Re: Venting: Injury Care in Modern Medical System

Unread postby Olaf » Fri 18 Jul 2008, 14:38:08

$this->bbcode_second_pass_quote('mgibbons19', 'I') thought somewhere else was dead guys.


His indication was that it would come from my body (if my memory serves correctly, he said from somewhere else in my hand) at least that is how I understood it. My thought on this was they do this to minimize any chance for the body to reject it (from a cadaver) and then have to go back in for another round.

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Re: Venting: Injury Care in Modern Medical System

Unread postby smallpoxgirl » Fri 18 Jul 2008, 15:03:36

Maybe it's not nice of me to rain on your vent, but seriously dude. You have a relatively minor injury to your thumb and you're getting tens of thousands of dollars of medical care for it. You should be on your knees thanking whatever god that you believe in that you are in the 1% of people in human history that ever had such an opportunity. Do you have any idea how much money it costs society to train a hand surgeon? And you're griping because there aren't more to provide you with more timely repair of your finger? It's gamekeepers thumb for gosh sakes, not a brain aneurysm.
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Of a thousand burning bridges
Sifting through the ashes every day
What we thought would never end
Now is nothing more than a memory
The way things were before
I lost my way" - OCMS
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Re: Venting: Injury Care in Modern Medical System

Unread postby joelcolorado » Fri 18 Jul 2008, 15:06:48

Do you know how many patients my wife sees every day? Sometimes 7 days a week 12 hours a day? Unbelievable. I couldnt do that and be perfect, can YOU.
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Re: Venting: Injury Care in Modern Medical System

Unread postby RonMN » Fri 18 Jul 2008, 15:08:28

This has been my experience of the medical "professionals" since our family doctor retired (when I was in my teens).

Dad is dying...well, nothing we can do...and we don't care.
No feeling in a toe for a year...nothing we can do.
Vomiting 12 times a day...hmmmm, we just can't figure it out, Oh well.

And the ironic part is now, you'll put your trust in these "professionals" to perform surgery on you.

I'm not giving you medical advice (I ain't qualified to do so), but if it were me, I would seriously consider giving it a year to heal on it's own without surgery.
Quis custodiet ipsos custodes.
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Re: Venting: Injury Care in Modern Medical System

Unread postby joelcolorado » Fri 18 Jul 2008, 15:11:37

THAT wont heal on its own, duh.
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Re: Venting: Injury Care in Modern Medical System

Unread postby WildRose » Fri 18 Jul 2008, 15:14:28

How has your wrist been, Olaf? Was there any swelling with your wrist? If so, you could have sustained a Bennett's fracture.

Sometimes more than one x-ray is needed to make the diagnosis of a fracture/dislocation because there is too much swelling to see the fracture.

An MRI would be the way to go to show the ligament damage.
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Re: Venting: Injury Care in Modern Medical System

Unread postby RonMN » Fri 18 Jul 2008, 15:14:32

I don't know about that...the feeling in my toe came back after 2 years & I did eventually stop vomiting :P
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Re: Venting: Injury Care in Modern Medical System

Unread postby smallpoxgirl » Fri 18 Jul 2008, 15:14:37

$this->bbcode_second_pass_quote('RonMN', 'N')o feeling in a toe for a year...nothing we can do.


Ever heard of Chistopher Reeve?
"We were standing on the edges
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Sifting through the ashes every day
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Now is nothing more than a memory
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Re: Venting: Injury Care in Modern Medical System

Unread postby Olaf » Fri 18 Jul 2008, 15:40:04

$this->bbcode_second_pass_quote('smallpoxgirl', 'M')aybe it's not nice of me to rain on your vent, but seriously dude. You have a relatively minor injury to your thumb and you're getting tens of thousands of dollars of medical care for it. You should be on your knees thanking whatever god that you believe in that you are in the 1% of people in human history that ever had such an opportunity. Do you have any idea how much money it costs society to train a hand surgeon? And you're griping because there aren't more to provide you with more timely repair of your finger? It's gamekeepers thumb for gosh sakes, not a brain aneurysm.


A little defensive smallpoxgirl? Got to say I disagree. Minor, as in not life threatening, sure, but my hand right now is pretty useless. I don't really consider that minor, especially considering my pretty active lifestyle. Tell me how useless a surgeon would be with the same injury? Bet they'd get theirs fixed faster. If they aren't fixing the problem, it doesn't make any difference. I didn't expect to get surgically treated right away, but all the literature I read says the sooner the better with substantial decrease in success after 6 weeks. I'm in week 5. So far, all said and done, I think I've received about an hours worth of medical tretament for it, and that includes the occupational therapist time. The diagnosing surgeon I have seen continues to be completely unresponsive. Apparently, they forgot the telephone part of his training. I'm largely expressing what I consider to be a fast food que line approach to patient treatment and I think it effin' sucks. Sorry if you don't like that.

I have lots of respect for what doctors can do, pretty d@mn amazed actually. I know they work hard. They aren't the only ones. I am glad to live in a time that has folks that can fix an injury such as mine. But not all doctors are ethical, and not all of them give crap, and unfortunately, many of them are stuck working in a system that doesn't treat people like people.

