This one I've had some experience with. It's interesting to note that I no longer have a scar from a compound fracture of my ring finger, but rather from an open fracture. Treatment for it certainly agreed with the BUFF guidelines; I had a whacking great boxing glove over the entire hand for several months.

Posted September 12, 2007 6:02 PM by Linkmeister

"Without traction splinting a fractured femur is 80% fatal. With traction splinting, it’s only 20% fatal."

I am just now realizing that my little brother nearly died when he was ten. (He's 38 now, and fine.)

Posted September 12, 2007 6:08 PM by Yatima

Cracked ribs (they didn't get x-rayed, so I don't know how bad it was): 'rib belt' which is some kind of hybrid of 'Ace' bandage and long-line bra. It hurt less with the thing on, but I wouldn't recommend giggling with broken ribs, and ROFLMAO is right out.

Posted September 12, 2007 6:14 PM by P J Evans

I'm confused by what you say on "how to hold c-spine". You say to stand behind the patient, but I'm expecting the patient to be lying on the ground at least some of the time. This makes standing while reaching down to do this seem ridiculous, and also makes "behind" somewhat unclear. I haven't looked at any of the references in that section, maybe they make it obvious; but delineating the positions better would help a lot (and it'd still be easy to adapt to related positions).

Also (and I may be dangerously stupid here), it seems like standing up isn't a safe position for a person with a possible spine injury. On the other hand having them lie down constitutes "moving them" in some sense, too.

Posted September 12, 2007 6:17 PM by David Dyer-Bennet

All this reminds me of a section of the early seventh century Alamannic laws: "If anyone breaks another person's head so that the very bone is detached from the head and makes a sound when thrown at a shield across the road, let him pay six solidi..."

I used to have a history professor who liked to use that passage to point out that, unlike modern legislation, medieval laws were not written with the intent that they should be interpreted literally.

Posted September 12, 2007 6:49 PM by Ariella

Okay, the thing with neck injuries.

Oftentimes the guy will be standing or walking around, or sitting in an automobile. You'll be able to get behind him then.

If the person is lying down, kneel at the top of his head and hold his head and neck in-line with his body.

Getting to a place where you can actually hold c-spine sometimes requires that you pass the EMT Ingenuity Test.

Posted September 12, 2007 6:49 PM by James D. Macdonald

PJ Evans (#3): I hear you. My experience with three broken (not just cracked) ribs included a bout of hiccups.

Not recommended.

Posted September 12, 2007 6:55 PM by Janet Miles

Are there multiple ways to pop shoulders in depending on which way they were dislocated, or does one way work for everything?

For my husband's dislocated shoulder, I do the crawl stroke motion:
Upper arm pointed straight out to the side and lower arm pointed up, elbow at a right angle.
Rotate lower arm forward until it's parallel to the ground.
Pull in the direction the upper arm is pointing, and listen for the wet pop and sigh of relief.

Posted September 12, 2007 7:11 PM by shadowsong

Reducing a dislocation depends on where the various bones are before you start. You need to be very familiar with normal anatomy in order to visualize where things are, and where they should wind up.

While reducing dislocations in the field is part of the Wilderness EMT protocols, it isn't something that you normally do in the field, in a situation when you can get the patient to an ER in a reasonable time. Y'see, if the joint is not only dislocated but fractured, you can do additional damage by manipulating it.

With a patient who has a history of repeated dislocations, it's usually easy to move the joint back into position, and the patient can guide you. If it's a first-time dislocation, don't mess around. And do get some formal hands-on training.

Posted September 12, 2007 7:31 PM by James D. Macdonald

The thing about fractures is: I expected them to HURT. When my sister, at seven and again at twelve, fractured a bone, she was screaming bloody murder.

So when I fell off my bike and hit my arm hard, I thought, "Well, I'm not screaming bloody murder, but I guess I'd better go to the ER just to be on the safe side" - and it was broken. Just six months later, I stepped in a hole and twisted my ankle, but I could still stand and walk on it okay. Couldn't be broken, I thought; just a sprain. That was in the summer, and I wasn't insured -- and even though I was ensured then, the broken arm cost me $2000 --, so I didn't go in until the student clinic opened the next week. That was broken too. The ankle, I mean, not the clinic.

Adrenaline can cover up for a lot.

Posted September 12, 2007 7:32 PM by Emily H.

Sometimes bones don't hurt at all when they're broken, or at least very little -- I had a green stick fracture of my elbow as a teenager (took a header over the handlebars of a bike) and my parents wouldn't believe it was broken because I wasn't hurting enough. X-ray years later established, yes, old fracture there. It hurt, but never beyond an, "Owe, I need ibuprofen!" level.

I also fell off a horse once, with my hand tangled in the reins. When I got up, I had a finger on backwards. I was somewhat in shock (also rang my bell pretty good), looked at the finger for a moment, then grabbed it, twisted the finger around the right way, and pulled on it until the dislocated joint slipped back into place. In my somewhat concussed thinking, my logic was that if I could push everything back together in a hurry it'd heal right away and not be broken and not hurt, and that it would hurt more later if the doctor had to set it. I did mention concussion, right?

The hand doctor advised me later that this is not the generally recommended way to set a broken finger. And that I'd also broken a couple bones in my hand.

It never did hurt much, though I've got a pretty good bad-weather detector in the joints of that hand now too.

Posted September 12, 2007 8:12 PM by Leva Cygnet

A few years ago, I wrote up on my livejournal the worst physical accident I ever saw. Back when I was hang gliding, a guy took a turn too close to the ground, his wing touched, and he became a guy tied to a 22' lever accelerating from a starting speed of >30 mph. (He lived.) The scariest parts: the inhuman noises of pain he made. The way he flopped around when we weren't sure if his spine was damaged.

I don't know, if a badly hurt guy is moving around, how do you get him to stop without hurting him more?

Glad you asked about holding the spine, #4 David Dyer-Bennet; I was confused about that, too. (Barry the hang glider had his head held straight by Ann as she talked him down, kneeling behind him with her hands on either side of his head, like #6 James D. Macdonald says.)

Another interesting hang glider bit: they have their very own fracture: spiral fracture of the upper arms, I believe. When the glider crashes, your body keeps on going, swinging through the triangular control frame. If you're still holding on to the control frame, the force undoes your arm bones like a twisted slinky. They drill it into your head again and again, if you crash, LET GO! Regardless, about 1 in 40 forgets in the heat of the moment.

Me, the worst I ever had was when a bag hanging from the handlebars of my bike swung into the front wheel and I went over the top like something out of Indiana Jones. Landed and took all the force on hands and knees. Did not realize I had hairline fractures in both elbows until that night at dinner at a friend's, when I went white and slid off the seat in a dead faint. Putting on shirts sucked for the next while... "You're not in a cast how bad can it be?" Bah! ;) Anyway, don't ever hang anything off the handlebars of your bike. It is never ever worth it.

Figent Figary, an ER doc in the midwest somewhere, has brilliant posts on medicine in the ER. This one has neat stuff about a guy with shoulder dislocation, but I really recommend you click the "emergency medicine" tag and read them all.

Posted September 12, 2007 8:14 PM by Madeline F

I love these posts. As an x-ray tech (Radiologic Technologist, to be official), I have been amazed at how hard it can be to convince seriously injured people, especially drunks, to lie down and hold still. Folks really do walk on dislocated hips and broken knees.

Then there's the joy of trying to keep someone's neck straight, in C-spine precautions, when they're puking. Airway first, right?

Both scary and gratifying are the fractured cervical spines, discovered three days later, when the patient finally decides to walk into the ER, stiff and sore. No, don't try to stretch out that neck, sir, please hold still. The neurosurgeon is coming to see you RIGHT NOW.

Posted September 12, 2007 8:17 PM by melospiza

Leva Cygnet #11: When the tombstone fell on my foot, there was never any pain. One of my ankles is bigger than the other now, but it never hurt.

