A humerus story that is not funny (broken arm)

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georgegassaway

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“Houston we have a problem. Left humerus structural failure.”

They say bad news can wait, so I waited. I did not want to mention this until Christmas was over. A week ago, late Friday night, December 23rd, about midnight, I slipped on ice, fell hard, and broke my upper left arm, the humerus bone. Went to a nearby hospital urgent care, they took x-rays to confirm it was broken and in what manner. They put my arm in a sling.

Due to the holiday I could not even call to arrange an appointment for orthopedics to see me, until Tuesday morning the 27th. When I did call they could not arrange anything until Thursday the 29th. However the arm had begun to hurt more and swell. So I went back to the urgent care late Tuesday afternoon. It was badly swollen so they did ultrasound to look for clotting. They found a clot near my carotid artery. Said I needed to be put on blood thinners and was transported to a hospital.

Got a CAT scan, and surgical and medical teams discussed options for surgery , or letting it heal by itself. Is complicated by the blood thinners, and many other trade-offs and risks either way. There are some smaller pieces, surgery can pin them back together. The surgeon is very impressive. I decided to go for surgery, which will happen Saturday morning. If things go well I'll leave Sunday otherwise may not leave till Monday (blood thinner IV has to be stopped for a few hours for operation, resumed a few hours later). I will give an update later after the surgery.

As for working on models, Will not be able to do much for at least a month, and even then limited. Maybe back to more normal building in a couple of months. Though I will plan out things in the meantime.

So now I have more things in common Wernher von Braun. Von Braun broke his left arm shortly before surrendering to the Allies. I surrendered to ice and gravity.

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BTW - I am using voice dictation to help write this message. And have written this message on and off over time.

I did not let that put a damper on Christmas. The presents I gave were well received, everyone enjoyed what I gave them. I'm glad I wrapped most of the presents earlier. I got some help with wrapping three presents later. So I had fun with my gift giving.

I got a lot of nice goodies, including a signed copy of astronaut Mike Massimino’s Book “Spaceman”. Also a book about shuttle history leading up to Columbia's first flight in 1981: “Into the Black", and an extended edition of “The Martian”, among other things.

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Bummer. I broke my femur last year. What an inconvenience! Here's to a speedy healing!
 
Hang in there George-positive vibes your way. Looks like you have some good reading material to last you a few days. Mike's book was pretty enjoyable. I can't say enuff about the extended Martian version. Peace and prosperity to you and yours this coming year.
 
Glad you're on the mend.
Well, at least you were able to attend your Christmas celebrations. Thursday before Christmas, I woke up dizzy. Tried showering and got too dizzy to stand. Then started throwing up. GF took me to the emergency room, where they decided (AFTER a CAT scan...) that I was having an inner ear problem caused by a sinus infection. Prescribed meds for infection and for nausea. Woke up the next morning dizzy and puking. Saturday was OK. Went to the GF's dinner party (parents drove me). Sunday (X-Mas) woke up puking and stayed home by myself all day. Never felt well. Monday morning, more puking... Went to doctor Tuesday, prescribed Prednisone and another pill for nausea. I'm feeling a lot better and driving myself a little now.
 
Ow George!! I can relate...smashed my own right humerus in a hang glider crash 30+ years ago, not long after we first met. It knocked me out of attending NARAM-23. Glad you found a good surgeon, that ought to help quite a bit. Don't try to start building too soon :) Here's to a quick recovery.
 
The comminuted fracture would be second on my list of concerns after discovery of the carotid clot. Generally speaking, clots in brains are bad news^2. Speculation without more info. Did they mention anything more regarding the vascular issue? Hope all goes well, especially considering the risks to the organ threatened by the carotid thrombosis. Hopefully the lack of stated concern regarding the clot is reflective of its' clinical insignificance. Keep us posted.
 
Not good news George. Are you on a blood thinner that you give yourself a shot or pill type. I have been on BT for years for a PE and had a surgery a number of times and always had to go off thinner 4 days before surgery. If its the Heprin shot type thinner that leaves your body in a few hours. You need the arm fixed so they need to do what they think is best.

Goos luck
 
Speedy recovery, George.

A broken bone isn't as bad as a torn quadricep tendon, which I had this year. At least you don't have to figure out how to sit on a toilet with a full leg cast...high altitude bombing is not the answer. LOL Get well.
 
Awww geez George,,,
Did ya really need this one ?? lol..
Heal quickly without any complications ...
And Be Safe,, lol..

