Everyday I'm hustling. And crutching.
April 23, 2010 8:44 AM   Subscribe

I broke my foot. And am a mess on crutches. Now what? And you are not my doctor, but my doctor won't see me.

In a flurry of industriousness, I flew down the stairs on the DC metro. Only to miss a step and break my fifth metatarsal (specifically, fractured and displaced it). Great. Wonderful. I went to the ER, where they gave me a fiberglass splint and some underarm crutches. Oh dear.

So, a few things:
I have no car. I walk and take DC public transportation everywhere. I live close to one end of the Red Line and work on the other end in Maryland. Elevators exist, but I have to transfer and move around. I also live in a townhouse up two flights of stairs. Any tips on making moving around town easier to handle?

I broke my foot Wednesday. Everything hurts after a day and a half of the crutches - my ribs where the crutches hit, my hands, my good leg. Pretty much the only thing that doesn't hurt is the damn broken foot (which is non-weight-bearing). I have an ulcer, so don't take NSAIDS. How can I make everything feel less hurty?

You are not my doctor. I have not even met my doctor. The nurse in the ER gave me discharge papers telling me to see an orthopedist within 3 days (the displacement is apparently something they want looked at). I called the orthopedist yesterday. He took a look at my X-rays. His office called me back this morning and said he would see me in mid-May. What. Seriously? A walking cast / boot / etc would make my life so much easier, and I would at least like to have that shot down by a doctor before crutching for three weeks. Is it ok to see another doctor, or should I wait?

I currently have a fiberglass splint that I can't get wet, which means sponge baths for everyone! Or just me, actually. Also, I am moving the second week in May, which promises to be a challenge. General tips on crutching, reducing my whining, swallowing my pride and asking for help for people, and navigating public transportation all really appreciated.
posted by quadrilaterals to Health & Fitness (34 answers total) 1 user marked this as a favorite
Best answer: Yes, find a doctor that will see you sooner. Or, something that worked for me before was to call back to the ER and tell them what the ortho doc said, the ED physician may be able to get you in sooner
posted by ghharr at 8:49 AM on April 23, 2010 [1 favorite]

I don't know about the doctor thing. I would imagine that if you explained your situation to them, you could maybe get in sooner.

I spent months on crutches (9 months after breaking my femur, and a few weeks at a time with various broken ankles/toes/feet).

In my experience, the crutches pain will go away with time and conditioning. Try to take it slowly and work up to it. After a while, you can become quite nimble with them. Also, never be afraid to ask for help - many people will leave you alone if you seem to be struggling because they don't want to interfere, but will be pleased to help if you just ask.

As for bathing with a cast - well, my dad put a garbage bag over it, and duct taped it to my leg above the cast so I could shower. The last cast I had, I had access to a tub, so I *carefully* got in and left my foot hanging out. It's uncomfortable, but it works.

Good luck. :-)
posted by Pogo_Fuzzybutt at 8:55 AM on April 23, 2010

Whatever happens with the doctor, I think you need to make some serious changes to your moving plan. You need people to help you box things, and friends or movers to get things out of your apartment (carrying boxes down stairs with any kind of cast or dressing still on your foot sounds like a bad idea) and into the next apartment. I don't think you're going to be able to do much except perhaps drastically pare down what goes, if you haven't already. Put a ton of your stuff on craigslist for pick-up only, let other people get it out of your apartment and pay you for it, then put the money toward movers.
posted by slow graffiti at 8:58 AM on April 23, 2010

Best answer: Oh, I almost forgot, I used a pair of cycling gloves - they looked dorky, but worked pretty well and preventing blisters and the extra padding was nice.
posted by Pogo_Fuzzybutt at 9:00 AM on April 23, 2010 [1 favorite]

Carry a shoulder bag with you, since you can't use your hands to carry things.
You should use your crutches with your arms straight and bear all the weight on your wrists, if you haven't figured that out already—you shouldn't be bearing any weight on your armpits. It's no picnic, but you can actually be pretty damned mobile on crutches.
I've showered by wrapping my, uh, affected region in saran wrap and being careful.
I generally found that when I was on crutches, people were more accommodating than I really needed.
posted by adamrice at 9:03 AM on April 23, 2010

Those wrap-around-the-seatbelt fleece things fit around the top of the crutch and make it more comfortable on the old armpits.
posted by lazydog at 9:13 AM on April 23, 2010 [2 favorites]

Did anyone give you any basic instruction on using the crutches? I too spent quite a while on them after suffering a broken femur, and, like any other motor skill, there are tips and techniques which will make things considerable easier.

