The changing pace of time

~ k4thybrown ~ Leave a comment

Everyone knows time speeds up as you get older. There’s a theory that this occurs because every unit of time is progressively smaller in relation to one’s lifespan already lived. For a five-year-old child the wait until their next birthday seems interminable – it’s approaching one fifth of their life lived to date. At 60 years old, a year is only 1/61st to 1/60th of a life lived.

Whyever it happens, as we get older we usually wish time would do us a favour and just slow down a bit. We tell ourselves to enjoy every moment, as the birthdays accelerate relentlessly towards us. Where have the last few years gone?… “You think it’s bad at 50?” exclaims my dad, “Wait til you’re 70!”.

So with a fractured limb, it seems somehow wrong to be wishing time away. How wicked at my time of life, when every leaking moment is so precious! But <whinge> everything sounds so far away: 2 weeks until the next X-ray; 4 weeks until the bones start to knit; 2 months until the splint can be removed; 3 months til you can drive again; 6 months to get back to running fitness; over a year to do weight-bearing exercise… And so on. The physio is going to drag on endlessly… </whinge>.

And yet, here’s where age-time-relativity (not a thing) kicks in: because with a broken arm, time is whizzing by. Since every single thing takes ages to complete with one damaged arm, before you know it, another day is over. Typing: one hand flying around the keypad, no matter how adroitly, is slow-going compared to two. More mistakes need to be corrected, some key combinations take a bit of working out to achieve. Unpacking the dishwasher one item at a time. Taking a shower…. Sheesh!

In fact I now wonder if that’s why time goes so fast for old folk. Because they can only fit a fraction of the tasks into one day that younger people can.

So I’ll simply take my time with everything. Hopefully I’ll be better in double-quick time!

 

 

 

 

Pain, pills and prunes

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Pain management is tricky! I was sent home from hospital with paracetamol, Naproxen (a stronger NSAID than ibuprofen) and codeine phosphate. The nurse said as he handed me my party bag, “Your GP may be able to get you something stronger if you need. This is all we can prescribe from here”. I was intrigued and a little nervous, this already seemed like a lot.

No point in being brave

I know from previous experience what it’s like when regular painkillers are not enough. When I bruised my rib a few years ago they told me two things of interest.

  • Take whatever painkillers in safe quantities and mixtures for as long as you need to control the pain. There’s no value in ‘being brave’.
  • NSAIDs have a cumulative effect. That is, for as long as you keep taking them the pain-masking builds up to a certain level. If you miss them or drop some doses you lose this buffer. So again, no point cutting down ‘to be brave’, you are simply not getting best benefit from them.

It’s very important however not to overdose on the various painkillers. Taking more than recommended can do irreparable internal damage. In the case of codeine you also have to consider its addictive qualities. You are advised not to take for more than 72 hours, however in the case of acute need like a fracture there doesn’t seem any problem with getting a week’s worth to see you through the worst of it.

So if you’ve taken as many paracetamol as you are allowed in 24 hours and still in pain, the answer is to mix up different types of painkillers across the day. To explain further, it’s worth understanding how the different types of painkiller work:

Paracetamol relieves mild to moderate pain and reduces fever. It doesn’t reduce inflammation or address the cause of the pain, but it works fast. It’s usually the first resort. But you should only take up to 4g a day (four doses of up to 1000mg).

Non-steroidal anti-inflammatory drugs (NSAIDs) equally address mild to moderate pain but also work to inhibit inflammation. Example types are Ibuprofen, Naproxen and Aspirin. Aspirin is also used to prevent blood clots so is taken preventatively by some people. NSAIDs have side effects though – they can cause thinning and erosion of the stomach lining and bowel, so recommended dosage is limited to 1.6g a day (4 doses of 400mg).

If you are clear to take ibuprofen you can alternate doses with paracetamol to give you good mild to moderate pain cover over the entire day and night and continue this as long as you need. A slight complication is that ibuprofen ideally needs to be taken with or after food to help prevent irritation of digestive system.

A note about anti-inflamms and fractures

There is some evidence that taking NSAIDs in the first fortnight is counter-productive because inflammation is part of the natural healing process. I asked the consultant about this at my two-week appointment and he agreed, but said it was too late as it was more than two weeks gone. I guess we’ll see at the next fracture clinic/x-ray whether the union process has begun as it should. I think the nurse and doctor in A&E should have let us know about this when we were discharged.

Opioids are the next step up. These are divided into weak and strong types: you are only likely to need the stronger ones at the outset of treatment, or at moments where enhanced pain management is needed over a short time-frame, eg if your broken limb needed to be manipulated for some purpose. Hence being given Oramorph by mouth just before my first x-ray.

