It depends of the amount of water the cast padding absorbed.  There are three components to your cast: a cotton lining next to the skin called stockinette, a cotton padding called Webril and a hard shell component of either fiberglass or plaster. 

 If you have a plaster cast which is wet  you should make an appointment to come in to the office and have a new one put on because the water will soften the plaster and cause the cast to breakdown.

If your cast is fiberglass and only a small amount of water got into the cast try blowing air with a hairdryer on cool setting to dry the cotton padding.  The water will not soften the fiberglass like it does plaster. 

If your cast was completely soaked such as immersing it in a swimming pool I recommend you come in to have the cast changed.  The reason is that the cast padding will not dry out completely and will mold which can cause a skin infection. 

This is most commonly caused by swelling of the area around your fracture because the size of the cast does not change.  This is most common in the first few days after the cast is put on.  I always stress to my patients to keep their extremity elevate for the first few days after the cast is put on.

If your cast feels too tight, immediately lay down and elevate your extremity on 2-3 pillows, above the level of your heart.  This will work most of the time to reduce the swelling and help ease the pressure

If you have done this and the cast still feels too tight, you will need to come into the office and have it replaced.  If this is during business hours, come into the office immediately.  Just make sure you call ahead to let us know you are coming

If this happens after business hours, our office is closed and you will have to go to the emergency room to have the cast split.

It depends on the surgery and your insurance

If you have an HMO or IPA then they will generally cover the cost of the surgery including anesthesia services, surgery fees and hospital bills.  However, most IPA's are contracted with a certain hospital meaning that you have to use that hospital for your surgery.  Prior to the surgery my office will obtain and "authorization" from the insurance company or IPA for permission to do the surgery. 

If you have Medicare then your expenses including surgeon's fee, anesthesia services and hospital expenses are covered and you don't have to pay out of pocket for the surgery.  Medicare is contracted with most hospitals so you have a choice of which hospital you can have the surgery.

If you have a PPO insurance then you can choose which doctor and hospital you like but you will generally have a 10-20% co-payment for services.  In addition, if the hospital or doctor is "in network" then the amount they (hospital and surgeon) can charged is predetermined to a lower rate.  If the doctor is "out of network" then your share of the cost is much higher because the amount that can be charged is much higher.

If you have straight Medical then the authorization process is very slow, averaging 3-4 months and your choices of hospitals and doctors is very limited.  However, you do not have any out of pocket expenses

There are a few components to getting your surgery scheduled. Each one must be completed before we can do your surgery

1. Insurance Authorization: Most insurance companies need to pre-authorize your surgery.  I communicate with them through codes which describe the type of surgery we want to perform.  If you have a PPO insurance or Medicare and your surgery is outpatient then we don't need to obtain authorization first.  If you have an HMO or IPA insurance, this typically takes 4 days to 2 weeks depending on the insurance.  If you have Medical, the authorization process can take 3-4 months.

2. Pre-op clearance:  If you have pre-existing conditions (hypertension, diabetes) then you need to be "cleared" by your primary care doctor prior to the surgery.  This generally involves blood work, chest x-ray and an EKG prior to surgery.  This factor is dependent on how fast your primary care doctor can do this.

3. My schedule: I take care of both elective cases (scheduled) and emergency cases.  I always schedule extra time to take care of emergencies and trauma that are admitted so I tend to be backed up 3-6 weeks for elective cases.