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Medical Forum / Diseases and Disorders / Arthritis / January 2008

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otp:  ortho appmt.

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d'huit - 31 Dec 2007 00:30 GMT
saw my ortho on thursday.  something must have gone amok, cuz my xrays
showed almost no healing, just a bit of calcification above and below where
it should be, none in the break itself.  what happened to the almost healed
broken bone xray, from just 3 weeks after i broke this leg?  i just don't
get this.  my bone healing seems to be going backwards.  i'm wondering if
his xray machine is properly calibrated?  natch.  it can't be me!<smile>

my orthopod said that by february he will call this broken bone an
"official" non-union.  said 6 months makes it "official".  struck me funny -
sounds like something we are supposed to celebrate, doesn't it?LOL

we/he discussed surgery - pins and screws with a bone graft.  he was
speaking of soon.  i dismissed it, cuz this isn't an important leg bone and
the break isn't in a critical location.  (and because i just don't want to
go there.)  he agreed.  he said we'll see how it goes in february.  said we
won't worry about it too much unless pain and swelling becomes an issue.  he
said i don't have to wear the aircast anymore, cuz it isn't helping and the
bone ends aren't going anywhere they shouldn't be--that's the good news. :-\

i sorta round about told him that i didn't think much of his "take tums"
suggestion from the last appmt. and suggested it wasn't a good option to
tell his patients about.  told him that tums doesn't have any vitamin d in
it to help absorb the calcium. also told him that people my age, who live at
this latitude, often have vitamin d deficiencies.  he  said i was right and
said he was originally from arizona and forgot about that fact.  asked me
what i recommended and take.  i started LOL.  i still think that is funny,
since what i've been taking doesn't appear to be working for me.

anyway, i lived with a femoral non-union for more than 7 years.  this broken
bone is not as important as a femur, so i guess i can live with this.

kate
vickie b. - 31 Dec 2007 08:31 GMT
Kate,  In 2000 my husband broke a bone in his foot.  It healed nicely
for 4 monthes and then did just like yours, it stopped and went
backwards.  The doctor then went in and put a screw.  He then had to
go through two monthes of work hardening therapy before he could
return to work.

Vickie B.
d'huit - 02 Jan 2008 17:39 GMT
Kate,  In 2000 my husband broke a bone in his foot.  It healed nicely
for 4 monthes and then did just like yours, it stopped and went
backwards.  The doctor then went in and put a screw.  He then had to
go through two monthes of work hardening therapy before he could
return to work.

Vickie B.

thanks, sweetie.  weird how that happens, isn't it?  i'm sorry he had to go
through that, vickie.   it sounds like the screw did the trick for him.
what is "work hardening therapy"?  (i'm certain it can't mean what work
hardening means in metallurgy classes--which is when you repeatedly bend or
work soft metal to harden it so that you can break it at a given point.)

kate
DeeTee and Bob Taggart - 01 Jan 2008 00:55 GMT
Just remember....they call it "practicing" medicine. Sigh.

DeeTee

> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below
[quoted text clipped - 39 lines]
>
> kate
d'huit - 02 Jan 2008 17:48 GMT
Just remember....they call it "practicing" medicine. Sigh.

DeeTee

yeah, spot on.  it's almost scary realizing that medical analysts have
determined that 50% of the time doctors are flying blind, by guessing and by
goshing.  that means that half the time patients are more like lab rats than
anyone cares to admit.  and one from me, sigh . . .

kate

> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below
[quoted text clipped - 39 lines]
>
> kate
Nann Bell - 08 Jan 2008 15:05 GMT
> yeah, spot on.  it's almost scary realizing that medical analysts have
> determined that 50% of the time doctors are flying blind, by guessing and by
> goshing.  that means that half the time patients are more like lab rats than
> anyone cares to admit.  and one from me, sigh . . .

It's interesting, my current PCP actually thinks out loud in front of me.  I
suspect he doesn't do this with some of his less knowledgeable patients, but
I usually have a clue as to what he's ruling out and rasoning through.  My Rd
thinks in quiet, but if he's thinking for a while, will tel you that's why.  
Personally, I find it reassuring that they are thinking things through and
are willing to admit they someimes need to reason out the answers.  Of
course, those of us whose bodies refuse to play by the rules have to seek out
these thinking doctors!

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

Paul Cassel - 01 Jan 2008 05:12 GMT
> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below where
> it should be, none in the break itself.  what happened to the almost healed
> broken bone xray, from just 3 weeks after i broke this leg?