Codeine is a mild opioid. So it’s available on prescription to help augment your pain relief if paracetamol and ibuprofen are not enough. Downsides of codeine are sleepiness, and that it makes your digestive tract sluggish too… So you are bound to get constipation.

So, managing the pain day-to-day becomes a juggling act of scheduling paracetamol, ibuprofen and codeine. A system is good for this. If, like me, you’re also taking other supplements and unrelated medication it becomes tricky to remember what you’ve taken when. More on this later.

What’s the pain like?

To be honest, there is very little pain for most of the time. In the first week there’s the pops, crackles, jolts and spasms of the raw break and inflamed muscles shifting around. Then things settle down and as long as you don’t move wrongly, or too fast, and remember to relax your shoulder and elbow downwards and not tense up, the painkillers keep everything at bay.

Where do the prunes come in?

After three weeks, I wanted to give up the codeine. I’d moved from prescription codeine phosphate to over-the-counter Solpadeine to help me  get through the night. It felt wrong to be on it for so long. Although it was helping me to sleep I didn’t much like the thought of dependency. I’d started to notice feeling headachey with it, a bad sign… And then there was the constipation. I’d been tackling that pre-emptively since day 3 with fruit, dried apricots, and tinned prunes. I was drinking plenty of water too. Later I tried adding in Senna capsules overnight. But the clogging power of codeine is all-powerful. In the end the only way to overcome it was to quit. The effects continued for a week after stopping it. I’m also taking Dulcolax stool softeners and overnight caps now and finally getting back to normal but still can’t take anything for granted. So prunes and fruit it is, whenever I can.

2017-07-31 10.34.36

Back to pain. This sounds really stupid but the weird thing I realised after three weeks was that the painkillers had  been working effectively all along (duh!). All the time I thought the broken arm didn’t really hurt much it was because the pain was masked successfully. So as I left the codeine behind and tried extending periods between paracetamol and ibuprofen doses, I would suddenly notice that my arm felt ridiculously sore, stiff and heavy. It felt especially sore along the forearm and at the wrist where it was resting on the cuff of the sling. I would try to relax to no avail. Only paracetamol would relieve the feeling. Of course without codeine I am now down to juggling just paracetamol and ibuprofen all day, and the real trick here is to space them out and not miss doses. If I go too long I get what I now recognise as the ache of the broken arm, but also the referred pain of ligaments and muscles, not just along my arm and in my elbow, but elsewhere… Neck, shoulder, hips and back from sleeping in the same position so much, and now also sore knee ligaments, from inactivity I presume.

Keeping track

A good way to manage this regular and effective dosing without going over the top is to make yourself a chart to tick off. Or perhaps a tray with a sheet of paper on it, laying out your meds at the beginning of each day so you can see what you’ve taken so far. I’m at day 27 now so this is what I’m going to be doing from now on.

2017-07-31 10.40.52

Now, tell me about your pain and how you’ve coped with it.

How to shower alone in * easy steps

~ k4thybrown ~ Leave a comment

So hubby went away for a few days. I still had to shower. Arm was feeling a bit better and slightly steadier in the brace by day 23 so I thought – ok, let’s do this. But… how am I going to do this? Step by step was the answer. It was long-winded but I’ve tried to detail below the steps I took, including some tips. Note – I’m not yet ready to remove my brace/splint and couldn’t do it by myself even if I wanted to… so the aim is to keep the damaged arm, brace and tube bandage dry.

