injury update

[mckitterick]

Went to the doctor today to get a checkup about my shoulder. The first fun aspect was that his office, FirstMed in Lawrence, doesn't accept vehicular insurance. Prior to going there, I had asked my scoot insurance person how I should handle medical stuff, and she said that I should give them the Progressive card and they'd deal with what was covered and then we'd figure out later who pays for what. Well, apparently FirstMed didn't get the memo. They haven't accepted vehicular insurance for three years, because "it's too much of a pain to deal with." Um, so it's better to make your patents deal with it, eh? Nice service. Why do they even have a billing department if they're too lazy to deal with bills? I love Dr. Burt, but I'm not sure I love him enough to stay with this joynt.

Anyway. Doctor Burt has me remove my shirt and says, "Wow, that's quite a bump you have there." Hmph. Then he asks, "Has it been getting better or worse?"

I tell him that the pain has declined from I'm being stabbed to death through the top of my shoulder! to a mild It aches all the time and has bright-white twinges when I do something wrong.

He sends me to take an x-ray, which the tech shows me as it pops out of the developer (yup, they still use film at FirstMed). "That doesn't look good," he says. No kidding. Check this out:


The clavicle (collarbone) is sticking up, out of place, more than half an inch. Fuck. Here's what it should look like:


After a while, Doc takes a look at the image and comes to chat with me wearing a bit of a frown. "I want to take another picture of you holding a milk-jug and see if the Acromioclavicular dislocation becomes greater." I laugh. He's serious. He wants to know if the other little tendons holding the clavicle down are snapped off or not, thus letting my collarbone float upward.

So I go back to x-ray and see a pair of - I'm serious - milk jugs filled with water sitting on the table by the machine. The tech looks real nervous. "I'm not sure about this," he says. "How about I give it to you a little bit at a time and we see if you can hold it?"

As it turns out, I can hold 8 pounds in my bad arm (also my good one - they take a pic of each to compare), but it hurts like hell, and my shoulder remains sore for many hours later. Oddly, this weighted x-ray shows the joint closed up more than the previous one, a sign that the tendon isn't completely separated - perhaps good news. Here's that photo:


Here's an anatomical drawing of how things should look:


I go back to wait for the doctor. It's now been 3 hours since the appointment started, and I'm pretty sore from sitting in a chair without arms, not to mention having just hung a bunch of weight from a hurtin' arm. Doc comes in kinda smiling. "I don't think you'll need to go under the knife. Unless that bump bothers you."

"Will it always be out of place like this?"

"Yeah, you'll pretty much always have a bump there. Does that bother you?"

"What can I do to get the joint to go back to where it belongs? Physical therapy? What can we do to fix it?"

"Well, you can have surgery, but only if the bump bothers you."

"It hurts when I move my arm up - I can feel the bones rub with them being out of place."

He grimaces at that. "Maybe we should send you to the orthopedist."

So I have an appointment next Tuesday. In the mean time, there's nothing I can do to try to get the thing back into place; I even asked him if I could push it down to try to help: "Well, if you could press 50 pounds down on it all the time." He chuckles.

The problem is, the tendon is all stretched-out - if it's even attached at all anymore. It makes me sick to think this is a permanent injury from one idiot's moment of inattention while driving. Because she was in too much of a hurry to wait for a scooter to ride past her. What if I'd been a newbie scooterist? I'd have driven right into the side of her car and over the top when she stopped in the middle of my lane.

Dammit. Not in a good mood. Taking a Lortab and going to bed.

Best,
Chris

Comments

[bammba-m.livejournal.com]

I wasn't there, but it kind of sounds like you need a new doctor.

What a huge pile of suck. *hugs*

[ellen-datlow.livejournal.com]

Sounds awful. And I suggest you get a second opinion. This doc doesn't sound too empathetic.

[arian1.livejournal.com]

I broke my collarbone when I was younger. It sucks.

I wish you a speedy recovery man...and hire a stuntman next time.

[mckitterick.livejournal.com]

I'd love to, but a stuntman giving me a ride from class to the office would have just tried to jump OVER the car, which would have ended in tears.

