I broke my arm
January 30, 2020 9:04 PM Subscribe
On Tuesday morning. X-ray. Note says 'intra-articular fracture through olecranon with displacement of 3-5cm. ER referred me to orthopaedic outpatient clinic, they will contact me in 4 business days. They're not answering the phone atm.
Arm is in a cast atm. The piece of bone that broke off has to be pinned back on. I'm not sure what to expect. Will I be in hospital for long? Will they put me under for the operation? How long does this kind of thing usually take to heal?
Arm is in a cast atm. The piece of bone that broke off has to be pinned back on. I'm not sure what to expect. Will I be in hospital for long? Will they put me under for the operation? How long does this kind of thing usually take to heal?
Best answer: One more thing about the scar: once the splint comes off and your arm is exposed, use an arm sleeve as serious sun protection. UV exposure can thicken a scar and restrict your movement.
posted by maudlin at 10:03 PM on January 30, 2020 [1 favorite]
posted by maudlin at 10:03 PM on January 30, 2020 [1 favorite]
Best answer: Hi I broke my arm (I did not however require surgery) several years ago.
Assuming you are in the US, and US is a shithole for people who need longer term physical therapy. A few things.
1) DO YOUR PHYSICAL THERAPY EXERCISES AT HOME. I cannot stress this enough. Your arm is going to be attached to your body for the rest of your life. Being in a cast will mean your range of motion and suchwhat is decreased. Unless you want it to be this way all your life, DO THE FRIKKIN FRAKKIN EXERCISES AT HOME. It will hurt. I am sorry. Do them anyway.
2) Do not be afraid to advocate for yourself. Again, we are a shithole for physical therapy, you are going to probably have limited access. If the PT you are assigned isn't working for you, speak up. If you feel like you aren't making enough progress, speak up. Be a pain in the ass. You are paying for this. Make it worth your time. Also, see #1 above.
3) Range of motion therapy is hard. So, #1 above, do the shit out of your home exercises, but if you are not getting results, PLEASE know that there are other options. You can get a brace that you wear for 30m at a time that stretches your arm out flat. Ask me how I know. Again it hurts like nothing else, but if you want your arm back, you may need to do this. I had to fight like hell to get this therapy (Kaiser) but because I'd been a good patient who really did her at-home work, the PT went to bat for me and I finally got the brace. This is why I can straighten my arm basically 99% now. I also had dry needling which really helped with the pain and my ability to be compliant with home exercises. Again, be a pain in the ass.
I'm sorry your arm is broken. It sucks.
posted by Medieval Maven at 6:47 AM on January 31, 2020 [2 favorites]
Assuming you are in the US, and US is a shithole for people who need longer term physical therapy. A few things.
1) DO YOUR PHYSICAL THERAPY EXERCISES AT HOME. I cannot stress this enough. Your arm is going to be attached to your body for the rest of your life. Being in a cast will mean your range of motion and suchwhat is decreased. Unless you want it to be this way all your life, DO THE FRIKKIN FRAKKIN EXERCISES AT HOME. It will hurt. I am sorry. Do them anyway.
2) Do not be afraid to advocate for yourself. Again, we are a shithole for physical therapy, you are going to probably have limited access. If the PT you are assigned isn't working for you, speak up. If you feel like you aren't making enough progress, speak up. Be a pain in the ass. You are paying for this. Make it worth your time. Also, see #1 above.
3) Range of motion therapy is hard. So, #1 above, do the shit out of your home exercises, but if you are not getting results, PLEASE know that there are other options. You can get a brace that you wear for 30m at a time that stretches your arm out flat. Ask me how I know. Again it hurts like nothing else, but if you want your arm back, you may need to do this. I had to fight like hell to get this therapy (Kaiser) but because I'd been a good patient who really did her at-home work, the PT went to bat for me and I finally got the brace. This is why I can straighten my arm basically 99% now. I also had dry needling which really helped with the pain and my ability to be compliant with home exercises. Again, be a pain in the ass.