I sounds like you're aware that your hands should bear your weight, not your armpits. However, your ribs shouldn't be hurting much. It sounds like you're clasping the crutches tightly between your upper arms and your sides to keep them in place. Instead, the hand grips should be adjusted so that the cushioned tops of the crutches are secure up against your armpits. Again, the armpits don't bear weight, but they do secure the crutches and keep them stable. A rule of thumb I used was that if I wanted to rest on the crutches I didn't have to slouch much.

Also, you've probably figured it out intuitively, but going upstairs your feet (or rather, your good foot) leads. Going downstairs, the crutches lead.

Of course, I an not your physical therapist, doctor, nurse, lawyer, counselor, or decorator. Best of luck.
posted by dinger at 9:19 AM on April 23, 2010

Sure, see if you can get in to see another doctor. Always, always feel free to go see another doctor. Always.

Keep in mind that there might not be too much that they can do for you, though, which might be why the doc told you not to come in until it was time to follow up. Maybe the ER did a good job getting done what needed to done, which is a good thing.

You can always ask for non NSAID pain meds, too.
posted by internet fraud detective squad, station number 9 at 9:22 AM on April 23, 2010

Just coming in to second the garbage and duct tape for showers idea. I broke a whole lotta bones in my ankle/foot/leg and was in a cast and on crutches for 3 months. They told me no showers. Within a week, that was unacceptable, so I just taped myself into a garbage bag and went for it. Note: either get a bath mat that has good grip or put a chair in there with you, unless you want to break the other leg.

I had to move (across the state) on while on crutches, and really it just gave me a good excuse to have other people do the heavy lifting - it is much easier to convince people to help a cripple than a healthy person as it turns out. Packing wasn't that hard, once I got good at hopping, and then I just called in as many favors as possible. It certainly wasn't ideal, but it wasn't the end of the world.

And what Pogo said about the crutches - really you will be surprised about how good you get at them, if you give it a few days/weeks.

I'm sorry about your foot, and good luck getting to see the doctor sooner! Hope everything works out.
posted by CharlieSue at 9:24 AM on April 23, 2010

D'oh, garbage bag in the first sentence there.
posted by CharlieSue at 9:24 AM on April 23, 2010

What about a using a walking boot cast?
posted by axismundi at 9:36 AM on April 23, 2010

Best answer: You should definitely be able to see a doctor sooner than that. Oy.

As for the crutches: yours sound like they might not be adjusted correctly. They shouldn't hit your rib cage, really, or even sit in your armpits when you're walking. The weight of your body will be supported by them primarily through your arms and hands (yes, this will be tough on your triceps and shoulders for the first bit). So check to make sure they're the right height for you - the pads should be a bit below armpit height when standing on your good leg. (On preview - I guess this was said already.)

One hack I did on my crutches when my knee and wrist got smashed to hell in a bike accident three years ago, was a coffee/water bottle holder - very nice to be able to reach down and grab a sip without rifling through my backpack when I was at a light, or waiting for the bus! I just got a bike water bottle at Canadian Tire, along with a plumbing pipe clamp and it was solidly attached to my right crutch is less than 5 minutes.

I found public transit not too bad in my city (and it was very common for bus drivers to yell back that someone on crutches would need a seat as I was getting on the bus), but train folk may be less courteous. You may have to plan some routes ahead of time to make sure all your stations have elevators, etc.

I would seriously consider hiring movers for your move, and perhaps even a cleaner to clean up your old place after you move out if necessary, because it will not be easy.

For bathing, the gold standard solution is a plastic bag, *heavily* taped (if you're pain sensitive and don't normally, you might want to shave the area to be taped, because you will be ripping out a lot of leg hairs when you take it off), sitting on an ergonomic stool in the bathtub and showering with a showerhead that comes off (i.e. that's at the end of a hose, rather than straight out the wall). But, since it's your foot, you may be able to get away with drawing a bath, sitting on the side of the tub and lowering yourself in whilst keeping the bad foot out of the tub and propped over to the side. (Will depend upon your upper body strength, balance and confidence, though.)
posted by Kurichina at 9:36 AM on April 23, 2010

Response by poster: Thanks so much, everyone. I just didn't know that seeing another doctor else was an option! I called the ER's follow-up line and they said it was imperative that I see someone as soon as possible. I now have an appointment for Monday. Wish I would have asked this yesterday!

