Wrist pain, very likely a sprain: just watch and wait?

February 8, 2008 11:56 PM

I have some wrist pain from my wrist being twisted, which by all signs appears to be a sprain rather than anything more serious. I'm trying to make sure I don't need to visit an ER (other major factor is that I have no insurance and I don't know what would happen financially after an ER visit).

This is in NYC, if if matters. I've never been to an ER; I know they're required to treat you intially if you have no insurance, but I can assume the result afterwards would be me in debt to the hospital for god knows how much. If your first reaction is "money is no object when it comes to your health!" please respect that it's not that way for everyone; I really need to evaluate this critically. I'm trying to find out specifically what the cost would be after an ER visit, especially if they wanted to do x-rays.

I hope I can just wait and see what happens with my wrist. I think that two unrelated things happened to my wrist: it was twisted fast (= sprain) and it was pressed against an edge (= long but mild bruise). It's somewhat swollen and it hurts to twist it, but I see no unusual bone shape and the pain isn't intense. In other words, according to my googling, signs definitely point to sprain not fracture. Some sites say it should be x-rayed just in case, but most say ice it and if it doesn't improve fast, then see a doctor. If it's relevant, I've never had any other wrist pain or issues.

I also don't know if it's relevant (in terms of who pays) that cops were the source of whatever this injury is. (They got somewhat rough with me in the process of arresting my unrelated neighbor; details are below but not necessary to read if you just have an opinion on the wrist. I have zero interest in suing them but I might be willing to see if they'd just directly reimburse for x-rays, if it's that simple..... which I'm sure it's not.)

posted by sparrows to health (24 comments total)

DETAILS IF YOU'RE INTERESTED (* skippable if you just have wrist/ER advice *):

In hindsight I think I can understand everything the cops did (this was my first time encountering cops in a situation like this). For background you have to know that MANY times (at least 20 times over the last 3 months), groups of 2 to 4 angry people have come pounding on my next-door neighbor's door and sometimes they eventually start pounding on my door and other nearby doors, just to see if any of us "knows where he is" (none of us have anything to do with him). This doesn't feel good but I'm at least used to it as a pattern.

So tonight these cops were pounding on his door, shouting his name and shouting for him to open the door, just like everyone else does; then they started pounding on my door. I looked at them through the peephole and initially I didn't trust that they were cops (they were dressed in street clothes, had badges but I'm not exactly an expert on what a real cop badge looks like). While the ones in the hall were shouting at me to open the door, another one came up the fire escape and was at my window forcing my window open. I was trying (failing) to hold it shut, then he came in my window, shouted that I would get arrested if I did "anything else like that," and opened my front door from inside for the other cops. One of them was shouting OPEN YOUR HAND because my hand was in a fist around my earphones which I'd taken off. I didn't open my hand (maybe from panic -- remember I still was thinking these were not cops) so one of them twisted my wrist and had me against the wall while the other was coming through my place and out my window. They said they would cuff me if I moved, then they went through my place onto the fire escape, shouting the guy's name. Then two more came in and said I could move but should stay in my apt.

I started believing they were cops as they showed me photo IDs and I saw two more men in the hall who were older and in uniform. Eventually they pried open the window of the guy and took him away out his front door (my front door was closed for that part). When they were gone I called 911 and confirmed that yes they had been cops. The 911 operator asked if they'd damaged anything in my apartment. Strangely I just said no, without mentioning I might be hurt myself (I was still freaked and intimidated, and actually I don't think I noticed until after that my wrist hurt).

I'm still slightly freaked and strangely still feeling like I was assaulted because what I keep remembering was my initial panic when the guy got through my window and the other guys came in and had me against the wall, rather than the more rational hindsight of understanding this as people doing their jobs. I have no idea whether the police are set up to pay for an ER visit and x-ray (if I had one) in this context. Also, I don't have the slightest idea what anybody's badge numbers were and in fact I could barely begin to describe them physically, because I was terrified through most of this. I can understand this was their standard procedure, especially since I was holding something in my fist and wouldn't show it to them, and they had to focus on trying to get the guy to come out of his apt rather than being held up by me. (I can just feel thankful that I'm white and female so they didn't make even worse assumptions about my danger level.)

Thankfully this is my last month in this apt, so I can "walk away" soon in physical terms. Also I'm safe from the neighbor guy (at the end, one of the cops told me that the guy will not be coming back to his apt, because he broke parole). In case it needs saying, I'm perfectly clean myself (never even a parking ticket) so I have no reason NOT to get involved with the cops, just don't know if I have any reason TO get involved, especially if there's nothing wrong with my wrist and especially because I really don't want to interact with cops for a while.
posted by sparrows at 11:58 PM on February 8

"In hindsight I think I can understand everything the cops did."

