Should I stay or should I go, head injury edition

January 3, 2012 9:58 AM

Should I Go to the Doctor Filter: Last night, a friend and I were goofing around. He went to pick me up and toss me over his shoulder, and succeeded instead in tossing me face-first into the corner of a wall at a fairly decent velocity. I know the kneejerk response to these questions is usually YES GO TO THE DOCTOR WHY ARE YOU ON METAFILTER YOU IDIOT, but details inside.

I immediately developed an area of massive swelling above my left eye, and my friend was freaked out enough by my appearance that he insisted we go to the emergency room. Well, as it turns out, the downtown Los Angeles emergency room we visited was incredibly busy and I wasn't able to be seen by a doctor despite five hours of waiting. I was triaged and had a CT scan, but nobody talked to me about the results.

Anyway, I woke up this morning and the swelling now extends from my left temple to the outside edge of my right eyebrow and from my left eyelid to the crown of my head. I also have a nice black eye developing and a bit of a stiff neck, though the latter might be from sleeping in an awkward position so as not to put any pressure on the side of my face.

However, I actually feel a lot better than I did last night, and I figure that if there were something bad on the CT scan, someone would have told me during the subsequent five-hour wait to be seen. I know that head injuries swell a lot, so I'm not too concerned about that. My primary care doctor doesn't have any appointments today, but I can see another member of the practice if I want, and the emergency room has already faxed the results of my scan. I would REALLY like to avoid an unnecessary office visit if possible.

I feel like anything really serious would have already manifested by now, and I'm inclined to wait it out. Is there any harm in doing so? Should I make an appointment, or just stay home with aspirin and an ice pack?

posted by easy, lucky, free to health & fitness (23 answers total)

Doctor.
posted by iamabot at 9:58 AM on January 3, 2012 [1 favorite]

If I was your friend, I'd make you go to the doctor. Any injury involving the head/neck deserves the utmost attention.
posted by HopperFan at 10:02 AM on January 3, 2012

Doctor (YAY they're open today!)
posted by Ys at 10:02 AM on January 3, 2012

I wouldn't worry about if for a few more days, provided you're not having any vision or hearing problems. When I was into martial arts I had stuff like this happen all the time.
posted by coolguymichael at 10:04 AM on January 3, 2012 [1 favorite]

I have two words for you when it comes to whether you should still go to the doctor even though you feel okay: Natasha. Richardson.

Go to the Doctor.
posted by EmpressCallipygos at 10:12 AM on January 3, 2012 [14 favorites]

You had a head injury? Go to the doctor.
posted by schmod at 10:26 AM on January 3, 2012

YES GO TO THE DOCTOR WHY ARE YOU ON METAFILTER YOU IDIOT, as a wise person once said. I've taken two people to the ER after bonks to the head in the past few months and both times the doctors said yes, always be cautious with head injuries and come on in.
posted by The corpse in the library at 10:27 AM on January 3, 2012 [1 favorite]

I would at least call the doctor's office to get the results of the CT scan. You can ask them what you asked us, is it important that you come in or not. Don't rely on busy ER people to tell you stuff without you asking. Double check that you are ok. Head injuries are weird things, even badly hurt people can feel fine until they don't.
posted by bluefly at 10:27 AM on January 3, 2012 [3 favorites]

Call your doctor's office and ask them to fax you or read to you the results of the ct scan.
posted by JohnnyGunn at 10:39 AM on January 3, 2012

When I was in 6th grade, I had an...incident* on the stairs with a sleeping bag. I ended up plummeting face-first into a door frame, and had a similar injury progression to the one you describe. Thanks to strategically-placed hoodies and long hair, my parents didn't find out and I never went to the doctor. I made it through just fine.

That said, call the hospital for the results of your CT scan immediately, then decide from there whether you should go see a doctor. (You probably should anyway, just to be safe.)

*You know the sleeping bags they make for little kids with cartoon characters on them? You can sled down carpeted stairs superfast on them. It's really, really fun. Word of advice: aim your FEET down, not your head, and do NOT let your little brother give the sleeping bag a starter tug.
posted by phunniemee at 10:40 AM on January 3, 2012

You have two issues - potential brain stuff and facial swelling. So two points:
1) CTs are really good at seeing stuff like large brain haemorrhages, but they have been known to miss stuff (especially slowly developing things like slow bleeds) especially when looked at by busy overnight medical staff. They might be even less likely to spot something nasty if their patient has walked out because that's generally a good indicator.

2) Facial swelling may need to be looked at by the plastics team to see if it's a haematoma that might need draining.

