weaselman
weaselman
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February 17th, 2011 at 6:05:46 AM permalink
A ski trip went bad :(
Now I find myself spending unusually large time at the computer, browsing this board in particular (it takes too damn much effort to move away from it, and it hurts too damn much to try and focus and do something productive while I am at the computer anyway).

So, I thought, with the level of intelligence and the diversity of experiences on this board, there has to be a person or to, who can share some useful info from their own experience, or from someone they know. I am interested in anything at this point - what painkillers are better, how to sleep with the aircast on, techniques of putting on the pants, what about showering, how to climb the stairs etc...
"When two people always agree one of them is unnecessary"
DJTeddyBear
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February 17th, 2011 at 6:15:53 AM permalink
It's been about 40 years, but....

Sleep? Just give it a couple days and you'll be tired enough to sleep in any position.

Shower? Wrap the top edge of the cast with a towel. Stick your leg in a garbage bag. Use masking tape to seal it. Masking tape is less sticky, so it won't be too painful to remove. You won't be able to do a great job making it watertight, that's why you put a towel in. Then take your shower.

Stairs? If you have rails on both sides, you can try hopping, otherwise, be a three-year-old and do the butt-slde thing.

Pants? Just cut the seam, or cut the leg off.

Pain killers? Go downtown, find someone with a lot of bling and say "Pssst, buddy...."
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RaleighCraps
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February 17th, 2011 at 6:26:42 AM permalink
All of my adventures through my teen years (broken right foot, broken left wrist, broken left arm) were of the old plaster casts. You put bags over them to keep from getting them wet. And, the last 3 weeks of the 6 week duration was torture, as your skin started itching like crazy. Many a wire coat hanger ended up getting turned into a scratching tool.
My foot happened in the winter, with lots of snow on the ground. After the bone set and was healing, I was playing basketball and bowling with that cast on. It spent more time in the snow than our snow shovel. Poor doctor had an impossible time trying to cut it off, as all the snow damaged the plaster, and the saw did not want to cut it. The other thing I remember was I was sitting on the edge of the table, and when the cast finally came off, my leg started rising all on its own. I bet my foot came up 2 feet before it started settling back down. It was so strange.

I never took pain killers, but the first 7 to 10 days is the worst. Every time you move wrong and cause the bones to shift, it hurts like he11. If you can manage to not do that for about 3 days, that seemed to be about the time it took for the bones to start mending. After that it is not bad, and the air cast makes it even easier.

Worst thing I ever did though was chip the bone on my right thumb in the base of the hand. The bone chip was small, so they opted not to operate, just let it dissolve. But as long as 3 months after, if I bumped that hand on a doorknob or table, it would about drop me to my knees. I was so glad when that finally healed.
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Mosca
Mosca 
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February 17th, 2011 at 6:38:20 AM permalink
Quote: weaselman

what painkillers are better....



Oxycodone (Percocet, Roxicet, etc) beats the hell out of hydrocodone (Vicodin) by about 3 to one.
NO KILL I
Face
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Face
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February 17th, 2011 at 8:41:47 AM permalink
Disclaimer: I'm not a doctor. The following is merely personal experience...

I've never had an aircast, but imagine it as a balloon type thing filled with enough psi to be stiff. Is it adjustable? Can you deflate and inflate as desired? If you can, I'd just shower with it on, then deflate it while in a comfy position on the couch with your leg supported and let it air dry. If you cant, I'm afraid some arts and crafts skills will need to be implemented. Scissors, tape and a garbage bag. Keep water out of it or it will stink of rotten cabbage and old band-aids within a day or two.

Pants? Sweatpants or pajamas. Nice and loose fitting / stretchy to get over the cast easily. If you have somewhere fancy to go, who cares? You have undeniable permission to wear whatever is comfortable. This IMO was one of the greatest perks of being disabled. =)

Sleep will come, although not easily for about the first week. After about 5 days-ish the beginning of the mends will take hold and give you a slightly higher threshold of movement before hurting. Once it does, things will be a lot more comfortable. Just DONT PUSH IT. I do everytime and I swear I can actually feel the bones tearing back apart, like peeling a not-ripe-yet scab off of my skeleton. Hurts worse than the break and is quite nauseating.

