Not-really-gory photos

[rachelmanija]

Do not click unless you are in the mood for "Wanna see my broken foot?" Cut for photos of bruised foot (and a cat).

The photos don't really do it justice, especially of the top of the foot - there's very dark bruising at the base of my toes that didn't show up well. On the bottom, the bruise is actually darker and extends to the side of the foot. However, you can see how it's swollen so all the wrinkles have vanished. The red marks are from pre-existing blisters, not blood poisoning. ;)

Comments

[mme_hardy]

Oh, you poor *pumpkin*! That looks painful.

[rachelmanija]

It is. If the doctor tells me I have to sleep with the boot I'm going to demand painkillers, because that hurt so much that I've been taking it off before bed.

[mme_hardy]

Huh. When I sprained my ankle last fall the doctor wanted me on continuous NSAIDs to keep the swelling down. Different doctors, different methods.

[rachelmanija]

I haven't seen my actual doctor (a podiatrist) yet. He may well advise that.

[mme_hardy]

You've experienced this far, far more than I, but isn't the doctor-to-doctor handoff maddening?

[rachelmanija]

Yep. I'm bringing an older white man along as backup as there's three things I want to flat out demand even if he doesn't want to do them.

1. Forearm crutches. NOW.

2. Check ankle and knee, do more detailed scan of foot.

3. Better boot or cast for foot.

4. Referral to PT as soon as it's medically possible.

[mme_hardy]

Those sound like excellent things to insist on.

[movingfinger]

You can just get the crutches, you don't need a prescription or anything from a doctor. They're on Amazon. Height of the adjustable part should be such that you do not hunch shoulders when using them. If you're going to be on them awhile or walking on them a lot, it can be good to have spare tips on hand.

[rachelmanija]

Oh! Good to know, thanks. I'll see if I can get them prescribed as then my insurance should cover at least some of the cost, but otherwise, Amazon it is.

[movingfinger]

There must be a sizing guide somewhere. You've been given overlarge armpit crutches (I think they only carry one size honestly and they fit about 25% of the people who use them). On the forearm crutches, you care about height of the stick part (adjustable but you are wanting a shorter one to begin with) and watch also the length of the part that runs from below elbow to wrist. Too short and it will strain your wrist, too long and it will be uncomfortable and hook on your clothes and not work.

A lot of US orthos don't use them or don't know how to fit them. You may be on your own there.

On using them---you're pretty fit, a key thing is, use core muscles for stabilizing yourself; drawing down shoulder blades and firing that bra-band muscle set (forget the name) when you swing yourself off stairs or curbs is very helpful. Put the crutches down securely, lean forward onto them, touch down with good foot.

Good luck, you'll be much more comfortable with them.

[rachelmanija]

Thanks, that's very helpful. I take it you have personal experience?

[movingfinger]

Not personal-to-me, but I lived with a broken leg sufferer who found the forearm crutches liberating and watched another person with a broken leg find them transformative as well, and I have a good friend who uses them always; we've talked about the mechanics of it and the reluctance of the US medical industry to adopt them. There's an association with polio, I think, and some idea that they're for cases of paralysis, MS, chronic illness; but they're really better for everyone who needs crutches.

[rachelmanija]

Yes! I just listened to a podcast on this exact topic: https://www.outsideonline.com/2376996/can-we-please-kill-crutches

[kore]

Yeah, one of the FEW people I saw in the 90s who had forearm crutches had had polio as a kid. I still don't see them around too often as general mobility aids.

[rydra_wong]

Whereas over here, I'm not sure I've ever seen armpit crutches IRL!

[kore]

They are such a LITERAL PAIN. And in my case, they were really wrongly sized and I didn't get any tips or training on how best to use them with my injury, either. (The first time I badly sprained my ankle when I was 13 or so by tripping into a hole in a neighbour's backyard, the prescription was also "It's not broken, have some crutches.")

[naomikritzer]

When my father broke his ankle in the UK, he was given forearm crutches. I borrowed them from him when I badly injured my foot a couple years later. Haddayr has spent years telling me just how much better they are than shoulder crutches so I was an easy sell.

