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Sports Related Injury: Update [Mar. 2nd, 2013|11:14 am]
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[music |Mindy Smith: Jolene]

So earlier this week when I went for my 7.5 mile run along the river I had a glorious time but managed to add yet one more incident to my cavalcade of sports related injuries. A vague soreness of the right ankle in a circle the corresponds with the top of my shoe -- it felt like I'd jumped out of a window and landed heavily on one foot -- this didn't manifest itself until the next day. I stayed off of it, but resumed walking the day after, during which time it swelled up a bit and the pain remained constant. I got a doctor's appointment. My doctor poked at it a bit, looked at the swelling, was, for me, not nearly as enthused as she ought to have been that my resting pulse rate had dropped from 80 to 55 since I'd seen her last, and suggested that my injury was likely a number of small inflamed ligaments but that it might also be a stress-fracture from repeated impacts. So she wrote me a prescription for a powerful anti-inflammatory (so potent is this drug that were I locked in a tiny room with Ted Nugent and Michael Moore, the mere presence of my drug soaked anti-inflammatory self would calm them so much they would become dear friends and rent an apartment together in Astoria) and scheduled me for an x-ray of my right ankle.

I walked over to the x-ray room and witnessed bureaucracy in action while half of the staff insisted that I needed a referral and the other half didn't. I sat around for 45 minutes while this was sorted out, paid $30, and was lead into the x-ray room by a pleasant young woman in grey scrubs.

"So," she said, "we're xraying your left ankle today?" she asked.

"No," I said, "my right. I hurt it performing sports."





Clickenzee to see this fancy camera EVEN BIGGER!



She was unfazed by my manly-sports-jockness and scrutinized the paper I'd brought over. It said "x-ray: RIGHT ANKLE" but my doctor had also checked the box that said "side of body: left".

"It's the right ankle," I said, "I may have stress fracture."

"We can't x-ray it," she said, "because this says left side of body. You'll need to call your doctor and get a new form faxed over."

I called my doctor's office, knowing that she had nothing better to to. The nurse at the desk said they'd update my file on the computer. This turned out not to be enough, the x-ray office couldn't print the document out, they needed a fax of it, for some nebulous reason. I called my doctor's office back. The nurse said they'd print it out and fax it over.

I sat back on the x-ray table. Waiting. One of the technicians hovered over the fax machine.

And I waited.

And I waited.

And ... the x-ray office eventually closed and I walked home with no x-ray. I filled my prescription for the powerful drugs and took my second pill just now. Hopefully this will clear things up in a few days.

I am inspired, however, to stay away from the nightmare which is the hospital system. I'm inclined now to just wrap broken things in poultices I've cribbed together from ancient manuscripts and witches at the knitting circle. And I want my $30 back for the x-ray that never happened.....

And that's the news from lake Woebegon.




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Comments:
[User Picture]From: sheilagh
2013-03-02 04:44 pm (UTC)

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If you have any cooperative felines, have them sit near/on your ankle, as comfort permits. Their purr is clinically proven to heal, broken bones especially: http://suite101.com/article/cat-purring-heals-humans-too-a301041
[User Picture]From: sinboy
2013-03-02 04:47 pm (UTC)

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I'm betting that not a one of them knows the reason for that stupid fax requirement, or even who wrote it into being. Probably if they were on fire, they'd have to consult a manual for procedures.
[User Picture]From: i
2013-03-02 04:56 pm (UTC)

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think of all the billable procedures! filling out the form. reading the form. arguing with the patient about where it hurts. rewriting the form. emailing the form. reading the email. citing obscure rule. faxing the form. lathering, rinsing and repeating at patient's next visit.
[User Picture]From: ladycelia
2013-03-02 05:04 pm (UTC)

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You should have crossed your legs so that your right ankle was closer to your left side!
[User Picture]From: kylecassidy
2013-03-02 05:24 pm (UTC)

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I offered to do that! I also offered to lay face down so my right ankle would be on the left side of the table and I suggested they could just xray BOTH ankles. none were persuasive.
[User Picture]From: tripleransom
2013-03-02 05:34 pm (UTC)

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Welcome to Medical Hell.