Posted September 12, 2007 8:34 PM by ethan

Then there's the joy of trying to keep someone's neck straight, in C-spine precautions, when they're puking. Airway first, right?

Posted September 12, 2007 8:37 PM by Chris

Me, the worst I ever had was when a bag hanging from the handlebars of my bike swung into the front wheel and I went over the top like something out of Indiana Jones.

Handlebar bags are glorious things. So are front baskets, front or rear racks, and all the other assorted objects that let you carry stuff on a bike. If I'm reduced to hanging a bag off my handlebars, I *walk* the bike.

Also, it's kinda horrifying how many people end up in bike/car accidents and walk off the scene... to end up in the ER 2-4 days later. I keep reminding myself "do not leave the scene". Even if it's a low speed collision, there's pretty good odds that the cyclist took damage.

Posted September 12, 2007 8:38 PM by Emily Cartier

How do you deal with vomiting and suspected c-spine fractures?

1) The patient won't enjoy this at all. The patient will enjoy being dead even less.

2)If the patient is strapped to a long spine board, roll the entire board up on its side. Stand by with suction apparatus.

3) If the patient isn't secured, hold that c-spine with your mitts like you were Scrooge McDuck grasping your last nickle and aim his mouth at the floor. Log-roll the patient along the axis of his spine if you have to. (Get bystanders to help you. This may be a challenge. The lookie-loos tend to back off when the puke starts flying.) Suction is, again, your friend. A big ol' turkey baster will work.

4) If you get puke on you, oh well. When you decided to run over and help that guy you volunteered to get puke (and other substances) on you. It comes with the territory.

5) If his neck is broken and he moves it he may die. If he loses his airway he will die. That's your priority list, bucko.

Posted September 12, 2007 8:57 PM by James D. Macdonald

Chris # 15:

Mr. Macdonald should describe what it's like in the field. By the time I see a patient, he's on a backboard, in an immobilization collar. I don't know yet if there's a fracture or not--that's what I'm trying to find out, by x-ray or CT scan. I yell for help, turn the board while supporting the head, and hold a basin. It's messy. The patient is often fighting the restraints. A few of these in a night is the reason I refused long ago to work any more night shifts on New Year's Eve.

Posted September 12, 2007 8:57 PM by melospiza

The puking problem is one reason you get behind the patient when you're holding c-spine.

Posted September 12, 2007 9:06 PM by James D. Macdonald

It always gives me a little chill to realise the closest I've yet been to death (and hopefully, it will stay that way for a good long time) is when I was seventeen and broke my right femur while racing my brother home from church. I tripped on the edge of a curb and rolled into the street.

I had also broken my left clavicle in the roll. But when I pushed myself up just a little, I could tell my right thigh was suddenly half as short as normal, twice as big a round, and super jello-y. My little brother wanted me to move--I was lying on the edge of a dark road in the middle of a chilly November night about three houses down the street from my home--but I refused. I made him go find the nearest adult--the church bishop in the meetinghouse. (It took him about fifteen minutes to convince the bishop to come with him. Reportedly what he told the bishop was, "My sister has fallen down and she wants to talk to you." He still gets teased to this day about that.) Fortunately, it's not a heavily travelled road at all, and no cars rounded the corner, and I just lay still until a neighbour showed up. She wanted to move me, and I pretty much refused again. When the bishop and his counsellors and my brother all showed up, moving me was once again mentioned, and me, kicking into Girl Scout mode, mentioned that I thought my leg was broken and I worried about tearing an artery. (When they were talking about moving, it was all, "Oh, you can lean on me if you want." Eeesh. Thanks but no. I'll just lie here off to the side with my leg like jello.) So nobody moved me, and I told them to get their car and come park it with the lights on me, and oh, could somebody cover me with something, I was getting chilly. Anyway, fifteen minutes later, the ambulance and the EMTs showed up. They cut my clothes off of me so they could get enough local meds into me to splint me. My dad showed up about this time, and he rode to the hospital with me. I remember being all weirdly lucid about the whole experience and chatting with the EMTs and joking, and asking questions about my heart rate. I don't know if this was a weird example of shock, or if they were just humouring me and trying to keep me awake.

I remember the ambulance ride in particular because I was concentrating really really hard on being Not Tense. Every time my leg tensed, it hurt to high heaven. Then they got me to the hospital and covered me with warm towels and that was lovely. (I was kinda bummed about having my clothes cut off of me--it was my favourite outfit. My mom tried to replace it but it was never quite the same. Still....better than going into shock and dying.)

It wasn't until after my surgery that somebody finally told me that femoral fractures can be fatal in a number of ways. I kind of knew it before--what with all the Girl Scout manuals I'd read--and I knew it wasn't a good idea to move the injured person if they weren't directly in the line of traffic. But it never really sank in quite until that day.

BTW, it turned out I'd made a super clean break. There were no weird bone splinters, but there was also nothing for my bone to nestle against like a little puzzle piece and knit back together. So I went into surgery and they gave me a rod and pin. And I more or less had to keep off of it as much as possible for a month and then not run on it for a year. (Biking and swimming were my new forms of exercise, and it got me out of gym for the rest of high school.)

But yeah....that was my (knock on wood) my closest brush with death.

Emily @10: My femoral fracture REALLY hurt. I was crying with pain for a good five or ten minutes after it occured.

Posted September 12, 2007 10:47 PM by PixelFish

Janet @ 7

Not fun with mild asthma either - it's the tendency to cough. I think it was the knob on the gear shift that did it; there was a fairly impressive bruise on my thigh - not painful, but it took weeks to fade, and there was a dent for quite a while after that.

Then there was the time I was riding a bike and clipped the corner of a car. Scraped arm: minor injury. Hit left knee really well. The resulting bruise went around the medial side of the knee in the shape of a Greek e. That was unfun: a couple of weeks of extremely stiff and four months of don't-kneel-on-it.

Posted September 13, 2007 12:05 AM by P J Evans

While we're asking c-spine questions: if you arrive on the scene and your patient is lying there with his head turned to the side, do you straighten it for him and/or encourage him to straighten it before holding c-spine?

I've always assumed that the answer is "no, it's more important to avoid moving the neck than to make it perfectly straight," with a side order of "unless you don't have airway and your patient is dying, in which case you do what you gotta do." But what do I know?

(Note to self: put first aid classes back on the calendar!)

Posted September 13, 2007 12:37 AM by MikeB

In general, hold the neck in the position found. Airway takes precedence. If possible hold the head in anatomic position, but don't be yarding around on your patient's head to get it there.

Be particularly suspicious of pain, tenderness, and guarding in the neck. Crepitus is a very bad sign indeed.

Early on, the muscles may tighten up and hold fractured or dislocated bones in place. Later, as the patient relaxes or the muscles tire, the neck may become more mobile and compromise the spinal cord.

Posted September 13, 2007 12:47 AM by James D. Macdonald

Retrospectively, I was an idiot after I took a full force knee to the face. I finished the rest of the bout (karate class), went home, and lay down on the couch with ice. Half my face was black and purple (including the solid black mass under the eye), but it never occurred to me that maybe, just maybe, an X-ray and some professional treatment might be in order.

I have a notch on the cheekbone to this day (nine years later), so I'm inclined to think I fractured it, if only slightly. I'd claim a concussion for the stupidity, but then how do I explain that nobody else either at the dojo or at home, thought to recommend a doctor's visit?

Posted September 13, 2007 2:01 AM by Cynthia Wood

Cynthia @24,

I venture to suggest, your accident being nine years ago, that the instructors had yet not been on the kind of coach-training course that I went on this summer, to get my UK aikido coach accreditation.

Where the duty of care by a sports coach was most strongly emphasised, with all the legal consequences and potential penalties laid out for us.