(She also enthusiastically recommends tornado tips for them, but that's going to be less crucial given that you're using these temporarily. She really likes the extra shock absorption those offer, though.)

[kore]

THEY ALWAYS FREAKING GIVE YOU CRUTCHES THAT ARE TOO BIG

I AM 6' AND SOMEHOW THE ER DEPT FOUND OVERSIZED CRUTCHES

[rachelmanija]

Wow, that really says it all.

[kore]

I think I probably landed smack in the middle of "too small for men's, too huge for women's," which also happens to me with jeans and shoes.

I don't have a car, so I didn't do this, but while you're injured, a temporary handicapped parking permit might make it easier to get around?

[rachelmanija]

Oh, good idea. Hmm. I can get the doctor to sign it tomorrow, but it takes two weeks to show up. SIGH.

[rydra_wong]

Good how-to guide:

https://www.rcem.ac.uk/docs/Local%20Guidelines_DischargeAdvice/12ei.%20Elbow%20crutches%20(Oxford%20University%20Hospitals,%202015).pdf

For stairs, sans handrail: going up, you move your good leg up first, then the crutches follow. Going down, crutches go down a step first first, thenleg follows.

Tutorials:

https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/walking-aids/using-crutches

[rachelmanija]

Thank you! You are a lifesaver.

I fell on my broken foot last time because the crutches weren't stable enough for me to rest my weight on and then step up with my good foot. And everyone told me my crutches were unusable on steps and to scoot up on my butt, which 1) not ideal, 2) my apartment has a high step before the stairs start, so if you sit down to scoot up that, you're then stranded and can't get up or reach the start of the stairs. That is a BAD DESIGN. Actually, that step is too. Why not a ramp?

[rydra_wong]

I pass it on as it was passed onto me!

And yes, I would not rec trying this on underarm crutches. But IIRC I got quite chill about stairs on the forearm crutches; more tiring than having both legs to do it with, but definitely do-able.

(I have two flights of stairs in my home and worked out how to parkour up them braced between the handrail and the wall on the other side, no crutches at all.)

[rachelmanija]

No wonder you could do 50 pull-ups by the time you were off them!

Hmm. I think my stairs are too wide for that. I have short little arms.

[rydra_wong]

I was looking back at my notes and ironically I was much stronger then than I am now -- climbing outdoors a lot is great for technique but not for strength. I need to get that strong again!

[julian]

Yeah, seriously, WHY NOT a ramp? And/or why have stairs in random places that don't need them?

A gym I went to was very old-style (concrete everywhere), and its women's changing room had a little barrier step in front of both the shower (which can make some sense from drainage perspectives) *and* the toilet area. It was completely maddening, accessibility-wise.

[rydra_wong]

Also, rec I got from one of my doctors: cycling gloves make crutch use more comfy.

[rachelmanija]

Fingerless or with fingers?

I got a prescription for forearm crutches! Hopefully I can pick them up tomorrow. The nearest medical supply store turned out to be closed on Mondays, and his office didn't carry them.

[rydra_wong]

Fingerless -- it just gives you a bit of extra protection and cushioning on your palms. Also makes you look like Shuos Jedao.

ETA: you want the ones with padded palms, to clarify (don't know if there are ones without as I do not cycle).

Yay better crutches!

[rydra_wong]

Linking without comment:

https://vassraptor.tumblr.com/post/183885232593/what-purpose-do-fingerless-gloves-have-other-than

[kore]

Those all sound good. The ER and the follow-up GP also had me on higher than usual quantities of Advil, for my bad sprain, like mme-hardy's did. They did a REALLY space age scan of my foot, too -- detailed x-rays from different angles that they didn't have to wait to develop but could read right there.

[feldman]

Oh ouch! The only bone I've ever broken was a foot bone, that truly sucks, I hope you recover speedily!

[rachelmanija]

How was your recovery? Did you use crutches?

