Is there a doctor in the house
August 4, 2008 10:42 AM   Subscribe

I sort of smashed my finger a couple of hours ago, and it looks pretty nasty. Nothing broken, bit there is a 3/8 inch gash with what looks like fat protruding from it. I've never seen anything like this before and don't have insurance or workman's comp, so would like to avoid the emergency room if I can. Any imformed advice is appreciated. Gruesome photos of the aftermath.
posted by Huplescat to Health & Fitness (33 answers total) 5 users marked this as a favorite
posted by kldickson at 10:53 AM on August 4, 2008

What do you mean when you say you don't have worker's comp? If you mean you weren't injured on the job, that's one thing, but nearly everyone who posts on AskMe will be in a jurisdiction with some statutory form of worker's compensation.
posted by allen.spaulding at 10:54 AM on August 4, 2008

My opinion: Looks possibly infected. Go to a hospital.
posted by Citrus at 10:54 AM on August 4, 2008

Didn't look at the pictures but it sounds like the white stuff could be pus.
posted by wongcorgi at 10:54 AM on August 4, 2008

Just leave it as it is. When in infection sets in, or it starts turning gangrenous because the tissue is dead, and you get sceptacemia, you can rest happy in the knowledge that at least you saved yourself a huge bill.

Seriously, what do you expect us to say other than "go to the emergency room"?
posted by Solomon at 10:56 AM on August 4, 2008

nth on the visit to the hospital. Its better to go into debt for the bill than to lose sensation in your finger (or possibly the whole finger due to infection). As a veteran home renovation guy, I feel for your pain--that thing is going to keep you up nights, feeling each beat of your heart.
posted by midwestguy at 10:59 AM on August 4, 2008

An urgent-care clinic would probably work as well as the emergency room and be slightly cheaper - I don't think you're going to fall over dead in the next ten minutes - but I concur that medical attention is warranted. It would suck to lose partial use of your hand.
posted by restless_nomad at 11:00 AM on August 4, 2008

Best answer: Try an urgent-care clinic if you don't want to go to the ER.

Doomsday scenario anecdote: I have a friend who had a similar injury. It was not treated right away or properly. He subsequently lost all use of the finger despite several attempts at corrective surgery. Said finger has now been amputated to the middle knuckle. YMMV, IANAD, go to the doctor now, etc.
posted by bedhead at 11:06 AM on August 4, 2008

That really looks like it needs attention. And if you haven't had your tetanus booster in the last 10 years, you're probably going to need that too.
posted by meerkatty at 11:06 AM on August 4, 2008

Response by poster: Yeah, I realize that this is pretty marginal use of askmefi and sort of a shot in the dark... just trying to gather imformation and any insight is useful. I cleaned it up right away and have it firmly bandaged. I just don't know how serious it really is. For all I know it could be minor or very bad. In any case, if the extrusion is still there tomorrow, I will seek medical care.
posted by Huplescat at 11:08 AM on August 4, 2008

Yeah yeah, off to the Doc for pete's sake. Looks to me like you smashed it pretty good and have a hematoma (IANAD - just a klutz who's injured himself innumerable times). Stop waiting for replies and go get it looked at.
posted by elendil71 at 11:09 AM on August 4, 2008

Just chiming in to say that even without looking at the photos, I know that as a writer and a teacher I would never, ever risk losing the use of any part of my hand. Go to the ER now, suck up the bill, and be glad you've got a full set.
posted by mdonley at 11:09 AM on August 4, 2008

Best answer: Too early for pus or infection.

If it's important to you to keep this finger, you should go to the E/R right now. If you don't mind losing the finger but don't want to die of sepsis from gangrene, hold off a couple of days and go to the E/R then.
posted by ikkyu2 at 11:14 AM on August 4, 2008 [20 favorites]

Seconding the "don't wait for tomorrow" chorus. (Yes, I've been checking back to see if you've actually gone...) Don't bother replying, just go.
posted by Citrus at 11:28 AM on August 4, 2008

Good God, first vomiting for days, and now someone's expelling their innards? What's wrong with people?

posted by TheNewWazoo at 11:35 AM on August 4, 2008

Best answer: Get yee to a doctor - go!

Seriously - do you think the extrusion is just going to go away on its own? That certainly doesn't look minor. I'm leaning towards bad or very bad.
posted by Solon and Thanks at 11:37 AM on August 4, 2008

Response by poster: OK, I'm going. Thanks everyone. Check back and I'll let you know how it turned out.
posted by Huplescat at 11:39 AM on August 4, 2008

Yes, GO TO THE ER NOW if you want to save this finger.

