QUESTION ABOUT AN ELBOW

Discussion in 'Health and medical' started by Aha09, Feb 20, 2004.

  1. Aha09

    Aha09 Guest

    About a month ago, i slipped and fell on ice....ouch

    now, a month later....the soreness has gone, and even on the day of my fall to now, i have full
    range of motion.

    i can even still go to the gym and grab a bar with my right hand (its the right elbow) and hold my
    weight....but

    i have this swelling....i wander what i should do.
     
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  2. "aha09" <[email protected]> wrote in message
    news:[email protected]...
    > About a month ago, i slipped and fell on ice....ouch
    >
    > now, a month later....the soreness has gone, and even on the day of my fall to now, i have full
    > range of motion.
    >
    > i can even still go to the gym and grab a bar with my right hand (its the right elbow) and hold my
    > weight....but
    >
    > i have this swelling....i wander what i should do.

    You may have an olecranon bursitis from the trauma. It's a swelling in the bursa around the elbow
    joint which can occur from chronic inflammation due to the blow to the elbow.

    If it's not hot, red, or painful, you don't have to do anything. If it bothers you, see an
    orthopedist. It may require drainage.

    HMc
     
  3. Anon

    Anon Guest

    On 2004-02-20 21:02:13 -0500, "Howard McCollister" <[email protected]> said:

    > If it's not hot, red, or painful, you don't have to do anything. If it bothers you, see an
    > orthopedist. It may require drainage.

    Um, yeah...an orthopedic surgeon (if you're into major-league overkill and high-copays) or any
    primary care physician.
     
  4. "anon" <[email protected]> wrote in message
    news:2004022021571916807%[email protected]...
    > On 2004-02-20 21:02:13 -0500, "Howard McCollister" <[email protected]>
    said:
    >
    > > If it's not hot, red, or painful, you don't have to do anything. If it bothers you, see an
    > > orthopedist. It may require drainage.
    >
    > Um, yeah...an orthopedic surgeon (if you're into major-league overkill and high-copays) or any
    > primary care physician.
    >

    Um, yeah...right...I'm going to let a family practicioner excise my olecranon bursa, or make the
    determination as to when that's necessary.

    HMc
     
  5. Anon

    Anon Guest

    On 2004-02-21 08:27:10 -0500, "Howard McCollister" <[email protected]> said:

    >
    > Um, yeah...right...I'm going to let a family practicioner excise my olecranon bursa, or make the
    > determination as to when that's necessary.

    Sounds like you're pretty ignorant about what F.P.'s do. Visit http://www.familydoctor.org for
    more info.
     
  6. Anon

    Anon Guest

  7. "anon" <[email protected]> wrote in message
    news:2004022109323516807%[email protected]...
    > On 2004-02-21 08:27:10 -0500, "Howard McCollister" <[email protected]>
    said:
    >
    > >
    > > Um, yeah...right...I'm going to let a family practicioner excise my olecranon bursa, or make the
    > > determination as to when that's necessary.
    >
    > Sounds like you're pretty ignorant about what F.P.'s do. Visit http://www.familydoctor.org for
    > more info.

    Actually, I've spent many years observing the scope of practice of family practicioners, and the
    consequences of stepping outside their skill or knowledge set. I've seen it many times and I have
    even testified in court to it. Co-pay or not, most patients will be better served by having their
    specialty problems addressed by a specialist.

    Having said all of that, I'll backtrack and agree that non-septic olecranon bursitis is no big deal,
    and, to be honest, many family practicioners could probably handle that.

    HMc
     
  8. Anon

    Anon Guest

    On 2004-02-21 09:59:05 -0500, "Howard McCollister" <[email protected]> said:

    > Co-pay or not, most patients will be better served by having their specialty problems addressed by
    > a specialist.

    Key word, my friend: "specialty problems." Trouble is, lots of people think they need an ENT for
    their earaches, a pulmonologist for their cough, an allergist for their runny nose, an dermatologist
    for their pimples, an orthopedist for their sore back, a neurologist for their headaches...well, you
    get the picture. Then they'll turn around and berate medical doctors for not treating them "as a
    whole person".

    Sad, but true in far too many cases.

    This isn't about F.P.s "protecting their turf"; it's about the appropriate utilization of limited
    and expensive medical resources, and delivering routine care in a timely and personal manner.

    Do some F.P.s "step outside their skills"? I'm sure they do. Show me one profession that doesn't
    have its bad apples.

    > Having said all of that, I'll backtrack and agree that non-septic olecranon bursitis is no big
    > deal, and, to be honest, many family practicioners could probably handle that.

