Thursday, March 31, 2011

Broken Humerus - First Day In Hospital

The problem with breaking your humerus, isn't so much the break, it's how to fix it (this is going to become a running theme!) quickly and effectively... how to reduce the pain and discomfort, stabilise the break so it can heal and return the patient to as close to 100% mobility, functionality and range as possible.

A visit from the consultant orthopedic surgeon was the first order of the day. Mr Surgeon Man (no permission to name him has been obtained so I won't break privacy laws) is a renowned surgeon in his field and after reviewing my xrays decided that a humerus fracture brace would be sufficient to restrict the fracture and hold it in place so it could begin to unite. In his words, I had a "clean, mid-shaft fracture of the humerus" which was a "perfect candidate" for the use of a brace and therefore avoid surgical intervention.

Brilliant, get me fitted and get me out of here away from "the poor old dear who had obviously left her marbles somewhere back in 1973 who refuses to sleep".

Not bloody likely.

You must take note that at this point my arm from about 2 inches below the shoulder, is hanging by muscles and tendons, being supported by a backslab cast and some bandages, and that's about it. Any movement of the arm is going to cause raw ends of broken bone to rub against each other, and that's a one way ticket to PainVille right there.

Enter: Mr Occupational Therapy Man who has come to fit me with a brace. Two pieces of moulded plastic which compress everything in your arm, thus holding the bone straight to encourage union, as modelled below:
Humerus Brace

Those who are interested, there's a blurry picture of my own modelling of said brace here.

The process went something a little like this:
  1. Remove backslab cast
  2. Support arm from elbow to minimise disruption of the humerus
  3. Try not to passout from pain
  4. Request to sit down as pain is too great and starting to get that dizzy, room spinning feeling again
  5. Wait a while
  6. Go for it, slide both slabs of plastic around the arm
  7. Tighten
  8. Try, again, to not pass out from pain
  9. Success
Time for a mix of Diclofenac, Tramadol and Paracetamol IV and back to sleep I go... what with the sleepless night, rest was well received.

I'm woken later that afternoon by Mr Surgeon Man who informs me that another night stay is probably for the best... I inform him that a change of room or a prescription for sleeping medication is probably for the best given the other inhabitant of the ward. He agrees, at least sleep will come easier tonight...

Broke My Humerus

Day One

With 10 minutes left to go of a game of rugby versus HMS Monmouth, a tackle which was clean in every way possible resulted in a mid-shaft fracture of my left humerus. If the prop who smashed me ever reads this, I hold no grudges, and actually kept my shirt which they had to cut me out of, in case the ship stops back in Gibraltar after your six month tour of the Gulf... Would be a great souvenir for the ship's club house (galley) and definitely beats one of those silly ties we usually give out!

I knew something was up from the second I found myself laying on the floor. The pain hadn't kicked in yet, but as far as I could tell my elbow and shoulder were relatively straight... so why was my hand under the small of my back? Had I dislocated my shoulder? My elbow? I tried to move my arm and realised it was excruciatingly painful so actually used my right hand to pull my left arm out from underneath me - and that's when the shaking started.

The pain was like nothing I have ever experienced and the resulting surgery comes a modest second in comparison. It wasn't sharp, or dull... it was hot. I remember repeating to the nurse or doctor from Gibraltar's PRMC (fortunately located right beside the rugby pitch) who had kindly sourced some entonox that it felt like my arm was on fire. The slightest movement stoked said fire even more.

A slow ambulance ride to Gibraltar's St Bernard's Hospital (not wanting to move me about to much) after the mission to get me from the ground onto a trolley and into the bus with only some more "gas & air" to alleviate the pain (the ambulance crews out here are not allowed to administer anything stronger) gets me to A&E to be assessed. More pain as some idiot pushes on my mangled, broken, floppy arm to help move me from the ambulance trolley onto the bed in A&E and my body finally gives in and goes into shock.

Blood pressure plummets to 72/50, the room is spinning, I start to feel sick and ask, nae plead, for some pain relief. "Not until your BP is up a bit". The bed is tilted with my feet raised to try and help bring it back up to "not quite blacking out" and finally we get some analgesia, couple with a backslab cast and a bed in the ward for the night opposite some poor old dear who had obviously left her marbles somewhere back in 1973 who refused to sleep.

Didn't even get a post match pint.