I don't think what the cops did is acceptable.

"While the ones in the hall were shouting at me to open the door, another one came up the fire escape and was at my window forcing my window open. I was trying (failing) to hold it shut, then he came in my window, shouted that I would get arrested if I did "anything else like that," and opened my front door from inside for the other cops."

This is where they broke your rights. You did not open your door to them. You did not invite them in. They did not have a warrant for your residence I assume. I am pretty sure you should take this information to the police station, but I would wait for a couple, more knowledgeable mefites to weigh in on this.
posted by B(oYo)BIES at 12:14 AM on February 9 [1 favorite]

If you're typing all of that with both hands, you'll be fine. The cops are another story.
posted by rhizome at 12:29 AM on February 9

Whether it's sprained or fractured, you should immoblize the wrist while it heals. Go to Bigelow Surgical Supply (2nd floor over Bigelow Pharmacy on 6th Avenue between 8th and 9th St) and ask at the counter for a wrist splint - the people there are very helpful.

If you go to the emergency room with it, they'll have it X-rayed, you'll owe them for both the visit and the radiology, and in the end they'll put it in a splint or a cast while it heals. If you can rotate and flex the wrist with only moderate pain I'd say it's not worth the time and expense - but of course IANAD.

I'm just a block from there and have a good splint for the right wrist that I'm not using - it might not fit you, but if that's the wrist that's hurt I can save you $35 bucks or so. E-mail's in my profile.
posted by nicwolff at 1:07 AM on February 9

It's hard to guess what the cost of the ER visit would be, but radiology alone would probably be $300 or so.

Oh, and don't worry about the cops. I'm sure it was scary, but they were just trying to control a situation with a lot of unknowns, and you were making them nervous. Of course they have the authority to clear your apartment while executing a warrant next door. I'm afraid there's no chance that NYPD will pay for your medical costs on this unless you sue them which is not worthwhile.
posted by nicwolff at 1:19 AM on February 9

Of course they have the authority to clear your apartment while executing a warrant next door.

Wow.. Is this true? Can anybody provide a source for this information?
posted by B(oYo)BIES at 1:26 AM on February 9

Thank you all! I am already feeling so much better just talking about this. *Boy* is AskMe a good thing.

Yes, I am typing all of this tale with both hands (gingerly :)). Wrist does hurt when I try to rotate it, but I would definitely call the pain moderate rather than intense. (It's the left wrist, and I'm WAY north of you anyway, but thank you so much for the splint offer, that was very cool!)

I think I'm just going to be very gentle with it and make sure it gets less sore rather than more sore.
posted by sparrows at 1:35 AM on February 9

nicwolff is probably right about immobilizing the wrist, sparrows. You move it in your sleep without knowing and it can keep happening and worsen your pain and take a lot longer to heal; it's better to keep it from moving, and it will heal much faster.
posted by cgc373 at 1:40 AM on February 9

Okay, that makes sense to me. I can wait to sleep for a few hours (I'm still kind of wired) and when it opens, there's a place just a couple blocks from me that probably has good cheap splints.
posted by sparrows at 2:01 AM on February 9

I really, really don't see how they can force entry into an apartment that they: a) don't have a warrant for, and b) don't have a need to empty for the occupant's safety (like there's a shootout or the building's on fire).

They forced entry into your place. Then they hurt you.

If you want someone to pay for medical care, I suspect that by talking to the right people (possibly a lawyer, possibly a mayor's aide) you can get all of your medical bills taken care of.

And, for all you know, you may have injured your hand while holding your fire escape window shut while strange men tried to break in.
posted by zippy at 2:19 AM on February 9

Fantastic story, I'd complain. Got any witnesses?
posted by mattoxic at 3:04 AM on February 9

Sprains can take a long time to heal fully - longer than straight-up fractures sometimes, depending on the sprain. So don't worry too much if it's still kinda twingey in a few weeks. I sprained my ankle once and it took about three months to completely heal. Your sprain doesn't sound too severe, though, so if you keep it immobilized (at least a night) and are gentle with it, it should be okay sooner rather than later.

As for the cops....If I were you, I'd start investigating how to file a complaint (citizen review board? precinct captain?), because what they did wasn't right.
posted by rtha at 5:53 AM on February 9

WRIST:

If you've actually torn a ligament or broken a bone, you can partially accommodate while it heals, convincing yourself that it's merely a muscle tear. Unfortunately, such damage may never repair to normal by itself, and the longer you wait, the more involved the reparations will be.

