THR Severe Fall - Four fractures

[spaniel]

@spaniel I had issues about 5 years ago and had a hysterectomy with pelvic floor repair for prolapse. I had a great pelvic floor PT post op. When I complained about pain in other places (like back and hip) she did some manual pressure point releases for tight muscles in the pelvic area (including the iliopsoas.) It helped tremendously. So, you might ask your therapist if she’s able to add that to your regimen. It might be a little tender afterwards but nothing a little ice or heat won’t take care of. It was well worth it. Best wishes going forward.

Great suggestion. I lightened up big time in the other ones. Thanks. I will do just this.

 

[spaniel]

Strengthening the pelvic floor can take quite a while, so don’t give up on the exercises just yet. However, if your hip continues to hurt, I agree with your idea to take it easy for a while and see if things improve. It is possible that one or more of the exercises is impacting your hip. I can see that the exercise you describe as the Asian Squat might be a problem unless your hip muscles are very loose and flexible. Input from your hip therapist would probably help.

I stopped the Asian squat. I’m not sure where my head was at! It was clearly too intense. Thanks!

 

[spaniel]

I know the topic has been debated to no end. My old ortho (whom I no longer see) indicated that I absolutely need dental antibiotic prophylaxis prior to cleaning for LIFE. My dentist also wants this. I took the recommended amount of Amoxicillin today and got a bit of a mild rash. This is the second time this happened. Now from my understanding, amoxicillin rashes are not rare. This was not right after taking it. I could possibly ask my PCP for let’s say Clindamycin instead… but often other docs don’t want to switch from what dentist prescribes. I am not a prescriber (though I am a retired medical professional.) So- I know I can go to pubmed and look at the “latest” peer reviewed stuff on this debate.. But I’m curious as to any new “ finding” that folks in this group know about. I have read the dental profession statement from years ago….but I’ve been lazy in my own pubmed research! Again my right hip replacement was 2022. Thanks folks.

 

[myglasshalffull]

My ortho recommended amoxicillin during dental procedures for two years after my replacement which was also in 2022.
Since that time I have not take antibiotics prior to my cleanings or any other dental procedure.
But my friend is a dental hygienist and her practice recommends it for life.
But so far I haven’t had any adverse issues not taking the meds.

 

[spaniel]

My ortho recommended amoxicillin during dental procedures for two years after my replacement which was also in 2022.
Since that time I have not take antibiotics prior to my cleanings or any other dental procedure.
But my friend is a dental hygienist and her practice recommends it for life.
But so far I haven’t had any adverse issues not taking the meds.

Oh what a quandary. My former surgeon’s sheet says LIFE. I have three welts and online doc thinks it might be a true allergy. Odd to develop this at 73. But i wonder if they are bites.. I am super sensitive to mosquito bites! I guess off to allergist I will go… thanks!

 

[barbloki]

I had my right hip replaced in 2022 and the surgeon said 1 year for antibiotics on dental work. I had my left hip replaced in October and he again said 1 year.

 

[benne68]

My research indicates that there has been no "new" studies about this since 2015 when the American Dental Association (ADA), concluded
"antibiotic prophylaxis does not prevent PJIs" and found it is “unwarranted unless the person is predisposed to infection, in which case, it may be appropriate for the treating physician to prescribe the antibiotic.”

The ADA does note that people in the following groups may require antibiotic prophylaxis:
People who have experienced a PJI in the past;
People with autoimmune diseases like rheumatoid arthritis or lupus;
People with hemophilia or type 1 diabetes;
People who are immunocompromised.

Unfortunately, there is not consensus about this among members of the medical community. Many older surgeons and dentists still insist on prophylaxis for extended periods.

Ultimately, the decision is yours whether or not to take the antibiotic. Personally, I decided to stop taking it after 2 years post-op since the research shows that PJI shows up anywhere from 4 weeks to two years post-op.

That said, if you worry about an allergy to amoxicillin, you should bring this up with your PCP and your dentist and request an alternative.

 

[spaniel]

Hmm -PJI up to about 4 years. Interesting. Yea.. I have a call into dentist! I guess I should have formal allergy testing. I thank you for your response.