So at the slightest sign of neurological issues (dizziness, changes in eyesight, bad headache, changes in movement, changes in speech) I would rush back to a hospital. I would also go back to a doctor just to check things out (primarily the facial swelling, but also CT results).
posted by kadia_a at 10:44 AM on January 3, 2012

Doctor!
posted by Forktine at 10:54 AM on January 3, 2012

Yes, doctor. Call the ER and get your CT results and tell the doctor what they say. There are a ton of ERs and urgent cares near downtown, but if you can get a ride to South Pasadena, go to the ER at Huntington Memorial. It's quite nice and usually not incredibly busy.
posted by bedhead at 10:59 AM on January 3, 2012 [1 favorite]

You're already getting a lot of good advice here, but just as a data point, I got hit in the head with a volleyball recently, and it took around 18-24 hours for symptoms to manifest. Go to the doctor: better safe than sorry :)
posted by Stephanie Duy at 11:01 AM on January 3, 2012

Regarding the CT scan and someone telling you if there was anything going on: a couple years ago I spent all night in an ER because of chest pain* that woke out of a dead sleep and some difficulty breathing. Among other things they gave me a chest X-ray. I spent five or six hours waiting, saw a couple different doctors and was eventually sent home with a shrug and "maybe an esophageal spasm?"

That was the Saturday night of a long weekend and as days went on, I started coughing more and feeling kinda crummy. Tuesday morning, I got a call from the radiologist who came in that morning and looked at my X-ray and said, "Hey I just looked at your X-ray and if you are coughing or feeling crummy, you should come in because it kind of looks like you might have double pneumonia." Apparently whatever junior resident staffer worked the overnights on long weekends missed it.

So, if you think you're fine because they didn't tell you otherwise, I wouldn't count on no news being good news.



*pro tip: when you go the ER tell them you have chest pain, they take you IMMEDIATELY; of course, when a ECG rules out heart attack, you get to sit in the waiting room with everyone else...
posted by looli at 11:17 AM on January 3, 2012

Thanks, everyone. Since the swelling isn't going away at all, I made an appointment for this afternoon with another doctor from my PCP's practice.

Thanks for the recommendation, bedhead. I actually live in Pasadena, but this happened in downtown Los Angeles, so I ended up at Good Samaritan. They were ridiculously busy.
posted by easy, lucky, free at 12:41 PM on January 3, 2012 [2 favorites]

I figure that if there were something bad on the CT scan, someone would have told me during the subsequent five-hour wait to be seen.

You'd think so. But things can get overlooked or missed in ERs, especially when they're slammed over a holiday weekend. So you have two calls to make: one to your doctor's office to make an appointment, and one to the ER to get the CT results sent to your doctor.

Note that if your doctor is in the same hospital system as the ER you went to, and the hospital system has computerized their patient records, your doc may have immediate access to the CT results already. But this is not universally the case, so if you're not dealing with computerized patient records, find out if they will fax the results -- be sure to have your doc's fax number handy, and confirm the name and direct phone number, if possible, of the person who says the results will be faxed -- or if they want you to come in and pick them up in person.
posted by scody at 12:42 PM on January 3, 2012

Sorry, missed on preview that you'd just made the doctor's appt. Definitely still find out from Good Sam the best way to get those CT results in hand or sent over to your PCP's practice.
posted by scody at 12:43 PM on January 3, 2012

You didn't mention anything about not having insurance, so I don't see why you wouldn't go to the doctor. Anyway, go to the doctor. I had a head injury ten years ago (toboggan mishap involving a cement curb), and the ER doctor scared the crap out of me by telling me I could have an aneurysm (which killed my aunt, btw). I turned out fine, but why risk it? It's several hours out of your life to not have to worry about suddenly keeling over.
posted by desjardins at 12:47 PM on January 3, 2012

Glad you made the appt! Let us know how it went.
posted by sucre at 3:42 PM on January 3, 2012

Thanks to all of you for your sensible advice. I went to the doctor this afternoon.

CT results show "massive left frontal scalp hematoma." At this point, said massive left frontal scalp hematoma has spread across most of my forehead, so I have a referral to a plastic surgeon to have it drained. The swelling is definitely worse tonight, and I'm working on a second black eye, so I'm glad I went to the doctor. I also have a prescription for pain medication, which is really welcome, since the pressure from the hematoma is pretty much killing me at this point.

For the morbidly curious, here is a photo of my face tonight.
posted by easy, lucky, free at 7:31 PM on January 3, 2012 [1 favorite]

AAAHHH WHY DID I LOOK AHHHHH

I mean, I'm glad you went to the doctor and that things are under control.
posted by The corpse in the library at 8:29 PM on January 3, 2012

AAAHHH WHY DID I LOOK AHHHHH

I mean, I'm glad the Metafilter patented YES GO TO THE DOCTOR WHY ARE YOU ON METAFILTER YOU IDIOT approach had such a positive outcome.
posted by canine epigram at 5:55 AM on January 4, 2012