Teddy

Ohh,,
Mike Massimino stopped by our launch field a year ago or so...
Just my luck, I wasn't there that day,, lol...
 
Ditto, sending positive vibes. I think that, in addition to your broken bone problem, your other problem is getting injured during a huge holiday week. I know, I have a minor problem right now, just move to an area, and get even get a phone call returned. Sheesh...trying to avoid an urgent care, so I don't get lumped in with all the drunks.

The comminuted fracture would be second on my list of concerns after discovery of the carotid clot. Generally speaking, clots in brains are bad news^2. Speculation without more info. Did they mention anything more regarding the vascular issue? Hope all goes well, especially considering the risks to the organ threatened by the carotid thrombosis. Hopefully the lack of stated concern regarding the clot is reflective of its' clinical insignificance. Keep us posted.

regarding the clot, it cold be "fatty embolism," which is often associated with a fracture (see https://www.medicinenet.com/script/main/art.asp?articlekey=116363)...I agree, not good news, at some point George, you should just camp out on the surgeons front porch and demand to be taken care of...not that that would get you anywhere.
 
Thanks, all.

I had the operation Saturday morning , it was successful. They went in through the shoulder. Used a lot of titanium parts and screws. Surgeon said that there were more pieces than expected, so a very good thing I went for the operation instead of trying to heal itself.

I had not considered how much pain there would be, but worth it in he long run. I had a nerve block, which helped a lot, pretty rough after it faded away. Feeling a bit better now though. Began some physical therapy, and Walking through hallways. Back on the blood thinner IV that had to be stopped for surgery.

Might be discharged Monday
 
Thanks, all.

I had the operation Saturday morning , it was successful. They went in through the shoulder. Used a lot of titanium parts and screws. Surgeon said that there were more pieces than expected, so a very good thing I went for the operation instead of trying to heal itself.

I had not considered how much pain there would be, but worth it in he long run. I had a nerve block, which helped a lot, pretty rough after it faded away. Feeling a bit better now though. Began some physical therapy, and Walking through hallways. Back on the blood thinner IV that had to be stopped for surgery.

Might be discharged Monday

Good news!


Steve Shannon
 
Glad to hear the surgery went for you George.
Did they say anything about your bone density?
When my mother broke her hip in a fall, we found out she had AP.
She then had a daily shot in her belly increase bone density, administered by my wife.
Don't want to put a scare in you, but as we all get older we loose bone density.
No MRI's for while with metal in your arm.
 
Thanks, all.

I had the operation Saturday morning , it was successful. They went in through the shoulder. Used a lot of titanium parts and screws. Surgeon said that there were more pieces than expected, so a very good thing I went for the operation instead of trying to heal itself.

I had not considered how much pain there would be, but worth it in he long run. I had a nerve block, which helped a lot, pretty rough after it faded away. Feeling a bit better now though. Began some physical therapy, and Walking through hallways. Back on the blood thinner IV that had to be stopped for surgery.

Might be discharged Monday

Great to hear! I hope you get discharged soon/when ready. Better luck in the New Year!
 
I got home Monday afternoon. I am on a lot of pain medication, so not feeling much pain, unlike Saturday night / Sunday morning. Able to move around okay. I am hoping to get a copy of the X-rays to show all the work. Below is a pre-op sketch the surgeon drew on a whiteboard, but he said after the operation there were more pieces than that. Definitely needed to be operated on.

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Picture below left shows the swelling last Tuesday night (Dec 27th) when I went back in because I knew it didn't feel right. The picture on right is after the swelling reduced and there are marks on my arm to measure the swelling.

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Last two pictures from before I left the hospital. First at left shows the the incision across the shoulder where they had to go in to operate on the arm (Picture taken before putting the dressing back over the incision). At right, the sling is in place.

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It is amazing what they can do today with surgery. Sorry about your discomfort, George. I guess I was lucky when I had my tendon surgery and I had no pain. Therapy was another matter.
 