Painkillers are quite a gamble. Hydrocodone (Loritab) will dull the sharpness of the pain, although the deep ache will still be there. Depending on your chemistry, it'll either make you groggy or give you a jolt of nervous energy. It'll also dehydrate the hell outta you, drink lots when you come down. Oxycodone will most likely send you to the moon on a fuzzy cloud of happy thoughts. It will obviously kill the pain that much more effectively, but will likely make any attempt to do anything but stare at the TV, or the wall, futile. Staring at the wall is usually not fun; in this case you won't care. I'd warn that the more you kill the pain, the more likely you are to reinjure yourself as you wont have the pain warnings that your moving too much / too far. Also, opiates can cause some serious addiction / withdrawl symptoms, which should not be taken lightly. If you are in absolute AGONY, I'd still only go as far as Hydrocodone, just to take the edge off. If by chance you are in a state that doesnt frown on it too harshly, marijuana would be my first choice. It's not much of a pain killer, but will knock out the aggrivation of being immobilized and allow you to relax, which in my case is usually the worst part of the ordeal. Also, it'll help you to sleep.

And finally, if I good give only one piece of my non-Dr. advice, it would be to MOVE IT. After about 10-14 days, when the 'very sharp' pain has passed and it 'just hurts', start going through range of motion. I'm talking mere millimeters of rotation, nothing extreme. Just GENTLY rotate your ankle until you hit the pain wall and stop. Rotate it the other way in the same manner. Pitch it forward, pitch it backward, side to side. By far, greater than every serious injury I've sustained COMBINED, the worst pain I've felt was the total immobilization of my hand when I snapped it in half. The break hurt not at all, I actually finished the game I was in. The next few days hurt a little, although it was more gross feeling the ends of bone scraping past each other. But after 6-8 weeks of total immobilization and atrophy, the pain of moving it again after the cast was off was some of the worst pain I've ever experienced, and took better than 9 MONTHS to dissipate. On the other hand, when I broke my wrist I cut the cast off after 4 days. I kept it more or less immobilized, but still used it for very light duty, like pushing salt across the table. Once the 6-8 weeks had passed and I was cleared by the doctor, I unwrapped it, spent a mere week on range of motion, and was out four wheeling that weekend. Haven't had a problem since. So don't push it, but for your own sake, move it when you can.
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Mosca
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February 17th, 2011 at 9:43:46 AM permalink
After major surgeries and other issues pretty much yearly for the last 6-7 years or so,

I never had an addiction problem with either of the -codones, or even with the morphine pump in the hospital; when I stopped hurting, I stopped taking the drugs, without even thinking about it. BUT: some people do get hooked fast. The one that I could have gotten hooked on within a day or so was the Dilaudid. Inject.... Boom. I almost stopped breathing, it was so intensely warm and relaxing. I talked them into a second hit, but they wouldn't give me a third right before discharge. Damn.

I'm groggier with the oxy-, more laid back with the hydro-. But the oxy works better on the pain for me. With either of them I have trouble sleeping. My mind just flies through thoughts, I can't seem to turn it off.

YMMV, for both of the above. If the hydro- is enough, yeah, it's enough. I just always request the oxy- any more.

Face's mobility advice is spot on. If you have medical insurance, it might cover some sort of rehab, where you can go through that stuff under supervision.
NO KILL I
MathExtremist
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February 17th, 2011 at 9:54:30 AM permalink
Quote: Face

And finally, if I good give only one piece of my non-Dr. advice, it would be to MOVE IT. After about 10-14 days, when the 'very sharp' pain has passed and it 'just hurts', start going through range of motion. I'm talking mere millimeters of rotation, nothing extreme.



I second this, though within reason. I had a doctor tell me once that "all healing is in blood flow". If you think about it, that makes a lot of sense. Even if you're not moving your broken foot, move something. Get a tension band and do upper-body stretches, take your crutches outside and walk around, etc. Don't just lie there.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
discflicker
discflicker
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February 17th, 2011 at 10:11:54 AM permalink
My thing with bone injuries, if they aren't really serious, if you can just wait a day or so for an appointment with an orthopedic surgeon, just skip the entire emergency room visit. Save yourself from a probable > $2,000 expense and exposure to x-rays and hospital acquired coodys.

The Orthopedic surgeon will treat you exactly the same anyway; he will duplicate the X-rays and do whatever he can to charge as much as possible. You can bet on it.

Drugs? Advil is the best because it reduces swelling, and it should be taken immediately for this benefit in any bone injuries.

