Wheelchair or crutches?

August 3, 2008 8:15 PM

A distal fibula fracture will prevent me from bearing weight with my right leg for some six weeks. The E.R. sent me home with crutches, but I'm having such trouble with them (detailed within) that I'm thinking of asking for a wheelchair. Would anyone with wheelchair or crutch experience tell me whether these are abnormal and would improve in a wheelchair? Any other solutions?

I'm fairly out of shape and having a lot of trouble going more than a block without pause, plus being cross-eyed means I have no depth perception and tend to snag the crutches. In four days I've outright fallen twice and nearly fallen too many times to count, particularly when fatigue makes me sloppy. I also can't carry anything, which is a big problem for someone who works in a biology lab, and with a normal fingers-wrapped-around-the-bar grip every step gives a moment of tingly numbness along the edge of my hand to the tip of my pinky. (Not asking for a diagnosis on that one; I'll see the doctor on Wednesday.) The reason I think this isn't supposed to happen is (1) it feels similar to what happens if I grip my bicycle the same way too long, and (2) it doesn't happen with my left hand.

The way I've been avoiding that grip is by turning my hand so the thumb is on the bar, but this is now making an odd soreness in the first joint of my thumb (the one buried in the flesh at the heel of the hand).

There's some tenderness where the top of my (armpit-style) crutches presses against my ribs, and of course lots of soreness in all the muscles, but these two feel par for course.

I've been very briefly in a wheelchair before so I realize that it won't make this all better. I'll still have as much trouble getting around, I won't be able to use staircases or hold open sprung doors for myself, and now both my legs would atrophy. But it'd at least be harder to fall out of a wheelchair, and I wouldn't hurt my wrist so much.

In addition, I could probably carry things in the seat next to me. The wheelchairs at my local hospital (the University of Chicago's in Hyde Park) all seem to be around a meter wide, maybe to give room for the nurses to reach in around the patient. That would let me work again, since I can stand on one foot or sit as needed to keep myself at the bench. It's just collecting all my reagents that's stopping me.

What does the hive mind think? I'm entirely open to alternatives, as long as they get me around and let me work again.

A bit about my work, in case someone has an alternative. I'm doing mostly molecular biology, so a lot of gathering things to one place and then putting them back when I'm done without contamination. That rules out any solution where I can't keep a flask steady or see it all the time, which is why I can't put a liter of bacteria in my backpack and bounce down the hall on crutches.

posted by d. z. wang to Health & Fitness (16 answers total)

When I broke my foot in the spring, I was on crutches for six weeks as well. I have zero upper body strength and very little coordination. The first few days, the massive soreness in every part of my body from the crutches outshone the break by light years. I tripped continually, and had aches in muscles and tendons I never knew existed. It did, however, get better. I never got what you might call speedy, efficient, or graceful on them, and I could never make it a full block without a rest, but it did get easier after the first week or so. I found it helpful to quietly hum the Hawaii Five-0 theme to myself for motivation.

I can't speak to a wheelchair, but I have a hard time imagining it wouldn't cause as many problems as it solved. I actually found most people were as accommodating possible when I was temporarily handicapped; it probably helped that I'm a pitiful and non-stoic looking injured person.

I ended up getting around at work by rolling around in a wheeled office chair and in the kitchen (I'm an avid cook) by putting a cushion on a rolling stool, resting my knee on it at a 90 degree angle with my booted foot poking backwards, and kind of doing a hop and roll thing. It wasn't massively comfortable and I still needed tons of assistance, but it allowed me the full use of both hands for chopping and stirring.
posted by mostlymartha at 8:56 PM on August 3, 2008

Have you had someone, like a physical therapist at the hospital, properly adjust your crutch height and train you to use them correctly? There should not be armpit or rib soreness because you should be weight-bearing with your arms, not your armpits.

I hate to say this, but both your work and your mobility simply will be impacted for the next six weeks. While you can move, you cannot carry anything with crutches, which is very frustrating. And with a wheelchair, you can carry things, but not move - you still need your hands to propel yourself. Which, by the way, is exhausting.

The best option I found was a walker because it provided the most stable mobility. You still cannot carry anything that isn't in a bag, but at least you do have that option. It is slow and cumbersome but people give you a nice wide berth and for me, it eliminated falling.

