Sad news from Schweitzer get-together - Page 5

Bonni's left her mark @ Sandpoint,Idaho

I heard Ilene has a brother... Ulick. Oohhh, bad..bad Bonni......

I want to ski like Slider skis. The man is a marvel. I think I fell trying to emulate his swan-smooth style, but a sow's ear will never be a silk purse, will it!

Just saw this -- so sorry, heal fast!

Bonni ... Bonni ...

There are easier ways to get the patrol guys to swoon over you! Wishing you a very speedy recovery!!

****Here are some good vibes on your travel day****

Adding medmarko!

Wishing you the best on your travel day, and looking forward to the trip report of First Class indulgence.

I'm home.........urp.........not doing well after not being able to elevate this leg all day. Uneventful trip, all flights on time, and no delays. Wonders!

Will peck a few lines tomorrow. I'm a swollen mass of pain tonight.

Well. the worst should be over (the travel). Hope for a speedy recovery.

Don't forget to take your meds.

I've been offline for a while and have just seen this thread. Bonni, I heard of your misfortune here at the ESA, and want you to know that everyone here is pulling for your rapid and full recovery. Know that I am personally sending my most positive thoughts (and prayers! ) in your direction.

I am so sorry that this has happened!

The swelling has to be the worst part of these injuries. It's certainly been a learning process for me. I never thought swelling could last so long. You have to be very diligent about keeping the injury elevated (at least 6" above your heart) all the time. Don't forget to ice the injury for about 30 minutes at least 4-6 times/day.

I started using ACE wraps to help provide compression (part of R.I.C.E. therapy), but they were a major pain to deal with (it took 4 wraps and getting the pressure distribution right was more art than science). Then the doctor recommended buying some medical support stockings (like those used to prevent DVT). The stocking was a major improvement. It provides perfect, even, all-around compression and makes managing the swelling much easier.

After my second surgery I also received a much better immobilizer boot. This one has air bladders that are pumped up to provide as much pressure as you need. The boot also cover my entire lower leg - from the foot all the up to my knee. This provides much more even pressure and support. I wish I had this boot during the first 6 weeks I was dealing with my injury.

Bonni - it's quite possible though that you won't even get a boot since you have the rod and there are no other breaks. What did your doctor say?

I won't get a boot, Noodler, but I do have that support stocking. Isn't that the greatest? It's a pain to put on initially, though. I've showered a few times, and taking it off is no big deal, but putting in on takes an octopus of arms and a lot of grimacing.

I'm out of meds as of Saturday, and I hope I can get a refill. I've been taking 2 percoset every 4 hours, and it keeps the worst at bay. The meds don't touch the swelling very much, and I'm on my back with it elevated all day today. I've been exercising it constantly.

I got an old belt from Ging, and made a loop out of it and put the loop under the ball of my foot. I pull on it and move my foot toward my shin with it, stretching it out and keeping things moving. I sleep with the belt on, and when it 'spasms', I can pull on the belt and ease some pain. It's saved me on a lot of occassions, and I have great range of motion. If not for the muscle damage where the bone went through, I think I could walk.

The horizontal wound at the ankle is where the bone went through. Woof. I did a little yelling, so I hear.
The vertical incision near the knee is where the rod went in, with the other two incisions for the screws holding it all together. It looked pretty good, but this picture was taken 3 days later, on Saturday. It's since bruised up more along the shin, and has swollen more since the trip home.

Bonni - that's too funny - I did the same thing with you did with the belt. I used a silk belt from one of my wife's robes to wrap around the ball of my foot and pull it up (dorsiflex). It really makes things feel better doesn't it? That's one of the benefits of the boot. It puts your foot into a dorsiflexed position and gives you some comfort through its support. You might want to talk to the doc about it even if you don't absolutely need it.