The crutches tips are great. I swallowed my pride and asked someone to take me to the grocery store tomorrow, and will stop at Target for some padding and cup holders.

And re: moving - my mom is going to come in to help me pack, and I fortunately live with three guys who can carry the heavy things. You guys have convinced me to give movers a try for my bed and the like; we were on the fence getting some for the couches, but being a set of hands short I think will be the catalyst for doing so.
posted by quadrilaterals at 9:58 AM on April 23, 2010

When I broke my leg, I used an office chair with wheels in the house to get around. Just pushed myself backwards with my good foot. I also hopped on the good one a lot, which I would recommend avoiding for the reason that by the time I got the cast off, I looked like Schwartzenegger on one leg and Twiggy on the other. Took two years to even out completely.

They sell oversized rubber "socks" to go over your cast to be able to shower in (though standing is a challenge).

Also, taking your own sweet time with the crutches helps a lot. It's hard to keep to your old pace comfortably.
posted by qwip at 10:00 AM on April 23, 2010

When you are going up and down stairs on crutches. I take both crutches under one arm and use the rail with the other hand. Going up, lead with your good foot and going down lead with the bad foot. Good goes to heaven, bad goes to hell. Instructions for Using Crutches

I was on crutches for a couple months. My suggestion is to budget for cabs or beg rides if you are going more than a couple blocks. This is the time to call in your favors. One great thing about crutches is they inspire people to offer you a seat on public transit, and as Kurichina mentions this is better on the bus.
posted by Gor-ella at 10:06 AM on April 23, 2010

Best answer: This is silly, but: Every time you swing through the crutches, think to yourself, Wheee!
posted by Sys Rq at 10:07 AM on April 23, 2010 [4 favorites]

I did this and I could not swing through crutches. I ended up sort of hopping on them. It was tiring and painful and I didn't really go anywhere for six weeks because of this.

Also: get a friend to help you shower. You can lean the bad leg on a stool, or if you have a shower over bath, lean over the bath,
posted by mippy at 10:28 AM on April 23, 2010

Forget the walking cast, get a waterproof liner under a normal fiberglass cast, then you can get wet as you please without worrying about your foot. Also you don't have to be super worried about water for most fiberglass casts/splints (call back and ask about the one you have now). The worry is that the skin underneath could become..moldy..but it's not a "no damp at all" situation like old plaster casts. A bag and some tape should be plenty safe in the shower.
posted by anaelith at 11:18 AM on April 23, 2010

Best answer: I feel for you. I broke my knee about 18 months ago and spent 12 weeks (over Xmas and new years) on crutches, 100% non-weight bearing on that leg.

You've gotten a lot of good advice above, but I'll just add a couple of things:

- There is no shame in going up and down stairs on your butt. None. You might get dirty but if you feel safer, then don't be ashamed to do it.

- The thing that made showers tolerable for me was getting a detachable shower head and putting a stool in the shower and showering sitting down, with my leg sticking out of the shower curtain. (Of course, I couldn't bend my leg at all, so I didn't fit sitting otherwise).

- Don't be afraid or ashamed to ask for help. One thing that drove me crazy was my inability to carry a simple cup of water from one place to another. You broke a bone! No one will think less of you for asking for help.

- Of course, you already have a backpack and are using it with both straps, right?