Put simply, it is the coach's responsibility to ensure all appropriate medical treatment for injuries is given or obtained, whether or not the accident-sufferer is saying, oh, no, I'll be fine etc. If they absolutely refuse to co-operate, you need their signature to that effect on your accident reporting form.

These days, without formal coach accreditation by your particular sport or martial art in the UK, you cannot get coaching insurance and without that insurance, no venue should be letting you set up a martial arts or any other kind of sporting club.

Indeed, increasingly, schools, sports halls, leisure centres, church halls etc now require you to provide a risk-assessment for your activity in their premises as a condition of their own public liability insurance.

And yes, it's a pain from the paperwork point of view but the reduction in sports injuries and in particular, long term consequences from them, is worth it.

I shan't get started on the legal headaches of teaching kids nowadays as that's waaaay off topic.

Posted September 13, 2007 5:40 AM by Juliet E McKenna

23: Something I've been told repeatedly - when you are first approaching the casualty, do it from the feet end, not the head end. Because you're going to be speaking to him ("Can you hear me?") and if the voice is coming from above his head (assuming he's supine) he'll turn his head to see you and could wrench his c-spine.

Posted September 13, 2007 5:41 AM by ajay

James D. Macdonald:
(6) Getting to a place where you can actually hold c-spine sometimes requires that you pass the EMT Ingenuity Test.
Sometimes it requires that you pass the audition for a Cirque du Soleil acrobat.
(19) The puking problem is one reason you get behind the patient when you're holding c-spine.
The other reason is that you then get to point the head at your buddies.

Posted September 13, 2007 7:15 AM by John Houghton

Old Dan Sickles was lucky to lose his leg at Gettysburg--as wounded war hero, he could avoid being court martialed for disobeying orders and almost losing the battle (& the war). Given his pre-war acquittal of murder on the basis of temporary insanity, perhaps the prospect of a court martial didn't bother him, though.

Having a wooden leg didn't stop him from using his position as US Ambassador to Spain to embark on an affair with Queen Isabella II . . .

Posted September 13, 2007 8:09 AM by rea

Osteopathic or Orthopedic Surgeons? Not that both groups don't have a thing for bones, although osteopaths (at least in the beginning) have some very different notions on that topic.

Posted September 13, 2007 9:11 AM by fidelio

Thanks for another great post!

You missed an acronym: FOOSH (Fall On Out-Stretched Hand, as in how my sister managed to break both wrists at once while cleaning up the church nursery).

Posted September 13, 2007 9:21 AM by Lila

Cynthia Wood @24, Juliet E. McKenna @25, about facial fractures and coaches:

I have had two fractures in my life, at least ones which were diagnosed; the first, on my sixteenth birthday, involved a knee to my left eye socket and resulted in an orbital fracture (covering third base, bad bounce on a thrown ball, aggressive base runner). In May, 1968, there was apparently no requirement that PE teachers have any training in first aid; I lost consciousness and woke up vomitting, and my coach yelled at me for faking it.

39 years later, I still have the black eye.

The other fracture? About twelve years ago I shattered the tip of my left ring finger getting it between a cow's head and something hard, and had to have my wedding ring cut off ; today I'm finally getting the ring replaced in time for my 25th wedding anniversary later this month.

The worst musculo-skeletal damage I've sustained, again in PE, same teacher, was a severe sprain of the left ankle which left the joint unstable and prone to reinjury; it's now showing signs of both osteoarthritus and compromized vascular function. We were doing gymnastics, vaulting over a horse, and she made me take off my glasses for safety reasons. Unable to see the ground, I misjudged my landing and came down with my entire weight on the outside edge of my foot. She screamed at me for being fat and clumsy, and was one of the teachers who demanded that I stop using crutches well before the injury had healed. I'm pretty sure that was against the law even then.

Why yes, I have issues.

Posted September 13, 2007 10:45 AM by JESR

JESR @ 31

I think you had a teacher who should have been fired and had her teaching credential revoked (permanently) for endangering students. And also been sent for psych observation.

Posted September 13, 2007 11:12 AM by P J Evans

I have another category of broken skin: what the joint specialists called "the worst possible kind of sprain" when I brought a friend to the ER over the summer. She'd jumped up to hit a soccer ball with her head and come down wrong, been carried off the field, and, despite insisting it was just a sprain, was bleeding steadily from a wound on the outside of her ankle. The ankle was incredibly swollen within a minute, which was worrying enough, but we managed to convince her to make an ER visit when the bleeding hadn't decreased despite pressure and ice after half an hour.

The eventual diagnosis was that her ankle had briefly dislocated. A bone had thrust far enough out of alignment to break the skin, then snapped back into place. She had to have surgery that night to repair the membrane that encapsulates the joint, which would be a very bad place to get an infection. She can walk on it now, and the physical therapist says total recovery is certain. If we had let her just go home, maybe not so much.

(The fun part was driving my car onto the soccer field to pick her up.)

Posted September 13, 2007 11:37 AM by Kylee Peterson

Emily H @ #10

Your experience mirrors my own. Broken metacarpal, right hand, extra knuckle and everything. Never a twinge! Not when I half-heartedly tried to put it back into place myself. Not after a trained professional drilled holes in it an laced it back together with a piece of wire.

I always expected incredible pain with a broken bone. The most painful parts of the experience were having the stitches removed and getting the "pimp my skeleton" bills.

Posted September 13, 2007 11:50 AM by Avery

Woo! Open dislocations! You treat them out on the street the same way you treat an open fracture: Control the bleeding, then RICE, then splint it.

People's experience of pain varies, from "HOLYCOWOHCROMITHURTSITHURTSITHURTS" to "Gee, that's sure odd."

Posted September 13, 2007 1:16 PM by James D. Macdonald

If you want to read more about traumatic skull fractures, read Lee and Bob Woodruff's book In An Instant. It's about his being injured by an IED in Iraq in early 2006. The book includes photos of what his head looked like without some of his skull. They also included an X-ray of all the crap that hit the upper part of his body. Fascinating and scary reading.

I've only ever broken 2 bones - my collar bone (from falling down a flight of stairs when I was 4) and a small bone in my left foot (while wearing sandals with a tiny sole a few days before the '99 Nebs in Pittsburgh - I wound up in one of those "broken foot shoes" for most of the weekend). I don't remember much about the collar bone other than starting to fall, then, later, having my left arm in a sling and trying to do sewing cards one-handed. As to the foot, I didn't think it was broken as it only hurt when I walked on it. It started to swell a little, so I went to the ER early in the evening. As it was spring, there were about 20 Little Leaguers ahead of me, but so long as I was sitting, I was OK. After about 5 hours, I finally got seen, got an X-ray and went home with crutches.

Posted September 13, 2007 1:43 PM by Laurie D. T. Mann

Delurk-for-embarrassing story time!

Several years ago, my parents and I rented a lakeside house in Maine. As I was getting ready for bed, we heard a camp somewhere nearby singing. My mother wanted to figure out the song, so she went out onto the pitch-black deck ... forgetting there were about three steps down. When the house shook and she screamed, I ran out to find her on her side on the deck. (It later turned out she knocked a few slats out of the railing as she fell forward, but that kept her from plummeting down the drop to the lake.)

In emergencies, I have no brain; I go into "tell me what to do and I'll do it!" mode. My father thinks he knows everything (despite having no training), so he was trying to manipulate her swollen lower arm -- to see if it was broken! -- as she begged him to stop.

I put my hand firmly on her shoulder to try to comfort and steady her and asked whether to call an ambulance or put her in the car and drive to the hospital. Stupid -- always call the ambulance, but see above about the no brain thing. She's an RN, so when she insisted on the car, I went with it, not thinking that the pain would have her confused and wanting to do something rather than lie there waiting.

We sped through the dark to the interstate, and I asked the toll booth attendant where the nearest hospital was (!) -- should we just drive towards Portland? (We were 20 or 25 miles away from Portland.) She didn't know (!), so I went with that plan. About halfway there we saw a police car's lights flashing at the roadside. I don't know if I made the suggestion, but my mother asked please to stop and ask the officer for help.

