Know what hospital I’m going to.
Thanks for the help everyone. 
What was your original injury? ( I just looked that up in your old threads, actually - moving hay.)
“I have pain in the back of my wrist (not the bottom)”
Does that mean the palm side or the other side?
Did you take any medications for it? Do you work with your hands? Do much computer work? Barn work? Do you shoe your horses or just trim and how many horses?
I’d not write off PAs. Often I like them better or at least as well as Doctors. You just need the right one. Carpal tunnel can take a crazy long time to improve or even not at all, if it is not managed the right way.
I’d skip that practice and find a new one. Do you know any medical professionals who might be able to recommend someone? I’ve had decent success with even looking on Google for a specialist in the area and then looking at reviews for them.
“I will admit I’ve been putting this off, since I’m afraid I’d need surgery.”
Well, no, that approach will not help. 
Perhaps you can be managed with medication and more conservative/better physical therapy.
“Then I had about 10 minutes with the MD.”
Lots of these guys have to see 4 patients in an hour. It doesn’t, usually, matter how long they spend with you, it matters that they can diagnose and treat properly.
Feel better.
I was taking hay off a hay elevator. They were much heavier than what I’m used to (50lbs). I bent my knees to pick up a bale (have an old back injury, so I’m super cautious), got a hold of it, and something popped and hurt in the back of my hand. I had a lot of bales to put up that day, so I had to keep going with that load. Then I had to duck out, since my wrist really hurt. Luckily I had other people to come finish putting the hay up.
Back of my wrist is the opposite side from the palm, and the side of my arm that has hair swells up when I do stuff with my hand. I was never clear on what my diagnosis really was. The PA and MD said sprain, but the PT seemed more for carpal tunnel. And the carpal tunnel diagnosis really puzzled me, since the pain I have is on the opposite side. It seemed like the PT was aimed at carpal tunnel. There was a lot of talk about ergonomics, use a brace for heavy stuff, don’t use a brace. One appointment I was doing isometric exercises, then next I was supposed to lift a 1lb weight. I was told not to push through pain, which meant I could only do 1 rep 2-3x a day of the tendon glides, and 1 rep 2-3x every other day of the isometric exercises. I tried communicating this to the PT, but he insisted on pushing it.
I have a rare immune system disorder and have a lot of trouble tolerating most medications…anything from severe side effects, to skin rash to anaphylaxis. Pretty much all NSAIDs wreck my stomach, and stronger stuff doesn’t agree with me at all. I have been working with a really good functional medicine doctor, and I’m on some supplements that work really well for me. As far as pain medication goes.
What I do every day is variable. On a bad day, I just feed my horses (someone else takes care of hay/manure) twice a day and watch tv. On a good day, I might spend the day outside mowing or at work or gardening. Work is variable. Recently, I’ve been making sample packets in preparation for a trade show. Other days, I could be keeping an eye on a machine. I’ve only spent one day this month doing computer work all day. I used to do the heavier barn work (moving hay, manure pickup), but I can’t do that anymore because of my hand.
I have an old pony and 2 minis. Thankfully, they’re all just trims. Before my injury, I could do all 3 in a day. Now I have to do them on separate days, since I don’t have the hand strength to trim them all at once. Right now, I trim my pony one day and then trim the minis a week later. Every 4-6 weeks, depending on how things look and weather.
Unfortunately, I haven’t had good experiences with any of the PAs I’ve seen here. I went in with an injury that wasn’t healing. I tried wearing a brace most of the time and resting it for about 6 weeks before I made the appointment. It didn’t seem to be getting better (still weak, numb and painful) and there was a bone that could slip out of place a little. When it shifted, I’d get a little feeling back in my fingers. I told all this to the PA. Had X-rays, manual exam of my wrist (pressing to see if it hurt), and ordered an MRI. Didn’t do any neuro exam of my hand, or look at my arm or neck to see if there’s some nerve impingement going on, since the injury happened when I twisted my body. The PAs I’ve seen all seem to focus on a narrow area and aren’t able to see more than that.
I don’t know any medical professionals at all. The functional medicine doc I see for my other issues used to be here, then she moved out of state. Fortunately, I’ve been able to consult her via the phone. I’d like to see her in person, but traveling is really hard on me. I did ask if she knew anyone here and she didn’t know anyone.
I know putting things off isn’t helpful. I’m just so frustrated with the whole situation now. If it was easy to get to one, I would have tried another PT. But the closest is 40 minutes away (the one I had issues with). They only had 1 hand therapist there, so I couldn’t even work with another therapist. I had to get a ride to those appointments.