[amysisson.livejournal.com]

Oh, ouch. I'm so sorry you're going through this.

[mckitterick.livejournal.com]

Thanks. It's kind of sucky. Even hurts to type, which has pretty much ended up wasting my weeks off between semesters - during which time I had been planning to write and send off stories. Which is great.

[royal-spice.livejournal.com]

That is full of suck. I'm sorry you have this injury to deal with.

Please do see an orthopedist. This is too much injury for a primary care doc to manage without a specialist, IMHO. Referral should be the first word, rather than the last, upon seeing this. Ouch.

[astein142.livejournal.com]

I would have screamed "specialist" as soon as I saw that xray. I'm so sorry you're going through this. Do your due diligence. See the specialist. Discuss your options with a lawyer -- you are (hopefully only temporarily) disabled. Also see if you can get a copy of voice recognition software (Dragon is mentioned as a good one) so you can keep creating while you're healing.

[mckitterick.livejournal.com]

Yeah, I think I'll have to see a lawyer, considering how I'll be paying out-of-pocket for a while....

[maryrobinette.livejournal.com]

Having had more than my fair share of shoulder injuries, I'm going to second the advice to get another opinion. At the very least, ask to be sent to an occupational therapist who can do wonders to get things that are stretched out back into alignment and can also show you ways to work without pain.

[gryphonrose.livejournal.com]

Damn, dude, that sucks. I hope you get good news--as good as you can--from the orthopedist.

[mckitterick.livejournal.com]

I'm with you on that.

[ericreynolds.livejournal.com]

Man, I know the waiting sucks bad. But I hope the orthopedist is able to give more definitive answers.

[mckitterick.livejournal.com]

Me too.

[edichka2.livejournal.com]

Agreed about the ortho referral. Agreed that this is not an injury that primary care should manage (unless, contrary to the actual situation, the patient reports that things are basically improving satisfactorily).

I might suggest trying to find out who specializes in shoulder injuries in your area, and requesting a referral to that person rather than a general orthopedist. It's difficult to ascertain who's truly good, especially since experiences and opinions may vary, but it shouldn't be hard to figure out who's specialized.

G'luck,
- E

[mckitterick.livejournal.com]

Thanks for the rec's. Good ideas!

[piezocuttlefish.livejournal.com]

Holy shit, dog. *hug*
That is some shit.

[woadwarrior.livejournal.com]

Did your Doc classify you injury as a type two or a type three? They don't usually do a surgical correction on a two or less. (Mine was a type two). Definitely go see the ortho guys and get the second opinion.

S

[mckitterick.livejournal.com]

He's not sure - but I did a bunch of research last night, and it's looking like a very-large-displacement II or a mild III. The primary difference seems to be something you can't know from outside: Tears to the coracoclavicular ligaments.

[klingonguy.livejournal.com]

Not that you need another person telling you this, but... go to the orthopod. And while you're there, tell him/her the story about the milk jugs and see what your ortho thinks of your PCP.

[mckitterick.livejournal.com]

In my research, it seems that's an old-fashioned way to test. But he's not an ortho....

[fortyozspartan.livejournal.com]

I've been reading about your accident :( I'm sorry that happened. Hopefully they're giving you some decent pain medication - best of luck!

[mckitterick.livejournal.com]

Yeah, I have Lortab (powerful stuff), but it seems that booze works just as well. And is cheaper.

[geekmom.livejournal.com]

Um, ow. And it really does suck that someone else's inattentiveness has cost you a permanent injury.

[mckitterick.livejournal.com]

Suckage indeed.

[j-cheney.livejournal.com]

I have nasty arthritis in that joint, and the PT lady gave me a long list of no-nos. Given that mine's just arthritis....and all the things I'm not supposed to do, I'm shocked you can still lift 8 pounds! Ouch!

[mckitterick.livejournal.com]

Yeah, I read that I'll likely get arthritis out of this, too. Awesome.

[robinbailey.livejournal.com]

I hope my elbow doesn't turn out to be one of those "you'll just have to live with it" things.