I naively figured he was assisting a stranded motorist; it was something more like a drug bust, so I'm impressed he didn't pull his weapon when a car stopped behind his cruiser and a woman in pajamas rushed towards him. He called for an ambulance but warned it would be a bit because they were coming from ... the town we had left. Dammit!

I then irked the chief EMT or paramedic (I'm not sure which she was) by following her rig at Boston-area commuting distance. It wasn't intentional -- no brain.

My mother turned out to have a comminuted fracture of the proximal humerus, I think it was. So I was pressing right on the shattered break, but even knowing that, she says my father's fiddling hurt more.

Anyway, the valuable lesson: Always know where the nearest hospital is -- but always call the ambulance. I'm sure the smart folks here know that, but it bears repeating.

And if anyone here was somehow involved ... I'm so very sorry I was an idiot.

Posted September 13, 2007 4:07 PM by michelel

Back in 1979 right after that year's OVFF, Monday morning, I was headed to work.(My brain was chanting "I don't wanna go to work.)

I was headed down the stairs from my door, when I parted company with the staircase about 3 steps above the first landing. Knowing I was falling I tried to relax. The space was too close to try any sort of save, and trying to do so would have made the results worse.

I hit the landing with my right leg folded under me. My right ankle was under my left buttock and I heard a "pop" like the sound of two football players hitting each other. (Did I mention I was wearing a backpack too?)

I figured I'd broken the ankle. So I crawled back up the steps, managed to get my apartment door open and crawled to the phone. (The cats thought this was fascinating...)

Did I call 911? Oh no, called my best friend, told her I thought I'd broken my ankle and could she please come drive me to the hospital?

Bless her heart, she left work. In the meantime I realized I was wearing a brand new pair of Dockers, and I figured the folks in the ER would cut them off, and doggone it, I wasn't going to lose a new pair of pants...

I actually managed to get my shoes off, pull off the Dockers and put on a pair of sweatpants, and put my shoes back on! Hurt like hell.

When I finally got to the ER and they x-rayed the ankle, it turns out I'd torn 2 of the three ligaments. They put it in a soft cast and told me to stay off of it for 48 hours. After that I could use a walker. The bruise was spectacular, it really did turn almost black.

I didn't find out until a couple of weeks later that I had jammed 13 vertebrae together. (Remember the backpack?) The chiropractor had a fun time working the spine back to it's normal form.

Posted September 13, 2007 5:03 PM by Lori Coulson

American Red Cross First Aid Courses

British Red Cross First Aid Courses

SOLO Wilderness First Aid Course

(Ah, Portland. We take people over there from my hospital occasionally, to Maine Med. It's a bit tricky to find if you're from out of town. About a three-hour drive on two-lane blacktop for me; only the last little bit is on the interstate.)

Posted September 13, 2007 5:43 PM by James D. Macdonald

Why are the stories on this thread making me shriek and cringe in imagined pain in a way that the other trauma and emergency posts haven't done?

Yes, I have broken bones before (non-dominant wrist, two separate occasions, playground and backstage falls, and a bone in my foot, stair slippage) but I've also lived through some of the other trauma stuff (heat and cold problems particularly) and those don't nearly make me cringe the same way!

Great information. I just have to read it through my fingers this time.

Posted September 13, 2007 6:17 PM by Rikibeth

Ah, Jim... I thought I had forgotten: "On old Olympus'...". It came right back.

Posted September 13, 2007 6:52 PM by dan

Rikibeth @ #40, I'd hazard a guess that these stories describe real tangible pain more than the others have.

Posted September 13, 2007 7:30 PM by Linkmeister

My favorite subluxation/dislocation story: My friend Matt tore his ACL. In a rock band accident.

Matt was the bassist for a metal band. They were playing a show one night, to a really excited crowd. When Matt's playing a show, he gets all rock star, jumping around with his bass. This is funny, because ordinarily Matt is a giant nerd, just like me.

The problem that night was that the lead singer had put down an uncapped bottle of water on Matt's amp. It got knocked over. And Matt, jumping around with his eyes closed, slipped in it and landed such that he tore his knee.

He finished the rest of the song, playing his bass, lying on his back in a puddle of water. When the song was over, his bandmates said "Man, get up. The song's over, you can stop being a rock star and playing your bass lying down." He said "No, seriously, I don't think I can get up."

He played the rest of the show sitting in an office chair dragged from backstage. Then, and only then, did they take him to the ER.

He was disappointed when he had surgery and was told he was not getting an ACL from a cadaver. He'd hoped to become part zombie.

Posted September 13, 2007 8:25 PM by Caroline

Funny this came up. I just had to deal with, briefly, a possibly damaged skull/neck. Bike accident, walked around the corner, one guy lying on ground, unconscious, wrapped around bike, with the other guys (who weighed 75 pounds soaking wet) trying to pick him up.

Story elided. End result. Guy#1 off to hospital on a backboard, with c-collar, etc. Guy#2 walked away carrying his bike.

Mr. Macdonald will now tell you why Guy#2 walked away and Guy#1 was carried away on a backboard, etc.

Posted September 13, 2007 9:21 PM by Erik V. Olson

I've never had a broken bone but I've had some truly spectacular bruises. And I have what I think is a vertical dent in my skull from second grade, when I turned a corner a wee bit too soon.

Of course, I think I probably was in more danger the time I slipped and hit my neck on the monkey bars, but I was a kid then and lighter. The teacher let me off from verbal participation the rest of the day— it didn't hurt to talk but it sounded truly awful.

I think Evil Rob wins for nasty bone injuries, though. He was something like 14 years old and on vacation when he got both hands caught in the scissored joints of a collapsing folding chair— that he was sitting on. They couldn't find the pinky and ring fingers on his left hand on the X-ray, so they splinted them, bound them up, and hoped good things would happen.

This is why he plays guitar. It started out as therapy. He's pretty good at it, and I have great joy in telling the above story to people after they've complimented his playing.

Posted September 13, 2007 10:47 PM by B. Durbin

Let's see: believing you broke your arm. When I broke my ankle (nine places in three inches) neither the EMTs or especially the hotel manager believed me. I think it's because I moved it back straight before they got there because it hurt less straight. (I'd also asked the janitor who came to my yells of help to get me a blanket and I used it to support the ankle.) The ER doctor clearly didn't believe me. The X-ray tech didn't believe me until she asked me to roll over and I did and my foot didn't.

Dislocating shoulder by falling on outstretched arm. They teach you not to do this in OT. You're taught to automatically drop what you're carrying, cover your face with your hands, and bring your elbows in front of your chest. This is why I don't carry things often. It's a lot faster getting my hands in place and just falling if I don't have to drop things.

Flail. I got this by coughing too hard. Now I have codeine to take as soon as my coughing can't be controlled by hard candy.

I've had a lot of painful things happen but the worst was getting potassium IV. It feels like acid in your veins.

Posted September 13, 2007 10:50 PM by Marilee

I'll read through the whole thread later, but I just want to say that what Jim said is really good basic aid. From personal experience: RICE made a serious bruise-trauma (nothing broken) into something that basically fixed in a week (though a year later there's still occasional pain).

Posted September 14, 2007 1:07 AM by Tom Whitmore

Well, if nothing else, this thread is making me vow to actually go to the doctor about my right thumb. I fell on my hand a couple months ago (softball), and jammed my thumb. While it's *mostly* better, if I try and bend it any more than "normal", it hurts a *lot*, and occasionally I tap the knuckle and almost shriek in pain. Also, pushing "down" on my thumb with my pointer-through-ring fingers is fairly excructiating. I've been pretty much just ignoring it, hoping it will go away. You guys have convinced me that's not the smartest thing I've ever done...