I was also on 2 Percoset every 4 hours after my second operation (used Dilaudid after the first - much stronger) though now I've got it down to 1 every four hours. I've also begun staggering the Percoset with Ibuprofen to help manage the swelling. You should discuss this with the doc too since the Ibuprofen will help with the swelling. I also found that staggering the meds helps get you "through" the transitions between dosage times. Before doing that I was hating life at right about the 4 hour mark - then I'd have to wait for the new dose to kick in. Staggering solves that problem and if done with Ibuprofen addresses the swelling issue.

I'm also wondering about your knee. How's your range of motion there? I could barely move mine after the first operation (it wasn't injured, just due to the rod insertion). It took me 6 weeks to get it back to about 85% good and now that I'm approaching the 8 week mark I'm at about 95% on the ROM, but it's still very stiff until I get it warmed up a bit.

P.S. - wow - it just hit me that your leg isn't bandaged up. That surprises me. My doctor completely covered my wounds and wouldn't let me remove the bandages after either operation until the 2 week mark. He said that the wounds were bandaged in a sanitary environment and keeping them on prevented possible infections. It also looks like you may have stitches instead of staples. What's holding your incisions together?

Watch out for ibuprofen with fractures

Noodler, Bonni, be sure you check with your doctors before taking ibuprofen while a fracture is healing. My ortho warned me not to take any ibuprofen nor any other NSAID (aspirin, naproxen: Aleve) while the fracture in my shoulder is healing up. He even had me discontinue the 81mg daily baby-dose aspirin I was taking as a heart-health and colon-health prophylaxis until the bone is healed up.

Tylenol (acetaminophen) is ok because it's not an NSAID, though of course it won't help with swelling. Also watch out for the recommended 4 grams max/day of acetaminophen, given that it is an ingredient in Percoset. A couple of percs at bedtime plus 2 extra-strength tylenol 3 times per day and you're just about at the maximum acetaminophen dosage. Also you really don't want to be drinking any alcohol at that acetaminophen level, if you want to keep your liver.

There is solid evidence that NSAIDs interfere with bone healing.

Here's an article from the BBC summarizing a New Jersey study on that.
Here's a link from a different study (in this case rabbits, and the TMJ joint but same concept).
A search for ibuprofen bone healing will bring up lots more cites.

This seems to be true for all the Non-Steroidal Anti-Inflammatory Drugs, both the general OTC ones, and the remaining COX-2 inhibitors still on the market for arthritis such as Celebrex.

I'd never heard of this before until my doctor mentioned it. Just keep it in mind and go for Tylenol (or generic acetaminophen) instead. With you're doctor's advice/approval of course.

This picture was taken after the initial dressings were taken off, and I still have gauze pads on all the wounds. He said it was more for ease in sliding the compression sock over the whole mess. They look good, though.

There are sutures holding the horizontal wound closed, and staples on everything else. You just can't see them very well.

Interesting that you also fashioned an 'aid' to help stretch. Do I see a market for a new product here? The belt is really not all that comfortable, but works wonders!

I have good range of motion in my knee. It's probably at about 60%. It doesn't hurt as bad as the ankle, and I don't know why. From looking at it, you'd think the pain would be fairly good at the knee, too. I'm working this leg to death every chance I get. I just don't stop moving my toes, ankle, knee, etc. The last thing I want is for this to stiffen up!

Staggering the meds sounds like a plan. I think I'll give it a try starting today. It's been a week almost to the hour, so it's time to wean off the Percoset. Tell me: How do you deal with the constipation?: I'm drinking prune juice, which I like anyway, but unless I do it by the quarts, it's not going to do the whole job.

Thanks for the heads up, Mark. I am waiting for a call back from the doc on getting some kind of painkiller refill. I'll ask the professionals what will work best.

I also found out that I bent a prong on my ring! It's shoved way over to meet another prong. Being that it's platinum, and that's a tougher metal than gold or silver, it must have been whacked a good one at some time! Yeeps!

Just found this, it's so sad. Get well soon Bonni.