Beyond that, just be careful because there are lots of side effects like constipation and neural damage. Be careful, I've seen intelligent people lose track of themselves and get into trouble.

What state do you live in?
The difference between zero and the smallest possible number? It doesn't matter; once you cross that edge, it might as well be the difference between zero and 1. The difference between infinity and reality? They are mutually exclusive.
weaselman
weaselman
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February 17th, 2011 at 10:50:37 AM permalink
Quote: Face


I've never had an aircast, but imagine it as a balloon type thing filled with enough psi to be stiff. Is it adjustable? Can you deflate and inflate as desired? If you can, I'd just shower with it on, then deflate it while in a comfy position on the couch with your leg supported and let it air dry. If you cant, I'm afraid some arts and crafts skills will need to be implemented. Scissors, tape and a garbage bag. Keep water out of it or it will stink of rotten cabbage and old band-aids within a day or two.



Yeah, I can inflate and deflate it, and I can also take it off completely. It's like a large rigid boot with lots of velcro fasteners. So far, I have been taking it off to shower, and then putting it back on. Do you think it is a bad idea?

Quote:

Pants? Sweatpants or pajamas. Nice and loose fitting / stretchy to get over the cast easily. If you have somewhere fancy to go, who cares? You have undeniable permission to wear whatever is comfortable. This IMO was one of the greatest perks of being disabled. =)


Well, like I said, it's literally a boot, including the foot part with big hard sole, and I can't bend my ankle in it (obviously) as you usually do when putting the pants on, so the "loose" fitting would have to be loose enough to let the whole 14-sized base through it ... I don't think, there is anything this loose.
So, again, I was just taking the boot off to put the pants on and off, but not sure how much I am hurting the whole process by doing that twice a day.


Quote:

Sleep will come, although not easily for about the first week.


I am actually sleeping ok, but the damn boot hurts the foot so much (it's hard surfaces press against the bone), that it's much worse than the pain from the fracture.


Quote:

And finally, if I good give only one piece of my non-Dr. advice, it would be to MOVE IT. After about 10-14 days, when the 'very sharp' pain has passed and it 'just hurts', start going through range of motion. I'm talking mere millimeters of rotation, nothing extreme. Just GENTLY rotate your ankle until you hit the pain wall and stop. Rotate it the other way in the same manner. Pitch it forward, pitch it backward, side to side.




I was afraid to do that, because I though the whole point of the cast was to make sure I am NOT moving it. Same goes about putting some light pressure on the foot. Before I got to the doctor yesterday, I was walking using the bad foot, and it was moderately painful, but bearable, way better than crutches. It seems sometimes, that it could save me lots of grief if I could help myself by stepping lightly on the injured foot (like when I climbing the stairs or trying to get into a bathtub), but I am trying very hard not to do that, out of fear to make things worse :(

I tried asking the doctor about it, and he said "no pressure, and no movement whatsoever". But I don't trust their advice very much in such matters, because I think their approach is "better safe than sorry" - they just think, what if I am a moron, that will just start jumping up and down, and running around you you tell him that a little bit of pressure is ok. He also told me that I should not use ibuprofen, because it slows bone healing, but most of the internet seems to be saying that it's just a rumor, that was never confirmed by any research, and that ibuprofen is the best medicine because it both reduces pain and fights the inflammation ...
"When two people always agree one of them is unnecessary"
weaselman
weaselman
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February 17th, 2011 at 10:55:54 AM permalink
Quote: discflicker

My thing with bone injuries, if they aren't really serious, if you can just wait a day or so for an appointment with an orthopedic surgeon, just skip the entire emergency room visit. Save yourself from a probable > $2,000 expense and exposure to x-rays and hospital acquired coodys.


The Orthopedic surgeon will treat you exactly the same anyway; he will duplicate the X-rays and do whatever he can to charge as much as possible. You can bet on it.



Yeah, that what I did. I got injured on Sunday, went to see my PCP on Monday, who then got me an appointment with an orthopedic doc on Wednesday. The last guy finally took X-rays, and got me into the cast, but he is still not a surgeon, I am going to see the surgeon next Tuesday :-/

Quote:

Drugs? Advil is the best because it reduces swelling, and it should be taken immediately for this benefit in any bone injuries.