IANAD. I'm speaking from personal experience, though it was a tendon break elsewhere on my arm (and, yes, my body was able to compensate enough to convince me the tendon was still there!). The window of opportunity for such injuries can be a few days.

I, like you, really really did not want to go to the doctor.

A free, over-the-phone medical opinion can be obtained from most hospitals by calling their "24-hr nurse line" (or whatever they call it), if that helps.

So, the question is: do you feel lucky? You're risking your lifelong usage of your wrist.


POLICE:

Of course the police have the legal authority to break in, while trying to control a violent situation.

Warrants are never necessary when there is a reasonable concern that immediate action is required by the police. For instance, if they see a known felon on parole walk into a house carrying a firearm (which violates parole), they can immediately follow, using all necessary force, and apprehend the criminal. It does not matter if the parolee is entering his own house, or that of someone else (perhaps an intended victim).

In like manner, if during the confusion of this incident, the police came to believe that suspects were entering your house, they would have the right to pursue them, using force as needed.

In the excitement & confusion of the incident, it's not surprising that the police mistook you for a potential threat. Naturally, they prefer to err on the side of safety in such situations - their own safety.
posted by WorkingOnANewMe at 5:58 AM on February 9

I've read about cases in which people assaulted in the street in New York had their healthcare paid for by a fund for crime victims... since you were (somewhat) innocently injured during the execution of a warrant maybe you'd be eligible?

Ah... here it is, the New York State Crime Victims Board. But I'm not sure if you'd be eligible... You have to cooperate with the police... and they might say you didn't do that... and I'm also not sure what the crime would be (the parole violation perhaps?).

It also looks like you'd have to pay out of pocket and then seek reimbursement, which may or may not be successful.
posted by Jahaza at 6:36 AM on February 9

About 6 months ago I took my daughter to the ER for a wrist injury. They took x-rays, discovered it wasn't broken, gave [rather, sold] us a flimsy piece of cloth they called a "sling" and told her to be more careful on her skateboard. If it had been broken, the doctor told us our treatment would have been pretty much the same, with the addition of a splint or cast. The cost of all this was around $1000, before our insurance paid a few hundred. We could have saved by going to one of those "doc-in-a-box" ambulatory care kind of places, but our pediatrician recommended the hospital ER.

There's not a whole lot that could be done for a non-severely broken or sprained wrist anyway, other than immobilizing it. The ER doc might also prescribe pain-killers and/or anti-inflammatory medication, which you could buy over-the-counter if you feel you need them.

The most important thing to remember for sprains is RICE: rest, ice, compression and elevation:

*Rest your wrist as much as possible, obviously.

*Ice it, especially in the first 48 hours after the injury. The best way to ice a wrist is to hold it in a large bowl with an ice and water mixture. Keep it in there until you can't feel it anymore (maybe 10-15 minutes?) than remove. Once the skin on your hand has returned to its normal color, start the icing process again. Repeat.

*Try to minimize swelling by keeping your wrist wrapped in an elastic bandage or rig up some kind of splint using whatever sturdy thing you have around the house and some white athletic tape. Be careful not to make it too tight - you just want it snug enough to support and slightly compress your wrist, not to cut off circulation.

*You can make a sling out of a towel or scarf to keep your wrist elevated above your elbow. When you're sitting around watching tv or whatever, rest your arm in such a way that your wrist is elevated.

Any throbbing pain will subside, but it might not go away completely for a long time (months?).

IANAD, but I've taken athletic training courses, and this is what I did with my daughter's injury.

Good luck to you.
posted by SuperSquirrel at 6:49 AM on February 9

IANAD, but I have fractured a wrist five different times and injured wrists, arms, and shoulders in several other ways, which means I'm full of good-old folksy farm advice for "am I injured enough to seek treatment." In each case where I've broken a bone, whether the fracture was minor or severe, I knew that I had broken a bone. In cases where I suffered a different injury (sprain, tendon, or ligament damage), I knew that I did not break a bone. If I were you, based on your seeming lack of financial means to seek treatment, and given what you have already provided about your wrist's functionality and your level of pain (you didn't mention any numbness), I would buy a wrist brace, a bottle of Advil, and look up how to do an appropriate ice/heat treatment. Even if you didn't break anything, you're probably going to be sore for at least a few weeks, and notice the injury for a few months. I would seek treatment if you experience any numbness or loss of feeling, if your pain increases, or if you mobility decreases. But, as some others have mentioned, it's a gamble and residual long-term pain from injuries (both treated and untreated) is no fun.
posted by mrmojoflying at 7:07 AM on February 9

Have you thought about going to an urgent care clinic or your GP? I know you might not have one but I would imagine that cost would be significantly less then an ER, the care would be as good and faster.