MarkXS - My doctor prescribed the Motrin (actually in a higher dose than I'm taking) and recommend the stagger. I didn't come up with this myself. I will, however, check out those studies. Personally if I had to lean in one direction or the other right now I'd lean toward controlling the swelling (and the pain) and not worry about slowing down the bone healing (my season is gone already anyhow). Technically Bonni and I already have all the support we need with a titanium rod down our legs. My doctor told me that as soon as my ankle fracture has sufficiently healed I can begin walking due to the support from the rod.

So I checked out the issue with NSAIDs and bone healing. The medical community is very divided on this issue and there have been no dependable studies done on humans (only rats and rabbits). I'll discuss it with my doctor, but I doubt he'll change his recommendation.

Check out this article:http://www.jr2.ox.ac.uk/bandolier/bo.../NSAIbone.html

You can just skip down to the summary, but it basically says that there's just nothing in science that currently backs up the claim that ibuprofen slows down bone healing in humans.

You didn't hear me say OUCH!!!!:

Interesting info, noodler. Like so many other things in medicine, studies seem to go both ways.

In that case, it makes sense to go with what your doctor recommends. My orthopedist made a strong point about avoiding the NSAIDs based on the studies that do show bone healing impairment. I guess the docs go different ways on this.

It also could be because he does not have any kind of pin or clamp in my shoulder and wants to avoid having to do a complex surgery (there are a lot of little cracks in the broken fragment itself, so a standard screw-type repair is out, it would just shatter to pieces.) So anything that might lessen the chances of the broken fragment from getting "sticky" in the right place quickly could be a risk. The longer the time before it starts to knit, the more chance it could get pulled out of place by the arm muscles. Whereas you guys have the rods which are keeping things aligned; thus a few extra days or weeks for to start knitting back together (assuming the debatable effect of the NSAIDs) doesn't carry that mis-alignment risk.

Ah well no Vitamin-I for me! Glad it's working for you guys - staggering the prescription percs and the OTC ibus sounds like a good plan for pain management.

My doc just told me that Aleve can be used opposite the percoset. Huh!!

Good for you Bonni - did you discuss staggering with him? Were you having any problems with the "transition" time between your Percoset doses? Did your doctor mention anything specifically about Aleve versus Motrin in your case?

MarkXS - Did you have any problems with swelling around your injury? That's certainly another consideration. If you haven't had much swelling then I wouldn't see the need to take the risk even if the science can't decide what's correct.

Either way - I've cut back on all my meds and I think that by this weekend I may only be on plain old aspirin.

Some swelling, but the doc still wanted no NSAIDs. Just icing and rest for the swelling.

I'm still on percs at nighttime but just the acetaminophens during the day. Definitely getting better.

Glad the pain management routine is working out for you and Bonni. Yeah, Aleve (naproxen) opposite the percs makes sense if there's no NSAID concern, since it won't lead to overdoing the acetaminophen that's already in the percoset.

I'm going to try and weave other things in and out starting today. I have all these drugs in bulk, may as well use them. The doc said if I can tolerate the pain level, swap them round.

I didn't ask about Motrin.

I have trouble the last 40 minutes or so before a dose. I'm on the 8-12-4-8 schedule...on the hour. I can tell time by the pain. Whoo hah!

Bonni - it sounds like your experience mirrors mine. I hope the drug staggering works out for you. I'm not sure what schedule you would use though since Aleve is significantly stronger than OTC ibuprofen.

I should say though that I did do research on bone healing after my accident and found a few studies that discussed how pain killers in general actually slow down healing in general. The thought is that if the brain isn't receiving signals that there's something wrong then it won't prioritize the repair job. So basically doctors recommend only using pain killers in limited amounts and only as long as you absolutely need them. Once they released me from the hospital I ran an "experiment" to see just how long I could go until the pain was unbearable and then how much pain medication I needed to get it under control. From there I just continue to reduce the amounts every so often to get a feel for where my pain levels are really at.

I'm not saying that's the best course of action for everyone, but it has worked for me. I hate taking lots of meds.