Olaf
Last edited by Olaf on Fri 18 Jul 2008, 15:42:22, edited 1 time in total.
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Re: Venting: Injury Care in Modern Medical System

Unread postby darwinsdog » Fri 18 Jul 2008, 15:40:19

The US health care system is by far the worst in the developed world. For-profit medicine says it all: $$ is more important than people. If you're rich there's plenty of greedy physicians ready to provide cosmetic &/or recreational medicine to you. If you're poor you're shitty out of luck. That's the reality here in the "land of the free, home of the brave" (keep repeating that mantra 'til you believe it). & btw, a sprained thumb will be a fatal injury once you're forced by necessity to provide for yourself & defend what you provide, which won't be much longer.
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Re: Venting: Injury Care in Modern Medical System

Unread postby Olaf » Fri 18 Jul 2008, 15:50:08

$this->bbcode_second_pass_quote('WildRose', 'H')ow has your wrist been, Olaf? Was there any swelling with your wrist? If so, you could have sustained a Bennett's fracture.

Sometimes more than one x-ray is needed to make the diagnosis of a fracture/dislocation because there is too much swelling to see the fracture.

An MRI would be the way to go to show the ligament damage.


The wrist is fine, but I have continuing pain in the ligament area opposite the UCL, as well as some pain running down the centerline of the thumb at the top joint (tendon?). Additionally, I still have pain below the joint into the hand area of the thumb but above the wrist. I have asked every single medical professional I have been to about an MRI. Every single one of them declined to do one (that's three folks, all at the same facility).

Olaf
Last edited by Olaf on Fri 18 Jul 2008, 15:57:19, edited 1 time in total.
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Re: Venting: Injury Care in Modern Medical System

Unread postby midnight-gamer » Fri 18 Jul 2008, 15:55:09

I did similar thing years ago working in a warehouse. My hand slipped while moving a heavy entertainment cabinet designed to hold those huge crt. televisions. The damn thing fell 2-3 feet onto my poor thumb, mashing it into a metal dolly.
At the hospital the desk receptionist wanted my insurance information even though the injury happened at work. I had a long wait but I don't hold it against the staff. When a doctor had a moment to spare, he looked at my hand for less than one minute. He took firm hold of the hand and started twisting and moving the sore digit. He asks me "does this hurt?" To which I replied "yes, and I might pop you if you don't stop doing that." I don't hold that against him either, I know they are busy. I was diagnosed with a hyper extended ligament, and sent off to the therapist for a cast fitting.
Everything works well enough now. I had trouble with billing though. My work took their time paying the hospital and the collectors tried their best to get it out of me.
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Re: Venting: Injury Care in Modern Medical System

Unread postby WildRose » Fri 18 Jul 2008, 15:58:07

$this->bbcode_second_pass_quote('Olaf', '')$this->bbcode_second_pass_quote('WildRose', 'H')ow has your wrist been, Olaf? Was there any swelling with your wrist? If so, you could have sustained a Bennett's fracture.

Sometimes more than one x-ray is needed to make the diagnosis of a fracture/dislocation because there is too much swelling to see the fracture.

An MRI would be the way to go to show the ligament damage.


The wrist is fine, but I have continuing pain in the ligament area opposite the UCL, as well as some pain running down the centerline of the thumb at the top joint (tendon?). Additionally, I still have pain below the joint into the hand area of the thumb but above the wrist. I have asked every single medical professional I have been to about an MRI. Every single one of them declined to do one.

Olaf


Why do they decline the MRI? If you may need ligament repair, sometimes how successful it is depends on how soon after the injury the repair is done.
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Re: Venting: Injury Care in Modern Medical System

Unread postby Olaf » Fri 18 Jul 2008, 16:04:11

$this->bbcode_second_pass_quote('WildRose', '')$this->bbcode_second_pass_quote('Olaf', '')$this->bbcode_second_pass_quote('WildRose', 'H')ow has your wrist been, Olaf? Was there any swelling with your wrist? If so, you could have sustained a Bennett's fracture.

Sometimes more than one x-ray is needed to make the diagnosis of a fracture/dislocation because there is too much swelling to see the fracture.

An MRI would be the way to go to show the ligament damage.


The wrist is fine, but I have continuing pain in the ligament area opposite the UCL, as well as some pain running down the centerline of the thumb at the top joint (tendon?). Additionally, I still have pain below the joint into the hand area of the thumb but above the wrist. I have asked every single medical professional I have been to about an MRI. Every single one of them declined to do one.

Olaf


Why do they decline the MRI? If you may need ligament repair, sometimes how successful it is depends on how soon after the injury the repair is done.


That is a very good question. Purely speculation, I think the insurance companies give a hard time about paying for them, so the docs are trying to avoid doing them unless absolutely necessary. Your statement regarding the promptness of treatment v. success is exactly one of my points.

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Re: Venting: Injury Care in Modern Medical System

Unread postby smallpoxgirl » Fri 18 Jul 2008, 16:30:57

$this->bbcode_second_pass_quote('Olaf', 'I') don't really consider that minor, especially considering my pretty active lifestyle.


You are getting tens of thousands of dollars of medical care for an injury to your finger that you sustained from an inherently dangerous hobby. Meanwhile people with AIDS are dying because they can't afford $25 worth of anti-virals. Most places in the world, the treatment for that would be to ignore it until it got too painful and then either fuse the joint or amputate your thumb. You're getting mega-expensive microscopic finger tendon repair from a doctor that spent 15 years in training just specializing in hands and you're pissed off because it's taking too long. Do you really whine this much around all your sword fighting buddies?

Your story is a great example of why American healthcare is screwed, but not for the reason you think. You think it's about poor service. Really it's about patient's with unrealistic expectations willing to spend baskets full of other people's money for trivial problems.
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