 

[spaniel]

Oops typo 4 weeks to two years! Thanks @benne68 ! .. for research on pji

 

[Layla]

My best advice would be to ramp up your immune system so it's functioning optimally through diet and a good probiotic. Easier said than done though...sometimes.
Good luck with the rash, thankfully it's mild. I hope it resolves quickly for you, spaniel.
Hugs and best wishes!
@spaniel

 

[spaniel]

My best advice would be to ramp up your immune system so it's functioning optimally through diet and a good probiotic. Easier said than done though...sometimes.
Good luck with the rash, thankfully it's mild. I hope it resolves quickly for you, spaniel.
Hugs and best wishes!
@spaniel

Yes indeed thanks. My most recent rheumatologist ( 35 yrs experience) did a bit of “rediagnosing”. My ANA has always been positive with a fine dense speckled pattern. The titer s high but not dreadfully so. So the possibility is forme fruste lupus- which is typically diagnosed when some other markers are absent. And with this-typically mild.Anyway, yup- my nutrition is excellent. I could stand to be a bit less chubby! Weird stuff-after decades of no issues with antibiotics-whoosh sudden welts after the dental prophylaxis. And it does not seem there is a hard and fast consensus as to whether the prophylaxis even helps lets say after 4 years. But I wish we knew more. Again thanks. So off to formal allergy testing in my “free time”.

 

[eaglemom]

This is a very interesting conversation, with many differing medical opinions. Just yesterday I had dental procedure. My ortho insists on antibiotic for life, which is what I've done. For some odd reason I ask the dentist about her opinion on me taking it. (Which I had taken it.) She said she will always defer to the ortho's opinion, not because she doesn't want to make the decision, but because the ortho is the one whom initially deemed it necessary. She said many ortho's only recommend antibiotics for certain clients, not all clients. So it's possible there is some reason the ortho felt it's necessary for you to take it.

If anyone is uncomfortable with the decision to take the medication I would assume you would need to speak with your ortho prior to a dental appointment. I know my dentist asks every which way to make certain I've taken my medication.

 

[spaniel]

Fortunately My 2022 r hip replacement seems ok. Fell 5/21 on kitchen floor where i had wiped a wee dog mess. I was barefoot! Toll: 1. Distal fibula fracture (ankle) at odd angle 2. Proximal fibula fracture 3.Tibia plateau fracture 4.radial head and neck fracture. Threw blood clot (DVT) and huge swelling in calf. Requested vascular study. Now on Zarelto. Surgery on hold - may not be necessary. But situation tenuous. Two questions: who has stopped blood thinners prior to surgery (or if)? And for how long? No history of atrial fibrillation here. PA thinks it was provoked dvt but I have consult with hematology mid July. Just curious.
2. What is the absolute best non slip footwear/ no matter the expense… anyone?
I would not go to nursing home for rehab as I’ve consulted in many for 21 years. Spouse is spectacular. Only tip toe weight bearing. Ortho tomorrow for yet another X-ray. I’m so curious as to blood thinners question and footwear question!

 

[Legseleven]

I am so sorry to read this, what a shock for you and how painful. I can’t help much with your specific questions however I’ve flagged our team and hopefully someone will be along to assist you soon.
I’m sure it’s a relief to know the hip is ok, and I’m very glad to know you have great support at home.
The shoes I use post op are either Sketchers or Riekers, a comfortable slip on type trainer. They suit me but I’m in the Uk, I’m sure there’s even more choices in the US.
Thinking of you.

 

[benne68]

How frightening!

As someone who has been through a triple ankle fracture and the long recovery, I empathize. Mine required surgery to place a plate and screws. My recovery was slow but the ankle healed completely and I actually forget it ever happened.

Regarding blood thinners:
I have not been on blood thinners prior to surgery, so can't answer your question from personal experience. As a general rule, surgeons want you off blood thinners anywhere from two days to two weeks prior to any procedure -- but it depends upon the type of surgery and the reason for the blood thinner.

That said, people who are on blood thinners have emergency surgeries all the time. There are protocols for those situations and you should trust your surgeon's recommendation -- if it gets to that point. But since it is likely a provoked DVT and you might not need surgery anyway, you may not face the situation at all, so try not to worry needlessly.

Regarding the footwear.
There are no "best" shoes, because everyone is different. I wore a simple pair of Sketchers slip-in sneakers during my ankle surgery recovery. (Actually, only on one foot because the other was in a boot! )

We have a thread that members have contributed to over the years with their personal recommendations. You might find it helpful to read through: https://bonesmart.org/forum/threads/shoes-for-recovery.42383/

Please keep us posted as you learn more.

