A Medical Occam's Razor

In May, my upper left arm began swelling and became extremely sensitive to touch. A student who noticed the swelling as I was teaching a class came to me, touched my arm in the area of the swelling, and I about went through the ceiling from the pain. A student in the class who has EMT training encouraged me to call my doctor and get an appointment -- asap.

I went to the doctor the next day and explained that there were 3 places on my left hand that constantly throbbed and sometimes caused me to lose the use of the hand. The sudden swelling in my upper left arm was a new symptom, but it seemed to be important. Because the PA could see the swelling and bruising at my wrist, but had no idea what could be causing it, I was sent for x-rays of my neck, shoulder, arm and hand. Those x-rays didn't provide information about the swelling and the throbbing in my hand, although they confirmed the fairly extensive arthritis, as well as the deformity caused by the shattered shoulder. I was told to wear a brace if I had to use the hand, try both heat and ice to reduce the swelling, and take Alleve for the pain.

I was also given a referral to a hand specialist qualified to diagnose the problem and then prescribe a treatment protocol. Today was that appointment; well, actually, it wasn't the appointment I scheduled with the hand specialist, but an appointment with another doctor at the facility, a doctor who specializes in knees. When I questioned the change, I was blown off: the hand specialist is busy, busy, busy, so if I want to be seen, I'll need to be seen by another doctor. When I began to explain that I really need a hand specialist, I got the look that told me there was no way that was going to happen, so let's move on.

I walked up to the third floor and checked in to see the knee specialist, but he was busy, busy, busy, so I saw his PA, who checked out the x-rays, which didn't address the issues I showed her in my left hand. She could see the symptoms of the problem, but she admitted that this is not their area of expertise.

I pointed out the blood vessel that appears to have collapsed in the middle, both ends of which swell until I seriously worry about them bursting and me bleeding to death as a result. I also showed the very large swollen "fatty tumor" in my wrist area that appears to be connected to the pressure and the pain in my left wrist. I also pointed out the blood vessel that runs the length of my left thumb, constantly throbs, and often causes my thumb to cease function when I try to either pick up or hold anything. I am going to have an MRI of my neck, shoulder, arm and hand, as well as a nerve induction test before anyone hazards a guess as to what the problem may be, much less how to treat it.

How is a nerve induction test going to explain what appears to be a blocked blood vessel? Why am I being seen by a knee specialist when I was referred to a hand specialist because the problem is with my left hand? I don't have much confidence that my problem is going to be diagnosed, treated, and cured by this medical team -- unless it is somehow connected to the 3 previous surgeries on my left knee!

Occam's Razor says that the simplest answer is usually the right answer, and if you ask me, there's a fatty tumor on the inside of my wrist that needs to be removed before either the pain or the swelling are going to disappear.