Um, that's the worst story I got. I know, I'm a piker :-)

Posted September 14, 2007 2:26 AM by David Bishop

David Bishop #48 - jammed fingers are annoying as hell. I've been nursing one along since Febuary - not as sensitive as yours, but not right either. Somehow I can't bring myself to go to the doctor because my finger hurts when pushed sideways. I've learned somewhat better since my day of knee-in-face, but not totally.

I think I may be so persistantly ignoring this because it's my finger of doom - aka my wedding ring finger. The finger that needed the ring replacement, that caused my Dad to shove me in an MRI, that found the pituitary tumor, that turned my life upside-down. My subconscious says bad things happen when I bring that finger to the attention of doctors.

Posted September 14, 2007 3:08 AM by Cynthia Wood

OK, so now I have the evaluation criteria. How did I do when faced with a broken finger on a child?

Fiona fell in the shower, naked. I was wearing underwear and a shirt, but no trousers, because I was helping her. She got up crying, with her right pinky finger sticking out. Deformed.

Her cries started at startlement and quickly turned to pain. She held the wrist of her right hand, and I carefully touched the finger and the attachment to the hand.

I thought it might be dislocated (there is a family history of loose ligaments. At one point we had three shoulder subluxions in the family at once), but it didn't feel, on the brief touch, like something I could just "put back".

I had her wiggle her fingers, and noted that she couldn't move the pinky. At this point, I thought, broken. So did we RICE it?

Um...no. Rest, of course, but we clean did not think of ice. Compression was not going to work - it was not a wrappable structure as it sat there. And again, we didn't think of elevation.

She stopped crying very quickly, and claimed that the pain was much less. We got her dried and dressed (which involved getting a sleeve on her - I suppose we could have left that arm out of the sleeve, but we just worked the hand carefully through.

Then, of course, we did the absolutely right thing and sought medical attention. It was a partial (greenstick) fracture of the inside of the lowest long bone in the finger. They put a cast on from fingertip to elbow (it was night shift in the ER; they were not being delicate and artistic). A few days later, they swapped it for a joint above to joint below number, which meant that she didn't even lose wrist mobility.

The smaller cast came off on Tuesday, and she's already almost back to full mobility.

Posted September 14, 2007 4:47 AM by abi

dan @ #41: I prefer "Oh, once one takes the anatomy final, a good vacation sounds heavenly."

Caroline @ #43: I've torn both my ACLs. First one was a shopping accident (I turned a shopping cart full of gravel and concrete pavers over on myself); second was in the middle of my black belt test when my teenaged daughter did a sweep that dumped me but didn't clear my foot off the mat. I then tried to finish my test (board breaking) and found out why people don't customarily break boards while standing on one foot.

Still haven't had surgery. Neither orthopedist ordered an MRI (x-ray only) so I don't know the extent of the tears. First doc wanted to do surgery--"otherwise the knee will eventually fail". I asked what difference there was in prognosis with immediate surgery vs. when the knee fails--he said none. I told him I'd be back when the knee failed (12 yrs. and counting).

With the 2nd knee, the other doc said "what did you do to rehab the first one? Go do the same thing for this one. Do leg presses till you're blue in the face." I liked him a lot better than I did the first doc.

Posted September 14, 2007 8:16 AM by Lila

Marilee (46): I've had a lot of painful things happen but the worst was getting potassium IV. It feels like acid in your veins.

Really? It felt like any other IV to me. But I still have a port from having chemo, so the IV was never in surface veins. That could make a difference.
------------
No broken bones, but I did sprain my foot when I was a kid. ("You mean you sprained your ankle." "No, I sprained my foot.")

Posted September 14, 2007 9:24 AM by Mary Aileen

I feel so inadequate... I never broke any bone - mine or those of others- although I once slammed a fingertip into my car's door. Not even a partial fracture though. But my nail fell off. Does that count?

Posted September 14, 2007 9:37 AM by Serge

Several years ago, I did the standard Fall On Out-Stretched Hand. When I got up, I thought I'd sprained/strained my wrist. Ran out, picked up an Ace bandage, wrapped the wrist. Didn't seek medical attention.

I kept it wrapped for weeks, because it hurt less when there was pressure on it. I'm pretty sure it was a fracture; a couple of times a year, I'll overwork that wrist and it'll hurt like hell.

Posted September 14, 2007 10:27 AM by Malthus

Serge, I'm the same. I don't do much of anything. I have a weird nervey thing in one finger from too much tiny-fiddly-scissoring a few months ago, I lost a toenail once, and I have half a fake tooth, but my sister's the one with the medically interesting leg-- we think it started with a bone bruise from skiing and went on from there. And I still feel bad for swooshing past her the first time instead of stopping and making sure she was okay.

Posted September 14, 2007 10:35 AM by Diatryma

Diatryma... About 8 years ago, I was on my bicycle and took a curve a bit too fast. Bike went flying sideways and I landed hard on my knee, or rather just below. It hurt like Hell. Did I go to the doctor? Of course not, not even when, while doing leg presses, I could feel my tibia popping around a bit. I stopped doing leg presses for a long time, but that was it. I fully recovered. Still, thinking back, that was stupid of me.

Posted September 14, 2007 10:49 AM by Serge

Lila @ 51: Probably for the best. Matt said that recovering from knee surgery was the worst pain he's ever been in, and he hopes never to feel that much pain again. (The biggest problem was that he wasn't told to start taking his painkillers before the anesthesia fully wore off. By the time he could feel his knee, it was too late -- the painkillers didn't touch the pain.)

Serge @ 53, it's okay, I've never broken a bone either.

For some reason, this was the post that made me really decide to get some first aid training. Maybe it seems the most do-able.

Posted September 14, 2007 11:02 AM by Caroline

Serge #53: I broke my right arm at seven. I have a scar on my right knew as a result of a fall when I was 14 (it isn't smart to run downhill while carrying a sackload of dung if you're going to trip over a tree-root and have your knee land on a rough rock), and I have a scar inside my right elbow as a result of an accident when I was 19.

Posted September 14, 2007 11:09 AM by Fragano Ledgister

Fragano... That darn dung dunnit.

Posted September 14, 2007 11:21 AM by Serge

Marilee @46: sometimes the doctors don't believe the grownup telling them their son's arm is broken. My son was about 5 when he fell (it was a classic jump for something he couldn't reach, and then the FOOSH). I palpated it right away and felt no deformity, so we RICEd him. Two days later, he slipped in the school hall and did another FOOSH. This time palpation elicited pain, so I sent him to get radiographed. My partner said the doctor palpated and didn't think it was broken, but she told him to radiograph it anyway. It was indeed a mild fracture, not even completely through the radius. He wore a cast for 5 weeks and has been fine for the past 6 years.

The only broken bones I've ever had were fingers and toes. The fingers came from getting my hand caught in a closing car door. Two fingers were fractured in the proximal bones, but nothing else. The bone calluses were kind of cool. I've had a toe fracture from stubbing my foot on the couch, which resulted in a spectacular bruise. Once a horse tripped over his own feet, and broke my foot, which was terribly unfair of him. None of them really hurt very much, but as mentioned, this is a very individual response.

Posted September 14, 2007 11:30 AM by Ginger

I wonder how Abi's daughter is doing. I presume her finger is still in a cast.

Posted September 14, 2007 11:39 AM by Serge

Serge @61:
See the last line of comment 50. Fiona's hand is no longer in a cast, and her finger is already almost back to full mobility (she can't quite make a fist yet).

The current worry is the barfing, feverish 6 year old son, though. Fun times!

Posted September 14, 2007 11:49 AM by abi

Oops. Missed your earlier post, Abi. So Fiona can't do the Power Fist yet. As for your son, has anybody figured out his problem? By the way, it's weird, thinking that people around here now have kids who were born in the 21st Century. When those kids hit puberty, will they make fun of their parents for being born in an earlier century? But I digress.

Posted September 14, 2007 12:06 PM by Serge

Serge #59: True, and I wasn't anywhere near Dungeness either.