Meanwhile, sending hugs your way.

 

[Eman85]

Wow! sorry to hear of your accident. I took my own tumble this week down the deck steps, I fared better and it was because of wrong footwear. The hip implants are remarkably durable! I have had good luck with my Skecher slip-ons, which I should have been wearing instead of Oofos slide-ons.

 

[Layla]

I am so sorry for your fall and resulting injuries, spaniel. It had to be terribly frightening and painful! Then add a blood clot to all of that, it's difficult to imagine. Was this your op leg? Or your left leg?

As far as shoes go, if you're questioning athletic footwear, I've heard many good things about the Hoka brand, but haven't tried them myself. I've had several different versions of Sketcher slip-ons over the years for when I want a comfy or athletic shoe. I've liked them all. Your OS, PT, or a podiatrist may be your best bet for info to begin your search.

Thankfully you have a loving supportive caregiver in your husband so you're able to be at home. I wish you comfort and hope you'll keep us posted on your progress. We're here for support always.

Your update from today was moved (here) to your original recovery thread and the title changed to reflect your current condition. I will be following your healing journey with interest as I'm sure others will also.
Best wishes for speedy and perfect healing.
@spaniel

 

[myglasshalffull]

Oh no spaniel, so sorry to read this.
Footwear. I was a server and bartender for many years and Skechers sells “work” shoes that are non slip which I always wore at work. Kitchens and behind bars are notorious for being wet & slippery.
I’m not on any blood thinners but recently had hernia surgery and was advised to discontinue all aspirin or Advil at least one week prior to my surgery.
I broke my left ankle 7 years ago this week. Fractures on both sides and needed surgery. Was a tedious recovery and having to go through it in summer months was no “picnic.”
I’m happy you have a great husband, I also have an amazing partner that has seen me through the ankle & hip. I had rod through back of my ankle to stabilize it along with pins and screws. In January of the following year (6 months after initial surgery), the rod was removed in order to make my ankle more flexible and walk easier. I fully recovered and went back to server and bartender and my ankle is totally fine to this day. My initial recovery was 8 weeks in a cast after the surgery, then the boot. Keep us posted.

 

[spaniel]

I am so sorry for your fall and resulting injuries, spaniel. It had to be terribly frightening and painful! Then add a blood clot to all of that, it's difficult to imagine. Was this your op leg? Or your left leg?

As far as shoes go, if you're questioning athletic footwear, I've heard many good things about the Hoka brand, but haven't tried them myself. I've had several different versions of Sketcher slip-ons over the years for when I want a comfy or athletic shoe. I've liked them all. Your OS, PT, or a podiatrist may be your best bet for info to begin your search.

Thankfully you have a loving supportive caregiver in your husband so you're able to be at home. I wish you comfort and hope you'll keep us posted on your progress. We're here for support always.

Your update from today was moved (here) to your original recovery thread and the title changed to reflect your current condition. I will be following your healing journey with interest as I'm sure others will also.
Best wishes for speedy and perfect healing.
@spaniel

Yes it was left side! (Non-op side). Indeed super grateful to be at home instead of the rehab nursing homes here.

 

[spaniel]

Oh no spaniel, so sorry to read this.
Footwear. I was a server and bartender for many years and Skechers sells “work” shoes that are non slip which I always wore at work. Kitchens and behind bars are notorious for being wet & slippery.
I’m not on any blood thinners but recently had hernia surgery and was advised to discontinue all aspirin or Advil at least one week prior to my surgery.
I broke my left ankle 7 years ago this week. Fractures on both sides and needed surgery. Was a tedious recovery and having to go through it in summer months was no “picnic.”
I’m happy you have a great husband, I also have an amazing partner that has seen me through the ankle & hip. I had rod through back of my ankle to stabilize it along with pins and screws. In January of the following year (6 months after initial surgery), the rod was removed in order to make my ankle more flexible and walk easier. I fully recovered and went back to server and bartender and my ankle is totally fine to this day. My initial recovery was 8 weeks in a cast after the surgery, then the boot. Keep us posted.

Wow and I thought my stuff was tedious. I don’t know how caregivers retain their sanity.