PT Leads to more PT...

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Ji in Hawaii
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PT Leads to more PT...

#1 Post by Ji in Hawaii » Wed May 02, 2018 12:21 am

I was at my physical therapy session on the 12th for my chronic back issues. My wife dropped me off and went shopping. After my session I called her up to come pick me up. The PT happens at a waterfront YWCA near my old childhood clam digging grounds. I decided to wait for my wife at a picnic table right near the shoreline. I got there and looking at the water I started reminiscing about my childhood spending time with my dad digging for clams and fishing the bay 50 years ago. I sat for about a minute then decided to take a closer look at the water's edge. I took about 3 steps then suddenly my leg drops into a hole and I hear a loud SNAP! and I'm on the ground and look at my left leg and see my feet disconnected from my leg and at a weird angle. This happened so quick a matter of seconds. I had a compound fracture and could not get up at all. I felt so stupid and angry at myself even though the hole was hidden by the lush green grass. I yelled for the PT staff and they finally showed after several minutes and they carried me to my wife's car and she drove me to the ER. Surprisingly very little pain though seeing my lifeless foot dangling at a unnatural angle was pretty gross looking. I suffered a trimalleolar fracture (3 bones of the ankle) and went into surgery the next day (Friday the 13th). Now I have new screws and plates in my ankle to match the hardware in my back. I wonder if I'll set off the metal detector at the airport now. I was in the hospital for 3 days but the day they sent me home I was starting to feel very weak. When I got home I took a 3 hour nap but when I awoke I was SO weak, and when I tried to move all my muscles were extremely sore. I called the hospital, and they said come right back so I was in the ER again on the evening of the 14th. Blood tests showed I was suffering from Rhabdomyolysis a side effect of my traumatic injury suspectedly combined with the anesthesia used during my surgery. My blood was flooded with CK or creatine kinase released from injured tissue. Normal levels are 50 to 220, my blood had 25000. 5 days of intravenous flushing with saline got me down to a CT count of 3000 and they sent me home with instructions to drink plenty of fluids to finish the flushing process. I drank and pee'd 5 gallons of lemon water every day for a week. On Friday at my followup visit my CK levels were down to 146 so normal. The Rhabdomyolysis was way more suffering than my broken ankle. This was the first time I ever broke a bone. Maybe they're getting brittle with old age. I'll never forget the SNAP sound of my bones breaking almost sounded like a 22 short.

Before & After photos below
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Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

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Re: PT Leads to more PT...

#2 Post by piller » Wed May 02, 2018 2:14 am

Ouch! I have had a few broken bones, and they hurt less than a tissue injury and heal faster. You should be OK in about 6 weeks. Get plenty of calcium and vitamin D.

From now on watch out for those holes which are probably left over from when you dug them as a kid. The ghost of a clam was waiting to get revenge.

Heal well.
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Re: PT Leads to more PT...

#3 Post by gamekeeper » Wed May 02, 2018 2:58 am

Sorry to hear about your broken ankle Ji, I hope you heal well and quickly.
As Piller said, probably a ghost clam is responsible.
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Ji in Hawaii
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Re: PT Leads to more PT...

#4 Post by Ji in Hawaii » Wed May 02, 2018 5:15 am

This hole was several yards up from the water in the grassy lawn. The clams lived underwater 50 yards out from shore in the mud flats and were dug up at low tide, no holes ever left. Digging for clams 50 years ago has absolutely nothing to do with this injury.
We have no prairie dogs, gophers, moles, etc. that dig holes in lawns. What I suspect from the location of the hole is that at one time there was a sign post there and once the post rusts away usually the old post is dug up concrete base and all for disposal leaving a hole that should have been covered but due to laziness or forgetfulness the hole was left and grass grew back hiding the hole an unintentional boobie trap. :o
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Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

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Re: PT Leads to more PT...

#5 Post by fordwannabe » Wed May 02, 2018 6:01 am

Wow Ji, sorry to hear this. Heal well
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Re: PT Leads to more PT...

#6 Post by J Miller » Wed May 02, 2018 7:24 am

JI,

Rest up and heal, being flat on your back is no fun.

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Re: PT Leads to more PT...

#7 Post by Bill in Oregon » Wed May 02, 2018 9:13 am

That's the stuff of nightmares right there Ji! Hope the healing is quick and complete.
Man, I will watch my step as I am having PT for my back right now, too.