I'm sorry your arm is broken. It sucks.
posted by Medieval Maven at 6:47 AM on January 31, 2020 [2 favorites]
Best answer: I think the OP is concerned that there is a known fracture, with displacement, but no one seems to be in a hurry to reduce the fracture (realign the displaced parts) and immobilize it. This seems to be common among orthopedists, in my experience. If it is acceptable to wait that long, there should be some way that this is explained to the patient, but that often does not happen.
posted by megatherium at 7:23 AM on January 31, 2020 [2 favorites]
posted by megatherium at 7:23 AM on January 31, 2020 [2 favorites]
Response by poster: Yes! I mean there's a chunk of bone in there floating. Their note said call us in four days if we don't call you first but they're not answering.
Also I am Australian so this is all free.
posted by adept256 at 7:29 AM on January 31, 2020
Also I am Australian so this is all free.
posted by adept256 at 7:29 AM on January 31, 2020
Best answer: Your current cast should help keep it immobilized BUT yes, you are better with surgery sooner rather than later. Can your family doctor go to bat for you?
With the time difference from North America, was the break two days ago and now it's Saturday there? If so, an ER visit may be necessary to keep things going. I broke my elbow on a Friday night in a tiny town in Alberta which, lucky for me, had an excellent medical facility and ER, a bed opened for me in the closest major city by Saturday, and I had surgery Sunday morning.
posted by maudlin at 7:38 AM on January 31, 2020 [1 favorite]
With the time difference from North America, was the break two days ago and now it's Saturday there? If so, an ER visit may be necessary to keep things going. I broke my elbow on a Friday night in a tiny town in Alberta which, lucky for me, had an excellent medical facility and ER, a bed opened for me in the closest major city by Saturday, and I had surgery Sunday morning.
posted by maudlin at 7:38 AM on January 31, 2020 [1 favorite]
Best answer: I think time actually might be of the essence in this case.
As the result of a (careless!) 25 ft. fall/slide down a rock face, I split one of my tibias from the ankle one third of the way to the knee, and waited three days to seek treatment.
My orthopedic surgeon said that if I'd waited much longer, the repair would have been much more difficult because the broken faces of the bone had already begun to heal over, making it harder to fit them back together.
posted by jamjam at 1:57 PM on January 31, 2020 [1 favorite]
As the result of a (careless!) 25 ft. fall/slide down a rock face, I split one of my tibias from the ankle one third of the way to the knee, and waited three days to seek treatment.
My orthopedic surgeon said that if I'd waited much longer, the repair would have been much more difficult because the broken faces of the bone had already begun to heal over, making it harder to fit them back together.
posted by jamjam at 1:57 PM on January 31, 2020 [1 favorite]
Best answer: You're Australian? Keep calling, fracture clinics are busy. You can also ask the hospital switchboard - ours are basically drop in three times a week, so you can likely just turn up.
posted by quercus23 at 4:33 PM on January 31, 2020 [1 favorite]
posted by quercus23 at 4:33 PM on January 31, 2020 [1 favorite]
Best answer: You are in one of the 3 worst parts. They may be waiting for the moment between swelling going down and the bone starting to heal. Or for a space in an operating theatre. I never got an answer, and found the initial , continued delay to be the most painful and exhausting part of the ordeal. Post surgery was different. Dealing with bruising , keeping everything in alignment and treating a wound that’s turning into a scar was surprisingly scary, since everything is weak, easily jarred, and there’s a feeling that you could break down completely by accidentally doing something the normal way. Pt is not fun, and works. The doctor will give you a prognosis based on a group that includes people that don’t do their work. The PT will generally stop at “functional”. As far as I can tell, if surgery goes well, you won’t get back to 100%, but you can get close enough to need decimals.
posted by unknown knowns at 8:34 PM on January 31, 2020 [1 favorite]
posted by unknown knowns at 8:34 PM on January 31, 2020 [1 favorite]
Response by poster: Had the operation yesterday. Typing with one hand so I'll be brief rambling in a drug induced daze.
There are three screws and some wires. Apparently not metallic, something new. Good for MRIs. I'll know more in the follow up in a few weeks, the doctor that discharged me wasn't an orthopaedic doctor so they were a little vague. Also my brain was on the moon.
It's been 20 years since I've had an operation and things have really changed. They gave me a choice between morphine and a nerve block, which is a new thing. Using an ultra sound, they found a bundle of nerves on top of an artery in my shoulder. They marked it with a pen and injected a local anaesthetic directly into those nerves. This paralyzed and numbed my whole arm from the shoulder to my fingertips. Just like dead meat hanging there. I could have smashed it with a hammer without blinking. 26 hours later, it's almost worn off.