You're kind of asking "how can I proceed through my normal daily life as if I am not temporarily disabled?" and the answer is: you can't. You are. Can you get help at work?
posted by DarlingBri at 9:04 PM on August 3, 2008 [1 favorite]

I can't help you with the crutches but I can tell you that wheelchairs (especially the dismal ones loaned out by hospitals) are not easy to use and are not a stable platform for the transport of liquids. They are portable though. Your other solution may be short term scooter rental from somewhere like Scootaround. (Warning: annoying voice-over advertisement.) Some scooters, depending on your strength and mobility or help available, are transportable in a car. Your other option might be to leave the thing at work for use there and use other methods at home. Scooters come with a basket up front which you could replace with something larger and sturdier for your work if necessary. They are stable and maneuverable.

And if you get a walker as DarlingBri suggests, make sure you get one with wheels, basket and seat (which doubles as a platform) like one of these. Walkers are terrific but I'm not sure how practical they are in your situation.

Good luck.
posted by firstdrop at 9:22 PM on August 3, 2008

Seconding DarlingBri. That post reflects my experience when I had a broken leg. And as Martha says, it will get better.
I was able to hold a flattish briefcase in one hand while using crutches--but that's unnecessary since you can easily use a backpack or messenger bag with crutches.
As Bri says, see someone at the hospital about this, and have someone at work carry liquids around for you.
Best of luck. This too shall pass.
posted by JimN2TAW at 9:42 PM on August 3, 2008

Would your fracture location allow you to use a knee walker? I've seen some people using those, and it seems like it might provide you with a smoother motion and the ability to stand/carry while taking stress off of your arms. (Though, really, the person above is correct about getting the crutches adjusted properly.)
posted by Madamina at 9:48 PM on August 3, 2008

Response by poster: @mostlymartha: The rolling stool is a good idea I will try, but I hope you're wrong about the tripping being just something to get used to. I still reflexively try to catch myself by stepping forward, even if it's with the broken leg. I'm terribly afraid to displace the bone.

@DarlingBri: I will ask the doctor to watch me take a few steps and correct me, and also about a walker. At work I would basically need someone to fetch and carry for me, and it wouldn't be fair to commandeer one of the interns for that full time. (To be clear, it wouldn't be educational for them; it would be a level of micromanagement even Dilbert has never seen.) The alternative, which has been offered to me, is just to scrap my project entirely and try either to restart it in six weeks or to assign me to someone else's.

Hey, crazy idea: how stupid would it be to ride a bike around? This is how I originally got to the hospital, and maybe if I went real slow on sidewalks only it'd work out. It's not hard to pedal in very low gear with only one leg applying force, and let the bicycle carry itself through the other half of the revolution.
posted by d. z. wang at 11:37 PM on August 3, 2008

Could you commandeer an intern for your fetch and carry tasks at work and make it educational for them? You know, get them involved with your project, help them learn about your methodologies and progress?

I had a bad ankle sprain with a bonus chipped ankle bone a few years ago, and had terrible problems with crutches. I'm not the most coordinated person, and I just couldn't make them work. So I got a walker. I definitely recommend the kind with wheels, a basket, and a seat. You could probably modify it to safely carry your liquids for you.

Or, just go with the earlier suggestion of rolling around on an office chair at work. I mean, most people roll around on them when they don't have injuries, so why not when you do?
posted by bedhead at 12:14 AM on August 4, 2008

I absolutely second (third?) how important it is to get your crutches properly sized. I did some work in a physiotherapy department at a local hospital when I was younger and this was my job. Now, I can't help but notice that about 80% of people I see on crutches either have them sized wrong or are using them improperly - it makes a big difference. Used properly, they are far more convenient and easier to use than a wheelchair.

Do you have any access to a physical or occupational therapist? No offence to doctors, but in my experience doctors are not taught proper sizing and use of crutches, and won't necessarily be able to pinpoint your problem. An occupational therapists may also be able to make suggestions on how to minimize the impact of your temporary disability on your job.

Your crutches will take some time to get used to, but you shouldn't be having the problems that you are. Try and find someone (and that someone may not be your doctor) who can help you figure out how to do this the right way.
posted by scrute at 2:37 AM on August 4, 2008

When I was on crutches, the pain you describe faded after a while. I had two pairs: one the wooden armpit kind and one the nifty plastic kind that grip your upper arm. (They had bike reflectors on them, which was neat.) Which pair I used depended on where I was sore that day.