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Re: PT Leads to more PT...

#8 Post by ollogger » Wed May 02, 2018 10:17 am

WOW, glad you have most of the worst over, I too have been the victim of un fore seen circumstance's, so far none
of them has killed me yet




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Re: PT Leads to more PT...

#9 Post by mikld » Wed May 02, 2018 10:31 am

Yeah, day dreamin' about clams will do it every time... :roll: Rest easy and heal quickly...
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Re: PT Leads to more PT...

#10 Post by 2ndovc » Wed May 02, 2018 2:53 pm

Ouch!

This group's been taking a beating!

Speedy recovery, Sir!

jb 8)
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Re: PT Leads to more PT...

#11 Post by Nath » Wed May 02, 2018 3:01 pm

Ji, heal our friend.
Isaiah 40: 25-29.

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Re: PT Leads to more PT...

#12 Post by Pitchy » Wed May 02, 2018 3:06 pm

Bummer pard, hope ya heal up fast.
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Re: PT Leads to more PT...

#13 Post by BlaineG » Wed May 02, 2018 3:22 pm

Prayers and Good Thoughts coming your way.
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Re: PT Leads to more PT...

#14 Post by AJMD429 » Wed May 02, 2018 3:36 pm

Prayers up.

Be sure your testosterone level, and vitamin D level are pretty high, and calcium/magnesium/protein intake stay good. Ask your doc if calcitonin nasal spray or Forteo shots would speed bone growrh (orthos use both 'off-label' here sometimes).

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Re: PT Leads to more PT...

#15 Post by Sixgun » Wed May 02, 2018 4:36 pm

Whoa! That pic makes my run over leg look like a bee sting. But....the smile on your face shows the positivity of your dilemma..... I wish I could be positive.----6
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Re: PT Leads to more PT...

#16 Post by Ysabel Kid » Wed May 02, 2018 8:57 pm

Holy Moly! :shock:

Prayers up Ji. I hope you heal better than before!!!
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Re: PT Leads to more PT...

#17 Post by piller » Wed May 02, 2018 9:35 pm

Ji, I was just teasing about the hole being the ghost of a clam haunting you. As far as the sign post theory, yes it sounds about right. I have worked with people who would leave a hole like that. They were fast at finishing the job because they never took the time to do it right.

AJMD429 gave good advice about the bone growth promoter meds. If your Doctor will prescribe calcitonin nasal spray, it would help a lot. If he refuses the nasal spray, then Forteo injections are also good. Those two are shown to build bone density. The pills are only proven to slow down bone loss. Worse, the pills cause stomach upset and are difficult to take.

Calcium is necessary. Approximately 500 mg at eact meal, and get 1,000 units of Vitamin D3 with each dose of calcium for about the first 2 to 4 weeks, then you can go down to 1,000 units daily if the healing is progressing well. 15 minutes of sunlight daily is good. I know that we are told to avoid sunlight to avoid cancer, but sunlight turns cholesterol into vitamin D. The companies who sponsor the studies which say to avoid sunlight are the ones who make statin drugs.
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Re: PT Leads to more PT...

#18 Post by rossim92 » Thu May 03, 2018 1:59 am

fair warning! I hit a buck on my ride and broke my right ankle. Have two screws in it. after coming in from cold weather and when you walk on concrete floors will make the ankle hurt. It does on mine, just not as bad now as did at first about eight years ago. I was out of work for four months. Therapy will a bit rough till your mobility back. I lost about 20% percent of motion range in my ankle. makes climbing ladders and hills a bit difficult. I wish you a speedy recovery and long health. :D
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Re: PT Leads to more PT...

#19 Post by GunnyMack » Thu May 03, 2018 5:06 am

Geeze Ji talk about a step in the wrong direction! Hope you heal well and fast!
Your story kinda reminds me of my 26th birthday. Long story short I had an argument with a tree stand, broke left wrist after falling. Had to walk out, drove out, borrowed phone at veterinarians office to call Doc, no we can't help you. Another office yes we can X-ray, go there, no we can't help you- you need surgery. Have to go to specialist. Off I go into this office in full camo, face paint & all- YOU COULD HAVE HEARD A MOUSE FART!
When doc finally saw me he says you need surgery to pin a 90 degree fracture. Then he says oh I see you don't have insurance, you don't need surgery...WTF!? Do I or don't I ?
Worst part of was when I got home my dog saw what she took as a rawhide bone, grabbed my wrist by the cast!

