Shoule I get the diagnosis changed?

peaches1

A week ago I was working in the garden I rent in one of the community gardens in Evanston. I planted some green onions and watered my garden. I then started walking towards my car, and discovered that my car keys were not in my pocket. I went back to my garden to see where I dropped them. It was starting to get dark, but after a few minutes I finally found them after I got on the ground to look around. As I was standing up, I tripped over some fence posts I had lying in my garden, and fell back down. I then got up again, and noticed that one of my fingers was hurting. I went home and changed clothes and washed up, and then headed to the ER. I was there for 3 hours. I was not high priority. They took a picture of the finger, and determined that it was broken, and they put a splint on it, and told me to see an ortho guy.

I saw the bone doctor on Monday, and he took the splint off of my finger, and told me that I had a chip fracture. Apparently I suffered a bad sprain, and while the ligament was being stretched, it took a small piece of my bone with it. I have to buddy tape my finger for three weeks and then go back to see him. When they gave me the sheet with the information to show the people at the front desk though, I noticed that under diagnosis they had fracture of the wrist. Should I call them up and ask them to change it to finger fracture?

I have to also get on my MO's case about putting me on prolia or some other bone med. I spoke to his nurse two weeks ago, and she was going to give hime the message, but I have not heard back. I don't think he was in the office that day. I have osteopenia, and my PCP was ticked off that I was not on anything when I saw her in June. Thanks

ChiSandy

Peaches, definitely call them (or message through your patient portal if the ER was at one of your regular hospitals) to point out the discrepancy in your chart. The finger fracture you describe is a classic “avulsion fracture:” a severe sprain tears off a tiny chip of bone. It’s exactly what my husband had happen to his ankle back in June when he walked too far and fast. It was an avulsion fracture of the fibula, secondary to a sprain of the anterior talofibular ligament. (He didn’t get a cast either—he wore a lace-up brace for a couple of weeks).

Definitely talk to Dr. M. about Prolia or another bone med. Highly unusual, especially at Kellogg, not to discuss it at the beginning of AI treatment. Maybe he’s waiting for a longer period after finishing chemo & radiation, but I don’t think that would make a difference. But an avulsion fracture is not the kind of fracture that is characteristic of thinning bones.

If the error appears in your patient portal, it often takes a few tries to get it corrected—my North Shore portal kept mentioning all the immunizations and tests that were “overdue since…” even though I had them timely done at Presence St. Joe’s. It kept nagging me about my “Annual Medicare Wellness Visit” being overdue too, so I gave up and faxed ALL my test results & X-ray reports from my PCP at Presence to my MO at Evanston & vice versa. I ended up having to have the nurse manually make corrections in the computer at my respective visits. Meanwhile, the “Annual Medicare Wellness Visit” is showing up as “overdue” again—even though that’s what got this whole foofaraw over my anemia started, when my PCP noticed a pattern of declining hemoglobin & ferritin since 2015. (I have my EGD tomorrow at Evanston to try to determine a cause—actually hope they find a little ulcer or esophagitis so they don’t have to test for something more serious).

peaches1

Hi Sandy- My sister in New Orleans called me up Wednesday evening, and told me that I should probably call up Illinois Bone and Joint to ask them to change the diagnosis code. I went to the ER at St. Francis when it first happened, and I just got a diagnosis of finger fracture. IBJ some how changed it to pain in the wrist. I am supposed to see Dr. Merkel sometime in September, and I will ask him about prolia or something else. My sister said that she thinks fosamax would work too. She was going to look it up to see if there were any contraindications to it. She said fosamax would be a whole lot cheaper too. She also told me that my fracture was not caused by my osteopenia, but that I should wait until my finger is healed before I go on any bone meds, and so by the middle of September I can go on something. Dr. Merkel's nurse when she called me back a few weeks ago, told me that Dr. Merkel was not in the office, but she offered to give me his cell phone number, but I said that was okay, and to just give him the message. He never got back to me. I think they want to be absolutely certain that there are no problems with my teeth.