Yeah, that's what I thought too, and was taking it till yesterday, when the doc told me, ibuprofen is actually bad, because it slows down the bone healing. Most of the stuff I could find on internet seems to disagree with it (they seem to say, it's just a rumor, that was never confirmed by any serious research), but I always think it was kinda silly to go to a doctor for advice, and then do opposite of what he says because you foudn somethong on the internet :-/


Quote:

What state do you live in?


I am in MA. No (easy) access to weed :(
"When two people always agree one of them is unnecessary"
weaselman
weaselman
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February 17th, 2011 at 11:30:25 AM permalink
Quote: Mosca

The one that I could have gotten hooked on within a day or so was the Dilaudid. Inject.... Boom. I almost stopped breathing, it was so intensely warm and relaxing. I talked them into a second hit, but they wouldn't give me a third right before discharge. Damn.



Oh yeah, I loved that one too! I was getting it IV when I had a pancreatitis attack last year. Damn, that was good!
I was there for almost a week, and they did not mind giving it to me as often as I asked. At some point I realized, that I wasn't in pain for while, but still kept asking for it every 6 hours or so ... That was a scary realization.
No, I am not addicted, but I would sure not refuse another shot right now :)
"When two people always agree one of them is unnecessary"
Face
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Face
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February 18th, 2011 at 9:11:36 AM permalink
If you can inflate / deflate / totally remove it, then it seems to be no more than a brace of sorts, which I had when I broke my wrist. I'm not sure biologically how wrist bones relate to ankle bones, but the particular bone I broke was the worst, as it is small and receives little blood flow. I was warned that any additional stress could quite possibly injure it to the point of needing surgery, and surgery was already quite likely as it was due to the blood flow issue. Funny thing is, it was over a month later until I was fitted with the actual hard plaster cast. If so fragile, why the wait? Anyways, I took the brace off every day in the first month, whenever I so felt like it, and even when it was on it was on quite loose. Just tight enough to prevent extreme movement if I happened to bang it off something. And as I said, the rigid cast bothered me so bad I cut it off after 4 days, so this oh so fragile bone that would almost definately require surgery had the minimum of support througout the whole ordeal, and I was still out 4-wheeling a week after being cleared. It's always my opinion that Dr's are on the side of utmost (and sometimes ridiculous)caution, but be reasonable in your disobeying of their advice.

I wouldnt worry too much about 'damaging' it by taking off the boot for showering or for dressing. Id say having it off only opens you up to the risk of banging it off of something, or catching a toe in the pant leg and cranking it, in which case it wont be supported and THAT could damage it. I assume this is a partial break? As in the bone did not snap completely in half? If by some chance it was a complete break, leave it on always for about the first 2 weeks so the bones are lined up and can fuse properly. Otherwise, take it off when you want but be careful not to bang it. It only takes one time to F* it up royally.

I would not walk on it at this point, but know plenty who have. I'd just think that normal walking may be fine, but if you trip or slip or stumble, reflex is going to kick in and your going to plant on the bad leg and jack yourself up. If you trip and slip while not using it, chances are you wont use it in the fall. I guess thats up to you.

And back to moving it, I wouldn't for the time being. I didnt mean to imply that rehab starts now, but just wanted to warn of the danger of never moving it until cleared. I'd imagine that right now is so soon after the injury that any movement hurts like hell anyways, so just don't. Do give it time to heal, but DO NOT just let it hang loose for 6 - 8 weeks straight. And when you do move it, I really am talking small increments. Imagine your finger placed on the spacebar, then imagine the distance moved once you press it. Nothing so extreme you risk re-injury, but even that little movement, done consistently, will dramatically reduce your recovery time. I'd rather have a bone rebroken by hand sans painkillers than have to go through atrophy pain again.
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SOOPOO
SOOPOO
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February 18th, 2011 at 11:15:00 AM permalink
There are many different types and specific bones and specific sites on the bones that are called 'broken ankles'. I can only tell you how often the surgeon tells me in preop ' this idiot was told not to put weight on it for 6 weeks but 3 weeks later he was walking on it....' and now he needs surgery.... As a doctor, friends often ask me for advice, hoping I will contradict what their doctor has told them. Almost uniformly, my advice is this- If for some reason you do not trust what your doctor has told you, seek a second opinion from someone in the needed specialty, but, really, is it that you don't trust his judjment or you were just hoping to hear something else? As this is a gambler's forum, think of it this way, what is the EV of not following his instructions versus following them? As far as the painkillers, take them if you are in pain, and you will not get addicted to them. The first time you take one because of another reason, watch out...

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