If it were my wrist I'd want it looked at.
posted by red_lotus at 7:21 AM on February 9

Wrist; the suggestion for a split is prolly the best.

Cops: Absolutely complain. I can find no proof that legally they can break into your apartment to serve a warrant next door. I would absolutely call the NY Bar association, I'm sure you can get a pro bono (free) lawyer to take this case. Here's my logic, the only way that we can stop a police state is to complain about it when they break the law. Cops are not above the law. They cannot break into places without a warrant. They cannot injure citizens. (They cannot injure criminals either.)

Absolutely lawyer up and find out your rights.
posted by dejah420 at 8:05 AM on February 9

IAAL - But not your lawyer, this isn't legal advice, consult a NY attorney.

A warrant is only good for the residence specified on the warrant and approved by the judge. There have been incidents where the cops get too excited and serve a warrant approved for 123 Main Street on 321 Main Street instead - generally resulting in the cops getting their pants sued off by the wrongly searched person.

If there's some exigent circumstance the cops MAY be able to break into your place - but these are very limited to situations like hot pursuit. Here the guy was at home in his own apartment... unless they had some reason to believe he was in your place, they had no reason to break into your place.

The cops have NO authority to enter and clear residence just because they're serving a warrant next door. Whoever said that is wrong.

What the cops should've done is knocked on your door and then asked real nice if they could use your fire escape. You can say no, and in theory they should then go away (unlikely in reality).

I'd consult your local ACLU.
posted by falconred at 8:56 AM on February 9 [1 favorite]

I really appreciate the concern and input about the cops' actions (which is definitely On Topic and which I am still confused/disturbed about).
posted by sparrows at 9:08 AM on February 9

A few months ago I sprained my wrist and the pain got quite bad at times. I had to have quite a few x-rays as my sprain was a little weird, it took a few weeks for it to get better. I do know that generally doctors are concerned about such things as there is a small bone in the wrist that if it looses blood supply can mean permanent damage to your hand. A doctor will be able to tell you more, but I'm pretty sure that whilst I don't know the exact details, this isn't inaccurate. I know that you don't have insurance but you should probably get it seen to just in case. Anyway, good luk with the wrist and with the cops.
posted by ob at 10:44 AM on February 9

No one's "personal experience" on Ask Metafilter should be taken as a substitute for seeing a physician. Just because someone's daughter had problem X which was solved with treatment Y doesn't mean yours is anything like it. Especially for musculoskeletal complaints, there's no substitute besides having a physician look at it, check range of motion, possibly get films.

When you go to an Emergency Department, you're going to be seeing Emergency Medicine physicians. We are trained to make sure things are not emergencies, so yes, you'll probably often get a more thorough workup than you might get at a primary care physician, and yes, it's going to cost more.

Note: A primary care physician can do the diagnosis as well, and will be cheaper, but may not have access to Xrays as quickly or casting materials. Who knows, you may need neither. Or you may need both, plus a referral to an orthopedic surgeon. Can't say without seeing you and the wrist.

(This is not medical advice; I am not a doctor; you are not my patient; I am not your doctor.)
posted by gramcracker at 11:11 AM on February 9 [1 favorite]

IANAD but what ob is alluding to is called a scaphoid fracture. The scaphoid is a small bone in your wrist that can be fractured in a wrist injury usually during a fall on the outstretched hand. Unfortunately the blood supply to the scaphoid is unidirectional so some fractures can cut of the supply to the distal part of the bone causing avascular necrosis (essentially death of the bone due to poor blood supply). This leads to more longterm problems with the wrist, in particular, arthritis with pain and decreased range of motion. Here is some info on this if you are interested. It includes some advice on when you should seek medical attention.
posted by madokachan at 7:21 AM on February 10

The cops have NO authority to enter and clear residence just because they're serving a warrant next door. Whoever said that is wrong.

If the police, while executing a warrant, reasonably believe that they might be in danger from an adjacent apartment, then they can perform a protective sweep and a cursory search through it, and can use reasonable force to do so. She can take the NYPD to court and demand that they articulate their reasons for believing that there was a potential threat from her apartment, and see how far that gets her; I expect she'll be told that her initial refusal to admit them is a valid reason for suspecting such a threat.

Now, if she can help the ACLU establish that the police have a common practice of sweeping or searching residences they don't have warrants for and can't specifically and reasonably suspect of harboring an immediate threat, then they would have a good Constitutional case, and more power to them.
posted by nicwolff at 3:05 PM on February 10