Bone growth + beer = absolutely no, mostly no, or kinda OKish?
August 10, 2018 8:08 PM Subscribe
My question is in some ways similar to this question from earlier. I'd love to be able to have a drink with friends nightly for about 3 days this coming week. But I'm just under 11 weeks post–ORIF surgery for a bimalleolar ankle fracture and dislocation. I'm definitely still healing and only in the past week able to walk with difficulty and some pain with a single crutch. Can I have a couple beers each night, or does that have the potential to negatively affect bone growth to the point that I shouldn't consider it?
Of course, I'm aware that another consideration is how alcohol might affect my coordination. I'm mainly still using a walker or two crutches, and I will only have crutches with me when I'm with friends those 3 days. A major drinking spree seems undesirable and absolutely not worth the risk, so to be clear, that's not really what I'm contemplating. I've been through a lot in the past couple months and haven't had more to drink than a single small glass of white wine once, in the days immediately following my father's death last month, while sitting on the couch at home that I was subsequently going to sleep on, because I didn't want to risk any adverse effects in terms of coordination or bone healing, even in my grief. I'm also perhaps hyperaware of the dangers of drinking while taking medication containing acetaminophen, so if my pain is great enough to take acetaminophen on a given day, I of course wouldn't drink.
I've had considerable time to read articles and study results about bone healing and growth in the past 2 months, and most sources seem to suggest that drinking at very least isn't good for bone health, healing, and growth, and at worst can even halt the healing process. That of course terrifies me, but I'm not sure quite how terrified to be at this stage of things, with my last X-rays from 3 1/2 weeks ago already looking solid enough for my orthopedist to have recommended gradually transitioning to full weight-bearing. I've since been working my way up to it in twice-weekly physical therapy sessions, and I of course don't want to jeopardize the good results of all that hard work.
But yeah, I've had trouble finding more than anecdotes and potentially not-entirely-relevant study results. Some of the studies I was seeing were done on mice, for instance, and involved injection of a perhaps disproportionate amount of alcohol relative to a mouse's size, as well as breakage of a much larger bone relative to a mouse's size. So of course healing isn't going to go so well under those circumstances! In other cases, the correlation found in human subjects between alcohol consumption and heightened risk of refracture seemed to have a clear potential confounding factor of issues with coordination caused by alcohol consumption. I also read some study results about the effect of drugs like metformin or fexofenadine on bone health and healing that had completely contradictory findings—some studies' results found a protective effect from taking each of those drugs, for instance, whereas other studies seemed to suggest increased risk of fractures while on metformin or antihistamines. (To be clear, I'm not currently taking metformin, and I'm aware of the potential adverse effects of taking it with alcohol. I was reading up on it while contemplating restarting the drug.)
I'm kind of as interested in this from an academic perspective as I am from a practical one—I'm almost more curious than anything what the data actually suggests the effect of a couple beers might be. So I'm interested in any relevant data you might be able to point me to or cite regarding the actual likelihood and magnitude of risk involved, in terms of A. potentially negatively affecting bone growth or B. potentially halting bone growth, in having a few beers each night for a few nights in a row while I'm at this stage of recovery from a fracture. Please feel free to speak to me in clinical terms using precise language—I'm not a doctor, and I know you're not my doctor, but I've been reading a lot about this, so I will probably be able to understand it. It's just been hard for me as a layperson to find good, relevant data to inform my thought process on this. Thank you!
Of course, I'm aware that another consideration is how alcohol might affect my coordination. I'm mainly still using a walker or two crutches, and I will only have crutches with me when I'm with friends those 3 days. A major drinking spree seems undesirable and absolutely not worth the risk, so to be clear, that's not really what I'm contemplating. I've been through a lot in the past couple months and haven't had more to drink than a single small glass of white wine once, in the days immediately following my father's death last month, while sitting on the couch at home that I was subsequently going to sleep on, because I didn't want to risk any adverse effects in terms of coordination or bone healing, even in my grief. I'm also perhaps hyperaware of the dangers of drinking while taking medication containing acetaminophen, so if my pain is great enough to take acetaminophen on a given day, I of course wouldn't drink.
I've had considerable time to read articles and study results about bone healing and growth in the past 2 months, and most sources seem to suggest that drinking at very least isn't good for bone health, healing, and growth, and at worst can even halt the healing process. That of course terrifies me, but I'm not sure quite how terrified to be at this stage of things, with my last X-rays from 3 1/2 weeks ago already looking solid enough for my orthopedist to have recommended gradually transitioning to full weight-bearing. I've since been working my way up to it in twice-weekly physical therapy sessions, and I of course don't want to jeopardize the good results of all that hard work.