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Re: PT Leads to more PT...

#20 Post by .45colt » Thu May 03, 2018 6:15 am

Man that's a tough one. ! I wish You a speedy recovery. It's a good thing You live where You do as the damp/cold in Ohio would make it much worse.

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Re: PT Leads to more PT...

#21 Post by octagon » Thu May 03, 2018 6:10 pm

Heal quickly Ji. Hope they used some locktite on all that hardware! :D

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Re: PT Leads to more PT...

#22 Post by 30-30 » Sat May 05, 2018 1:57 am

prayers sent....big OUCH! ... :)
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Re: PT Leads to more PT...

#23 Post by Paladin » Sat May 05, 2018 7:43 pm

Heal ASAP with as little pain as possible.
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Re: PT Leads to more PT...

#24 Post by Rusty » Sun May 06, 2018 10:12 pm

Oh Ji, how I wish you were in Florida. So sorry to hear this brother. I'll be praying for you. Since you don't have anything to do now you can start posting more pictures of that beautiful water around you.
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Re: PT Leads to more PT...

#25 Post by RKrodle » Thu May 10, 2018 8:18 pm

Heal well ol friend.
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Re: PT Leads to more PT...

#26 Post by Griff » Thu May 10, 2018 9:40 pm

Heal well. Stuff happens! Prayers up!
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Re: PT Leads to more PT...

#27 Post by Ji in Hawaii » Sat May 12, 2018 6:43 pm

Aloha kakou gentlemen and a hearty mahalo a nui loa for all your positive thoughts and well wishes. Yes told the surgeon to make sure he uses the red Lock-Tite on all the screws, I assumed he followed through. I have been taking calcium, magnesium citrate, and D3 but never heard of the shots or nasal spray. I shall mention it to my doctor asap. My cast is off but I have to wear a boot whenever I'm up and about. I have never broken a bone before in all my almost 60 years but I still appreciate not having to wear a cast so long and having to deal with an itch inside one. Showering much easier not having a cast too. My foot is still numb and stiff 3 weeks after the surgery. Is this normal? I can't get my foot to bend a normal 90 degrees, extremely tight and a tad sore when trying to bend up. Should I force stretch it or is it too early? When my doc removed the cast acouple weeks ago he said I should start stretching right away but when I do I am more sore than before. I am on the last of my pain meds and debating on getting a refill. It is Hydrocodone and it takes the edge off the pain but I fear addiction. Should I? Thank you again for all the encouragement, and best wishes to you all especially to those suffering similar trials & tribulations. 😣
Illegitimus Non Carborundum
Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

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Re: PT Leads to more PT...

#28 Post by piller » Sun May 13, 2018 1:00 am

Hydrocodone, and all opioid pain relievers, have a funny biological safety mechanism. When used for actual physical pain, the addiction risk is Very Low! When used without pain, the addiction risk becomes BIG! Just using enough to knock the edge off of the pain while still leaving a little pain to remind you to be careful will carry only a small addiction risk.

As far as the stretching, there is some new scar tissue in there to loosen up. You might or might not regain full range of motion. Keep working it. The more you work it the better. Don't damage yourself further.

Good luck Ji.
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Re: PT Leads to more PT...

#29 Post by Old No7 » Sun May 13, 2018 10:21 pm

Good luck with the recovery Ji!

I just added some boat pictures to the "Poop Deck" post for you... Take a look. :wink:

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Re: PT Leads to more PT...

#30 Post by Malamute » Mon May 14, 2018 11:21 am

Holy cow man! You better quite being so wild and crazy! :D

Hope you heal up well.
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Re: PT Leads to more PT...

#31 Post by Mainehunter » Wed May 16, 2018 7:23 pm

OMG..... :shock: Ji! Slow Down!!!!!!!

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Re: PT Leads to more PT...

#32 Post by Old Savage » Thu May 17, 2018 4:44 am

Wow that is ugly. Ji, I hope this comes along well for you from here on out. You certainly have been through it. Won't set off the airport alarms. I have a lot more metal and coming to the big island last year no airport alerts.
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Re: PT Leads to more PT...

