Is It Big Enough to Matter?

As sad as it may sound, after about 100+ fractures (and for some of you maybe even less) I have been able to compare fractures. "Yeah, I think I broke my toe or something - whatever it's not a big deal. I don't really even walk anyway." How many of you have said something along those similar lines to non-OI'ers and gotten a  look of stunned disbelief? I will admit to have broken ribs or a shoulder and not gone to see my orthopedic doctor. Instead  I have grown to know how to slip in and out of my clothes when I can't raise my arm above my ear. Or I have been able to stifle coughs and sneezes, shifting to the un-injured side a bit, to dull the wincing stab of a broken rib. Recently I broke my ankle and called my doctor the same day it happened, his response was: "well can you use an old cast or splint to stable it until tomorrow?" For most other kids a broken arm can be a painfully uncomfortable 5 hour wait at the emergency room, for us familiar with the situation it's 'pull out the sling and be damn cautious.' Or we just lay in bed and pop a tylenol w/codeine pill left over from our last surgery.
Is this reckless behavior? When will OI kids begin to know 'if it's a 'big' enough fracture?' to warrant fretting parents and an hour or longer drive to the hospital? Why do OI'ers do this? Should it be discouraged?
Disclaimer: I am not advocating for kids to skip the doctor's visit if there IS a fracture regardless of how painful or not it is. This is just what I've done, and have known other OI'ers to do as well.

I remember in elementary school when fractures would occur (which was frequent), I would just stop by the nurses office and my mom or dad would bring an old splint or sling and then send me back to class. (The fact that I loved school and being there had much to do with this). The doctor's appointment would be made after school and then life would continue as normally as ever. I can't imagine what my teachers thought as this continued well into high school and schools would be paranoid with worry about liability issues. As I grew and as fractures happened I learned to be able to tell the radiologist that turning or shifting an injured area would be too painful, the memory of the pain - no matter how long ago my last fracture, could be quickly recalled and I would wince just thinking about it. Luckily I also happen to have an orthopedic doctor that takes my word before the x-ray; his attention to where I pointed to the pain even as a 4 year-old not only empowered me to know that I was in control of my own body and the O.I., but that despite his stupendous ingenious and medical degrees - he trusted me to know my own body. This is key. If it weren't for that I probably wouldn't trust myself as much, be as willing to explore and push my body to discover what I can and cannot handle. So now whenever the snap, pop, crack, and the burning swords pierce my insides I am able to breathe calmly and ask myself: is this big enough to matter? When I say "enough to matter" I mean is it necessary to call the doctor right then? His page number is ingrained in my head and listed as my emergency contact in my cell phone. Or can I trust myself to know what to do next, because I know that when I get to him he'll ask me "well, can you point to me where it hurts? And how much does it hurt?"

Other tips to gauge fracture 'seriousness':

  • If you have a young child who is unable to communicate a doctor's visit is required. But even at this stage you can begin to get into a 'pain threshold' routine. Ask him or her how much it hurts, where it hurts, use the scale of 1-10, or use a pain chart with smiley and frowning faces to exemplify how much it hurts. Getting into a routine will help establish some semblance of "normalcy" or "what can I expect?" consistency despite the uncertainty of not knowing where and how much is the pain. 
  • For school-aged children I would suggest letting your child's school nurse/principal/teachers/P.E. teachers know of the plan when fractures happen. (Day care personnel, baby sitters and other care takers). I know my mother was not always so keen on listening to me first when I broke something in school, it took about... 25 fractures to happen before she felt like she could listen to me. Get a signed doctor's note to "okay the plan" if necessary!
  • If you have a infant who you suspect has a fracture but you are uncertain? My parents used to gently tickle me in various places, whichever limb flailed with that unique cry/scream would be the injured area. 
  • Know that your child is not taking this lightly, s/he is probably not just "blowing something off." The bottom line is that fractures are painful, regardless of how large or small. At least 50% of how painful something is is dependent upon how the pain is being managed. If it has happened before our bodies have their own memories. I always seem to inherently know/remember just how to get dressed or turn in bed in the least painful way possible. (Again, this is true for me - may not be the case for everyone!)
  • Even if it's NOT "big enough to matter" pain should never be taken lightly. If it is bothersome go see your doctor. Hairline fractures can be just as painful as a clean break. 
Her mouth thinned into a quivering line when she saw me come home from the hospital with a cast on my lower leg. "Oh no, so it was broken??!"
She knelt down and looked up at me, she put her hand to the side of her face and it seemed as if she could rest all of her worries in the palm of her hand. I wished that she could. The ends of her oval eyes seemed to sharpen more every time she is about to cry. I looked away from her face, at the ground, and then at my fresh cast. My leg had been bothering me for a few days but I had put off going to see the doctor until finals were done.
"It's fine mom, not a big deal. I'm just in it for 3 weeks and then I go back and see him again. It doesn't hurt anymore, it's over." I went into the house hoping that my reassurances could take a few years of worry from her face.   

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4 Responses to Is It Big Enough to Matter?

  1. There were a few times where I had broken things and decided not to get it checked out. So I know exactly what you are talking about. But I used to break my ribs and always had them checked out for fear it could puncture something you need (lol), at least that was what my mom had always feared. But I was about 12ish when I had broken my middle finger (have no idea how I did that) and since it wasn't that serious I asked my mom (always ask for parents permission, kids) if I could make my own splint. So, we went to the grocery store, got a box of popsicles, took two sticks and cut them to match the length of my finger and taped it together using medical tape. I thought I did a pretty good job. I was pround of myself, I made my first splint! But unfortunately I did it wrong and when it healed 6-8 weeks later it became healed crooked. So the moral of this story is, if you do decide to handle the breaks yourself, it is highly possible that you may set it wrong!

  2. Wow, so many mistakes in that post. I typed it too fast. Sorry! I'm at work.

  3. Man you're writing is awesome Sandy. Couldn't put this stuff into words better myself and seems like much of the stuff could come off my keyboard. Gonna continue reading tomorrow and I'll try not to comment on too many ancient posts, but you've got brilliant stuff if the May 2011 is an indication of anything.

    1. Heyo thanks much! Go ahead and comment away I love when people connect with me on the bizarre things we might share. It makes me feel less like a freakazoid :-)


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