Once it was numb they took me to the operating room. They started playing Beyonce, which is fine. Then a nice lady put a teleportation tube over my mouth and sent me to a different room which was three hours in the future.
They kept me overnight then but I felt so well rested I didn't sleep at all. It was like, when I go to London and it's midnight on the clock, my body's asking what's for lunch, because it's from down under. They reset my clock to London time. The staff didn't mind me playing with my phone all night, they said everyone's different and if I wasn't sleepy, then don't sleep. I even made a few comments on mefi posts, which aren't much more loopy than usual, considering I was high AF on oxycodone.
They gave the famous oxycodone, the killer drug behind the epidemic. I'm wise, I've seen the reporting and I'm treating them like dynamite. They gave me ten. The instructions are vague 'take ONE to TWO tablets every SIX hours as required'. I've decided to take them when it's unbearable. I can have ibuprofen and paracatomol. I know bumping my elbow causes lightning bolts, I'll save the strong stuff for the lightning bolts.
Another thing new to me, they put compression stockings up to my knees, and around them they wrapped these air bags, with different pockets that would inflate and deflate in a cycle. It's kind of like the blood pressure tube they wrap around your arm, but lots of them in array. The effect was of a gentle calf massage that lasted twelve hours, when I was finally bored with them.
I was nervous enough to make this post but being in the hospital and seeing other patients really put things into perspective. My problems are trivial. I'll have a scar and a cool story. Hate is a strong word, I don't 'hate' ninjas now, but there were so many, it just wasn't fair. Actually I fell off my bike and landed on my elbow.
The hospital itself is a model, a showcase, of 2020 state of the art technology and best practice. Besides the bothersome part of being crippled it was all a bit of an adventure. The final update to my chart before going into the theatre, the doctor remarked how slow my pulse was, 50bpm, even after the sedation this was atypical. The truth is I wasn't stressed at all, I felt safe and calm, in exactly the right place, with the right people, about to get exactly the help I need.
I wanted share my story specifically with Americans. This was all free, except for the oxycodone, which cost $5.60. I know we pay through tax, rich people pay a little more, poor people pay a little less, and if you're really poor, you pay nothing. It works and it's glorious and totally worth it. It's worth fighting for. Here, we take it for granted. I don't! Because I've read all the debates here on metafilter going back to 2008. How much would the last 11 days have cost?
Yes I'm high AF right now but I mean every word. Half your country has been brainwashed into thinking this is impossible. You tell them from me, your Aussie mate, that's bullshit. You know what? They can call me and I will tell them personally, just memail me. I have time off.
Finally, thanks for the advice. Very appreciated and helpful.
posted by adept256 at 8:55 PM on February 6, 2020 [2 favorites]
There are three screws and some wires. Apparently not metallic, something new. Good for MRIs. I'll know more in the follow up in a few weeks, the doctor that discharged me wasn't an orthopaedic doctor so they were a little vague. Also my brain was on the moon.
It's been 20 years since I've had an operation and things have really changed. They gave me a choice between morphine and a nerve block, which is a new thing. Using an ultra sound, they found a bundle of nerves on top of an artery in my shoulder. They marked it with a pen and injected a local anaesthetic directly into those nerves. This paralyzed and numbed my whole arm from the shoulder to my fingertips. Just like dead meat hanging there. I could have smashed it with a hammer without blinking. 26 hours later, it's almost worn off.
Once it was numb they took me to the operating room. They started playing Beyonce, which is fine. Then a nice lady put a teleportation tube over my mouth and sent me to a different room which was three hours in the future.
They kept me overnight then but I felt so well rested I didn't sleep at all. It was like, when I go to London and it's midnight on the clock, my body's asking what's for lunch, because it's from down under. They reset my clock to London time. The staff didn't mind me playing with my phone all night, they said everyone's different and if I wasn't sleepy, then don't sleep. I even made a few comments on mefi posts, which aren't much more loopy than usual, considering I was high AF on oxycodone.
They gave the famous oxycodone, the killer drug behind the epidemic. I'm wise, I've seen the reporting and I'm treating them like dynamite. They gave me ten. The instructions are vague 'take ONE to TWO tablets every SIX hours as required'. I've decided to take them when it's unbearable. I can have ibuprofen and paracatomol. I know bumping my elbow causes lightning bolts, I'll save the strong stuff for the lightning bolts.