With getting around, I found that it helped to think of myself as a four-legged creature, and not a biped using sticks.

Yes, get them adjusted and take it slow.
posted by Pallas Athena at 2:55 AM on August 4, 2008

Hey, crazy idea: how stupid would it be to ride a bike around?

Extremely stupid. If you have balance, tripping and the inclination to steady yourself with your broken leg while walking, it's going to be exponentially worse on - hello - a bicycle?!?

It sucks. It's going to keep sucking, though it will suck slightly less as time goes by. Eventually, you will be recovered and it will stop sucking all together.
posted by DarlingBri at 4:37 AM on August 4, 2008

The knee walker or a wheeled walker sounds like a better alternative for you if crutches are that iffy. When I broke my ankle 3 years ago I found the dependency aspect of it very difficult. A wheeled device - chair or walker will help but truly don't try a bike because the chance of really damaging yourself is far too great if you fall.

Even if you don't continue using crutches be sure to look into physical therapy when you're allowed to weight bear because you'll lose a lot of muscle and flexibility in your ankle in the six weeks.
posted by leslies at 5:56 AM on August 4, 2008

Is there a rolling tray you could use at work? You could carefully nudge it ahead of you as you go along on crutches or a walker.

I've done both a wheelchair and crutches, and I preferred the crutches when I got used to them, because I was much more ambulatory with them and could reach things better. I never did figure out how I was supposed to open the freezer doors in a supermarket while sitting in a wheelchair.
posted by PatoPata at 7:33 AM on August 4, 2008

Having just spent too much time on crutches this summer, I will nth the recommendation that you have them adjusted by someone who knows how they should fit. I am accident prone and eventually just bought my own pair of crutches. Hence, I have perfected my padding strategy over the course of several injuries.

To combat hand fatigue, I wrapped the hand grips with cork tape for bicycle handlebars. I stuffed a pair of old socks with polyester batting (used for quilting and various crafts), placed one on each of the armpit pads (angled slightly to one side, so it would provide a little cushion to my ribs) covered it with inexpensive, sturdy fabric and sewed it tightly in place. It helps relieve some of the rubbing.

You might also try the so-called Canadian or forearm crutches if you find the underarm style to be too cumbersome.

No way should you ride a bike with an injury like yours. Even if you are an accomplished cyclist, the constant worry about falling is likely to impair your judgment (and sidewalks are full of obstacles for a cyclist). And if you would actually happen to fall or even plant your bad leg firmly on the ground to catch yourself...

Wheelchairs can move you around certain places quickly (like corridors), but IMO, they are not as versatile as crutches. Having your mobility limited enough that you must rely on equipment like crutches and wheelchairs to get around becomes tedious real fast. Make sure you keep your spirits up and remember this is only a temporary condition. Best of luck to you!
posted by Heretic at 9:20 AM on August 4, 2008

A friend used a knee walker in a similar situation. You can rent them.
posted by colt45 at 9:22 AM on August 4, 2008

Response by poster: Thanks to everyone who suggested a knee walker. I'm afraid renting one would be beyond my means, but today I put a cushion on a milk crate on a little flatbed cart, and it was glorious. I have to stop every half-block or so because the milk crate keeps sliding around on the cart, but that's a two-second stop to adjust the crate, not a half-minute panting aching stop to convince myself my arms are still on.

The only unintuitive part, in case some poor soul finds this question and tries it, is you have to pull up on the cart handle in front of you. If you press down, the cart tips forward.
posted by d. z. wang at 4:07 PM on August 4, 2008

Do you have insurance? The insurance may pay for a better assistive device for you. If you have fallen on crutches already, then crutches are not an appropriate device for you to be using. A milk crate on a rolling cart, though ingenious, is also not safe. You need to be using a rolling walker or a wheelchair if you have balance issues. If you are on non weight bearing precautions on that leg, you should not be in a position where you are likely to have to use that leg to break a fall.

When you talk to your MD on Wednesday, talk to her about getting a rolling walker or wheelchair. Explain about your balance issues and fatigue, and explain about your fear of having to use that leg to maintain balance, and she will likely prescribe a different assistive device.
posted by jennyjenny at 4:42 PM on August 4, 2008