Medical Forum / Diseases and Disorders / Arthritis / January 2008
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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