Another thing new to me, they put compression stockings up to my knees, and around them they wrapped these air bags, with different pockets that would inflate and deflate in a cycle. It's kind of like the blood pressure tube they wrap around your arm, but lots of them in array. The effect was of a gentle calf massage that lasted twelve hours, when I was finally bored with them.
I was nervous enough to make this post but being in the hospital and seeing other patients really put things into perspective. My problems are trivial. I'll have a scar and a cool story. Hate is a strong word, I don't 'hate' ninjas now, but there were so many, it just wasn't fair. Actually I fell off my bike and landed on my elbow.
The hospital itself is a model, a showcase, of 2020 state of the art technology and best practice. Besides the bothersome part of being crippled it was all a bit of an adventure. The final update to my chart before going into the theatre, the doctor remarked how slow my pulse was, 50bpm, even after the sedation this was atypical. The truth is I wasn't stressed at all, I felt safe and calm, in exactly the right place, with the right people, about to get exactly the help I need.
I wanted share my story specifically with Americans. This was all free, except for the oxycodone, which cost $5.60. I know we pay through tax, rich people pay a little more, poor people pay a little less, and if you're really poor, you pay nothing. It works and it's glorious and totally worth it. It's worth fighting for. Here, we take it for granted. I don't! Because I've read all the debates here on metafilter going back to 2008. How much would the last 11 days have cost?
Yes I'm high AF right now but I mean every word. Half your country has been brainwashed into thinking this is impossible. You tell them from me, your Aussie mate, that's bullshit. You know what? They can call me and I will tell them personally, just memail me. I have time off.
Finally, thanks for the advice. Very appreciated and helpful.
posted by adept256 at 8:55 PM on February 6, 2020 [2 favorites]
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TL;DR: It's a not-great situation to be in -- we'd all rather have intact elbows -- but there is nothing to freak out about. You will have surgery, another splint, rehab. Bone takes 6-8 weeks (typically) to heal. Range of motion will take several more weeks, and strength / muscle mass also takes time to regain. So you may not be fully healed until June/July. Depending on what you expect your elbow to do and other factors, it may take longer than that. For example, I broke my elbow in late May 2019 and was too weak to trust myself on my bike in September, but was cycling 5 km round trips in October.
Surgery: This will probably be a standard visit to the operating room where you will go under general anaesthesia. An incision a few inches long will almost certainly be needed to access and repair your elbow. One or more screws, plates and possibly pins will be needed. You may be discharged the same day or you may stay overnight. You will have the start of a nifty, conversation-starting scar -- congrats! (I actually like my scar a lot.)
Immediate post-surgery pain and pain management: You will feel sore and exhausted. Prescribed meds will mean that you won't be in any major pain. I used prescribed Tylenol+codeine for 7-10 days, switched to occasional Tylenol as needed for a few more days, then nothing. Do NOT use aspirin, Advil or other NSAIDs for pain as it may interfere with bone healing. Use Tylenol only.
Cast or splint: This will need to stay on for several weeks (6-8 weeks), but you will probably be going back to your surgeon on a regular basis for examination and x-rays. The great thing about splints is that immobilize your elbow as needed and let the bone heal. The not-great thing about splints is that your arm stiffens up and gets weak, and you have to be diligent about rehab after the splint comes off. You may get a soft arm brace after the hard splint, and this should be taken off for showers and physiotherapy. You should ask your doctor when you can stop wearing the soft arm brace. I used mine only in crowds and public transit and went without it at home after the first 7-10 days (I think).
Physiotherapy and rehab for range of motion: You should get assigned a physiotherapist once you get out of the cast/splint. You will need to work with them and at home to address:
1 - Elbow range of motion (extension/flexion): You will not be able to fully straighten or bend your arm when you start. With regular, serious work, you will get a LOT better.
2 - Wrist/forearm bending and rotation: Because the tendons for your wrist attach to the elbow, you will need to work on the wrist as well.
3 - Hand flexibility and strength: Again, everything is attached to everything, and even though your hand is technically free of the cast, it will take some time and physio to get back to normal. This is really typical.
Physio and rehab for strength: Your PT will probably emphasize range of motion over strength at first, but you will have the chance to move on to exercises to strengthen your arm and hand.
If you have any other questions, ask away!
posted by maudlin at 9:55 PM on January 30, 2020 [10 favorites]