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08 July 2010

Help me decide if I should go to Urgent Care [More:]
I hurt my hand yesterday trying to climb onto a stage at work--well, specifically, I hurt the part of my hand where my thumb is attached. Internet research leads me to suspect I have a sprained thumb--I have limited mobility and it hurts like heck, especially when I try to: hold my laptop, twist a twist-tie, open a bag of cereal, unscrew my water-bottle-cap, typing certain words, etc.

I know there's not much to be done for a sprain. Should I just ice it and maybe try and find a brace at CVS? Or should I suck it up and go to Urgent Care? (Note that I only have short-term insurance that only covers catastrophic things, so I'm paying out of pocket for any treatment, and I am broke broke broke.)

Please advise, I really don't know what to do.
How exactly did you hurt it? Did you pull the wrong way, or did you smack it?
posted by JanetLand 08 July | 11:05
I'm just some stranger on the internet - can you show it to a bunch of people and gage the reaction? If everyone urges you to go - go. If the reaction is more "sorry that must smart" - don't.

My opinion - if you are talking about the palm side of your hand between your thumb and index finger, and you can make a small circle with your thumb? Don't go unless you need more than OTC pain meds to function.
posted by rainbaby 08 July | 11:06
I was trying to push myself up and it just hurt all of a sudden, I'm not sure what happened. It's a little swollen but not really noticeable. You're right, I'll take a couple advil and I'm sure it'll feel better. Thanks for reassuring me!
posted by leesh 08 July | 11:09
I'm sorry, leesh, but you'll have to cut it off. It's the only way to be sure.
posted by deborah 08 July | 11:26
I would go the RICE path with it with the caveat that if it's significantly worse (hugely swollen, purple, looking infected] in a few hours, I'd consider urgent care. It's pretty unlikely that there's anything that could be done outside of what you've done yourself already.

I am not a doctor, but I am neither terrified of them or excited about going to them. I hope you feel better.
posted by jessamyn 08 July | 11:33
Ice it a bit and take some OTC goodies and try not to fuck with it too much. (I sprained both thumbs many times in HS.)
posted by sperose 08 July | 11:36
What jessamyn said. There is most likely nothing they can do except give you pain meds, unless you suspect it's out of joint or broken (in which case you probably wouldn't be sitting here typing).

Some CVS and Walgreens have nurses on-site for $20 or so, if you want to make sure you've made the right call.
posted by desjardins 08 July | 11:37
What Jessamyn said x2. I've done something similar to what this sounds like - fell on the ice and broke my thumb in college - but didn't check it until the next day. By that time, even though it was broken, the only treatment option they gave me was to re-break and set it. And they didn't think it was necessary, and that was definitely a break. This doesn't sound quite that intense. I'd say the RICE thing too. Of course I'm not a doctor at all either, so caveat poster applies.
posted by Miko 08 July | 11:58
Unless it starts getting worse, if it were me I wouldn't go.
posted by amro 08 July | 11:58
Jessamyn is right. If it isn't mangly looking, ice that baby, elevate it and use it as little as possible. Use a brace if you can't get out of work. For what it's worth, 4 regular otc strength aleve is the equivalent of the rx strength the doc gave me when I had pneumonia. Take it on a full stomach.
posted by toastedbeagle 08 July | 12:02
I hurt my thumb a couple weeks ago and it wasn't improving under my "eh, ignore it and it'll go away" regime. I ran my symptoms through this and was reasonably confident it was just a sprain that I wasn't taking care of properly. So I got a brace at CVS and it's been doing better - actually made typing easier, since I can't move my thumb in a way that causes discomfort.
posted by EvaDestruction 08 July | 12:08
Ice ahoy! Thanks, guys!
posted by leesh 08 July | 12:15
But wait a sec leesh, are you in the US? Because if this happened at work, then Worker's Comp should cover the cost of a doctor visit. I do think you're supposed to go right away at the time of injury, though - still, you might want to check out that possibility, and at least get a free look-see from a doctor.
posted by Miko 08 July | 13:59
Worker's Comp doesn't cover independent contractors or organizations with below a certain # of employees. . .
posted by rainbaby 08 July | 14:23
Heh, funny that Miko should be the one to point that out, considering that I am a workers comp attorney. Bad amro!
posted by amro 08 July | 14:54
rainbaby: That differs state to state.