I also hope you're planning to sue the bastard who hit you.

[mckitterick.livejournal.com]

I hope so, too - and at least you're smiling in your photos; my face seems to have a scowl most of the time. Pain over time is fatiguing.

According to the medical literature I can find, this bump will be permanent. Unless I do surgery, which is not often recommended in recent years unless the muscle is penetrated by the clavicle. (Yuck.)

Yeah, I'm going to have to sue her insurance company, because the bills are going to mount for the next six months.

[rougewench.livejournal.com]

Oh, that's really awful. May a proper orthopedist give you a more manageable prognosis and a course of treatment that will actually fix the problem.


D.

[mckitterick.livejournal.com]

Thanks; I hope so, too.

Hey Man

[(Anonymous)]

Sorry to hear about your accident, that really sucks. It sounds like something you'll have to deal with for awhile, but I have faith you will be tip-top again! Let me know if you need someone to rub hot baby oil into your naked body and I'll call Mike over for you.

--Scot

Re: Hey Man

[mckitterick.livejournal.com]

What, you're not willing to do that anymore? ;-)

[orin2.livejournal.com]

Well at least you have a plan of action. Inaction at times like these is a killer. My advice to you my friend is not to try to overdo anything. Don't let yourself get frustrated to the point where you hurt yourself again. I get that way sometimes. And take the drugs if you need them! Feel better, Chris.

[mckitterick.livejournal.com]

Yeah, I know: It's so frustrating to not be able to use this time off between semesters. And feel my shoulder getting weaker day by day. Grrrr.

:( & >:(

[siro-gravity.livejournal.com]

what a huge pile of steaming shit this is. all about it is shit.

i don't remember every mini detail about anatomy, but the top picture of your clavicle sticking out into the air, is painful just to look at. it's like 2 puzzles pieces not put together.

the thing about them NOT ACCEPTING VEHICULAR INSURANCE???? WTF WTF WTF??????????? how do they expect to be paid? and why do we buy the insurance if doctors won't accept it?

i think it's good you're going to the orthopedist.

and i think the other driver sucks, too.

so there ya go.
(((((((((((((chris)))))))))))))

Re: :( & >:(

[mckitterick.livejournal.com]

Thanks for the commisseration. A big pile of it, for sure.

[kalimeg.livejournal.com]

Well, it's either surgery to pin it back in place; or when it stops hurting you can go to a chiropractor. You might call a chiropractor and ask whether they work on clavicles, and offer to share x-rays. That will inform your choices better than guessing.

[mckitterick.livejournal.com]

Yeah, I think the pinning-it-down is not a good idea; mostly one does it for appearance reasons. Because it's never the same afterward.

Irritated? Yes, a little.

Popped Clavicle

[muggsmcginnis.livejournal.com]

I'm really sorry about that. I have another friend who tore hers loose... 3 doctors. Osteopath told her it's permanent. She does physical therapy to strengthen it, but one of her shoulders will always hang lower.

Re: Popped Clavicle

[mckitterick.livejournal.com]

Awesome. That's kind of what I'm discovering with my research.

I'm pretty unhappy about all this. (That's an example of the literary technique, "understatement.")

[http://users.livejournal.com/_starlady_/]

Awww . . . here I was having the best time of my life while you were having a totally sucky time. I feel for you. I hope you and Anthony can numb that pain with some liquid refreshments. I'm glad to see you being proactive with your health care. It's amazing how much of a struggle it is. Here's wishing your path smooths up.

[mckitterick.livejournal.com]

Thanks. Yeah, totally sucky right now.

Ouch!

[bodandra.livejournal.com]

A similar thing happened to me a long time ago, Chris. But it happened from being thrown out of my car as it rolled (good thing I was not wearing a seat belt andhD the windows rolled mostly down).
The thing on me that broke was the coracoid process.
It is a small bone that holds all the tendons in the shoulder in place.
They did surgery to push that little bone back where it belonged. Put rods into my clavicle to force it to remain down.
The rods had to be removed in two months time, because my body was pushing them back out.