  1. Make sure there’s plenty of hot water in the tank. Showering one handed could take a while with long hair.
  2. Make a waterproof arm shield out of a black bin-liner. Cut an armhole in the sealed end small enough to make it tight when pulled up over your shoulder, wide enough to fit over the brace (about 10 cm across, doesn’t matter if it splits a bit further but try to keep it snug).
  3. Get everything ready. One towel within reach outside the shower, another spread on bed. Comb beside bed (right hand side). Shampoo and conditioner in basket at reachable level in shower. Make sure bottles are unsealed and ready to use. A facecloth in the shower to make it easier to get a grip on the shower tap.
  4. Prepare proxy sling (I use a long, thin cotton scarf)
  5. Remove dress/clothing
  6. Sit on bed and remove collar and cuff, resting lower arm on lap or on a thin pillow on lap
  7. Gently work black bin-bag up over hand, arm and brace. If you pull it up over your shoulder it should make a reasonable seal at the top to stop water running down. If in doubt, you could have an elastoplast handy or some surgical tape to hold it in place.
  8. Tie on proxy sling by placing it round neck, and passing it under forearm. Tip head forward to narrow the gap between arm and neck. Use teeth to pull sling tighter so it supports wrist at the right height. Tie in a slip knot if you’re clever or just a granny knot if less so or doing this with your ‘wrong’ hand.
  9. This should feel comfy and secure enough to stand.
  10. Climb in shower and turn it on, keeping your damaged arm away from the shower of water.
  11. Squeeze shampoo onto your head directly or if you can, into the palm of your bad hand (I found this difficult as I still can’t rotate my lower arm very well). Massage in as well as you can. My friend Marjory suggested you could do this before even getting in the shower while looking in a mirror to see what you are doing.
  12. Rinse and repeat. Wash yourself/condition/rinse etc.
  13. Turn off shower and step out.
  14. Pat gently where you can reach, then sit on the towel on the bed to air dry while you remove the proxy sling, then the bin bag. Take your time and relax. Remember to drop your shoulder down to allow gravity to help your bone alignment – don’t hunch your arm up.
  15. At this point I like to make sure my limp arm is dry and put my collar n cuff sling back on for a bit of security while I take my time combing the knots out of my hair.
  16. If it’s still too difficult to wash under your broken arm, you can use a baby wipe now to gently clean there. It’s easier if you lean forward slightly to create a gap between your arm and side, then slide your hand in against your side rather than pressing against your arm, even when it’s in the brace, because pushing your arm away from your side hurts! Use a tissue to dry in there and (if applicable) under your boob/moob on the sling side.
  17. Apply roll-on deodorant – this is quite fun to do (chimpanzee impression) on your good side, and if you are careful you can use it under your bad arm too.
  18. Get dressed etc
    Ta daaaa!

Bracing myself…

~ k4thybrown ~ Leave a comment

I had been really looking forward to day 17 – Thursday 20th July was my first appointment at the fracture clinic at Frimley Park. I say looking forward; I suppose there was an element of trepidation mixed in with the curiosity. I hoped I’d find out how my arm was progressing, if the bones were lining up, and above all that I’d be offered a more robust brace of some kind to give my wobbly arm more protection. I was also slightly nervous that there would be pain, that they’d try to manipulate my arm in some painful way (why, I have no idea?) or that fitting a new brace might hurt. Also that they’d look and say ‘I’m sorry, your bones are not going to meet up’. Totally irrational but that’s the nature of fear and the unknown!

Waiting room

We arrived in good time, not really sure what to expect. There were signs up warning people that if they needed both x-rays and plastering they could be in clinic for two to four hours. I knew I wouldn’t be getting plastered but settled in with a puzzle book in my bag, ready for a lengthy visit. The other clinic visitors appeared to be ankle and lower leg breaks at different stages of repair. One lad and his mum emerged smiling from the consultation rooms and went to the desk to hand in his crutches and leg brace. Job done! A few ladies with lower leg fractures were in wheelchairs. Once again I thanked my lucky stars.

In the event it was all quite quick. We were called in promptly and the doctor took a quick look and organised a chitty for an  x-ray and a brace to be fixed (relief!), promising we could come back to ask questions afterwards. We moved into the plaster room as instructed but a nurse asked me to climb into a chair with a raised armrest and I stared at in fear, saying “I don’t think I can lift my arm onto there!”. She quickly realised we were in the wrong place and the consultant came back to see us again to explain he’d only been at Frimley a week and he’d got it wrong – an x-ray today was too early to see improvement. I needed a moulded plastic brace fitting though – so we were sent off to occupational therapy to get one sorted.

Before we left I checked a few things with him – pain relief, swelling, likely timescales. I don’t think we learned anything new. He said we’d have to experiment with the pain meds to get it right, and gave 10 to 12 weeks before I’d be able to have the brace removed. He said there was a possibility the union wouldn’t be perfect but up to 30% displacement was normal and my arm would regain full functionality. I was to return in two weeks to get the update x-ray.

20108301_1907254362822331_8367183052961138024_nGetting the brace

In occupational therapy we walked past the rooms full of crutches, stools and wheelchairs and found our way to the therapist, Jane, who was to fit the moulded plastic brace to my arm. She was very calm and gentle and put me at ease. First she measured and cut the plastic to a paper template. Then she put the plastic sheet into the warm water machine (like an electric bain marie) to soften it up. She pulled the tube stocking carefully up over my upper arm. It hurt at first with the pressure, but then felt snug. Her colleague Fiona came out to pull my elbow downwards in slight traction while they wrapped the plastic sheet warmly round my arm and then fixed the velcro round. The two velcro straps were pulled tight in opposite directions. It felt nice and secure and reassuring.

