(note: I began composing this on 2/1. I am somewhat, but nowhere near fully, recovered, and none of has anything to do with the motorycle, other than I can't ride it right now, and it will probably be the best "therapy" for getting back in to shape)
IF YOU'RE LOOKING FOR ADVICE ON DEALING WITH BROKEN RIBS, IT'S AT THE BOTTOM OF THIS POST.
I have four broken ribs. To find which ribs on your person, take one arm, reach it up and over your head, and reach for the ear lobe on the opposite side of your head. You'll notice your rib cage sticks out. Down at the bottom, you have two tiny little ribs. They're mostly cartilage, I think, and they're pretty fragile. However, since, compared to the rest of your body, they're pretty recessed, they're not real subject to getting bashed by things. Well, I broke the lowest two ribs on both sides of my rib cage.
This does amazing things to one's mood. The pain is exquisite, and it's hard for me to sit up, lie down, reach for anything, twist, even sit on the toilet. Basically, a body at rest is more or less comfortable, but if I were to, e.g., turn over on the couch, ... well, it hurts a lot like I've got a claw tugging at my soft tissue there.
Doctors, for whatever reason, are not real good at prescribing analgesics, especially when they think of something as a subjective, soft-tissue injury. If you look at those bottom ribs, you can see they're pretty tenuous to begin with, and they don't show up so good on x-ray. Basically, you can palpate them and say "yeah, them's broken," but as I've been through numerous times here, trauma doctors just don't care about broken ribs ... or at least don't find them important enough to treat with strong palliative (I'm not saying unmonitored!) care, despite documented, successful use of morphine sulphate p.o. There are at least two good reasons for this.
The first is the morale of the patient. Broken ribs suck. A lot. I mean, there's nothing you can do. you lean in any direction, you can't cough, cleaning and cooking are out, too. You're stuck, being a vegetable, unless somebody treats your pain. With the ribs that I have broken, I find it hard to even sit up and type this (which is why it's taken almost two weeks to write this!), let alone get any work done and support myself (hah!) or my family.
So, as in the past, I've been using a (mylan, not Sandoz; the Sandoz product sucks. Avoid at all costs) fentanyl patch. Instead of one busted rib this time, though, I've got four. This time I'm on the 100-μg (microgram; ug; mcg) patch. Well, instead of pain, I have lots of vomiting. Normally such strong opiates are prescribed with iv/im smooth muscle relaxants, such as phenergan or vistaril. No such luck here; the whole point of "the patch" is that it's outpatient. Since they're not going to give me a supply of phenergan with syringes, and I can't keep the pills down, I'm left with suppositories, which people are less willing to prescribe than the damn F-patches anyways.This is why I've been mostly a slug this last week, largely incoherent in email when you've heard from me at all, and I've "fallen asleep IM" on at least one of you (literally, fall asleep in mid-sentence with a letter being repeated until Oscar's poor little SNAC buffer gets full and spewed across the web).
One good thing has come of this, though. 5.11 Tactical, makers of the worlds least-safe tactical knifes, produces a great shirt. They call it a "muscle mapping" shirt. Basically think of it as twice as much material as your average underarmour shirt:
If you notice, it's sculpted around the ribcage and shoulders. For a guy who just dislocated both his shoulders and broke his bottom two pairs of ribs, it provides incredible support for my torso. Unfortunately, the support is elasticized, so I can wear it for a few hours, kind of like a corset, and it feels great. At least, it feels a lot better than not having the support.
Anyways, it's really amazing how many hits this website gets from people looking for help with broken ribs. So these are the things you really should be doing:
- Broken ribs create a huge incidence of depression. You must treat broken ribs aggressively including with narcotic analgesics. There are exotic treatments, such as calcium injections, and so on, but the fact that there are no simple treatments is not an excuse to not treat the symptoms: pain, lethargy, and depression.
- Get a high-compression shirt like the above. You could go to the trouble of wrapping it with an ace bandage if you don't wan to spend the money and you don't want a washable garment (the ace bandages really aren't).
- Be prepared for weeks of pain. If your doctor is not willing to treat you for weeks, find another doctor.
- A long-acting medicine, like a patch, or Oxycontin, is a much better way of treating the pain than treating it reactively (like with a percocet or vicodin). The other thing is, even with forty vicodin or percocet, you won't have enough to treat the pain for the time it takes for your ribs to heal. However, be prepared to go through detox'ing (this can be a lot worse for some people than others – just think of Trainspotting) with multi-week-long use of opiates that are "on" 24x7 (again, your physician is crucial here; the ER docs you will run into are worthless unless you have a sucking chest wound or show up with a double tall soy chai green tea latte max).
- An anti-inflammatory, in addition to a traditional narcotic analgesic, like Relafin is also important because you have inflammation around the damaged areas. Needless to say, with anti-inflammatories, narcotics, and depression, it's probably a good idea to lay off the booze for a while.