Posted September 14, 2007 12:22 PM by Fragano Ledgister

Abi #62: Ah, the joys of having small children! (I remember ear infections with a shudder...)

Posted September 14, 2007 12:24 PM by Fragano Ledgister

Mary Aileen @52: But I still have a port from having chemo, so the IV was never in surface veins. That could make a difference.

I wonder if you had an experience similar to mine with that? Depending on where the port's placed, I guess. I underwent chemo from 1987-89, and I had a dual port catheter installed for the purpose into some blood passage in my chest. I don't know about potassium, but I quickly discovered that Heprin (anti-coagulant I had to inject in each port) made an unpleasant cold feeling at the back of my throat, ketamine had to be injected slowly or I'd gag on my way out, and IV-style Benadryll would make me gag to the point of vomiting no matter how slowly it went in. Surprised the heck out of me; I had been under the impression that one shouldn't be able to feel stuff going into the veins. Maybe it was because the insertion point was so close to the heart? How does that work?

Posted September 14, 2007 12:25 PM by Nicole J. LeBoeuf-Little

When I give platelets, I sometimes get an effect from the citrate anticoagulant. The easiest part to notice is the tingling lips-- citrate binds calcium ions, which leads to the tingling. I think there's an effect for fingertips, but I'm usually not paying attention to them. Yesterday, I noticed that my throat felt sort of weird, and the backs of my eyes, if that makes any sense-- sort of muzzy-wrapped, so while things felt the same, the signal to the brain was being lost. I think a lot of that was me being tired and a little bored from sitting in the same chair, wrapped in warm blankets, for an hour. The effects go away if I drink a bit of milk to replenish the calcium in my blood.
Since I am fairly suggestible, I think the throat and eyes might be in my head. They might be tied to the chilliness, too.

Posted September 14, 2007 12:35 PM by Diatryma

No broken bones for me, but I did badly sprain/strain my left ankle many years ago...diagnosis uncertain because I never had anything but wilderness first aid. I was on an Outward Bound trip - third day, late in the afternoon, and we were doing the first rock-climbing bit. I got about three feet up the last face, and then slid down the face and landed with all my weight on my left foot, which wedged sideways into a crevice. Ouch! Didn't appear to be broken, though, and I was wearing hiking boots with ankle support. So I struggled back up (about 8 feet) to the top, and rapelled down (whee!). After soaking it in the creek, the instructor bandaged it up, and we had a decision: go back with one of the instructors (2.5 days hike), or continue forward with the group (4 days hike). In the morning, we decided that it really probably wasn't broken or fractured, just muscle/ligament/tendons, so I kept going with the trip, after it got taped up. I pretty much kept up with the group, though I begged out of one rock scramble, and I got to pass on the 5-mile run at the end of the trip. :) By the time I got back to civilization, it didn't seem like there would be much that modern medicine could do for it, so I just used an ACE bandage for a few weeks. It's never been quite the same since, though - most of the time it's just fine, but I have an odd ability now to trip over very small objects on flat surfaces when I hit them wrong with my foot, and I end up stepping on the side of my foot - ouch!

Now, my sister had a broken leg when she was 6 or 7 - classic skiing accident on the "last run" of the day, about 3:30pm. And my brother broke his arm when he was about 3 - the story's long, but basically he fell out of the back seat of a car when the door opened [1974ish - no car seats then!]. The car was slowing down to a stop sign in a residential neighboorhood, and he fell out and must have caught most of his body weight on that arm first. No other injuries, except for some scraping on his hands. It was technically a fracture - it didn't break all the way through, probably because he was so little and light.

Posted September 14, 2007 12:48 PM by oliviacw

Diatryma (67):
When I was a platelet donor, I always felt it in my belly first. Chewable Tums (provided by the Red Cross donor center) worked well for me, I tend to be warm most of the time, so rarely needed the electric heating blanket turned on, even though the blood was coming back a good deal cooler than it went out.

Movies not to watch while giving platelets: Reindeer Games (the scene with the darts — not what I want to see while I'm pretending that there aren't these humongous needles in my arms).

Posted September 14, 2007 1:02 PM by John Houghton

Somehow, my FOOSHes have never resulted in anything broken; somewhere I learned how to roll and wind up on my bum. One did end up getting me 3 months of PT for a frozen shoulder; this was the time I was out walking on a cold night, tripped and fell into a mud puddle. My treatment was to walk the five blocks home, have a stiff belt of scotch, and take a hot bath. In retrospect, probably the wrong thing, but the idea of ice after a 40F night was rather unsettling. (Had I known, I would have traded an hour of frozen shoulder on the spot to several months of frozen shoulder later.)

Several weeks later I discovered I could no longer scratch my back, and that I couldn't fasten my bra in the normal way. I got X-rayed to make sure that nothing more than outraged muscles was going on (it wasn't) and embarrassed everyone when I got stuck taking the Xray gown off.

Moral: For Ghu's sake don't forget the ice part.

Posted September 14, 2007 1:19 PM by joann

My "I think I may have broke it" story:

When I was 22, I was on a dig in the Skagit Valley. The field school was run on the theory that every job on a dig is essential, so we cycled through excavation, lab, survey, and cooking crew. The second week I was on cook crew, three of us wasted time trying to find a third leg of lamb (from one lamb) in a cold-room meat-locker. Coming out into the humid air, my glasses frosted over, and I missed the turn going down the long, narrow, steep, unlit staircase and fell down eight steps, landing with all my weight on my right knee cap. When I got up, it was swollen, extremely painful, and could be moved past its normal range of motion, with a distinct grating feeling as if there was bone-on-bone contact.

The dig director had no patience with injury, and had already sent one person home after he hurt his leg. So I didn't report the injury, immobilized it with, first, my heaviest hiking socks and some safety-pins, and then a wide elastic bandage, and toughed it out. The last two days of cook crew weren't fun; I rested some over the weekend (where "rested" includes having to walk a block to the latrine and two blocks to the cook tent, not to mention a quarter mile down to the Skagit to soak the sore knee in glacial meltwater). The last three weeks of the field schoolI bulled through walking five miles a day, under pack, over uneven terrain between camp and site.

When I was forty, that stupidity was delivered to my door postage due. It pretty much has hurt every minute of the last fifteen years.

Posted September 14, 2007 1:33 PM by JESR

Nicole (66): I have a single port just under my right collarbone. I don't remember any odd effects from any IVs going in, but Heprin (sp?) always makes things smell of vomit for about 24 hours afterwards. *Not* what I needed when I'd just had chemo!

Posted September 14, 2007 1:37 PM by Mary Aileen

The last time I had to be retrieved by an ambulence, the lovely folk who stopped to help me were so confused about what to tell 911 that I ended up doing the whole accident description, location, injuries, condition of patient ... and then finishing with "I'm sorry - I think I need to sit down now, before I fall down".

Having an arthrogram for my separated shoulder still rates as one of my most painful experiences (and - well - I've injured enough parts to not look forward to damp days). The MRI after was almost relaxing, and definitely musical.

Posted September 14, 2007 2:23 PM by xeger

Caroline @ #57, when I had two knee surgeries to repair a severed patellar tendon (long story told here) I remember that it wasn't the surgery or the days afterward which hurt so much, it was the PT on the exercise bike. Getting that pedal over the top and on its downward stroke the first time was up there with the other big pain sensation I've had: gout.

Posted September 14, 2007 2:35 PM by Linkmeister

Cynthia #49: The finger that needed the ring replacement, that caused my Dad to shove me in an MRI

Probably not entirely on topic, but would you mind terribly unpacking that?

Posted September 14, 2007 2:54 PM by joann

Caroline @ #57, we are constantly nagging our patients to take their painkillers BEFORE the pain gets bad. There's a strain of Puritanism down here or something. You're right: once you're really hurting, it's too late for the drugs to help much.

