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Old 12-11-2013, 11:07 PM   #46
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Wow! A lot of anger/hatred directed towards this "hotshot" physician.

He probably wants the best outcome for you and the long term functionality of your wrist. Surgery is probably not your only option but, the ONE with the best possible outcomes in terms of ROM/pain/use of your wrist after treatment (whichever) you choose.

By all means get a second opinion but please, if the second physician also recommends surgery, come back to this thread and at least acknowledge that this "hotshot" doc had your best interests in mind and wasn't just after your money.
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Old 12-11-2013, 11:53 PM   #47
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The longer you put off surgery if it is really needed
will just make it more difficult as well. At some
point you will have waited to long.
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Old 12-12-2013, 05:19 AM   #48
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Surgery is required to stabilize some fractures. Fixation devices — such as wires, plates, nails or screws — may be needed to maintain proper position of your bones during healing. Complications are rare, but can include infection and lack of bone healing.

I had a friend who would lose his leg from an infection in a pin in his ankle.
He apparently jumped a fence and hit a sprinkler, it hurt but not so bad to go to the doctor, wrong move.

I think many of you are living within the Myth that Doctors have your best interest at heart. They like any other profession need money to exist, as such some will do it for care, but the majority will be in it for the money and status.
There is nothing wrong with a second opinion, or in following your instinct.
Since I doubt anyone took the time to read my first article, I will post the second one up and hopefully will save someone not only money, but wellness in life.

Tens of thousands of Americans each year undergo surgical procedures that are not necessary because their physicians are “immoral, incompetent and indifferent,” according to a study by USA Today.
“It’s a very serious issue, (and) there really hasn’t been a movement to address it,” warned Lucian Leape, a professor at the Harvard School of Public Health.

The patient-safety expert began studying unneeded surgeries when a congressional report from nearly 40 years ago estimated there were 2.4 million cases each year and 12,000 people died because of those surgeries.
He said things “haven’t changed very much.”
The USA Today study indicates there are tens of thousands of surgeries each year that are unnecessary and, in many instances, dangerous.
According to the USA Today report, it’s mostly a matter of money.
“Doctors who perform needless operations to enrich themselves are the public face of the problem. Lured by the millions of dollars that can be made by billing Medicare, Medicaid and private insurers for expensive procedures that aren’t necessary, they’ve become a top target of investigators who consider this type of health care fraud to be particularly insidious,” the report said.
The USA Today evaluation found that 10 percent to 20 percent of some common surgeries are done unnecessarily, and more than 1,000 doctors already have paid malpractice claims.
The report used Jonathan Stelly, 22, as an example.
He was a semipro baseball player when a fainting spell sent him to the doctor’s office.
Stelly was told if he “wanted to live to age 30 … he’d need a pacemaker.”
He trusted his doctor’s recommendation and had the surgery.
But months later, “local news outlets reported that the Louisiana cardiologist, Mehmood Patel, was being investigated for performing unnecessary surgeries.”
“Stelly had another doctor review his case,” the report said. “Then another. And another. They all agreed: He needed blood pressure medication, but he never needed the pacemaker.”
USA Today said today Patel is in prison on convictions for dealing in unneeded surgeries. And Stelly has lost whatever baseball opportunities he may have had.
“The scope and toll of the problem are enormous, yet it remains largely hidden. Public attention has been limited to a few sensational cases, typically involving doctors who put cardiac stents in patients who didn’t need them,” the report said.
The study said that 10 percent of all spinal fusions funded by Medicare in 2011 were not needed. It also cited a Journal of the American Medical Association report that of 112,000 patients who had an implantable cardioverter-defibrillator, in nearly 25,000 cases there was no medical evidence supporting the use of the machines.
USA Today cited another study, from the Surgical Neurology International publication, that looked at 274 patients with neck and back complaints. More than 17 percent were told they needed surgery.
“The procedures are notoriously tough to identify, even for the victims. If, for example, someone has an unnecessary knee replacement, that person might never know that the pain could have been relieved just as effectively with physical therapy or a less invasive procedure. The symptoms are gone, so the patient suspects nothing,” the report said.
“If we ever learn about it at all, it’s only after the fact, if something goes wrong and the patient sees another doctor, or if Medicare or someone else comes in retroactively and does an audit,”said Rosemary Gibson, an authority on patient safety and author of “The Treatment Trap.”
“The system, in my opinion, doesn’t want to know about this problem,” she said.
The report explained: “Doctors who perform needless operations to enrich themselves are the public face of the problem. Lured by the millions of dollars that can be made by billing Medicare, Medicaid and private insurers for expensive procedures that aren’t necessary, they’ve become a top target of investigators who consider this type of health care fraud to be particularly insidious.”
The study concluded that in most cases of unnecessary surgery, there is no sinister or criminal incentive.
But, said Patty Skolni of the Citizens for Patient Safety organization, don’t take a doctor’s word.
“Research your doctor, research the procedure, ask questions, including the most important one: ‘What will happen if I don’t get this done?’” she said.
“We expect the physician to know what’s best for a patient,” William Root, chief compliance officer at Louisiana’s Department of Health and Hospitals, told USA Today. “We put so much faith and confidence in our physicians, (and) most of them deserve it. But when one of them is wrong or goes astray, it can do a lot of damage.”

