Fao Sqad (Again)!

[237SJ]

The doctor said that there was no cancer showing on the x-ray of my Mum`s pelvis and has prescibed Alendronic Acid. My GP surgery have pretty terrible reviews and I can see why. We were told a nurse would come to take blood tests. That hasn`t happened. We were told stronger painkillers would be prescribed as she`s using the ones she was given for what they originally thought was a muscle strain. That hasn`t happened either but I will sort all of that out next week. What I want to know is, should she be in bed? Nobody has told us anything about how to manage regarding the fracture. I emailed a friend who is a nurse but she obviously hasn`t looked at her email tonight. I even phoned the new 111 NHS service who excelled themselves by saying they would get someone to phone back. They never did. I thought you shouldn`t put weight on a fracture. Should she be confined to bed or is she OK being about the house? I am trying to make her take it easy but she does go up stairs a few times a day and potters around the living room. Is this going to do harm and make it harder to heal?

[Sqad]

Morning 237.

It would seem that we are dealing with two problems here 1) Medical 2) Nursing and in my opinion it is the latter that is the most important.

Medical: Well we never thought that her symptoms were due to malignant spread did we ( and i am still awaiting that kiss), mat worst it is a crack fracture and at best still a muscular problem.
The pain killers will be the order of the day and just make her as comfortable as possible without confining her to her bed.

Nursing: When boxy, bednobs RATTER, wolf or any one of the "nursing gang" see your post they will give you better advice as to TLC and home support.

Keep me informed.

[boxtops]

Mroning sqad and 237..... I'd suggest you ring your GP, you may be "lucky" and have a saturday morning clinic, some do - if not, there will be a number for an out of hours service if you still have one. There are huge problems being reported with 111 - some GPs want their out of hours option back, but that's another story. You don't have to stay with your GP, you can always swap these days. A formal written complaint to your practice manager will mean that your mum's care (or lack of it) is investigated - there is a very clear process and timelines for complaints, these days. It sounds as if the GP should have instructed a district nurse or community matron to visit (which can be a good thing) but it hasn't happened - not good.

From personal experience when my mum had a fractured pelvis, she was confined to bed for about a week, but she was in her 80s and I don't remember too much of the detail. I've googled a bit and about 3 weeks' bed rest is advocated - stairs might not be a good idea, IMO, but it all depends on the nature of the fracture.

[237SJ]

Thanks for the replies. I Googled as well but it is quite hard to find a definitive answer. Most info about pelvic fractures seems to focus on sports injuries and rehabilitation towards getting back to sport. I wouldn`t even bother phoning the Health Centre today. They have a 2 hour medication clinic on a Saturday and that`s it. If you try to phone the GP, they book a telephone appointment. No way would that be on the same day. A lot of the doctors aren`t there 5 days a week so there is no continuity. It`s a training practice too so lots of people "passing through". I keep meaning to switch to another practice but they are a training practice too. Regarding 111, I know NHS Direct were a waste of time but I just wanted to ask them a simple question. They took the details at 5pm last night and said they would get someone to call within the hour. They actually woke my mum up at 10 past midnight. Asked her a million questions such as her ethnicity, cut her off once, made her listen to holding music, and still never answered the simple question. What a farce!

[Sqad]

237...Oh! dear you are in the doldrums.............and i can understand.

I see little point in keeping her in bed as i feel if she is semi mobile, as in sitting in a chair would be of greater value and would minimise DVT's etc.
Are the pain killers working?

[237SJ]

I`m glad you said that Sqad because she is so strong-willed I fear that unless a doctor tells her face to face that she should be in bed, there is no way she is going to listen. She has phoned me and this morning, she had put a load of washing on (I have to get round there to intercept her trying to put it out on the line) and is on her way upstairs to wash her hair! The pain killers are working although I will have to get more next week as they run out on Thursday. I try to get her to sit in her armchair as much as possible but she does get up for one thing and another. I was just worried that by moving about, she is preventing the fracture from healing.

[Sqad]

naaah! it is only a hairline fracture and the strong muscles around the pelvis will hold it still and prevent slow healing.

[237SJ]

Thanks Sqad. Have you thought of going to work for the 111 service? :-)

[Sqad]

LOL......what about the kiss you promised me.......you keep ignoring my plea ;-)

[237SJ]

It depends. The diagnosis was option 2 so that would probably be a kiss - but no tongues though.

[Sqad]

LOL...LOL

[237SJ]

I`ve just also discovered that alendronic acid shouldn`t be given with NSAIDs (which they have also prescribed) due to the risk of gastro-intestinal problems. Clever eh?

[Sqad]

237....LOL

Well, if Nsaids were relieving MY pain and there was a recorded intereaction with Alendronic acid.....I wouldn't care a "toss."

The relief of pain is paramount to any "supposed" and "recorded" drug interaction.

Just my opinion 237.

[237SJ]

Her ibuprofen prescription (given at the assumption of a muscle strain) runs out on Thursday. She also has co-codamol. She was going to take the first alendronic acid tomorrow morning. I was thinking of suggesting she delays it by a week (as it`s preventative medicine) until she finishes the ibuprofen. What do you think? Obviously, if the pain comes back when the ibuprofen finishes the situation might be different.

[Sqad]

\\\\I was thinking of suggesting she delays it by a week (as it`s preventative medicine) until she finishes the ibuprofen. \\\\

Yes....a good idea.....237.

[237SJ]

Thanks. This is doing my head in and I shouldn`t even be here. I should be in Johannesburg quaffing a nice glass of Pinotage now!

[Sqad]

I know......you are certainly stressed......it will all settle......believe me (I'm a doctor...I think ;-)