But yeah, I've had trouble finding more than anecdotes and potentially not-entirely-relevant study results. Some of the studies I was seeing were done on mice, for instance, and involved injection of a perhaps disproportionate amount of alcohol relative to a mouse's size, as well as breakage of a much larger bone relative to a mouse's size. So of course healing isn't going to go so well under those circumstances! In other cases, the correlation found in human subjects between alcohol consumption and heightened risk of refracture seemed to have a clear potential confounding factor of issues with coordination caused by alcohol consumption. I also read some study results about the effect of drugs like metformin or fexofenadine on bone health and healing that had completely contradictory findings—some studies' results found a protective effect from taking each of those drugs, for instance, whereas other studies seemed to suggest increased risk of fractures while on metformin or antihistamines. (To be clear, I'm not currently taking metformin, and I'm aware of the potential adverse effects of taking it with alcohol. I was reading up on it while contemplating restarting the drug.)
I'm kind of as interested in this from an academic perspective as I am from a practical one—I'm almost more curious than anything what the data actually suggests the effect of a couple beers might be. So I'm interested in any relevant data you might be able to point me to or cite regarding the actual likelihood and magnitude of risk involved, in terms of A. potentially negatively affecting bone growth or B. potentially halting bone growth, in having a few beers each night for a few nights in a row while I'm at this stage of recovery from a fracture. Please feel free to speak to me in clinical terms using precise language—I'm not a doctor, and I know you're not my doctor, but I've been reading a lot about this, so I will probably be able to understand it. It's just been hard for me as a layperson to find good, relevant data to inform my thought process on this. Thank you!
You’re not finding good data because it would likely be either impractical or unethical to conduct a randomized, controlled trial involving alcohol use after surgery. Any studies you’re going to find are probably going to involve self-reported data. It’s not that you’re a layman, it’s that it’s not out there.
posted by pecanpies at 7:25 AM on August 11, 2018 [4 favorites]
posted by pecanpies at 7:25 AM on August 11, 2018 [4 favorites]
I had ORIF on my hip 4 years ago. There was absolutely no admonition about drinking, but the assumption is of course you're not binging.
I wouldn't sweat a couple beers a night.
(Obligatory xray pic.)
posted by uberchet at 10:56 AM on August 11, 2018 [1 favorite]
I wouldn't sweat a couple beers a night.
(Obligatory xray pic.)
posted by uberchet at 10:56 AM on August 11, 2018 [1 favorite]
I'm afraid all I have to give you is anecdotal information. I had ORIF surgery on my foot last fall. I was not advised to avoid alcohol, aside from the obvious interactions with various painkillers. It was also explained to me that bone healing is generally very rapid- and at the point where you've been cleared for weight bearing, I really don't think there's any bone growth to speak of going on. My understanding was that at this point you are mostly rebuilding and healing tendons and muscles.
FYI- Your question isn't really similar to the tooth-graft/marijuana question- because the issue with marijuana is that the action of smoking (or other sucking) could dislodge a blood clot in the early stages of healing, leaving nerves and bone exposed. An equivalent maybe would be if you planned to consume alcohol by smashing beer bottles over your healing ankle?
posted by Secretariat at 8:41 PM on August 11, 2018
FYI- Your question isn't really similar to the tooth-graft/marijuana question- because the issue with marijuana is that the action of smoking (or other sucking) could dislodge a blood clot in the early stages of healing, leaving nerves and bone exposed. An equivalent maybe would be if you planned to consume alcohol by smashing beer bottles over your healing ankle?
posted by Secretariat at 8:41 PM on August 11, 2018
Best answer: I’m a medical librarian and couldn’t find any applicable research on this topic. From what I read, it appears that infection is the primary concern following ORIF. A meta-analysis showed that alcohol abuse can be a factor in infection rates, but thats we’ll beyond a couple beers with friends. On an anecdotal note, I’m currently on crutches following knee surgery and I’ve found that a beer or two helps my confidence on crutches but more than that leaves me beat.
posted by galvanized unicorn at 6:29 AM on August 12, 2018 [1 favorite]
posted by galvanized unicorn at 6:29 AM on August 12, 2018 [1 favorite]
Response by poster: Thanks for the info and advice, everyone. I did have 2 to 3 beers or ciders each night, and at the end of my trip, I still successfully trekked on crutches across two concourses of my connecting airport while wearing two backpacks (long story short, no one ever showed up to get me when my gate changed and my American Airlines gate agent took off to who knows where, fuck them forever), so it seems the beers didn't wreck my ankle! I did also find that I was good in terms of balance after 2 to 3 fermented beverages, though I wouldn't have trusted myself to crutch well with more. Even those affected my balance a little.
Anyway, thanks again! Resolved as it'll ever be!
posted by limeonaire at 8:02 PM on August 16, 2018
Anyway, thanks again! Resolved as it'll ever be!
posted by limeonaire at 8:02 PM on August 16, 2018
This thread is closed to new comments.
I'd love to be able to have a drink with friends nightly for about 3 days this coming week.
3 drinks in as many nights? A hangnail would worry me more
have fun
posted by BadgerDoctor at 4:23 AM on August 11, 2018 [10 favorites]