Sliced finger in LA...ER or Urgent care? Need ideas.

February 22, 2013 12:28 AM

I'm almost certain I just severed the tendon in my pinky...the bleeding is under control but I cannot bend it. I have severe fear of ER costs due to bad past experiences that cost me lots and lots of money. How bad is this, and can it wait for an Urgent Care place?

This is a rather spontaneous question and I don't really know who else to query. About half an hour ago I reflexively caught a falling knife by the blade and deeply cut through the palm-side middle joint of my pinky finger on my right hand. It appears as though I have cut through the flexor tendon of my pinky as I saw what looked like a cut strand of spaghetti coming out of the wound and I can no longer bend it. I still have feeling in it and the blood seems to be under control (I have it wrapped up).

My question is this - is it imperative that I go to an ER, or might this wait until I can see an urgent care clinic in the morning? I ask because I am terrified of an ER visit because of the potential cost. I have horrible individual market insurance that covers virtually nothing and has a deductible of 6,000. I am currently in between contracts and would love to avoid paying that much.

I realize this seems ridiculous...and I very well may go to the ER anyway...but if anyone out there in MeFi land has medical experience and can chime in...I'm all ears right now...

posted by jnnla to health & fitness (25 answers total)

Your finger is worth $6,000. Please go to the ER.

I'm sorry this has happened to you. You will get through it.
posted by samthemander at 12:31 AM on February 22 [6 favorites]

Also: if it's that bad, all that urgent care will do is refer you to the ER. I once dropped a knife and caught it with my ankle, slicing into my tendon. Put off going to the dr for 24 hours, because I dropped the knife at 10 pm and had a job interview the next day at 4. I hobbled to the job interview and was physically unable to walk out of the building at the end of the day. I really, really wish I'd just gone to the ER.
posted by samthemander at 12:33 AM on February 22

The urgent care place will almost certainly tell you to go to the ER if the injury is as you describe. Just go. It sucks, but your hand is worth the deductible.
posted by charmedimsure at 12:36 AM on February 22

Dude. ER. Now.
posted by Ursula Hitler at 12:49 AM on February 22 [3 favorites]

I don't know where in LA you are, but if you really can't afford anything, go to County. Now.

There's a 24-hour Urgent Care in Silverlake. There are others sure to be near you. Find one. Do not wait.

If you cannot (or probably should not) drive, I will come get you and take you.
Check your memail.
posted by ApathyGirl at 12:53 AM on February 22 [11 favorites]

This is worth the money.

This is not worth the wait.
posted by Chutzler at 12:53 AM on February 22

I can't think of a better thing to spend six grand on than my fingers.
posted by Chutzler at 12:55 AM on February 22 [5 favorites]

When you get to the ER, I bet you'll go right to the front of the line, after shooting victims. This isn't like going in for a bad flu and waiting 8 hours in the ER wondering if you've made a mistake. You'll be glad you went.
posted by ceribus peribus at 12:56 AM on February 22

Here's a 24hour Urgent Care by LAX.
Here's one in West LA.
posted by ApathyGirl at 1:02 AM on February 22

Egads, it's your right hand.

Go to ER. Fark.
posted by Salamander at 1:36 AM on February 22 [1 favorite]

Indeed, get thee to an ER. My mother sliced through three of her fingers before I was even born. She waited to go to the ER and her options were limited as a result. She wound up without the ability to flex those three fingers. She made it work, but there was always something that was harder for her as a result.
posted by FlamingBore at 1:40 AM on February 22 [1 favorite]

ER NOW, LIKE IMMEDIATELY.

DO NOT PASS URGENT CARE, FUCK THE $200.

Having a useless hand, much less dominant hand, will cost you a hell of a lot more than anything the ER could even hope to charge you.
posted by Blasdelb at 2:33 AM on February 22 [2 favorites]

I'm almost certain I just severed the tendon in my pinky...the bleeding is under control but I cannot bend it.