Take the narcs and don't feel guilty about it. The kind of pain you're having warrants it. Whittling on bone hurts pretty badly. Nerve block is great but is like stroke practice. Whole arm is dead, motor and sensory for 7 to 12 hours.
I'll trade temporary paralysis for severe pain any day. Kurt
 
Take the narcs and don't feel guilty about it. The kind of pain you're having warrants it. Whittling on bone hurts pretty badly. Nerve block is great but is like stroke practice. Whole arm is dead, motor and sensory for 7 to 12 hours.
I'll trade temporary paralysis for severe pain any day. Kurt

Just before surgery, the anesthesiologist mentioned the nerve block option. I felt that I was running so many risks that I turned that one down. He said they could still do it afterwards during recovery if I wanted. My first recollection starting to wake up was to grunt “nerve block, nerve block”, which they did. :)

So for a while, some discomfort not much pain until the nerve block started tapering off (definitely strange to have the whole arm, hand and fingers numb). As that wore off, it took a while to find the right pain med combination that worked, without being too much.

But when the physical therapist came in at 9 AM Sunday, I felt up to getting out of bed, and trying some every day things such as getting in and out of bed, bathroom, and stairs. Before leaving Monday we covered some other things including some basic hand and arm exercises for now, to get more advanced later.

As far as the pain medication, I have always walked a fine line with that. Not using it all up because it's there, using enough to be comfortable. The hernia surgery I had November 18, about half of those pills were still left over. So when I broke my arm on the night of December 23rd, I had enough to use it until after Christmas, before filling the new prescription.

An odd thing Monday afternoon, I sat down to use the computer for about 10 minutes, intending to a take a nap after the 10 minute computer session. 2.5 hours later, I woke up sitting in my chair at the computer. Then got to bed and took the originally planned nap for another three hours.

This is a long reply considering the situation, but once again I'm using Voice dictation to help write it.
 
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Ortho surgery is no fun. I have hardware in my right ankle, and it hurt pretty badly. Take your medication, and do not feel bad about napping more.

Hopefully in a few days you will begin to feel better.
 
Recovery going pretty well so far. Once again using voice dictation to help write a lot of this.

Ran into a bureaucratic issue. When I was discharged Monday, I was supposed to have two types of pain medication. One a slow acting type, good for about 12 hours, to take 1 tablet twice a day. That was to be the primary. In addition to that, shorter-term tablets, to take from 1 to 3 as needed, as often as every four hours, depending on the pain and pain goals.

I had a great care in the hospital, but discharge process was a bit ragged. I certainly wanted to get out of there, but wanted to have everything ready as well by the time my ride arrived. I had not gotten any of the discharge materials, paperwork or medications, yet I had been given the okay to call my ride to come get me. I pressed the nurse call button to see what was going on but nobody answered for over 20 minutes, and by then I'd walked out of the room in the hall to find someone else to help figure it out..... although they were not able to do anything. Anyway, this is a bit long about way of saying that finally, just before my ride arrived, I was rapidly given my paperwork and a sealed bag full of various medications for different purposes, wheeled out to the entrance within five minutes of that.

The very kind of rushed departure I had hoped to avoid.

"Do I have everything, all the medication?"

"Yes" (no, as it turned out)

That first night back, I found the short-term pain medication, to take 1 to 3 tablets as often as every four hours, and I did as needed. However, I did not find the long term 12 hour tablets that I should have had as the primary pain medication. But I was glad to be back, mostly feeling okay from the 12 hour tablet I was given shortly before leaving. So that was fine for then. By Wednesday, I had gone through my belongings bag and medication paper bag multiple times, to confirm that I did not have a bottle of those 12 hour tablets.

I contacted them using "my chart", which I have had great success in using for communicating with the local County hospital system that I've used the last few years. However when I broke my arm near midnight it was not practical to go to the county hospital way downtown. I went to a closer-by urgent care, and ended up in a totally different healthcare system (ironically when I did get hospitalized I was transported to a different hospital farther away than downtown). I have found out the hard way that they do not communicate very well via my chart, as I have come to expect with the county healthcare System that also uses my chart. In other words I never got an answer using that system.

By this morning (Friday), I maybe had enough of the other pain medication (not refillable) to last me through Monday if I was willing to increase the pain level more (as I had already done). So I called around, taking three tries to reach someone that could even attempt to address the problem. It turned out that they did not send me home with the 12 hour pain medication in a bottle, they sent me home with a paper prescription to be filled at a pharmacy. Except.... Nobody told me this.... And after going through dozens of pages of printouts.... No.... Nope.... No such paper prescription was there. So not only did they not tell me that a bottle was NOT in the bag like I had asked ("Do I have everything, all the medication?"), they did not send me home with the paper prescription to begin with.