Did you ask 'your ortho' what went wrong? What did he say?
d'huit - 02 Jan 2008 18:26 GMT
d'huit wrote:
> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below
> where
> it should be, none in the break itself.  what happened to the almost
> healed
> broken bone xray, from just 3 weeks after i broke this leg?

Did you ask 'your ortho' what went wrong? What did he say?

<smiling>he said, 3 times, that ("maybe"--my word inserted there) all my
"past orthopedic injuries and surgeries must have caused circulation
damage", implying, logically, that poor circulation would interfere with the
break site getting the proper nutrients it needs to complete repairs.

however, years ago when i broke my malallus, in the same ankle area, it
healed right away, as did that same foot's stress fracture, a few years
later.  and, i don't notice any circulation issues currently--feet stay
warm, pedal (sp?)/foot pulse is strong and my toe nails when pressed show
good circulation.  and, that broken bone had been healing better than normal
for the first 3 weeks' xrays (looked very much like it was almost completely
healed).  for my femoral non-union, back in the 1970s, the cause was
said/suggested to have been a major infection i wound up with after the
first surgery.  i think medicos guess when they don't know for certain,
paul, because somebody/a patient wants an answer.

i'm playing with an hypothesis here.  this has been right around the 35 year
mark since my femoral non-union began and was healed by a complete metabolic
change, supposedly caused by pregnancy 7 years later (which now seems to me
to have just happened to coincide with a 7 year biological cycle).  i was
curious.  so, i've been doing a bit of math regarding my last non-union
(which i thought had been longer than 7 years, and wasn't--just seemed like
it) and my own guessing here -- thinking . . . in college biology i learned
that every 7 years our bodies complete a total metabolic changeover.  i'm
thinking this broken bone might be caught in another of one of those
metabolic cycles.  and, the hypothesis (just for laughs) -  if that's the
case, this bone break was poorly timed. ;-)

kate
Paul Cassel - 02 Jan 2008 08:51 GMT
> i'm playing with an hypothesis here.  this has been right around the 35 year
> mark since my femoral non-union began and was healed by a complete metabolic
[quoted text clipped - 7 lines]
> metabolic cycles.  and, the hypothesis (just for laughs) -  if that's the
> case, this bone break was poorly timed. ;-)

Possible, but I've never heard of any healing activity interrupted by
metabolic cycles. The problem with doing a bone graft / transplant (I've
had a few) is that mining your body for the material to do the graft is
darn traumatic. My first was such that the mining operation took more
healing than the arm which was helped by the grafting procedure.

OTHO, you gotta do something....
d'huit - 02 Jan 2008 22:23 GMT
d'huit wrote:

> i'm playing with an hypothesis here.  this has been right around the 35
> year
[quoted text clipped - 12 lines]
> metabolic cycles.  and, the hypothesis (just for laughs) -  if that's the
> case, this bone break was poorly timed. ;-)

Possible, but I've never heard of any healing activity interrupted by
metabolic cycles.

***it was only meant as a joke.  that's why i said, "playing with" and
"just for laughs" and put a winking smiley at the end.  i was being a bit
silly, kinda saying my guess was a good as the medicos.<smile>

The problem with doing a bone graft / transplant (I've
had a few) is that mining your body for the material to do the graft is
darn traumatic. My first was such that the mining operation took more
healing than the arm which was helped by the grafting procedure.

***yes.  you are correct.  i've had bone grafting done to my left femur,
when that was a non-union for so long.  my ortho hoped the donor material
from my hip would help knit the rest of the femur "oatmeal" together.
however, the bone grafting didn't take, in my case.  the effort wasn't worth
the discomfort and my hip didn't regrow the "scrapings" either.  this is
partly the reason i dismissed the proposal of surgery for this specific
non-union.

that was not my only reason however, because there is another reason i
didn't mention.  the ortho-surgeon i had in the '70s instructed me to warn
any orthopaedic surgeon wanting to do *any* bone surgery on me, but
especially on that leg.  surgery to that particular leg has a heightened
risk of infection, because the original life threatening infection now lies
dormant behind that same leg's knee (one reason i don't dare have a tkr for
that knee, though i need one).   that same infection is NOT an experience i
want to relive -- sky high fever (i'm talking the kind of fever that does
brain damage, 107 degrees and i was just lucky to avoid brain damage --  
though some of my friends might suggest otherwise.<smile>).  there were two
subsequent major surgeries to clean out the infection, multiple and
simulaneous antibiotics (which were, both, injected every few hours and
given by i.v. drip through inter-vascular tubes that lined my veins.  have
forgotten what those were called and can only describe them), i.v.
anti-biotics so potent that they painfully ruptured/infiltrated the veins in
my arms and chest below those internal tubes after only the second dose (and
had to be restarted in many other vein sites, every two doses; and when
those infiltrated and doctors ran out of non-infiltrated veins, cut-downs in
my ankle and groin had to be done), tubes and noisy pumps removing infected
tissue and fluids from the site.  complete isolation was imposed and that
wound up making my room look like a medical warehouse and bio-hazard dumping
ground, as nothing could leave my room (and all of my personal effects had
to be disposed of, along with the medical litter at the end of it all, when
they moved me to another room.) and visitors could not enter.  and the smell
that would gag maggots.  i'd rather live with a non-union than go through
that again.  unfortunately, for me, the raging fever didn't prevent me from
remaining lucid throughout that experience.  so, i remember those weeks
vividly.  this dormant infection still makes me ocassionally feel like a
walking potential bio-hazard.