[feldman]

My recovery was complicated by a dismissive ER doc telling me I'd only broken a toe, so I taped my toes together and hobbled on it for a week, because what else do you do for a broken toe? My working class upbringing and ability to ignore pain overrode my medical knowledge.

Which is dumb, because my foot looked like a rainbow balloon animal.

The podiatrist I saw when it got worse after a week told me I'd broken a metatarsal in the body of the foot, so there was a walking boot, cortisone shots, physical therapy for the foot, and then again later for the hip because I'd been limping speedily in the FrankenFoot instead of using a normal gait.

Don't do that. I don't recommend that at all.

[mtbc]

Yeah, my doctor told me it was probably just a soft tissue injury so I ended up just buying stuff myself that felt like it helped: I was walking strapped firmly into one of those big aluminum-frame boots for weeks because it felt too bad otherwise, weird though it was to learn to do staircases in one. It was some time later when I was still suffering that they decided maybe it hadn't been a soft tissue injury after all: the guy working the MRI machine was very much ah yes, that's the issue when he saw inside my foot and then I had cortisone shots and stuff but it's never been quite right since. Fine for walking and running at least. So best of luck to people in getting sufficient timely treatment!

[kore]

Ohhh yeah, "we can't do anything for broken toes except tape them together" was medical Common Wisdom for a long time, for some reason. When I badly badly sprained my ankle in junior high, all they did was give me (OVERSIZED) crutches and tell me to stay off it (while still going to school where I changed classrooms every hour). And that bad sprain probably led to the ankle being super prone to sprains, &c &c.

[pameladean]

Ow ow FUCKING ow.

Erin seems justifiably concerned.

Did they tell you to ice it?

P.

[rachelmanija]

Yep. This is the amount of swelling WITH icing/elevation.

[pameladean]

Holy shit. You don't do things by halves, do you?
P.

[rachelmanija]

I couldn't just trip over my cat like a normal person, I had to fall 15 feet ON PURPOSE.

[pameladean]

*snort* This makes me envision a cat-ruled world where an anxious conference occurs about how it is fated that Rachel is going to hurt her foot but we really don't want her to trip on a cat, that's dangerous, well, how about that bouldering she does, hmmm? You know that ridiculous doctor told her she'd break it?

[naomikritzer]

I mean compared to the etiology of my worst injuries, "fell off a bouldering wall" is BADASS.

(I tore the cartilage in my knee when I was 22. People asked if I did it playing frisbee? or skiing? or falling on ice? NOOOOOOOOO. I was sitting on the floor and the phone rang and I stood up to answer it.)

(My other two noteworthy injuries -- broken ankle at 10, badly sprained food in 2015 -- I got by falling down the stairs in my own goddamn house.)

[oracne]

Owww!

[graydon]

You did that up proper, you did.

That's by-no-means-excessive swelling for the type of injury. If the camera-shy purple bits are not spreading and it's been a day or two, that's good, too; not much internal bleeding. (You know about aspirin being Right Out under the circumstances?) Still going to be severely miserable; sympathy!

Ibuprofen can be a big help. Last time I was in the ER for a muscle tear, I got given naproxen, which was nigh-miraculous at reducing the swelling. If you can get it, that might be an idea.

I so hope none of your cats like to sleep on your feet!

[rachelmanija]

Oh, yeah, naproxen is over the counter here. I'll try some.

The cats have been shoved off my foot with great prejudice and have now learned to avoid it. I am still having to repeatedly evict them from the chair I'm using as a wheelchair.

[graydon]

I am glad they figured out the foot is now a no-go area.

[naomikritzer]

I find naproxen to be slower-acting but better-working than ibuprofen. My husband finds it to be easier on his stomach (but his digestive tract responds really badly to ibuprofen.) I rarely get an upset stomach from drugs BUT when I was in Paris and developed plantar fasciitis and my doctor friend told me I could take the double dose of Naproxen twice a day if I wanted to, after about five days of this I noticed that I was feeling nauseated all the time and it occurred to me after another two days that MAYBE this was because I was taking a higher-than-OTC-recommendations dose of a drug known to be irritating to the stomach?