    Thanks for being honest.
     
  9. David Rind

    David Rind Guest

    Howard McCollister wrote:
    > Actually, I've spent many years observing the scope of practice of family practicioners, and the
    > consequences of stepping outside their skill or knowledge set. I've seen it many times and I have
    > even testified in court to it. Co-pay or not, most patients will be better served by having their
    > specialty problems addressed by a specialist.
    >
    > Having said all of that, I'll backtrack and agree that non-septic olecranon bursitis is no big
    > deal, and, to be honest, many family practicioners could probably handle that.

    As septic spaces go, septic olecranon bursitis is probably easier for a non-expert to handle than
    many. The treatment is really just antibiotics and repeated drainage. That drainage can initially be
    done with a small needle and so is within the competence of many primary care physicians. If the
    infection persists or doesn't improve, more aggressive drainage or excision of the bursa may be
    needed and that would be something I'd want an orthopedist or general surgeon to do.

    --
    David Rind [email protected]
     
  10. "anon" <[email protected]> wrote in message
    news:2004022110305616807%[email protected]...
    > On 2004-02-21 09:59:05 -0500, "Howard McCollister" <[email protected]>
    said:
    >
    > > Co-pay or not, most patients will be better served by having their specialty problems addressed
    > > by a specialist.
    >
    > Key word, my friend: "specialty problems." Trouble is, lots of people think they need an ENT for
    > their earaches, a pulmonologist for their cough, an allergist for their runny nose, an
    > dermatologist for their pimples, an orthopedist for their sore back, a neurologist for their
    > headaches...well, you get the picture. Then they'll turn around and berate medical doctors for not
    > treating them "as a whole person".
    >

    I agree that the definition of "specialty problems" can be a tricky little sucker.

    > This isn't about F.P.s "protecting their turf"; it's about the appropriate utilization of limited
    > and expensive medical resources, and delivering routine care in a timely and personal manner.
    >

    No, I'm not talking about turf protection either. I think that the most important thing is making
    sure the patient gets the best care, the most appropriate care for the problem at hand. We all have
    to be cognizant of appropriate utilization of limited and expensive medical resources. The problem
    is in delivering the best care with that concept in mind. It would be unfortunate to not give the
    best care possible in the name of saving the system money. I acknowledge that it can be a fine line
    to walk, FP's trying to avoid unnecessary consultation vs. "stepping outside their skills". I see
    both sides of that coin often enough to make me sympathetic to that pressure, but as a surgeon, I
    would much rather consult on a patient unnecessarily than be called in at the 11th hour to deal with
    a problem that has now become an emergency. E.G, the closed loop small bowel obstruction that I
    consulted on and operated on yesterday who had been in the hospital for 36 hours, or the ruptured
    ectopic that had been at another hospital for 12 hours, with my emergent consultation obtained
    yesterday after she finally went into shock. And that was just yesterday. I don't really mean to
    pick on primary care, since I know that you can provide many cases of surgical misadventures too,
    but these very recent experiences color my participation in this thread.

    > Do some F.P.s "step outside their skills"? I'm sure they do. Show me one profession that doesn't
    > have its bad apples.

    I agree with this, but since "primary care" is just that, *primary*, there is greater pressure on
    those doctors to triage appropriately and therefore probably a greater tendency to err in obtaining
    appropriate/timely consultation. This is not meant as a criticism, just an observation of 20 years
    of evolution of our health care system.

    HMc
     
  11. "David Rind" <[email protected]> wrote in message
    news:[email protected]...

    > As septic spaces go, septic olecranon bursitis is probably easier for a non-expert to handle than
    > many. The treatment is really just antibiotics and repeated drainage. That drainage can initially
    > be done with a small needle and so is within the competence of many primary care physicians. If
    > the infection persists or doesn't improve, more aggressive drainage or excision of the bursa may
    > be needed and that would be something I'd want an orthopedist or general surgeon to do.
    >

    OK. I'll go along with that.

    HMc
     
  12. Aha09

    Aha09 Guest

    Since I do not have insurance, generally what is the cost of this procedure? Of course I guess
    it makes a difference if i go to a primary care physician or a specialist. A dollar range
    would be okay.

    Thanks


    [email protected] (aha09) wrote in message news:<[email protected]>...
    > About a month ago, i slipped and fell on ice....ouch
    >
    > now, a month later....the soreness has gone, and even on the day of my fall to now, i have full
    > range of motion.
    >
    > i can even still go to the gym and grab a bar with my right hand (its the right elbow) and hold my
    > weight....but
    >
    > i have this swelling....i wander what i should do.
     
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