Posted September 14, 2007 3:24 PM by Lila

If you were to ask me how many bones there are in a skeleton, I’d have to say “Beats the heck out of me.”

Once upon a time I went to a foot doctor and he told me the reason I have flat feet is that I have an extra bone in each foot that weakens the whole structure. I am a mutant! Though I still haven't heard from either Dr. Xavier or Magneto. *pout*

I did feel slightly better though when I heard about a lady who'd found out, via an unrelated x-ray, that she'd been born with just one kidney.

Posted September 14, 2007 3:26 PM by mayakda

mayakda @ 77... So you that ToeGirl, whose power is to tow lines, like Spiderman, but out of your ankles instead your wrist?

Posted September 14, 2007 3:53 PM by Serge

When I had my wisdom teeth out, I mentioned that my mother had only three. The doctor told me that he'd once had an entire family with five each, all inherited from the mother, and one poor boy with twelve total.
I wish I could see those X-rays.

Posted September 14, 2007 3:53 PM by Diatryma

The ice question for strains and sprains: for the first 24-36 hours, use cold packs. For the next 72 hours, switch to warm, moist packs.

Don't forget the Rest part of RICE.

Posted September 14, 2007 4:09 PM by James D. Macdonald

I only ever broke one bone that I know of, a greenstick fracture (I assume) of the index finger of the right hand due to my shutting it in the hinge of a door when I was quite young. It left me with a most interesting fingernail. The worst part of it was the medicine I had to take, which was disgusting. Years after that, my brother got a finger on his left hand caught in one of those heavy outside school doors, resulting in stitches and a cast and a finger that goes about thirty degrees off to the left after the last joint.
I did have a fun little accident last winte involving being on a sled and falling off over a bump, landing on my right hip first and then the side of my head, resulting in about half a mild black eye, broken glasses and hip pain. I got hauled off the sledding scope on somebody else's sled, butt-up, and couldn't walk (well, not without a cane, and then exceedingly slowly) for two days. I was, um, going on the theory that if anything had been broken it would have hurt much worse than that, which I gather may not be accurate.

Posted September 14, 2007 4:51 PM by Ledasmom

joann @75 - sure. I wasn't trying to be mysterious, it's just lengthy.

About eighteen months ago, my husband lost his wedding ring. By that time we had become less enamored of our ring design, and so we decided to look for rings for both of us. The lady at the jewelry store checked my ring, gasped and ran to get the ring cutter. I had known my ring was too snug to get off, but apparently it had gone well beyond that, and only my habit of blowing air under my ring had kept nasty things like rotting skin from happening.

So we got replacement rings. My new size ring was a full five sizes bigger than my old ring (7 to 11). When we next went to visit my dad (a neurologist), he noticed how big the ring was and asked. When told, he flipped, and I found myself shoved in an MRI looking for a pituitary tumor, tentative diagnosis of acromegaly (overproduction of growth hormone). The tumor was there, though bloodwork hasn't confirmed acromegaly. Since then I've gotten to know an endocrinologist very well, added about four medications to my life, and am still hoping to avoid people sticking pointy things in my skull.

Hence the bad associations with ring finger problems!

Posted September 14, 2007 5:29 PM by Cynthia Wood

Like I said earlier, I never broke a bone. My dad, on the other hand... He was a mechanic and worked on a quarry's heavy machinery. One day, he was in the process of unscrewing some part of an engine which, unbenownst to him, was still under pressure. Bam! went the suddenly free part to the ceiling. Had my dad's head been a bit closer, it too would have become a cannonball. As it was, the only thing that got in the way was his forearm. It took a copper plate to keep the bone segments in place, and about a year for everything to grow back. (Later he sliced a fingertip off, but that, as they say, is another story.)

Posted September 14, 2007 5:39 PM by Serge

Cynthia #82:

Thanks! (This only serves to confirm me in my habit of not being a person who keeps their rings on for all occasions. Frex, I never cook, sleep or bathe with them on.)

Posted September 14, 2007 6:51 PM by joann

Cynthia @ #82, Jeepers! I need to talk to She-Who-Shares-Your-Name (Mom) about one of her rings - it's pretty darned tight and not removeable.

Posted September 14, 2007 8:03 PM by Linkmeister

Diatryma: My mother had a wisdom tooth erupt last year. At the age of 61.

I don't have any. I'm even short a molar. Since Evil Rob has no wisdom teeth either, we expect our kids (future tense) to not have any.

Twelve would have been a great evolutionary advantage back when you'd grind down your teeth with stone in your bread meal. Wear your teeth out? Hey! Here comes another, and another...

Posted September 14, 2007 9:42 PM by B. Durbin

Mary Aileen, #52, yes, it was painless once I got central lines. It's the small veins that hurt like hell. The nurses offered heat, cold, all sort of things, but nothing really helped.

Nicole, #66, I never had gagging problems with stuff going in the central line, but I could taste them. I used to amuse the nurses by telling them what they were piggybacking. Now, the n-g tube, that I had problems with gagging. I learned quickly how to pull them out myself rather than wait for a nurse while I can't breathe.

Ledasmom, #81, I don't need an accident to make my fingers turn directions. I was born with the outer fingers slightly curving in, but my right index finger is now curving in at about 30 degrees, as well as rotating inward. Osteoarthritis, my rheumatologist says. I'm going to stop buying beads; I won't be able to bead much longer.

Posted September 14, 2007 10:58 PM by Marilee

About 20 years ago I was running late at night on First Avenue in downtown Seattle (while carrying a bagful of books) so I wouldn't miss the late-night bus to the Vashon ferry and have to wait half an hour in a dodgy part of town. I was crossing the crosswalk across the exit from Highway 99 when I tripped and fell.

I managed to grab my bag of books and stagger to the bus (the need to get to your feet and out of oncoming traffic from a major highway at night makes a normal adrenal surge seem like weak tea), but something was very wrong with my arm and/or shoulder. I plopped myself on a seat at the front of the bus and the driver actually said "Are you O.K.?"

"No!" I snarled.

"Well, at least you caught the bus."

We got to the ferry dock and I asked the driver to go to the ticket booth and get someone to help me to the pay phones--the pain was truly amazing. Fortunately I knew the attendant: she got someone to bring their car up so they could drive me to the phones.

I called home and let my dad know I'd fallen and the arm was either dislocated or broken and asked if I should try to call a cab and head for the hospital or catch the ferry home. Since waiting for a cab would have taken longer than the 20 minutes for the ferry ride and the doctor's office was five minutes from the ferry he said come across and he'd wake up the doctor and staff and have them ready for me and would pick me up at the ferry and take me right to the office.

At the end of this he asked "Does it hurt?" I consider it a sign of the deep and abiding love I had for my father that all I did was shout "Hell yes it hurts!"

I got on the ferry, but couldn't face trying to climb the stairs and find a comfortable way to sit at one of the overstuffed booths/couches so I rode across on the car deck with my arm propped on a fuel drum to keep my shoulder together. As a minor fact I can report that extreme cold does not stop the fumes from fuel oil from kicking the crap out of your nasal passages.

I arrived on the island and staggered off the ferry and onto the dock where Dad and Mom picked me up and drove me to the doctor's office where x-rays proved I had a dislocated shoulder.

Now the fun began. The half-hour bus ride and the 20 minute ferry ride meant that my shoulder muscles had begun to cramp and swell--and I've always had a strong upper body anyway. The doctor had given me some painkillers as soon as I came in the door, but when the first attempt to put my arm back into the socket failed he got out the Demerol and gave me a dose which eliminated all pain (as well as the ability to walk in a straight line and most rational thought) on my part. Even so, it took two more tries to put the arm back in place--and for a second or so during the last attempt he thought he'd have to call out an ambulance and have me taken to a hospital with some really big interns and have them pull on my arm.

I learned several things over the next few weeks, the most annoying of which was Percocet is useless on me--all it does is to slow my speech slightly and give me hell's own case of cottonmouth without touching the pain in any way. And for two years I could tell when the weather was going to change long before it came up on the newscasts.