#33 Post by Old Savage » Thu May 17, 2018 4:48 am

Is the tibia maleolus a refracture of an old fracture?
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Re: PT Leads to more PT...

#34 Post by Ji in Hawaii » Thu May 17, 2018 5:12 am

I had been requesting a refill for my hydrocodone via email since last week but no reply from the pharmacy, my doctor, and when I call they put me on hold and don't pick back up. I ran out of meds last Friday and I have been going thru increasingly terrible withdrawal symptoms due to my sensitivity to opiates. They finally email me today that my refill has been approved but I replied that I do not want to go thru withdrawals again, cancel the order, thanks allot. My left foot throbs with pain when not elevated, and it is extremely stiff and difficult to move to perform my stretching exercises. I'm taking extra strength Tylenol right now but not much good that is. Any suggestions on a non-opioid pain killer stronger than acetaminophen or ibuprofen? A couple friends suggested medical marijuana but I don't smoke, and never touched the stuff even in high school so would rather avoid it now even in brownies. Is the active ingredient available in pill form. I tried the drops but it does nothing for me. Maybe ice packs before and after stretching my foot? Thanks for the support!
Illegitimus Non Carborundum
Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

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Re: PT Leads to more PT...

#35 Post by Ji in Hawaii » Thu May 17, 2018 5:18 am

Old Savage wrote:
Thu May 17, 2018 4:48 am
Is the tibia maleolus a refracture of an old fracture?
First time I ever broke a bone in my body, I read in report it's a trimalleolar fracture which includes the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia aka the posterior malleolus thus a trimalleolar.
What's weird is I heard it snap like a crack of a 22 rifle but didn't feel much pain. It was more painful when they removed the staples from my skin. Foot still swollen and stiff.
Illegitimus Non Carborundum
Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

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Re: PT Leads to more PT...

#36 Post by Old Savage » Thu May 17, 2018 11:34 am

I broke my elbow at age 16 and again at 27. At 27 they said it was an old fracture that had worn smooth and then joined by cartilage. Yours had the same look. Did you ever sprain that ankle? I have had a dozen fractures, some were very painful, others not at all.
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Re: PT Leads to more PT...

#37 Post by Pete44ru » Fri May 18, 2018 12:08 am

.

Bad ju-ju, Ji - I hope your recovery goes speedily.

I would suggest you stay away from where you might have to flee from the lava, too... ;)

(Seriously, I hope you/yours aren't effected directly by the eruptions there this past couple of weeks.)

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IF IN THESE TYMES OF JEOPARDY,
MORTAL PERIL INVADES THY THOUGHT,
TAKE UP THIS TRVSTY PIECE,
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Re: PT Leads to more PT...

#38 Post by Ji in Hawaii » Sat May 19, 2018 2:53 am

Old Savage wrote:
Thu May 17, 2018 11:34 am
Did you ever sprain that ankle? I have had a dozen fractures, some were very painful, others not at all.
I come from a long line of thick boned scottsmen. Those body weight fat index weight charts don't work with my family. I'm 5'10, and when l got married l was skin and bones and weighed 165 pounds which is heavy for my height. 180 is about the lightest l want to be without looking annorexic. Like l said before l have never broken a bone in my body in my whole life not even a sprained ankle. I am pushing 60 so maybe my thick bones are finally getting brittle with old age.
Illegitimus Non Carborundum
Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

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Old Savage
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Re: PT Leads to more PT...

#39 Post by Old Savage » Sun May 20, 2018 12:16 pm

Ji, thought about you all day yesterday hiking through this
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piller
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Re: PT Leads to more PT...

#40 Post by piller » Sun May 20, 2018 7:14 pm

Ji,I suggest that you ask for Meloxicam 15 mg. It is a pretty good anti-inflammatory and it doesn't seem to tear up the stomach as bad as some do. For the first 5 days, and only 5 days, you should ask for Ketorolac 10 mg to be taken every 6 hours. After that, you really need to switch to something else so that you don't burn a hole in your stomach. Always take Ketorolac with food or an antacid such as Rolaids or Tums. It is harsh on the stomach, and has a Black Box Warning against using it more than the manufacturer says. Black Box Warnings are the last step before the FDA yanks it from the market due to a probable issue. Anything more than 20 tablets in 5 days, and you run an extremely high risk for causing a bleeding ulcer. However, it is a very strong anti-inflammatory and pain reliever without being any sort of narcotic/opiate. It is useful for situations such as yours, and that is why Doctors and Pharmacists are fighting to keep it available.