Also, its been two days. Two days. Just rest a little. I suspect a lot of your soreness is coming from the general bumps and bruises from falling down a flight of stairs.
posted by anastasiav at 11:24 AM on April 23, 2010 [2 favorites]

Best answer: Did you receive any gait training (training on how to walk with the crutches)? There is a difference between "step to" and "step through" walking. With "step to", you will place your crutches ahead of you with your "bad leg", then bring your "good leg" forward to where the crutches are. With "step through", you place your crutches/bad leg ahead of you, then move your good leg forward past where the crutches are (more like regular walking, where one leg moves forward past the other). This early on, you will probably find "step to" much easier, and as you progress, you can try "step through". I am also agreed with some of the other crutch-fitting tips:

- The crutches should hit about 3 fingers below your armpits
- The hand grip should hit about where the crease of your wrist is when your arm hangs at your side (you want a slight bend to your elbow when you are using the crutches)
- The crutches should be a few inches out from each foot when you are walking, meaning that they won't be totally vertical while you are using them - very slightly diagonal (and that's the position in which measurements should be tested)

Other stuff -
- Do remember to bear weight through your arms and hands, not your armpits. If you don't regularly do a lot of upper-body work, this is probably going to be pretty tiring and soreness-inducing. Heat on the sore muscles (assuming that there is no redness/inflammation) will help, and this will get better over time as you build strength.
- Some "Energy Conservation" (Occupational Therapy principle) will probably be helpful. Here are some ideas.
- The ability to progress to a walking cast will depend on how well your foot is healing. Make sure to eat well, and restrestrest!

Good luck!
posted by purlgurly at 12:20 PM on April 23, 2010 [2 favorites]

Oh, one other thought - if you need to be out-and-about for a while, using biking/weight-lifting/climbing gloves would probably make your hands feel more comfortable and less prone to blisters.
posted by purlgurly at 12:27 PM on April 23, 2010

Check with your insurance to see if they will cover taxis for getting to and from work. A friend broke his leg (in NYC) and cabs were covered.
posted by valeries at 12:35 PM on April 23, 2010

I've never used crutches, but saw someone using a cunning "crutch hack" the other day which might help, depending on your looking-a-bit-odd tolerance.

Tie a long piece of string/cord between the crutches, and when you pick the crutches up, put the cord over your shoulders, behind your neck. That way, when you need to let go of one crutch to e.g. take your wallet out of your pocket, the crutch will just dangle there in place, waiting for you to grip it again, so you won't drop it/have to pass it over to hold onto it with the other hand/prop it against the wall. It's kind of like a grow-up version of having string between your mittens as a kid.

I think the person I saw had elbow crutches so you might need to experiment as to exactly where to tie the string, and I guess some kind of padding around your shoulders/neck might be nice.
posted by penguin pie at 1:02 PM on April 23, 2010

Any tips on making moving around town easier to handle?

Get a backpack and gloves, and assuming your crutches are properly adjusted (purlgurly's advice is spot-on) wear shirts that are thick enough to prevent the inevitable chafing. Don't be shy about applying a large bandage to points that are getting irritated.
posted by davejay at 1:04 PM on April 23, 2010

Consider buying elbow crutches. I'm skinny and the underarm crutches rubbed holes in my arm and ribs even with padding. And get a backpack with rear access (a zip up the back part) its so much easier to deal with than a regular one.
posted by fshgrl at 1:41 PM on April 23, 2010

Best answer: I don't know why Americans seem to prefer underarm crutches - I found elbow ones much, much easier. I broke my ankle really badly 5 years ago and was non-weight bearing for 4 months and partially weight bearing for another 3. As others have said, using crutches is a skill - by the end of 4 months I was faster crutching than walking. Stairs are easy. To go down, position yourself next to a handrail (ideally on the bad leg side) and grab it with your hand. Transfer the crutch to your other hand - you can hold it with your fingers, without letting go of that hand's crutch. Now put the crutch down a step, then put your good foot down a step, then move your hand down a bit. Repeat till bottom, the grab your spare crutch again. To go up, basically do the same in reverse and hop up a step with your good leg. This is pretty safe and secure - and you will find yourself getting pretty quick. Saves using your butt, which is a fine way for manoeuvring at home, but embarrassing in public. Nthing bin bags for showers (with a seat!) and cycling gloves - you will get blisters. One word of advice, be careful when it's been raining - it can make it very slippery for crutches and, if one slips, you slip! Good luck - you'll soon wonder what you were worrying about!
posted by prentiz at 2:00 PM on April 23, 2010

I broke my second metatarsal a couple years ago and just went out and bought one of those boot things for like 70 bucks or something at a medical supply store. I was in it for 6 weeks, and it really wasn't that bad. Sort of annoying, but doable. Crutches SUCK. I would have hated trying to get around on them. I actually didn't ask my doctor about wearing a boot at all (not saying you shouldn't check with yours). Not sure if the location of the break makes a difference or not, and I'm sure your second opinion doctor can tell you if it is appropriate.