And yeah leesh, you should tell your supervisor.
posted by amro 08 July | 14:59
I may mention it, but rest and ice have helped a ton, and I'm pretty sure the comic book store doesn't have worker's comp coverage anyway.
posted by leesh 08 July | 15:13
Oh, they might - clearly amro is our resident expert, but I think it's mandatory or nearly so. I've never worked anywhere that didn't have it. Wikipedia (great legal resource, I know) says

In the United States, most employees who are injured on the job have an absolute right to medical care for any injury, and in many cases, monetary payments to compensate for resulting temporary or permanent disabilities. Most employers are required to subscribe to insurance for workers' compensation, and an employer who does not may have financial penalties imposed.
posted by Miko 08 July | 15:49
Yeah, i was coming in to suggest worker's comp. Hope you feel better soon!
posted by Stewriffic 08 July | 17:53
I jammed my index finger a month and a half ago. I still can't play a C chord on the guitar. But my doctor (2 weeks ago) wasn't impressed. I'd go with the RICE approach and avoid musical instruments.
posted by Obscure Reference 08 July | 18:28
glad to hear it's feeling better, I would have suggested the same as Jessamyn.

THAT SAID, this is coming from someone who once famously broke her collarbone clean through at a bike race, and refused medical care and transport on the grounds that it was a) too expensive (no primary insurance, and getting the event insurance to ever actually *do* anything is a massive PITA) and b) it was, after all, just a broken collarbone*. Which, assuming it's not actually poking through the skin, most U.S. orthopedists will do very little about aside from shooting a bunch of (expensive) xrays, saying "yep it's broken", prescribing a course of (also expensive) painkillers, billing you several hundred bucks and sending you home in a sling. Since it wasn't massively displaced and I'm allergic to most prescription painkillers anyhow, I made a DIY figure eight out of a dishtowel, took alternating ibuprofen and naproxen as necessary, didn't bother to raise my arm over my head for a couple weeks, and went back to riding, then racing, about 3 weeks after the crash. It's got a nice big ugly knot on it now, but other than that it's fine.

DON'T EVER DO THIS by the way, and particularly not if you have decent care available to you and you wont potentially face bankruptcy/foreclosure from a few hundred bucks in medical bills. Broken bones can potentially cause Very Scary Issues if not properly supervised/treated.

*collarbones are the #1 most common fracture in cyclists and as a demographic, we do tend to be kinda blase' about them.
posted by lonefrontranger 08 July | 18:28
lfr, whoa!! this is nowhere near that crazy, just sore and annoying! my thumb is definitely not broken and now that i've been resting and icing all day, i can say it's not even a very bad sprain. thanks again for all the advice and reassurance, everyone.
posted by leesh 08 July | 19:20
Heh, 'playing through' injury is what separates the serious competitors from the weekend warriors, I think. I once got spat out of my boat during a race (including tearing the side out of the cockpit on the way through), got straight back in and finished the race. It was only after I got back to shore that I realised my ribs were really, really sore. Turned out I had broken a couple and now have a kind of bump in my chest where one didn't quite meet up.

My treatment regime was similar to lfr's - shrug and move on. Probably not what a doctor would advise, though...
posted by dg 08 July | 19:35
Oh, they might - clearly amro is our resident expert, but I think it's mandatory or nearly so.

All I can tell you for sure is that it's mandatory in NJ. My expertise is fairly geographically limited.
posted by amro 08 July | 20:08
Are You Covered by Workers' Compensation?
Most workers are eligible for workers' compensation coverage, but every state excludes some workers. Exclusions often include:

business owners
independent contractors
casual workers
domestic employees in private homes
farm workers
maritime workers
railroad employees, and
unpaid volunteers.
Check the workers' compensation law of your state to see whether these exclusions affect you.

Federal government employees are also excluded from state workers' compensation coverage, but they receive workers' compensation benefits under a separate federal law.

In addition, some states do not require workers' compensation coverage of employers having fewer than a designated number of employees -- three to five, depending on the state. So, if you work for one of these employers, you may be excluded from the state program.



posted by rainbaby 09 July | 07:53
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