I was given two options. One, return to the hospital, about a 90 minute round trip across town, potential to get caught up in rush hour traffic, to get the stupid piece of paper. Only the holy official piece of paper (prescription) would be acceptable for me to get the prescription for pain medication to be filled. No faxing, no email, no nothing - this is the 1800s when it comes to pain medication prescription documentation. By all rights they should've sent someone to me to bring me the paper prescription but that was never going to happen. Even though this was 100% their screw up.

The other option was to see a doctor to write a "New" prescription. I'd had not intended to see my primary care physician until after I visited the surgeon for a follow-up and staple removal. That was the sane logical thing to do, and my primary care physician had already agreed I should not see him until later. But given this situation, I called the clinic of my primary physician, and was very fortunate that he could see me this afternoon. His location is not exactly close by either, but not nearly as bad as going back to the hospital I would've needed to go to for the piece of paper.

At least by going to him, he was also able to check and verify that the arm was doing okay in the four days since I was discharged. And he adjusted my pain medication prescriptions, to not only provide the primary 12 hour tablets that I have not had since I left the hospital, but to add more of the short term pain medication that I was running low on (which could not be refilled without seeing him).

So that finally all got resolved. But it was extremely frustrating, and totally unnecessary, because somebody made a mistake (sending me home without the holy piece of paper prescription, as well as not telling me about it), but I was going have to deal with finding out how to solve the issues surrounding their mistake. Also, as I sat waiting to see my doctor, a lady came in with her 4 to 5-year-old daughter, they were late for their appointment and missed it. There were no openings available, so they had to leave. Most likely if I had not needed to visit my doctor today, due to bureaucratic screw ups, this lady's daughter probably would have been able to see my doctor (rather than me). So that screw up in its own way screwed up someone else. I can't feel guilty about it, not my fault. But this made me more upset with whoever screwed this up to begin with, knowing that my needs as a result of the screwup, probably cost a little kid being able to see their doctor today.

I have taken pride in the fact that when I have needed pain medication in the past, I have used it as needed only. Not just using it up because I have it laying around. And I know it's easy to get hooked on this stuff, yet another reason to be careful. But when you need it you need it. I woke up this morning at the end of a dream where something bizarre was happening in the dream to cause me to feel pain..... and I was feeling real pain when I woke up. To try to stretch out what I had left, I had not taken as much as I should have in the previous 24 hours.

Anyway, that prescription screwup is resolved, and I feel I'm about right in the middle of where I should feel. Not as much pain as before, but feeling a little bit, which to me means I should be at about the right level. The mistake would be to take so much that I don't feel any pain. And as I found out that hospital it's more like a pain goal, where a pain goal of zero at this point in time, is unrealistic.

I'm mostly posting about it just to vent.

I do want to stop to note note that regardless of the chain of events that occurred to cause me to end up where I ended up I am very glad that I became a patient of the surgeon who operated on me. I was super impressed by him, and the way he mentioned his surgical team and the separate medical team which was considering my nonsurgical issues (on blood thinners due to clotting, the need to stop the thinner for the operation, as normally an operation would not be done once on thinners), I was reminded somewhat of Wernher von Braun. Von Braun was a great rocket scientist but he also had a great crew, some of which were even better rocket scientists than him, whom he listened to and relied on. Von Braun was a great manager. This surgeon, Dr. Armitage, came across to me not only as someone that seem like a great surgeon, but a fantastic manager. This prescription hiccup reflects in no way on the great work that he and his people did.

As unfortunate as I was to break the arm, I was very fortunate for the chain of events to result with him and his team to be the ones to be so involved in the planning and work to do this operation.

Otherwise, there's not much significant to update about. Simply that in general (ignoring the prescription complications)
it's a little better each day. It's a bit easier to climb out of bed each day, and that is a bit complicated for me because ideally I should roll out of the right side of the bed but there is wall there so I need to roil out the the left side. What has helped with that, is to tie a jump rope to the foot of bed, so I can use my right arm pulling on the rope, to pull me upright, then I can get my legs over the left side of bed.

In the few days between the original break and going back to urgent care and getting hospitalized, not only was getting in and out of bed an issue as mentioned above, but with the arm just in a sling at that time, it was just a hanging hunk of meat which hurt most anytime I moved it especially getting in and out of bed. With the surgery having been done, I cannot put any stress on the arm, but it no longer feels like a free swinging pendulum hunk of meat. My arm is really attached now.... with a lot of titanium parts, and some surgical cement. Fragile, but with time it will heal and be stronger. So the arm does feel attached, unlike before the surgery.