I know of which I speak. I had a severed finger reattached 20 years ago in a hospital that specialised in such things, and there were a number of people who thought they'd just bandage it up for a day or so and see how it was, with horrible consequences for every single one of them, varying in seriousness, from lost knuckles and fingers, an amuptated hand, right up to the man who died of septicaemia as the result of failing to seek immediate medical attention after he dropped a sledgehammer on his finger and smashed it.
posted by essexjan at 11:40 AM on August 4, 2008

Best answer: Huh. If I'd posted two minutes earlier I could say that it was my answer that made him go. Rats!
posted by essexjan at 11:41 AM on August 4, 2008

Please let us know how it turned out.
posted by crapmatic at 11:59 AM on August 4, 2008

That 'fat' is torn flesh. I really dont think you have any other option than seeking care now.
posted by damn dirty ape at 12:53 PM on August 4, 2008

Major ouch. That finger needs stitches, possibly minor surgery, and most of it can probably be saved as long as the wound is still fresh. You already went to the ER, but posting anyway for the record (speaking from experience - didn't I run to the ER I wouldn't be touch typing this).
posted by _dario at 1:10 PM on August 4, 2008

My office mate agrees: "That's disgusting who is that did he go to a doctor?". There you have it. Hope it wasn't too pricey.
posted by GilloD at 1:14 PM on August 4, 2008

Being a nine fingered responder, please get that x-rayed and sewn up. The swelling will begin, or has already, and the pain will be intense. The number of things you will find to hit that sore finger upon will stun and amaze you.

Get a plastic guard pronto and be prepared for a long period of awkwardness, bathwise, working your fly-wise and otherwise.
posted by Freedomboy at 1:58 PM on August 4, 2008 [1 favorite]

Best answer: For what it's worth... oh. He already went to the hospital. That's good.

Well, for what it's worth, I had an injury almost identical to this one when I was about 24 and worked construction, but it was my thumb. I didn't go to the hospital, but cleaned it out really well and changed the bandages often. It hurt. Eventually it started to heal, but I had a torn piece of flesh similar to this one, and it started healing as if it was a second tiny thumb on my actual thumb.

So, no insurance, no money. I went to the store and bought a pair of toenail scissors. I wanted something really strong that wasn't going suddenly decide to not cut through the skin. I also bought some anbesol, thinking it would act as a local anesthetic, but it turned out to be totally useless.

I filled a cup with ice water and sat in the bathroom letting my thumb soak and numb in the icewater, then taking it out and holding the scissors, ready to cut. Ready... ready... no. Not ready. I chickened out repeatedly for about two hours.

Then finally I got up the courage to do it. It didn't snip quite so easily as I might have hoped. It took about three seconds, which is a long time when you're cutting through your second thumb with a pair of scissors. And then I jammed my thumb back into the icewater. When I poured out the cup of water, it was very dark red.

I don't know if I could do that again. These days I'm much queasier and get lightheaded just giving blood. But then--all I can say is that it sucks living in the U.S. with no health insurance.

On preview I see I was luckier than some, as I still have all my fingers.
posted by The Loch Ness Monster at 2:09 PM on August 4, 2008 [3 favorites]

1. Go to the ER, ASAP.
2. No, it is not safe to eat.
3. Name it Frank.
posted by Fuzzy Skinner at 2:58 PM on August 4, 2008 [1 favorite]

Response by poster: I just got back from the hospital, and I want to thank everyone who urged me to go. The x-rays found two breaks in the finger tip bone. The tip was broken off about a millimeter back and floating and there was a diagonal fracture thru the length of that bone. They also found what looked like a break in the first bone up from my hand, but it was asymptomatic and they didn’t know exactly what to make of it.

They put me on an anti-biotic drip before surgery, and it looks like I might well have lost the finger due to infection moving into the broken bone if I hadn’t sought treatment. I spent about 10 hours there, mostly waiting patiently and was tended to by a very competent and much overworked intern who cut off the extrusion and stitched me up.

He wanted to refer me to a plastic surgeon to kind of wrap things up, but I said there was no way I could afford that, and after awhile he relented and found a primary care physician to do follow up. He even gave me a special pair of tweezers so I could pull my own stitches. Bless his heart, he said that he was obligated to advise me vis a vis standard procedure but he understood that all medical dilemmas are not created equally.

The ER is a sad place, overfilled with poor people who have nowhere else to go. I felt worse for a lot of them than I did for myself.

Anyway, I’m out 180$ for the ER visit, plus a little for prescriptions... not bad when you consider the alternative.
posted by Huplescat at 10:45 PM on August 4, 2008 [3 favorites]

Wow, $180? My ER visit cost three times that and I have insurance. Fingertip breaks are often hard to self-diagnose. That bone is thin and hard to heal. Glad to hear that everything went well.
posted by Foam Pants at 11:57 PM on August 4, 2008

Great news. I'm glad it worked out for the best. All of these serious medical dilemmas popping up on askme lately are freaking me out.
posted by Solon and Thanks at 4:36 AM on August 5, 2008

Sorry about the dough but really thank goodness you went to the er. I'm glad to hear it worked out well.
posted by doorsfan at 2:28 PM on August 5, 2008

fantastic news and thanks for posting the follow up.
posted by Wilder at 7:55 AM on August 7, 2008

Ditto. Thanks for following up. We know we have saved thousands lives, but it's nice to hear a survivor's story.
posted by Fuzzy Skinner at 2:23 PM on August 7, 2008

Wow, $180 is like the cost to darken the ER door where I am.

Good luck with the finger.
posted by yort at 11:04 PM on August 7, 2008

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