Jane suggested I try from time to time removing my wrist from the collar and cuff and gently lifting my hand up and down, supported, to ‘oil’ my elbow joint and stop it completely stiffening up. I also need to squeeze a ball and flex my wrist up and down.

I’ve spent two nights in it the brace now and it feels fine. We’ve only had to loosen and readjust it once so far. Tomorrow we will attempt to shower with it ON, but covered by a plastic bag or shield. In future we can try removing it to shower.

Two weeks on

~ k4thybrown ~ Leave a comment

Today is day 14, two weeks on from splat day. Where does it go, eh?

I can report that things feel a little better in some ways, but are just as bad in others. There are still a great many things I can’t do – see below. Things that have improved or changed:

• I can move about more easily. Standing up, sitting down, stepping up and down are all more natural. I even managed to carry a cup of tea upstairs to my husband this morning.
• The involuntary spasms in my arm are fewer and painless now – a few sudden twitches. My arm still ‘clicks out’ from time to time but is less painful when it does.
• I’ve cut down a bit on painkillers. However my arm is getting heavy and achey. I guess the painkillers were masking that but I’m trying not to take any in the middle of the day, especially codeine which I am leaving to 3 times a day – evening, bedtime and early waking 5 to 6 am.
• I can put on my own proxy sling made out of a cotton scarf and tie it with my teeth. I can take off and put on my own dress and underwear.
• I can bend a little lower to pick up things from about knee height, as long as I bend my knees and keep my back quite straight. So crouching slightly with one foot in front of the other, or squatting in a ballet plié – style move. With ninja moves I can plug something into a wall socket by sliding my back down the wall. I can pick up things from the coffee table using kitchen tongs!
• I can lightly grip things in my left hand if careful.

Things that are still difficult

• I can still only sleep in my monster chair
• I can’t stand up from the normal sofa without assistance
• I cannot pick up anything from the floor. I’m sure somewhere I have a litter-picker-upper that I got as a prop for work but it can’t be located right now.
• My arm is in the sling 24/7. I don’t dare release it except supported by a cushion while I swap to the makeshift sling. It feels very vulnerable.
• I am still very wary of others’ movements near me.
• I can only type one-handed…. Slow and full of typos which keep needing correcting. I can’t type accented letters using the number keypad because the alt key is left of the space bar. I have to gently hold a pen in my left hand to keep ‘alt’ depressed. Tricksy. Scrolling and selecting on the laptop touchpad is challenging.
• Washing under my left arm. Still can’t lift my arm away from my side so poor left armpit only gets a gentle wipe with baby wipes – no chance of deodorant!
• I can’t completely close my fingers on the left hand yet – they are too swollen.

How’s it all looking?

• My upper arm still looks a bit concave
• Some bruising – it took a week for any to show and it wasn’t as dramatic as I thought it would be – but I noticed this evening it’s a bit ugly and green underneath my elbow, where the blood pools I guess.


• My left hand isn’t as swollen but I still can’t make a fist or grip anything
• My feet, lower legs and upper legs are still rather swollen but much better if I spend time with my feet raised. I’m not looking forward to having to wear shoes.
• My tummy is still bloated. I’ve gained 6 pounds, wah!

The other thing to report is itching. Argh, the skin is dry and it gets sweaty under my elbow where my arm is resting. One good time to not be wearing a cast. At least I can have a gentle scratch.

My monster chair

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The telephone conversation with the doctor about sleeping (or lack of it) on Day 3 wasn’t very helpful… best advice he had was to play with the timing of the drugs I have (paracetamol, codeine sulphate, Naproxen – a rather vicious NSAID). If I can, the plan is to ensure I have paracetamol and codeine just before settling down to sleep. This is fine except you’re supposed to not have the codeine on an empty stomach so that has to be factored in. I’m not a fan of eating just before bedtime but needs must. A bit of cheese, a cup of tea, a choc-ice. Or a banana or yoghurt maybe. Really not things to be putting in your tummy at this time of night.

Anyway, by Friday, day 5, I knew I needed a better solution for sleeping. What I needed was a reclining chair. I recalled from seeing them in furniture shops that they are really expensive – hundreds of pounds – so that wasn’t going to happen. I wondered if anyone had one I could borrow. I spoke to someone on Friday morning who said, ‘Have you tried the local Red Cross?’ I confess, I’d never thought of that – but hell, why not? I called them but they closed for the afternoon and I knew I couldn’t wait until Monday so I asked on Facebook in my local town’s group. Several people suggested local charity shops, so I thought I’d give it a try. To my very great surprise, the local Phyllis Tuckwell Hospice Shop knew exactly what I was talking about and said there was an electric ‘rise and recline’ chair in stock in their Frimley store. I was uncertain – £185 still seemed like a lot of money. But maybe – what price a decent night’s sleep after all? I left it to discuss with Geoff.