I could mention some other ways of daily improvement, but some of those would go past the edge of TMI. :)

I am doing a bit of exercise with it, mostly involving the hand and wrist and some with the elbow. I Want the upper arm to heal more before I exercise it more specifically.

When I visited my regular doctor today, that was the first significant amount of walking around I had done since before the accident. Later when I went to Target to get the prescriptions filled, I walked in for that, and had to kill 20 minutes while they verified my insurance would cover it and filled the prescriptions. So I walked around the store for a while and got something from the grocery department while I was at it. So I can walk okay. I still feel some of the bruising on my bottom or hip from the fall but I don't need the walking stick I rigged up earlier.

A week from now, there is a holiday party that was delayed from December due to weather. I feel confident I can go to that, and enjoy it.

When it comes to rocket building, certainly not soon. But I am trying to plan things out so when I do feel up to building, it should involve more actual building, and less planning. So I can make more efficient use of time and capabilities.

- George Gassaway
 
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Surgeons and surgical teams can certainly be impressive...
I'm glad you're happy with yours..
Feel better George..

Teddy
 
So here is an all positive post.

Things did go better sleeping last night. I had been wearing the sling continuously. But when I had the sling off for a few minutes at the doctors office the arm felt okay. Not the proper position for healing, but good for exercise, and nice to not have the sling squeezing on my skin for awhile. I also realized I was able to handle removing and putting the sling back on much better than just before I was released, when I needed help.

The only position for sleeping that I had found a comfortable enough, was flat on my back. But last night I tried things differently. I took the sling off, so I could have many hours without the sling squeezing on my arm. I laid on my right side, so my left arm was mostly above my heart level. When the arm is below heart level, that hurts circulation and increases swelling. So by having it above heart level for sleeping, the circulation was improved, and it helps reduce some of the remaining swelling.

Pain wise, that position was not better then being on my back. But now that the pain medication is back on track, I felt good enough to sleep that way, knowing in the longer term it's better for the arm to be out of the sling for a while (as long as it is in a similar position as the sling holds it). And sleep wise I usually sleep on my side.

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Every little thing helps. I also spotted a U-shaped travel pillow I have, which has microbead filling, it is very soft and plushy. Realized I should try using it as well. After using a small pillow to help support some of the arm, that travel pillow was perfect to have under my left hand to find just the right support and position, the microbead fill can be tweaked to get the feel very comfortable for the hand. Wish I also had a rectangular pillow with the same kind of microbead fill.

Of course an even more comfortable option would be to float in zero gravity. But it would be very costly to do, not practical. Would have to be in orbit. The zero G simulations inside Aircraft that zoom and dive, only have microgravity for 25 to 30 seconds, then during the pull up there are two G’s for more, so not exactly practical for Multi hour “weightless” naps. So, it is fun to think about, but then reality creeps in :)

Floating in water, could be a lot more practical. But then the reality of water creeping into the surgical wound, creeps in. :)

Well there are flotation tanks. Often meant more for relieving stress. But that probably would work nicely as long as keeping the surgical wound dry was solved. But I know my insurance would never cover anything like that, just interesting to think about. I would much prefer to float onboard the international space station, than inside of a flotation tank. :wink:

Better yet, a Bacta Tank. but.....

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Have had some good progress this week. Drove my car for a short distance to get some supplies, mainly just to "test drive" my ability to handle the car with only my right arm. That went pretty well. The only time I wish I could do hand over hand steering is for tight turns at low speeds such as in a parking lot or coming out of the driveway. But I adjusted to doing that with one arm, being extra careful, and waiting if need be. Driving down the road at 20 miles an hour or more, does not require very much arm motion so that's fine.

I even went to see a movie, Hidden Figures.

Today (Thursday) I visited my surgeons office. Some new x-rays were taken to evaluate the healing process. He said it is healing well, though I need to stay in the sling as much as possible for a couple more weeks before beginning to work on upper arm motion.

Got the staples removed, the incision has healed well.

And so, here are pictures I shot of the x-rays. Titanium plate and screws. Staples also visible as they had not been removed yet.

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To make driving easier and safer, I ordered a steering wheel spinner knob from eBay (Stock photo. If only that was my car, but it is not). I was surprised it arrived so quickly, got it today, put it on the steering wheel, drove to Target, works great. I will remove it once I can use my left arm to drive well.

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