Watch out for the anti-inflammatories, they can cause stomach ulcers. If your ankle turns out not to be a stress fracture, please ask your doctor for a prescription for Voltaren Gel instead. It's a topical anti-inflammatory that works well on close to the surface things. Check it out on the internet.
We use the equine version (called Surpass) all the time and it's extremely effective. Consider this: race horses are among the most valuable athletes in the world and they are very prone to orthopedic injuries, so it's very important to keep them sound. One of the horses can't use any systemic anti-inflammatories because of his ulcer problem, but I can use that on him.
Based on the results from him, DH, who is also ulcer-prone and can't take any oral anti-inflammatories, uses the people version himself and it does work, with much less potential for problems.
Oh, and good luck.
[User Picture]From: redmorlock
2013-03-02 05:47 pm (UTC)

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Go easy on that ankle. Emma broke hers in December, and didn't realize it was broken for several days, which really did not help. Good luck!
[User Picture]From: coffeeem
2013-03-02 05:57 pm (UTC)

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Days, hell. I walked on it for almost two weeks. (Okay, limped on it. Still. If I'm going to fall prey to it, I want credit for my stupid macho.)
[User Picture]From: coffeeem
2013-03-02 05:59 pm (UTC)

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The drugstore sells a quite nice elastic-and-Velcro ankle brace for when you have to walk on the healing ankle. I'd say "Ask me how I know," but Will already told you.
[User Picture]From: anmorata
2013-03-02 06:36 pm (UTC)

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I'm sorry that your experience was awful. :/ There are just as many incompetent people in the field as there are competent, sadly. I saw that Gabe sent you some advice via Twitter, as have others here, so I will just commiserate with you. But when they open back up on Monday? Give them hell, since you are the best advocate for your health. There is *NO* reason why they should have sent a person walking on a potential fracture (even a stress fracture, but still), and no reason why they could not have called your doctor's office themselves (that's the job of the medical office staff) to get it sorted out before closing.
[User Picture]From: molinaslim
2013-03-02 06:52 pm (UTC)

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Nurses and doctors who can't tell their left from their right are pretty common. When I worked for the Dept of Health I often found charting errors like this where the injury would start out on one side, then magically switch to the other side, then slowly work it's way back over to the original side, so by the end of two weeks of medical charting you couldn't tell if there was one wound or two. It was always entertaining to read.

Edited at 2013-03-02 06:53 pm (UTC)
[User Picture]From: kylecassidy
2013-03-02 07:02 pm (UTC)

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Im sure it's some fear of malpractice that they couldn't xray the obvious proper foot, but it's nuts.
[User Picture]From: molinaslim
2013-03-02 07:06 pm (UTC)

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They obviously forgot the purpose of why people chart - to ensure good care. This time they dropped the ball on the care to ensure good charting. Stupid.
[User Picture]From: kylecassidy
2013-03-02 07:11 pm (UTC)

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It's not like they were amputating one of them, right? Worst case, the doctor's like "this isn't the ankle i wanted to see!"
[User Picture]From: molinaslim
2013-03-02 07:15 pm (UTC)

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My guess is that it all gets tied back to how they're paid for each procedure.
[User Picture]From: hyperiate
2013-03-02 07:49 pm (UTC)

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[User Picture]From: lawbabeak
2013-03-02 08:19 pm (UTC)

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Call the practice manager and demand your $30. The only things places understand is money, and often the only way practice managers figure out their practices are being stupid is by people calling a demanding their money back for lack of services. There's also the threat of insurance fraud, since the business office probably doesn't check to see if the x-ray technician actually did the x-ray they are billing your insurance company for.

Raise some hell. It makes the horrible system have to look at itself.

You do want to get the x-ray, though. Hairline fractures may heal on their own, but they can cause chronic problems and arthritis and turn your ankle into your own personal barometer. I walked into a wall last year and REALLY hurt my arm. Like, take a few moments to gasp and gather myself. I felt stupid for getting an x-ray, but it would have been even more stupid to risk wandering around with a broken arm I was trusting to heal itself.
[User Picture]From: simplystars
2013-03-02 08:30 pm (UTC)

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While you are off your feet, I think you need some kitties to watch. :)

This is a livecam feed (24/7) of sixteen-day-old foster kittens Boris, Pavel, Valentina & Yuri and their gorgeous calico mama Laika - named for Russian cosmonauts. The foster dad, John Bartlett, has cared for 35+ litters and uses Livestream and Facebook to help Purrfect Pals shelter in WA. He has a 100% adoption rate since using the kitten cam... His last litter was adopted just a week ago which was bittersweet but the adopters made Facebook pages and it's wonderful to keep up with the kittens as they adjust to their new homes. <3

Theis litter is little now but John watches for developmental milestones and introduces toys & climbing structures etc as they grow - there's the TARDIS and the Enterprise and the Contact rings and just so much fun. I figured as Roswell's dad and a foster-er yourself you might enjoy the cam.

