Fell and hurt both feet. Do I get an x-ray today?

January 27, 2020 12:21 PM

I really screwed up this morning and fell while taking my bike down the stairs. My right ankle and my left foot are both swollen. I've been icing them for an hour, but now I'm a bit concerned I might have broken something in my left foot. What do I do? I'm in Hawaii.

My options, as I see them:
- book an appointment with my primary care provider (soonest available is tomorrow), get an x-ray appointment, follow up, etc. This will be difficult as everything will be in different places, and I would need to take Lyfts since my feet are messed up.
- go to ER and wait. I have no idea how long the wait would be... I'm Canadian, and have never needed to go to the hospital in America before. I have good insurance luckily so no problem there, I'm just not sure if it's the best approach, since my situation would be very low priority.

Can anyone give me any insight? I'm currently stressed out (I'm in the last few months of my thesis and this is NOT what I needed, also what a terrible way to start a Monday) and need some help figuring out what to do.

posted by Paper rabies to Health & Fitness (12 answers total)

Response by poster: To clarify: I'm in Honolulu, Oahu.
posted by Paper rabies at 12:22 PM on January 27, 2020

Best answer: Urgent Care. They're no good if you're having a heart attack, but minor fractures are usually something they can handle, and they'll be quick. They're used to non-traditional billing. Call ahead to make sure they do X-rays and then just head over. You'll probably be in and out in 60 minutes if nothing is broken.
posted by caek at 12:28 PM on January 27, 2020 [13 favorites]

I'm an emergency physician

Go to the emergency department and let them take a picture of your ankles.

I'm not a huge fan of urgent care clinics for soft tissue/orthopedic injuries: they don't do MRIs, nor have radiologists or orthopedic specialists for consultation in the event of an ambiguous diagnosis or treatment protocol.
posted by BadgerDoctor at 12:46 PM on January 27, 2020 [8 favorites]

If your regular provider doesn’t have space for you today (did you call and talk to an actual human being?), this is the perfect use case for an urgent care place, which Honolulu absolutely has. In my city you could also book directly, same-day, with a group of orthopedists, but that may be a specific my-city thing.
posted by charmedimsure at 12:47 PM on January 27, 2020

I know this isn't the place for back-and-forth, but since the OP is from outside the US, I feel like I have to give a caveat to BadgerDoctor's advice: don't go to an emergency room in the United States unless it's an emergency or you are very sophisticated and experienced user of the US health insurance system. Ideally both.

Urgent cares don't have MRIs, but they also don't have have the capital cost of MRIs to defray by overuse of MRIs. This is a feature not a bug IMO. They also won't bill you for a private room. They also wont have someone outside your network glance in your direction and bill you for an out of network consultation.

And they'll send you to the hospital if you need an MRI!
posted by caek at 12:57 PM on January 27, 2020 [3 favorites]

Response by poster: Okay, it looks like urgent care may be my best choice. Unfortunately the only ones that offer x-rays are 30 mins drive away, and not sure if I should attempt that with potentially broken feet. I'll see if I can find a friend to drive me or take a Lyft.
posted by Paper rabies at 1:19 PM on January 27, 2020

And double and triple check your insurance because it's a shark infested area in the US.
posted by mightshould at 1:55 PM on January 27, 2020 [1 favorite]

I mean, the urgent care I last went to in the US (Austin, TX) in 2018 had an MRI... so it's not like that's unheard of.
posted by fiercecupcake at 3:24 PM on January 27, 2020

There's a Kaiser hospital on Moanalua. The plus side to using them is you'll get a couple of bills from one system rather than a million bills from everyone that sees you. The ED can't deny you services so being a member doesn't matter but you might want to check with your Canadian insurance what they'll pay for Kaiser claims.

I work for a different Kaiser region but haven't been to any of their hospitals so can't say to the quality, just that the billing will be less crazy.
posted by fiercekitten at 4:44 PM on January 27, 2020

Response by poster: Thanks everyone for the help and advice! I ended up going to Straub, which is closer than other options and had a walk in clinic. Took two hours all said and done (including x-ray). And nothing is broken, hooray!!!!

Also, I should retroactively clarify that while I am Canadian, I actually live here as a permanent resident and have local (HMSA) insurance. I just have never needed urgent care while living here before, and not going to lie, I fear and do not understand the American health care system, hence my panic. But all is well!
posted by Paper rabies at 5:26 PM on January 27, 2020 [2 favorites]

Best answer: If you're in town in Honolulu, you should not be 30 minutes from an urgent care with X-ray. I can say from experience that Island Urgent care on Kapahulu has X-ray (https://islandurgentcare.com/iuc-kapahulu/) and I would expect that Straub Urgent care probably does, as well. I can't speak to the insurance issues.
posted by LadyOscar at 5:29 PM on January 27, 2020

And, I am glad to see that you posted that the problem was resolved while I was typing!
posted by LadyOscar at 5:30 PM on January 27, 2020