There are other anti-inflammatories which work well, but they carry a higher risk of stomach issues than Meloxicam does. Meloxicam is not without risk, but as it hits the cyclooxygenase pathway at point 2 instead of point 1 such as Ibuprofen, Diclofenac, Ketoprofen, Etodolac, and several others, it is a lower risk for ulcers. Not low or no risk, but lower than the others. It is once daily, and works pretty well. It is in the top 200 fastest moving medicines throughout the U.S.

One other possibility is a cycle of Prednisone or Methylprednisolone. They are steroids, but not the kind to cause the big muscles and heart attack. They are mineralocorticoid steroids, and they reduce inflammation. Not the most fun due to the side effects, but they work. The side effects can include insomnia, anger, irritability, and nervousness. They work!

If you have any questions, or want more suggestions, just post. I will help as much as I can.
D. Brian Casady
Quid Llatine Dictum Sit, Altum Viditur.
Advanced is being able to do the basics while your leg is on fire---Bill Jeans
Don't ever take a fence down until you know why it was put up---Robert Frost

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Ji in Hawaii
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Re: PT Leads to more PT...

#41 Post by Ji in Hawaii » Sun May 20, 2018 7:46 pm

I have been taking Meloxicam for several years for my chronic back pain but I ran out. I tried to get a refill but my doctor refuses to give me a refill without coming in for a visit. I told him I can't drive and have to keep my foot elevated. I asked him to call in the refill to my nearby pharmacy but he claims he can't do that with WC cases. I know that's not true as with previous doctors that was the only way I got my meds. What I found out is that all the doctors I have dealt with here hate to hear suggestions from their patients, I think it hurts their pride. My inquiries on calcitonin nasal spray, and Forteo injections were shot down without much thought. I guess I'm stuck taking less effective over the counter meds.
Illegitimus Non Carborundum
Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

piller
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Re: PT Leads to more PT...

#42 Post by piller » Sun May 20, 2018 9:55 pm

That sucks. Sorry to hear that.
D. Brian Casady
Quid Llatine Dictum Sit, Altum Viditur.
Advanced is being able to do the basics while your leg is on fire---Bill Jeans
Don't ever take a fence down until you know why it was put up---Robert Frost

piller
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Re: PT Leads to more PT...

#43 Post by piller » Wed May 23, 2018 11:17 pm

Hey Ji, are the winds blowing the volcanic ash far enough to reach where you are?
D. Brian Casady
Quid Llatine Dictum Sit, Altum Viditur.
Advanced is being able to do the basics while your leg is on fire---Bill Jeans
Don't ever take a fence down until you know why it was put up---Robert Frost

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Ji in Hawaii
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Re: PT Leads to more PT...

#44 Post by Ji in Hawaii » Thu May 24, 2018 7:33 am

piller wrote:
Wed May 23, 2018 11:17 pm
Hey Ji, are the winds blowing the volcanic ash far enough to reach where you are?
The prevailing winds are northeast trade winds so all that pollution (Volcanic+fog=vog) is blown southwest away from us. If the wind swings around to what we call "Kona Winds" blowing from the southeast then we are in trouble. Air quality and visibility plummets, worse than 1960s LA smog.
Illegitimus Non Carborundum
Akā, ʻo ka poʻe hilinaʻi aku iā Iēhova, e ulu hou nō ko lākou ikaika;
E piʻi ʻēheu aku nō lākou i luna, e like me nā ʻaito;
E holo nō lākou, ʻaʻole hoʻi e māloʻeloʻe,
E hele mua nō lākou, ʻaʻole hoʻi e maʻule.
`Isaia 40:31

piller
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Posts: 7353
Joined: Sat Sep 29, 2007 9:49 pm
Location: South of Dallas

Re: PT Leads to more PT...

#45 Post by piller » Thu May 24, 2018 10:31 pm

I hope the winds keep blowing it away from you.
D. Brian Casady
Quid Llatine Dictum Sit, Altum Viditur.
Advanced is being able to do the basics while your leg is on fire---Bill Jeans
Don't ever take a fence down until you know why it was put up---Robert Frost

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