Anyway, uh, my point here is, if your stomach gets cranky, make sure you're taking your NSAIDS with food or maybe cut back on the dosage.

[graydon]

Pretty sure the expectation for all NSAIDs is "food first"; I get this from dentists, nurse practitioners, bone specialists, pharmacists, it doesn't seem to vary across speciality. That might mean people in Ontario are burning holes in their duodenum with advil a lot, I don't know. But as advice it's a constant.

[movingfinger]

Ibuprofen gel would be good for this.

[rachelmanija]

Thanks! I will order some. I just now tripped over a curb, went sprawling, and landed on it. AGAIN.

[movingfinger]

omg, just saw that, ow, ow, no don't do that

Using the topical ibuprofen is really really helpful for bruising/local swelling. I think you can get up to 10% without a prescription?

Massaging the lower leg (non injured area) gently to help keep circulation going may help with the swelling. Stroke upward, not hard pressure.

You are doing a lot on a fresh injury. Also, it's possible that the evil shoulder crutches are up a little high, people (generic medical professionals, I'm looking at you) tend to adjust those too high in the pits, so there's a hunch in the shoulders and even poorer control than the crappy design dictates. Your weight shouldn't hang on them.

Thinking of you, wish I were close enough to help out.

[rachelmanija]

Thanks! I do have nearby friends helping out. It's just that this is so recent that I don't yet know what I can do, what I can't do, and what's not worth doing until I actually try it. I could have called an uber to the farmers market, for instance, and will do that next time.

The crutches are too high, yeah, and they can't be adjusted further down - they're already at max.

[vass]

Caution re NSAID topical gels: they're wonderful, but cover them up if your cats are the sort that might lick them. They're very not safe for cats.

[rachelmanija]

Thanks for the warning. I'll keep a sock on.

[minoanmiss]

Dramatic foot comparison! And a cat.

[julian]

That's quite impressive swelling. (Also: Ow!)

[vass]

Wow, that is some downright heroic bruising and swelling.

[kore]

OWWWWWWW FUCK OW.

Are those the boot strap marks? OW.

[rachelmanija]

Yep! There's enough swelling extending up my ankle that those sorts of marks stay for a while.

[kore]

Fuuuuck that is some nasty edema.

Also, IDK why, but dark bruises never seem to show up well with a camera, whether film or digital. Something about the light reflection? But you can have smeary giant dark purple ones IRL and they will just look like tiny shadows through a camera.

[lilacsigil]

That looks like some kind of forced perspective foot, one Gandalf and one hobbit! Oh dear! I broke my foot as a teenager (it wasn't diagnosed or treated at the time) and my main problem ever since is that now one of my feet is much taller than the other, so I have to shoe shop with caution. Keep reducing that swelling and keep everything in place as much as you can now!

[nenya_kanadka]

Ooh, that reminds me of the time I fucked up my knee in a minor MVA. Nothing broken, but ridiculous swelling; could not wear jeans for a few days.

OW! And I hope it heals speedily and with as little trouble as possible.

(Hi, kitty! *scritchy scritch scritch!*)

[telophase]

I'm surprised you didn't get one of these since they're all over the university here.

Good luck! I ended up being unable to take any NSAID but ibuprofen after taking naproxen for an extended period after hurting my back. (note: if your non-swollen ankle starts swelling after taking an NSAID, stop that NSAID immediately.)

[rachelmanija]

Will do!

[telophase]

I failed to explain what's going on with the swollen feet/ankles in this case: it's basically your body having problems with processing salts, as a doc I know explained to me at a party. That's a very short, very incomplete, not entirely wrong explanation, but as we were at a party she didn't want to attempt to explain further. :)

[monanotlisa]

OUCH!

Still, thanks for sharing. Ouch. Would you like to receive something to make you more comfy? I forgot to cancel my Amazon Prime. Might as well use it to help you (and Jeff Bezos, alas).

[rachelmanija]

SURE. Thanks!

[monanotlisa]

DM me your address?

[rachelmanija]

Thank you very much! I've been using it a lot.