Posted September 15, 2007 2:55 AM by Bruce E. Durocher II

Bruce @88
At the end of this he asked "Does it hurt?" I consider it a sign of the deep and abiding love I had for my father that all I did was shout "Hell yes it hurts!"

I honestly have no idea what I said to my dad when he came up to me on the trail through the woods and saw that I had nearly cut the tip of my left thumb off with a machete. The hand was covered in blood, the glove* was covered in blood. It was dripping.

He asked if I was hurt.**

-----
* I have no memory of taking the glove off. All things considered, this is fine with me.

** To be fair, he's not good with the sight of blood. He was present at the births of 3 of his 4 children, and always had to sit down and put his head between his knees at the end.

Posted September 15, 2007 3:11 AM by abi

abi #89: When I imagine you chopping your finger off (which I had never until now had occasion to do), I imagine it being similar to when Gwyneth Paltrow did it in The Royal Tenenbaums.

Posted September 15, 2007 3:37 AM by ethan

I look forward to the day when medical science can predict which painkiller a particular patient should take, and what dosage will work for a given level of pain. There are some guidelines, of course, but response to analgesics, sedatives, and anesthetics can be so idiosyncratic that sometimes it's just a roll of the 20-sided dice.

My partner inherited from her mother a bizarre reaction to valium in which she becomes hyperactive rather than sedated. My MIL decked her obstetrician shortly before delivery because of this reaction.

My reaction to morphiates, codeine, and oxycontin below a dose that sends me to Cloud Cuckoo-Land is roughly, "well, the pain certainly is muffled somewhat, but I feel so crappy I'd rather have the pain." I don't think I'm in any danger of becoming addicted; after my back back surgery six years ago Eva had to watch me constantly and nag me to take the Vicodin I'd been prescribed. I hated the sensation of the stuff so much I would take only enough to just keep ahead of the pain, which is not a good way to recover from surgery.

Posted September 15, 2007 3:49 AM by Bruce Cohen (SpeakerToManagers)

I also had only three wisdom teeth. One of the uppers just never got generated.

I've never broken a bone, but I did rupture my Achilles tendon once. I was taking a box of envelopes to a place that does offset printing. Just outside was a hole containing a water meter, and the hole lacked the usual cap. I misjudged where I was, and my right foot went right into the twelve-inch-deep hole. I fell and couldn't get up. After a while, a worker from the printer happened to come outside. "Are you okay?" he said. I replied, "No." He helped me up and we went inside, where I elevated the foot for a while.

At that point I was still hoping that I wasn't badly hurt, so I just drove back to the copy shop where I work. It wasn't a long drive, but I had to use my right foot to work both the gas and the brake -- it was a stick shift. I thus became acquainted with many interesting feelings of intense pain. By the time I got back to the shop, it was clear that I needed a doctor. Someone took me to Kaiser Oakland, where they diagnosed the ruptured tendon and put a preliminary splint on my leg. (One of the tests was this: a nurse put a hand on the sole of my foot and told me to push the ball of my foot forward. I tried to make this motion, I felt the calf muscle contract, but the foot didn't move. A very odd sensation.) The heat from the curing plaster helped the pain quite a bit.

I then gained a new definition of the term "false economy". I live about ten minutes' walk from that hospital, so I figured I'd just go home on my own rather than call a taxi, especially as I happened to be a bit low on pocket money. I'd never been on crutches before, and nobody had ever told me that it was so much damn work. An hour into that "ten minute walk", I somehow managed to make it up the stairs to my second-story apartment and fell into bed.

I wound up having surgery, and my leg in a cast for three months. (They asked me what color I wanted the cast. "Ooh!" I said when they mentioned "glow-in-the-dark" as a possibility. "Gimme that!") To this day, seven years later, my right calf muscle is a tiny bit smaller than the left.

Posted September 15, 2007 7:01 AM by David Goldfarb

abi @ 89... Ouch. I sliced my wrist once. Summer job at a nearby motel. I was in their storage building where all kinds of things were, including a tall standing lamp with a broken porcelain head. So, of course, when I tripped over something, I flung my right arm forward to stop the fall, which I did, with my wrist intersecting with the lamp's very sharp edges. A couple of hours later, with a few stitches on me, with some less blood in me, I was back at the motel, where I picked my bike and rode my way back home, uphill, two miles. (No, it wasn't in the snow.)

Posted September 15, 2007 8:38 AM by Serge

abi #89: When I squashed my finger in the door hinge there was, well, considerable bleeding, and I marched into the kitchen and requested a Band-Aid. Unfortunately, I don't remember the immediate reaction to that request, but I like to imagine it as "Auugggghhhhh!"

Posted September 15, 2007 10:09 AM by Ledasmom

#93 ::: Serge wrote:
I sliced my wrist once. Summer job at a nearby motel.

I usually describe the results of bottle feeding kittens as similar to those of an incompetent suicide. They're much more enthusiastic than bramble bushes.

Posted September 15, 2007 12:47 PM by xeger

xeger, I'll see you kittens and raise you trying to disentangle a still-wet calf from barbed wire.

Posted September 15, 2007 1:25 PM by JESR

xeger @ 95... No fool I. If my cat wants to be clean, I let him do it himself. He's good-natured and quite mellow, even when one of my dogs try to boink him, but making him take a bath might be another story.

Posted September 15, 2007 2:16 PM by Serge

Ledasmom @ #94, yes. Bleeding does ensue following that form of accident. The finger described in my comment @ #1 did quite a lot of that once I got it out from the ring latch I'd left it in.

I was treated on the USS Hope, the nearest Navy clinic to Palos Verdes, where the incident occurred. At ten, being taken to a Navy hospital ship almost made up for the pain.

Posted September 15, 2007 2:16 PM by Linkmeister

JESR... I take it that you keep your rose bushes safe from your family's bovines.

Posted September 15, 2007 2:17 PM by Serge

Serge, the rose bushes are, for the most part, away from the fence. The past week my BIL got delayed by equipment problems and left the cows without hay overnight. As a result I lost the top eighteen inches plus blooms and green and red fruit on my new fall-bearing raspberries, along with the secondary fence that protected them.

I have unfair advantage in any game of compare-the-scars (even excludingfor the moment sociopathic PE teachers) thanks to the combination of cattle, big thorny roses, and world-beating clumsiness.

Posted September 15, 2007 2:43 PM by JESR

JESR @ 100... You do indeed have an advantage over the rest of us. Still, I am amazed that I have all my extremities intact, considering all the powertools in my dad's basement, the hammers, saws, nails, and all other things a man who built his own house needs, and which he actually let me use.

Posted September 15, 2007 4:04 PM by Serge

When I was eight, I was in ski lessons. The biggest lesson I took away from them was: never go over a mogul taller than you are. In my case, doing this meant catching both tips in the snow on my way down--and only one of my bindings releasing.

I don't recall coming off the hill. I do recall insisting I was fine, and demonstrating this by walking around mostly normally on a knee that was screaming at me, because you see, this happened on a Friday and there was this slumber party I'd been invited to that night...

The mother of the hostess was a nurse, however, and she told me, after looking me over, that I had broken the leg and should go to a doctor. The stepfather disagreed, and saved the expense. As a result, I spent two months limping, several years predicting the weather, and to this day, the damn leg vanishes from under me on an irregular basis.

Seriously: it just disappears. I scared my co-workers once this way--I was talking to one, took a step back, and the leg evaporated. I kept going back and hit a file cabinet hard enough to bring half the floor running.

I've gotten pretty good at falling on my forearms, when I'm falling forward, but the second-to-last time this happened, I didn't get my arms under me in time and sprained my wrist, because my hand was twisted under me. The last time it happened I was on stairs, and I slid down at least one step on my knee and wrenched my shoulder stopping myself from going down on my face