OTHO, you gotta do something....\

***or perhaps doing nothing is the best way to go and i think i prefer
that.<smile>

kate
Paul Cassel - 02 Jan 2008 12:52 GMT
> OTHO, you gotta do something....\
>
> ***or perhaps doing nothing is the best way to go and i think i prefer
> that.<smile>

There is no such thing as doing nothing. Deciding not to decide is an
action. Deciding to let things ride is another 'something'. I have
several medical conditions I prefer to let ride than seek treatment
because the ride is smoother than I anticipate the treatment. So with
you too.

-paul
d'huit - 03 Jan 2008 02:40 GMT
d'huit wrote:

> OTHO, you gotta do something....\
>
> ***or perhaps doing nothing is the best way to go and i think i prefer
> that.<smile>

There is no such thing as doing nothing. Deciding not to decide is an
action. Deciding to let things ride is another 'something'. I have
several medical conditions I prefer to let ride than seek treatment
because the ride is smoother than I anticipate the treatment. So with
you too.

-paul

<smiling>a man who thinks as i do -- regarding "doing nothing", "decisions",
"action" and "inertia", as implied.  who'dda thunk it?!

perhaps, i should have restated my comment as, "doing nothing aggressive",
which might also open up a semantics discussion as to what constitutes
aggressive action, medically speaking of course.  to me, surgery is very
aggressive action, though sometimes it is absolutely necessary.

however, "doing nothing aggressive" does not preclude personal pro-activity.
i'm not one who just lets anything ride when i believe i can do something
beneficial, besides submitting to surgery, to help myself.  often, allowing
something to ride (basically ignoring it) creates more deterioration
problems and issues to deal with in the long run, in certain situations.  in
other words:  the ride might be smooth for awhile . . . but the stop, at the
end of the ride, might throw you a$$ over teakettle .<smile>

kate
Nann Bell - 08 Jan 2008 15:05 GMT
> perhaps, i should have restated my comment as, "doing nothing aggressive",
> which might also open up a semantics discussion as to what constitutes
> aggressive action, medically speaking of course.  to me, surgery is very
> aggressive action, though sometimes it is absolutely necessary.

out of curiosity - how about a bone stimulator?  isn't that something
external or does it require invasive action to implant something?  Seems I
also saw something somewhere rectnely about hyperbaric chambers improving
bone healing with their high doses of concentrated oxygen.  Of course, i
don't know if there's one near you - we had a local one in G'ville through a
partnership with NASA.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

Carole - 01 Jan 2008 21:29 GMT
Did your doctor explain why this happened?

Carole

> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below where
[quoted text clipped - 28 lines]
>
> kate
d'huit - 02 Jan 2008 18:27 GMT
Did your doctor explain why this happened?

Carole

he kind of suggested a reason, carole.  (see my reply to paul.)

kate

d'huit wrote:

> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below
[quoted text clipped - 39 lines]
>
> kate
Squirrely - 02 Jan 2008 08:47 GMT
Kate,

I sure hope things turn out good for you with this. I am sorry to hear what
is happening and not happening there. You are always in my thoughts and
prayers.

Signature

Love and Hugs to all
Jo the squirrely one
I am nuts about you.

> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below
[quoted text clipped - 39 lines]
>
> kate
d'huit - 02 Jan 2008 22:24 GMT
Kate,

I sure hope things turn out good for you with this. I am sorry to hear what
is happening and not happening there. You are always in my thoughts and
prayers.

as are you in mine, dear heart.  thanks, sweetie.

kate

Signature

Love and Hugs to all
Jo the squirrely one
I am nuts about you.

> saw my ortho on thursday.  something must have gone amok, cuz my xrays
> showed almost no healing, just a bit of calcification above and below
[quoted text clipped - 39 lines]
>
> kate
 
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