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Old 12-12-2013, 06:27 AM   #49
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I wouldn't worry about the arthritis. You are going to get that anyway. 90% of the population over age 60 has some osteoarthritis. You seem to think you can get Rolls Royce treatment for the price of a Yugo. Not gonna happen. If you don't like the first guy you saw, then go somewhere else and don't complain to us that its difficult to get there. You chose to live where you do and you knew what kind of healthcare options are available there. You could just put a good motorcycle glove hand, tape it up nice and tight with duct tape and forget it. Who cares ?
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Old 12-12-2013, 06:52 AM   #50
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When a scaphoid fracture is recognized on the first X-ray, treatment begins immediately. But patients often assume that the injury is just a sprain, and they wait for it to heal on its own. In some cases, the wrist gets better. In many cases the bone fails to heal. The scaphoid fracture then develops into what surgeons call a nonunion.

A nonunion can occur in two ways. In a simple nonunion, the two pieces of bone fail to heal together. The second type of nonunion is much more serious. The lower half of the fractured bone loses its blood supply and actually dies. This condition is called avascular necrosis (Avascular means no blood supply, and necrosis means dead.)

...from "A Patient's Guide to Scaphoid Fracture of the Wrist":
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Old 12-12-2013, 07:10 AM   #51
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I think we all agree that some fractures require surgery, some casts and some only support/restraint. But unless any of you are orthopedists, I think we all should simply advise GearHeadGrrrrl and anyone else to seek competent, professional expertise as soon as possible. Could you or I determine for sure from an X-ray weather a broken bone would heal properly without treatment?
Oh, and if any of you are orthopedists, I apologize in advance.
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Old 12-12-2013, 08:31 AM   #52
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Originally Posted by GearHeadGrrrl View Post
Pretty atrocious considering that setting broken bones has been part of the skill set of every physician for over a century...

Christ... some fractures can't just be set. In 2010 I had a minor motorcycle crash (front-wheel lockup) in which my right hand hit the pavement in just the wrong way and fractured the distal end of my radius where it forms a sort of cup for the carpal bones to sit against. Basically, one side of this cup broke off, which meant my entire hand shifted out of position.

You can't just set a fracture like this because the piece of bone that's broken off is what holds the hand in position. I had surgery the same day to have a titanium plate installed to hold the broken-off piece of bone in place.

Your fracture could be in any number of places; some of them might be fine untreated, but some of them might leave you in danger of much more severe problems in the future. Go get a second opinion, even a third if it makes you feel better. But don't just assume that you know better than the people who've been through many years of intensive education about this.

Yes, it can be expensive, but that's what insurance is for. This is not something to cheap out on.

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Old 12-12-2013, 12:48 PM   #53
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As someone with a titanium plate in each wrist go find a better Dr.

First broken wrist in 2007 was a motorcycle accident. I also busted up my front teeth. Rode the rest of the way to work with a sorta clean rag in my mouth for all of the blood. Was more worried about securing the motorcycle than myself. Eventually I had a friend drive me home and then I had my girl friend take me to urgent care who then said no way go to ER. Couple of xrays latter they cast it up and said in a week you get to have surgery need to managed through swelling first.

Broken wrist number two was in 2008 I slipped and fall on ice. Bent back on my wrist so far they thought I snapped the tendon. Dislocated just about every bone in the hand. That one was xrays and a MRI. And a cast and then surgery and then a cast for 6 months for the tendon to heal. The whole time for the second surgery I kept telling the Dr he better not cut my tattoo and I did not care how big the scar was as long as the tat was not cut. Plus I was awake for that surgery thanks to them scheduling so late in the day and me having sleep apnea they said nerve block and stay awake or we put you out and you stay over night.

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Old 12-12-2013, 02:31 PM   #54
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For what its worth, some doctors are bad, some are good. Some (probably most) have your best interests at heart.

Without any films posted here, no one should give you any advice on a course of treatment. Even if you did post them, I'd take any of that advice with a BIG grain of salt. Clinical exam is very important in deciding the course of treatment as well. Clinical exam and Radiographic exams are necessary for a satisfactory plan for treatment. Prudence dictates you get a second opinion.

You need to find someone you are comfortable with. Particularly if surgery is involved. Good luck
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Old 12-12-2013, 02:57 PM   #55
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Very well stated. The Doc she consulted first may be a hot-shot, but he can't communicate for beans. Unfortunately, medical care in the US is an expensive commodity. Any reasonable person should have the right to a clear explanation of what the procedure will involve, and why it's necessary.

My body is mine. It is my natural right to choose or reject treatment on an informed basis. My step-father did this, and passed because of Leukemia that would have likely been treatable but for his religious beliefs. His integrity held strong to the end.

If anyone is doing anything invasive as surgery, I want a full and cogent explanation why, with pictures and diagrams and 8 x 10 glossies, particularly if it's going to cost a year's wages.

Medicine is one of the few commodities we buy without knowing either the price or the outcome.

I actually think this thread has been remarkably civilized in tone, given the acrimonious debate over national health care.

Originally Posted by chicagotrauma View Post
Clinical exam is very important in deciding the course of treatment as well. Clinical exam and Radiographic exams are necessary for a satisfactory plan for treatment. Prudence dictates you get a second opinion.

You need to find someone you are comfortable with. Particularly if surgery is involved. Good luck
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Old 12-13-2013, 05:56 AM   #56
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Injury +9 days update...

Swelling has gone down quite a bit and function is improving- I'm getting comfortable gripping and lifting light stuff. More importantly, I can work the clutch of an airhead, though it hurts enough that I wouldn't care to do it often. Pain is well controlled with OTC Naproxine Sodium 2x/day, and I'm sleeping well at night. I'm adapting my environment- I stocked up on paper bowls & plates at Costco so I don't have to do dishes and vice grips work well to hold stuff while I work on it. My Dakar jacket's generous sizing and velcro closures are a useful adaptation, only problem is the velcro on my wrist brace wants to catch on the velcro on the for the pads... Oh well, my old Postal Service Carrier's button front parka works good too!

Now to put this downtime to good use wrenching...
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