Holy goddamn crap. Go to an ER. Now. It's your hand.

Even if you don't care about keeping the mobility of your finger, what about the possibility of infection? Go, now.
posted by His thoughts were red thoughts at 3:06 AM on February 22 [1 favorite]

I'm not going to say you shouldn't head for the ER, but here's my experience which might suggest that infection (which urgent care can probably handle) be your main concern: Cleaning up after a wedding in LA a few years back, I broke a vase which severed both tendons (and the radial artery!) [NOT for the squeamish!] in my left wrist. The ER attending doc cleaned out the wound, sewed it shut, and told me to find a surgeon to reconnect the tendons within a week. I had the surgery three days later, and today have full use of that hand. (Turns out you don't really need your radial artery. Who knew?)
posted by nicwolff at 3:25 AM on February 22

If you've cut your tendon, it's an emergency. You need to go in.
posted by h00py at 4:05 AM on February 22 [1 favorite]

Go to the ER.
posted by OmieWise at 4:45 AM on February 22

what nicwolff describes is typical for this sort of injury, but it doesn't mean you should not go to the ER - that is still your best option here. IANYERD, and this is not medical advice, and I feel you on the billing issue and am sorry about it. A pinky injury (even one involving the tendon) won't necessarily get you to the front of the line, but that shouldn't be part of the equation - you need a working hand.
posted by treehorn+bunny at 5:20 AM on February 22 [3 favorites]

You're also welcome to call your urgent care and ask if they handle lacerations with a likely tendon injury. My guess is that they will direct you to the emergency department.
posted by treehorn+bunny at 5:23 AM on February 22 [4 favorites]

Considering you posted this ~5 hours ago, I hope you have gone to the ER and are being treated. Serious injuries are nothing to fool around with.
posted by GenjiandProust at 5:26 AM on February 22 [5 favorites]

Late to the party. Hand surgeon here, not dispensing medical advice but letting you know that the ER is not equipped to fix a flexor tendon. They will clean it up, loosely suture it and refer you to a hand surgeon. An urgent care can do this. Or, if you waited and haven't gone anywhere, make an appt to see a hand surgeon today. Surgery will be necessary and the post-op rehab is as important if not more than the surgery itself. This will be expensive, unfortunately. You will probably hit your deductible if you truly cut your flexor tendon. Good luck.
posted by karlos at 5:49 AM on February 22 [14 favorites]

You can negotiate the cost of your RE visit/surgery afterwords. I has no insurance and was in tears explaining to urgent care nurse that I couldn't go to the ER b/c I didn't have the money. She said that I had to go and when I got the bill I should call Billing and explain my situation. Long story short, my $25,000 surgery cost me $0.

Memail me if you want.
posted by futz at 7:30 AM on February 22 [3 favorites]

I truly hope you went to the ER. Thank god I live in Canada. It's mind-boggling to us that in a western, 1st-world country like the US, people can't get critical medical care unless they are well-off.
posted by LauraJ at 11:07 AM on February 22 [1 favorite]

Go straight to a hand surgeon imho.
posted by fshgrl at 11:18 AM on February 22

Thanks to all for the concern and good advice. I did end up going to a 24 hour Urgent Care last night. My experience was basically what karlos described. I was almost immediately told I would need to see a hand surgeon and discharged so now the wheels are in motion for a hand surgeon referral. It does appear that I have cut my flexor tendon but i'll need a specialist to look at it to be sure. My finger still has blood flow and actually does not hurt at all but it cannot bend

As per the good advice here I have tried to make money a second concern and will do what I can to actually continue using my pinky. This should be yet another odyssey through US Healthcare. Thanks again to all!
posted by jnnla at 11:32 AM on February 22 [1 favorite]

I cut the flexor tendon in my pinky around 1995 or so. It was a $1200 repair job. Finger works fine. I expect prices have gone up since then, but so has the medical care. Good luck with it!
posted by caution live frogs at 11:49 AM on February 22