Next morning, Geoff went to parkrun as usual. On return, he said our friends had a reclining chair their brother in law had slept in successfully with a broken collarbone and would I like to borrow it? That was very kind! I said ‘Yes please!’ They came round late afternoon – but it was too low for me, more of a garden recliner and tipped too far back. ‘I’ll keep looking,’ I said. ‘What you need,’ said friend Mark, ‘is one of those electric ‘Rise and Recline’ type chairs like old people have. ‘Funny you should say that!’ I replied, explaining to both Mark and Geoff about the one at the Phyllis Tuckwell shop. So the guys agreed to head over there quickly before it shut and see if it was suitable.

And here it is! My monster chair!2017-07-08 17.49.53

It’s fab. It has a motor allowing smooth motion in recline and to tip the seat up, helping me to standing position more easily. The footrest also rises automatically so I can sit with my feet raised to try to get my lower leg swelling down (it’s working!).

My sleep on Saturday and Sunday nights was miles better – two big chunks of sleep, and woke feeling rested and relatively pain free. Amazing!

Since then it’s been mixed. Still, way better than sleeping on the sofa, I have a squishy cushion behind me on the left to support my bad arm and stop it flopping too far back. I am experimenting with how far back I can tip to still be comfortable, and how far raised my feet need to be. Also with pillow position to ensure my head doesn’t flop forward or to the side and get too stiff. I have a very light chenille throw over me as I sleep. It’s really very, very comfortable and practical. Getting up to go to the loo or get more paracetamol in the night is made easy with the ‘rise’ function.

I am very much reminded of this:

Homer Simpson – Bed

I am still waking in the night in discomfort – I’m not a natural back-sleeper and I get stiff hips when sitting for a long while – but at least I can then sit up or get up easily to stretch, reposition my arm, rub my stiff bum,  give my legs a shake out etc

Poor me!
Swollen feet and legs

 

So if you are in my position, and can beg, borrow or buy one of these chairs. I really recommend it!

 

Showering and dressing

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When you’re incapacitated it only makes things worse to feel dirty, sticky and unkempt. I started to tackle this on day 1 by requesting a pack of disinfectant wipes in the downstairs loo. Not for me, but for the radiator, tap and flush that I am touching with my single functional hand. It feels good to clean up after yourself! Washing your one hand is tricky too. I do my best with liquid soap, but also have wet wipes to hand. I asked hubby to get some so I could keep wiping my poor swollen left hand too – it was feeling  left out. Feeling cleaner is a bit of relief.

Note – cleaning under your broken arm is too sore at first but it eases off. Within a week I was able to lean forward slightly to create a gap between my arm and armpit, and if you very carefully wipe with a flat palm, pressing mainly against your chest, not your arm, you can do it. Forget putting deodorant on for a while. Maybe try deodorising wipes? I also realised I would have to face having a hairy armpit for a while until that arm can be raised enough for a shave. Meh. Whatevs!

So far (day 12) I’ve had four showers in all. It’s been a bit of a trauma tackling each one but it’s getting easier. It’s so worth it to feel fresh again, and apart from that it feels lovely and soothing having warm water flowing over your sore arm. My goal is to be able to shower alone, maybe the shower after next. I appreciate some people don’t have anyone to help them, so here are a couple of hacks to help.

  1. Baby wipes. Time to imagine you’re at a music festival living in a tent! Best way to keep clean? Wipe where you can reach!
  2. Dry shampoo. OMG – revelation. I remember the dry shampoo my mum used in the seventies – kind of like fine talc in your hair. It’s come on leaps and bounds, I am SO impressed! I’m blonde, so I’m using the Batiste blonde spray shampoo. It’s so easy and works like magic.

2017-07-16 11.50.24

3. You shouldn’t shower in your regular sling, it would make it heavy and uncomfortable and lead to sores on your skin where you leave it wet. It’s probably bad for bacteria and stuff as well. The first two showers I had, Geoff removed the sling for me and I used my right arm to support my limp lower left arm – which gave me a slight feeling of security but left me unable to hold anything for balance, wash or do anything with the taps. You need someone to help you if doing it this way.

The third time we made an improvised sling. I read somewhere about using a pair of tights to make a proxy sling for in the shower. I grabbed a little cotton scarf that would dry quickly. My husband ties it round my neck so it is tensioned to the same length as my collar and cuff, then removes the proper sling. This provides enough support and security to allow you to use your other hand to assist in the showering process.

