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From: isaacyho on 10 Jan 2007 14:23
Hello---

I fell on a glass bottle and cut my hand open in mid November. There
was a fairly deep laceration that ran across the base of my middle and
4th fingers ( right at the junction of the finger and palm, the
underside of the hand ), about 1.25 inches long. They stitched it up
that night, and everything seemed ok---i could use my hand normally, no
pain, although my middle finger stayed unusally swollen at the base.

Around Dec 15, i noticed that i could no longer move my middle finger
from a fully curled to a fully extended position smoothly -- it would
lock up after getting to a midway curl, and sometimes I would have to
use my other finger to fully extend it. No pain, but it made a
clicking sound when i pushed it past the midway curl.

Dec 20, i went to the batting cages and found that after i put the bat
down, my middle finger stayed locked in that midway curl. I couldn't
apply gently force to straigten it any more. At the ER, the doctor was
very confident that i needed hand surgery: he thought i had cut a
tendon at the base of the palm and that it had healed, but scar tissue
built up and now was getting in the way of smooth movement. He said I
should get it ASAP---in his words, a week or two was ok, but the sooner
the better.

Now it is Jan 5. I have Kaiser insurance, and i saw a primary doctor,
who referred me to a hand surgeon. The primary doctor was not
convinced surgery was the answer, but thought the hand surgeon would
have a better idea. Problem is, kaiser cannot schedule me in until
Feb 7 for the consultation ( I have tried several avenues through
Kaiser but they're simply booked up). I am worried, based on what the
ER guy said, that I would be waiting too long and complicating the
surgery significantly by waiting till then ( because after the consult,
i'd have to wait some more time to actually get surgery ).

This problem is signficiant for me, because I am a part time
keyboard/piano player and part-time software engineer. I cannot play
piano at near my normal ability right now, and typing is a arduous. I
also cannot write normally, or grip sports equipment. The band I am
in is having to decide whether they can wait for me to heal, or must
find a replacement.

My two questions are:

- in your opinon, how much could i get out of an early consultation
without any MRI/CTScan? Hoping to get an early second opinion, I have
called up a renowned hand surgeon, i explained my situation and the
secretary said that while they'd be happy to schedule me ( in 3 days ),
they don't know if it will be a fruitful visit unless I have an
MRI/CTScan ( preferably MRI ). Unfortunately, my Kaiser doctor
refuses to sign off on approving the MRI/CTScan, saying it is
potentially unnecessary and in fact highly unusual to get one for a
hand injury. To me, i think getting one would tell alot no matter
what the treatment ends up being, whether or not I opt to go the Kaiser
route or potenially do a surgery purely out-of-pocket; it's purely a
money issue for them.

At the early consult, I would mainly want to know how serious the
situation is, and how long I can wait before it is treated. Secondly,
i want to know how i should care for the hand in the meantime, and what
activities I can/cannot do, as well as if there's anyway to allow me to
play piano before it is treated.

- is 1 month too long to wait for my initial consult with Kaiser?
Realistically, I have the money to pay $1000 for the CTScan, or even
$3000 for an MRI + consults out of pocket, but would rather not if it
won't make much difference. Ideally, i'd love to have a probability
curve that shows "% chance of full recovery" on the y-axis, and "length
of wait, starting from today" on the x-axis. If the % chance goes
from 95 to 94 over 1 month, it's probably not worth $3K. But if it
drops from 95 to 75, then yes it is worth it. Any ballpark guesses as
to this probability curve would be much appreciated!

Thanks!

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