Good luck!
posted by afton at 2:11 PM on April 23, 2010

Best answer: I broke my femur about 6 years ago and was on crutches for something like 12 weeks.

nthing what everyone says about proper crutch form.

My friend sewed up a pouch for me that used velcro loops to attach to the area just below the crutch handles. I used that as a pocket that I could get to without having to wear normal pants, bring a bag, or reach very far. It was awesome.

Also, when you move to a cane, the cane goes on the GOOD side, not the bad (hurt) side. If you put it on your good side, you have a much wider supported stance with a cane, whereas if you have the cane on the same side as your hurt leg/foot/etc, you end up hobbling a lot more.

Don't be afraid to call on your friends. They will be happy to help. When I broke my leg, I sent out a mass e-mail to everyone I had seen in the past year or so who lived in town, letting them know I could use some occasional help for the next couple months. I had at least 3-5 visitors per week, some of whom would help me with groceries, clean my apartment, or even just hang out while I took a shower in case I fell and couldn't get up.

Now the part I don't know if any doctor would back... But I got VERY VERY good at hopping around. I rarely used my crutches in my apartment after a few weeks. My good leg got strong enough to just hop, squat, get up from sitting, etc. I always plotted a path that would take me near things I could lean on if I need to, though.
posted by MonsieurBon at 2:36 PM on April 23, 2010

Response by poster: I am pretty sure it is the absolute exhaustion from crutching around town, but this thread is making me tear up. Thank you, everyone, for all your wonderful advice. I managed to talk my way into an insurance-covered orthopedist appt at 2 pm. I have a boot now (which I am affectionately referring to as "Das Boot") and can put a slight bit of weight on my heel, which means my life is that much easier, despite remaining on crutches.

I'm marking a few best answers, but this entire thread was really great at making me feel less like a damn idiot. Thank you.
posted by quadrilaterals at 3:23 PM on April 23, 2010

I don't know what it's called but there is a little stool on wheels that you rest your knee on, with a handle, that is supposed to replace crutches.
posted by IndigoRain at 4:51 PM on April 23, 2010

I was on crutches while we were taking a long-planned, very special trip to England. I found that public places such as museums offered wheelchairs and I could get around faster and with far less exhaustion using the chair. Not recommending it for everyday living (partly because you want to use your muscles, partly because most places aren't very accessible) but for me it made things possible that I would have had to miss out on otherwise.
posted by metahawk at 6:21 PM on April 23, 2010

I broke my fifth metatarsal about 1.5 years ago, but it was a (faster healing) distal fracture and not displaced. Never had to use crutches--just a stiff, stupid-looking velcro shoe for about a month. But if you've got a proximal fracture (i.e., a Jones fracture), please make sure you keep your weight off of your foot as much as possible for the time being, as these take longer to heal. IANAD.

Scooting around my apartment on my desk chair was how I dealt with this problem at home. But you might look into getting a knee scooter for doing the same thing and getting off the crutches.
posted by bennett being thrown at 7:43 PM on April 23, 2010

Not sure how if you're still reading this, but I just had to weigh in. Several years ago I had ankle surgery and strict instructions to stay completely off of it for 8 weeks. The crutches were killing my arms, so I googled about and found this: the roll-a-bout. It's a silly name, but seriously, this saved my sanity. It is basically an elevated skateboard that you rest your leg on and steer. It's brilliantly fun to get around on and saves all of the underarm pain and soreness. You can rent them or buy them, and they're not too expensive -- and well worth every penny, in my opinion. The only downside (and it's minor) is that you look unusual, and will be bothered by having people coming up to you every day wanting one for themselves or their grandmother or their friend who is on crutches. But that's minor. I was actually kind of sad when my cast came off and I had to stop using it, because it was so fun.
posted by forza at 12:18 AM on April 24, 2010 [1 favorite]

Forgot to mention http://mybrokenleg.com/, which is a great community for chatting about the very specific issues that arise in your situation. Just don't share any pictures of yourself in a cast with anyone on there, as there can be some occasional creepy cast fetishist lurkers.
posted by MonsieurBon at 10:56 AM on May 4, 2010

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