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.
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.
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.
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.