I’ve done some google searches and there might be some good orthos or physiatrists. But most are hospital based, so there’s no way of knowing if I’d actually see the doctor or a PA. The office I was at is supposed to be the best orthopedic practice in the state. I found a general ortho doc who’s in private practice, has in house PT and was/is a professor of surgery. He’s about an hour away, which is doable. I’m just afraid of wasting more time and money on this.
The only reason I was unhappy with spending just 10 minutes with the doctor was because I had to wait so long to see him. And the reason I had to wait so long was because he wasn’t notified that I was there. I missed lunch as a result and was starving by the time I was done. If I knew the wait would be that long, I’d have brought a snack.
Did they ever do any serious diagnostics, x-rays, scans?
Seems that you need a diagnosis first, before proceeding with any treatments, that may not be addressing what is wrong.
I had x-rays done and an MRI. Supposedly, its one of the best MRI machines in the state. I was told there wasn’t any evidence of a tear on either. But I know there’s room for error when reading imaging.
I went on vacation for 4 weeks during the winter, so there was minimal/no extra strain on my wrist during that time. I used to knit, spin fiber, weave and play video games. I’ve given up on all those.
Maybe they ought to consider sending you to a real fancy medical center that has someone specializing in wrists, for one more opinion?
I had a wrist that was hurting all the time, day and night, was getting so stiff I was not hardly able to use it.
Finally mentioned it to my Dr, that sent me to a hand specialist, that looked at it, took my history, that wrist had been injured in gymnastics at 12 years old, eventually healed and never gave a problem for half a century.
He took x-rays, confirmed that, when injured previously, one bone had quit growing while the other did and, after all these years, that difference was finally destroying those little bones in the wrist from the maladjustment.
He called that gymnast wrist and said it was a common injury, had done that surgery before.
He proposed to operate to cut the bone that was too long to shorten it and fix it with a plate and screws.
Then clean the damage in the wrist and use that extra bone to repair the damaged little wrist bones and realign it all properly.
I went for a second opinion, that sounded so … barbaric, but the second Dr said yes, that is what I needed.
The operation was quick and no problems from it, the wrist after that like new and years later still working fine.
All that to give you an idea of what all can go wrong with wrists and to say, keep being the squeaky wheel, until someone finds what is wrong and what to do for it.
How to find a good doctor?
I would try posting or just reading through the HealthBoards forum. It is segregated by body part/injury/disease. I found it to be a wealth of information when I was navigating ankle hell.
Orthopedics This Week is a online med journal that does rank ortho specialties. It’s super technical, but the search function will probably turn up a list of hand/arm guys. I found my ankle guy from their ankle OS list & Healthboards.
I would plan on a day in Boston at some point (looks like Harvard & Brigham & Womens have guys on the above list). IME, it would be a day well spent. When I got my ankle evaluated by a good doc, I was amazed at the difference in the exams. The guy took like a half hour, it was like listening to an eye doctor (better here? or here?) and by the time he was done I wanted to cry, but I finally had an answer.
I had my shoulder checked out by their arm/shoulder guy who trained at one of the top programs. That exam took forever too.
In general I’m not fond of PAs, except for treating ongoing stuff. For a nagging issue with no real diagnosis, I would skip a PA in favor of a good ortho. I have left practices because of crappy office staff, but I will wait for time with a good doc.
Thanks Bluey and red mares. What you said was helpful.
I’ve spent some time looking for a good specialist today. I found one who sounds really good, but he doesn’t take my insurance. I have pretty bad insurance from the state exchange here. I looked up a couple of the docs from Brigham & Womens and another one, and none of them are listed either. And the in-state doctor I was thinking about also isn’t listed. If I’m reading my plan right, I’d have to pay everything out of pocket if I go outside the network. And going to a top specialist out of pocket is way more than I could afford. In which case I’m well and truly screwed. Unless I sell my car.
I would give Brigham & Women’s a call anyway. If they’ve got one guy on the list, the rest are usually pretty good. My doc isn’t on the list, but his boss is. When I called, I was to the point of just get me an appt with anyone, asap. What really freaked me out was I got in within a week.
I would be really surprised if they didn’t have some sort of assistance program or very large self pay discount. I know Mercy, where I go, does. They are also used to dealing with out of state patients. It’s a bit different than going to your local doctor.