  1. Getting the sling back on. It’s really scary taking it off at first – but it’s getting it back on that’s miserable. My left hand is swollen – sausage fingers – so the gap is narrower, you’re pushing the lower arm back towards the elbow, which hurts, and if your skin is still slightly damp it makes it all the trickier. I was almost in tears, yelling ‘No, no, wait!’ and having to deep breathe and relax and get a grip on myself. We tried talcum powder the second time, which did help. The secret is to make sure your ‘broken’ hand is as dry as possible to make slipping it through the loop in the cuff as frictionless as can be.

Time three, I was sitting air-drying on the bed (nicer if it’s summer!!) and asked husband to give me a pillow to rest my arm on. With my sling hanging ready round my neck, I was able to put my own wrist back through the cuff – progress! The fourth time this was even easier. We’re getting there.

  1. Don’t neglect your teeth. You can face life and other people better with a fresh mouth, and, lord knows, toothache is the last thing you need right now. But how the hell do you rinse and spit if you can’t lean forward over the sink? Simples! With a glass or mug in front of your mouth. Brush (carefully at first, the jiggling wobbles your arm and hurts…), then spit your foam into the mug, tip it out, rinse, sloosh, spit, tip. It’s long-winded but it works without getting foamy saliva all down your chest.

Dressing

The clothes I had come home from hospital in had to be cut from my body the next morning. Only an old t-shirt and stretchy netball dress. I knew I was going to be housebound for a few weeks so only comfort would matter. The problem is, what can you wear that doesn’t involve having to lift your arm? Putting on a bra is out of the question for now. Luckily for me it’s summer, and the ideal solution is to wear stretchy strapless bandeau-style summer dresses which can be pulled on upwards, under your arms, and helps get round the bra issue. I already have one maxi-dress in this style and put out a request on Facebook for others to borrow from friends. One friend popped round later that day with two perfect shorter examples she’d bought on a beach holiday, and I’ve been cycling through these three dresses since then. You can buy them very cheaply on ebay so I might order a couple more.

Another thing I hadn’t expected at all was the swelling and bloating. My tummy has billowed out as if I’m six months pregnant. Rock solid – I’m sure this is a reaction to the pain relief meds, but I’m swollen in my legs and hand too so who can say? My friends have suggested it’s nature’s way of providing me with a little shelf to rest my broken arm on. Anyway, I’m glad I have these sundresses as they are nice and loose – not sure I could bear anything with a waistband right now!

When it got cooler, I needed a cover up, so the ideal thing, as I’d read online, was an oversized man’s shirt with your good arm through the sleeve and the other held inside, with one button done up to keep it in place. This feels really nice and snug. Also it acts as a bib when you spill food down yourself!

I haven’t been worrying much about underwear – but actually it has been OK getting pants (as in knickers) on and off. It’s my feet I need to think of next. I’ve been totally barefoot for 12 days. It feels safer and is no hassle. But now they’ve been getting chilly at night. Not sure I want socks on, so I’m going to ask hubby to look for my duvet slippers today. Stylish!!

Oh – and I haven’t bothered changing at night. I think some people might struggle with the idea of not separating day and nightwear. But this is only for a short while. Comfort is the main thing – I don’t mind getting a bit grubby and crumpled. I’m changing outfit every three days when I shower.

Really would like to hear from other people their tips and tricks for day-to-day living with a broken arm. What clothing have you been able to put on? Wearing normal t shirts and tops is going to be an accomplishment – how long did it take you to be able to do that? Ladies – what about bras? I’ve got a couple of front-loader sports bras which I think are going to be very handy once I’m ready for that.

Fragile Days 1, 2 and 3

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The scariest thing about a mid-shaft humeral fracture is that it isn’t protected by a cast. That was an eye-opener, being sent home with just a collar and cuff. I’d always thought those were for people with minor wrist injuries, not major limb breaks! The idea is that gravity provides the traction needed to align the bones. It’s the ‘natural’ way to set them, referred to as the ‘conservative’ approach vs surgery/pinning. There are massive drawbacks though.

Staying vertical

You have to keep the upper arm as loose and vertically suspended and relaxed as possible. For the first few days, I spent a lot of time sitting bolt upright on the sofa or standing at a kitchen counter, or sitting at my desktop pc. The problems come with moving from one state to another. Standing up from the sofa got harder and harder. At first I was all bravado… “My quads are going to get a great workout!”. It is certainly easier to push up through your legs. You can’t lean at all, well, not by much, without feeling your bone shifting and pain shooting through your lower arm. So the best way to get to standing is to squat and push up. Going to the loo gets easier with practice. I have been staying downstairs to use the downstairs loo, which is narrow so enables me to grip the radiator on the right hand side to balance while sitting down and up. After one day though, with all this standing and sitting vertically, my lower legs began to swell again, and my muscles got tired. More on this swelling later.

the best way to get to standing is to squat and push up

In any case, I decided after a couple of days not to try to be brave, but just to avoid sitting down low if I didn’t have to, and to make sure I had a support of some kind to my right or to ask for help if I needed it. I even tried a walking stick to try and stand but that didn’t work. I rejected the low garden chairs and asked for my office chair to be taken outside.