The Cosmo Fosters on KittenCam

(Sorry for all the words.)

Edited at 2013-03-02 08:31 pm (UTC)
[User Picture]From: lois2037
2013-03-03 12:15 am (UTC)

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I sure hope you can get that $30 back. I'm sure there are better ways to spend $30 than on not getting X-Rays. I NEVER go to doctors any more except for my once a year, "you're alive, time to renew asthma Rx" visit with my MD. I've had injuries like yours (NOT sports-related, though), and figured if I could stand on it, it would heal. And I've been right. And I don't have to carry medical debt to have had some hospital resident tell me the same thing.
[User Picture]From: alphaloria
2013-03-03 03:29 am (UTC)

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Get the x-ray and if possible talk with a sports doc.

Get fitted for running shoes if you haven't already, make sure you are doing all of the right kinds of stretching, and look into ankle-strengthening routines and strength training. It really could be a simple matter of having weak ankles.
[User Picture]From: alyngodes
2013-03-03 01:45 pm (UTC)

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If nothing is broken, you might want to consider looking for a massage therapist who does MAT (muscle activation technique) to help with your running related injuries. The results I've seen have been kind of amazing.
[User Picture]From: tigerinvaseline
2013-03-03 02:50 pm (UTC)

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Dude! I was just schooled in this at my day job by one of my staff who is training to be a nurse. Earlier in the week she cut her right thumb using a chef's knife, and as I was writing out the accident report and documenting the injury was to her *right thumb* she said that it is actually her *LEFT* thumb if you are looking at it anatomically.

I bet that's why the doctor wrote it was for the left side of your body, because she was looking at you anatomically.
From wikipedia, trusted source of all sources "When anatomists refer to the right and left of the body, it is in reference to the right and left of the subject, not the right and left of the observer. When observing a body in the anatomical position, the left of the body is on the observer’s right, and vice versa."

Still doesn't excuse the fact that you didn't get your X-Ray--I hope you feel better soon!
[User Picture]From: kylecassidy
2013-03-03 03:08 pm (UTC)

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WTF???? MY DOCTOR WAS RIGHT! how do these people ever give anybody an xray??
[User Picture]From: tigerinvaseline
2013-03-03 03:48 pm (UTC)

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Your Doctor was totally right! I hope you can get your X-Ray with your original form if they still have it. And in the meantime, arnica oil, gel, or cream can topically be used to help the inflammation and pain, says I, your knitting witch friend in Minnesota.
[User Picture]From: kylecassidy
2013-03-03 04:38 pm (UTC)

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I have a super-powerful perscription anti-inflammatory. The pain is almost all gone, though the swelling seems to have remained identical. weird.
[User Picture]From: gaminette
2013-03-03 08:11 pm (UTC)

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re: anti-inflammatories. I found out the hard way that they affect the good flora in your belly like antibiotics do, that is, they destroy it. You ought to be eating yogurt or drinking kombucha while you're on them.

Good luck - hope you feel better soon!!
From: ext_1681534
2013-03-04 10:22 am (UTC)

treating sporting injuries

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Hi Kyle, I'm a fitness instructor from the UK and I have to say I'm appalled at how your system puts the paper chasing above the treatment of patients. It's fashionable to criticise the NHS (National Health Service) but I have always had fantastic treatment from them. Three years ago I tore my ACL aand another ligament in my knee on a skiing holiday. As soon as I returned to the UK I attended my local A & E department to get some crutches. I was seen by a doctor within an hour and immdeiately put into the system. This meant I had an appointment with a specialist the next day, and physio two days later. My treatment was prompt, exactly what was needed and my surgery took place as soon as possible taking my healing into consideration. I think I did get fast tracked because of the nature of my work.

A little advice on the inflamation, in the UK and Europe we tend to favour ice pack treatment as a way of reducing inflamation. The easiest way is a packet of frozen peas wrapped in a towel and applied for 5-10 minutes three times daily. This reduces the inflamation without any of the side effects of the medication. The way to remember how to treat injuries is RICE: Rest, Ice, Comfort and Elevation. Rest immdeiately, apply ice, keep the area comfortable (which used to be compression but that led to people strapping too tightly), and if needed elevate the limb (sit down and elevate the foot).

I healed well from my injury and was skiing the next season. I followed the advice of my health professionals and it worked.
[User Picture]From: nerak_g
2013-03-04 06:12 pm (UTC)

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"I'm inclined now to just wrap broken things in poultices I've cribbed together from ancient manuscripts and witches at the knitting circle."

Hells yes. Who even has a fax anymore ? How archaic :-P