Sleeping

If you need to stay upright, how do you sleep? On day 1, husband Geoff made me a nest in one corner of the sofa, with loads of pillows and cushions to hold me up while I slept. The problem is, twisting to lift your feet off the floor is agony, and over night, as you relax, you flop backwards into the sofa or sideways onto your bad arm. Getting back up to the vertical feels panicky and painful. If you manage, exhausted, to find a comfortable position to sleep, it doesn’t last long, your lower back, hips and legs get stiff. For the first two nights I spent a few hours at a time with my legs on the floor, asleep sitting propped up on the sofa.  Best I could do but it wasn’t ideal. Getting up in the night for pain relief or the toilet was a whole traumatic experience leading to at least an hour awake, making strategies for getting to my feet, trying, failing and trying again. No fun at all.

The second night I awoke in pain at about 5am and decided to make the expedition upstairs to wake my husband for some co-codamol I had stored away in the bathroom. I knew taking co-codamol on top of my prescribed paracetamol and codeine was a bad idea but I was desperate. I decided to call my doctor in the morning for advice on how to better get through the  night – perhaps something to knock me out so I could get at least six hours, perhaps…?

like the princess and the pea

I started to realise I needed to come up with a better solution for sleeping. For the 3rd and 4th nights I experimented with different ends of the sofa and with piling on more sofa cushions to give me more height vs the floor – like the princess and the pea. But by Day 4 Friday, I also had another idea… I started looking for a reclining chair.

Feeling vulnerable

With your arm supported only by a piece of spongey sling at the wrist and round the neck, your broken arm feels terribly exposed. If you think about it, with the humerus bone snapped, the entire lower arm is connected by just the muscle, tendons, arteries and nerves, it sometimes feels like an artificial limb dangling off a living stump. Every little movement results in a crunching, grinding or popping sensation, with or without pain. Sometimes the bone pops out sideways again, making the muscle spasm and tense involuntarily.

You become quite scared in order to protect your injured limb. Tiny jolts can cause it to spasm – so you do anything to avoid tiny jolts. You walk around at snail’s pace, carefully placing one foot in front of the other. Gliding as much as possible. Don’t knock into doorways, countertops, other people. I am SO glad not to have boisterous small children or pets around. Avoid steps… stepping down with your injured-side leg first is OK – but stepping back up on either side is hard without help or a support to keep you on the vertical.

my husband and I manoeuvre around each other like tanks

Even now, the idea of falling, or of being attacked by an intruder, keep popping into my mind as I shuffle around the house. It’s hard not to become fearful. There’s definitely no question of going anywhere away from the house and garden until I have to for my next X -ray. It’s lovely when friends come round to chat – it has been brilliant having them round, but there’s a tacit understanding they need to keep their distance – don’t touch me. My husband and I manoeuvre around each other like tanks, being careful not to collide anywhere. He moves towards me proffering a cushion for comfort, I flinch. It’s not nice at all.

Relax and let it hang

If you get it wrong in the first days, you will find your bone sticking out again and locked out of position, with your muscle firm and proud. This really hurts and feels uncomfortable and it’s easy to panic and tense up. Each time this happened to me I said out loud to myself, ‘Relax, breathe, loosen. Relax, breathe…’ and by allowing my left shoulder to relax and droop and my arm to dangle, eventually gravity pulls the bones back into alignment with a series of pops and clicks. Such a relief!

 

After a few days you will work out what works for you and what range of motion you can manage. I find I can lean a little to my right so that left upper arm is stretched along my ribs and supported by my torso. You have to be careful straightening up again though.

I’ve also learned I can lean forward slightly so long as I allow my left arm to dangle in its sling and on the vertical still. This helps to get your arm back if it clicks out. It has proven helpful for washing and drying myself and changing my dress.

 

 

 

 

 

Bone density part 1

~ k4thybrown ~ Leave a comment

I’m calling Monday 3rd July ‘Day 0’. Given that I wasn’t seen in A and E until 2am on Tuesday 4th, the Monday doesn’t really count, so from here on in, I’ll be referring to individual days as a count from Tuesday 4th =1. Today is day 11 so I’m trying to capture as much of my early days experience as quickly and accurately as I can before too much time passes. After all I’m a 50-year-old woman with my fair share of memory fog.

My age raises an interesting concern: the possibility that my arm broke due to bone density issues. The thought didn’t cross my mind – to me I’d just gone down in a convincing spiralling ‘splat’ against hard tarmac – but my GP raised it in a phone call I had on day 3. I’ll get back to this later, I’m sure. He’s insisting that I arrange a bone density scan after my fracture clinic visit at Frimley Park next Thursday. I feel a bit sulky at the suggestion – after all I eat healthily, and exercise more than most women of my age, I resent the idea that I’m a candidate for osteoporosis. As I said to my netball team friends – ‘You should see how much cheese I eat!’

Happy after our little run, Day -1

Funny thing is, this very concern had crossed my mind only the day before my fall. I had been for a gentle 5km run around the parkrun course at Rushmoor, Aldershot, on the Sunday. It was a ‘getting back into running’ jog to get my legs turning over after six weeks off due to heavy work commitments and an infected blackfly bite. Coincidentally I had sustained the blackfly bite at netball three weeks previously. I am very prone to them and always react horribly with bloated, infected legs. The swelling on my left lower leg had finally receded and I was ready to start the road back to running fitness. I loved my run! On the way back with Geoff I commented that as part of losing weight and getting fit I really ought to look up alkalizing diets, as I was conscious that with perimenopause under way I should be giving my bones the best possible chance. Oh the irony! So I have very mixed feelings about getting my bone density checked but ultimately it will be worth knowing if this turns out to have been a factor. I will be able to take whatever appropriate measures are recommended. I still think it was just the force of the fall though… we shall see.

In the meantime I have been finding out about best bone-strengthening foods and minerals to help speed my recovery. Here’s a fabulous article from Betterbones.com.

On the plus side

~ k4thybrown ~ Leave a comment

As I fell, the thought which flashed through my mind was ‘Don’t crack your head!’ So I didn’t, which is a plus. I was surrounded by friendly faces who knew how to make me comfortable and to call an ambulance – which was lucky. My husband was at home and only ten minutes’ drive away, which was a bonus.

The journey to the hospital, as previously mentioned, could have been smoother, but at each bend or bump in the road I thought, ‘Thank goodness I only have one limb affected.’ I couldn’t help but remember, as I cradled my poorly arm in its loose sling, people whom I knew had suffered more than one fracture – my friend Marjory’s mum in a car crash last year, my friend Jilly and her daughters with brittle bones, a former colleague’s near-death motorbike crash… one break is bad enough, what on earth would multiple ones be like? Eek!

Then I started thinking about those movies where someone is called upon to escape or change location with a broken limb… and I’m thinking yeah, right, you’d never be able to do that! But it must happen in real life, there must be people who daily suffer in countless ways while also sustaining a fracture, who manage to get through it. Then I thought of people who don’t come out unscathed. The guy at our parkrun whose broken ankle became infected, leading to amputation of his lower leg; the friend of a colleague whose leg was in plaster when he developed thrombosis and died, and so on… I suddenly felt very fortunate indeed with my paltry broken humerus. I started thinking not of the things I would not be able to do, but the things I could *still* do, must try to get better for, and would challenge myself to do.

As the days have gone by I’ve felt very lucky in many other ways and continue to do so…

  • It’s summer, so I don’t have to worry about dressing to keep warm. I can pad about barefoot and step into the garden for vitamin D
  • I have a wonderful husband who goes out of his way to care for me
  • I live in a civilised country with access to free healthcare.
  • I don’t have small children to care for
  • I don’t have pets to worry about
  • It’s a clean, apparently uncomplicated, break
  • I’m not ill in other ways. The thought of being sick and needing to vomit is a terrifying one when I can barely squat to pick things up from a coffee table, let alone kneel and stand again (I can’t lean off vertical at all – we’ll come to the ‘can’ts’ later!)
  • I work at home – so can carry on best I can with my business while taking the time I need to rest
  • Because I work at home I can slob about in whatever is most comfortable to wear
  • I’m just coming to the end of a really busy period at work so there is an opportunity ahead to get some proper rest without feeling guilty
  • I was reasonably fit at the time of my tumble. Although I’d had the infected leg, my history over the past three years includes lots of distance and trail running, some weight loss and strengthening exercises. This meant I recognised really quickly that squatting slightly and using my thighs to stand, get up and down from the loo, go up and down stairs etc, would be useful to me.
  • I found my monster chair after five days in a hospice shop and it’s been a godsend.
  • Lovely friends have rallied round to visit, keep me company, bring food, flowers, fruit, puzzles and activities and strapless sundresses.

Things could be so much worse. I’m a very lucky lady.